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the rheumatologist

Sang Jin Lee, Ju Hye Jeong, Chang-Hee Lee, Byeong-Cheol Ahn, Jung Su Eun, Na Ri Kim, Jong Whan Kang, Eon Jeong Nam, Young Mo Kang
OBJECTIVES: Clinical joint count assessment is important for detecting synovitis but its reliability is controversial. This study assessed the correlation of positron emission tomography (PET)-derived parameters in 68 joints with disease activity and compared the reliability of joint counts between PET/computed tomography (CT) and clinical assessment in rheumatoid arthritis (RA). METHODS: We enrolled 91 patients with active RA who underwent fluorine-18-fluorodeoxyglucose PET/CT and disease activity evaluation at the same time...
February 16, 2019: Arthritis & Rheumatology
Simon Krabbe, Iris Eshed, Frédérique Gandjbakhch, Susanne J Pedersen, Paul Bird, Ashish J Mathew, Robert G Lambert, Walter P Maksymowych, Daniel Glinatsi, Maria S Stoenoiu, René Poggenborg, Lennart Jans, Jacob L Jaremko, Nele Herregods, Violaine Foltz, Philip G Conaghan, Christian E Althoff, Joel Paschke, Charles Peterfy, Kay-Geert A Hermann, Mikkel Østergaard
OBJECTIVE: To develop a whole-body MRI-scoring system for peripheral arthritis and enthesitis. METHODS: After consensus on definitions/locations of MRI pathologies, four multi-reader exercises were performed. Eighty-three joints were scored 0-3 separately for synovitis and osteitis, thirty-three entheses 0-3 separately for soft tissue inflammation and osteitis. RESULTS: In the last exercise, reliability was moderate-good for musculoskeletal radiologists and rheumatologists with previously demonstrated good scoring proficiency...
February 15, 2019: Journal of Rheumatology
Tarimobo M Otobo, Philip G Conaghan, Walter P Maksymowych, Desiree van der Heijde, Pamela Weiss, Iwona Sudol-Szopinska, Nele Herregods, Jacob L Jaremko, Arthur B Meyers, Dax Rumsey, Emilio C Inarejos, Eva Kirkhus, Jennifer Stimec, Jyoti Panwar, Kevin Thorpe, Lennart Jans, M A J van Rossum, Mirkamal Tolend, Manuela Perez, Nikolay Tzaribachev, Pulukool Sandhya, Shirley Tse, Appenzeller Simone, Vimarsha G Swami, Zahi Touma, Robert Lambert, Andrea S Doria
OBJECTIVE: To develop definitions for the assessment of MRI pathologies of the sacroiliac joints (SIJ) in juvenile idiopathic arthritis (JIA). METHODS: An OMERACT consensus-driven methodology consisting of iterative surveys and focus group meetings within an international group of rheumatologists and radiologists. RESULTS: Two domains, inflammation and structural, were identified. Definitions for bone marrow edema, joint space inflammation, capsulitis and enthesitis were derived for joint inflammation; sclerosis, erosion, fatty lesion and ankylosis were defined for assessing structural joint changes...
February 15, 2019: Journal of Rheumatology
L Arkin, K Buhr, H Brandling-Bennett, Y Chiu, B Chong, M Curran, R Hunt, A S Paller, V Werth, M Klein-Gitelman, E von Scheven, K Ardalan
BACKGROUND: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care of children with DLE. OBJECTIVES: We compared practice patterns among pediatric dermatologists/rheumatologists treating pediatric DLE. METHODS: An online survey was sent to 292 pediatric rheumatologists in the Childhood Arthritis & Rheumatology Research Alliance (CARRA) and 200 pediatric dermatologists in the Pediatric Dermatology Research Alliance (PeDRA)...
February 15, 2019: British Journal of Dermatology
Zohra Layegh, Jill Ruwaard, Renske C F Hebing, Merel J L' Ami, Wilfred van der Weele, Mike T Nurmohamed, Charlotte Krieckaert, Gertjan Wolbink
OBJECTIVES: To evaluate the transition from reference infliximab Remicade to biosimilar Remsima in patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA). METHODS: Patients were informed through a letter about the transition to a biosimilar and were subsequently contacted for possible additional questions and whether they agreed upon the transition. Once agreed, Remsima was administered at the same dosage and interval as previous treatment with Remicade...
February 14, 2019: International Journal of Rheumatic Diseases
Daniel M Hartung, Kirbee Johnston, Atul Deodhar, Dennis N Bourdette, David M Cohen
Despite little evidence supporting its superiority to glucocorticoid therapy, use and expenditures for repository corticotropin (rACTH) injection (H.P. Acthar Gel; Mallinckrodt) have increased dramatically in the last 5 years, particularly among a small number of nephrologists, rheumatologists, and neurologists. Recently, the manufacturer justified the extremely high and rapidly increasing cost of rACTH by citing the ongoing need to generate clinical data to support its use. We test this assertion by investigating the quality and provenance of the evidence likely to emerge in the foreseeable future...
February 11, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Christoph M Schempp, Franziska Schauer, Christian K Huhn, Nils Venhoff, Stephanie Finzel
Syndromes associated with concurrent skin and joint inflammation frequently pose a therapeutic challenge for both dermatologists and rheumatologists. In part 1 of this review, we discussed psoriatic arthritis as well as the autoinflammatory disorders SAPHO syndrome, Still's disease and Behçet's disease. Part 2 will address rheumatoid arthritis, reactive arthritis, Reiter's syndrome and Lyme borreliosis. In addition, we will discuss dermatomyositis and lupus erythematosus, two common autoimmune disorders that frequently present with both cutaneous and joint involvement...
February 2019: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
M Weidenbusch, Y Bai, J Eder
'Refractory lupus nephritis' is a frequently used term but poorly defined. We conducted a survey among nephrologists and rheumatologists to spot the diversity of perceptions of this term and to better understand the clinical practice related to 'refractory lupus nephritis'. A total of 145 questionnaires completed by lupus nephritis experts were available for analysis, of which 52% were nephrologists, 34% rheumatologists, and 13% internists. Response to induction treatment was mostly assessed after six months (58%), but assessment at three months was more common with the use of the EURO lupus protocol than with other treatment protocols...
February 12, 2019: Lupus
Dmitry Karateev, Natalia Belokoneva
Physician awareness and perceptions towards biosimilars are important factors in their adoption to clinical practice. Our objectives were to assess levels of knowledge and attitudes towards biosimilars and key policies on their use among Russian physicians, define the level of interest in new information on biosimilars, and determine what evidence drives treatment decisions in Russia. Physicians with awareness of biologics across different specialties and regions of Russia completed an online survey. A Likert and other rating scales were used to collect opinions, which were summarized descriptively...
February 11, 2019: Biomolecules
Kundan Iqbal, Dennis W Lendrem, Ben Hargreaves, John D Isaacs, Ben Thompson, Arthur G Pratt
Objective: The diagnostic value added by musculoskeletal ultrasound (MSUS) over standard clinical and laboratory parameters has proved difficult to quantify. The additive contribution to diagnostic classification of a pragmatic, 15 min MSUS protocol was appraised in a large, unselected cohort of early arthritis clinic attendees. Methods: Detailed baseline characteristics were recorded. Semi-quantitative MSUS scoring of the most symptomatic wrist, second/third MCPs and PIPs and second/fifth MTPs was recorded, along with the sonographer's scan impression (definitely inflammatory, possibly inflammatory or non-inflammatory)...
February 8, 2019: Rheumatology
Heather M Greysen, Oi Saeng Hong, Patricia Katz
Mind-body exercises such as yoga offer patients with rheumatoid arthritis (RA) a symptom management strategy for improving physical and mental health. Studies have evaluated yoga to manage symptoms of RA and improve physical function; however, none has examined the relationship between yoga and work status in adults with RA. The objective was to describe differences in RA symptomatology, physical function scores, and work status between adults with RA who participate in yoga and those who do not. This cross-sectional study surveyed adults with rheumatologist-diagnosed RA regarding yoga use in the past year, symptoms, physical function, and work status...
March 2019: Holistic Nursing Practice
Florencia S Pierini, Marina Scolnik, Valeria Scaglioni, Florencia Mollerach, Enrique R Soriano
BACKGROUND/OBJECTIVE: Our objective was to estimate incidence and prevalence rates of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) using data from a university hospital-based health management organization (HIMCO) in Latin America. METHODS: Multiple methods for case finding were used to ensure complete ascertainment. GPA was diagnosed if fulfilling ACR 1990 criteria or a clinical diagnosis was made by an experienced rheumatologist. For MPA, a clinical diagnosis made by an experienced rheumatologist in concordance with Chapel Hill 2012 consensus...
February 11, 2019: Clinical Rheumatology
Devy Zisman, Aaida Samad, Stacy P Ardoin, Peter Chira, Patience White, Idit Lavi, Emily von Scheven, Erica F Lawson, Melinda Hing, Elizabeth D Mellins
OBJECTIVE: To assess the attitudes and common practices of adult rheumatologists in the United States regarding health care transition (HCT) for young adults with rheumatic diseases. METHODS: An anonymous online survey was sent to U.S. adult rheumatologist members of the American College of Rheumatology to collect demographic data and information on attitudes and common practices regarding the transition process. RESULTS: Of 4,064 contacted rheumatologists, 203 (5%) completed the survey...
February 11, 2019: Arthritis Care & Research
Megan L Curran, Emma E Martin, Erin C Thomas, Rashmi Singh, Saima Armana, Asnia Kauser, Eesha A Zaheer, David D Sherry
BACKGROUND: Of 37 pediatric rheumatology fellowship training programs in the United States, many have three or fewer fellows at a given time, making large-scale assessment of fellow performance difficult. An objective structured clinical examination (OSCE) is a scenario-based simulation method that assesses individual performance, thus indirectly measuring training program effectiveness. This study describes the development and implementation of two national pediatric rheumatology OSCEs and methods used for programmatic improvement...
February 8, 2019: Pediatric Rheumatology Online Journal
G Koller, S Katz, T L Charrois, C Ye
Glucocorticoid-induced osteoporosis (GIOP) is common in patients prescribed with long-term glucocorticoids. Guidelines suggest patients receiving moderate-dose glucocorticoid therapy receive GIOP preventive care. Previous studies have shown preventive care rates are not optimal. We look at GIOP preventive care rates in rheumatology patients and predictors of various components of care. PURPOSE: Glucocorticoid-induced osteoporosis (GIOP) is a common concern in patients prescribed with long-term glucocorticoids...
February 5, 2019: Archives of Osteoporosis
J L Horsley-Silva, S B Umar, M F Vela, W L Griffing, J M Parish, J K DiBaise, M D Crowell
Systemic scleroderma/sclerosis (SSc) is an autoimmune connective tissue disease, which can lead to esophageal motor dysfunction and gastroesophageal reflux disease (GERD). Nocturnal GERD symptoms may be associated with sleep disturbances, which in turn can drastically affect well-being and fatigue levels. We hypothesized that GERD symptoms would be associated with poorer sleep in patients with SSc.Rheumatologist established SSc patients completed the following questionnaires: the UCLA scleroderma clinical trial consortium gastrointestinal tract instrument (GIT) 2...
January 31, 2019: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Tomohiro Koga, Atsushi Kawakami
Autoinflammatory diseases are characterized by recurrent systemic inflammation due to dysfunction of the innate immune system, and they are originally the hereditary recurrent fever syndromes that develop in early childhood. Many cases are thus diagnosed in the pediatric field, but there are many cases that are not diagnosed until adulthood, including adult-onset cases. Accordingly, not only pediatricians but also rheumatologists and primary care physicians play a major role in the diagnosis and treatment of autoinflammatory diseases...
February 3, 2019: Immunological medicine
Rafael Cáliz Cáliz, Petra Díaz Del Campo Fontecha, María Galindo Izquierdo, Francisco Javier López Longo, María Ángeles Martínez Zamora, Amparo Santamaría Ortiz, Olga Amengual Pliego, María José Cuadrado Lozano, María Paloma Delgado Beltrán, Loreto Carmona González, Evelin Cecilia Cervantes Pérez, Gisela Díaz-Cordovés Rego, Sandra Garrote Corral, Clara Fuego Varela, María Martín López, Betina Nishishinya, Marta Novella Navarro, Claudia Pereda Testa, Hiurma Sánchez Pérez, Lucia Silva-Fernández, Víctor Manuel Martínez Taboada
OBJECTIVE: The difficulty in diagnosis and the spectrum of clinical manifestations that can determine the choice of treatment for primary antiphospholipid syndrome (APS) has fostered the development of recommendations by the Spanish Society of Rheumatology (SER), based on the best possible evidence. These recommendations can serve as a reference for rheumatologists and other specialists involved in the management of APS. METHODS: A panel of four rheumatologists, a gynaecologist and a haematologist with expertise in APS was created, previously selected by the SER through an open call or based on professional merits...
January 31, 2019: Reumatología Clinica
A Teeple, L A Ellis, L Huff, C Reynolds, S Ginsburg, L Howard, D Walls, J R Curtis
OBJECTIVE: This study was designed to understand the level of familiarity of US rheumatologists, gastroenterologists and dermatologists with biosimilar therapies, their experience with non-medical switching (switching medications for reasons unrelated to patient health) of patients between biologics and their attitudes towards switching from a biologic to a biosimilar. METHODS: A total of 297 US physicians who currently prescribe biologics for their patients completed a 15-minute online survey...
February 4, 2019: Current Medical Research and Opinion
Gaëlle Clavel, Eric Gabison, Luca Semerrano
Corneal and scleral disorders related to inflammatory rheumatic diseases vary both in frequency and in severity. Sicca syndrome and its complications are the most common ocular manifestations and, together with episcleritis, can usually be managed by topical treatments. In contrast, the various forms of scleritis and peripheral ulcerative keratitis generally require systemic glucocorticoid therapy and the initiation or intensification of immunosuppressive treatment. Corneal and scleral manifestations are inaugural in a few patients with chronic inflammatory rheumatic disease...
January 31, 2019: Joint, Bone, Spine: Revue du Rhumatisme
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