Pub Date : 2025-04-01DOI: 10.1016/j.reuma.2025.501851
Benitez Cristian Alejandro , Gomez Ramiro Adrián , Peón Claudia , Alfaro María Agustina , Federico Andrea , Klimovsky Ezequiel , Gamba María Julieta
<div><h3>Objective</h3><div>To correlate ΔRDW and ΔVCM (baseline and week 12) with the number of patients achieving remission or low disease activity by CDAI at week 24 after initiating MTX.</div></div><div><h3>Materials and methods</h3><div>Retro-prospective, analytical, and observational study in consecutive adult patients diagnosed with RA (ACR/EULAR 2010). Demographic data, clinical characteristics, personal history, initiated treatments, and VCM (fL) and RDW (%) at weeks 0, 4, 12, and 24 were evaluated. Safety data was recorded. Statistical analysis: descriptive analysis, Chi<sup>2</sup> test or Fisher's exact test; Student's <em>T</em>-test or Mann–Whitney; and ANOVA or Kruskal–Wallis. Lineal and/or multiple logistic regression.</div></div><div><h3>Results</h3><div>139 patients were included, of whom 109 completed the study requirements. 83.5% were women, median age (m) 50 years (IQR 39–60), with a median disease duration of 12 months (IQR 0–78). In the per-protocol analysis of 109 patients, the m ΔRDW between baseline and week 12 was 0.8 (IQR 0–2.4), and the m ΔVCM was 2.0 (IQR 0.1–4.4). No correlation was found between ΔRDW and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.08; <em>p</em> <!-->=<!--> <!-->0.416), but a statistically significant correlation was found between ΔVCM and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.190; <em>p</em> <!-->=<!--> <!-->0.048).</div><div>Results were analyzed by intention to treat for 139 patients. Between baseline and week 12, a m ΔRDW of 0.8 (IQR 0–2.4) and a m ΔVCM of 2.2 (IQR 0.2–4.5) were recorded. No correlation was found between ΔRDW and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.073; <em>p</em> <!-->=<!--> <!-->0.433), but a statistically significant correlation was found between ΔVCM and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.217; <em>p</em> <!-->=<!--> <!-->0.018). 64.2%, 39.4%, and 15.6% of patients achieved CDAI 50/70/85 responses at week 12, respectively, with no significant changes at week 24. Univariate and multivariate analysis identified that the only factor significantly associated with achieving CDAI 50 at week 24 was achieving such a response at week 12 (<em>p</em> <!-->=<!--> <!-->0.001).</div><div>Safety evaluation showed that 68 patients (48.9%) experienced adverse events, with 20 events (14.4%) related to MTX. Only 5 (3.6%) were considered serious adverse events, all of them unrelated to treatment.</div></div><div><h3>Conclusions</h3><div>This study revealed that an increase in red cell distribution width (RDW) and mean corpuscular volume (VCM) was associated with the initiation of MTX treatment. However, only a significant correlation was found between the change in VCM and RA activity measured by CDAI at week 24. Although ΔRDW did not show a significant association with RA activity, ΔVCM negatively correlated with CDAI at week 24. Additionally, a significant percentage of patients achieved a positive response at week 12, but there were no significant changes at we
{"title":"Mean corpuscular volume and red cell distribution width as predictors of methotrexate response in RA patients","authors":"Benitez Cristian Alejandro , Gomez Ramiro Adrián , Peón Claudia , Alfaro María Agustina , Federico Andrea , Klimovsky Ezequiel , Gamba María Julieta","doi":"10.1016/j.reuma.2025.501851","DOIUrl":"10.1016/j.reuma.2025.501851","url":null,"abstract":"<div><h3>Objective</h3><div>To correlate ΔRDW and ΔVCM (baseline and week 12) with the number of patients achieving remission or low disease activity by CDAI at week 24 after initiating MTX.</div></div><div><h3>Materials and methods</h3><div>Retro-prospective, analytical, and observational study in consecutive adult patients diagnosed with RA (ACR/EULAR 2010). Demographic data, clinical characteristics, personal history, initiated treatments, and VCM (fL) and RDW (%) at weeks 0, 4, 12, and 24 were evaluated. Safety data was recorded. Statistical analysis: descriptive analysis, Chi<sup>2</sup> test or Fisher's exact test; Student's <em>T</em>-test or Mann–Whitney; and ANOVA or Kruskal–Wallis. Lineal and/or multiple logistic regression.</div></div><div><h3>Results</h3><div>139 patients were included, of whom 109 completed the study requirements. 83.5% were women, median age (m) 50 years (IQR 39–60), with a median disease duration of 12 months (IQR 0–78). In the per-protocol analysis of 109 patients, the m ΔRDW between baseline and week 12 was 0.8 (IQR 0–2.4), and the m ΔVCM was 2.0 (IQR 0.1–4.4). No correlation was found between ΔRDW and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.08; <em>p</em> <!-->=<!--> <!-->0.416), but a statistically significant correlation was found between ΔVCM and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.190; <em>p</em> <!-->=<!--> <!-->0.048).</div><div>Results were analyzed by intention to treat for 139 patients. Between baseline and week 12, a m ΔRDW of 0.8 (IQR 0–2.4) and a m ΔVCM of 2.2 (IQR 0.2–4.5) were recorded. No correlation was found between ΔRDW and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.073; <em>p</em> <!-->=<!--> <!-->0.433), but a statistically significant correlation was found between ΔVCM and CDAI at week 24 (Rho<!--> <!-->=<!--> <!-->−0.217; <em>p</em> <!-->=<!--> <!-->0.018). 64.2%, 39.4%, and 15.6% of patients achieved CDAI 50/70/85 responses at week 12, respectively, with no significant changes at week 24. Univariate and multivariate analysis identified that the only factor significantly associated with achieving CDAI 50 at week 24 was achieving such a response at week 12 (<em>p</em> <!-->=<!--> <!-->0.001).</div><div>Safety evaluation showed that 68 patients (48.9%) experienced adverse events, with 20 events (14.4%) related to MTX. Only 5 (3.6%) were considered serious adverse events, all of them unrelated to treatment.</div></div><div><h3>Conclusions</h3><div>This study revealed that an increase in red cell distribution width (RDW) and mean corpuscular volume (VCM) was associated with the initiation of MTX treatment. However, only a significant correlation was found between the change in VCM and RA activity measured by CDAI at week 24. Although ΔRDW did not show a significant association with RA activity, ΔVCM negatively correlated with CDAI at week 24. Additionally, a significant percentage of patients achieved a positive response at week 12, but there were no significant changes at we","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 4","pages":"Article 501851"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.reuma.2025.501856
Osmar Antonio Centurión , Paloma de Abreu , Gabriela Avila-Pedretti , Sonia R. Cabrera , María T. Martínez de Filártiga , Astrid Paats , Judith M. Torales , Christian O. Chávez , Carmen R. Montiel , Laura B. García , Karina E. Scavenius , Rocío del Pilar Falcón , Jose C. Candia , Alfredo J. Meza , Isabel Acosta-Colmán
Objectives
Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA.
Methods
In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion ≥ 38 ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits.
Results
A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3 ± 4.9 ms in the control group vs. 57 ± 14.9 ms (p < 0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p < 0.0001). The value of VEGF in the control group was 15.2 ± 15.1 pg/ml vs 51.1 ± 55.5 pg/ml (p < 0.001) in RA. The value of VEGF in RA without altered PWD was 20 ± 12 pg/ml vs 56 ± 57 pg/ml in RA with altered PWD (p < 0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA.
Conclusions
This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA.
目的：血清血管内皮生长因子（VEGF）水平与类风湿关节炎（RA）的结构改变相关。由于P波弥散度（PWD）与心房缺血相关的纤维化改变有关，因此我们认为RA中PWD改变与VEGF水平升高可能存在相关性。方法在这项前瞻性观察性研究中，我们对RA患者进行评估，并将其与对照组进行比较。PWD被认为是P波最大持续时间与最小持续时间之差。改变的PWD被认为弥散≥38 ms。采用酶配体、免疫吸附测定ELISA试剂盒测定血清VEGF水平。结果共对99例RA患者和48例对照组进行评估。对照组PWD为25.3±4.9 ms，对照组为57±14.9 ms (p <；0.0001)。对照组无PWD改变，而RA组有94例（95%）患者出现PWD改变(p <；0.0001)。对照组VEGF值分别为15.2±15.1 pg/ml vs 51.1±55.5 pg/ml (p <；0.001)。未改变PWD的RA组VEGF值为20±12 pg/ml，而改变PWD的RA组VEGF值为56±57 pg/ml (p <；0.02)。VEGF升高在预测RA患者PWD改变方面的特异性为80%，阳性预测准确率为95%。结论本研究首次证实血清VEGF水平显著升高的RA患者PWD发生改变。VEGF血清值升高对RA中PWD改变的存在具有高特异性和高阳性预测准确性。
{"title":"Association of electrocardiographic altered P wave dispersion and vascular endothelial growth factor in rheumatoid arthritis","authors":"Osmar Antonio Centurión , Paloma de Abreu , Gabriela Avila-Pedretti , Sonia R. Cabrera , María T. Martínez de Filártiga , Astrid Paats , Judith M. Torales , Christian O. Chávez , Carmen R. Montiel , Laura B. García , Karina E. Scavenius , Rocío del Pilar Falcón , Jose C. Candia , Alfredo J. Meza , Isabel Acosta-Colmán","doi":"10.1016/j.reuma.2025.501856","DOIUrl":"10.1016/j.reuma.2025.501856","url":null,"abstract":"<div><h3>Objectives</h3><div>Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA.</div></div><div><h3>Methods</h3><div>In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion<!--> <!-->≥<!--> <!-->38<!--> <!-->ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits.</div></div><div><h3>Results</h3><div>A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3<!--> <!-->±<!--> <!-->4.9<!--> <!-->ms in the control group vs. 57<!--> <!-->±<!--> <!-->14.9<!--> <!-->ms (<em>p</em> <!--><<!--> <!-->0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (<em>p</em> <!--><<!--> <!-->0.0001). The value of VEGF in the control group was 15.2<!--> <!-->±<!--> <!-->15.1<!--> <!-->pg/ml vs 51.1<!--> <!-->±<!--> <!-->55.5<!--> <!-->pg/ml (<em>p</em> <!--><<!--> <!-->0.001) in RA. The value of VEGF in RA without altered PWD was 20<!--> <!-->±<!--> <!-->12<!--> <!-->pg/ml vs 56<!--> <!-->±<!--> <!-->57<!--> <!-->pg/ml in RA with altered PWD (<em>p</em> <!--><<!--> <!-->0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA.</div></div><div><h3>Conclusions</h3><div>This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 4","pages":"Article 501856"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sjögren's disease it's a heterogeneous and complex rheumatological disease, can present central neurological manifestations, with a prevalence that varies between 1-5% according to the international literature. We report a series of three cases; we present a patient who debuted with epileptic seizures, one with catatonic syndrome and a last one with optic neuritis. Knowing the various presentations of the central neurological manifestations allows us to broaden the diagnostic suspicion from the beginning, providing timely treatment.
{"title":"Síntomas neurológicos centrales como primera manifestación en la enfermedad de Sjögren","authors":"Dianela Gasca Saldaña , Wallace Rafael Arturo Muñoz Castañeda , Antonio Gonzalez Pineda , Karen Burgueño Aguilar , Andrés Vega Rosas","doi":"10.1016/j.reuma.2025.501846","DOIUrl":"10.1016/j.reuma.2025.501846","url":null,"abstract":"<div><div>Sjögren's disease it's a heterogeneous and complex rheumatological disease, can present central neurological manifestations, with a prevalence that varies between 1-5% according to the international literature. We report a series of three cases; we present a patient who debuted with epileptic seizures, one with catatonic syndrome and a last one with optic neuritis. Knowing the various presentations of the central neurological manifestations allows us to broaden the diagnostic suspicion from the beginning, providing timely treatment.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 4","pages":"Article 501846"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.reuma.2025.501845
Carlota Navarro-Joven , María Alonso de Francisco , Margarita Pich-Aguilera Blasco , Rita María Cabeza Martínez , José Luis Andreu Sánchez , Hildegarda Godoy-Tundidor
Rowell's syndrome is an unusual form of subacute cutaneous lupus. We present the case of a male patient with chronic Rowell's syndrome, who exhibits a remarkable response to anifrolumab.
{"title":"Uso de anifrolumab en un paciente con síndrome de Rowell crónico multirrefractario","authors":"Carlota Navarro-Joven , María Alonso de Francisco , Margarita Pich-Aguilera Blasco , Rita María Cabeza Martínez , José Luis Andreu Sánchez , Hildegarda Godoy-Tundidor","doi":"10.1016/j.reuma.2025.501845","DOIUrl":"10.1016/j.reuma.2025.501845","url":null,"abstract":"<div><div>Rowell's syndrome is an unusual form of subacute cutaneous lupus. We present the case of a male patient with chronic Rowell's syndrome, who exhibits a remarkable response to anifrolumab.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 4","pages":"Article 501845"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.reuma.2025.501852
Pablo Martínez Calabuig , Jorge Juan Fragío Gil , Roxana González Mazarío , Laura Salvador Maicas , Mireia Lucía Sanmartín Martínez , Antonio Sierra Rivera , Laura Abenza Barberá , María Cristina Sabater Abad , Francesc Puchades Gimeno , Inmaculada Castelló Miralles , Amalia Rueda Cid , Cristina Campos Fernández , en representación del Grupo de trabajo de Enfermedad Relacionada con IgG4 del HGUV
Background and objective
IgG4-related disease (IgG4-RD) is a systemic, immune-mediated, fibro-inflammatory condition with an uncertain etiology and pathophysiology that can affect multiple organs, presenting common clinical, radiological, and serological features. Although the disease is associated with IgG4, serum levels are not elevated in all patients and have also been described in other diseases. The aim of this study is to evaluate the clinical utility of elevated serum IgG4 as a screening marker in the suspicion of IgG4-RD.
Materials and methods
A retrospective single-center study was conducted, analyzing serological IgG4 test requests from electronic medical records of patients ordered by various hospital departments from January 2010 to June 2023. Only those with elevated IgG4 levels were included in the analysis. Additionally, demographic data and final diagnoses, including those with IgG4-RD, were collected.
Results
A total of 2,288 test requests were reviewed, of which 247 showed elevated IgG4 levels (181 after excluding duplicates). Among the patients with elevated IgG4, only 11 met the criteria for IgG4-RD based on the 2011 Umehara-Okazaki classification and its 2020 update. However, only 6 patients (3.31%) met the more recent 2019 ACR/EULAR classification criteria for IgG4-RD. In the remaining patients with elevated IgG4, the most common diagnoses were respiratory diseases, such as COPD and asthma, followed by systemic autoimmune diseases, primarily SLE, RA, and EGPA. Elevated IgG4 levels were also observed in malignant neoplasms, predominantly lung and hematologic cancers.
Conclusions
Our study highlights that elevated IgG4 levels are not exclusive to IgG4-RD and can also be observed in various respiratory diseases (e.g., COPD), autoimmune diseases (e.g., SLE and RA), and neoplasms (e.g., lung cancer).
{"title":"Evaluación de los niveles séricos de IgG4 como herramienta de cribado de la enfermedad relacionada con IgG4: datos procedentes de un estudio retrospectivo","authors":"Pablo Martínez Calabuig , Jorge Juan Fragío Gil , Roxana González Mazarío , Laura Salvador Maicas , Mireia Lucía Sanmartín Martínez , Antonio Sierra Rivera , Laura Abenza Barberá , María Cristina Sabater Abad , Francesc Puchades Gimeno , Inmaculada Castelló Miralles , Amalia Rueda Cid , Cristina Campos Fernández , en representación del Grupo de trabajo de Enfermedad Relacionada con IgG4 del HGUV","doi":"10.1016/j.reuma.2025.501852","DOIUrl":"10.1016/j.reuma.2025.501852","url":null,"abstract":"<div><h3>Background and objective</h3><div>IgG4-related disease (IgG4-RD) is a systemic, immune-mediated, fibro-inflammatory condition with an uncertain etiology and pathophysiology that can affect multiple organs, presenting common clinical, radiological, and serological features. Although the disease is associated with IgG4, serum levels are not elevated in all patients and have also been described in other diseases. The aim of this study is to evaluate the clinical utility of elevated serum IgG4 as a screening marker in the suspicion of IgG4-RD.</div></div><div><h3>Materials and methods</h3><div>A retrospective single-center study was conducted, analyzing serological IgG4 test requests from electronic medical records of patients ordered by various hospital departments from January 2010 to June 2023. Only those with elevated IgG4 levels were included in the analysis. Additionally, demographic data and final diagnoses, including those with IgG4-RD, were collected.</div></div><div><h3>Results</h3><div>A total of 2,288 test requests were reviewed, of which 247 showed elevated IgG4 levels (181 after excluding duplicates). Among the patients with elevated IgG4, only 11 met the criteria for IgG4-RD based on the 2011 Umehara-Okazaki classification and its 2020 update. However, only 6 patients (3.31%) met the more recent 2019 ACR/EULAR classification criteria for IgG4-RD. In the remaining patients with elevated IgG4, the most common diagnoses were respiratory diseases, such as COPD and asthma, followed by systemic autoimmune diseases, primarily SLE, RA, and EGPA. Elevated IgG4 levels were also observed in malignant neoplasms, predominantly lung and hematologic cancers.</div></div><div><h3>Conclusions</h3><div>Our study highlights that elevated IgG4 levels are not exclusive to IgG4-RD and can also be observed in various respiratory diseases (e.g., COPD), autoimmune diseases (e.g., SLE and RA), and neoplasms (e.g., lung cancer).</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 4","pages":"Article 501852"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.reuma.2025.501848
Carlos Antonio Guillén-Astete , Boris Blanco Cáceres , Jaime Arroyo Palomo , Aliuska Malena Palomeque Vargas , Marta Serrano Warleta , Ana María Ruiz Bejerano , Ana Sánchez-Poves García , Javier Bachiller Corral , Mónica Vázquez-Díaz
Introduction
Ultrasound-guided synovial biopsy is a procedure for diagnostic and research purposes that is not yet available in most rheumatology departments.
Methods
We describe the experience with synovial biopsy procedures in our department.
Results
Thirty-eight synovial biopsies were performed on 33 patients during observation. The patients’ mean age (standard deviation) was 59 (17) years, ranging between 26 and 90 years. The most frequently biopsied territories were the carpus and the knee. No complications occurred during the procedures. Sixteen residents were trained in the procedure. Two joint sessions have been held with the Immunology and Anatomical Pathology services, and our service sessions have been organised based on the scope and usefulness of the procedures.
Conclusions
Our service's experience has been positive regarding patient care and resident training. The procedure has had no serious complications and has been, in general, very well tolerated.
{"title":"Experiencia tras la implantación de la biopsia sinovial ecoguiada en un Servicio de Reumatología","authors":"Carlos Antonio Guillén-Astete , Boris Blanco Cáceres , Jaime Arroyo Palomo , Aliuska Malena Palomeque Vargas , Marta Serrano Warleta , Ana María Ruiz Bejerano , Ana Sánchez-Poves García , Javier Bachiller Corral , Mónica Vázquez-Díaz","doi":"10.1016/j.reuma.2025.501848","DOIUrl":"10.1016/j.reuma.2025.501848","url":null,"abstract":"<div><h3>Introduction</h3><div>Ultrasound-guided synovial biopsy is a procedure for diagnostic and research purposes that is not yet available in most rheumatology departments.</div></div><div><h3>Methods</h3><div>We describe the experience with synovial biopsy procedures in our department.</div></div><div><h3>Results</h3><div>Thirty-eight synovial biopsies were performed on 33 patients during observation. The patients’ mean age (standard deviation) was 59 (17) years, ranging between 26 and 90 years. The most frequently biopsied territories were the carpus and the knee. No complications occurred during the procedures. Sixteen residents were trained in the procedure. Two joint sessions have been held with the Immunology and Anatomical Pathology services, and our service sessions have been organised based on the scope and usefulness of the procedures.</div></div><div><h3>Conclusions</h3><div>Our service's experience has been positive regarding patient care and resident training. The procedure has had no serious complications and has been, in general, very well tolerated.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 4","pages":"Article 501848"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.reuma.2025.501844
Carmen Raya-Santos , José Antonio Bernal , José Rosas , María Cabezas Macían
{"title":"Tumor de células gigantes de las vainas tendinosas","authors":"Carmen Raya-Santos , José Antonio Bernal , José Rosas , María Cabezas Macían","doi":"10.1016/j.reuma.2025.501844","DOIUrl":"10.1016/j.reuma.2025.501844","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 3","pages":"Article 501844"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.reuma.2025.501841
Tomás Miranda-Aquino , Diego Alejandro Ramos-Aguas , Silvia Esmeralda Pérez-Topete , María del Socorro Cepeda-Rocha , Xochitl Citlalli Gómez-Gómez , Daniel Ochoa-Castillo , Sergio Cerpa-Cruz , Verónica González-Díaz , Christian González-Padilla , Jorge Eduardo Hernández-del Río
Introduction
Right ventriculoarterial coupling (RVAC) is altered early before presenting right ventricular (RV) dysfunction and pulmonary hypertension; its measurement in patients with rheumatoid arthritis (RA) has been barely studied.
Objectives
To determine if there is a difference in RVAC in patients with RA. To investigate if there is an association in patients with RA to present abnormal RVAC.
Methods
A single-center, analytical, cross-sectional, observational study was performed. Patients with a diagnosis of RA were included according to the ACR/EULAR 2010 classification criteria, without any other comorbidity, and the echocardiograms were made at the Hospital Civil de Guadalajara Fray Antonio Alcalde. Patients were compared with healthy controls matched by age and gender. The clinical, laboratory and echocardiographic variables were contrasted. The RVAC was determined with the RV free wall longitudinal strain/pulmonary artery systolic pressure ratio.
Results
Fifty one patients were included in each group. Among the echocardiographic variables, it was found that patients with RA had a greater RV diastolic area and the pulmonary artery systolic pressure; while the RV fractional shortening, the RV free wall longitudinal strain and the RVAC were lower. RA was independently associated to an abnormal RVAC.
Conclusion
The RV subclinical myocardial damage, determined by the RVAC, is present in patients with RA, and it was associated with an abnormal ventriculoarterial coupling.
引言 在出现右心室（RV）功能障碍和肺动脉高压之前，右心室-动脉耦合（RVAC）会发生早期改变；而类风湿性关节炎（RA）患者的 RVAC 测量结果却鲜有研究。方法进行了一项单中心、分析性、横断面观察研究。根据 ACR/EULAR 2010 年的分类标准，纳入了诊断为 RA 的患者，患者无任何其他合并症，超声心动图检查在瓜达拉哈拉 Fray Antonio Alcalde 民用医院进行。患者与年龄和性别相匹配的健康对照组进行了比较。对比了临床、实验室和超声心动图变量。用 RV 游离壁纵向应变/肺动脉收缩压比值确定 RVAC。在超声心动图变量中，发现 RA 患者的 RV 舒张面积和肺动脉收缩压较大，而 RV 分形缩短、RV 游离壁纵向应变和 RVAC 较低。结论 RA 患者存在由 RVAC 确定的 RV 亚临床心肌损伤，且与异常的心室-动脉耦合有关。
{"title":"Acoplamiento ventriculoarterial derecho como marcador de daño miocárdico subclínico en artritis reumatoide","authors":"Tomás Miranda-Aquino , Diego Alejandro Ramos-Aguas , Silvia Esmeralda Pérez-Topete , María del Socorro Cepeda-Rocha , Xochitl Citlalli Gómez-Gómez , Daniel Ochoa-Castillo , Sergio Cerpa-Cruz , Verónica González-Díaz , Christian González-Padilla , Jorge Eduardo Hernández-del Río","doi":"10.1016/j.reuma.2025.501841","DOIUrl":"10.1016/j.reuma.2025.501841","url":null,"abstract":"<div><h3>Introduction</h3><div>Right ventriculoarterial coupling (RVAC) is altered early before presenting right ventricular (RV) dysfunction and pulmonary hypertension; its measurement in patients with rheumatoid arthritis (RA) has been barely studied.</div></div><div><h3>Objectives</h3><div>To determine if there is a difference in RVAC in patients with RA. To investigate if there is an association in patients with RA to present abnormal RVAC.</div></div><div><h3>Methods</h3><div>A single-center, analytical, cross-sectional, observational study was performed. Patients with a diagnosis of RA were included according to the ACR/EULAR 2010 classification criteria, without any other comorbidity, and the echocardiograms were made at the Hospital Civil de Guadalajara Fray Antonio Alcalde. Patients were compared with healthy controls matched by age and gender. The clinical, laboratory and echocardiographic variables were contrasted. The RVAC was determined with the RV free wall longitudinal strain/pulmonary artery systolic pressure ratio.</div></div><div><h3>Results</h3><div>Fifty one patients were included in each group. Among the echocardiographic variables, it was found that patients with RA had a greater RV diastolic area and the pulmonary artery systolic pressure; while the RV fractional shortening, the RV free wall longitudinal strain and the RVAC were lower. RA was independently associated to an abnormal RVAC.</div></div><div><h3>Conclusion</h3><div>The RV subclinical myocardial damage, determined by the RVAC, is present in patients with RA, and it was associated with an abnormal ventriculoarterial coupling.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 3","pages":"Article 501841"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.reuma.2025.501817
Mayte Serrat , Jaime Navarrete , Carla Rodríguez-Freire , Estíbaliz Royuela-Colomer , Miriam Almirall , Rubén Nieto , Jesús Montero-Marín , Juan V. Luciano , Albert Feliu-Soler
Introduction and objectives
The given text describes a pilot randomized controlled trial aimed at evaluating the feasibility and acceptability of outdoor sessions as an add-on to an online multicomponent program (FIBROWALK) for fibromyalgia (FM) patients.
Materials and methods
The trial involved 110 participants with FM (99% women; mean age of 51.89 ± 1.89 years) from a tertiary hospital in Spain who were randomly assigned to either the online FIBROWALK program (n = 38) or the blended FIBROWALK program arm (n = 61; online FIBROWALK plus 4 outdoor sessions).
Results
Overall, attrition was minimal (14.01%) and adherence to the outdoor session was modest (52% of the group attended at least one outdoor session). Participants’ expectations and opinions were positive. Paired-samples t-tests for examining within-group differences showed that participants in each arm had significantly improved functional impairment, anxious-depressive symptomatology, physical function, and fear of pain symptoms. Analysis of covariance for examining between-group differences showed that the blended FIBROWALK had a significantly higher effect on psychological distress than the online FIBROWALK (F(1,96) = 4.23; p = .042; Cohen's d = .60).
Conclusions
These results suggest that the blended program was feasible, secure, and acceptable to the participants. Although the online FIBROWALK program alone may be sufficient for managing fibromyalgia symptoms, the addition of outdoor sessions may provide significant additional benefits. Future definitive randomized controlled trials are warranted.
简介和目标本文介绍了一项试点随机对照试验，旨在评估户外课程作为纤维肌痛（FM）患者在线多组件课程（FIBROWALK）的附加课程的可行性和可接受性。西班牙一家三甲医院的 110 名 FM 患者（99% 为女性；平均年龄为 51.89 ± 1.89 岁）被随机分配到在线 FIBROWALK 计划（n = 38）或混合 FIBROWALK 计划组（n = 61；在线 FIBROWALK 加 4 次户外训练）。参与者的期望和意见都是积极的。用于检验组内差异的配对样本 t 检验显示，每组参与者的功能障碍、焦虑抑郁症状、身体功能和疼痛恐惧症状均有显著改善。用于检验组间差异的协方差分析表明，混合 FIBROWALK 对心理困扰的影响明显高于在线 FIBROWALK（F(1,96) = 4.23; p = .042; Cohen's d = .60）。尽管仅靠在线 FIBROWALK 程序就足以控制纤维肌痛症状，但增加户外课程可能会带来显著的额外益处。未来有必要进行明确的随机对照试验。
{"title":"The feasibility and acceptability of outdoor sessions as an add-on of an online multicomponent program (FIBROWALK) for fibromyalgia: A pilot randomized controlled trial","authors":"Mayte Serrat , Jaime Navarrete , Carla Rodríguez-Freire , Estíbaliz Royuela-Colomer , Miriam Almirall , Rubén Nieto , Jesús Montero-Marín , Juan V. Luciano , Albert Feliu-Soler","doi":"10.1016/j.reuma.2025.501817","DOIUrl":"10.1016/j.reuma.2025.501817","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The given text describes a pilot randomized controlled trial aimed at evaluating the feasibility and acceptability of outdoor sessions as an add-on to an online multicomponent program (FIBROWALK) for fibromyalgia (FM) patients.</div></div><div><h3>Materials and methods</h3><div>The trial involved 110 participants with FM (99% women; mean age of 51.89<!--> <!-->±<!--> <!-->1.89 years) from a tertiary hospital in Spain who were randomly assigned to either the online FIBROWALK program (<em>n</em> <!-->=<!--> <!-->38) or the blended FIBROWALK program arm (<em>n</em> <!-->=<!--> <!-->61; online FIBROWALK plus 4 outdoor sessions).</div></div><div><h3>Results</h3><div>Overall, attrition was minimal (14.01%) and adherence to the outdoor session was modest (52% of the group attended at least one outdoor session). Participants’ expectations and opinions were positive. Paired-samples <em>t</em>-tests for examining within-group differences showed that participants in each arm had significantly improved functional impairment, anxious-depressive symptomatology, physical function, and fear of pain symptoms. Analysis of covariance for examining between-group differences showed that the blended FIBROWALK had a significantly higher effect on psychological distress than the online FIBROWALK (<em>F</em>(1,96)<!--> <!-->=<!--> <!-->4.23; <em>p</em> <!-->=<!--> <!-->.042; Cohen's <em>d</em> <!-->=<!--> <!-->.60).</div></div><div><h3>Conclusions</h3><div>These results suggest that the blended program was feasible, secure, and acceptable to the participants. Although the online FIBROWALK program alone may be sufficient for managing fibromyalgia symptoms, the addition of outdoor sessions may provide significant additional benefits. Future definitive randomized controlled trials are warranted.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 3","pages":"Article 501817"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.reuma.2025.501850
Marco Aurelio Ramírez Huaranga , Juan Carlos Quevedo Abeledo , Julio Sánchez Martin , Álvaro García Martos , Angel Estuardo Plasencia Ezaine , David Castro Corredor , Vanesa Hernández Hernández , Yanira Pérez Vera , Enrique Ornilla Laraundogoitia , Rocío Arenal Lopez , Félix Manuel Francisco Hernández , Cristina Zamora Ramos , Paz Collado Ramos , Fernando Felipe Poma Vera , Javier Seoane Romero , Tamara Libertad Rodríguez Araya , en representación del Grupo de Trabajo INTERVSER
Introduction
Interventional procedures are highly useful and applicable in rheumatology for degenerative and inflammatory diseases such a therapeutic alternative available for our patients.
Objective
To describe the current clinical characteristics of interventional procedures in rheumatology departments in our country and to identify the training needs in this area.
Material and methods
This is a multicenter, observational, descriptive, and cross-sectional study conducted through a survey sent to all heads of rheumatology departments/sections across the national territory, registered with the Spanish Society of Rheumatology.
Results
A total of 38 appropriately completed and valid surveys were received for analysis (56% of those sent). A percentage of 94.7 of the departments have one or more ultrasound machines, and 60.53% have a designated physical space specifically for performing procedures. A percentage of 97.73 perform joint injections, 31.58% perform sacroiliac joint injections, 21.05% perform lumbar facet injections, 15.79% perform myofascial injections, 13.16% perform epidural injections, and only 5.26% have access to radiofrequency therapy. Other procedures described were synovial biopsy (15.79%), salivary gland biopsy (10.53%), and isotopic synoviorthesis (7.89%). In 89.47% of the departments, the procedures are part of the rheumatology activities services, and 73.68% have nursing/auxiliary nursing support. Finally, 81.6% agree that there is insufficient specific training in performing more complex procedures.
Conclusion
The 21st-century rheumatologist must also be trained in performing interventional procedures for the treatment of mechanical and/or inflammatory pain, with the aim of incorporating them into their daily clinical practice and continuing to expand the range of care we can offer our patients.
{"title":"Análisis situacional de la reumatología intervencionista en España: estudio observacional multicéntrico","authors":"Marco Aurelio Ramírez Huaranga , Juan Carlos Quevedo Abeledo , Julio Sánchez Martin , Álvaro García Martos , Angel Estuardo Plasencia Ezaine , David Castro Corredor , Vanesa Hernández Hernández , Yanira Pérez Vera , Enrique Ornilla Laraundogoitia , Rocío Arenal Lopez , Félix Manuel Francisco Hernández , Cristina Zamora Ramos , Paz Collado Ramos , Fernando Felipe Poma Vera , Javier Seoane Romero , Tamara Libertad Rodríguez Araya , en representación del Grupo de Trabajo INTERVSER","doi":"10.1016/j.reuma.2025.501850","DOIUrl":"10.1016/j.reuma.2025.501850","url":null,"abstract":"<div><h3>Introduction</h3><div>Interventional procedures are highly useful and applicable in rheumatology for degenerative and inflammatory diseases such a therapeutic alternative available for our patients.</div></div><div><h3>Objective</h3><div>To describe the current clinical characteristics of interventional procedures in rheumatology departments in our country and to identify the training needs in this area.</div></div><div><h3>Material and methods</h3><div>This is a multicenter, observational, descriptive, and cross-sectional study conducted through a survey sent to all heads of rheumatology departments/sections across the national territory, registered with the Spanish Society of Rheumatology.</div></div><div><h3>Results</h3><div>A total of 38 appropriately completed and valid surveys were received for analysis (56% of those sent). A percentage of 94.7 of the departments have one or more ultrasound machines, and 60.53% have a designated physical space specifically for performing procedures. A percentage of 97.73 perform joint injections, 31.58% perform sacroiliac joint injections, 21.05% perform lumbar facet injections, 15.79% perform myofascial injections, 13.16% perform epidural injections, and only 5.26% have access to radiofrequency therapy. Other procedures described were synovial biopsy (15.79%), salivary gland biopsy (10.53%), and isotopic synoviorthesis (7.89%). In 89.47% of the departments, the procedures are part of the rheumatology activities services, and 73.68% have nursing/auxiliary nursing support. Finally, 81.6% agree that there is insufficient specific training in performing more complex procedures.</div></div><div><h3>Conclusion</h3><div>The 21st-century rheumatologist must also be trained in performing interventional procedures for the treatment of mechanical and/or inflammatory pain, with the aim of incorporating them into their daily clinical practice and continuing to expand the range of care we can offer our patients.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 3","pages":"Article 501850"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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