Jama ustna w reumatologii

W artykule przedstawiono znaczenie zmian w obrębie jamy ustnej z punktu widzenia reumatologa. Przewlekłe ogniska zapalne w jamie ustnej mogą przyczyniać się do rozwoju chorób reumatycznych oraz stanowić przeszkodę dla intensywnego leczenia immunosupresyjnego. Co więcej, zmiany w jamie ustnej mogą mieć charakter typowy dla konkretnych chorób reumatycznych, umożliwiając w ten sposób trafne rozpoznanie. Dodatkowo, w obrębie jamy ustnej można obserwować objawy niepożądane leczenia immunosupresyjnego, tak powszechnego w reumatologii

How to stop radiographic progression. Reimbursement of secukinumab in the B.82 drug program

In the past, axial spondyloarthropathies (axSpA) were considered synonymous with ankylosing spondylitis (AS). However, there is a group of patients who present clinical features of axSpA but do not have radiographic changes. Advances in medicine, especially diagnostic imaging and genetics, have made it possible to diagnose the disease at this earlier stage. For this group of patients, the concept of non-radiographic axSpA has been introduced. It is already known that for patients with non-radiographic axSpA, as for those with AS, it is crucial to diagnose as soon as possible and initiate effective treatment, which causes the relief of clinical symptoms, but also is to prevent the progression of radiological changes. The introduction of tumor necrosis factor-alpha (TNFα) inhibitors changed the course of the disease and the prognosis of patients with axSpA. However, drugs with other mechanisms of action are being sought. One of the new drugs is secukinumab, which blocks interleukin-17 (IL-17), which is important in the pathogenesis of SpA. It has been shown that the majority of patients with nonradiographic axSpA treated with secukinumab did not show radiological progression. The role of IL-17 blockade in the therapy of axSpA seems to be more appreciated, which was reflected in the updated global guidelines. Until recently, in Poland, only two drugs with the same mechanism of action — TNFα blockade (certolizumab pegol and etanercept) were reimbursed for patients with non-radiographic axSpA. Fortunately, from July 1, 2022, patients with non-radiographic axSpA can also receive IL-17 inhibitors (ixekizumab and secukinumab) in the B.82 drug program

Zastosowanie aceklofenaku w leczeniu chorób reumatycznych

Niesteroidowe leki przeciwzapalne nadal są szeroko stosowane i zajmują ważne miejsce w reumatologii. Niestety, wszystkie niesteroidowe leki przeciwzapal­ne mogą wywołać charakterystyczne działania nie­pożądane, dlatego poszukuje się leków o większym profilu bezpieczeństwa. Wiele badań klinicznych potwierdza dobrą skuteczność i bezpieczeństwo aceklofenaku w leczeniu chorób reumatycznych, co skłania do jego stosowania w codziennej praktyce klinicznej. W artykule przedstawiono krótką charakte­rystykę i zastosowanie aceklofenaku w reumatologii

Jan Mikulicz-Radecki — jego wkład w rozwój reumatologii

Jan Mikulicz-Radecki był wybitnym lekarzem i nauczycielem, pionierem nowoczesnych me­tod operacyjnych i diagnostycznych w chirurgii, a przede wszystkim niezwykłym, charyzmatycz­nym człowiekiem, którego nazwisko nadal funk­cjonuje we współczesnej medycynie. Kojarzony głównie z chirurgią, wniósł jednak także znaczny wkład do reumatologii. W niniejszej publikacji przedstawiono postać Jana Mikulicza-Radeckie­go i omówiono jego wkład w rozwój reumato­logii

Therapeutic Role of Animals: A Comprehensive Literature Review on the Prevalent Forms and Species in Animal-Assisted Interventions

Animals have been valued and used to improve human physical and mental health since ancient times. Animal-assisted therapy (AAT) is a complementary approach to traditional medicine, involving trained animals. AAT can enhance cognition, commitment, character growth, and the learning process. Commonly used species in animal-assisted therapy include cats, dogs, horses, dolphins, and others. Feline-assisted therapy alleviates loneliness and stress, whereas canine-assisted therapy positively impacts emotions and overall well-being. Equine-assisted interventions benefit individuals with cognitive and motor disabilities. Dolphin-assisted therapy shows promise for conditions like autism and cerebral palsy. However, ethical concerns have arisen, particularly in children with behavioral disorders. Safety measures, adult supervision, and proper screening and hygiene practices are crucial in AAT programs. In conclusion, AAIs have a significant potential to enhance well-being and mental health across various contexts, but more research is needed to fully understand their effectiveness and safety in different settings and age groups. The existing literature consists of subjective accounts and inadequate methodologies

Favourable pregnancy outcome in a woman with secondary pulmonary hypertension complicating mitral stenosis

Pulmonary hypertension (PH) is a rare condition with a high incidence of maternal and perinatal mortality (30–56% and 10–13%, respectively). Pulmonary hypertension is a contraindication to pregnancy because of high risk of maternal death, therefore the World Health Organisation (WHO) advises to discuss a termination in the event of pregnancy with women suffering from PH

Tryptophan metabolism via the kynurenine pathway in selected rheumatic diseases: A review of the literature

In chronic inflammatory diseases, as a result of pro-inflammatory cytokines, the enzyme indoleamine 2,3-dioxygenase (IDO) is excessively activated, resulting in increased tryptophan metabolism via the kynurenine pathway (KP). Both IDO and metabolites of the KP affect cells of the immune system, mainly T lymphocytes. In this way, they exert an immunosuppressive effect, reducing inflammation. Also in rheumatic diseases such as rheumatoid arthritis (RA), osteoporosis, osteoarthritis and ankylosing spondylitis, there is excessive activation of the KP. This publication reports on disorders of tryptophan metabolism found in the above-mentioned disease entities

Cardiovascular manifestations of Lyme disease - a literature review

Lyme disease is an infectious zoonosis transmitted by ticks infected with Borrelia spirochetes. Condition affects multiple organ systems and typically has a protracted course. Although Lyme carditis is a comparatively rare symptom of Lyme borreliosis, it can cause major cardiac conditions, including death, if left untreated. Atrioventricular block of various degrees is the hallmark of cardiac involvement, although other manifestations of the disease are increasingly describe such as ventricular and supraventricular arrhythmias, pericarditis, acute coronary syndrome, mild heart failure, cardiac tamponade or individual cases of cardiomyopathy, degenerative valvular lesions and vasculitis. Cardiovascular conduction disorders have a good prognosis despite their abrupt onset and completely resolve after a few days of antibiotic therapy. Therefore, a wait-and-see attitude should be maintained. However, a temporary or permanent pacemaker may be required if the patient's clinical condition necessitates prompt intervention. Nevertheless, current recommendations suggest avoiding temporary stimulation wherever possible and limiting its use to the shortest treatment time possible