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Optimal non-opioid analgesic combinations after total hip arthroplasty 全髋关节置换术后最佳非阿片类镇痛药组合。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00153-X
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引用次数: 0
The outcomes of children born to mothers with autoimmune rheumatic diseases 患有自身免疫性风湿病的母亲所生子女的结局。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00096-1

Maternal autoimmune rheumatic diseases can influence the outcomes of children through several life stages. During pregnancy, maternal inflammation and autoantibodies can hinder fetal development and lead to growth restriction, preterm birth, and low birth weight; prematurity, especially at extreme gestational ages, can in turn impair future child health. Treatment with compatible immunomodulatory drugs and preventive medications aims to keep maternal disease under control and minimise the risk of adverse pregnancy outcomes. However, concerns have been raised about the effects of immunomodulatory drugs on neonatal conditions (ie, the risk of serious infections, inadequate responses to vaccinations, and organ toxicity) and long-term outcomes (metabolic and cardiovascular problems and neurodevelopmental disorders). Among the unmet needs of parents with autoimmune rheumatic diseases, there is the estimation of risk for the children to develop autoimmune disorders and the need for reassurance about parenting capacity while living with a chronic condition. This Series paper provides a comprehensive overview of the literature and guidance on discussing these topics with patients.

母体自身免疫性风湿病会在多个生命阶段影响儿童的预后。在妊娠期间,母体炎症和自身抗体会阻碍胎儿发育,导致生长受限、早产和出生体重不足;早产,尤其是胎龄过大的早产,反过来又会损害未来儿童的健康。使用相容的免疫调节药物和预防性药物治疗的目的是控制母体疾病,最大限度地降低不良妊娠结局的风险。然而,免疫调节药物对新生儿状况(即发生严重感染、对疫苗接种反应不足和器官毒性的风险)和长期结果(代谢和心血管问题以及神经发育障碍)的影响也引起了人们的关注。患有自身免疫性风湿病的父母尚未满足的需求包括:估计子女患自身免疫性疾病的风险,以及在患有慢性疾病的情况下对养育能力的信心需求。本系列论文全面概述了与患者讨论这些话题的文献和指南。
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引用次数: 0
Navigating the complexities of pregnancy in rheumatic disease 驾驭风湿病患者怀孕的复杂性。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00201-7
The Lancet Rheumatology
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引用次数: 0
For SLE activity and glucocorticoids: aim low 对于系统性红斑狼疮活动和糖皮质激素:目标要低。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00152-8
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引用次数: 0
Optimal non-opioid analgesic combinations after total hip arthroplasty – Authors' reply 全髋关节置换术后最佳非阿片类镇痛药组合--作者回复。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00154-1
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引用次数: 0
Global, regional, and national burden of gout, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021 1990-2020年全球、地区和国家痛风负担以及到2050年的预测:2021年全球疾病负担研究的系统分析。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00117-6

Background

Gout is an inflammatory arthritis manifesting as acute episodes of severe joint pain and swelling, which can progress to chronic tophaceous or chronic erosive gout, or both. Here, we present the most up-to-date global, regional, and national estimates for prevalence and years lived with disability (YLDs) due to gout by sex, age, and location from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, as well as forecasted prevalence to 2050.

Methods

Gout prevalence and YLDs from 1990 to 2020 were estimated by drawing on population-based data from 35 countries and claims data from the USA and Taiwan (province of China). Nested Bayesian meta-regression models were used to estimate prevalence and YLDs due to gout by age, sex, and location. Prevalence was forecast to 2050 with a mixed-effects model.

Findings

In 2020, 55·8 million (95% uncertainty interval 44·4–69·8) people globally had gout, with an age-standardised prevalence of 659·3 (525·4–822·3) per 100 000, an increase of 22·5% (20·9–24·2) since 1990. Globally, the prevalence of gout in 2020 was 3·26 (3·11–3·39) times higher in males than in females and increased with age. The total number of prevalent cases of gout is estimated to reach 95·8 million (81·1–116) in 2050, with population growth being the largest contributor to this increase and only a very small contribution from the forecasted change in gout prevalence. Age-standardised gout prevalence in 2050 is forecast to be 667 (531–830) per 100 000 population. The global age-standardised YLD rate of gout was 20·5 (14·4–28·2) per 100 000 population in 2020. High BMI accounted for 34·3% (27·7–40·6) of YLDs due to gout and kidney dysfunction accounted for 11·8% (9·3–14·2).

Interpretation

Our forecasting model estimates that the number of individuals with gout will increase by more than 70% from 2020 to 2050, primarily due to population growth and ageing. With the association between gout disability and high BMI, dietary and lifestyle modifications focusing on bodyweight reduction are needed at the population level to reduce the burden of gout along with access to interventions to prevent and control flares. Despite the rigour of the standardised GBD methodology and modelling, in many countries, particularly low-income and middle-income countries, estimates are based on modelled rather than primary data and are also lacking severity and disability estimates. We strongly encourage the collection of these data to be included in future GBD iterations.

Funding

Bill & Melinda Gates Foundation and the Global Alliance for Musculoskeletal Health.

背景:痛风是一种炎症性关节炎,表现为急性发作的剧烈关节疼痛和肿胀,可发展为慢性痛风或慢性侵蚀性痛风,或两者兼而有之。在此,我们介绍了《2021 年全球疾病负担、伤害和风险因素研究》(GBD)按性别、年龄和地区对全球、地区和国家痛风患病率和残疾生活年数(YLDs)的最新估计,以及到 2050 年的患病率预测:方法:利用 35 个国家的人口数据以及美国和中国台湾(省)的索赔数据,对 1990 年至 2020 年的痛风患病率和 YLD 进行了估算。采用嵌套贝叶斯元回归模型,按年龄、性别和地点估算痛风的患病率和YLD。采用混合效应模型对2050年的患病率进行了预测:2020年,全球有5500-800万人(95%不确定区间为44-4-69-8)患有痛风,年龄标准化患病率为每10万人中有659-3人(525-4-822-3),自1990年以来增加了22-5%(20-9-24-2)。从全球来看,2020 年男性痛风患病率是女性的 3-26 倍(3-11-3-39),并且随着年龄的增长而增加。据估计,到2050年,痛风患病总人数将达到9500万-800万(8100万-1116万),其中人口增长是导致患病人数增加的最大原因,而痛风患病率的预测变化只起到很小的作用。预计 2050 年年龄标准化痛风患病率为每 10 万人 667(531-830)例。2020 年全球痛风的年龄标准化 YLD 率为每 10 万人 20-5(14-4-28-2)。高体重指数占痛风YLD的34-3%(27-7-40-6),肾功能障碍占11-8%(9-3-14-2):我们的预测模型估计,从2020年到2050年,痛风患者人数将增加70%以上,主要原因是人口增长和老龄化。由于痛风致残与高体重指数之间存在关联,因此需要在人口层面进行以减轻体重为重点的饮食和生活方式调整,以减轻痛风的负担,同时采取干预措施预防和控制痛风复发。尽管标准化的 GBD 方法和建模非常严谨,但在许多国家,尤其是低收入和中等收入国家,估算数据都是基于建模数据而非原始数据,而且也缺乏严重程度和致残率的估算数据。我们强烈鼓励将这些数据的收集工作纳入未来的《全球残疾发展报告》迭代中:比尔及梅林达-盖茨基金会和全球肌肉骨骼健康联盟。
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引用次数: 0
Correction to Lancet Rheumatol 2024; 6: e537–45 柳叶刀风湿病学》2024;6:e537-45 更正。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00200-5
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引用次数: 0
Research, pregnancy, and the ethics of parental consent 研究、怀孕和父母同意的伦理。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00155-3
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引用次数: 0
Silvia Aguilera: learning from lived experience Silvia Aguilera:从生活经验中学习。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00157-7
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引用次数: 0
Research in Brief 研究简介
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2665-9913(24)00202-9
Jennifer Thorley
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引用次数: 0
期刊
Lancet Rheumatology
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