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[PMID]:29390551
[Au] Autor:Li D; You L; Fan S; Tan L
[Ad] Endereço:Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan.
[Ti] Título:Xanthomatosis in bilateral hands mimicking rheumatoid arthritis: A case report.
[So] Source:Medicine (Baltimore);96(51):e9399, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Xanthomatosis often accompanies familial hypercholesterolemia. This disease usually occurs in tendons, most commonly located in the Achilles tendon; occasionally it can also be seen in other systems. Although there are previous reports for bilateral hand extensor tendon involvement, to our knowledge there is no report in English literature regarding bilateral hands with small joint synovium presenting as rheumatoid arthritis. Therefore, the case that is presented in this report is unique. PATIENT CONCERNS: An 18-year-old woman was admitted to our department because she presented with morning stiffness, joint deformation, and swelling in both hands. Computed tomography of the right hand showed soft tissue swelling on multiple small joints, including metacarpophalangeal and proximal interphalangeal joints, but without obvious bone destruction. There was soft tissue swelling around the small joints, which were hypointensities on T1-weighted and hyperintensities on T2-weighted images, not uniformly enhanced appearances on magnetic resonance imaging. DIAGNOSES: Biopsy from the 3rd metacarpophalangeal joint capsule of the left hand confirmed xanthoma. INTERVENTIONS: She was treated with statin drugs to reduce blood fat. OUTCOMES: After 3 months of follow-up, no recurrence or complications were detected regarding a full range of motion remaining of the affected joints. LESSONS: The young patient with symptoms of small joint synovium involved in both hands and the performance of magnetic resonance imaging similar to rheumatoid arthritis may be suffering from xanthomatosis.
[Mh] Termos MeSH primário: Artrite Reumatoide/diagnóstico
Articulações dos Dedos
Articulação Metacarpofalângica
Xantomatose/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Artrite Reumatoide/patologia
Diagnóstico Diferencial
Feminino
Articulações dos Dedos/diagnóstico por imagem
Articulações dos Dedos/patologia
Seres Humanos
Imagem por Ressonância Magnética
Articulação Metacarpofalângica/diagnóstico por imagem
Articulação Metacarpofalângica/patologia
Tomografia Computadorizada por Raios X
Xantomatose/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009399


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[PMID]:29350502
[Au] Autor:Stepic N; Koncar J; Rajovic M
[Ti] Título:The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome.
[So] Source:Vojnosanit Pregl;74(1):19-23, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Dupuytren's disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the relation between finger's contracture degree and success of surgical treatment of the Dupuytren's disease. Methods: This prospective analysis included 60 patients operated on due to Dupuytren's contracture. According to preoperative contracture degree of proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint, patients were divided into three groups: the group 1: < 15°, the group 2: 15−30° and the group 3: > 30°. All the patients underwent operation of partial palmar fasciectomy. Postoperative improvement was expressed with contracture reduction INDEX. Results: There were 60 patients with 85 fingers affected. The groups 1, 2 and 3 had 22 (37%), 37 (62%) and 26 (43%) fingers with MCP contracture and 32 (37.4%), 24 (28.2%) and 29 (34.1%) fingers with PIP contracture, respectively. Postoperative contractures of MCP joint in these groups were 0, 0.135° and 5°, and of PIP joint 0, 2.08 ° and 16.89°, respectively. After six months all MCP contractures resolved, while PIP joint contracture in the group 3 remained 13.62°. The reduction INDEX was 98.85%, 97.62% and 75.52% in the groups 1, 2 and 3, respectively. There was a statistically significant difference in the INDEX value between the groups (p = 0.0001). Conclusion: The degree of PIP joint contracture is related to the outcome of surgical treatment of Dupuytren's disease. Optimal results are achieved when contracture degree is between 15° and 30°. Surgical treatment of MCP joint contracture is successful regardless of the preoperative joint contracture degree.
[Mh] Termos MeSH primário: Contratura de Dupuytren/cirurgia
Fasciotomia
Articulações dos Dedos/cirurgia
Deformidades Adquiridas da Mão/cirurgia
Articulação Metacarpofalângica/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Fenômenos Biomecânicos
Contratura de Dupuytren/diagnóstico
Contratura de Dupuytren/fisiopatologia
Fasciotomia/efeitos adversos
Feminino
Articulações dos Dedos/fisiopatologia
Deformidades Adquiridas da Mão/diagnóstico
Deformidades Adquiridas da Mão/fisiopatologia
Seres Humanos
Masculino
Articulação Metacarpofalângica/fisiopatologia
Meia-Idade
Estudos Prospectivos
Recuperação de Função Fisiológica
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150331103S


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[PMID]:29054766
[Au] Autor:Liu J; Wang P; Huang J; Yu Z
[Ad] Endereço:Department of Pediatrics, Fuzhou Dongfang Hospital, Second Military Medical University, Fuzhou 350025, Fujian, China.
[Ti] Título:Rethinking genotype-phenotype correlations in papillorenal syndrome: a case report on an unusual congenital camptodactyly and skeletal deformity with a heterogeneous PAX2 mutation of hexanucleotide duplication.
[So] Source:Gene;641:74-77, 2018 Jan 30.
[Is] ISSN:1879-0038
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Papillorenal syndrome (PRS), an autosomal dominant inherited condition, is clinically featured by renal hypoplasia and optic nerve dysplasia. Based on current knowledge of genotype-phenotype correlations in PRS, mutations in the Paired box 2 (PAX2) gene have been recognized as a critical pathogenesis of typical renal and optic disease manifestations. However, little information is currently available on the skeletal abnormalities of PRS and the potential contribution of PAX2 mutations. Here, we present a case of a 10-year-old female PRS patient with the typical features of chronic renal failure and severe myopia, but was unexpectedly discovered camptodactyly of her left middle finger which affects the proximal interphalangeal joint. Pathologically, the camptodactyly was further indicated by radiology as a skeletal deformity, demonstrating a decline of bone mineral density and disappearance of joint space. Molecular diagnostics revealed a heterozygous mutation, 220_225dup, in the exon 3 of her PAX2 gene, which is de novo considering the lack of this mutation in her non-consanguineous parents. This mutation leads to duplication of glutamic acid at position 74 and tyrosine at position 75 in PAX2 protein, which may influence the DNA-binding function. Besides, the absence of Spalt like transcription factor 4 (SALL4) mutation excluded the diagnosis of acro-renal-ocular syndrome (AROS), of which clinical characteristics are similar to our patient's. This case unravels a previously unrecognized phenotype of camptodactyly due to a significant skeletal deformity of PRS with a heterogeneous PAX2 mutation of hexanucleotide duplication. This report challenges against the current belief of genotype-phenotype correlations in PRS.
[Mh] Termos MeSH primário: Coloboma/genética
Articulações dos Dedos/anormalidades
Deformidades Congênitas da Mão/genética
Fator de Transcrição PAX2/genética
Insuficiência Renal/genética
Refluxo Vesicoureteral/genética
[Mh] Termos MeSH secundário: Densidade Óssea/genética
Criança
Coloboma/patologia
Feminino
Seres Humanos
Falência Renal Crônica/genética
Miopia/genética
Insuficiência Renal/patologia
Fatores de Transcrição/genética
Refluxo Vesicoureteral/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (PAX2 Transcription Factor); 0 (PAX2 protein, human); 0 (SALL4 protein, human); 0 (Transcription Factors)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171022
[St] Status:MEDLINE


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[PMID]:27773588
[Au] Autor:Srivanitchapoom P; Shamim EA; Diomi P; Hattori T; Pandey S; Vorbach S; Park JE; Wu T; Auh S; Hallett M
[Ad] Endereço:Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: prachaya.srivanitch
[Ti] Título:Differences in active range of motion measurements in the upper extremity of patients with writer's cramp compared with healthy controls.
[So] Source:J Hand Ther;29(4):489-495, 2016 Oct - Dec.
[Is] ISSN:1545-004X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY DESIGN: Exploratory case-control study. INTRODUCTION: Writer's cramp (WC) is a type of focal hand dystonia. The central nervous system plays a role in its pathophysiology, but abnormalities in the affected musculoskeletal components may also be relevant. PURPOSE OF THE STUDY: We compared the active range of motion (ROM) in patients with WC and healthy volunteers (HVs) and correlated the findings with disease duration and severity. METHODS: Affected limb joints were measured with goniometers. Patients were assessed at least 3 months after their last botulinum toxin (botulinum neurotoxin) injection, and strength was clinically normal. t tests were used to compare the ROMs of WC with matched HVs. The Spearman correlation coefficient assessed the relationship of active ROMs to the disease duration and handwriting subscore of the Dystonia Disability Scale. RESULTS: ROMs of D1 metacarpophalangeal (MCP) joint extension as well as D2 and D5 MCP flexion were significantly smaller in WC, and distal interphalangeal joint extension in D3 and D5 was significantly greater compared with HVs. There were negative correlations between D2 MCP flexion and disease duration and with Dystonia Disability Scale. DISCUSSION: Abnormalities in ROMs in WC were found. Severity and disease duration correlated with reduced D2 MCP flexion. This may be related to intrinsic biomechanical abnormalities, co-contraction of muscles, or a combination of subclinical weakness and atrophy from repeated botulinum neurotoxin injections. CONCLUSIONS: Hand biomechanical properties should not be ignored in the pathophysiology of WC. LEVEL OF EVIDENCE: 2c.
[Mh] Termos MeSH primário: Toxinas Botulínicas/uso terapêutico
Distúrbios Distônicos/tratamento farmacológico
Amplitude de Movimento Articular/fisiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Estudos de Casos e Controles
Distúrbios Distônicos/diagnóstico
Distúrbios Distônicos/reabilitação
Articulação do Cotovelo/fisiopatologia
Feminino
Articulações dos Dedos/efeitos dos fármacos
Articulações dos Dedos/fisiopatologia
Seres Humanos
Injeções Intralesionais
Masculino
Meia-Idade
Amplitude de Movimento Articular/efeitos dos fármacos
Valores de Referência
Medição de Risco
Índice de Gravidade de Doença
Fatores Sexuais
Resultado do Tratamento
Articulação do Punho/fisiopatologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.24.69 (Botulinum Toxins)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29045229
[Au] Autor:Créteur VM; Durieux PF; Cuylits N
[Ad] Endereço:From the Departments of Radiology (V.M.C., P.F.D.) and Plastic Surgery (N.C.), Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium.
[Ti] Título:Case 247: Jersey Finger of the Fifth Finger.
[So] Source:Radiology;285(2):683-689, 2017 Nov.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:History A 34-year-old man without underlying medical conditions came to the emergency department for evaluation of persistent pain over the volar portion of his right fifth finger after a fall during a football match 3 days before. At physical examination, the injured finger was swollen and purple. Passive and active flexion of the proximal and distal interphalangeal joints were compromised, without interphalangeal instability. Radiography was performed in the emergency department, and the patient was released with a diagnosis of a fifth digit sprain. After the senior radiologist (V.M.C.) reviewed the radiographs, the patient was called back for assessment with ultrasonography (US) on the same day. US was performed with an Aplio 500 unit (Toshiba Medical Systems, Tokyo, Japan) using a multifrequency linear array 7.2-18.0-MHz PLT-1204BX transducer focused at the level of the flexor tendon. The patient was sitting in front of the examiner, with the hand lying palm up on the examination bed. No abnormality was observed during color Doppler US.
[Mh] Termos MeSH primário: Traumatismos dos Dedos
Articulações dos Dedos
Dedos
[Mh] Termos MeSH secundário: Adulto
Traumatismos dos Dedos/diagnóstico por imagem
Traumatismos dos Dedos/patologia
Traumatismos dos Dedos/cirurgia
Articulações dos Dedos/diagnóstico por imagem
Articulações dos Dedos/patologia
Articulações dos Dedos/cirurgia
Dedos/diagnóstico por imagem
Dedos/patologia
Dedos/cirurgia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017152673


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[PMID]:28594687
[Au] Autor:Oishi SN; Agranovich O; Pajardi GE; Novelli C; Baindurashvili AG; Trofimova SI; Abdel-Ghani H; Kochenova E; Prosperpio G; Jester A; Yilmaz G; Senaran H; Kose O; Butler L
[Ad] Endereço:*Department of Hand Surgery, Texas Scottish Rite Hospital for Children, Dallas, TX †Arthrogrpyosos Clinic, Turner Scientific and Research Institute for Children's Orthopedics §Department of Foot and Ankle Surgery, Neuroorthopaedics and Systemic Disorders, Pediatric Orthopedic Institute n.a. H. Turner, Saint-Petersburg, Russia ∥Departments of Pediatric Orthopedics and Radiodiagnosis, Faculty of Medicine, Cairo University, Cairo, Egypt ‡Plastic & Reconstructive Surgery School, Università degli Studi di Milano ¶Hand Surgery & Rehabilitation Department Ospedale San Giuseppe, MultiMedica Group, Milan, Italy #Department of Hand Surgery, Birmingham Children's Hospital, Birmingham, UK **Department of Orthopedics and Traumatology, Medical School of Selcuk University ††Faculty of Medicine, Selcuk University §§Konya Bozkir State Hospital, Konya ‡‡Faculty of Medicine, Erzincan University, Erzincan, Turkey.
[Ti] Título:Treatment of the Upper Extremity Contracture/Deformities.
[So] Source:J Pediatr Orthop;37 Suppl 1:S9-S15, 2017 Jul/Aug.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients with arthrogryposis multiplex congenita have a characteristic upper extremity resting posture consisting of internal rotation of the shoulders, elbow extension, flexed wrists, thumb-in palm deformities, and variable degrees of finger contractures. Treatment of these patients is aimed at improving independence and performance of activities of daily living. Although each area needs to be assessed independently for the most appropriate surgical procedure, often multiple areas can be addressed at the same operative setting. This limits the number of anesthetic exposures and cast immobilization time. The following is a synopsis of treatment strategies presented at the second international symposium on Arthrogryposis which took place in St Petersburg in September 2014.
[Mh] Termos MeSH primário: Artrogripose/cirurgia
Artroplastia/métodos
Contratura/cirurgia
Músculo Esquelético/cirurgia
[Mh] Termos MeSH secundário: Anormalidades Múltiplas/cirurgia
Atividades Cotidianas
Pré-Escolar
Articulação do Cotovelo/cirurgia
Articulações dos Dedos/cirurgia
Seres Humanos
Lactente
Masculino
Amplitude de Movimento Articular
Articulação do Ombro/anormalidades
Articulação do Ombro/cirurgia
Polegar/anormalidades
Polegar/cirurgia
Articulação do Punho/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000001002


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[PMID]:28446181
[Au] Autor:Rong W; Li W; Pang M; Hu J; Wei X; Yang B; Wai H; Zheng X; Hu X
[Ad] Endereço:Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
[Ti] Título:A Neuromuscular Electrical Stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke.
[So] Source:J Neuroeng Rehabil;14(1):34, 2017 Apr 26.
[Is] ISSN:1743-0003
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: It is a challenge to reduce the muscular discoordination in the paretic upper limb after stroke in the traditional rehabilitation programs. METHOD: In this study, a neuromuscular electrical stimulation (NMES) and robot hybrid system was developed for multi-joint coordinated upper limb physical training. The system could assist the elbow, wrist and fingers to conduct arm reaching out, hand opening/grasping and arm withdrawing by tracking an indicative moving cursor on the screen of a computer, with the support from the joint motors and electrical stimulations on target muscles, under the voluntary intention control by electromyography (EMG). Subjects with chronic stroke (n = 11) were recruited for the investigation on the assistive capability of the NMES-robot and the evaluation of the rehabilitation effectiveness through a 20-session device assisted upper limb training. RESULTS: In the evaluation, the movement accuracy measured by the root mean squared error (RMSE) during the tracking was significantly improved with the support from both the robot and NMES, in comparison with those without the assistance from the system (P < 0.05). The intra-joint and inter-joint muscular co-contractions measured by EMG were significantly released when the NMES was applied to the agonist muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P < 0.05) were captured by the clinical scores, i.e., Modified Ashworth Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). CONCLUSIONS: The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers. TRIAL REGISTRATION: ClinicalTrials.gov. NCT02117089 ; date of registration: April 10, 2014.
[Mh] Termos MeSH primário: Estimulação Elétrica
Exoesqueleto Energizado
Músculo Esquelético
Robótica
Reabilitação do Acidente Vascular Cerebral/instrumentação
Extremidade Superior
[Mh] Termos MeSH secundário: Adulto
Idoso
Doença Crônica
Articulação do Cotovelo/inervação
Articulação do Cotovelo/fisiologia
Feminino
Articulações dos Dedos/inervação
Articulações dos Dedos/fisiologia
Seres Humanos
Masculino
Meia-Idade
Paresia/etiologia
Paresia/fisiopatologia
Paresia/reabilitação
Educação Física e Treinamento
Resultado do Tratamento
Articulação do Punho/inervação
Articulação do Punho/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1186/s12984-017-0245-y


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[PMID]:28445369
[Au] Autor:Yamamoto M; Malay S; Fujihara Y; Zhong L; Chung KC
[Ad] Endereço:Ann Arbor, Mich.; and Nagoya, Japan From the Section of Plastic Surgery, Department of Surgery, and the Section of Plastic and Reconstructive Surgery, University of Michigan Health System; the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School; and the Department of Hand Surgery, Nagoya University Graduate School of Medicine.
[Ti] Título:A Systematic Review of Different Implants and Approaches for Proximal Interphalangeal Joint Arthroplasty.
[So] Source:Plast Reconstr Surg;139(5):1139e-1151e, 2017 May.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Outcomes after implant arthroplasty for primary degenerative and posttraumatic osteoarthritis of the proximal interphalangeal joint were different according to the implant design and surgical approach. The purpose of this systematic review was to evaluate outcomes of various types of implant arthroplasty for proximal interphalangeal joint osteoarthritis, with an emphasis on different surgical approaches. METHODS: The authors searched all available literature in the PubMed and EMBASE databases for articles reporting on outcomes of implant arthroplasty for proximal interphalangeal joint osteoarthritis. Data collection included active arc of motion, extension lag, and complications. The authors combined the data of various types of surface replacement arthroplasty into one group for comparison with silicone arthroplasty. RESULTS: A total of 849 articles were screened, yielding 40 studies for final review. The mean postoperative arc of motion and the mean gain in arc of motion of silicone implant with the volar approach were 58 and 17 degrees, respectively, which was greater than surface replacement implant with the dorsal approach at 51 and 8 degrees, respectively. The mean postoperative extension lag of silicone implant with the volar approach and surface replacement with the dorsal approach was 5 and 14 degrees, respectively. The revision rate of silicone implant with the volar approach and surface replacement with the dorsal approach was 6 percent and 18 percent at a mean follow-up of 41.2 and 51 months, respectively. CONCLUSION: Silicone implant with the volar approach showed the best arc of motion, with less extension lag and fewer complications after surgery among all the implant designs and surgical approaches.
[Mh] Termos MeSH primário: Artroplastia
Articulações dos Dedos/cirurgia
Prótese Articular
Osteoartrite/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Seres Humanos
Complicações Pós-Operatórias/epidemiologia
Desenho de Prótese
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003260


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[PMID]:28399930
[Au] Autor:Selvaag AM; Kirkhus E; Törnqvist L; Lilleby V; Aulie HA; Flatø B
[Ad] Endereço:Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Post-box 4950, Nydalen, 0424, Oslo, Norway. anselv@ous-hf.no.
[Ti] Título:Radiographic damage in hands and wrists of patients with juvenile idiopathic arthritis after 29 years of disease duration.
[So] Source:Pediatr Rheumatol Online J;15(1):20, 2017 Apr 11.
[Is] ISSN:1546-0096
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There are few studies on radiographic outcome after long-term disease duration in juvenile idiopathic arthritis (JIA). We wanted to evaluate 29-year radiographic outcome in hands/wrists and predictors of damage in patients with long-term active JIA. METHODS: Patients diagnosed from 1980 to 1985, who had active disease at 15-, 23- or 29-year follow-up and arthritis in the wrists during the disease course, were reexamined with radiographs of hands/wrists. We used the adapted version of the Sharp van der Heijde (aSvdH) score and Carpal Height Ratio (CHR) to evaluate radiographic outcome. RESULTS: Sixty patients, mean age 38 years, were reexamined at median 29-year follow-up. 33 patients (55%) had an aSvdH score >0, median score was 4.0 (range 0-313), and 25% of the scores were high (≥53). Most patients with radiographic damage (88%) had both erosions and JSN. 52% of the patients had damage in the wrists, 43% in the MCP joints and 40% in the PIP joints. The CHR correlated strongly with the aSvdH. Both scores had high correlations with the Juvenile Arthritis Damage Index and the number of joints with limited range of motion (LROM) (r = -0.688 to 0.743, p ≤ 0.001). The aSvdH correlated weakly with measures of disease activity. The number of joints with LROM, ESR and the HAQ disability score at 15 years and HLAB27 positivity predicted the aSvdH score and the CHR at 29-year follow-up. CONCLUSIONS: The majority of patients with long-term active JIA had modest radiographic damage, but more frequently in wrists than in fingers. The radiographic scores correlated well with measures of disease damage. Restricted mobility in joints at 15 years was the most important predictor of radiographic damage at 29 years.
[Mh] Termos MeSH primário: Artrite Juvenil/diagnóstico por imagem
Articulações dos Dedos/diagnóstico por imagem
Articulação Metacarpofalângica/diagnóstico por imagem
Articulação do Punho/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Artrite Juvenil/fisiopatologia
Feminino
Articulações dos Dedos/fisiopatologia
Seguimentos
Articulação da Mão/diagnóstico por imagem
Articulação da Mão/fisiopatologia
Seres Humanos
Masculino
Articulação Metacarpofalângica/fisiopatologia
Radiografia
Índice de Gravidade de Doença
Articulação do Punho/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1186/s12969-017-0151-7


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[PMID]:28376239
[Au] Autor:Mease PJ; Karki C; Palmer JB; Etzel CJ; Kavanaugh A; Ritchlin CT; Malley W; Herrera V; Tran M; Greenberg JD
[Ad] Endereço:Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington.
[Ti] Título:Clinical Characteristics, Disease Activity, and Patient-Reported Outcomes in Psoriatic Arthritis Patients With Dactylitis or Enthesitis: Results From the Corrona Psoriatic Arthritis/Spondyloarthritis Registry.
[So] Source:Arthritis Care Res (Hoboken);69(11):1692-1699, 2017 Nov.
[Is] ISSN:2151-4658
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To characterize psoriatic arthritis (PsA) patients with dactylitis or enthesitis and evaluate the associations of these manifestations with disease activity and patient-reported outcomes. METHODS: Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and patient-reported outcomes at registry enrollment were assessed for PsA patients ages ≥18 years with or without dactylitis or enthesitis. Regression models were used to evaluate associations of dactylitis and enthesitis with outcomes, including minimal disease activity, Health Assessment Questionnaire scores, patient-reported pain and fatigue, and work productivity (Work Productivity and Activity Impairment questionnaire). Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologic agent, disease-modifying antirheumatic drug, and prednisone use. RESULTS: This analysis included 1,567 PsA patients (420 with enthesitis; 228 with dactylitis). Patients with versus without dactylitis or enthesitis had greater disease activity and were less likely to be in minimal disease activity (P < 0.05). Patients with versus without enthesitis had poorer functional status as assessed by the Health Assessment Questionnaire (adjusted P = 4.15 x 10 ), greater patient-reported pain and fatigue (adjusted P < 0.0001), and greater likelihood of any impairment while working (adjusted odds ratio [OR] 1.57, P = 0.027), overall work impairment (OR 1.85, P = 0.006), and activity impairment (OR 1.77, P = 0.008). Dactylitis was associated with similar numerical trends, but differences versus patients without dactylitis did not reach statistical significance. CONCLUSION: Enthesitis and dactylitis are associated with greater overall disease burden of PsA, underscoring the importance of identifying, assessing, and effectively managing these periarticular manifestations.
[Mh] Termos MeSH primário: Artrite Psoriásica/diagnóstico
Artrite Psoriásica/epidemiologia
Entesopatia/diagnóstico
Entesopatia/epidemiologia
Articulações dos Dedos/patologia
Sistema de Registros
[Mh] Termos MeSH secundário: Adulto
Idoso
Artrite Psoriásica/terapia
Estudos de Coortes
Estudos Transversais
Progressão da Doença
Entesopatia/terapia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Autorrelato
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.1002/acr.23249



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