Clinical rheumatology
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Clinical rheumatology · Mar 2020
Multicenter StudyComparing the association of widespread pain, multi-joint pain and low back pain with measures of pain sensitization and function in people with knee osteoarthritis.
To compare 1. measures of pain sensitization (PS) in people with widespread pain (WSP), multi-joint pain, low back pain (LBP) and knee osteoarthritis (KOA) only, in people with knee OA and 2. results of self-reported function and physical performance tests amongst these sub groups. ⋯ In patients with knee OA, those with WSP demonstrated greater degrees of PS compared with those with knee OA only, LBP and multi-joint pain. They also demonstrated a slower SCT compared with those with KOA only and LBP and decreased self-reported function compared with those with KOA only. These results should be confirmed in a longitudinal study.Key Points• In people with knee OA and widespread pain, measures of sensitization, self-reported function and physical performance were poorer compared with those with knee OA and LBP, knee OA and multi-joint pain or knee OA only.• Clinicians can consider these outcomes when planning management for these subgroups planning a comprehensive treatment program for this subgroup.
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Clinical rheumatology · Mar 2020
Teacher training for rheumatology fellows: a national needs assessment of fellows and program directors.
Teaching is an integral part of what we do as physicians, and exposure to training on how to effectively teach is not consistently implemented in the curricula within medical training. ⋯ There is significant need to develop effective fellow-as-teacher programs aimed at enhancing fellows' teaching skills, with focus on giving feedback and working within fellow and faculty time constraints. The program can help address a curriculum gap identified by fellows as well as PDs before fellowship-to-faculty transition.Key Points• There is a notable gap between faculty physicians' expectations to teach as clinician-educators and the lack of training dedicated to learning how to teach during medical training. Despite the fact that past clinical educators have identified instructional design and assessment as low-confidence areas, there is a paucity of structured program dedicated to developing these teaching skills during fellowship training.• With 97% fellows and 84% program directors, both groups agreed fellows could use additional instruction in teaching skills, but there was a significant discrepancy between fellow and program director perspectives regarding fellows' ability to give feedback.• Consistent with past needs assessments in other medical specialties, lack of time and potential faculty interest were recognized as potential barriers, calling for a structured training program dedicated to education on didactics that takes into account trainee and faculty time constraints.• Our needs assessment can direct future research on analyzing effectiveness of fellow-as-teacher program implementation by focusing on improvement of fellow teaching and feedback skills.
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Clinical rheumatology · Feb 2020
Associated factors with interstitial lung disease and health-related quality of life in Chinese patients with primary Sjögren's syndrome.
The main purpose of this study was to investigate the current situation of primary Sjögren's syndrome (pSS) patients with interstitial lung disease (ILD) in China. The relationships between social demography, disease activity, psychological status, clinical variables, and ILD were analyzed. Besides that, the quality of life (QoL) in pSS with ILD was also analyzed. ⋯ ILD was very common in pSS. ILD had a significant negative impact on the QoL of patients. Therefore, it is of great significance to strengthen the early intervention and drug treatment of pSS patients to prevent ILD and improve their QoL.Key Points• This cross-sectional study finds that the incidence of ILD in patients with pSS is 30.1%.• The occurrence and development of ILD is associated with disease duration, fatigue, alanine aminotransferase (ALT), neutrophils, albumin, and use of hormone.•The study also finds that the QoL of pSS-ILD is significantly lower than in patients with non-ILD, especially the score in the dimension of role physical function.
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Clinical rheumatology · Feb 2020
Comparison of signal detection of tumour necrosis factor-α inhibitors using the Korea Adverse Events Reporting System Database, 2005-2016.
There are no pharmacovigilance studies on adverse event (AE) data for tumour necrosis factor alpha (TNFα) inhibitors in South Korea. We analysed AEs induced by adalimumab, infliximab, and etanercept METHODS: We used data from the Korea Institute of Drug Safety and Risk Management-Korea Adverse Events Reporting System Database (KIDS-KD) collected between 2005 and 2016. We used three different signal detection methods: proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). The drug was compared with drug labels in the USA and Korea. Logistic regression analysis identified AEs that are more likely to occur with drug use. ⋯ Seven new signals that were not included in the current label were identified for TNFα inhibitors and should be updated and monitored.Key Points• Large-scale spontaneous AE reporting data and data mining techniques are useful for detecting signals of rare AEs as well as common AEs induced by drugs.• Drug labels should be updated to reflect signals that are newly discovered by continuous monitoring.
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Clinical rheumatology · Jan 2020
The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases.
This study explored the role of central sensitization (CS) pain in patients with various rheumatic diseases using the CS inventory (CSI). ⋯ The CSI usefully detects CS pain in patients with rheumatic diseases. Treatment of such pain can enhance the quality of daily life in patients with rheumatic diseases.Key Point• Central sensitization pain is common in patients with rheumatic diseases including rheumatoid arthritis, spondyloarthropathies, and osteoarthritis.