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Classification of salivary gland biopsies in Sjögren's syndrome by a convolutional neural network using an auto-machine learning platform. 利用自动机器学习平台的卷积神经网络对斯约戈伦综合征的唾液腺活检样本进行分类。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-11-06 DOI: 10.1186/s41927-024-00417-3
Jorge Álvarez Troncoso, Elena Ruiz-Bravo, Clara Soto Abánades, Alexandre Dumusc, Álvaro López-Janeiro, Thomas Hügle

Background: The histopathological analysis of minor salivary gland biopsies, particularly through the quantification of the Focus Score (FS), is pivotal in the diagnostic workflow for Sjögren's Syndrome (SS). AI-based image recognition using deep learning models has demonstrated potential in enhancing diagnostic accuracy and efficiency in preclinical research.

Objectives: The primary aim of this investigation was to utilize an auto-machine learning (autoML) platform for the automated segmentation and quantification of FS on histopathological slides, aiming to augment diagnostic precision and speed in SS.

Methods: A cohort comprising 86 patients with sicca syndrome (37 diagnosed with SS based on the 2016 ACR/EULAR Classification Criteria and 49 non-SS) was selected for an in-depth histological examination. A repository of 172 slides (two per patient) was assembled, encompassing 74 slides meeting the classificatory thresholds for SS (FS ≥ 1, indicative of lymphocytic infiltration) and 98 slides showcasing normal salivary gland histology. The autoML platform utilized (Giotto, L2F, Lausanne Switzerland) employed a Convolutional Neural Network (CNN) architecture (ResNet-152) for the training and validation phases, using a dataset of 172 slides.

Results: The developed model exhibited a reliability score of 0.88, proficiently distinguishing SS cases, with a sensitivity of 89.47% (95% CI: 66.86% to 98.70%) and a specificity of 88.24% (95% CI: 63.56% to 98.54%). The model found histological slides of suboptimal quality (e.g., those compromised during fixation or staining processes) to be the most challenging for accurate classification.

Conclusion: AutoML platforms offer a rapid and flexible approach to developing machine learning models, even with smaller datasets, as demonstrated in this study for SS. These platforms hold significant potential for enhancing diagnostic precision and efficiency in both clinical and research settings. Multicentric studies with larger patient cohorts are essential for thorough evaluation and validation of this innovative diagnostic approach.

背景:对唾液腺小切片进行组织病理学分析,特别是通过量化病灶评分(FS),是诊断斯约格伦综合征(SS)工作流程的关键。在临床前研究中,使用深度学习模型进行基于人工智能的图像识别在提高诊断准确性和效率方面已显示出潜力:本研究的主要目的是利用自动机器学习(autoML)平台对组织病理切片上的FS进行自动分割和量化,以提高SS的诊断精度和速度:选取了86名筛查综合征患者(37名根据2016年ACR/EULAR分类标准诊断为筛查综合征,49名非筛查综合征)进行深入的组织学检查。共收集了 172 张切片(每位患者两张),其中 74 张切片符合 SS 的分类阈值(FS ≥ 1,表明淋巴细胞浸润),98 张切片显示正常唾液腺组织学。使用的 autoML 平台(Giotto,L2F,瑞士洛桑)采用卷积神经网络(CNN)架构(ResNet-152)进行训练和验证,使用的数据集为 172 张幻灯片:所开发模型的可靠度为 0.88,能有效区分 SS 病例,灵敏度为 89.47%(95% CI:66.86% 至 98.70%),特异度为 88.24%(95% CI:63.56% 至 98.54%)。该模型发现,质量不佳的组织学切片(如在固定或染色过程中受损的切片)最难进行准确分类:AutoML 平台为开发机器学习模型提供了一种快速灵活的方法,即使是较小的数据集也不例外。这些平台在提高临床和研究环境中的诊断精度和效率方面具有巨大潜力。要对这种创新诊断方法进行全面评估和验证,必须对更大的患者群体进行多中心研究。
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引用次数: 0
Prevalence of co-existing autoimmune and autoinflammatory diseases in vitiligo: a survey-based study from Egypt. 白癜风患者并存自身免疫性疾病和自身炎症性疾病的患病率:埃及的一项调查研究。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-11-06 DOI: 10.1186/s41927-024-00427-1
Samar Tharwat, Fatma Hamdy, Sara Hamdy, Mohammed Kamal Nassar

Background: The exact cause of vitiligo is still unknown. Genetic factors, self-destruction of melanocytes, the autoimmune process, and oxidative stress all can contribute to the pathogenesis of vitiligo.

Objectives: The aim of this study was to figure out the frequency of coexisting autoimmune and autoinflammatory diseases (AIIDs) in Egyptian patients with vitiligo and identify the associated risk factors.

Materials and methods: Egyptian children and adults with vitiligo and their parents were asked to answer a web-based survey. The survey consisted of multiple questions centered around demographic, clinical, and therapeutic data. The vitiligo disease activity (VIDA) score was evaluated for all the patients. Patients were also asked about the presence of co-existing AIIDs.

Results: There was a total of 294 participants, mostly females (54.8%), with a median age of 35 years and a median disease duration of 9 years. Nearly 27% had at least one AIID. The most common associated AIIDs were autoimmune thyroid disease (47 patients, 16%), followed by alopecia areata (14 patients,4.8%), then psoriasis and rheumatoid arthritis (11 patients, 3.7%). Univariate regression analysis revealed that age (OR 1.02, P = 0.036), female gender (OR 2.2, P = 0.004), disease duration (OR 1.04, P < 0.001), affected body surface area (OR 1.7, P = 0.048), and family history of AIIDs (OR 2.7, P < 0.001) were predictors for the presence of AIIDs in patients with vitiligo.

Conclusion: AIIDs are prevalent among vitiligo patients. Age, female gender, and family history of AIIDs are the main predictors of the presence of AIIDs in vitiligo patients.

背景:白癜风的确切病因尚不清楚。遗传因素、黑色素细胞自毁、自身免疫过程和氧化应激都可能导致白癜风的发病:本研究旨在了解埃及白癜风患者同时患有自身免疫性疾病和自身炎症性疾病(AIIDs)的频率,并确定相关的风险因素:要求埃及儿童和成人白癜风患者及其家长回答一项网络调查。该调查由围绕人口统计学、临床和治疗数据的多个问题组成。对所有患者的白癜风疾病活动性(VIDA)评分进行了评估。此外,还询问了患者是否同时患有AIIDs:共有 294 名参与者,大部分为女性(54.8%),年龄中位数为 35 岁,病程中位数为 9 年。近 27% 的人至少患有一种 AIID。最常见的相关 AIID 是自身免疫性甲状腺疾病(47 名患者,16%),其次是斑秃(14 名患者,4.8%),然后是银屑病和类风湿性关节炎(11 名患者,3.7%)。单变量回归分析表明,年龄(OR 1.02,P = 0.036)、女性性别(OR 2.2,P = 0.004)、病程(OR 1.04,P 结论:AIIDs 是一种常见的皮肤病:AIID在白癜风患者中很普遍。年龄、女性性别和 AIIDs 家族史是白癜风患者出现 AIIDs 的主要预测因素。
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引用次数: 0
Norwegian society of rheumatology recommendations on diagnosis and treatment of patients with Polymyalgia Rheumatica: a narrative review. 挪威风湿病学会关于多发性风湿病患者诊断和治疗的建议:叙述性综述。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-11-04 DOI: 10.1186/s41927-024-00422-6
Stig Tengesdal, Andreas P Diamantopoulos, Lene Kristin Brekke, Emilio Besada, Geirmund Myklebust

Background: To provide evidence-based, up-to-date recommendations for physicians in primary and specialist healthcare setting in diagnosing and treating patients with polymyalgia rheumatica (PMR).

Methods: The PMR working group conducted a narrative review of the available evidence in the field and wrote the draft guidelines. These guidelines were discussed and revised according to the standard operating procedures within the Norwegian Society of Rheumatology. The European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR) recommendations for the management of PMR, the British Society for Rheumatology (BSR) guidelines for the management for PMR, the treat-to-target recommendations in giant cell arteritis and PMR and the 2023 recommendations for early referral of individuals with suspected polymyalgia rheumatica were used in particular for purpose of harmonization.

Results: A total of 10 recommendations have been formulated covering initial diagnostic investigations, comorbidity assessment, imaging, specialist referral criteria, treatment involving glucocorticoids and steroid-sparing agents and follow-up care.

Conclusion: Norwegian recommendations for diagnostics and treatment to improve management and outcome in patients with PMR were developed.

背景:为初级和专科医疗机构的医生提供诊断和治疗多发性风湿痛患者的循证建议:为初级和专科医疗机构的医生诊断和治疗多发性风湿痛(PMR)患者提供基于证据的最新建议:多发性风湿痛工作组对该领域的现有证据进行了叙述性回顾,并撰写了指南草案。这些指南按照挪威风湿病学会的标准操作程序进行了讨论和修订。欧洲风湿病学协会联盟(EULAR)和美国风湿病学会(ACR)关于多发性风湿病管理的建议、英国风湿病学会(BSR)关于多发性风湿病管理的指南、巨细胞动脉炎和多发性风湿病的目标治疗建议以及2023年关于疑似多发性风湿病患者早期转诊的建议被特别用于协调目的:结果:共制定了10项建议,涵盖初步诊断检查、合并症评估、影像学检查、专科转诊标准、糖皮质激素和类固醇替代药物治疗以及后续护理:结论:挪威制定了有关诊断和治疗的建议,以改善 PMR 患者的管理和治疗效果。
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引用次数: 0
Headaches in SLE patients: a cross-sectional analysis of clinical, immunological, and Radiological Correlations. 系统性红斑狼疮患者的头痛:临床、免疫学和放射学相关性的横断面分析。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-31 DOI: 10.1186/s41927-024-00424-4
Eman Samy, Enas S Zahran, Mona Sabry, Hosna Elshony

Background: Systemic Lupus Erythematosus (SLE) is a multifaceted autoimmune disorder characterized by diverse clinical manifestations, including a significant prevalence of headaches. This cross-sectional study aimed to thoroughly explore the relationship between SLE and headaches by analysing their prevalence, types, and associated clinical, immunological, and radiological factors.

Method: A comparative analysis was conducted on 179 SLE patients, who were categorized into two groups: those with headaches and those without. Data collection encompassed demographic details, disease activity levels, neurological assessments, immunological profiles, and brain imaging results. Headaches were diagnosed and classified following the International Classification of Headache Disorders (ICHD-3). Disease activity was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Statistical analyses were performed to identify significant associations and correlations.

Results: Headaches were observed in 55% of the SLE patients, predominantly presenting as tension-type headaches (65%) and migraines (27%). Notably, no patients met the criteria for a lupus-specific headache. The Headache Group exhibited significantly higher disease activity (SLEDAI scores). Tension-type and migraine headaches were particularly associated with increased muco-cutaneous manifestations. The presence of antiphospholipid (aPL) antibodies was significantly linked to migraines and cluster headaches. While neurological disorders such as ischemic stroke and venous sinus thrombosis were more prevalent in the Headache Group, these findings were not statistically significant. Brain MRI abnormalities were detected in 9.4% of patients with headaches, including venous sinus thrombosis (2.3%), ischemic stroke (5.8%), and white matter hyperintensities (1.1%).

Conclusion: This study underscore es the complex relationship between SLE and headaches, suggesting that headaches may serve as an indicator of heightened SLE disease activity. Immunological factors, particularly aPL antibodies, show a strong association with specific headache types. MRI abnormalities further emphasize the intricate neurobiological aspects in SLE patients experiencing headaches. Continued research is essential to better understand biomarkers, genetic factors, and effective treatment strategies for managing headaches in SLE patients.

背景:系统性红斑狼疮(SLE系统性红斑狼疮(SLE)是一种多发性自身免疫性疾病,临床表现多种多样,其中头痛的发病率很高。这项横断面研究旨在通过分析系统性红斑狼疮与头痛的发病率、类型以及相关的临床、免疫学和放射学因素,深入探讨系统性红斑狼疮与头痛之间的关系:方法:研究人员对179名系统性红斑狼疮患者进行了对比分析,并将他们分为两组:有头痛和无头痛。数据收集包括人口统计学细节、疾病活动水平、神经系统评估、免疫学特征和脑成像结果。头痛按照国际头痛疾病分类(ICHD-3)进行诊断和分类。疾病活动度采用系统性红斑狼疮疾病活动指数(SLEDAI)进行测量。结果显示,55%的患者出现头痛:55%的系统性红斑狼疮患者出现头痛,主要表现为紧张型头痛(65%)和偏头痛(27%)。值得注意的是,没有患者符合狼疮特异性头痛的标准。头痛组的疾病活动度(SLEDAI评分)明显更高。紧张型头痛和偏头痛尤其与粘液-皮肤表现增多有关。抗磷脂(aPL)抗体的存在与偏头痛和丛集性头痛密切相关。虽然缺血性中风和静脉窦血栓等神经系统疾病在头痛组中发病率较高,但这些结果并无统计学意义。9.4%的头痛患者发现脑磁共振成像异常,包括静脉窦血栓(2.3%)、缺血性中风(5.8%)和白质增生(1.1%):这项研究强调了系统性红斑狼疮与头痛之间的复杂关系,提示头痛可能是系统性红斑狼疮疾病活动加剧的一个指标。免疫因素,尤其是 aPL 抗体,与特定类型的头痛有密切关系。核磁共振成像异常进一步强调了系统性红斑狼疮患者头痛中错综复杂的神经生物学因素。要更好地了解系统性红斑狼疮患者头痛的生物标志物、遗传因素和有效的治疗策略,就必须继续开展研究。
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引用次数: 0
What are the functional and clinical characteristics shared by fibromyalgia and low back pain? A scoping review. 纤维肌痛和腰背痛有哪些共同的功能和临床特征?范围综述。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-28 DOI: 10.1186/s41927-024-00430-6
Bastien Couëpel, Mathieu Tremblay, Marjorie Bernier, Jacques Abboud, Martin Descarreaux

Background: Fibromyalgia and chronic primary low back pain are two chronic pain conditions with a significant biopsychosocial burden. Recently, the International Association for the Study of Pain has grouped them under the term chronic primary pain. To further explore similarities and differences between these two conditions, the objective of this scoping review is to explore the pain-related, physiological and psychological outcomes in individuals with fibromyalgia and low back pain.

Methods: The following databases were used to find relevant studies, using the PRISMA guidelines: Medline, Psycinfo, and CINAHL. Studies were included if they encompassed both participants with fibromyalgia or low back pain, with the objective to compare pain-related, physiological and/or psychological outcomes.

Results: Nineteen studies were selected for extraction. Among the 2801 participants, 968 had fibromyalgia (mean age 48.56 ± 7.97 years, with 94% being female) and 896 had low back pain (mean age 47.48 ± 8.15 years, with 80% being female). Pain sensitivity, physical dysfunction, illness perception, psychological distress, alexithymia, depression, and anxiety were generally more severe in participants with fibromyalgia. Most studies found similar levels of pain intensity, kinesiophobia, quality of pain, quality of life, impact of pain, suicidal risk, anger, and social support comparing individuals with fibromyalgia and individuals with low back pain.

Discussion: This scoping review highlights that although both conditions show similar pain intensity and impact on quality of life, fibromyalgia is associated with greater overall severity than low back pain, especially in sensitivity to pain and depression/anxiety.

背景:纤维肌痛和慢性原发性腰背痛是两种对生物-心理-社会造成重大负担的慢性疼痛。最近,国际疼痛研究协会将它们归为慢性原发性疼痛。为了进一步探讨这两种病症的异同,本范围综述旨在探讨纤维肌痛和腰背痛患者与疼痛相关的生理和心理结果:采用 PRISMA 指南,使用以下数据库查找相关研究:Medline、Psycinfo 和 CINAHL。如果研究的参与者同时患有纤维肌痛或腰背痛,并旨在比较与疼痛相关的生理和/或心理结果,则将其纳入研究范围:结果:共选取了 19 项研究。在 2801 名参与者中,968 人患有纤维肌痛(平均年龄为 48.56 ± 7.97 岁,94% 为女性),896 人患有腰背痛(平均年龄为 47.48 ± 8.15 岁,80% 为女性)。纤维肌痛患者的疼痛敏感性、身体机能障碍、疾病感知、心理困扰、自闭症、抑郁和焦虑通常更为严重。大多数研究发现,纤维肌痛患者与腰背痛患者在疼痛强度、运动恐惧、疼痛质量、生活质量、疼痛影响、自杀风险、愤怒和社会支持方面的水平相似:本范围界定综述强调,虽然两种疾病的疼痛强度和对生活质量的影响相似,但纤维肌痛的总体严重程度高于腰背痛,尤其是在对疼痛的敏感性和抑郁/焦虑方面。
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引用次数: 0
Correction: Patient-reported outcome measures for systemic lupus erythematosus: an expert Delphi consensus to guide implementation in routine care. 更正:系统性红斑狼疮的患者报告结果测量方法:指导常规护理实施的德尔菲专家共识。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-25 DOI: 10.1186/s41927-024-00432-4
Isabel Castrejón, Laura Cano, María José Cuadrado, Joaquín Borrás, Maria Galindo, Tarek C Salman-Monte, Carlos Amorós, Carmen San Román, Isabel Cabezas, Marta Comellas, Alejandro Muñoz
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引用次数: 0
Correlations among quality of life, spinal mobility, and disease activity in early-treated axial spondyloarthritis: a single-center cross-sectional study. 早期治疗的轴性脊柱关节炎患者生活质量、脊柱活动度和疾病活动度之间的相关性:一项单中心横断面研究。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-16 DOI: 10.1186/s41927-024-00426-2
Tinh Khampaen, Thanuchporn Kafaksom, Nichapa Dechapaphapitak, Nattakirana Tongdee, Parawee Chevaisrakul

Background: Axial spondyloarthritis (axSpA) significantly impacts patients' lives. The ASAS-OMERACT guideline was formulated for the multidimensional evaluation of axSpA patients, employing a specific set of tools. Given the pivotal role of patient perception, comprehensive correlation among these tools, especially concerning quality of life, may provide a clinically relevant perspective and enhance treatment efficacy in the early stages of the disease. This study aims to investigate the correlation among disease activity, functional ability, and quality of life in early-treated axSpA patients. In addition, the association between high disease activity and clinical characteristics was explored.

Methods: This cross-sectional study was conducted in a tertiary hospital in Thailand. Patients diagnosed with axSpA according to ASAS classification criteria and receiving treatment from rheumatologists within three years of onset of symptoms were included. Clinical and laboratory data were retrieved from a hospital database. Disease activity was assessed using the Ankylosing Spondylitis Disease Activity Score with ESR or CRP (ASDAS-ESR/CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Spinal mobility was measured using the Bath Ankylosing Spondylitis Metrology Index (BASMI), while quality of life and function were evaluated using the ASAS Health Index (ASAS-HI) and Bath Ankylosing Spondylitis Functional Index (BASFI), respectively. The correlation between these measurements was analyzed using the Pearson correlation coefficient (r). Additionally, factors associated with high disease activity (ASDAS/CRP > 2.1) were explored using multivariate regression analysis.

Results: Sixty-six patients (41 males; mean age 49.3 ± 13.3 years) were enrolled between April to December 2022. Disease activity (ASDAS-CRP) was significantly inversely correlated with spinal mobility (BASMI), function (BASFI), and quality of life (ASAS-HI). High disease activity was associated with obesity (BMI ≥ 30 kg/m^2) and a longer duration of symptoms before treatment (≥ 2 years).

Conclusion: In early-treated axSpA patients, ASDAS-CRP showed significant correlations with functional ability, quality of life, and spinal mobility. High disease activity was associated with obesity and a longer pre-treatment symptom duration in our study. Early treatment may enhance patients' function, mobility, and quality of life, with weight reduction being possibly beneficial for obese axSpA patients.

Clinical trial number: Not applicable.

背景:轴性脊柱关节炎(axSpA轴性脊柱关节炎(axSpA)严重影响患者的生活。ASAS-OMERACT 指南是为轴性脊柱关节炎患者的多维评估而制定的,采用了一套特定的工具。鉴于患者感知的关键作用,这些工具之间的全面相关性,尤其是生活质量方面的相关性,可提供与临床相关的视角,并提高疾病早期的治疗效果。本研究旨在探讨早期治疗的 axSpA 患者的疾病活动度、功能能力和生活质量之间的相关性。此外,还探讨了高疾病活动度与临床特征之间的关联:这项横断面研究在泰国一家三级医院进行。研究对象包括根据 ASAS 分类标准确诊为 axSpA 的患者,以及在发病三年内接受风湿免疫科医生治疗的患者。临床和实验室数据均来自医院数据库。疾病活动度采用强直性脊柱炎疾病活动度评分与血沉或CRP(ASDAS-ESR/CRP)和巴斯强直性脊柱炎疾病活动度指数(BASDAI)进行评估。脊柱活动度采用巴斯强直性脊柱炎计量指数(BASMI)进行测量,而生活质量和功能则分别采用巴斯强直性脊柱炎健康指数(ASAS-HI)和巴斯强直性脊柱炎功能指数(BASFI)进行评估。使用皮尔逊相关系数(r)分析了这些测量值之间的相关性。此外,还利用多变量回归分析探讨了与疾病活动度高(ASDAS/CRP > 2.1)相关的因素:16 名患者(41 名男性;平均年龄为 49.3 ± 13.3 岁)于 2022 年 4 月至 12 月间入组。疾病活动度(ASDAS-CRP)与脊柱活动度(BASMI)、功能(BASFI)和生活质量(ASAS-HI)显著成反比。高疾病活动度与肥胖(体重指数≥30 kg/m^2)和治疗前症状持续时间较长(≥2年)有关:在早期治疗的 axSpA 患者中,ASDAS-CRP 与功能能力、生活质量和脊柱活动度有显著相关性。在我们的研究中,高疾病活动度与肥胖和治疗前症状持续时间较长有关。早期治疗可提高患者的功能、活动能力和生活质量,减轻体重可能对肥胖 axSpA 患者有益:临床试验编号:不适用。
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引用次数: 0
Reproductive health and rheumatoid arthritis. 生殖健康与类风湿性关节炎。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-15 DOI: 10.1186/s41927-024-00429-z
Mohammad Erfan Ranjbaran, Maryam Kazemi

Introduction: The prevalence of Rheumatoid Arthritis (RA) has been steadily increasing over the last thirty years, particularly among women. Due to the conflicting results of various studies on the link between rheumatoid arthritis and reproductive health, we have undertaken this study to explore their relationship.

Methods: This cross-sectional study utilized primary data from5557 women involved in the Fasa Persian Cohort in the years 2013 to 2018. The study examined the frequency of RA and its association with various factors related to reproductive health, including age at first pregnancy, number of alive children, history of abortion, and infertility. SPSS software was utilized for data analysis, with the significance level set at p < 0.05.

Results: 5557 women with an average age of 48.6 ± 9.5 years participated. Of these women, 7.2% were diagnosed with rheumatoid disease, with an average onset age of 38.2 ± 15.2. The study did not find a significant correlation between RA and factors such as number of pregnancies, age at first pregnancy, duration of breastfeeding and number of children.

Conclusion: The study suggests that the experience of RA is independent of gynecological, obstetric factors, or reproductive life. This finding may provide reassurance to women affected by RA.

导言:在过去的三十年中,类风湿性关节炎(RA)的发病率一直在稳步上升,尤其是在女性中。由于有关类风湿性关节炎与生殖健康之间关系的各种研究结果相互矛盾,我们开展了这项研究,以探讨两者之间的关系:这项横断面研究利用了 5557 名妇女在 2013 年至 2018 年期间参与法萨波斯队列的原始数据。研究考察了 RA 的频率及其与生殖健康相关的各种因素的关系,包括首次怀孕年龄、存活子女数、流产史和不孕症。数据分析采用 SPSS 软件,显著性水平设为 p 结果:5557 名妇女参加了调查,平均年龄为(48.6±9.5)岁。其中,7.2%的妇女被诊断患有类风湿病,平均发病年龄为(38.2±15.2)岁。研究没有发现 RA 与怀孕次数、首次怀孕年龄、母乳喂养时间和子女数量等因素有明显的相关性:研究表明,RA 与妇科、产科因素或生育期无关。这一发现可让受 RA 影响的妇女放心。
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引用次数: 0
Survey self-report of rheumatoid arthritis and treatments versus specialist clinician confirmation. 类风湿关节炎和治疗方法的自我报告调查与专科临床医生的确认对比。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-09 DOI: 10.1186/s41927-024-00425-3
Shamil Jugnundan, Gabriela Schmajuk, Laura Trupin, Paul D Blanc

Objective: To assess agreement between patient survey report and physician recorded arthritic conditions and medication use in order to validate population-based epidemiologic approaches to auto-immune arthritic conditions.

Methods: Rheumatologists in the U.S. Appalachian region recruited men 50 years or older with a confirmed rheumatoid arthritis (RA) diagnosis. For each participating patient, the treating specialist completed a brief chart abstraction that included rheumatic diagnosis and corresponding treatment. Patients participated in a telephone interview using the same questionnaire as applied in a larger random digit dial survey that queried arthritis diagnosis and treatment. We assessed patient-clinician agreement with the Prevalence Adjusted and Biased Adjusted Kappa (PABAK) statistic.

Results: We included 36 patient-clinician dyads in this analysis. All clinicians and patients concurred in the RA diagnosis (PABAK = 1). For concomitant systemic lupus and scleroderma, we observed generally concordant responses (PABAK 0.89 and 1, respectively). For medication use, for hydroxychloroquine or sulfasalazine was associated with the lowest PABAK (0.39), intermediate values for methotrexate and for the "other conventional synthetic DMARDs" category (0.67), and with the highest agreement PABAK value for the "biologic DMARD or JAK 2 inhibitor" category (0.89).

Conclusion: Survey-based self-report of RA offers a useful approach in epidemiological investigation. This is particularly relevant to population-based approaches to autoimmune arthritis related to occupational and environmental factors.

目的:评估患者调查报告与医生记录的关节炎病情和用药情况之间的一致性:评估患者调查报告与医生记录的关节炎状况和用药情况之间的一致性,以验证基于人群的自身免疫性关节炎流行病学方法:美国阿巴拉契亚地区的风湿病学家招募了50岁或50岁以上确诊为类风湿性关节炎(RA)的男性患者。对于每位参与调查的患者,主治专科医生都会填写一份简短的病历摘要,其中包括风湿病诊断和相应的治疗方法。患者参加了电话访谈,访谈中使用的问卷与一项大型随机数字拨号调查中使用的问卷相同,都是询问关节炎的诊断和治疗情况。我们用患病率调整和偏倚调整卡帕(PABAK)统计法评估了患者与医生之间的一致性:我们在分析中纳入了 36 个患者-医师二元组。所有临床医生和患者对 RA 的诊断结果一致(PABAK = 1)。对于并发的系统性红斑狼疮和硬皮病,我们观察到的反应基本一致(PABAK 分别为 0.89 和 1)。在药物使用方面,羟氯喹或柳氮磺胺吡啶的PABAK值最低(0.39),甲氨蝶呤和 "其他常规合成DMARDs "类别的PABAK值居中(0.67),而 "生物DMARD或JAK 2抑制剂 "类别的PABAK值最高(0.89):基于调查的 RA 自我报告为流行病学调查提供了一种有用的方法。结论:基于调查的自我报告为流行病学调查提供了一种有用的方法,尤其适用于与职业和环境因素相关的基于人群的自身免疫性关节炎调查。
{"title":"Survey self-report of rheumatoid arthritis and treatments versus specialist clinician confirmation.","authors":"Shamil Jugnundan, Gabriela Schmajuk, Laura Trupin, Paul D Blanc","doi":"10.1186/s41927-024-00425-3","DOIUrl":"10.1186/s41927-024-00425-3","url":null,"abstract":"<p><strong>Objective: </strong>To assess agreement between patient survey report and physician recorded arthritic conditions and medication use in order to validate population-based epidemiologic approaches to auto-immune arthritic conditions.</p><p><strong>Methods: </strong>Rheumatologists in the U.S. Appalachian region recruited men 50 years or older with a confirmed rheumatoid arthritis (RA) diagnosis. For each participating patient, the treating specialist completed a brief chart abstraction that included rheumatic diagnosis and corresponding treatment. Patients participated in a telephone interview using the same questionnaire as applied in a larger random digit dial survey that queried arthritis diagnosis and treatment. We assessed patient-clinician agreement with the Prevalence Adjusted and Biased Adjusted Kappa (PABAK) statistic.</p><p><strong>Results: </strong>We included 36 patient-clinician dyads in this analysis. All clinicians and patients concurred in the RA diagnosis (PABAK = 1). For concomitant systemic lupus and scleroderma, we observed generally concordant responses (PABAK 0.89 and 1, respectively). For medication use, for hydroxychloroquine or sulfasalazine was associated with the lowest PABAK (0.39), intermediate values for methotrexate and for the \"other conventional synthetic DMARDs\" category (0.67), and with the highest agreement PABAK value for the \"biologic DMARD or JAK 2 inhibitor\" category (0.89).</p><p><strong>Conclusion: </strong>Survey-based self-report of RA offers a useful approach in epidemiological investigation. This is particularly relevant to population-based approaches to autoimmune arthritis related to occupational and environmental factors.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disabling foot pain and its impact on daily living among people with psoriatic arthritis in Singapore: a cross-sectional observational investigation. 新加坡银屑病关节炎患者致残性足部疼痛及其对日常生活的影响:一项横断面观察调查。
IF 2.1 Q3 RHEUMATOLOGY Pub Date : 2024-10-09 DOI: 10.1186/s41927-024-00409-3
Vanessa H Y Teo, Kai Li Chia, Catherine Bowen, Manjari Lahiri, Peter P M Cheung, Deborah E Turner, Kate Carter

Background: Psoriatic Arthritis (PsA)-related foot involvement has been shown to have a profound impact on daily functioning, with most studies having focused on predominantly Caucasian populations. The aim was to describe disabling foot pain (DFP) and its impact on daily living in PsA in Singapore.

Methods: A cross-sectional, retrospective study was conducted using clinical data collected during a single-visit to a rheumatology clinic in Singapore. Records for adults with physician-diagnosed PsA were reviewed for sociodemographic information, disease characteristics, global disease activity and burden. Foot-specific measures included clinical assessment and the Manchester Foot Pain and Disability Index used to define DFP and evaluate between-group differences.

Results: Forty-two participants with PsA (83% female, 57% Chinese, 31% Malay, 9.5% Indian, mean (SD) age 54-years (16)) attended the rheumatology clinic over the study-period. The median (IQR) disease duration was 2-years (11) and all were taking current DMARDs. Global disease measures demonstrated mild-to-moderate global disease activity and mild functional impairment, and were significantly higher in those with DFP. Despite 90% reporting to be coping well with their condition, self-care and having emotional support (n = 38), this study sample demonstrated high levels of anxiety/depression (29%), sleep disturbance (34%) and fatigue (24%), and a lack of disease- and drug-specific knowledge (64%). Further management was indicated for medication adherence counselling (48%), occupational therapy (43%), physiotherapy (36%) and podiatry (30%). Nearly half had current foot pain with 40% reporting DFP (n = 17), which caused significantly greater difficulty walking 3 km than those without DFP (p < 0.05). Rearfoot enthesitis (plantar fasciitis, Achilles enthesitis) was the most common cause of DFP (67%) with pain lasting longer than 1-year. 72% were overweight or obese, with a high proportion not engaging in any cardiovascular exercise (70%). Three of 42 participants had previously seen a podiatrist.

Conclusions: People with DFP in PsA experience more severe global disease activity, reduced mobility and higher levels of negative impact on their daily lives in Singapore. In the absence of working in a multidisciplinary-team, there is value in comprehensive assessments that have potential to capture a holistic view of personal impact and improve person-centred care in PsA.

背景:与银屑病关节炎(PsA)相关的足部受累已被证明会对日常功能产生深远影响,而大多数研究主要集中在白种人群体中。本研究旨在描述新加坡 PsA 患者的致残性足部疼痛(DFP)及其对日常生活的影响:这项横断面回顾性研究使用了在新加坡一家风湿病诊所单次就诊时收集的临床数据。研究人员查阅了经医生确诊的成年 PsA 患者的病历,以了解其社会人口学信息、疾病特征、总体疾病活动度和负担。足部特异性测量包括临床评估和曼彻斯特足部疼痛和残疾指数,用于定义DFP和评估组间差异:42名PsA患者(83%为女性,57%为华人,31%为马来人,9.5%为印度人,平均(标清)年龄为54岁(16岁))在研究期间前往风湿病诊所就诊。病程中位数(IQR)为2年(11),所有患者目前都在服用DMARDs。总体疾病指标显示,总体疾病活动度为轻度至中度,功能障碍程度为轻度,DFP患者的这一指标明显高于其他患者。尽管90%的患者表示能够很好地应对病情、进行自我护理并获得情感支持(n = 38),但该研究样本显示,焦虑/抑郁(29%)、睡眠障碍(34%)和疲劳(24%)程度较高,且缺乏疾病和药物相关知识(64%)。需要进一步治疗的患者包括药物依从性咨询(48%)、职业治疗(43%)、物理治疗(36%)和足病治疗(30%)。近一半的人目前有足部疼痛,其中 40% 的人报告有 DFP(n = 17),与没有 DFP 的人相比,他们行走 3 公里的难度明显更大(p 结论:PsA 患者中,有 DFP 的人比无 DFP 的人更难行走 3 公里:在新加坡,患有 DFP 的 PsA 患者会经历更严重的全身疾病活动、更低的活动能力和更高程度的日常生活负面影响。在缺乏多学科团队合作的情况下,综合评估很有价值,有可能全面了解个人影响并改善以人为本的 PsA 护理。
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引用次数: 0
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BMC Rheumatology
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