Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.437
Filtrar
2.
Rheumatol Int ; 40(6): 991-995, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32314010

RESUMEN

In December 2019, numerous coronavirus disease 2019 (COVID-19) cases were reported in Wuhan, China, which has since spread throughout the world. However, its impact on rheumatoid arthritis (RA) patients is unknown. Herein, we report a case of COVID-19 pneumonia in a 61-year-old female RA patient who was receiving conventional disease-modifying antirheumatic drugs (cDMARDs). The patient presented with a 4-day history of myalgia and febrile sensation. COVID-19 was confirmed by real-time polymerase chain reaction (PCR). Chest X-ray showed increased opacity on the right lower lung area, and C-reactive protein level was slightly elevated. The patient was treated with antiviral agents (lopinavir/ritonavir), and treatment with cDMARDs was discontinued except hydroxychloroquine. Her symptoms and laboratory results gradually improved. Three weeks later, real-time PCR for COVID-19 showed negative conversion, and the patient was discharged without any complications.


Asunto(s)
Artritis Reumatoide/inmunología , Infecciones por Coronavirus/tratamiento farmacológico , Lopinavir/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Ritonavir/uso terapéutico , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/virología , China , Infecciones por Coronavirus/complicaciones , Combinación de Medicamentos , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Huésped Inmunocomprometido , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Reacción en Cadena en Tiempo Real de la Polimerasa , Resultado del Tratamiento
3.
Medicine (Baltimore) ; 99(14): e19658, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32243398

RESUMEN

BACKGROUND: Through this analysis, we aimed to systematically compare the cardiovascular outcomes observed in patients with co-existing coronary artery disease (CAD) and rheumatoid arthritis (RA). METHODS: Mendeley, Web of Science (WOS), MEDLINE, Cochrane central, EMBASE, Google scholar, and http://www.ClinicalTrials.gov were searched for English-based publications on CAD and RA. Selective cardiovascular outcomes were the endpoints in this analysis. The statistical software RevMan 5.3 was used for data assessment. Risk ratios (RR) with 95% confidence intervals (CI) were used to represent each subgroup analysis. RESULTS: One thousand four hundred forty six (1446) participants had co-existing CAD and RA whereas 205,575 participants were in the control group (only CAD without RA). This current analysis showed that the risk of asymptomatic or stable angina was similar in CAD patients with versus without RA (RR: 0.98, 95% CI: 0.84 - 1.14; P = .78). However, all-cause mortality (RR: 1.47, 95% CI: 1.34 - 1.61; P = 0.00001), cardiac death (RR: 1.51, 95% CI: 1.05 - 2.17; P = .03) and congestive heart failure (RR: 1.41, 95% CI: 1.27 - 1.56; P = .00001) were significantly higher in CAD patients with RA. However, multi-vessel disease (RR: 2.03, 95% CI: 0.57 - 7.26; P = .28), positive stress test (RR: 1.69, 95% CI: 0.70 - 4.08; P = .24), and ischemic events (RR: 1.18, 95% CI: 0.81 - 1.71; P = .40) were similar in both groups. The risk for myocardial infarction, repeated revascularization, and the probability of patients undergoing percutaneous coronary intervention (PCI) (RR: 1.20, 95% CI: 0.75 - 1.93; P = .45) were also similar in CAD patients with versus without RA. When we considered outcomes only in those patients who underwent revascularization by PCI, all-cause mortality (RR: 1.43, 95% CI: 1.29 - 1.60; P = .00001) was still significantly higher in CAD patients with RA. CONCLUSIONS: This analysis showed a significantly higher mortality risk in CAD patients with RA when compared to the control group. Congestive heart failure also significantly manifested more in CAD patients with co-existing RA. However, the risks all the other cardiovascular outcomes were similar in both groups. Nevertheless, due to the several limitations of this analysis, this hypothesis should be confirmed in forthcoming trials based on larger numbers of CAD patients with co-existing RA.


Asunto(s)
Artritis Reumatoide/mortalidad , Enfermedades Cardiovasculares/mortalidad , Enfermedad de la Arteria Coronaria/mortalidad , Anciano , Artritis Reumatoide/complicaciones , Enfermedades Cardiovasculares/etiología , Enfermedad de la Arteria Coronaria/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
4.
Medicine (Baltimore) ; 99(15): e19850, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32282749

RESUMEN

RATIONALE: Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a serious complication in patients treated using methotrexate. It occasionally develops in extra-nodal sites, but rarely in the central nervous system (CNS) or in 2 different sites at the same time. We present the rare case of a patient with rheumatoid arthritis who developed lymphoma in the CNS and stomach during MTX therapy. PATIENT CONCERNS: A 75-year-old Japanese man with rheumatoid arthritis who received methotrexate was admitted to our hospital because of gait ataxia and anorexia. DIAGNOSES: Imaging findings and biopsy led to a diagnosis of 2 different types of MTX-LPD in the central nervous system and stomach. INTERVENTIONS: The lesion in his stomach improved after methotrexate withdrawal, whereas the cerebellar mass required high-dose methotrexate and rituximab therapy. OUTCOMES: Complete remission has been maintained for the 2 years following the initiation of chemotherapy. LESSONS: In patients with RA who receive MTX and develop new neurological symptoms, CNS lymphoma as an MTX-LPD may be considered as a differential diagnosis.


Asunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Artritis Reumatoide/complicaciones , Neoplasias del Sistema Nervioso Central/patología , Linfoma/inducido químicamente , Metotrexato/efectos adversos , Anciano , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/diagnóstico por imagen , Diagnóstico Diferencial , Endoscopía del Sistema Digestivo/métodos , Femenino , Ataxia de la Marcha/diagnóstico , Ataxia de la Marcha/etiología , Humanos , Linfoma/diagnóstico , Linfoma/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Rituximab/uso terapéutico , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Resultado del Tratamiento
5.
Autoimmun Rev ; 19(5): 102523, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32205186

RESUMEN

The outbreak of the new coronavirus infections COVID-19 in December 2019 in China has quickly become a global health emergency. Given the lack of specific anti-viral therapies, the current management of severe acute respiratory syndrome coronaviruses (SARS-CoV-2) is mainly supportive, even though several compounds are now under investigation for the treatment of this life-threatening disease. COVID-19 pandemic is certainly conditioning the treatment strategy of a complex disorder as rheumatoid arthritis (RA), whose infectious risk is increased compared to the general population because of an overall impairment of immune system typical of autoimmune diseases combined with the iatrogenic effect generated by corticosteroids and immunosuppressive drugs. However, the increasing knowledge about the pathophysiology of SARS-CoV-2 infection is leading to consider some anti-rheumatic drugs as potential treatment options for the management of COVID-19. In this review we will critically analyse the evidences on either positive or negative effect of drugs commonly used to treat RA in this particular scenario, in order to optimize the current approach to RA patients.


Asunto(s)
Antirreumáticos/uso terapéutico , Artritis Reumatoide/inmunología , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Huésped Inmunocomprometido , Neumonía Viral/tratamiento farmacológico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/virología , China , Infecciones por Coronavirus/complicaciones , Humanos , Pandemias , Neumonía Viral/complicaciones
6.
BMJ ; 368: m512, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32144210

RESUMEN

The studyHewlett S, Almeida C, Ambler N, et al. Reducing arthritis fatigue impact: two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT). Ann Rheum Dis 2019;78:465-72.Hewlett S, Almeida C, Ambler N, et al. Group cognitive behavioural programme to reduce the impact of rheumatoid arthritis fatigue: the RAFT RCT with economic and qualitative evaluations. Health Technol Assess 2019;23:57.This project was funded by the NIHR Health Technology Assessment Programme (project number 11/112/01).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000860/group-cognitive-behavioural-courses-may-reduce-fatigue-from-rheumatoid-arthritis.


Asunto(s)
Artritis Reumatoide/complicaciones , Terapia Cognitivo-Conductual/métodos , Fatiga/prevención & control , Fatiga/terapia , Psicoterapia de Grupo/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad
7.
Medicine (Baltimore) ; 99(9): e19415, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118795

RESUMEN

There has been some debate between biologic disease modifying anti-rheumatic drugs (bDMARDs) treatment and hypertension (HTN) in rheumatoid arthritis (RA). The aim of this study was to determine the effect of bDMARDs on the development of HTN in patients with RA.A total of 996 patients eligible for analysis were recruited from the Korean College of Rheumatology Biologics & Targeted Therapy (KOBIO) registry from 2012 to 2018. The bDMARDs were tumor necrosis factor (TNF) inhibitors, abatacept, and tocilizumab. The cDMARDs included methotrexate, hydroxychloroquine, and leflunomide. The incidence rate and 95% confidence interval of HTN were estimated using the Kaplan-Meier method. Hazard ratio (HR) of risk factors associated with hypertension was assessed by cox proportional hazard model analysis.Among the 996 patients, 62 patients (6.2%) were newly diagnosed with HTN. There were differences in incidence rate of HTN among conventional DMARDs (cDMARDs), TNF inhibitors, tocilizumab, and abatacept during the follow-up period (P = .015). Kaplan-Meier analysis showed that there was a significant difference in incident HTN only between cDMARDs and tocilizumab (P = .001). Systolic blood pressure and positive rheumatoid factor were associated with development of HTN (HR = 1.049, P = .016 and HR = 1.386, P = .010, respectively). Cox proportional hazard model analysis showed no difference in the development of HTN between bDMARDs and cDMARDs in RA.This study showed that bDMARDs treatment might not increase risk of incident HTN in patients with RA, compared to cDMARDs.


Asunto(s)
Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Hipertensión/etiología , Adulto , Anciano , Antirreumáticos/uso terapéutico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/epidemiología , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Sistema de Registros/estadística & datos numéricos , República de Corea/epidemiología
8.
Medicine (Baltimore) ; 99(12): e19568, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195966

RESUMEN

This study aimed to evaluate the relationship between Bell's palsy and rheumatoid arthritis in a national sample cohort from Korea.Data were collected for individuals ≥20 years old from 2002 to 2013 in the Korean National Health Insurance Service-National Sample Cohort. We extracted data for patients with rheumatoid arthritis (n = 7628) and 1:4-matched controls (n = 30,512) and analyzed the occurrence of Bell's palsy in both groups. Matching was performed based on age, sex, income, and region of residence. Rheumatoid arthritis was diagnosed according to International Classification of Disease-10 (ICD-10) codes (M05-M06) and the prescription of biological agents and/or disease-modifying antirheumatic drugs. Bell's palsy patients were diagnosed according to ICD-10 code H912 and treatment ≥2 times with steroids. Adjusted hazard ratios (HRs) were calculated using stratified Cox proportional hazard models for the Charlson comorbidity index and 95% confidence intervals (CIs). Subgroup analyses based on age and sex were also performed.The rates of Bell's palsy were similar between the rheumatoid arthritis group (0.5% [38/7628]) and the control group, with no significant difference (0.4% [124/30,512], P = .270). The adjusted HR for Bell's palsy was 1.12 (95% CI, 0.78-1.62) in the rheumatoid arthritis group (P = .540). In the subgroup analyses according to age and sex, the relationship between Bell's palsy and rheumatoid arthritis did not reach statistical significance.The risk of Bell's palsy was not increased in patients with rheumatoid arthritis.


Asunto(s)
Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Parálisis de Bell/diagnóstico , Parálisis de Bell/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/complicaciones , Artritis Reumatoide/tratamiento farmacológico , Parálisis de Bell/tratamiento farmacológico , Comorbilidad , Femenino , Humanos , Incidencia , Clasificación Internacional de Enfermedades/normas , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Prevalencia , República de Corea/epidemiología , Factores de Riesgo , Adulto Joven
9.
PLoS One ; 15(2): e0229273, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32084192

RESUMEN

OBJECTIVE: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. The risk of serious mental illness, including deliberate self-harm (DSH), in these conditions is not well known. We aimed to determine if RA or AS independently increases the risk for DSH. METHODS: We conducted retrospective, population-based cohort studies using administrative health data for the province of Ontario, Canada between April 1, 2002 and March 31, 2014. Individuals with incident RA (N = 53,240) or AS (N = 13,964) were separately matched 1:4 by age, sex, and year with comparators without RA or AS. The outcome was a first DSH attempt identified using emergency department data. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) for risk of DSH in RA and AS versus comparators, adjusting for demographic, clinical and health service utilization variables. RESULTS: Subjects with AS were significantly more likely to self-harm (crude incidence rate [IR] of 0.68/1,000 person years [PY] versus 0.32/1,000 PY in comparators), with an adjusted HR of 1.59 (95% CI 1.15 to 2.21). DSH was increased for RA subjects (IR 0.35/1,000 PY) versus comparators (IR 0.24/1,000 PY) only before (HR 1.43, 95% CI 1.16 to 1.74), but not after covariate adjustment (HR 1.07, 95% CI 0.86 to 1.33). CONCLUSIONS: AS carries an increased risk for DSH but no such risk was observed in RA. Further evaluation of at-risk AS subjects is needed, including the longitudinal effects of disease and arthritis therapies on self-harm behaviour. This will inform whether specific risk-reduction strategies for DSH in inflammatory arthritis are needed.


Asunto(s)
Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico , Conducta Autodestructiva/complicaciones , Espondilitis Anquilosante/complicaciones , Espondilitis Anquilosante/diagnóstico , Artritis Reumatoide/psicología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Espondilitis Anquilosante/psicología
10.
Rinsho Ketsueki ; 61(1): 33-38, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32023600

RESUMEN

CD20 antigen is an important marker for diagnosis of B-cell neoplasms that is highly expressed on the surface of neoplastic B lymphocytes. Patients with rheumatoid arthritis (RA) have an increased risk of developing malignant lymphoma, of which diffuse large B-cell lymphoma (DLBCL) is the most common type. We report an unusual case of CD20-negative DLBCL complicated by rheumatoid arthritis. An 81-year old female presented with a left-sided cervical tumor, enlarged tonsil, and polyarticular pain. Pathological findings of the left tonsil showed proliferation of large atypical cells with irregular shaped nuclei. Most large cells were negative for CD3 and CD20. Additionally, these cells were positive for CD79a, BCL2, and MUM1, and negative for CD10, CD138, BCL6, PAX5, EBV-ISH, HHV8, and ALK.. Therefore, she was diagnosed with CD20-negative DLBCL complicated with RA and received dose-modified CHOP that achieved partial remission. Because CD20-negative DLBCL is rare, the identification of the clinicopathological features of this disease is urgently required.


Asunto(s)
Artritis Reumatoide , Linfoma de Células B Grandes Difuso , Anciano de 80 o más Años , Antígenos CD20 , Artritis Reumatoide/complicaciones , Biomarcadores , Femenino , Humanos , Linfoma de Células B Grandes Difuso/complicaciones , Neprilisina
12.
PLoS One ; 15(1): e0227514, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31929568

RESUMEN

BACKGROUND: Patients with rheumatoid arthritis are at higher risk of developing stroke due to augmented systemic inflammation. While regular exercise has been shown to reduce inflammation in human subjects, the purpose of our study is to determine whether increased frequency of rehabilitation is protective against stroke or not. METHODS: A total of 16,224 rheumatoid arthritis patients with a catastrophic illness certificate were identified in our database from 2000 to 2006, and 663 of them developed stroke before the end of 2013. After statistically matching for age, sex, and the time interval between the diagnosis of rheumatoid arthritis and stroke, 642 patients without stroke were identified as the control group. Analyses with Student's t test and Chi-square test were done to compare the clinical characteristics of patients with and without stroke, and logistic regression analysis was then performed to evaluate the odds ratio of stroke. RESULTS: Higher odds ratio of stroke was revealed in patients with hypertension, diabetes mellitus, and moderate degree of rheumatoid arthritis disease severity. Furthermore, more than 40 rehabilitation sessions per year reduced the risk of developing stroke in patients with moderate disease severity. CONCLUSIONS: Physical activities brought by more rehabilitation sessions are beneficial and should be encouraged in patients with rheumatoid arthritis, particularly for those with higher disease activity but not taking biologic agents.


Asunto(s)
Artritis Reumatoide/rehabilitación , Accidente Cerebrovascular/diagnóstico , Anciano , Artritis Reumatoide/complicaciones , Artritis Reumatoide/patología , Estudios de Casos y Controles , Bases de Datos Factuales , Complicaciones de la Diabetes , Diabetes Mellitus/patología , Ejercicio Físico , Femenino , Humanos , Hipertensión/complicaciones , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Factores de Riesgo , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/complicaciones
13.
Georgian Med News ; (295): 137-140, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31804216

RESUMEN

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by synovial hyperplasia and the destruction of cartilage and bone with unclear morphogenesis of pathological changes in oral cavity. Simultaneously microcirculatory disturbance is important link of pathogenesis in many pathological conditions in oral cavity with inflammatory consequences. The aim of this study was to determine importance of microcirculatory disturbance of oral mucosa in modeling of rheumatoid arthritis. Experimental investigation has been performed with modeling RA on laboratory white male mice according to described before method. Investigated groups were formed according to severity manifestation as ankle changes using digital calipers measuring. The specimens of soft tissues of the oral cavity were stained with hematoxylin and eosin, according to van Gieson, according to Rego after the routine proceeding. Morphometric studies were performed with estimation of volumes of specific vascular density in microcirculatory bed, density of connective tissue in lamina propria and area of tissue with ischemia. It was detected that disturbance of oral mucosae microvasculature is formed in rheumatoid arthritis with strong correlation relationship between specific densities of microcirculatory bed vessels and rheumatoid arthritis severity (r=0.74). Development of ischemic area indicates strong correlation relationship between ischemic area and rheumatoid arthritis severity also (r=0.72) and it could be connected with changes in microvasculature (r=0.82). Development of sclerotic changes in the lamina propria of the mucosa could is characterized by increased area of connective tissue from 21.37±2.82% to 34.97±2.26 %.


Asunto(s)
Artritis Reumatoide , Isquemia , Microcirculación , Mucosa Bucal , Animales , Artritis Reumatoide/complicaciones , Huesos/irrigación sanguínea , Cartílago/irrigación sanguínea , Isquemia/etiología , Masculino , Ratones , Mucosa Bucal/irrigación sanguínea , Mucosa Bucal/patología
14.
Yakugaku Zasshi ; 139(12): 1553-1556, 2019.
Artículo en Japonés | MEDLINE | ID: mdl-31787644

RESUMEN

The skin is the largest human organ, comprising the epidermis that is composed of epithelial tissue, the dermis composed of connective tissue, and the innermost subcutaneous tissue. Generally, skin conditions are due to aging and the influence of the external environment, but empirically patients with gastrointestinal diseases are more prone to pruritus and inflammation caused by dry skin. A decrease in the skin barrier function, involving immunocompetent mast cells and oxidative stress, was noted in indomethacin-induced small intestine inflammation, dextran sodium sulfate (DSS)-induced ulcerative colitis, and azoxymethane+DSS-induced colorectal cancer. A possible correlation was found to exist between inflammatory gastrointestinal diseases and the skin, and this correlation was investigated using a rheumatoid arthritis model as representative of inflammatory diseases. Similar to previously reported results, deterioration of the skin barrier function was observed, and new information was obtained by analyzing changes in inflammatory markers in the blood and skin tissues. Understanding the underlying mechanism of decreased skin barrier function will help in establishing effective prophylaxis and treatment methods and clarify the importance of crosstalk between organs. It will also help accelerate drug development.


Asunto(s)
Artritis Reumatoide/complicaciones , Gastroenteritis/complicaciones , Enfermedades de la Piel/etiología , Fenómenos Fisiológicos de la Piel , Piel/fisiopatología , Animales , Modelos Animales de Enfermedad , Humanos , Ratones , Envejecimiento de la Piel
16.
Medicine (Baltimore) ; 98(50): e18415, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852165

RESUMEN

RATIONALE: Urinary obstruction are relatively rare complications of autoimmune diseases including systemic lupus erythematosus and systemic vasculitis. It has never been reported in rheumatoid arthritis (RA). PATIENT CONCERNS: We report a case of a female patient with seropositive RA who presented with gross hematuria associated with worsening joint symptoms, found to have acute kidney injury (AKI), bilateral hydronephrosis with bilateral renal pelvis, and ureteral wall thickening. Uroscopy with biopsy demonstrated inflammation without evidence of malignancy. DIAGNOSES: Rheumatoid arthritis related inflammation and obstruction of the urinary tract. INTERVENTIONS: Prednisone 50 mg daily (tapering began 1 month later), iguratimod 50 mg daily, and leflunomide 20 mg daily were prescribed. OUTCOMES: The patient responded well to steroids and immunosuppressive therapy with complete resolution of hematuria, renal injury, and hydronephrosis. LESSONS: Our case showed that RA might cause local inflammation involving the urinary tract which leads to obstruction and AKI.


Asunto(s)
Artritis Reumatoide/complicaciones , Obstrucción Ureteral/etiología , Antiinflamatorios/uso terapéutico , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Progresión de la Enfermedad , Femenino , Hematuria/etiología , Humanos , Hidronefrosis/etiología , Inmunosupresores/uso terapéutico , Persona de Mediana Edad , Prednisona/uso terapéutico , Obstrucción Ureteral/tratamiento farmacológico
17.
Rev Med Chil ; 147(6): 762-775, 2019 Jun.
Artículo en Español | MEDLINE | ID: mdl-31859830

RESUMEN

Rheumatoid arthritis (RA) and chronic periodontitis (CP) may be related due to a bidirectional etiology. The evidence shows that CP could alter the clinical course of RA. We performed a systematic search to determine if CP alters the morbidity of RA, analyzing its clinical and molecular aspects. Of 552 initial articles found, 16 were selected for a thorough review. There is a greater prevalence of CP in patients with RA. Patients with RA have significantly higher values of periodontal clinical parameters than healthy controls. Arthritis activity is significantly greater in patients who suffer from CP and decreases with nonsurgical periodontal treatment. There is a significant relationship between the severity of CP and RA activity.


Asunto(s)
Artritis Reumatoide/complicaciones , Periodontitis Crónica/complicaciones , Artritis Reumatoide/fisiopatología , Artritis Reumatoide/terapia , Biomarcadores , Estudios de Casos y Controles , Periodontitis Crónica/fisiopatología , Periodontitis Crónica/terapia , Femenino , Humanos , Masculino , Factores de Riesgo
18.
Acta Chir Orthop Traumatol Cech ; 86(5): 313-319, 2019.
Artículo en Checo | MEDLINE | ID: mdl-31748104

RESUMEN

Rheumatosurgery is a discipline managing the symptoms of rheumatoid arthritis of the musculoskeletal system. In a vast number of patients this disease starts in the wrist and hand. The portfolio of surgical procedures performed on the skeleton and soft tissues in these regions can be divided into two groups that, however, often times overlap in practice. Commonly, a combination of these surgical interventions is used. The surgical management should commence with prophylactic interventions that aim to slow down the development of rheumatoid deformities. These are followed by reconstructive surgery which shall manage the already developed rheumatoid deformities and their complications. The prophylactic interventions include early and late synovectomy, peritenosynovectomy, tenodeses, tendon transpositions and limited arthrodeses. The reconstructive surgery procedures comprise osteotomy, resection procedures, alloplasties, total arthrodesis and tendon reconstructions. Key words: rheumatoid arthritis, rheumatosurgery, hand, wrist.


Asunto(s)
Artritis Reumatoide/cirugía , Deformidades Adquiridas de la Mano/cirugía , Articulaciones de la Mano/cirugía , Mano/cirugía , Artritis Reumatoide/complicaciones , Artrodesis , Deformidades Adquiridas de la Mano/etiología , Humanos , Sinovectomía , Tendones/cirugía
19.
Mayo Clin Proc ; 94(12): 2488-2498, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31759675

RESUMEN

OBJECTIVE: To determine the prevalence of comorbidities in rheumatoid arthritis (RA), discover which comorbidities might predispose to developing RA, and identify which comorbidities are more likely to develop after RA. PATIENTS AND METHODS: We performed a case-control study using a single-center biobank, identifying 821 cases of RA (143 incident RA) between January 1, 2009, and February 28, 2018, defined as 2 diagnosis codes plus a disease-modifying antirheumatic drug. We matched each case to 3 controls based on age and sex. Participants self-reported the presence and onset of 74 comorbidities. Logistic regression models adjusted for race, body mass index, education, smoking, and Charlson comorbidity index. RESULTS: After adjustment for confounders and multiple comparisons, 11 comorbidities were associated with RA, including epilepsy (odds ratio [OR], 2.13; P=.009), obstructive sleep apnea (OR, 1.49; P=.001), and pulmonary fibrosis (OR, 4.63; P<.001), but cancer was not. Inflammatory bowel disease (OR, 3.82; P<.001), type 1 diabetes (OR, 3.07; P=.01), and venous thromboembolism (VTE; OR, 1.80; P<.001) occurred more often before RA diagnosis compared with controls. In contrast, myocardial infarction (OR, 3.09; P<.001) and VTE (OR, 1.84; P<.001) occurred more often after RA diagnosis compared with controls. Analyses restricted to incident RA cases and their matched controls mirrored these results. CONCLUSION: Inflammatory bowel disease, type 1 diabetes, and VTE might predispose to RA development, whereas cardiovascular disease, VTE, and obstructive sleep apnea can result from RA. These findings have important implications for RA pathogenesis, early detection, and recommended screening.


Asunto(s)
Artritis Reumatoide/complicaciones , Artritis Reumatoide/epidemiología , Adulto , Anciano , Artritis Reumatoide/diagnóstico , Estudios de Casos y Controles , Comorbilidad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo
20.
Life Sci ; 239: 117012, 2019 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-31678279

RESUMEN

BACKGROUND AND PURPOSE: Reduced male fertility has been regarded as a serious complication of rheumatoid arthritis. Phytochemicals have been described as protective agents against rheumatoid arthritis-linked testicular impairment. The current study aimed to investigate the potential protective effects of ellagic acid on rheumatoid arthritis-evoked testicular dysfunction vis-à-vis the reference anti-inflammatory celecoxib. EXPERIMENTAL APPROACH: Ellagic acid (50 mg/kg/day) and celecoxib (5 mg/kg/day) were administered orally for 20 days in adjuvant-induced arthritic rats. KEY FINDINGS: Current data revealed that ellagic acid counteracted rheumatoid arthritis-evoked testicular histopathologic changes, disrupted sperm characteristics and low gonadosomatic index with comparable efficacy to celecoxib. Ellagic acid also enhanced the testicular steroidogenesis via upregulating the gene expression of 3ß-hydroxysteroid dehydrogenase, 17ß-hydroxysteroid dehydrogenase and steroidogenic acute regulatory protein with consequent boosting of serum testosterone. Notably, ellagic acid attenuated the testicular inflammatory responses through suppression of myeloperoxidase, tumor necrosis factor-α and cyclo-oxygenase-2 protein expression together with enhancing the anti-inflammatory signal interleukin 10. Ellagic acid also curbed the redox alterations via lowering the production of lipid peroxides and nitric oxide and elevation of the anti-oxidant reduced glutathione. In support of cell survival, ellagic acid combated testicular apoptosis through downregulating caspase-3 protein expression. SIGNIFICANCE: The present work accentuates the beneficial actions of ellagic acid in rheumatoid arthritis-incurred testicular impairment and disrupted spermatogenesis via combating the inflammatory, oxidative and apoptotic aberrations.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Antiinflamatorios no Esteroideos/uso terapéutico , Apoptosis/efectos de los fármacos , Artritis Reumatoide/complicaciones , Ácido Elágico/farmacología , Ácido Elágico/uso terapéutico , Enfermedades Testiculares/tratamiento farmacológico , Enfermedades Testiculares/etiología , Animales , Caspasa 3/efectos de los fármacos , Celecoxib/farmacología , Celecoxib/uso terapéutico , Regulación hacia Abajo/efectos de los fármacos , Masculino , Estrés Oxidativo/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Espermatozoides/efectos de los fármacos , Esteroides/biosíntesis , Testosterona/sangre
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA