ABSTRACT
OBJECTIVES: To search for subclinical inflammatory joint disease in patients with psoriasis without psoriatic arthritis (PsA), and to determine whether such changes are associated with the later development of PsA. METHODS: Eighty-five subjects without arthritis (55 with psoriasis and 30 healthy controls) received high field MRI of the hand. MRI scans were scored for synovitis, osteitis, tenosynovitis and periarticular inflammation according to the PsAMRIS method. Patients with psoriasis additionally received complete clinical investigation, high-resolution peripheral quantitative CT for detecting erosions and enthesiophytes and were followed up for at least 1â year for the development of PsA. RESULTS: 47% of patients with psoriasis showed at least one inflammatory lesion on MRI. Synovitis was the most prevalent inflammatory lesion (38%), while osteitis (11%), tenosynovitis (4%) and periarticular inflammation (4%) were less frequent. The mean (±SD) PsAMRIS synovitis score was 3.0±2.5 units. Enthesiophytes and bone erosions were not different between patients with psoriasis with or without inflammatory MRI changes. The risk for developing PsA was as high as 60% if patients had subclinical synovitis and symptoms related to arthralgia, but only 13% if patients had normal MRIs and did not report arthralgia. CONCLUSIONS: Prevalence of subclinical inflammatory lesions is high in patients with cutaneous psoriasis. Arthralgia in conjunction with MRI synovitis constitutes a high-risk constellation for the development of PsA.
Subject(s)
Arthritis, Psoriatic/etiology , Arthritis/diagnostic imaging , Magnetic Resonance Imaging , Psoriasis/diagnostic imaging , Synovitis/diagnostic imaging , Adult , Arthralgia/complications , Arthralgia/diagnostic imaging , Arthritis/complications , Case-Control Studies , Cross-Sectional Studies , Female , Hand/diagnostic imaging , Humans , Longitudinal Studies , Male , Middle Aged , Psoriasis/complications , Risk Factors , Severity of Illness Index , Synovitis/complicationsABSTRACT
Este estudo objetiva refletir acerca da saúde mental da população brasileira durante a pandemia do coronavírus (SARS-CoV-2) por meio de uma revisão integrativa da literatura. Pondera-se sobre a saúde mental como uma questão de saúde pública em tempos de pandemia para além dos danos biológicos e sociais. Para tal, acessaram-se as bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) e Latin American and Caribbean Health Sciences Literature (LILACS) no período de 15 de julho a 15 de agosto de 2020 em busca de trabalhos produzidos no Brasil sobre o tópico. Foi identificado que os sentimentos mais presentes na população são de ansiedade, estresse, depressão e alteração no sono, ocasionados principalmente pelo medo de adoecer e morrer. Os grupos mais afetados por esses sentimentos são os profissionais de saúde que estão na linha de frente do combate ao coronavírus e pessoas com transtornos mentais preexistentes. Fatores como os condicionantes sociais, as fake news e o distanciamento social estão entre os maiores responsáveis pelo aumento desses sentimentos nas pessoas. Houve também alteração no comportamento da população no tocante ao aumento do consumo de bebidas alcoólicas. Concluiu-se a necessidade de uma maior assistência à saúde mental da população para que os impactos da pandemia não sejam tão duradouros quanto relatam os estudos levantados.
This study aims to reflect on the mental health of the Brazilian population during the coronavirus pandemic (SARS-CoV-2) by an integrative literature review. It ponders on mental health as a public health issue in a pandemic beyond the biological and social harm. To this end, we accessed databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences Literature (LILACS) between July 15 and August 15, 2020 searching for Brazilian works on the topic. We identified that the most common feelings in the population are anxiety, stress, depression, and altered sleep patterns, caused mainly by the fear of falling ill and dying. The groups most affected by these feelings are the health professionals who are at the forefront of the fight against the coronavirus and people with pre-existing mental disorders. Factors such as social determinants, fake news, and social distancing are among the main factors responsible for increasing these feelings in the people. The behavior of the population also changed regarding the increased consumption of alcoholic beverages. In conclusion, a greater care to the population's mental health is needed so that the pandemic's impacts are not as long-lasting as reported in the studies.
Este estudio tiene como objetivo reflexionar sobre la salud mental de la población brasileña durante la pandemia de coronavirus (SARS-CoV-2) desde una revisión integradora de la literatura. Se considera la salud mental como un problema de salud pública en tiempos de pandemia, además del daño biológico y social que provoca. Para ello, se hizo una búsqueda en las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) en el período entre el 15 de julio y el 15 de agosto de 2020 al respecto de trabajos producidos en Brasil acerca del tema. Se identificó que los sentimientos más comunes en la población fueron la ansiedad, el estrés, la depresión y la alteración de patrones del sueño, provocados principalmente por el miedo a enfermarse y morir. Los grupos más afectados por estos sentimientos fueron los profesionales de la salud que están en primera línea contra el coronavirus y las personas con trastornos mentales preexistentes. Entre los principales factores responsables del aumento de estos sentimientos en la población se destacan las limitaciones sociales, las noticias falsas y el distanciamiento social. También hubo un cambio en el comportamiento de la población con respecto al aumento en el consumo de bebidas alcohólicas. Se concluyó que es necesaria una mayor asistencia a la salud mental de la población para que los impactos de la pandemia no sean tan duraderos como se reportan en los estudios.