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1.
Semin Musculoskelet Radiol ; 28(3): 225-247, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38768589

RESUMEN

Numerous anatomical variants are described around the knee, many of which look like bony lesions, so it is important to know them to avoid unnecessary complementary tests and inadequate management. Likewise, several alterations in relation to normal development can also simulate bone lesions.However, numerous pathologic processes frequently affect the knee, including traumatic, inflammatory, infectious, and tumor pathology. Many of these entities show typical radiologic features that facilitate their diagnosis. In other cases, a correct differential diagnosis is necessary for proper clinical management.Despite the availability of increasingly advanced imaging techniques, plain radiography is still the technique of choice in the initial study of many of these pathologies. This article reviews the radiologic characteristics of tumor and nontumor lesions that may appear around the knee to make a correct diagnosis and avoid unnecessary complementary radiologic examinations and inadequate clinical management.


Asunto(s)
Enfermedades Óseas , Neoplasias Óseas , Humanos , Neoplasias Óseas/diagnóstico por imagen , Diagnóstico Diferencial , Enfermedades Óseas/diagnóstico por imagen , Articulación de la Rodilla/diagnóstico por imagen , Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos
2.
Ultraschall Med ; 43(3): 252-273, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34734404

RESUMEN

The second part of the Guidelines and Recommendations for Musculoskeletal Ultrasound (MSUS), produced under the auspices of EFSUMB, following the same methodology as for Part 1, provides information and recommendations on the use of this imaging modality for joint pathology, pediatric applications, and musculoskeletal ultrasound-guided procedures. Clinical application, practical points, limitations, and artifacts are described and discussed for every joint or procedure. The document is intended to guide clinical users in their daily practice.


Asunto(s)
Artefactos , Niño , Humanos , Ultrasonografía
3.
Ultraschall Med ; 43(1): 34-57, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34479372

RESUMEN

The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice.


Asunto(s)
Artefactos , Sociedades Médicas , Medicina Basada en la Evidencia , Humanos , Ultrasonografía
4.
Reumatol. clín. (Barc.) ; 17(5): 284-289, May. 2021. graf
Artículo en Español | IBECS | ID: ibc-211932

RESUMEN

La ecografía es una técnica de amplia implantación en reumatología que implica una gran interacción entre paciente y profesional. La pandemia COVID-19 hace necesario un cambio en nuestra práctica clínica, mediante estrategias que permitan la asistencia integral de nuestros pacientes, garantizando la seguridad tanto de los pacientes como de los profesionales sanitarios. Objetivo: Desarrollar unas recomendaciones prácticas, consensuadas entre un panel de expertos, sobre el uso y seguridad de la ecografía reumatológica durante la pandemia COVID-19. Métodos: Analizando la literatura disponible se realizaron unas recomendaciones preliminares, posteriormente consensuadas con un panel de expertos mediante el método Delphi con una escala Likert 1-5. Resultados: Se elaboraron y consensuaron por el panel 5 principios fundamentales y 28 recomendaciones. El consenso del grupo se logró en el 100% de ítems (acuerdo para cada recomendación ≥4 en escala de Likert del 75% de componentes del panel). Conclusiones: El documento proporciona información de utilidad acerca de medidas preventivas en la práctica de ecografía en reumatología en tiempos de pandemia COVID-19 de acuerdo a la experiencia y literatura disponible hasta el momento.(AU)


Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. Objetive: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. Methods: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. Results:5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. Conclusions: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.(AU)


Asunto(s)
Humanos , Infecciones por Coronavirus , Pandemias , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Ultrasonografía , Diagnóstico por Imagen , Reumatología , Enfermedades Reumáticas
5.
Reumatol Clin (Engl Ed) ; 17(5): 284-289, 2021 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33376052

RESUMEN

Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. OBJETIVE: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. METHODS: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. RESULTS: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. CONCLUSIONS: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.


Asunto(s)
COVID-19/prevención & control , Control de Infecciones/normas , Pandemias , Reumatología/métodos , Ultrasonografía , COVID-19/transmisión , Desinfección/métodos , Desinfección/normas , Contaminación de Equipos/prevención & control , Geles , Humanos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Angioscopía Microscópica/instrumentación , Angioscopía Microscópica/métodos , Aceites , Equipo de Protección Personal , Enfermedades Reumáticas/diagnóstico por imagen , SARS-CoV-2 , Ultrasonografía/instrumentación , Ultrasonografía/métodos
6.
Reumatol Clin ; 17(5): 284-289, 2021 May.
Artículo en Español | MEDLINE | ID: mdl-38620742

RESUMEN

Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. Objetive: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. Methods: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. Results: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. Conclusions: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.

7.
Reumatol. clín. (Barc.) ; 17: 0-0, 2021. tab
Artículo en Español | IBECS | ID: ibc-196564

RESUMEN

La ecografía es una técnica de amplia implantación en reumatología que implica una gran interacción entre paciente y profesional. La pandemia COVID-19 hace necesario un cambio en nuestra práctica clínica, mediante estrategias que permitan la asistencia integral de nuestros pacientes, garantizando la seguridad tanto de los pacientes como de los profesionales sanitarios. OBJETIVO: Desarrollar unas recomendaciones prácticas, consensuadas entre un panel de expertos, sobre el uso y seguridad de la ecografía reumatológica durante la pandemia COVID-19. MÉTODOS: Analizando la literatura disponible se realizaron unas recomendaciones preliminares, posteriormente consensuadas con un panel de expertos mediante el método Delphi con una escala Likert 1-5. RESULTADOS: Se elaboraron y consensuaron por el panel 5 principios fundamentales y 28 recomendaciones. El consenso del grupo se logró en el 100% de ítems (acuerdo para cada recomendación ≥4 en escala de Likert del 75% de componentes del panel). CONCLUSIONES: El documento proporciona información de utilidad acerca de medidas preventivas en la práctica de ecografía en reumatología en tiempos de pandemia COVID-19 de acuerdo a la experiencia y literatura disponible hasta el momento


Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. OBJECTIVE: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. METHODS: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. RESULTS: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. CONCLUSIONS: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date


Asunto(s)
Humanos , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Pandemias , Sociedades Médicas , Enfermedades Reumáticas/diagnóstico por imagen , Ultrasonografía/normas , España
8.
Rheumatol Int ; 39(12): 2119-2127, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31535169

RESUMEN

The objective of our study was to standardize magnetic resonance imaging (MRI) assessment of spine and sacroiliac joints in patients with axial spondyloarthritis (axSpA) and/or inflammatory spinal pain, by creating checklists and templates based on the opinions of rheumatologists and radiologists. A scientific committee developed a series of questionnaires with multiple items regarding MRI in patients with axial inflammatory pain and/or axSpA. Then an expert panel of rheumatologists and radiologists rated all items in a 9-point Likert scale. Finally, the scientific committee and the expert panel met to create the definitive documents. Several definitive checklists and templates were generated for rheumatologist-requested MRI and for radiologist-requested MRI reports of sacroiliac joint and spinal examinations. A technical requirement protocol was also agreed on. Our results could be useful in increasing understanding between rheumatologists and radiologists regarding MRI in axSpA diagnosis and follow-up.


Asunto(s)
Lista de Verificación , Imagen por Resonancia Magnética , Articulación Sacroiliaca/diagnóstico por imagen , Columna Vertebral/diagnóstico por imagen , Espondiloartritis/diagnóstico por imagen , Humanos , Sacroileítis/diagnóstico por imagen , Encuestas y Cuestionarios
9.
Rheumatol Int ; 38(10): 1919-1926, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30022300

RESUMEN

To develop a semi-automated method to quantify inflammation in sacroiliac (SI) joints by measuring bone marrow edema (BME) on MRI. The SCAISS was designed as an image-processing software. Validation followed: (1) three readers evaluated SI images of 23 patients with axial SpA and various levels of BME severity with the SCAISS, and two non-automated methods, SPARCC and Berlin; (2) 20 readers evaluated 12 patients images, also with the three methods; (3) 203 readers evaluated 12 patient images with the Berlin and the SCAISS. Convergent validity, reliability and feasibility were estimated in the first two steps and reliability was confirmed with the third. The interobserver reliability (ICC and 95% CI) in the three observers' study was similar across methods: SCAISS = 0.770 (0.580-0.889); Berlin = 0.725 (0.537-0.860); and SPARCC = 0.824 (0.671-0.916). In the 20 observers' study, ICC was: SCAISS = 0.801 (0.653-0.927); Berlin = 0.702 (0.518-0.882); and SPARCC = 0.790 (0.623-0.923). In the 203 observers' study, ICC were: SCAISS = 0.810 (0.675-0.930), and Berlin = 0.636 (0.458-0.843). SCAISS showed good convergent validity (r with SPARCC = 0.760). Median time (interquartile range) employed in the reading procedure was 28 (27) seconds for the SCAISS, 14 (9) for the Berlin score, and 94 (68) for the SPARCC. The SCAISS permits a valid, reliable, and fast calculation of overall BME lesion at the SI joint on MRI images not dependent on readers' experience.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Sacroileítis/diagnóstico por imagen , Espondiloartritis/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética/normas , Espectroscopía de Resonancia Magnética , Reproducibilidad de los Resultados , Articulación Sacroiliaca/diagnóstico por imagen
10.
Rev. esp. quimioter ; 31(2): 131-135, abr. 2018. tab
Artículo en Español | IBECS | ID: ibc-174508

RESUMEN

Introducción. El objetivo del estudio fue conocer los datos relativos al diagnóstico microbiológico de la tuberculosis en la provincia de Soria, así como analizar la rentabilidad diagnóstica de las técnicas utilizadas y la utilización del laboratorio de microbiología en lo que concierne a la tuberculosis. Métodos. Se diseñó un estudio observacional, descriptivo y retrospectivo, incluyendo todos los pacientes con tuberculosis de cualquier localización que tuviesen su residencia en la provincia de Soria. El periodo de estudio abarcó los casos diagnosticados entre 1994 y 2013 realizando seguimiento durante 24 meses tras el inicio del tratamiento. Resultados. Se detectaron 337 pacientes durante el periodo estudiado. En más del 3% de los pacientes no se envió ninguna muestra al laboratorio de microbiología, porcentaje que ascendió al 23% en tuberculosis osteoarticulares y 33% en tuberculosis linfáticas. Se obtuvo confirmación microbiológica en el 80% y la baciloscopia fue positiva en el 32%. Las muestras se sembraron en medios sólidos y líquidos; el 10% de las cepas sólo se aislaron en un tipo de medio. El porcentaje de cepas resistentes a isoniazida fue de 2,9%, se detectó una cepa multirresistente (0,3%) y una cepa con resistencia únicamente a rifampicina (0,3%). De todos los pacientes bacilíferos con seguimiento, no se envió ninguna muestra para estudiar la negativización en el 36%. Conclusión. Destaca la necesidad de mantener el cultivo combinado en medios líquidos y sólidos. Es necesario potenciar el uso del laboratorio de microbiología, enviando todas las posibles muestras diagnósticas y realizando controles bacteriológicos de seguimiento para objetivar la curación


Introduction. The aim of the study was to describe the bacteriological diagnosis of the tuberculosis in the province of Soria (Spain), as well as to analyse the techniques diagnostic performance and the use of the microbiology laboratory regarding tuberculosis. Methods. An observational, descriptive and retrospective study was designed, including all patients with tuberculosis of any location that had their residence in the province of Soria. The period of study included patients diagnosed between 1994 and 2013 and a 24 months follow-up after the beginning of treatment was realized. Results. A total of 337 patients were detected during the studied period. No sample was sent to the microbiology laboratory in more than 3% of the patients (23% in skeletal tuberculosis and 33% in lymphatic tuberculosis). Bacteriological confirmation was obtained in 80% and 32% were smear-positive. Specimens were culture on solid and in liquid media; 10% of the strains were only isolated in one type of media. There were 2.9% isoniazid-resistant strains, 0.3% multi-drug resistant strains, and 0.3% rifampicin-resistant strains. A total of 36% of smear-positive pulmonary tuberculosis patients had no specimens sent for a follow-up study. Conclusion. It is essential to combine the use of a liquid and a solid medium. Physicians should be encouraged to submit specimens for mycobacteriological diagnostic and follow-up


Asunto(s)
Humanos , Estudio Observacional , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Tuberculosis/microbiología , Tuberculosis Pulmonar/tratamiento farmacológico , Antituberculosos/farmacología , Antituberculosos/uso terapéutico , Medios de Cultivo , Farmacorresistencia Bacteriana , Estudios de Seguimiento , Mycobacterium tuberculosis , Mycobacterium tuberculosis/aislamiento & purificación , Estudios Retrospectivos , Pruebas de Sensibilidad Microbiana , España/epidemiología
11.
Reumatol. clín. (Barc.) ; 14(1): 9-19, ene.-feb. 2018. tab
Artículo en Español | IBECS | ID: ibc-170367

RESUMEN

Objetivo. Establecer recomendaciones, basadas en la evidencia, sobre el uso de la ecografía (US) y la resonancia magnética (RM) en pacientes con artritis reumatoide (AR). Métodos. Las recomendaciones se consensuaron mediante metodología basada en grupos nominales. Un grupo de expertos (15 reumatólogos y 3 radiólogos) definió el alcance, usuarios, apartados del documento, posibles recomendaciones, revisiones sistemáticas a realizar (se utilizaron y actualizaron las revisiones de documentos de consenso previos de EULAR), y de la asignación de tareas. Los expertos delimitaron los apartados y redactaron las recomendaciones. El nivel de evidencia y grado de recomendación se realizó utilizando el sistema del Center for Evidence Based Medicine de Oxford. El grado de acuerdo se estableció mediante un Delphi a 2 rondas. Las recomendaciones se votaron según una escala de 1 (total desacuerdo) a 10 (total acuerdo), definiéndose el acuerdo como una puntuación ≥ 7 por al menos el 70% de los participantes. El documento completo fue revisado por los expertos y el proyecto coordinado por un metodólogo experto. Resultados. Se emitieron 20 recomendaciones que cubren: la validez de la US y RM para la detección de actividad y daño estructural, capacidad diagnóstica, predictora (de progresión de daño estructural, de brote de la enfermedad, respuesta al tratamiento, etc.), utilidad en la evaluación y monitorización de estos pacientes que están en tratamiento, y uso de la US como guía (para infiltraciones o biopsias). Conclusiones. Se presentan recomendaciones útiles para el manejo de la US y RM por los clínicos en pacientes con AR (AU)


Objective. To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA). Methods. Recommendations were generated following a nominal group technique. A panel of experts, consisting of 15 rheumatologists and 3 radiologists, was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of experts voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist. Results. A total of 20 recommendations were proposed. They include the validity of US and MRI regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies. Conclusions. These recommendations will help clinicians use US and MRI in RA patients (AU)


Asunto(s)
Humanos , Artritis Reumatoide/diagnóstico por imagen , Ultrasonografía , Imagen por Resonancia Magnética , Pautas de la Práctica en Medicina/tendencias , Revisión por Pares/métodos
12.
Reumatol. clín. (Barc.) ; 14(1): 27-35, ene.-feb. 2018. tab
Artículo en Español | IBECS | ID: ibc-170369

RESUMEN

Objetivo. Establecer recomendaciones, basadas en la evidencia, sobre el uso de la ecografía (US) y la resonancia magnética en pacientes con espondiloartritis, incluyendo la artritis psoriásica, y en la artritis idiopática juvenil. Métodos. Las recomendaciones se consensuaron mediante metodología basada en grupos nominales. Un grupo de expertos (15 reumatólogos y 3 radiólogos) definió el alcance, los usuarios, los apartados, las posibles recomendaciones y las revisiones sistemáticas a realizar (se utilizaron y actualizaron las revisiones de documentos de consenso de EULAR), y se asignaron tareas. Los expertos delimitaron los apartados y redactaron las recomendaciones. El nivel de evidencia y el grado de recomendación se establecieron utilizando el sistema del Centre for Evidence Based Medicine de Oxford, y el grado de acuerdo mediante Delphi a 2 rondas. Las recomendaciones se votaron según una escala de 1 (total desacuerdo) a 10 (total acuerdo), definiéndose el acuerdo como una puntuación≥7 por al menos el 70% de los participantes. El documento fue revisado por los expertos y el proyecto estuvo coordinado por un metodólogo experto. Resultados. Se emitieron 12 recomendaciones sobre la validez de la US y la resonancia magnética para la detección de actividad y daño estructural, capacidad diagnóstica, predictora (de progresión de daño estructural, brote de la enfermedad, respuesta al tratamiento, etc.), utilidad en la evaluación y monitorización del tratamiento, y uso de la US como guía (para infiltraciones, biopsias, etc.) en pacientes con espondiloartritis y artritis idiopática juvenil. Conclusiones. Se presentan unas recomendaciones útiles para el manejo de la US y la resonancia magnética por los clínicos en pacientes con espondiloartritis y artritis idiopática juvenil (AU)


Objective. To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging in patients with spondyloarthritis, including psoriatic arthritis, and juvenile idiopathic arthritis. Methods. Recommendations were generated following a nominal group technique. A panel of experts (15 rheumatologists and 3 radiologists) was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of participants voted≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence Based Medicine levels of evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist. Results. A total of 12 recommendations were proposed for each disease. They include, along with explanations of the validity of US and magnetic resonance imaging regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies. Conclusions. These recommendations will help clinicians use US and magnetic resonance imaging in patients with spondyloarthritis and juvenile idiopathic arthritis (AU)


Asunto(s)
Humanos , Espondiloartritis/diagnóstico por imagen , Artritis Juvenil/diagnóstico por imagen , Artritis Psoriásica/diagnóstico por imagen , Pautas de la Práctica en Medicina , Ultrasonografía/métodos , Espectroscopía de Resonancia Magnética/métodos , Práctica Clínica Basada en la Evidencia/métodos
14.
Reumatol Clin (Engl Ed) ; 14(1): 9-19, 2018.
Artículo en Inglés, Español | MEDLINE | ID: mdl-28029551

RESUMEN

OBJECTIVE: To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA). METHODS: Recommendations were generated following a nominal group technique. A panel of experts, consisting of 15 rheumatologists and 3 radiologists, was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of experts voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist. RESULTS: A total of 20 recommendations were proposed. They include the validity of US and MRI regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies. CONCLUSIONS: These recommendations will help clinicians use US and MRI in RA patients.


Asunto(s)
Artritis Reumatoide/diagnóstico por imagen , Imagen por Resonancia Magnética , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Técnica Delphi , Monitoreo de Drogas , Medicina Basada en la Evidencia , Humanos , Ultrasonografía
15.
Reumatol Clin (Engl Ed) ; 14(1): 27-35, 2018.
Artículo en Inglés, Español | MEDLINE | ID: mdl-28277255

RESUMEN

OBJECTIVE: To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging in patients with spondyloarthritis, including psoriatic arthritis, and juvenile idiopathic arthritis. METHODS: Recommendations were generated following a nominal group technique. A panel of experts (15 rheumatologists and 3 radiologists) was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of participants voted≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence Based Medicine levels of evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist. RESULTS: A total of 12 recommendations were proposed for each disease. They include, along with explanations of the validity of US and magnetic resonance imaging regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies. CONCLUSIONS: These recommendations will help clinicians use US and magnetic resonance imaging in patients with spondyloarthritis and juvenile idiopathic arthritis.


Asunto(s)
Artritis Juvenil/diagnóstico por imagen , Artritis Psoriásica/diagnóstico por imagen , Imagen por Resonancia Magnética , Espondiloartritis/diagnóstico por imagen , Humanos , Ultrasonografía
20.
Salud(i)ciencia (Impresa) ; 20(7): 726-729, Ago.2014. tab, graf
Artículo en Español | LILACS | ID: lil-796503

RESUMEN

La obesidad es un problema serio de salud en la población general, más importante aún entre las personas con enfermedad mental, en las que es frecuente la aparición de síndrome metabólico, propiciado por los malos hábitos de salud y el tratamiento con antipsicóticos. Por ello, en el Hospital de Día Psiquiátrico para pacientes con trastorno mental grave se puso en marcha un programa psicoeducativo acerca de la enfermedad, nutrición, hábitos de vida saludables y ejercicio físico, con componentes cognitivos yconductuales con modificación de conducta a través del modelado. La valoración de los pacientes del programa ha sido positiva, con cambios saludables del estilo de vida y conciencia en la necesidad decuidado personal. Además, se han encontrado resultados positivos, con pérdida de peso de 2.37 kg± 6.86 kg de promedio en el grupo que tenía inicialmente sobrepeso u obesidad (el 64% de la poblaciónde 50 pacientes), sobre todo entre las mujeres (34% de la población). El programa resulta eficaz para el control de la obesidad y la disminución de riesgo de aparición de síndrome metabólico, aunque dado el diseño del estudio no se puede discernir cuáles son los componentes del programa que son eficaces...


Asunto(s)
Humanos , Esquizofrenia , Hospitales Psiquiátricos , Obesidad , Antipsicóticos , Hábitos , Conducta Alimentaria , Prevención Primaria
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