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Best Practice & Research. Clinical Rheumatology

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https://read.qxmd.com/read/30527434/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-osteoarthritis
#1
REVIEW
Terence W O'Neill, Paul S McCabe, John McBeth
Osteoarthritis (OA) is the most frequent form of arthritis and a leading cause of pain and disability worldwide. OA can affect any synovial joint, although the hip, knee, hand, foot and spine are the most commonly affected sites. Knowledge about the occurrence and risk factors for OA is important to define the clinical and public health burden of the disease to understand mechanisms of disease occurrence and may also help to inform the development of population-wide prevention strategies. In this article, we review the occurrence and risk factors for OA and also consider patient-reported outcome measures that have been used for the assessment of the disease...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527433/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-psoriatic-arthritis
#2
REVIEW
Dilek Solmaz, Lihi Eder, Sibel Zehra Aydin
Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects different structures of the musculoskeletal system in addition to the skin and the nail. The complexity of the disease had been a barrier to understand the pathogenesis and define valid outcome tools; however, our understanding about the disease has considerably increased with time mainly because of the advances in imaging, new discoveries in genetics and underlying inflammatory pathways, and better understanding of the epidemiology of the disease and environmental risk factors...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527432/update-on-the-epidemiology-risk-factors-and-outcomes-of-systemic-vasculitides
#3
REVIEW
Alvise Berti, Christian Dejaco
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and giant cell arteritis (GCA) are the most common primary systemic vasculitides of the adult population, while polymyalgia rheumatica (PMR) is a clinical syndrome often associated with GCA. Incidence and prevalence rates of AAV have been increasing in the last decades, whereas those of GCA and PMR have remained stable. The mutual interplay between environmental and genetic risk factors leading to the development of these diseases has been further analyzed in the last years...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527431/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-beh%C3%A3-et-s-disease
#4
REVIEW
Nurullah Akkoç
Behçet's disease (BD) may be regarded as a polygenic autoinflammatory disease although adaptive immune system has also been implicated in pathogenesis. Different classification criteria sets exist for BD, including the new "International Criteria for BD." The pooled prevalence of BD was calculated as 10.3 per 100,000 population globally. BD is common along the Silk Road, including Turkey. Male sex and early onset are associated with a more severe disease course. For the follow-up of BD, there are five disease activity scales, one disease severity scale, and one QOL scale...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527430/update-on-the-epidemiology-and-disease-outcome-of-familial-mediterranean-fever
#5
REVIEW
Seza Özen
Autoinflammatory diseases (AIDs) are diseases of the innate immune system, with clinical and laboratory evidence of attacks of inflammation. The more common AIDs are those associated with periodic fevers: Familial Mediterranean fever (FMF); Mevalonate Kinase Deficiency (MKD)/Hyperimmunoglobulin D Syndrome (HIDS); Cryopyrin-associated Autoinflammatory Syndrome (CAPS); and Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS). Classification criteria have been developed for all these types. FMF is the most common AID worldwide with a particularly high prevalence in the Eastern Mediterranean region...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527429/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-axial-spondyloarthritis
#6
REVIEW
Clementina López-Medina, Anna Moltó
Axial spondyloarthritis (axSpA) is the prototype of a class of a rheumatic chronic inflammatory disease named spondyloarthritis (SpA). The prevalence of axSpA ranges between 0.1% and 1.4% globally, hence showing geographic differences that can be explained mostly by the prevalence of the HLA-B27 antigen. However, not many studies have evaluated the incidence of this disease. Inflammation may be initiated in the enthesis as a consequence of the action of IL-23, which can activate resident T cells. The elevated expression of IL-23 has been explained by three hypotheses: the presence of HLA-B27, variations in the gut microbiome and the biomechanical stress at the enthesis...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527428/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-systemic-sclerosis
#7
REVIEW
Francesca Ingegnoli, Nicola Ughi, Carina Mihai
Systemic sclerosis (SSc) is a chronic immune-mediated connective tissue disease with heterogeneous organ involvement. New classification criteria were developed allowing disease identification even before the onset of its hallmark, skin fibrosis. Incidence and prevalence vary among reports and are influenced by methodology. Despite earlier diagnosis, mortality of SSc is still considerable, mainly because of cardiopulmonary causes. Genetic predisposition is entangled and implies genes of the major histocompatibility complex and also other loci related to immune regulation...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527427/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-juvenile-idiopathic-arthritis
#8
REVIEW
Jason Palman, Stephanie Shoop-Worrall, Kimme Hyrich, Janet E McDonagh
Juvenile idiopathic arthritis (JIA) is the most common inflammatory joint condition of childhood and represents seven JIA subtypes characterised by distinct clinical and laboratory variables. Genetic and environmental factors are known to influence JIA, although many unanswered questions remain. Measurement of health outcomes in JIA is imperative for both clinical practice and research. Patient-reported outcomes present particular challenges in paediatric rheumatology in view of the importance of collecting reports from both the child/young person and the parent...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527426/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-systemic-lupus-erythematosus
#9
REVIEW
Irini Gergianaki, Alessandra Bortoluzzi, George Bertsias
Obtaining an updated view of the epidemiology, risk factors, and prognosis of systemic lupus erythematosus (SLE) is pivotal to our understanding of the disease burden. Recent community-based studies with comprehensive methodology provided more accurate disease occurrence estimates and suggested that SLE may be more frequent than previously thought. Gender, race, and socioeconomic status are important disease determinants, and there is increasing appreciation of the contribution of family history and environmental exposures in SLE susceptibility...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527425/update-on-the-epidemiology-risk-factors-and-disease-outcomes-of-rheumatoid-arthritis
#10
REVIEW
Diane van der Woude, Annette H M van der Helm-van Mil
Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation, which affects approximately 1% of the population. The benefit of early recognition and treatment has led to an increased interest in the early phases of disease. With the aim of classifying patients earlier in their disease course, new RA classification criteria have been developed. Much attention has been devoted to the identification in the prearthritis phase of arthralgia. The discovery of new risk factors and autoantibodies has led to new theories about the putative mechanisms involved in disease development...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527424/overview-of-changes-in-rmd-epidemiology-and-outcome-development-in-the-last-10-years
#11
Suzanne M M Verstappen, Loreto Carmona
Epidemiological studies have been affected by environmental (or technological and societal) changes in the last 10 years, such as the emergence of registries, big data and machine learning algorithms, epigenetics, data protection regulations or a more solid presence of the patient perspective in outcomes research. As a consequence we, epidemiologists, are facing challenges in the design, conduct, and analysis of the studies, as well as on the interpretation of the results. Not everything that is new may be better than the old ways of doing epidemiology...
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30527423/epidemiology-of-rheumatic-and-musculoskeletal-diseases
#12
EDITORIAL
Suzanne M M Verstappen, Loreto Carmona
No abstract text is available yet for this article.
April 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526901/conventional-and-biological-immunosuppressants-in-vasculitis
#13
REVIEW
Loic Guillevin, Chetan Mukhtyar, Christian Pagnoux, Max Yates
The following chapter outlines the main findings from clinical trials, which provide information on the current best evidence-based management of the myriad of conditions that comprise vasculitis. Glucocorticoids (GCs) have been the mainstay of treatment of large-vessel vasculitis since Birkhead et al. used intramuscular cortisone daily and obtained good results in patients with giant cell arteritis. Recent trial data offer the hope that future treatment regimens may not need to be quite reliant on steroids...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526900/investigations-in-systemic-vasculitis-the-role-of-renal-pathology
#14
REVIEW
Annelies E Berden, Maria A C Wester Trejo, Ingeborg M Bajema
ANCA-associated vasculitis (AAV) describes a group of small-vessel vasculitides with frequent renal involvement. The first description of these conditions can be traced back to the 19th-century paper on necrotizing vasculitis by Kussmaul and Maier. Since then, our understanding of the pathogenesis has improved and the histopathological lesions have been described in detail. Characteristic histologic lesions in ANCA-associated glomerulonephritis (AAGN) are fibrinoid necrosis and crescents, often accompanied by tubulointerstitial inflammation...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526899/investigations-in-systemic-vasculitis-the-role-of-imaging
#15
REVIEW
Wolfgang A Schmidt, Daniel Blockmans
Imaging plays an increasing role for confirming a suspected diagnosis of giant cell arteritis (GCA) or Takayasu arteritis (TAK). Ultrasound, magnetic resonance imaging (MRI), and computed tomography demonstrate a homogeneous, most commonly concentric, arterial wall thickening. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) displays increased FDG uptake of inflamed artery walls delineating increased metabolism. Ultrasound and MRI are recommended to be the initial imaging modalities in cranial GCA and TAK, respectively...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526898/investigations-in-systemic-vasculitis-the-role-of-the-laboratory
#16
REVIEW
Elena Csernok, Xavier Bossuyt
The diagnosis of systemic vasculitis is challenging. Laboratory testing may provide useful information. Routine laboratory tests include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), blood count, serum creatinine, urinalysis, specific autoantibodies, complement, immunoglobulin, cryoglobulin, and Hepatitis B and C serology. Although ESR and CRP are often helpful for the diagnosis of vasculitis, they are nonspecific and do not help in distinguishing between vasculitis disease activity and a concomitant infection or another source of inflammation...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526897/clinical-features-and-structured-clinical-evaluation-of-vasculitis
#17
REVIEW
C Ponte, A F Águeda, R A Luqmani
Systemic vasculitides are a group of heterogeneous conditions with overlapping patterns of clinical and laboratory manifestations. Moreover, clinical features can be non-specific and seemingly disparate. A major factor in defining optimal therapy and measuring treatment response is careful disease assessment targeting four main domains: activity, damage, prognosis and quality of life/function. Assessment tools such as the Birmingham Activity Score and the Vasculitis Damage Index have become a core feature of clinical trials in ANCA-associated vasculitis (AAV) and formed the basis for sound clinical management of these complex conditions...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526896/introduction-epidemiology-and-classification-of-vasculitis
#18
REVIEW
Richard A Watts, Joanna Robson
Classification of the vasculitides has been traditionally based on vessel size. The American College of Rheumatology (ACR) criteria were developed in the 1980s and published in 1990 before the development of ANCA testing and modern imaging techniques such as MRI and PET scanning, and therefore, these criteria are not fit for use in 2010s. The Chapel Hill Consensus Conference provided a framework for defining various types of vasculitis. In the next two years, new classification criteria will be published from the DCVAS study, which will provide a modern system for the classification of vasculitis for clinical studies...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526895/genetics-and-pathogenesis-of-small-vessel-vasculitis
#19
REVIEW
Alan D Salama
Small-vessel vasculitides are uncommon autoimmune diseases characterised by inflammation and necrosis of arterioles, capillaries and venules, frequently described as various (previously eponymous) clinical syndromes. Some are associated with vessel wall immune complex deposition, whereas others are pauci-immune but paradoxically often associated with circulating anti-neutrophil cytoplasmic antibodies (ANCA). Most is known about the pathogenesis of the pauci-immune ANCA-associated syndromes, which are gradually becoming better understood with regard to their genetic predisposition and the critical pathways mediating disease initiation, as well as their particular phenotypic features...
February 2018: Best Practice & Research. Clinical Rheumatology
https://read.qxmd.com/read/30526894/prognosis-and-future-developments-in-vasculitis
#20
REVIEW
N Basu, M Karabayas, C Pusey
The prognosis of ANCA-associated vasculitis has been transformed in recent years. Once it was a set of invariably acute and fatal conditions, but these disorders are currently considered to be chronic diseases. This change is largely attributable to earlier diagnosis and the careful application of immunotherapeutics. However, patients still experience premature mortality, relapse, comorbid ill health and poor quality of life. Mortality rates in large-vessel vasculitis are not comparable; however, morbidity and poor patient outcomes prevail...
February 2018: Best Practice & Research. Clinical Rheumatology
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