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Id: biblio-1144399
Autor: Romero-Marín, Juan David; Cantor, Yeison; Prieto-Bravo, Esteban; Sierra-Rosales, Reinaldo; Flórez-Vargas, Adriana; Mesa-Navas, Miguel Antonio; Velásquez-Franco, Carlos Jaime.
Título: Renal amyloidosis in ankylosing spondylitis: A case report / Amiloidosis renal en espondilitis anquilosante: un reporte de caso
Fonte: Rev. colomb. reumatol;27(1):46-49, 2020. tab, graf.
Idioma: en.
Resumo: ABSTRACT Renal manifestations of spondyloarthritis are rare. The case is presented of a patient with ankylosing spondylitis of nine years of evolution. He had intense inflammation, as well as articular sequelae, with a significant deterioration in his quality of life. At the initial evaluation, the patient had a serum creatinine of 1.44mg/dL and a 24-h urine protein in the sub-nephrotic range (1.44 g). Renal biopsy showed the presence of Congophilic material, confirming the diagnosis of AA amyloidosis. Treatment with a TNF blocking agent was initiated with clinical improvement, especially regarding articular disease.

RESUMEN Las manifestaciones renales de la espondiloartritis son poco comunes. Se presenta el caso de un paciente con espondilitis anquilosante de 9 anos de evolución, con intensa inflamación y secuelas articulares y con un deterioro significativo en su calidad de vida. En la evaluación inicial, el paciente tenía una creatinina sérica de 1,44mg/dL y una proteína en orina de 24 horas en un rango subnefrótico (1,44 g). La biopsia renal mostró la presencia de material congofílico que confirmaba el diagnóstico de amiloidosis AA. Se inició tratamiento con un anti-TNF, con mejoría clínica, especialmente con respecto al componente articular.
Descritores: Espondilite Anquilosante
Amiloidose
-Qualidade de Vida
Inflamação
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CO356.9


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Id: lil-594306
Autor: Alvarez, Dellys Adriana; Súárez Escudero, Juan Camilo.
Título: Espódilo Artropatía indiferenciada, espondilitis anquilosante y artropatia psoriasica: descripcion clinica, diagnostica y radiologica / Espódilo undifferentiated arthropathy, ankylosing spondylitis and psoriatic arthropathy: clinical description, diagnostic and radiological
Fonte: Med. U.P.B = Med. UPB;25(2):171-183, oct. 2006. tab.
Idioma: es.
Resumo: La espondilitis anquilosante, artritis reactiva, artritis psoriásica, artritis enteropática, espondilitis anquilosante juvenil y espondiloartropatía indife-renciada, conforman el grupo de Espóndilo artropatías seronegativas. Como síndrome clínico comparten signos y síntomas inflamatorios, compromiso articular y extra articular, HIA-B27 positivo, factor reumatoide negativo y curso crónico; debiendo ser incluidas como diagnósticos diferenciales del síndrome de dolor lumbar y cervical crónico, especialmente cuando es de tipo inflamatorio o maligno. Se realizó un estudio descriptivo, transversal y retrospectivo, elaborando una descripción clínica, diagnóstica y radiológica de pacientes incluidos en la base de datos de la unidad de reumatología de la Clínica Universitaria Bolivariana con diagnósticos de espondilitis anquilosante, espondiloanropatía indiferenciada y artritis psoriásica, atendidos entre septiembre de 2002 y julio de 2004, aplicando el formato de Espóndilo artropatías diseñado para esta investigación. Se evaluaron 27 pacientes: 55.6% hombres y 44.4% mujeres, entre 20 y 56 años. La Espóndilo artropatías serone-gativas más frecuente fue la espondilitis anquilosante (70.3%), seguida de artritis psoriásica (22.2%) y espon-diloartropatía indiferenciada (7.4%). Los síntomas más frecuentes se registraron en la región lumbar y en los talones (51.9%), rigidez artricular en la región lumbar (59.3%) y localización de la artritis en los hombros (11.1%). Los signos más frecuentes fueron Patrick y Sch6ber (62.9%).La sacroileitis bilateral y enteritis piramidal fueron los hallazgos radiológicos más frecuentes (48.1%). Para el presente estudio, la espondilítis anquilosante fue la entidad más frecuente y cursó con mayores signos y síntomas inflamatorios, predominó el compromiso del esqueleto axial, evolucionó de manera crónica y progresiva y cursó con mayor evidencia de compromiso radiológico, comparado con la anritis psoriásica y espondiloanropatía indiferenciada.

Ankylosing Spondyltis, Reactive Anhinis, Psoriasic Anhritis, Enteropatic Arthritis,youthful Ankylosing Spondylítis and Undifferentiated Spondyloanhropathies make up the group of sero-negative spondyloanhropaties. As a clinical syndrome, they share both inflammatory signs and symptoms, in-joint and out-joint involvement, positive HLA-B27, a negative rheumatoid factor and a chronic course. The physician ought to include them as differential diagnosis for chronic back pain and cervical pain, specially when the clínical picture is of inflammatory or maligntype. A descriptive, cross-sectional, retrospective study was performed, developing a description of the clinical, diagnostic and radiological issues of patients included in the Clínica...
Descritores: ANTIGENO HLA-BABORTION, EUGENIC
Artrite Reativa
Dor Lombar
Espondilite Anquilosante
Espondiloartropatias
Limites: Humanos
Tipo de Publ: Estudo Observacional
Estudo Clínico
Responsável: CO101.1 - BCdeS - Biblioteca Ciencias de la Salud


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Acúrcio, Francisco de Assis
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Id: biblio-962231
Autor: Machado, Marina Amaral de Ávila; Moura, Cristiano Soares de; Ferré, Felipe; Bernatsky, Sasha; Rahme, Elham; Acurcio, Francisco de Assis.
Título: Treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis / Persistência do tratamento em pacientes com artrite reumatoide e espondilite anquilosante
Fonte: Rev. saúde pública (Online);50:50, 2016. tab, graf.
Idioma: en.
Projeto: Conselho Nacional de Desenvolvimento Científico e Tecnológico; . Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Resumo: ABSTRACT OBJECTIVE To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD) and tumor necrosis factor blockers (anti-TNF drugs). METHODS This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription. Odds ratio (OR) with 95% confidence intervals (95%CI) were calculated by logistic regression models to estimate the patients' chances of persisting in their therapies after the first and after the two first years of follow-up. RESULTS The study included 11,642 patients with rheumatoid arthritis - 2,241 of these started on anti-TNF drugs (+/-DMARD) and 9,401 patients started on DMARD - and 1,251 patients with ankylosing spondylitis - 976 of them were started on anti-TNF drugs (+/-DMARD) and 275 were started on DMARD. In the first year of follow-up, 63.5% of the patients persisted in their therapies with anti-TNF drugs (+/-DMARD) and 54.1% remained using DMARD in the group with rheumatoid arthritis. In regards to ankylosing spondylitis, 79.0% of the subjects in anti-TNF (+/-DMARD) group and 41.1% of the subjects in the DMARD group persisted with their treatments. The OR (95%CI) for therapy persistence was 1.50 (1.34-1.67) for the anti-TNF (+/-DMARD) group as compared with the DMARD group in the first year for the patients with rheumatoid arthritis, and 2.33 (1.74-3.11) for the patients with ankylosing spondylitis. A similar trend was observed at the end of the second year. CONCLUSIONS A general trend of higher rates of therapy persistence with anti-TNF drugs (+/-DMARD) was observed as compared to DMARD in the study period. We observed higher persistence rates for anti-TNF drugs (+/-DMARD) in patients with ankylosing spondylitis as compared to rheumatoid arthritis; and a higher persistence for DMARD in patients with rheumatoid arthritis as compared to ankylosing spondylitis.

RESUMO OBJETIVO Avaliar a persistência do tratamento em pacientes com artrite reumatoide e espondilite anquilosante que iniciaram terapia com medicamentos modificadores do curso da doença (MMCD) e agentes bloqueadores do fator de necrose tumoral (anti-TNF). MÉTODOS Este estudo de coorte retrospectiva de julho de 2008 a setembro de 2013 avaliou a persistência na terapia, definida como o tempo do início até a descontinuação, permitindo-se um intervalo de até 30 dias entre o fim da prescrição e o início da prescrição seguinte. Odds ratio (OR) com intervalos de confiança de 95% (IC95%) foram calculados por meio de modelos de regressão logística para estimar a chance de apresentar persistência na terapia após o primeiro e os dois primeiros anos de seguimento. RESULTADOS Foram incluídos 11.642 pacientes com artrite reumatoide - 2.241 iniciaram uso de agentes anti-TNF (+/-MMCD) e 9.401 iniciaram MMCD - e 1.251 pacientes com espondilite anquilosante - 976 iniciaram uso de agentes anti-TNF (+/-MMCD) e 275 iniciaram MMCD. No primeiro ano de acompanhamento, 63,5% persistiram em terapia com anti-TNF (+/-MMCD) e 54,1% em uso de MMCD do grupo com artrite reumatoide. Em relação à espondilite anquilosante, 79,0% do grupo anti-TNF (+/-MMCD) e 41,1% do grupo MMCD persistiram no tratamento. O OR (IC95%) para persistência na terapia foi de 1,50 (1,34-1,67) para o grupo anti-TNF (+/-MMCD) comparado com MMCD no primeiro ano em pacientes com artrite reumatoide, e de 2,33 (1,74-3,11) em pacientes com espondilite anquilosante. Foi observada tendência semelhante ao final do segundo ano. CONCLUSÕES Observou-se uma tendência geral de taxas mais elevadas de persistência na terapia com anti-TNF (+/-MMCD) em relação a MMCD no período estudado. Foram observadas taxas de persistência mais elevadas para os usuários de anti-TNF (+/-MMCD) em pacientes com espondilite anquilosante em relação a artrite reumatoide, e maior persistência para MMCD em pacientes com artrite reumatoide em relação à espondilite anquilosante.
Descritores: Artrite Reumatoide/tratamento farmacológico
Espondilite Anquilosante/tratamento farmacológico
Fator de Necrose Tumoral alfa/uso terapêutico
Antirreumáticos/uso terapêutico
Adesão à Medicação
-Fatores Socioeconômicos
Terapia Biológica
Brasil
Estudos Retrospectivos
Estudos de Coortes
Resultado do Tratamento
Quimioterapia Combinada
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Responsável: BR1.1 - BIREME


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Id: biblio-1045800
Autor: Dawson, PUA; Dewar, NA; Tulloch-Reid, D.
Título: Fluoroscopy-guided intra-articular sacroiliac joint steroid injection for sacroiliitis in ankylosing spondylitis: a Case Report / Infiltración intraarticular de esteroides en la articulación sacro-ilíaca guiada por fluoroscopia para la sacroiliitis en la espondilitis anquilosante: Reporte de Caso
Fonte: West Indian med. j;63(1):109-111, Jan. 2014. ilus.
Idioma: en.
Resumo: Sacroiliitis, a condition commonly seen in ankylosing spondylitis, is well known to be one of the main pain generators of low back pain, which may result in difficulty with walking. A 20-year old male with history of ankylosing spondylitis presented to the University Hospital of the West Indies, Physical Medicine and Rehabilitation Clinic, with a two-year history of right buttock, low back and groin pain. Radiographic evaluation revealed increased sclerosis and erosive changes in bilateral sacroiliac joints, right greater than left. Right intra-articular sacroiliac joint steroid injection was administered under fluoroscopy guidance. Post-injection visual analogue pain scale (VAS) score with activity improved from 8 to 1 and Oswestry Disability Index improved from 40% moderate disability to 16% minimal disability. The patient's overall assessment was 95% perceived improvement in pain. This case report illustrates the effectiveness of intra-articular sacroiliac joint steroid injection in treating sacroiliitis in ankylosing spondylitis.

La sacroilitis, una condición comúnmente vista en la espondilitis anquilosante, es bien conocida por ser uno de los principales generadores de dolor lumbar, que puede ocasionar dificultad para caminar. Un paciente de 20 años de edad con una historia de espondilitis anquilosante, acompañada de dos años de dolor en la nalga derecha, la región lumbar, y en la ingle, acudió a la Clínica de Rehabilitación y Medicina Física del Hospital Universitario de West Indies. La evaluación radiográfica reveló esclerosis aumentada y cambios erosivos en la articulación sacroilíaca bilateral, mayor en el lado derecho que en el izquierdo. Con la ayuda de la fluoroscopia para guiar el procedimiento, se le administró al paciente una inyección intraarticular de esteroide en la articulación sacro-ilíaca, al lado derecho. La puntuación de la escala analógica visual del dolor (VAS) tras la inyección mejoró de 8 a 1, y el Índice de Discapacidad de Oswestry mejoró de una discapacidad moderada del 40% a una mínima discapacidad del 16%. La evaluación general del paciente fue de un 95% en cuanto a la percepción de la mejoría del dolor. Este reporte de caso ilustra la eficacia de la inyección intraarticular de esteroides de la articulación sacroilíaca para el tratamiento de la sacroiliitis en la espondilitis anquilosante.
Descritores: Espondilite Anquilosante/tratamento farmacológico
Fluoroscopia/métodos
Sacroileíte/tratamento farmacológico
-Espondilite Anquilosante/complicações
Esteroides/administração & dosagem
Resultado do Tratamento
Sacroileíte/etiologia
Injeções Intra-Articulares/métodos
Limites: Humanos
Masculino
Adulto Jovem
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Srougi, Miguel
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Id: lil-777314
Autor: Tiseo, Bruno Camargo; Cocuzza, Marcello; Bonfá, Eloisa; Srougi, Miguel; Clovis, A.
Título: Male fertility potential alteration in rheumatic diseases: a systematic review
Fonte: Int. braz. j. urol;42(1):11-21, Jan.-Feb. 2016. tab, graf.
Idioma: en.
Projeto: Fundação de Amparo à Pesquisa do Estado de São Paulo; . Conselho Nacional de Desenvolvimento Científico e Tecnológico; . Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Resumo: ABSTRACT Background Improved targeted therapies for rheumatic diseases were developed recently resulting in a better prognosis for affected patients. Nowadays, patients are living longer and with improved quality of life, including fertility potential. These patients are affected by impaired reproductive function and the causes are often multifactorial related to particularities of each disease. This review highlights how rheumatic diseases and their management affect testicular function and male fertility. Materials and Methods A systematic review of literature of all published data after 1970 was conducted. Data was collected about fertility abnormalities in male patients with systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, ankylosing spondylitis, Behçet disease and gout. Two independent researchers carried out the search in online databases. Results A total of 19 articles were included addressing the following diseases: 7 systemic lupus erythematosus, 6 Behçet disease, 4 ankylosing spondylitis, 2 rheumatoid arthritis, 2 dermatomyositis and one gout. Systemic lupus erythematosus clearly affects gonadal function impairing spermatogenesis mainly due to antisperm antibodies and cyclophosphamide therapy. Behçet disease, gout and ankylosing spondylitis patients, including those under anti-TNF therapy in the latter disease, do not seem to have reduced fertility whereas in dermatomyositis, the fertility potential is hampered by disease activity and by alkylating agents. Data regarding rheumatoid arthritis is scarce, gonadal dysfunction observed as consequence of disease activity and antisperm antibodies. Conclusions Reduced fertility potential is not uncommon. Its frequency and severity vary among the different rheumatic diseases. Permanent infertility is rare and often associated with alkylating agent therapy.
Descritores: Doenças Reumáticas/complicações
Infertilidade Masculina/etiologia
-Espondilite Anquilosante/complicações
Síndrome de Behçet/complicações
Dermatomiosite/complicações
Alquilantes/efeitos adversos
Gota/complicações
Infertilidade Masculina/fisiopatologia
Lúpus Eritematoso Sistêmico/complicações
Limites: Humanos
Masculino
Tipo de Publ: Revisão
Revisão Sistemática
Responsável: BR1.1 - BIREME


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Id: biblio-892860
Autor: Santana, Thiago; Skare, Thelma; Delboni, Vitor Steil; Simione, Juliana; Campos, Ana Paula B; Nisihara, Renato.
Título: Erectile dysfunction in ankylosing spondylitis patients
Fonte: Int. braz. j. urol;43(4):730-735, July-Aug. 2017. tab.
Idioma: en.
Resumo: ABSTRACT Background Rheumatic diseases such as ankylosing spondylitis (AS) may be associated with sexual dysfunction. Aim To study erectile function of a group of Brazilian AS patients comparing them with controls. Materials and Methods This was a cross sectional study approved by the local Committee of Ethics in Research. The questionnaire IIEF (International Index of Erectile Function) was applied to 40 AS patients and 40 healthy controls. AS patients had determination of disease activity (through BASDAI or Bath Ankylosing Spondylitis Disease activity index), ASDAS (Ankylosing Spondylitis Disease Activity Score, MASES or Maastricht Ankylosing Spondylitis Score and SPARCC or Spondyloarthritis Research Consortium of Canada), function (through BASFI or Bath Ankylosing Spondylitis Functional Index and HAQ or Health Assessment Questionnaire) and BASMI (Bath Ankylosing Spondylitis Metrological Index). Results AS patients had a median score on IIEF of 22.0 (IQR=18-25) while controls had 29 (IQR=27-30) with p<0.0001 Only 17.5% of the AS patients had no erectile dysfunction, in opposite to 87.5% of controls (p<0.0001). IIEF scores had a negative association with BASDAI (p<0.0001), HAQ (p=0.05), body mass index (P=0.03), MASES (P=0.02) and SPARCC (P=0.02) in a univariate analysis. Multiple regression showed that BASDAI was the only variable independently associated with IIEF. Conclusion There is a high prevalence of erectile dysfunction among AS patients that is associated with disease activity measured by BASDAI.
Descritores: Espondilite Anquilosante/complicações
Disfunção Erétil/etiologia
-Estudos de Casos e Controles
Estudos Transversais
Inquéritos e Questionários
Disfunção Erétil/epidemiologia
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Adulto
Responsável: BR1.1 - BIREME


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Id: biblio-1001835
Autor: Ishida, Suellen Narimatsu; Furtado, Rita Nely Vilar; Rosenfeld, André; Proglhof, Jorge Ernesto Passos; Estrela, Germana Brigida Queiroga; Natour, Jamil.
Título: Ultrasound of entheses in ankylosing spondylitis patients: The importance of the calcaneal and quadriceps entheses for differentiating patients from healthy individuals
Fonte: Clinics;74:e727, 2019. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: To compare the ultrasonographic findings of entheses in ankylosing spondylitis (AS) patients with those of healthy control individuals and to assess the ability of ultrasound (US) to identify aspects related to the disease. METHODS: A cross-sectional study involving 50 patients with AS and 30 healthy controls was performed. Clinical assessment included the use of a visual analog scale for pain, assessment of swelling of the enthesis, global assessments for patients and physician, use of a disease activity index, mobility and dysfunctional indices, erythrocyte sedimentation rate and clinical enthesitis index. US was performed for the following entheses by two experienced musculoskeletal radiologists: brachial triceps, distal quadriceps, proximal and distal patellar tendons, calcaneal tendon, and plantar fascia; the total and subitems of the Madrid Sonographic Enthesitis Index were used for evaluations. RESULTS: Comparison between groups showed a statistically significant difference with worse scores in AS patients, with bone erosion of the calcaneal enthesis and bone erosion and thickening of the plantar fascia. The odds ratio for thickening of the plantar fascia in the AS group was 3.47, according to logistic regression analysis. The AS group also had worse scores regarding the presence of calcification in the quadriceps enthesis, with a fivefold increased risk. CONCLUSION: US analysis showed that only entheses of the foot and quadriceps were able to differentiate AS patients from healthy individuals.
Descritores: Espondilite Anquilosante/diagnóstico por imagem
Calcâneo/diagnóstico por imagem
Músculo Quadríceps/diagnóstico por imagem
-Tendão do Calcâneo/diagnóstico por imagem
Índice de Gravidade de Doença
Variações Dependentes do Observador
Estudos Transversais
Ultrassonografia/métodos
Ligamento Patelar/diagnóstico por imagem
Diagnóstico Diferencial
Fáscia/diagnóstico por imagem
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Id: biblio-1133406
Autor: Shimabuco, Andrea Yukie; Medeiros-Ribeiro, Ana Cristina de; Miossi, Renata; Bonfiglioli, Karina Rossi; Moraes, Julio Cesar Bertacini de; Gonçalves, Celio Roberto; Sampaio-Barros, Percival Degrava; Goldenstein-Schainberg, Claudia; Souza, Fernando Henrique Carlos de; Prado, Leandro Lara do; Ugolini-Lopes, Michele Remião; Yuki, Emily Figueiredo Vieira Neves; Bonfa, Eloisa; Saad, Carla Gonçalves Schahin.
Título: Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area
Fonte: Clinics;75:e1870, 2020. tab.
Idioma: en.
Projeto: FAPESP; . CNPq.
Resumo: OBJECTIVES: To retrospectively evaluate the performance and distinctive pattern of latent tuberculosis (TB) infection (LTBI) screening and treatment in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) under anti-tumor necrosis factor (TNF) therapy and determine the relevance of re-exposure and other risk factors for TB development. METHODS: A total of 135 and 83 patients with AS and PsA, respectively, were evaluated for LTBI treatment before receiving anti-TNF drugs via the tuberculin skin test (TST), chest radiography, and TB exposure history assessment. All subjects were evaluated for TB infection at 3-month intervals. RESULTS: The patients with AS were more often treated for LTBI than were those with PsA (42% versus 30%, p=0.043). The former also presented a higher frequency of TST positivity (93% versus 64%, p=0.002), although they had a lower frequency of exposure history (18% versus 52%, p=0.027) and previous TB (0.7% versus 6%, p=0.03). During follow-up [median, 5.8 years; interquartile range (1QR), 2.2-9.0 years], 11/218 (5%) patients developed active TB (AS, n=7; PsA, n=4). TB re-exposure was the main cause in seven patients (64%) after 12 months of therapy (median, 21.9 months; IQR, 14.2-42.8 months) and five LTBI-negative patients. TB was identified within the first year in four patients (36.3%) (median, 5.3 months; IQR, 1.2-8.8 months), two of whom were LTBI-positive. There was no difference in the TB-free survival according to the anti-TNF drug type/class; neither synthetic drug nor prednisone use was related to TB occurrence (p>0.05). CONCLUSION: Known re-exposure is the most critical factor for incident TB cases in spondyloarthritis. There are also some distinct features in AS and PsA LTBI screening, considering the higher frequency of LTBI and TST positivities in patients with AS. Annual risk reassessment taking into consideration these peculiar features and including the TST should be recommended for patients in endemic countries.
Descritores: Espondilite Anquilosante/tratamento farmacológico
Artrite Psoriásica/diagnóstico
Artrite Psoriásica/tratamento farmacológico
Artrite Psoriásica/epidemiologia
Tuberculose Latente/diagnóstico
Tuberculose Latente/epidemiologia
-Espondilite Anquilosante/epidemiologia
Estudos Retrospectivos
Seguimentos
Inibidores do Fator de Necrose Tumoral/uso terapêutico
Limites: Humanos
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


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Id: biblio-990436
Autor: Nunes, Gabriel Pacífico Seabra; Cunha, Patrícia da Silva; Bosco, Daniele Patrícia Dal; Ribeiro, Sandra Lúcia Euzébio.
Título: Challenging management of hepatitis B infection in ankylosing spondylitis patients in an endemic area during immunosuppressive therapy
Fonte: Rev. Soc. Bras. Med. Trop;52:e20180386, 2019. graf.
Idioma: en.
Resumo: Abstract Hepatitis B infection is a global health issue. When considering patients with rheumatic diseases, this is no different. By using immunosuppressant drugs, such as DMARDs and biologics, viral reactivation is possible, leading to serious consequences on the patient. We report 3 cases of association between ankylosing spondylitis and hepatitis B with the use of immunosuppressant drugs. Case 1 was a patient with previous HBV infection using DMARD. Cases 2 and 3 were patients chronically infected by HBV during immunosuppressant therapy. The management of HBV infection during immunosuppressant therapy is challenging and needs multidisciplinary support.
Descritores: Espondilite Anquilosante
Ativação Viral/efeitos dos fármacos
Antirreumáticos/efeitos adversos
Hepatite B/imunologia
Imunossupressores/efeitos adversos
-Antirreumáticos/uso terapêutico
Doenças Endêmicas
Imunossupressores
Limites: Humanos
Feminino
Gravidez
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Bussadori, Sandra Kalil
Id: lil-527244
Autor: Lopes, Luciana Martins; Souza, Vanessa Silva de; Sampaio, Luciana Maria Malosá; Berbel, Andréa Marques; Fernandes, Kristianne Porta Santos; Martins, Manoela Domingues; Bussadori, Sandra Kalil; Mesquita-Ferrari, Raquel Agnelli.
Título: Fisioterapia respiratória no tratamento da espondilite anquilosante: estudo de caso / Respiratory rehabilitation in ankylosing spondylitis: case report
Fonte: Rev. Ter. Man;7(30):130-136, mar.-abr. 2009. graf.
Idioma: pt.
Resumo: A Espondilite Anquilosante (EA) é uma doença inflamatória crônica, sistêmica e de etiologia desconhecida que afeta primariamente o esqueleto axial, causando rigidez progressiva, diminuição da complacência pulmonar e da expansibilidade da caixa torácica. Objetivo: verificar o efeito da fi sioterapia respiratória na força muscular respiratória, expansibilidade torácica e qualidade de vida de um portador de EA. Metodologia: participou do estudo um paciente portadorde EA, 43 anos e este foi submetido a 4 avaliações fisioterapêuticas, pré, pós 10 sessões e 20 sessões de tratamento e após 2 meses seguintes sem tratamento, compostas por: avaliação da qualidade de vida (questionário SF-36), avaliaçãoda força muscular respiratória (pressão inspiratória e expiratória máximas) e da mobilidade toracoabdominal. As sessões de tratamento tiveram a duração de 30 min cada, freqüência de duas vezes por semana e foram constituídas por exercícios de Reeducação Funcional Respiratória e exercícios utilizando espirômetros de incentivo (Respiron e Threshould). Resultados: Após 10 e 20 sessões de tratamento foi verificada a melhora na qualidade de vida evidenciada pela obtenção de escores maiores na maioria dos domínios avaliados pelo SF-36 além de aumento da força muscular respiratória(aumento de PImáx e PEmáx) e da expansibilidade torácica em todos os níveis avaliados. Além disso, após 2 meses sem tratamento, a melhora obtida com o tratamento tanto na qualidade de vida como na força muscular respiratória e expansibilidade torácica, foi mantida. Conclusão: a fisioterapia respiratória promoveu a melhora do paciente portador de EA evidenciada pelo aumento da força muscular respiratória, expansibilidade torácica e qualidade de vida.

Ankylosing spondylitis (AS) is a chronic infl ammatory rheumatic disease, with unknown etiology, characterizedby insidious infl ammation of the spine and sacroiliac joints leading to pain and rigidity resulting in limited motion ofthe chest wall with the reduction in expansion of the ribcage and motion of the chest wall. Objective: The aim of thiswork was to evaluate the effects of respiratory physical therapy in respiratory maximal pressure, respiratory muscle strength, expansion of the ribcage and health quality in an AS patient. Methods: One male AS 43 year's old patient was submitted to an initial evaluation, before treatment and another two evaluations after 10 and 20 treatment sessions respectively and another one after two months without treatment. Each evaluation was constituted by measure of respiratory strength and maximal inspiratory and expiratory pressures, an evaluation of quality of life using the ShortForm-36(SF-36) Generic Questionnaire and the analysis of expansion of the ribcage in axilar, xyfoidean and abdominal levels. Each treatment session had 30min duration, was realized twice a week and included functional respiratory andspirometers (Respiron and Threshould) exercises Results: The results obtained after 10 and 20 treatment sessions andafter 2 months without treatment showed increase in expansion of the ribcage, respiratory muscle strength and a an improvement in the majority of SF-36 domains. Conclusion: The respiratory physical therapy treatment induced improvement in the functionality and life's quality of an AS patient.
Descritores: Espondilite Anquilosante
Força Muscular
Qualidade de Vida
Terapia Respiratória
Limites: Humanos
Masculino
Adulto
Responsável: BR512.1 - Biblioteca Setorial do Centro de Ciências da Saúde



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