34 research outputs found
Procjena funkcije Å”ake elektoniÄkim dinamometrom u bolesnika s reumatoidnim artritisom [Evaluation of the hand function using an electronic dynamometer in patients with rheumatoid arthritis]
Objectives. In order to more detailed assessment of grip strength an innovative electronic
dynamometer system is produced and a new dynamic parameters of hand grip are derived.
The aim of this study was to determine the connection between the new evaluation
parameters of hand grip with measures of functional ability and disease activity in patients
with rheumatoid arthritis (RA).
Patients and methods. The study included 43 consecutive RA patients and 45 healthy
participants. The main outcomes were the dynamometric parameters of the handgrip:
strength, velocity, endurance (fatigue) and functional capacity. DAS28 (CRP) is used in
the assessment of disease activity, and functional ability is assessed by modified HAQDI
and ABILHAND-RA questionnaires. Based on the hand radiogram Steinbrocker score
was calculated, and the JAM scale was used to estimate deformities.
Results. A positive correlation was shown between the ABILHAND-RA and
dynamometric parameters. Measures of disease activity (PhGA, PtGA, tender joint count,
morning stiffness) were associated with grip force and functional potential (DAS28,
PhGA, tender joint count, morning stiffness). There was no association between grip
velocity and measures of functional ability and disease activity.
Conclusion. Evaluation of hand function with a new electronic dynamometer is useful in
assessment of patients with RA
Balneotherapy/hydrotherapy in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis ā a descriptive overview
Balneoterapija/hidroterapija neizostavni je dio rehabilitacije bolesnika s upalnim reumatskim bolestima. Kako se njena uÄinkovitost Äesto dovodi u pitanje, cilj ovog rada je bio pretražiti literaturu koja govori o uÄinkovitosti balneoterapije/hidroterapije kod reumatoidnog artritisa, ankilozantnog spondilitisa i psorijatiÄnog artritisa. RaÄunalnim putem pretražene su najpoznatije baze struÄnih Äasopisa iz podruÄja biomedicine (PubMed, Scopus, Ovid) u razdoblju od 1993. do 2013. s kljuÄnim rijeÄima ābalneoterapijaā (engl. balneotherapy, spa-therapy) i āhidroterapijaā (engl. hydrotherapy) za navedene tri upalne reumatske bolesti. TakoÄer je koriÅ”tena sva dostupna pisana medicinska literatura. Rad donosi deskriptivni pregled osnovnih principa djelovanja i dobrobiti balneoterapije/hidrokineziterapije te njezin znaÄaj kod triju najÄeÅ”Äih upalnih reumatskih bolesti.Balneotherapy/hydrotherapy is an essential part of the rehabilitation in patients with inflammatory rheumatic diseases. Its effectiveness is often called into question, and for that reason the aim of this study was to summarize the literature about the effectiveness of balneotherapy/hydrotherapy in rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. The best known journal datebases in the field of biomedicine (PubMed, Scopus, Ovid) were computer searched in the period from 1993 to 2013 by keywords ābalneotherapyā, āspa therapyā and āhydrotherapyā for these three inflammatory rheumatic diseases. All the available written medical literature was also used. This article brings a descriptive overview of the basic principles of effect and the welfare of balneotherapy/hydrotherapy and its significance in the three most common inflammatory rheumatic diseases
SYSTEMIC PHARMACOLOGICAL TREATMENT OF PAIN IN RHEUMATIC DISEASE
Bol je kardinalni simptom reumatskih bolesti i najÄeÅ”Äi razlog traženja medicinske pomoÄi. OlakÅ”anje
boli donosi brojne dobrobiti i preduvjet je funkcionalnog oporavka. U lijeÄenju boli u reumatskim bolestima rabe se
razliÄiti lijekovi. Oni obiÄno ukljuÄuju paracetamol, nesteroidne antireumatike i opioide (uglavnom slabe). Antidepresivi
i antikonvulzantni lijekovi mogu se rabiti u sluÄajevima dominantne neuropatske sastavnice boli. U ovome
deskriptivnom pregledu predstavljamo ažurirane rezultate istraživanja sa sustavnim analgeticima u reumatskim bolestima,
ukljuÄujuÄi inhibitore Äimbenika rasta živca i simptomatske sporodjelujuÄe lijekove za osteoartritis.Pain is a cardinal symptom of rheumatic diseases and the most common reason for seeking medical
help. Pain relief has many benefi cial eff ects and is necessary for the functional recovery. A variety of drugs are used for
the treatment of pain in rheumatic diseases. Th ey usually include acetaminophen, nonsteroidal anti-rheumatic drugs,
and opioids (mostly weak opioids). Antidepressants and anticonvulsants can be used in cases with a predominant
neuropathic component. In this descriptive review we present up-to-date results of trials with systemic analgesic drugs
in rheumatic diseases, including nerve growth factor inhibitors and symptomatic slow-acting drugs for osteoarthritis
ISHOD I TIJEK BOLESTI COVID-19 KOD BOLESNIKA S UPALNIM REUMATSKIM BOLESTIMA KOJI SU NA BIOLOÅ KOJ ILI CILJANOJ SINTETSKOJ MODIFICIRAJUÄOJ TERAPIJI ā REZULTATI JEDNOGA REUMATOLOÅ KOG CENTRA
The aim of this study was to investigate the course and outcome of COVID in patients with inflammatory rheumatic diseases (IRD) who are on biological disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs). In this study, we used the data of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) who had been treated at the Department of Rheumatology, Physical and Rehabilitation Medicine of the Sestre milosrdnice University Hospital in Zagreb (Croatia) and in whose case the SARS-CoV-2 infection was proven in the period from February 2020 until the end of July 2021. In order to analyse this data, we have used the methods of descriptive statistics. Out of a total of 28 patients, 6 had a severe or critical case of COVID-19, but only one subject was hospitalized. All 6 patients were treated with bDMARDs before the onset of infection. Most of them (4/6) had moderate to high disease activity of IRD, as well as multiple comorbidities. No deaths were recorded in this cohort of patients. The results of this study suggest that the course of COVID-19 is associated with the disease activity of IRD and accompanying comorbidities, whereas the use of specific biological drugs might be associated with a more favourable outcome of the infection. Therefore, a better follow-up process and management of disease activity in patients with IRD should be implemented during the period of this pandemic, as well as the modification of specific therapy.Cilj ovog istraživanja bio je istražiti tijek i ishod bolesti COVID-19 kod ispitanika s upalnim reumatskim bolestima koji su lijeÄeni bioloÅ”kim lijekovima koji mijenjaju tijek bolesti (engl. biologic disease modifying antirheumatic drugs, skr. bDMARDs) i ciljanim sintetskim lijekovima koji mijenjaju tijek bolesti (engl. targeted synthetic disease difying antitheumatic drugs, skr. tsDMARDs). U istraživanju smo analizirali podatke bolesnika s reumatoidnim artritisom (RA), psorijatiÄnim artritisom (PsA) i aksijalnim spondiloartritisom (axSpA) koji su se kontrolirali na Klinici za reumatologiju, fizikalnu medicinu i rehabilitaciju KliniÄkoga bolniÄkog centra Sestre milosrdnice u Zagrebu i koji su
imali dokazanu infekciju virusom SARS-CoV-2 u razdoblju od veljaÄe 2020. do kraja srpnja 2021. godine. Od ukupno 28 bolesnika njih Å”estoro je imalo teÅ”ki ili kritiÄni oblik bolesti COVID-19, a samo jedna osoba je bila hospitalizirana. Svih tih Å”est bolesnika bilo je lijeÄeno bDMARDs-ima. VeÄina bolesnika (4 od 6) s teÅ”kim i kritiÄnim oblikom bolesti COVID-19 imali su umjereni do visoki stupanj aktivnosti upalne reumatske bolesti, kao i viÅ”e komorbiditeta. Smrtnog ishoda u ovoj kohorti bolesnika nije bilo. Rezultati ovog istraživanja sugeriraju da je tijek bolesti COVID-19 povezan sa stupnjem aktivnosti upalne reumatske bolesti i popratnim komorbiditetima, a moguÄi povoljniji ishod s upotrebom specifiÄne bioloÅ”ke terapije. Stoga je u ovo doba pandemije potrebna bolja kontrola aktivnosti upalne reumatske bolesti, kao i modifikacija specifiÄne terapije
VAGAL NERVE STIMULATION IN THE TREATMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS ā RESULTS THROUGH DAY 84 OBTAINED AT THE CROATIAN CENTER OF AN INTERNATIONAL PILOT STUDY
ElektriÄna stimulacija vagusa pokazala se uÄinkovitom u razliÄitim upalnim stanjima na životinjskim
modelima. Cilj je bio prikazati uÄinak neurostimulacije vagalnog živca na kliniÄke i laboratorijske pokazatelje u dva
bolesnika s aktivnim reumatoidnim artritisom (RA) i nedostatnim odgovorom na metotreksat.
Ispitanici i metode. Istraživanje je provedeno u sklopu meÄunarodne pilot-studije. Bolesnicima je ugraÄen sustav
Cyberonics za elektriÄnu stimulaciju vagusa. Nakon prve unutarbolniÄke stimulacije bolesnici su zapoÄeli sa stimuliranjem
kod kuÄe do dana 42. kada je ureÄaj deaktiviran. Na dan 56. stimulacije su nastavljene. Evaluirani su ovi
parametri: broj bolnih zglobova, broj oteÄenih zglobova, lijeÄnikova (PGA) i bolesnikova (PtGA) globalna ocjena,
jaÄina boli, aktivnost bolesti (DAS28), funkcionalna sposobnost (HAQ), serumska vrijednost CRP-a, kao i odgovor na
terapiju prema EULAR-ovim kriterijima.
Rezultati. U oba je bolesnika od probirne vizite do dana 42. nastupilo poboljŔanje u vrijednostima DAS28 (7,00
i 6,22 prema 4,03 i 2,13), PGA (70 i 53 prema 27 i 16), PtGA (48 i 43 prema 15 i 14), broja bolnih zglobova (26 i 28
prema 4 i 0) i broja oteÄenih zglobova (24 i 14 prema 8 i 2), jaÄine boli (72 i 87 prema 21 i 7), vrijednosti HAQ-a (2,25
i 2,25 prema 1,5 i 1,375) te razine CRP-a (23,8 i 5,58 prema 13 i 4,61). Nakon iskljuÄenja ureÄaja doÅ”lo je do pogorÅ”anja
DAS28 i VAS-a boli u oba pacijenta.
ZakljuÄak. Vagalna neuralna stimulacija u lijeÄenju bolesnika s aktivnim RA i nedostatnim odgovorom na tera piju
metotreksatom uÄinkovita je u smanjenju kliniÄkih simptoma i pokazatelja upale. NaÅ”i su rezultati u skladu s rezultatima
dobivenim i u drugim centrima. Potrebna su istraživanja na veÄem broju ispitanika da bi se bolje ocijenio uÄinak
ovoga novog pristupa lijeÄenju bolesnika s reumatoidnim artritisom.Electrical stimulation of the vagus has proven eff ective in various infl ammatory conditions in animal
models. Th e aim of this study is to show the eff ect of vagal nerve neurostimulation on clinical and laboratory parameters
in two patients with active rheumatoid arthritis (RA) and an inadequate response to methotrexate.
Patients and methods. Th e research was conducted as part of an international pilot study. Patients were implanted
with the Cyberonics system for electrical stimulation of the vagus. Aft er an initial in-clinic stimulation, the patients
performed the stimulations at home for 42 days, when the device was inactivated. On day 56 the stimulations were
reinitiated. Th e following parameters were evaluated: tender and swollen joint count, physicianās (PGA) and patientās
(PtGA) global score, intensity of pain, disease activity (DAS28), functional ability (HAQ), serum CRP level, and EULAR
response.
Results. In the period from the screening visit to the day 42 visit, both patients experienced an improvement of
DAS28 (7.00 and 6.22 vs. 4.03 and 2.13), PGA (70 and 53 vs. 27 and 16), PtGA (48 and 43 vs. 15 and 14), tender joint
count (26 and 28 vs. 4 and 0), swollen joint count (24 and 14 vs. 8 and 2), intensity of pain (72 and 87 vs 21 and 7), HAQ
score (2.25 and 2.25 vs. 1.5 and 1.375), and CRP levels (23.8 and 5.58 vs. 13 and 4.61). Aft er the device deactivation,
DAS28 and VAS pain worsened in both patients.
Conclusion. Vagal neural stimulation in the treatment of patients with active RA and an inadequate response to
methotrexate is eff ective in reducing clinical symptoms and parameters of infl ammation. Our results are in accordance
with the results obtained in other centers. Research on a larger number of subjects is necessary for a better evaluation
of the eff ect of this new approach to the treatment of patients with rheumatoid arthritis