2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative

Objective The 1987 American College of Rheumatology (ACR; formerly, the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticized for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA. Methods A joint working group from the ACR and the European League Against Rheumatism developed, in 3 phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease—this being the appropriate current paradigm underlying the disease construct “rheumatoid arthritis.” Results In the new criteria set, classification as “definite RA” is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints (score range 0–5), serologic abnormality (score range 0–3), elevated acute-phase response (score range 0–1), and symptom duration (2 levels; range 0–1). Conclusion This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimize the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct “rheumatoid arthritis.”Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78045/1/27584_ftp.pd

Is there any gender-specific impact in the treatment of patients with basal cell carcinoma in the head and neck region?

Summary: Background: There are no current studies concerning gender-specific impact on the treatment of BCCs. We performed a retrospective analysis with the aim of showing that selection of treatment by physician and patients’ evaluation concerning quality of life and aesthetic outcome has a gender-specific impact. Methods: Overall, 47 patients treated by excision of BCC from the head and neck region at our department from 2015 to 2020 were included. Defects were closed via flap, split-thickness skin graft. or primary closure. Pain, scar quality, patient satisfaction and quality of life were ascertained by the Skin Cancer Index (SCI), the Basal and Squamous Cell Carcinoma Quality of Life (BaSQoL) questionnaire, Patient and Observer Scar Assessment Scale (POSASv2.0EN) and Vancouver Scar Scale (VSS). Results: Women received significantly more flaps than split-thickness skin grafts (p = 0.025). The coverage method was independent of surgeons’ gender.Patient's POSAS were higher in women (p = 0.087), and observer's POSAS (p = 0.229) and VSS (p = 0.7) showed no significant difference between genders.SCI and BaSQoL scores showed that women are significantly more critical than men after BCC treatment (SCI p = 0; BaSQoL p = 0.022). Furthermore, dermatological follow-up frequency was significantly higher in women (p = 0.035). Conclusion: We determined the gender-specific impacts on the treatment of patients with BCCs regarding methods of closure, post-interventional dermatological follow-ups, quality of life, scar quality, and overall patient satisfaction. No difference in scar quality was found when assessed by physicians