Clinical rheumatology
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Clinical rheumatology · Mar 2019
Observational StudyValidation of a new symptom outcome for knee osteoarthritis: the Ambulation Adjusted Score for Knee pain.
Validation of a symptom measure for early knee OA may help identify new treatments and modifiable risk factors. Symptom measures that consider pain in the context of activity level may provide better discrimination than pain alone. Therefore, we aimed to compare sensitivity to change for radiographic progression between Ambulation Adjusted Score for Knee pain (AASK), which accounts for self-reported ambulation, and Western Ontario McMaster Osteoarthritis (WOMAC) knee pain score. ⋯ AASK is simple to assess using existing validated questionnaires. AASK performs well in individuals with and without OA and should be considered in clinical trials and observational studies of early knee OA.
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Clinical rheumatology · Mar 2019
Anti-RNP/Sm antibodies in patients with systemic lupus erythematosus and its role in thrombosis: a case-control study.
To validate the association of thrombotic events with positive lupus anticoagulant (LA) and co-presence of anti-RNP/Sm, as well as the diagnostic accuracy of this combination of antibodies for thrombosis. ⋯ Thrombosis was associated with disease activity, dose of prednisone, and the combination of anti-RNP/Sm antibodies and LA. This combination of antibodies could be useful in the identification of SLE patients at risk of thrombosis.
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In this study, we aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) might be helpful in the diagnosis of subclinical inflammation of familial Mediterranean fever (FMF). Clinical, laboratory, and genetic results of the patients who were followed up with the diagnosis of FMF were obtained retrospectively from the hospital files and recorded to standardized form. Age- and sex-matched healthy subjects were included as the control group. ⋯ However, they showed no statistically significant difference between acute attack and attack-free period. NLR is a useful marker to predict inflammation in FMF patients. However, our results did not support the idea that MPV might reflect acute attack and attack-free period.
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Clinical rheumatology · Mar 2019
Low back pain in Brazilian medical students: a cross-sectional study in 629 individuals.
Low back pain (LBP) is a common problem in the general population. Medical students may be at risk of LBP because of demanding curricula. To study the prevalence of LBP in Brazilian medical students and the associated factors. ⋯ LBP interfered with social activities in 20.5%, with physical activities in 33.1%, and in school activities in 29.2%. There is a high prevalence of LBP in medical students, mainly females, associated with bad posture habits. Physical dysfunction for LBP showed correlation with anxiety and depression.
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Clinical rheumatology · Jan 2019
LetterGout lessons from 2018: CARES, a direct comparison of febuxostat vs allopurinol, and CANTOS, IL1 blocker for cardiovascular risk minimisation.
In the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial conducted by White et al. (March 29 issue from NEJM), all-cause mortality and cardiovascular mortality are found to be higher among patients randomly assigned to febuxostat compared to allopurinol, but significant flaws are a clear lack of treat to target strategy with more powered treatment in the febuxostat arm, dysbalance with cardiovascular risk factors selectively in again the febuxostat arm, and discontinuation of the trial regimen in over 50% of patients with discontinuation of follow-up in about 45%. With these flaws, conclusions such as febuxostat-associated higher mortality are potentially if not probably incorrect, and thus febuxostat to be used not as first-line therapy may well be an invalid consequence? The paper here describes potential lessons to be taken.