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[PMID]: 22212412 [Au] Autor: Ai F; Ai T; Li X; Hu D; Zhang W; Morelli JN [Ad] Endereço: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, QiaoKou District, Wuhan 430030, China. [Ti] Título: Value of diffusion-weighted magnetic resonance imaging in early diagnosis of ankylosing spondylitis. [So] Source: Rheumatol Int;32(12):4005-13, 2012 Dec. [Is] ISSN: 1437-160X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: The objective of this study is to estimate the value of diffusion-weighted MRI (DWI) in the detection of abnormalities in sacroiliac joints in the patients with early ankylosing spondylitis (AS) and investigate the feasibility of whole-body DWI (WB-DWI) in systemic evaluation of AS. Sixteen patients with early AS, 18 patients with simple low back pain (LBP), and 18 healthy volunteers were involved in this study. All subjects underwent conventional MRI and DWI. Apparent diffusion coefficient (ADC) in subchondral bone marrows of sacroiliac joints was measured. Independent-sample t test was used to statistically analyze the difference of ADC values between groups. WB-DWI was performed in additional 12 patients with clinically confirmed AS. The image results were analyzed by multiple post-processing techniques, as compared to conventional MRI. In AS patients, mean ADC values were (0.494 ± 0.170) × 10(-3) mm(2)/s in sacrum and (0.513 ± 0.129) × 10(-3) mm(2)/s in ilium, which were significantly higher than those of LBP ((0.306 ± 0.057) × 10(-3) mm(2)/s in sacrum and (0.323 ± 0.083) × 10(-3) mm(2)/s in ilium) and healthy volunteers ((0.315 ± 0.009) × 10(-3) mm(2)/s in sacrum and (0.319 ± 0.012) × 10(-3) mm(2)/s in ilium). No statistical differences were found between simple LBP and healthy volunteers. Mean ADC value of multiple lesions in AS was (0.932 ± 0.299) × 10(-3) mm(2)/s. By WB-DWI, abnormal signals of sacroiliac joints and extra-sacroiliac joint lesions were demonstrated in the locations corresponding with clinical findings. Mean ADC values of multiple lesions were (1.298 ± 0.323) × 10(-3) mm(2)/s in sacrum and (1.216 ± 0.311) × 10(-3) mm(2)/s in ilium. DWI and WB-DWI were shown to be effective in differentiation and systemic evaluation of early AS. Both techniques are likely to play an importance role in the early diagnosis of AS and assessment of treatment response. [Mh] Termos MeSH primário: Dor Lombar/diagnóstico Articulação Sacroilíaca/patologia Espondilite Anquilosante/diagnóstico [Mh] Termos MeSH secundário: Adolescente Adulto Imagem de Difusão por Ressonância Magnética Diagnóstico Precoce Feminino Humanos Masculino [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s00296-011-2333-9

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[PMID]: 22210271 [Au] Autor: Slaus M; Novak M; Cavka M [Ad] Endereço: Department of Archaeology, Croatian Academy of Sciences and Arts, Ante Kovacica 5, 10 000 Zagreb, Croatia. [Ti] Título: Four cases of ankylosing spondylitis in medieval skeletal series from Croatia. [So] Source: Rheumatol Int;32(12):3985-92, 2012 Dec. [Is] ISSN: 1437-160X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Osteological changes consistent with ankylosing spondylitis were observed in three males and one female skeleton recovered from four medieval sites-Velim, Koprivno, Buje, and Rijeka-all situated on Croatia's eastern Adriatic coast and its immediate hinterland. The skeletons present changes in the spine, ribs, sacrum, and innominates that are typical of ankylosing spondylitis that is a progressive, inflammatory disease of connective tissue calcification. The disease most commonly affects the sacroiliac joints, the joints of the spine, and the costovertebral joints. In the final stages of the disease, the vertebral bodies remodel and together with the associated syndesmophytes form a continuous, smooth bone surface that is sometimes referred to as "bamboo spine." The prevalence of this disorder in the analyzed Croatian samples is 4/303 or 1.3% and thus corresponds with frequencies recorded in modern European populations. Differential diagnosis rules out the possibility of DISH, rheumatoid arthritis, and melorheostosis. These are the first cases of ankylosing spondylitis identified in Croatian archaeological series. [Mh] Termos MeSH primário: Articulação Sacroilíaca/radiografia Coluna Vertebral/radiografia Espondilite Anquilosante/diagnóstico [Mh] Termos MeSH secundário: Adulto Croácia Feminino Humanos Masculino Meia-Idade Paleopatologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s00296-011-2343-7

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[PMID]: 22205382 [Au] Autor: Bahouq H; Rostom S; Bahiri R; Hakkou J; Aissaoui N; Hajjaj-Hassouni N [Ad] Endereço: Department of Rheumatology, University Hospital El Ayachi, rue la plage, 11000 Rabat Sale, Morocco. hananebahouq@yahoo.fr [Ti] Título: Psychometric evaluation of the Arabic version of the multidimensional assessment of fatigue scale (MAF) for use in patients with ankylosing spondylitis. [So] Source: Rheumatol Int;32(12):3969-76, 2012 Dec. [Is] ISSN: 1437-160X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Fatigue is a frequent symptom during ankylosing spondylitis (AS) often under estimated which needs to be measured properly with respect to its intensity by appropriate measures, such as the multidimensional assessment of fatigue (MAF). The aims of this study were to translate into the classic Arabic version of the MAF questionnaire and to validate its use for assessing fatigue in Moroccan patients with AS. The MAF contains 16 items with a global fatigue index (IGF). The MAF was translated and back-translated to arabic, pretested and reviewed by a committee following the Guillemin criteria (J Clin Epidemiol 46:1417-1432, 1993). It was then validate on 110 Moroccan patients with AS. Reliability for the 3-day test-retest was assessed using internal consistency by Cronbach's alpha coefficient and the intra-class correlation coefficient (ICC). External construct validity was assessed by correlation with pain, activity of disease and other keys variable. The reproducibility of the 15 items was satisfactory with a kappa statistics of agreement superior to 0.6. The ICC for IGF score reproducibility was good and reached 0.98 (IC 95%, 0.96-0.99). The internal consistency was at 0.991 with Cronbach's alpha coefficient. The construct validity showed a positive correlation between MAF and the axial (r = 0.34) and peripheral (r = 0.32) visual analogical scale, the Bath ankylosing spondylitis disease activity index (BASDAI) (r = 0.77), the first item of BASDAI (r = 0.85), the functional disability by the Bath ankylosing spondylitis functional index (r = 0.64), the erythrocyte sedimentation rate (r = 0.43) and the C reactive protein (r = 0.30) (for all P < 0.001). There was no statistical correlation between MAF and the other variables. The Arabic version of the MAF has good comprehensibility, internal consistency, reliability and validity for the evaluation of Arabic speaking patients with AS. [Mh] Termos MeSH primário: Avaliação da Deficiência Fadiga/diagnóstico Espondilite Anquilosante/complicações [Mh] Termos MeSH secundário: Adulto Fadiga/complicações Feminino Humanos Masculino Meia-Idade Marrocos Psicometria Questionários Reprodutibilidade dos Testes Sensibilidade e Especificidade Índice de Gravidade de Doença Traduções [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s00296-011-2306-z

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[PMID]: 22198694 [Au] Autor: Gyurcsik ZN; András A; Bodnár N; Szekanecz Z; Szántó S [Ad] Endereço: Department of Physiotherapy, Faculty of Public Health, Medical and Health Sciences Center, University of Debrecen, Kassai u. 26, 4028 Debrecen, Hungary. gyurcsik@med.unideb.hu [Ti] Título: Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis. [So] Source: Rheumatol Int;32(12):3931-6, 2012 Dec. [Is] ISSN: 1437-160X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Physical therapy in ankylosing spondylitis (AS) is important for maintaining or improving mobility, fitness, functioning, and global health. It also plays a role in the prevention and management of structural deformities. In this study we assessed the functional status of AS patients in relation to disease duration and activity. Furthermore, in volunteering patients we analyzed the efficacy of a controlled, individualized physiotherapeutic program. Altogether, clinical data of 75 AS patients were retrospectively analyzed. Anthropometrical data, duration since diagnosis and disease activity, pain intensity, tender points, sacroiliac joint involvement determined by X-ray, functional condition, and physical activity level were recorded. Subjective, functional, and physical tests were performed. Out of the 75 patients, 10 volunteered to undergo a complex physical exercise program twice a week for 3 months. The program included 1.5 h of general posture reeducation, manual mobilization of the spine, and pelvic-, upper-, and lower-extremity exercises, stretching with joint prevention strategies and functional exercises. In AS, pain intensity recorded on a 10-cm visual analog scale (VAS), BASFI, BASDAI, modified Schober index, chest expansion and occiput-to-wall distance values showed significant correlation with disease activity. The 3-month physical therapy improved several subjective and functional parameters, and markedly reduced pain intensity and spine stiffness. A complex, individualized physical therapy program may be useful and should be introduced to AS patients in order to maintain and increase spine mobility, preserve functional capacity, decrease the pain and stiffness. [Mh] Termos MeSH primário: Terapia por Exercício/métodos Dor/reabilitação Amplitude de Movimento Articular/fisiologia Coluna Vertebral/fisiopatologia Espondilite Anquilosante/reabilitação [Mh] Termos MeSH secundário: Atividades Cotidianas Adulto Idoso Feminino Humanos Medicina Individualizada Masculino Meia-Idade Dor/fisiopatologia Medição da Dor Qualidade de Vida Índice de Gravidade de Doença Espondilite Anquilosante/fisiopatologia Resultado de Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s00296-011-2325-9

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[PMID]: 22159818 [Au] Autor: Konca S; Keskin D; Ciliz D; Bodur H; Sakman B [Ad] Endereço: Ankara Numune Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Ankara, Turkey. [Ti] Título: Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters. [So] Source: Rheumatol Int;32(12):3765-70, 2012 Dec. [Is] ISSN: 1437-160X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Magnetic resonance imaging (MRI) has major contribution in early diagnosis of ankylosing spondylitis (AS). As it is difficult to determine disease activity owing to the lack of close relation between laboratory tests, clinical findings and imaging, MRI has been used as an objective outcome measure. The aim of this study is to investigate the relation between spinal MRI findings with disease activity and other outcome measures. Fifty patients fulfilling modified New York criteria for AS were enrolled to the study. All the patients were evaluated with Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), Bath AS Radiology Index (BASRI) and As Quality of Life. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured as laboratory parameters, and ASspiMR scores were determined by spinal MRI. The median total ASspiMR-a score was 5.2. Spinal inflammation was evaluated in spinal segments, and thoracic segments had the highest mean ASspiMR-a level (3.1 ± 5.94). Cervical and lumbar ASspiMR were correlated with only BASRI, and total ASspiMR score was correlated with BASRI, BASMI and CRP. Thoracic ASspiMR score was correlated with patient's and doctor's global assessments, BASFI, BASMI, BASRI, ASDAS A, ASDAS B, ASDAS C, ASDAS D, ESR and CRP (P < 0.05). According to our results, the thoracic spine was the most related region with disease activity parameters and clinical outcome measures, so we suggest thoracic spine MRI evaluation in order to determine the disease activity. [Mh] Termos MeSH primário: Inflamação/patologia Espondilite Anquilosante/patologia Vértebras Torácicas/patologia [Mh] Termos MeSH secundário: Adolescente Adulto Sedimentação Sanguínea Proteína C-Reativa/metabolismo Avaliação da Deficiência Feminino Humanos Inflamação/sangue Imagem por Ressonância Magnética Masculino Meia-Idade Medição da Dor Qualidade de Vida Índice de Gravidade de Doença Espondilite Anquilosante/sangue [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 9007-41-4 (C-Reactive Protein) [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s00296-011-2248-5

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[PMID]: 21928121 [Au] Autor: Xu WD; Ye DQ [Ad] Endereço: Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, People's Republic of China. [Ti] Título: Interferon regulatory factor (IRF)-5: a potential therapeutic target for ankylosing spondylitis. [So] Source: Rheumatol Int;32(12):4065-7, 2012 Dec. [Is] ISSN: 1437-160X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Ankylosing spondylitis is a common inflammatory rheumatic disease that affects the axial skeleton, causing characteristic inflammatory back pain, which can lead to structural and functional impairments and a decrease in quality of life. New imaging techniques and therapies have substantially changed the management of this disease in the past decade. Whether inhibition of radiographic progression and structural damage can be reached with available drugs is as yet unclear. Furthermore, treatment with non-steroidal anti-inflammatory agents and physiotherapy remains an important approach to long-term management of patients with ankylosing spondylitis. The new treatment options with IRF-5 seem to be a breakthrough for patients' refractory to conventional and feasible treatment. [Mh] Termos MeSH primário: Antirreumáticos/uso terapêutico Fatores Reguladores de Interferon/genética Espondilite Anquilosante/quimioterapia [Mh] Termos MeSH secundário: Humanos Espondilite Anquilosante/genética [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Antirheumatic Agents); 0 (IRF5 protein, human); 0 (Interferon Regulatory Factors) [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s00296-011-2113-6

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[PMID]: 22941219 [Au] Autor: van Denderen JC; Blom GJ; van der Horst-Bruinsma IE; Dijkmans BA; Nurmohamed MT [Ad] Endereço: Jan van Breemen Research Institute/Reade, Amsterdam, The Netherlands. c.v.denderen@reade.nl [Ti] Título: Elevated liver enzymes in patients with ankylosing spondylitis treated with etanercept. [So] Source: Clin Rheumatol;31(12):1677-82, 2012 Dec. [Is] ISSN: 1434-9949 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: TNF-alpha blocking agents are very effective in patients with ankylosing spondylitis (AS), but several cases of liver problems have been published. We systematically studied the frequency of this potential side effect in our AS patients treated with etanercept. Consecutive AS patients treated with etanercept for at least 3 months were included. Liver disease was defined as elevated liver enzymes more than 1.5 times the upper normal limit (UNL) and was categorised as probably, possibly, probably not or not related to etanercept treatment. Patients with and without raised liver enzymes were compared for prognostic factors. A total of 105 patients were included. Fifteen patients had elevated liver enzymes more than once. In nine cases, the liver disease was probably (five) or possibly (four) related to etanercept treatment. The liver enzyme elevations were serious (>3× UNL) in six cases and resulted in permanent cessation of etanercept in two cases. The nine patients with liver disease were compared with patients without elevated liver enzymes. No differences were found in age or use of alcohol; however, in patients with liver disease, a higher body mass index and a trend for a higher atherogenic index were observed. Hepatic steatosis was observed in five of six patients with elevated liver enzymes. Elevated serum aminotransferases, probably or possibly related to etanercept treatment, were observed in 9 % of the AS patients. An increased risk for the elevation of liver enzymes was found in patients with a higher body mass index. We recommend regular testing of liver enzymes in patients treated with etanercept. [Mh] Termos MeSH primário: Alanina Transaminase/sangue Antirreumáticos/efeitos adversos Aspartato Aminotransferases/sangue Imunoglobulina G/efeitos adversos Espondilite Anquilosante/quimioterapia Fator de Necrose Tumoral alfa/antagonistas & inibidores [Mh] Termos MeSH secundário: Adulto Antirreumáticos/uso terapêutico Fígado Gorduroso/sangue Fígado Gorduroso/induzido quimicamente Fígado Gorduroso/enzimologia Feminino Humanos Imunoglobulina G/uso terapêutico Fígado/efeitos de drogas Fígado/enzimologia Masculino Meia-Idade Prognóstico Receptores do Fator de Necrose Tumoral/uso terapêutico Espondilite Anquilosante/sangue Espondilite Anquilosante/enzimologia Resultado de Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Antirheumatic Agents); 0 (Immunoglobulin G); 0 (Receptors, Tumor Necrosis Factor); 0 (Tumor Necrosis Factor-alpha); 185243-69-0 (TNFR-Fc fusion protein); EC 2.6.1.1 (Aspartate Aminotransferases); EC 2.6.1.2 (Alanine Transaminase) [Em] Mês de entrada: 1305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 121126 [St] Status: MEDLINE [do] DOI: 10.1007/s10067-012-2072-7

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[PMID]: 23144446 [Au] Autor: Schoels MM; van der Heijde D; Breedveld FC; Burmester GR; Dougados M; Emery P; Ferraccioli G; Gabay C; Gibofsky A; Gomez-Reino JJ; Jones G; Kvien TK; Murikama MM; Nishimoto N; Smolen JS [Ad] Endereço: Correspondence to Dr Monika M Schoels, 2nd Department of Internal Medicine, Center for Rheumatic Diseases, Hietzing Hospital, Wolkersbergenstrasse 1, Vienna 1130, Austria. monika.schoels@live.com [Ti] Título: Blocking the effects of interleukin-6 in rheumatoid arthritis and other inflammatory rheumatic diseases: systematic literature review and meta-analysis informing a consensus statement. [So] Source: Ann Rheum Dis;72(4):583-9, 2013 Apr. [Is] ISSN: 1468-2060 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Suppression of the immunoinflammatory cascade by targeting interleukin 6 (IL-6) mediated effects constitutes a therapeutic option for chronic inflammatory diseases. Tocilizumab is the only IL-6 inhibitor (IL-6i) licensed for rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), but also other agents targeting either IL-6 or its receptor are investigated in various indications. OBJECTIVE: To review published evidence on safety and efficacy of IL-6i in inflammatory diseases. METHODS: We performed systematic literature searches in Medline and Cochrane, screened EULAR and American College of Rheumatology meeting-abstracts, and accessed http://www.clinicaltrials.gov. RESULTS: Comprehensive evidence supports the efficacy of tocilizumab in RA in DMARD-naïve patients, and after DMARD- and TNFi-failure. Randomised comparisons demonstrate superiority of tocilizumab in JIA, but not ankylosing spondylitis (AS). Other indications are currently investigated. Additional IL-6i show similar efficacy; safety generally appears acceptable. CONCLUSIONS: IL-6i is effective and safe in RA and JIA, but not in AS. Preliminary results in other indications need substantiation. [Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/uso terapêutico Artrite Reumatoide Juvenil/quimioterapia Artrite Reumatoide/quimioterapia Interleucina-6/antagonistas & inibidores Espondilite Anquilosante/quimioterapia [Mh] Termos MeSH secundário: Antirreumáticos/uso terapêutico Artrite Reumatoide Juvenil/imunologia Artrite Reumatoide/imunologia Consenso Humanos Interleucina-6/imunologia Espondilite Anquilosante/imunologia [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Antibodies, Monoclonal, Humanized); 0 (Antirheumatic Agents); 0 (IL6 protein, human); 0 (Interleukin-6); 0 (tocilizumab) [Em] Mês de entrada: 1304 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 130226 [St] Status: MEDLINE [do] DOI: 10.1136/annrheumdis-2012-202470

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[PMID]: 22562972 [Au] Autor: Burmester GR; Panaccione R; Gordon KB; McIlraith MJ; Lacerda AP [Ad] Endereço: Correspondence to Professor G R Burmester, Department of Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany. gerd.burmester@charite.de [Ti] Título: Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease. [So] Source: Ann Rheum Dis;72(4):517-24, 2013 Apr. [Is] ISSN: 1468-2060 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: As long-term treatment with antitumour necrosis factor (TNF) drugs becomes accepted practice, the risk assessment requires an understanding of anti-TNF long-term safety. Registry safety data in rheumatoid arthritis (RA) are available, but these patients may not be monitored as closely as patients in a clinical trial. Cross-indication safety reviews of available anti-TNF agents are limited. OBJECTIVE: To analyse the long-term safety of adalimumab treatment. METHODS: This analysis included 23 458 patients exposed to adalimumab in 71 global clinical trials in RA, juvenile idiopathic arthritis, ankylosing spondylitis (AS), psoriatic arthritis, psoriasis (Ps) and Crohn's disease (CD). Events per 100 patient-years were calculated using events reported after the first dose through 70 days after the last dose. Standardised incidence rates for malignancies were calculated using a National Cancer Institute database. Standardised death rates were calculated using WHO data. RESULTS: The most frequently reported serious adverse events across indications were infections with greatest incidence in RA and CD trials. Overall malignancy rates for adalimumab-treated patients were as expected for the general population; the incidence of lymphoma was increased in patients with RA, but within the range expected in RA without anti-TNF therapy; non-melanoma skin cancer incidence was raised in RA, Ps and CD. In all indications, death rates were lower than, or equivalent to, those expected in the general population. CONCLUSIONS: Analysis of adverse events of interest through nearly 12 years of adalimumab exposure in clinical trials across indications demonstrated individual differences in rates by disease populations, no new safety signals and a safety profile consistent with known information about the anti-TNF class. [Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/efeitos adversos Antirreumáticos/efeitos adversos Doenças Reumáticas/quimioterapia Doenças Reumáticas/mortalidade [Mh] Termos MeSH secundário: Anticorpos Monoclonais Humanizados/administração & dosagem Antirreumáticos/administração & dosagem Artrite Reumatoide Juvenil/quimioterapia Artrite Reumatoide Juvenil/mortalidade Artrite Psoriásica/quimioterapia Artrite Psoriásica/mortalidade Artrite Reumatoide/quimioterapia Artrite Reumatoide/mortalidade Doença de Crohn/quimioterapia Doença de Crohn/mortalidade Humanos Psoríase/quimioterapia Psoríase/mortalidade Espondilite Anquilosante/quimioterapia Espondilite Anquilosante/mortalidade Saúde Mundial [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW [Nm] Nome de substância: 0 (Antibodies, Monoclonal, Humanized); 0 (Antirheumatic Agents); 0 (adalimumab) [Em] Mês de entrada: 1304 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 130226 [St] Status: MEDLINE [do] DOI: 10.1136/annrheumdis-2011-201244

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[PMID]: 22108606 [Au] Autor: López-Cortés LE; Garcia-Vidal C; Ayats J; Gudiol C; Bodro M; Sánchez-Ortega I; Peña C; Carratalá J [Ad] Endereço: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla, España. [Ti] Título: [Invasive aspergillosis with extrapulmonary involvement: pathogenesis, clinical characteristics and prognosis]. [Ti] Título: Aspergilosis invasora con afectación extrapulmonar: patogenia, características clínicas y pronóstico.. [So] Source: Rev Iberoam Micol;29(3):139-43, 2012 Jul-Sep. [Is] ISSN: 2173-9188 [Cp] País de publicação: Spain [La] Idioma: spa [Ab] Resumo: BACKGROUND: The incidence of invasive aspergillosis has increased worldwide. Information regarding the clinical characteristics of patients with extrapulmonary involvement is scarce. OBJECTIVE: We aimed to describe the pathogenesis, characteristics and outcomes of patients with invasive aspergillosis and extrapulmonary disease. METHODS: A retrospective study conducted in a university hospital in Barcelona, Spain (1995-2011). RESULTS: A total of 12 cases of invasive aspergillosis and extrapulmonary involvement were found. The most common clinical manifestations were invasive sinusitis, early postoperative prosthetic valve endocarditis, fungaemia, postoperative meningitis, multiple brain abscesses and lumbar spondylitis with epidural abscess. Sinusitis occurred frequently in patients without immunosuppression and had invasive brain involvement in one case. Endocarditis was associated with multiple septic metastases. Concomitant lung involvement was documented in 5 cases. The strains isolated were Aspergillus fumigatus (5), Aspergillus flavus (3), and Aspergillus niger (2). The species of Aspergillus was not established for 3 isolates. All patients were treated with antifungals and surgery was performed in 8 cases. Outcome was related with the source of infection; all patients with invasive sinusitis survived, while the remaining patients had a high mortality rate (88%). CONCLUSIONS: Invasive aspergillosis with extrapulmonary involvement is rare. The most common presentation is invasive sinusitis, which has a lower mortality. Other clinical forms with extrapulmonary involvement were associated with severe immunosuppression or previous surgery, and had a poor outcome. [Mh] Termos MeSH primário: Aspergilose/epidemiologia Infecção Hospitalar/epidemiologia [Mh] Termos MeSH secundário: Adulto Idoso Antifúngicos/uso terapêutico Aspergilose/quimioterapia Aspergilose/microbiologia Aspergilose/cirurgia Abscesso Encefálico/quimioterapia Abscesso Encefálico/epidemiologia Abscesso Encefálico/microbiologia Abscesso Encefálico/cirurgia Terapia Combinada Infecção Hospitalar/quimioterapia Infecção Hospitalar/microbiologia Infecção Hospitalar/cirurgia Endocardite/quimioterapia Endocardite/epidemiologia Endocardite/microbiologia Endocardite/cirurgia Feminino Seguimentos Fungemia/quimioterapia Fungemia/epidemiologia Fungemia/microbiologia Próteses Valvulares Cardíacas/efeitos adversos Mortalidade Hospitalar Humanos Hospedeiro Imunocomprometido Vértebras Lombares/microbiologia Masculino Meningite Fúngica/quimioterapia Meningite Fúngica/epidemiologia Meningite Fúngica/microbiologia Meningite Fúngica/cirurgia Meia-Idade Complicações Pós-Operatórias/quimioterapia Complicações Pós-Operatórias/epidemiologia Complicações Pós-Operatórias/microbiologia Complicações Pós-Operatórias/cirurgia Prognóstico Infecções Relacionadas a Prótese/quimioterapia Infecções Relacionadas a Prótese/epidemiologia Infecções Relacionadas a Prótese/microbiologia Infecções Relacionadas a Prótese/cirurgia Estudos Retrospectivos Fatores de Risco Sinusite/quimioterapia Sinusite/epidemiologia Sinusite/microbiologia Sinusite/cirurgia Espanha/epidemiologia Espondilite/quimioterapia Espondilite/epidemiologia Espondilite/microbiologia Espondilite/cirurgia Adulto Jovem [Pt] Tipo de publicação: ENGLISH ABSTRACT; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Antifungal Agents) [Em] Mês de entrada: 1304 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 120622 [St] Status: MEDLINE [do] DOI: 10.1016/j.riam.2011.10.001

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