Asociación entre Artritis Reumatoidea y otras enfermedades autoinmunes / Association between Rheumatoid Arthritis and other autoimmune diseases

Objetivos: Determinar la frecuencia de enfermedades autoinmunes (EAI) en pacientes con Artritis Reumatoidea (AR) y comparar la frecuencia de EAI entre pacientes con AR y sin AR ni otra EAI reumatológica. Material y Métodos: Estudio multicéntrico, observacional, analítico, retrospectivo. Se incluyeron pacientes consecutivos con AR (ACR/EULAR 2010) y como grupo control pacientes con diagnóstico inicial de Osteoartritis primaria (OA). Resultados: Se incluyeron 1549 pacientes: 831 con AR (84% mujeres, edad media 55.2 años [DE 13.6]) y 718 con OA (82% mujeres, edad media 67 años [DE 11.1]). La frecuencia de EAI en el grupo AR fue del 22% (n=183). Estos presentaron mayor frecuencia de EAI reumatológicas (9.4 vs 3.3%, p< 0.001), y menor frecuencia de EAI no reumatológicas que aquellos con OA (15.3 vs 20.5, p=0.007). La EAI reumatológica más prevalente fue el Síndrome de Sjögren, el cual fue más frecuente en el grupo AR (87.2 vs 29.2%, p< 0,001). La frecuencia de EAI reumatológicas en los pacientes con AR fue mayor en la forma erosiva (11 vs 6.8%, p=0.048). Conclusión: La frecuencia de EAI en los pacientes con AR fue del 22%, en quienes predominaron las de etiología reumatológica mientras que, las no reumatológicas predominaron en pacientes con OA.

Objectives: To determine the frequency of autoimmune diseases (AID) in Rheumatoid Arthritis (RA) patients and to compare this frequency between patients with and without RA or other rheumatologic AID. Methods: Multicenter, observational, analytical, retrospective study. Consecutive patients with diagnosis of RA (ACR/EULAR 2010) were included. Patients with initial diagnosis of primary ostearthritis (OA) were used as control group. Results: A total of 1549 patients were included: 831 RA (84% women, mean age 55.2 [±13.6]) and 718 OA (82% women, mean age 67 [± 11.1]). The frequency of AID in the RA group was 22% (n=183). RA patients showed higher frequency of rheumatologic AID (9.4 vs 3.3%, p< 0.001), and lower frequency of non-rheumatologic AID than OA patients (15.3 vs 20.5%, p= 0.007). The most prevalent rheumatic AID was Sjögren's Syndrome, which was more frequent in the AR group (87.2 vs 29.2%, p<0.001). The frequency of rheumatologic AID in RA patients was higher in those with erosive RA (11 vs 6.8%, p=0.048). Conclusion: The frequency of AID in RA patients was 22%. Rheumatologic AID were more frequent in RA patients, whereas non-rheumatologic AID prevailed in OA patients.

Evaluation of the Educational Needs in Argentine Patients with Rheumatoid Arthritis Using the SpENAT Questionnaire. / Evaluación de las necesidades educacionales de los pacientes con artritis reumatoide mediante el cuestionario SpENAT.

BACKGROUND: The SpENAT, a Spanish version of the Educational Needs Assessment Tool, is a self-completed questionnaire that assesses educational needs (ENs) with the purpose of providing tailored and patient-centered information. It consists of 39 questions grouped into the 7 following domains: Pain management, Movement, Feelings, Arthritic process, Treatments, Self-help measures and Support system. OBJECTIVES: The objective of the study was to describe the ENs of rheumatoid arthritis (RA) patients using the SpENAT and to determine the main sources of information consulted by these patients. MATERIAL AND METHODS: Multicenter, observational, cross-sectional study. We included consecutive patients≥18 years with diagnosis of RA (ACR 87/ACR-EULAR 2010). Sociodemographic data, disease characteristics and clinimetric properties were recorded. All patients completed the SpENAT and were asked about the sources employed to obtain information about their disease. STATISTICAL ANALYSIS: Population characteristics were described. ENs were determined as percentages of the highest possible score for each domain. Needs for each domain according to sex, years of education, disease duration, use of biologicals and functional capacity were analyzed by means of ANOVA, and bivariate comparisons were made with Student's t-test and the Bonferroni correction. Correlation between domains was determined with the Spearman correlation coefficient. We compared patients' age by source of information with Student's t-test. RESULTS: We included 496 patients from 20 centers across the country. More ENs were observed in the domains of Movement, Feelings and the Arthritic process. Patients with higher educational level (>7 years) reported more ENs in the Arthritic process and Self-help measure domains. A higher functional impairment (HAQ-A≥0.87) was associated with more ENs in every domain. Patients with high activity showed more ENs than those in remission in the domains of Pain management, Movement, Feelings, Treatments and Support system, as well as those with low activity in Self-help measures and Support system domains. All SpENAT domains showed positive correlations among each other (P<.0001), the most important being Pain management/Movement and Treatments/Arthritic process (r≥0.7). The source of information most frequently consulted was the rheumatologist (93.95%); those who made use of Internet were on average younger (P=.0004). CONCLUSION: RA patients were very interested about knowing more about their disease. High functional impairment was associated with more ENs. Patients with high disease activity had higher EN levels in almost every domain. The rheumatologist was the main source of information for the patient with RA.

Taping en rizartrosis / Taping in rhizarthrosis

Introducción: La osteoartritis (OA) de manos es una de las patologías particulares más frecuentes en la consulta diaria. Una de las localizaciones de la OA comúnmente afectada es la articulación trapecio 1° metacarpiana (TPM), denominada rizartrosis, que puede traer, además del dolor, alteraciones funcionales. Respecto al tratamiento, guías nacionales e internacionales recomiendan el uso de ortesis y ejercicios. El taping o vendaje neuromuscular actúa sobre estímulos propioceptivos generando analgesia sin limitación de la movilidad articular. Objetivo: Evaluar los efectos de la aplicación de taping, comparado con el tratamiento ortésico convencional, en un programa de rehabilitación de rizartrosis. Material y métodos: Fueron incluidos pacientes de ambos sexos, mayores de 45 años con OA primaria que cumplían los criterios clínicos grado II-III de Eaton, y radiológicos grado 2-3 de Kellgren y Lawrence. Fueron divididos aleatoriamente en dos grupos, el GRUPO TAPING (GT) en donde se realizó un vendaje para la TPM y el GRUPO FÉRULA (GF) a quienes se les realizó una ortesis tipo Spica corta en termomoldeable. Todos iniciaron un programa de ejercicios específicos y fueron instruidos en principios de protección articular (PPA). Fueron evaluados al inicio y al mes del tratamiento: dolor (VAS), fuerza muscular (dinamómetro Jamar), habilidad y destreza (picking up test), capacidad funcional (Australian Canadian Osteoarthritis Hand Index: AUSCAN). Para el análisis estadístico se utilizó la prueba T Student, del programa Excel versión 2010.

Introduction: Osteoarthritis (OA) of hands is one of the most commonjoint diseases in daily practice. One of the locations of OA commonlyaffected is the trapezoid 1st metacarpal joint (TPM), namedrhizarthrosis, which may further pain bring functional alterations. Regarding treatment, national and international guidelines recommendbracing and exercises. The taping or neuromuscular bandageacts on proprioceptive stimuli generating analgesia without limitationof joint mobility.Objective: To evaluate the effects of applying taping compared withconventional orthotic treatment in a rehabilitation program of rhizarthrosis. Material and methods: We included patients of both sexes, olderthan 45 years with primary OA who met the clinical stage II- IIIof Eaton, and radiological grade 2-3 Kellgren and Lawrence. Theywere randomly divided into two groups: GROUP TAPING (GT) wherewas performed a bandage for TPM and GROUP SPLINT (GF) whounderwent into a thermomoldable Spica type orthosis. All began aprogram of specific exercises and were instructed in joint protectionprinciples (PPA). All were assessed at baseline and one monthafter treatment: pain (VAS), muscle strength (Jamar dynamometer), ability and skill (picking up test), functional capacity (Australian CanadianOsteoarthritis Hand Index: AUSCAN). For statistical analysiswas used the Student T test, from the Excel 2010 version.

Calcificación del ligamento transverso del atlas en condrocalcinosis / Chondrocalcinosis: calcification of the transverse ligament of the atlas

A fin de evaluar la frecuencia de calcificación del ligamento transverso del atlas en pacientes con condrocalcinosis y describir las características de dicha calcificación se estudiaron 8 pacientes con condrocalcinosis y 8 de un grupo control, con artrosis pero sin evidencia de condrocalcinosis, encontrando una elevada frecuencia de calcificación del ligamento transverso del atlas en condrocalcinosis, muchas veces asintomática, sin correlación con síntomas cervicales agudos