Rheumatology
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To determine whether motor imagery performance is disrupted in patients with painful knee OA and if this disruption is specific to the location of the pain. ⋯ Motor imagery performance is disrupted in patients with knee OA, but is also disrupted in patients with arm pain. Accuracy of left/right judgements is disrupted in a spatially defined manner, raising the important possibility that brain-grounded maps of peripersonal space contribute to the cortical proprioceptive representation.
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Incongruence between sensory feedback and motor output may serve as an ongoing source of nociception inside the CNS, and hence may contribute to the development of chronic whiplash associated disorder (WAD). It has been demonstrated that sensorimotor incongruence exacerbates symptoms and provokes additional sensations in patients with chronic pain. This study aimed to evaluate whether a visually mediated incongruence between motor output and sensory input aggravates symptoms and triggers additional sensations in patients with chronic WAD. ⋯ This study demonstrates an exacerbation of symptoms and/or additional sensory changes due to reducing or disturbing the visual input during action, indicating altered sensorimotor central nervous processing and altered perception of distorted visual feedback in chronic WAD.
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Comparative Study
Functional status in severe juvenile idiopathic arthritis in the biologic treatment era: an assessment in a French paediatric rheumatology referral centre.
To investigate the functional status of difficult-to-treat JIA patients, including patients receiving biotherapies, and to correlate functional status to disease activity. ⋯ Despite the high proportion of severe JIA patients in this cohort, CHAQ values are within the lower range of recent reports, probably related to new therapeutic approaches. Impaired function and well-being remain a challenge for at least 10% of the patients. Impaired well-being and pain in ERA patients require further study. The strong correlation between functional status and well-being underlines the importance of improving function to optimize quality of life.
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Comparative Study
The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM.
Interstitial lung disease (ILD), especially rapidly progressive ILD (RPILD), is a major poor prognostic factor in patients with DM. We investigated the association of anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab) with clinical characteristics and mortality in Japanese patients with DM. ⋯ The presence of anti-MDA5 Ab identifies the characteristic skin, musculoskeletal, pulmonary and prognostic features in patients with DM. In addition, anti-MDA5 Ab seems to predict a group of patients with CADM-complicated fatal RPILD.
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Optimizing the use of key non-biologic drugs (MTX, prednisone) may prolong disease control, thereby delaying the need for costly biologic therapies. A number of lessons about the optimal use of therapy emerge from clinical studies. Clinical outcomes with non-biologic treatments, given early in the course of the disease, are as good as with biologic treatments. ⋯ The risk of adverse effects of low-dose glucocorticoids is often overestimated. Administration of low-dose glucocorticoids in accordance with physiological circadian rhythms may bring efficacy and safety benefits. As a case in point, the CAMERA (Computer Assisted Management in Early Rheumatoid Arthritis) II study applied these lessons and has clearly shown the benefits of optimizing MTX and prednisone therapy.