Polimiositis y dermatomiositis refractaria en adultos: Opciones terapéuticas

Dermatomyositis and polymyositis are rare autoimmune diseases, classified as inflammatory myopathies, clinically characterized by muscle weakness, frequently accompanied by extramuscular manifestations. Patients usually achieve remission or low levels of disease activity with initial treatment with glucocorticoids (may or may not be combined with immunomodulators), when this fails, it is considered refractory dermatomyositis and polymyositis (a new muscle biopsy must first be performed to rule out alternative diagnoses), thus additional treatments will be required for its management. The treatment of refractory dermatomyositis and polymyositis continues to be a challenge due to the lack of scientific evidence to validate the effectiveness of alternative drugs. This review presents some of the therapeutic alternatives. Biological therapies, especially rituximab and abatacept, were found in the literature as promising to reduce morbidity and mortality in both pathologies.La dermatomiositis y polimiositis son enfermedades autoinmunes raras, clasificadas dentro de las miopatías inflamatorias, y caracterizadas clínicamente por debilidad muscular, frecuentemente acompañada de manifestaciones extramusculares. Los pacientes usualmente logran la remisión o niveles bajos de actividad de la enfermedad con el tratamiento inicial con glucocorticoides (pueden o no estar asociados a inmunomoduladores), cuando este falla se considera una dermatomiositis y polimiositis refractarias (antes se debe realizar una nueva biopsia muscular para descartar diagnósticos alternativos) por lo cual se requerirán tratamientos adicionales para su manejo. El tratamiento de la dermatomiositis y polimiositis refractarias continúa siendo un reto debido a la falta de evidencia científica que permita validar la efectividad de fármacos alternativos. Esta revisión presenta algunas de las alternativas terapéuticas. Se encontró en la literatura como prometedoras para disminuir la morbimortalidad en ambas patologías las terapias biológicas, especialmente el rituximab y abatacept

Recommendations for early referral of individuals with suspected polymyalgia rheumatica: An initiative from the international giant cell arteritis and polymyalgia rheumatica study group

Objective To develop international consensus-based recommendations for early referral of individuals with suspected polymyalgia rheumatica (PMR). Methods A task force including 29 rheumatologists/ internists, 4 general practitioners, 4 patients and a healthcare professional emerged from the international giant cell arteritis and PMR study group. The task force supplied clinical questions, subsequently transformed into Population, Intervention, Comparator, Outcome format. A systematic literature review was conducted followed by online meetings to formulate and vote on final recommendations. Levels of evidence (LOE) (1–5 scale) and agreement (LOA) (0–10 scale) were evaluated. Results Two overarching principles and five recommendations were developed. LOE was 4–5 and LOA ranged between 8.5 and 9.7. The recommendations suggest that (1) each individual with suspected or recently diagnosed PMR should be considered for specialist evaluation, (2) before referring an individual with suspected PMR to specialist care, a thorough history and clinical examination should be performed and preferably complemented with urgent basic laboratory investigations, (3) individuals with suspected PMR with severe symptoms should be referred for specialist evaluation using rapid access strategies, (4) in individuals with suspected PMR who are referred via rapid access, the commencement of glucocorticoid therapy should be deferred until after specialist evaluation and (5) individuals diagnosed with PMR in specialist care with a good initial response to glucocorticoids and a low risk of glucocorticoid related adverse events can be managed in primary care. Conclusions These are the first international recommendations for referral of individuals with suspected PMR, which complement the European Alliance of Associations for Rheumatology/American College of Rheumatology management guidelines for established PMR

Recommendations for early referral of individuals with suspected polymyalgia rheumatica: an initiative from the international giant cell arteritis and polymyalgia rheumatica study group

Objective: To develop international consensus-based recommendations for early referral of individuals with suspected polymyalgia rheumatica (PMR).Methods: A task force including 29 rheumatologists/internists, 4 general practitioners, 4 patients and a healthcare professional emerged from the international giant cell arteritis and PMR study group. The task force supplied clinical questions, subsequently transformed into Population, Intervention, Comparator, Outcome format. A systematic literature review was conducted followed by online meetings to formulate and vote on final recommendations. Levels of evidence (LOE) (1-5 scale) and agreement (LOA) (0-10 scale) were evaluated.Results: Two overarching principles and five recommendations were developed. LOE was 4-5 and LOA ranged between 8.5 and 9.7. The recommendations suggest that (1) each individual with suspected or recently diagnosed PMR should be considered for specialist evaluation, (2) before referring an individual with suspected PMR to specialist care, a thorough history and clinical examination should be performed and preferably complemented with urgent basic laboratory investigations, (3) individuals with suspected PMR with severe symptoms should be referred for specialist evaluation using rapid access strategies, (4) in individuals with suspected PMR who are referred via rapid access, the commencement of glucocorticoid therapy should be deferred until after specialist evaluation and (5) individuals diagnosed with PMR in specialist care with a good initial response to glucocorticoids and a low risk of glucocorticoid related adverse events can be managed in primary care.Conclusions: These are the first international recommendations for referral of individuals with suspected PMR, which complement the European Alliance of Associations for Rheumatology/American College of Rheumatology management guidelines for established PMR.Keywords: Giant Cell Arteritis; Polymyalgia Rheumatica; Vasculitis

II Congreso internacional en educación física, recreación, deporte y actividad física. “Innovación y tendencias” - Memorias

El II Congreso Internacional de Educación Física, Recreación, Deporte y Actividad Física: “Innovación y Tendencias“ y el II Encuentro de Egresados del Departamento de Cultura Física de la Universidad de Córdoba se realizó en la ciudad de Montería, capital del Departamento de Córdoba, Colombia, como iniciativa del Grupo de Investigación en Ciencias de la Actividad Fisica y la Salud –GICAFS- del Departamento de Cultura Física, perteneciente a la Facultad de Educación y Ciencias Humanas de la Universidad de Córdoba, como muestra hacia la comunidad académica y la sociedad en general de la responsabilidad ética, social y profesional, para aportar a la construcción de tejido social, atendiendo a las recomendaciones del plan decenal del deporte, la Educación Física, la Recreación y la Actividad Física 2009-2019 (COLDEPORTES, 2009).Edición 201