Riding on Red Blood Cells

Professor\u27s drug delivery research could improve treatment options for cancer, rheumatoid arthriti

Molecular alterations in skeletal muscle in rheumatoid arthritis are related to disease activity, physical inactivity, and disability

Abstract Background: To identify molecular alterations in skeletal muscle in rheumatoid arthriti

Concerns and opportunities related to discontinuation of treatment in rheumatoid arthritis

In this thesis we describe the concerns and opportunities related to discontinuation of anti rheumatic treatment, in particular, glucocorticoids. We also have focused on treatment of RA patients during a (viral) pandemic (COVID19).Walaeus bibliotheekLUMC / Geneeskund

Book Reviews

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II Taller Nacional Estrategias terapéuticas en la artritis reumatoide

II Taller Nacional Estrategias terapéuticas en la artritis reumatoide Relationship II National Workshop Therapeutic strategies in rheumatoid arthriti

Declining needs for total joint replacements for rheumatoid arthritis

This millennium brings new views to rheumatology. Total joint replacement surgery is needed less often as active treatment strategies combined with availability of new medications has led to more effective rheumatoid arthritis control. This was beautifully shown in a recent issue of Arthritis Research & Therapy by a Swedish study that uses data from national registers and compares incidence rates for total hip and knee arthroplasties before and after the establishment of biologic agents use for rheumatoid arthriti

The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies)

Coronary heart disease (CHD) and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA). Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987). The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years). Results. The incidence of CHD in RA was as much as 45.9% (n = 118), including 52.5% (n = 62) for typical angina pectoris on exertion; 25.4% (n = 30) and 22.1% (n = 26) for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100) were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1), smoking (OR = 10.2), early menopause (OR = 3.6), decreased glomerular filtration rate (OR = 3.5), cardiovascular heredity (OR = 3.1), overweight (OR = 2.5), a heart rate of more than 70 beats/min (OR = 2.3), atherogenic dyslipidemia (OR = 2.3), hyperglycemia (OR = 2.1), and age (OR = 1.7). Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0), concomitant anemia as a common complication of RA (OR = 4.7), high DAS 28 scores (OR = 3.7), visual analog scale pain scores of > 50 mm (OR = 2.6), and RA duration of >10 years (OR = 2.2). Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent

Biloma secondary to blunt liver trauma in a pediatric patient: case report

Liver is the organ most frequently injured after blunt or penetrating abdominal trauma, being in pediatrics a pathology that has an increasing incidence; Non-operative management is the hallmark of treatment, however cases of secondary biliary leakage have been described, which may affect the intrahepatic or extrahepatic track. A male 8 years old, with blunt trauma in the right hypochondrium, presenting acute abdomen and hemodynamic instability, requiring exploratory laparotomy with a grade III liver injury in VI and VII hepatic segments. Four weeks after discharge, he presented as a complication a giant biloma in VII and VIII hepatic segments, performing percutaneous drainage guided by ultrasound. The incidence of biliary complications related to hepatic trauma is low, 4% in pediatric patients, dividing into bilomas or biliary fistulas; the presentation of biliary leakage is very non-specific and early diagnosis difficult; in the bilomas, the tomography allows to define precisely its size, nature, distribution and regional anatomy in relation to adjacent structures, as well as underlying cause. The approach of choice is percutaneous or endoscopic drainage, with surgical management being the last option

Особенности диагностики и лечения ишемической болезни сердца при ревматоидном артрите (результаты собственных исследований)

Coronary heart disease (CHD) and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA). Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987). The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years). Results. The incidence of CHD in RA was as much as 45.9% (n = 118), including 52.5% (n = 62) for typical angina pectoris on exertion; 25.4% (n = 30) and 22.1% (n = 26) for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100) were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1), smoking (OR = 10.2), early menopause (OR = 3.6), decreased glomerular filtration rate (OR = 3.5), cardiovascular heredity (OR = 3.1), overweight (OR = 2.5), a heart rate of more than 70 beats/min (OR = 2.3), atherogenic dyslipidemia (OR = 2.3), hyperglycemia (OR = 2.1), and age (OR = 1.7). Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0), concomitant anemia as a common complication of RA (OR = 4.7), high DAS 28 scores (OR = 3.7), visual analog scale pain scores of > 50 mm (OR = 2.6), and RA duration of >10 years (OR = 2.2). Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.В структуре причин преждевременной смертности при ревматоидном артрите (РА) ведущее место занимают ишемическая болезнь сердца (ИБС) и ее осложнения. Цель исследования — изучение частоты, структуры и особенностей течения ИБС у больных РА. Пациенты и методы. Проведено аналитическое одномоментное поперечное исследование 257 пациентов с РА (ARA, 1987). Средний возраст больных составил 55,4+11,6 года, продолжительность РА — 14,7(2; 20) года. Результаты исследования. Частота ИБС при РА достигала 45,9% (n=118), в том числе типичной стенокардии напряжения — 52,5% (n=62), безболевой ишемии и нарушений ритма — 25,4% (n=30) и 22,1% (n=26) соответственно. Отмечен высокий удельный вес вертеброгенных кардиалгий (48,8%; n=100) у предъявлявших жалобы на боли в области сердца. Выявлены традиционные факторы риска, такие как артериальная гипертензия (ОР — 12,1), курение (ОР — 10,2), ранняя менопауза (ОР — 3,6), снижение скорости клубочковой фильтрации (ОР — 3,5), наследственность по сердечно-сосудистым заболеваниям (ОР — 3,1), избыточная масса тела (ОР — 2,5), частота сердечных сокращений — более 70 уд/мин (ОР — 2,3), атерогенные дислипидемии (ОР — 2,3), гипергликемия (ОР — 2,1) и возраст (ОР — 1,7). Наряду с ними установлены предикторы ИБС, ассоциирующиеся с последствиями хронического воспаления — прием глюкокортикоидов (ОР — 5,0), сопутствующая анемия как частое осложнение РА (ОР — 4,7), высокая активность РА по DAS 28 (ОР — 3,7), ВАШ боли >50 мм (ОР — 2,6) и давность >10 лет (ОР — 2,2). Выводы. К особенностям течения ИБС при РА относится частое выявление нарушений ритма и безболевой ишемии. Наряду с традиционными факторами риска ИБС очевидно значение степени активности воспаления