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Haddad A, Elkayam PC, Stein N, Feldhamer I, Cohen AD, Saliba W, Zisman D. Epidemiological trends in psoriatic arthritis: a comprehensive population-based study. Arthritis Res Ther 2024; 26:108. [PMID: 38802958 PMCID: PMC11129442 DOI: 10.1186/s13075-024-03339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic, potentially debilitating inflammatory arthritis often associated with psoriasis. Understanding the epidemiology of PsA across diverse populations can provide valuable insights into its global burden and the role of genetic and environmental factors. This study aimed to estimate PsA's temporal trends, prevalence, and incidence, while assessing variations in age, gender, and ethnicity in Israel from 2016 to 2022. METHODS Data were sourced from the Clalit Health Services (CHS) database, covering over half of the Israeli population. Algorithm-based definitions for PsA and psoriasis cases were used. Demographic factors, including age, gender, socioeconomic status (SES), ethnicity, urban/rural residence, BMI, and smoking status, were analyzed. Standardized prevalence and incidence rates were calculated. Logistic regression analyses examined associations of sociodemographic variables with PsA. RESULTS In 2022, the prevalence of PsA was 0.221%, with an incidence rate of 13.54 per 100,000 population. This prevalence has tripled since 2006, reflecting a rising trend in PsA over time. Females exhibited a higher prevalence (1.15; 95%CI 1.09-1.21), and PsA was more common in Jewish individuals (1.58; 95%CI 1.45-1.71) those with higher SES (1.4; 95% CI 1.31, 1.5), and those with obesity (2.17; 95%CI 2.04-2.31). CONCLUSIONS This comprehensive population-based study pointed to an increase prevalence of PsA, emphasizing the rising healthcare demands and economic burden faced by this patient population. Further research is essential to delve into the factors driving these trends.
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Affiliation(s)
- Amir Haddad
- Rheumatology Unit, Carmel Medical Center, 7 Michal Street, Haifa, Israel.
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | | | - Nili Stein
- Department of Epidemiology, Clalit health services, Haifa, Israel
| | - Ilan Feldhamer
- Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel
| | - Arnon Dov Cohen
- Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben- Gurion University of the Negev, Beer-Sheba, Israel
| | - Walid Saliba
- Department of Epidemiology, Clalit health services, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Devy Zisman
- Rheumatology Unit, Carmel Medical Center, 7 Michal Street, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Özpınar Ş, Bornaun H, Sönmez HE, Doğan S, Sönmez S, Harman H. Pediatric Primary Raynaud's Phenomenon: A Comprehensive Cardiovascular Analysis. Pediatr Cardiol 2024:10.1007/s00246-024-03514-9. [PMID: 38739175 DOI: 10.1007/s00246-024-03514-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
Our aim in this study is to evaluate the cardiovascular findings of pediatric patients with primary Raynaud's phenomenon (RP) and to determine if there are any pathological findings. Our study included 42 pediatric patients aged between 7 and 18 who were diagnosed with primary RP and did not have any additional underlying structural vascular disease or secondary rheumatological conditions. The control group consisted of 30 healthy volunteers aged 7-18 years, matched by age and sex, without any additional diseases. We evaluated demographic, clinical, and laboratory findings, echocardiographic and capillaroscopic features, as well as carotid intima-media thickness. Compared to the control group, pediatric patients with primary RP showed increased A wave velocity and E/E' ratio parameters in the left ventricle, indicating diastolic dysfunction of the heart. The isovolumetric relaxation time (IVRT) was prolonged in both the left and right ventricles, and the E/A ratio decreased in the left ventricle. The myocardial performance index (MPI), indicating both systolic and diastolic dysfunction, increased in both ventricles. Additionally, the aortic stiffness index, aortic elastic modulus (Ep), and left carotid intima-media thickness (CIMT) significantly increased, while distensibility decreased in pediatric patients with primary RP compared to the control group. The cardiovascular evaluation of pediatric patients with primary RP revealed that diastolic dysfunction is likely present in both the left and right heart. Additionally, based on the aorta and carotid intima measurements, it is suggested that pediatric patients with primary RP are at risk for developing atherosclerosis.
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Affiliation(s)
- Şeyma Özpınar
- Department of Pediatrics, Faculty of Health Sciences, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey.
| | - Helen Bornaun
- Department of Pediatric Cardiology, Faculty of Health Sciences, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | | | - Sümeyra Doğan
- Department of Radiology, Faculty of Health Sciences, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | - Süleyman Sönmez
- Department of Radiology, Faculty of Health Sciences, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | - Halil Harman
- Department of Rheumatology, Faculty of Health Sciences, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
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3
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Sözeri B, Şahin N, Açarı C, Avar Aydın PO, Baba O, Bağlan E, Bakkaloğlu S, Bakırcı S, Bilginer Y, Bozkaya BY, Çağlayan Ş, Çakan M, Çakmak F, Coşkuner T, Demir F, Demirkan FG, Doğantan Ş, Adıgüzel Dündar H, Ersözlü ED, Gücenmez S, Gürler O, İşgüder R, Küçük A, Kalyoncu M, Kılıç L, Kılıç SŞ, Kısaoğlu H, Paç Kısaarslan A, Kızıldağ Z, Kurtuluş D, Özdel S, Öztürk K, Şenol P, Tanatar A, Taşkın SN, Tuncer Kuru F, Türkuçar S, Ulu K, Ünsal E, Yazıcı A, Gezgin Yıldırım D, Yüksel S, Kasapçopur Ö, Özen S, Aktay Ayaz N, Sönmez HE. Towards a standardized program of transitional care for adolescents with juvenile idiopathic arthritis for Turkey: a national survey study. Pediatr Rheumatol Online J 2024; 22:7. [PMID: 38167070 PMCID: PMC10762787 DOI: 10.1186/s12969-023-00943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is a prevalent childhood chronic arthritis, often persisting into adulthood. Effective transitional care becomes crucial as these patients transition from pediatric to adult healthcare systems. Despite the concept of transitional care being recognized, its real-world implementation remains inadequately explored. This study aims to evaluate the thoughts and practices of healthcare providers regarding transitional care for JIA patients. METHODS A cross-sectional survey was conducted among pediatric and adult rheumatologists in Turkey. Based on the American Academy of Pediatrics' six core elements of transitional care, the survey included 86 questions. The respondents' demographic data, attitudes towards transitional care, and practical implementation were assessed. RESULTS The survey included 48 rheumatologists, with 43.7% having a transition clinic. The main barriers to establishing transition programs were the absence of adult rheumatologists, lack of time, and financial constraints. Only 23.8% had a multidisciplinary team for transition care. Participants agreed on the importance of coordination and cooperation between pediatric and adult healthcare services. The timing of the transition process varied, with no consensus on when to initiate or complete it. Participants advocated for validated questionnaires adapted to local conditions to assess transition readiness. CONCLUSIONS The study sheds light on the challenges and perspectives surrounding transitional care for JIA patients in Turkey. Despite recognized needs and intentions, practical implementation remains limited due to various barriers. Cultural factors and resource constraints affect the transition process. While acknowledging the existing shortcomings, the research serves as a ground for further efforts to improve transitional care and ensure better outcomes for JIA patients transitioning into adulthood.
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Affiliation(s)
- Betül Sözeri
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Nihal Şahin
- Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ceyhun Açarı
- Department of Pediatric Rheumatology, Faculty of Medicine, Inönü University, Malatya, Turkey
| | | | - Ozge Baba
- Department of Pediatric Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Etlik State Hospital, Ankara, Turkey
| | - Sevcan Bakkaloğlu
- Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sibel Bakırcı
- Department of Rheumatology, Antalya State Hospital, Antalya, Turkey
| | - Yelda Bilginer
- Department of Pediatric Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Yücel Bozkaya
- Department of Pediatric Rheumatology, Samsun Research and Training Hospital, Samsun, Turkey
| | - Şengül Çağlayan
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, Zeynep Kamil Research and Training Hospital, Istanbul, Turkey
| | - Figen Çakmak
- Department of Pediatric Rheumatology, Başakşehir Çam and Sakura State Hospital, Istanbul, Turkey
| | - Taner Coşkuner
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Ferhat Demir
- Department of Pediatric Rheumatology, Acıbadem Hospital, Istanbul, Turkey
| | - Fatma Gül Demirkan
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Şeyda Doğantan
- Department of Pediatric Rheumatology, Mersin City Hospital, Mersin, Turkey
| | - Hatice Adıgüzel Dündar
- Department of Pediatric Rheumatology, Behçet Uz Research and Training Hospital, Izmir, Turkey
| | - Emine Duygu Ersözlü
- Department of Rheumatology, Adana City Research and Training Hospital, Adana, Turkey
| | - Sercan Gücenmez
- Department of Rheumatology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
| | - Oğuz Gürler
- Department of Rheumatology, Medikal Park Hospital, Samsun, Turkey
| | - Rana İşgüder
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Adem Küçük
- Department of Rheumatology, Faculty of Medicine, Konya Selçuk University, Konya, Turkey
| | - Mukaddes Kalyoncu
- Department of Pediatric Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Levent Kılıç
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sara Şebnem Kılıç
- Department of Pediatric Rheumatology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Hakan Kısaoğlu
- Department of Pediatric Rheumatology, Kayseri City Hospital, Kayseri, Turkey
| | - Ayşenur Paç Kısaarslan
- Department of Pediatric Rheumatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Zehra Kızıldağ
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Duygu Kurtuluş
- Department of Physical Therapy and Rehabilitation, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Semanur Özdel
- Department of Pediatric Rheumatology, Etlik State Hospital, Ankara, Turkey
| | - Kübra Öztürk
- Department of Pediatric Rheumatology, Göztepe Research and Training Hospital, Istanbul, Turkey
| | - Pelin Şenol
- Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşe Tanatar
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sema Nur Taşkın
- Department of Pediatric Rheumatology, Eskişehir City Hospital, Eskişehir, Turkey
| | - Fatma Tuncer Kuru
- Department of Rheumatology, Osmaniye State Hospital, Osmaniye, Turkey
| | - Serkan Türkuçar
- Department of Pediatric Rheumatology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Kadir Ulu
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Erbil Ünsal
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ayten Yazıcı
- Department of Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Deniz Gezgin Yıldırım
- Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Selçuk Yüksel
- Department of Pediatric Rheumatology, Faculty of Medicine, Onsekiz Mart University, Çanakkele, Turkey
| | - Özgür Kasapçopur
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical School, Istanbul, Turkey
| | - Seza Özen
- Department of Pediatric Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hafize Emine Sönmez
- Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
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Ozdel S, Coşkuner T, Demirkan F, Torun R, Aydın EA, Bağlan E, Yener GO, Öztürk K, Demir F, Karadağ ŞG, Çakan M, Sönmez HE, Makay BB, Ünsal ŞE, Bülbül M, Ayaz NA, Sözeri B. Inflammatory comorbidities ın the largest pediatric Familial Mediterranean fever cohort: a multicenter retrospective study of Pediatric Rheumatology Academy (PeRA)-Research Group (RG). Clin Rheumatol 2024; 43:407-413. [PMID: 37926798 DOI: 10.1007/s10067-023-06802-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
AIM The aim of this study was to investigate the frequency and type of FMF-associated inflammatory diseases in a large FMF pediatric patients and to compare them to those FMF patients without concomitant inflammatory diseases. MATERIALS AND METHODS Familial Mediterranean fever patients enrolled in the Pediatric Rheumatology Academy (PeRA)-Research Group (RG) were included. The patients were divided into two groups according to concomitant inflammatory disease as FMF patients who had a concomitant inflammatory disease (group 1) and FMF patients who did not have a concomitant inflammatory disease (group 1). The clinical findings and treatments were compared between the two groups. RESULTS The study group comprised 3475 patients with FMF. There were 294 patients (8.5%) in group 1 and 3181 patients (91.5%) in group 2. Juvenile idiopathic arthritis (n = 136) was the most common accompanying inflammatory disease. Arthritis, M694V homozygosity, and the need for biological therapy were more frequently observed in Group 1 (p < 0.05). Fever and abdominal pain were more frequently detected in Group 2 (p < 0.05). FMF patients with concomitant inflammatory diseas more frequently demonstrated colchicine resistance. There were no significant differences in the median attack frequency, chest pain, amyloidosis, erysipelas-like erythema, or family history of FMF between the two patient groups. CONCLUSION To the best of our knowledge, this is the largest pediatric cohort reviewed to date. FMF patients may have different clinical profiles and colchicine responses if they have with concomitant inflammatory diseases. Key points • FMF is associated with some inflammatory comorbidities diseases. • To the best of our knowledge, this is the largest cohort evlauated pediatric FMF associated inflammatory comorbidities diseases reviewed to date.
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Affiliation(s)
- Semanur Ozdel
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
- Department of Pediatric Rheumatology, Etlik City Hospital, Ankara, Turkey.
| | - Taner Coşkuner
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Fatmagül Demirkan
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Rüya Torun
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Elif Arslanoglu Aydın
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Gülçin Otar Yener
- Department of Pediatric Rheumatology, Medicalpark Hospital, Gaziantep, Turkey
| | - Kübra Öztürk
- Department of Pediatric Rheumatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ferhat Demir
- Department of Pediatric Rheumatology, Acıbadem Healthcare Group, Istanbul, Turkey
| | - Şerife Gül Karadağ
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Hafize Emine Sönmez
- Department of Pediatric Rheumatology, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Balahan Bora Makay
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Şevket Erbil Ünsal
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Mehmet Bülbül
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Betül Sözeri
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
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Maher CG, Jones CMP, Coombs D, Ferreira G. Considerable Uncertainty About the Burden of Gout in the Middle East and North Africa Region. J Rheumatol 2023; 50:1201-1202. [PMID: 37061231 DOI: 10.3899/jrheum.2022-1306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Affiliation(s)
- Christopher G Maher
- The University of Sydney, Sydney Musculoskeletal Health, Camperdown, New South Wales, Australia.
| | - Caitlin M P Jones
- The University of Sydney, Sydney Musculoskeletal Health, Camperdown, New South Wales, Australia
| | - Danielle Coombs
- The University of Sydney, Sydney Musculoskeletal Health, Camperdown, New South Wales, Australia
| | - Giovanni Ferreira
- The University of Sydney, Sydney Musculoskeletal Health, Camperdown, New South Wales, Australia
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Lancieri M, Bustaffa M, Palmeri S, Prigione I, Penco F, Papa R, Volpi S, Caorsi R, Gattorno M. An Update on Familial Mediterranean Fever. Int J Mol Sci 2023; 24:ijms24119584. [PMID: 37298536 DOI: 10.3390/ijms24119584] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: Familial Mediterranean Fever (FMF) is the prototypal autoinflammatory disease, characterized by recurrent bursts of neutrophilic inflammation. (2) Methods: In this study we look at the most recent literature on this condition and integrate it with novel information on treatment resistance and compliance. (3) Results: The canonical clinical presentation of FMF is in children with self-limited episodes of fever and polyserositis, associated with severe long-term complications, such as renal amyloidosis. It has been described anecdotally since ancient times, however only recently it has been characterized more accurately. We propose an updated overview on the main aspects of pathophysiology, genetics, diagnosis and treatment of this intriguing disease. (4) Conclusions: Overall, this review presents the all the main aspects, including real life outcome of the latest recommendation on treatment resistance of FMF, a disease, that not only helped understanding the pathophysiology of the auto inflammatory process but also the functioning of the innate immune system itself.
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Affiliation(s)
- Maddalena Lancieri
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Marta Bustaffa
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Serena Palmeri
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Ignazia Prigione
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Federica Penco
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Riccardo Papa
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Stefano Volpi
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Roberta Caorsi
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Marco Gattorno
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
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Kötter I, Krusche M. [Inflammatory rheumatic diseases in migrants]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2023; 64:426-434. [PMID: 37099225 DOI: 10.1007/s00108-023-01514-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/27/2023]
Abstract
The immigration of people from other countries or even from other continents represents new challenges even for rheumatologists. Although all inflammatory rheumatic diseases that occur in this country also exist in the countries of origin of immigrants, the frequencies are different. Diseases such as familial Mediterranean fever (FMF) or Behçet syndrome (BS) are rare in western Europe but are often more frequent than rheumatoid arthritis (RA) and spondylarthritis (SPA) in North Africa and Mediterranean countries. Furthermore, FMF is associated with the occurrence of spondyloarthritis, which is then frequently negative for the human leucocyte antigen B27 (HLA-B27). There is also an association with BS. Rheumatic fever also still occurs relatively frequently especially in African countries, whereas it is almost eradicated in Europe. Possible differential diagnoses such as rheumatic symptoms in genetically determined anemia or infections such as human immunodeficiency virus (HIV) infections, hepatitis, tuberculosis and parasitosis need to be considered as they are all much more frequent in the countries of origin of immigrants than in northwestern Europe. Last but not least, the treatment situation with modern diagnostic and treatment modalities is different in the countries of origin of the migrants, either because these possibilities are unavailable due to limited resources or because the situation has dramatically deteriorated due to acute events, such as the recent war in Ukraine.
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Affiliation(s)
- Ina Kötter
- III. Medizinische Klinik, Sektion für Rheumatologie und Entzündliche Systemerkrankungen, Universitätsklinikum Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
- Klinik für Rheumatologie und Immunologie, Klinikum Bad Bramstedt, Oskar-Alexander Str. 26, 24576, Bad Bramstedt, Deutschland.
| | - Martin Krusche
- III. Medizinische Klinik, Sektion für Rheumatologie und Entzündliche Systemerkrankungen, Universitätsklinikum Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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8
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Okuyucu M, Ozdemir AZ, Yalcin Kehribar D, Ozgen M. Ovarian Reserve and Pelvic Ultrasound Assessment in Familial Mediterranean Fever. Cureus 2022; 14:e28027. [PMID: 36134042 PMCID: PMC9472643 DOI: 10.7759/cureus.28027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Familial Mediterranean fever (FMF) is an inflammatory rheumatic disease that affects people in their reproductive period. The aim of this study was to investigate the number of gravida, ovarian reserve, and ovarian doppler characteristics in FMF patients. Methods The study design is cross-sectional. Between November 1, 2018, and October 31, 2019, 40 FMF patients, and 40 age-matched volunteers were included in the study. Early follicular phase follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), progesterone, and anti-Mullerian hormone (AMH) levels, as well as ovarian volume, antral follicle count (AFC), ovarian stromal artery doppler findings, and pelvic pathologies, were evaluated. Results The number of gravida, and the AFC was significantly higher in the control group (16.00 ± 5.22) compared to the patients with FMF (13.00 ± 4.09) (p = 0.026). LH values were significantly higher in the FMF group. Thirteen patients (32.5%) received anakinra and colchicine, and 27 patients (67.5%) received only colchicine. There was no significant difference between the patients receiving anakinra, and the patients receiving colchicine in terms of AMH, FSH, AFC, and E2 values. Conclusion FMF patients were found to have low gravida and AFC, and a significant portion was observed to have pelvic fluid and hydrosalpinx. In conclusion, the presence of pelvic fluid, hydrosalpinx, and low AFC persist in FMF patients despite colchicine and/or anti-interleukin-1 treatments. The low gravida may be related to these pathologies detected in patients with FMF.
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Guo Q, Chen C, Wu Z, Zhang W, Wang L, Yu J, Li L, Zhang J, Duan Y. Engineered PD-1/TIGIT dual-activating cell-membrane nanoparticles with dexamethasone act synergistically to shape the effector T cell/Treg balance and alleviate systemic lupus erythematosus. Biomaterials 2022; 285:121517. [DOI: 10.1016/j.biomaterials.2022.121517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022]
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Lai YF, Lin TY, Chien WC, Sun CA, Chung CH, Chen YH, Chen JT, Chen CL. Uveitis as a Risk Factor for Developing Acute Myocardial Infarction in Ankylosing Spondylitis: A National Population-Based Longitudinal Cohort Study. Front Immunol 2022; 12:811664. [PMID: 35087531 PMCID: PMC8787117 DOI: 10.3389/fimmu.2021.811664] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/17/2021] [Indexed: 12/17/2022] Open
Abstract
Background Ankylosing spondylitis (AS) is a chronic inflammatory disease. Excess cardiovascular risks were well recognized in patients with AS and were attributed to prolonged systemic inflammation. Uveitis is one of the most common extra-articular symptoms of AS and is also considered an indicator of systemic inflammation. This study aimed to investigate whether uveitis was a risk factor for developing acute myocardial infarction (AMI) in patients with AS using the National Health Insurance Research Database (NHIRD). Methods Data were collected from the NHIRD over a fifteen-year period. Variables were analyzed using the Pearson chi-square test and Fisher’s exact test. Risk factors for the occurrence of AMI were examined by calculating hazard ratio. Kaplan-Meier analysis was performed to compare the cumulative incidence of AMI in the uveitis and non-uveitis cohorts. Results A total of 5905 patients with AS were enrolled, including 1181 patients with uveitis (20%) and 4724 patients without uveitis (80%). The Kaplan–Meier method with the log-rank test showed that the uveitis group had a significantly higher cumulative hazard for patients with AMI than the non-uveitis group (p < 0.001). The adjusted hazard ratio (aHR) of AMI was higher in the uveitis group than in the non-uveitis group (aHR = 1.653, p < 0.001). Stratified analysis revealed that patients with uveitis had an increased risk of developing AMI regardless of their sex (male/female aHR = 1.688/1.608, p < 0.001). Patients with uveitis in all age groups were independently associated with an increased risk of developing AMI compared to those without uveitis (20–39 years/40–59 years/≥ 60 years, aHR = 1.550, 1.579, 3.240, p < 0.001). Patients with uveitis had a higher probability of developing AMI regardless of comorbidities. Uveitis patients with comorbidities had a higher risk of developing AMI compared to uveitis patients without comorbidities. Conclusion Uveitis is a significant risk factor for developing AMI in patients with AS. Physicians should be aware of the potential cardiovascular risk in AS patients with uveitis, especially simultaneously with other traditional risk factors of AMI. Further prospective studies are needed to elucidate the underlying mechanism between uveitis and AMI in patients with AS.
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Affiliation(s)
- Yi-Fen Lai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ting-Yi Lin
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.,Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Long Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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11
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Blasco F, García A Á, Martos MD, Muñoz S. Atypical familial Mediterranean fever with PFAPA-Like symptoms and psoriasis. REUMATOLOGIA CLINICA 2021; 17:489-490. [PMID: 34625154 DOI: 10.1016/j.reumae.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/22/2020] [Indexed: 06/13/2023]
Affiliation(s)
- Felipe Blasco
- Unidad de Diagnóstico Médico y Enfermedades Minoritarias, Servicio de Medicina Interna, Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain.
| | - Ángel García A
- Servicio de Reumatología, Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
| | - María Dolores Martos
- Servicio de Alergia, Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
| | - Sandra Muñoz
- Servicio de Medicina Interna, Hospital Quirón Torrevieja, Torrevieja, Alicante, Spain
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12
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Bairkdar M, Rossides M, Westerlind H, Hesselstrand R, Arkema EV, Holmqvist M. Incidence and prevalence of systemic sclerosis globally: a comprehensive systematic review and meta-analysis. Rheumatology (Oxford) 2021; 60:3121-3133. [PMID: 33630060 PMCID: PMC8516513 DOI: 10.1093/rheumatology/keab190] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/14/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We aimed to conduct a systematic review and meta-analysis on the incidence and prevalence of SSc covering the entire literature. METHODS This study followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement of 2009. We conducted a systematic search in MEDLINE, Web of Science and Embase to identify articles reporting incidence and/or prevalence of SSc. Two authors conducted the search, reviewed articles for inclusion and extracted relevant data. We used random-effects models to estimate the pooled prevalence and incidence of SSc and performed subgroup analyses by sex, case definition and region to investigate heterogeneity. We explored the association between calendar period and reported estimates using meta-regression. RESULTS Among 6983 unique records identified, we included 61 studies of prevalence and 39 studies of incidence in the systematic review. The overall pooled prevalence of SSc was 17.6 (95% CI 15.1, 20.5) per 100 000 and the overall pooled incidence rate of SSc was 1.4 (95% CI 1.1, 1.9) per 100 000 person-years. We observed significant regional variations in reported estimates; studies conducted in North America reported considerably higher estimates than other regions. The pooled incidence and prevalence in women were five times higher than in men. More recent studies reported higher estimates than older ones. CONCLUSION In this comprehensive review of the incidence and prevalence of SSc across the world, there was large heterogeneity among estimates, which should be taken into consideration when interpreting the results.
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Affiliation(s)
- Majd Bairkdar
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Marios Rossides
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Helga Westerlind
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Roger Hesselstrand
- Section for Rheumatology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund
| | - Elizabeth V Arkema
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Marie Holmqvist
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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13
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Malik J, Shabbir A, Nazir A. Cardiovascular Sequelae and Genetics of Familial Mediterranean Fever: A Literature Review. Pulse (Basel) 2021; 8:78-85. [PMID: 34307203 PMCID: PMC8280401 DOI: 10.1159/000516182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/27/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Familial Mediterranean fever (FMF) is an autoinflammatory fever syndrome distinguished by recurrent attacks of spontaneous peritonitis, pleuritis, fever, and arthritis. It is specifically seen in the ethnic groups of Mediterranean origin, but sporadic cases have been reported in Eastern Europe and America due to migrations. There is a number of cardiac manifestations associated with FMF. METHODS Using PubMed as the search engine, the literature search was done for articles published between 1958 and 2020. To summarize the body of available evidence, a scoping review was carried out to find relevant articles and case reports in patients of FMF with cardiovascular manifestations. RESULTS In the literature, there is a number of mechanisms explaining the cause of cardiac involvement in FMF, including the subclinical inflammation and secondary (AA) amyloid deposition in the vessels and the myocardium. There is a variable and often spurious course of these manifestations and it can be associated with a poor prognosis such as an acute myocardial infarction. In FMF patients, polyarteritis nodosa and Henoch-Schönlein purpura are seen more significantly as compared to the general population with increased frequency of mutations in Mediterranean fever (MEFV) gene. Through unclear mechanisms, Behçet's disease is associated with MEFV gene mutations and shares vascular manifestations with FMF. There is an interplay of IL-1 and MEFV gene, which impart an important role in inflammatory attacks of FMF. There is an intima-media thickening of blood vessels AA to persistent inflammation which can lead to atherosclerotic plaque formation resulting in atherosclerotic cardiovascular disease. CONCLUSION FMF and its associated cardiovascular diseases are interlinked to 2 main mechanisms: subclinical atherosclerosis and amyloid deposition, and colchicine is the primary treatment of patients with FMF which shows the regression of amyloid deposits and prevents cardiovascular sequelae.
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Affiliation(s)
- Jahanzeb Malik
- Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
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14
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Karmacharya P, Crowson CS, Bekele D, Achenbach SJ, Davis JM, Ogdie A, Duarte-García A, Ernste FC, Maradit-Kremers H, Tollefson MM, Wright K. The Epidemiology of Psoriatic Arthritis Over Five Decades: A Population-Based Study. Arthritis Rheumatol 2021; 73:1878-1885. [PMID: 33779070 DOI: 10.1002/art.41741] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/16/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine the incidence of psoriatic arthritis (PsA) in a US population and describe trends in incidence and mortality over 5 decades. METHODS The previously identified population-based cohort that included Olmsted County, Minnesota residents ≥18 years of age who fulfilled PsA criteria during 1970-1999 was extended to include patients with incident PsA during 2000-2017. Age- and sex-specific incidence rates and point prevalence, adjusted to the 2010 US White population, were reported. RESULTS There were 164 incident cases of PsA in 2000-2017 (mean ± SD age 46.4 ± 12.0 years; 47% female). The overall age- and sex-adjusted annual incidence of PsA per 100,000 population was 8.5 (95% confidence interval [95% CI] 7.2-9.8) and was higher in men (9.3 [95% CI 7.4-11.3]) than women (7.7 [95% CI 5.9-9.4]) in 2000-2017. Overall incidence was highest in the 40-59 years age group. The incidence rate was relatively stable during 2000-2017, with no evidence of an overall increase or an increase in men only (but a modest increase of 3% per year in women), compared to 1970-1999 when a 4%-per-year increase in incidence was observed. Point prevalence was 181.8 per 100,000 population (95% CI 156.5-207.1) in 2015. The percentage of women among those with PsA increased from 39% in 1970-1999 and 41% in 2000-2009 to 54% in 2010-2017 (P = 0.08). Overall survival in PsA did not differ from the general population (standardized mortality ratio 0.85 [95% CI 0.61-1.15]). CONCLUSION The incidence of PsA in this predominantly White US population was stable in 2000-2017, in contrast to previous years. However, an increasing proportion of women with PsA was found in this study.
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Affiliation(s)
| | | | | | | | | | - Alexis Ogdie
- University of Pennsylvania Perelman School of Medicine, Philadelphia
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15
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Pozzato M, Micaglio E, Starvaggi Cucuzza C, Cagol A, Galimberti D, Calandrella D, Cinnante C, Pappone C, Zanussi M, Meola G, Scarpini E, Bresolin N, Martinelli Boneschi F. Case Report: Efficacy of Rituximab in a Patient With Familial Mediterranean Fever and Multiple Sclerosis. Front Neurol 2021; 11:591395. [PMID: 33584496 PMCID: PMC7874168 DOI: 10.3389/fneur.2020.591395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/04/2020] [Indexed: 01/16/2023] Open
Abstract
Familial Mediterranean Fever (FMF) is a genetic autoinflammatory disease characterized by recurrent episodes of fever and serositis caused by mutations in the MEFV gene, while Multiple Sclerosis (MS) is an inflammatory demyelinating disease of the CNS with genetic and environmental etiology. The two diseases rarely occur in association with relevant implications for clinical management and drug choice. In this paper, we present the case of a 53-year-old male with an autosomal dominant FMF since childhood who presented acute paresthesia at the right part of the body. He performed a brain and spinal cord MRI, which showed multiple brain lesions and a gd-enhancing lesion in the cervical spinal cord, and then received a diagnosis of MS. He then started Interferonβ-1a which was effective but not tolerated and caused hepatotoxicity, and then shifted to Rituximab with 3-month clinical and neuroradiological efficacy.
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Affiliation(s)
- Mattia Pozzato
- Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit & MS Centre, Milan, Italy.,Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Emanuele Micaglio
- Arrhythmology and Electrophysiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milan, Italy
| | - Chiara Starvaggi Cucuzza
- Department of Neurology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, San Donato Milanese, Italy
| | - Alessandro Cagol
- Department of Neurology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, San Donato Milanese, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Daniela Calandrella
- Department of Neurology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Humanitas Research Hospital and University, Milan, Italy
| | - Claudia Cinnante
- Neuroradiology Unit, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Pappone
- Arrhythmology and Electrophysiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milan, Italy
| | - Monica Zanussi
- Clinical Genomics-Molecular Genetics Service, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, San Raffaele Hospital, Milan, Italy
| | - Giovanni Meola
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Neurorehabilitation Sciences, Casa di Cura Privata del Policlinico, Milan, Italy
| | - Elio Scarpini
- Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit & MS Centre, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Nereo Bresolin
- Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit & MS Centre, Milan, Italy.,Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Filippo Martinelli Boneschi
- Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit & MS Centre, Milan, Italy.,Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Milan, Italy
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16
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Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29-30:100587. [PMID: 34505846 PMCID: PMC7704420 DOI: 10.1016/j.eclinm.2020.100587] [Citation(s) in RCA: 417] [Impact Index Per Article: 104.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a major cause of disability in the elderly, however, there are few studies to estimate the global prevalence, incidence, and risk factors of knee OA. METHODS For this study, we searched PUBMED, EMBASE and SCOPUS from inception to April 4, 2020, without language restriction. We identified eligible studies with information on the prevalence or incidence of knee OA in population-based observational studies and extracted data from published reports. We did random-effects meta-analysis to generate estimates. This study was registered with PROSPERO (CRD42020181035). FINDINGS Out of 9570 records identified, 88 studies with 10,081,952 participants were eligible for this study. The pooled global prevalence of knee OA was 16⋅0% (95% CI, 14⋅3%-17⋅8%) in individuals aged 15 and over and was 22⋅9% (95% CI, 19⋅8%-26⋅1%) in individuals aged 40 and over. Correspondingly, there are around 654⋅1 (95% CI, 565⋅6-745⋅6) million individuals (40 years and older) with knee OA in 2020 worldwide. The pooled global incidence of knee OA was 203 per 10,000 person-years (95% CI, 106-331) in individuals aged 20 and over. Correspondingly, there are around annual 86⋅7 (95% CI, 45⋅3-141⋅3) million individuals (20 years and older) with incident knee OA in 2020 worldwide. The prevalence and incidence varied substantially between individual countries and increased with age. The ratios of prevalence and incidence in females and males were 1⋅69 (95% CI, 1⋅59-1⋅80, p<0⋅00) and 1⋅39 (95% CI, 1⋅24-1⋅56, p<0⋅00), respectively. INTERPRETATION Our study provides the global prevalence (16⋅0% [95% CI, 14⋅3%-17⋅8%]) and incidence (203 per 10,000 person-years [95% CI, 106-331]) of knee OA. These findings can be used to better assess the global health burden of knee OA. Further prospective cohort studies are warranted to identify modifiable risk factors for providing effectively preventive strategies in the early stages of the disease. FUNDING This work was supported by grants from the National Natural Science Foundation of China (nos. 81772384 and 81572174).
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Affiliation(s)
| | | | - Dawei Wang
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Junlong Zhong
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Yufeng Chen
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Huading Lu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
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17
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Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int 2020; 41:863-877. [PMID: 33175207 DOI: 10.1007/s00296-020-04731-0] [Citation(s) in RCA: 258] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/12/2020] [Indexed: 12/26/2022]
Abstract
The objective is to determine the global population prevalence of rheumatoid arthritis (RA) based on population-based studies and assess factors that influence RA prevalence estimates. Four electronic databases were searched (ProQuest Central, MEDLINE, Web of Science, and EMBASE) for peer-reviewed English publications that report prevalence estimates of RA from 1980 and 2019. We included case-control studies, cross-sectional studies, and prospective or retrospective cohort studies in our search strategy. A random-effect meta-analysis model was used to produce the pooled prevalence estimates. The potential between-study heterogeneity was identified using sensitivity analysis, sub-group and meta-regression analyses. A total of 67 studies were included in the meta-analysis, containing 742,246 RA patients and 211,592,925 healthy controls in the study period. The global RA prevalence estimate was 0.46% (95% confidence interval [CI] 0.39-0.54; I2 = 99.9%) with a 95% prediction interval (0.06-1.27). The RA point-prevalence was 0.45% (95% CI 0.38-0.53%) between 1986 and 2014, while the pooled period-prevalence was 0.46% (95% CI 0.36% and 0.57%) from 1955 to 2015. The highest RA pooled prevalence (0.69%; 95% CI 0.47-0.95) was derived from linked data source studies. Based on meta-regression, the factors that explain the studies' heterogeneity of RA prevalence, including geographical location, the risk bias assessment of studies and sample size. The global prevalence of RA between 1980 and 2019 was 460 per 100,000 population, with variations due to geographical location and study methodology. Linked data are the preferred method to estimate RA population prevalence as they provide the best case ascertainment.
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Affiliation(s)
- Khalid Almutairi
- School of Medicine, The University of Western Australia, Perth, Australia.
- King Fahd Specialist Hospital, Burydah, Saudi Arabia.
| | - Johannes Nossent
- School of Medicine, The University of Western Australia, Perth, Australia
- Sir Charles Gairdner and Osborne Park Health Care Group, Perth, Australia
| | - David Preen
- School of Population and Global Health, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | - Helen Keen
- School of Medicine, The University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Charles Inderjeeth
- School of Medicine, The University of Western Australia, Perth, Australia
- Sir Charles Gairdner and Osborne Park Health Care Group, Perth, Australia
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18
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Abstract
PURPOSE OF REVIEW To discuss the disease incidence and prevalence rates of axial spondyloarthritis (axSpA) and ankylosing spondylitis (AS) relative to those of rheumatoid arthritis (RA). RECENT FINDINGS According to the most recently published systematic reviews, pooled prevalence estimates for RA are 0.38% in North America, and 0.21 to 0.25% in European subregions, while that of AS is 0.20% in North America and 0.25% in Europe. The estimated prevalence of axSpA has been reported to be approximately twice as common as AS in a study from the USA. This finding has also been supported by studies from northern Norway, central Italy, western Turkey, northern and southern regions of China, and rural Taiwan. These data suggest that axSpA, that encompasses AS, may be more prevalent than RA, at least in some countries. In general, higher occurrences of RA relative to AS have been noted worldwide, both in terms of incidence and prevalence. But axSpA, that encompasses AS, may be more prevalent than RA, at least in some countries. There is a need for concurrently run studies in the same population for a reliable comparison to establish occurrence of RA, AS, and axSpA. It is hoped that the implementation of the ICD-11 codes for axSpA will be helpful in determining a more accurate estimate of its incidence and prevalence.
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19
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Iskandar IYK, Parisi R, Griffiths CEM, Ashcroft DM. Systematic review examining changes over time and variation in the incidence and prevalence of psoriasis by age and gender. Br J Dermatol 2020; 184:243-258. [PMID: 32358790 DOI: 10.1111/bjd.19169] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is a lack of any overview of changes over time and variation in the epidemiology of psoriasis with age and between genders. OBJECTIVES To perform a systematic review of published population-based studies on variations in psoriasis incidence and prevalence with age and between genders, and to explore trends in psoriasis epidemiology over time. METHODS Eleven electronic and regional databases were searched from their inception dates to October 2019. No language restrictions were applied. Studies were eligible if they reported on changes in psoriasis incidence and/or prevalence over time and/or by age group and gender. RESULTS In total 308 papers were critically appraised, from which 90 studies from 22 countries were included. Incidence data confirmed a clear bimodal age pattern in psoriasis onset, with the first and second peaks at around 30-39 and 60-69 years of age, respectively, and evidence suggesting that it presents slightly earlier in women than in men. Prevalence data showed an increasing trend with age until around 60 or 70 years, after which it decreases. Although there was lack of agreement on specific gender differences in psoriasis incidence and prevalence, a slight male predominance was reported in several studies. Studies worldwide suggested a stable or slightly decreasing trend in psoriasis incidence, while an increasing trend in psoriasis prevalence has been consistently reported. One particular challenge faced was the vastly different methodologies used in the included studies, which contributed to some of the heterogeneity of the results. CONCLUSIONS Studies on changes over time in the occurrence of psoriasis have contributed to a greater appreciation of the increasing burden of the disease. However, further research is required to determine the reasons driving the increase in psoriasis prevalence over time.
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Affiliation(s)
- I Y K Iskandar
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - R Parisi
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Division of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C E M Griffiths
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - D M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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20
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Romero Pérez A, Queiro R, Seoane-Mato D, Graell E, Chamizo E, Chaves Chaparro L, Rojas Herrera S, Pons Dolset J, Polo Ostáriz MA, Ruiz-Alejos Garrido S, Macía-Villa C, Cruz-Valenciano A, González Gómez ML, Sánchez-Piedra C, Díaz-González F, Bustabad-Reyes S. Higher prevalence of psoriatic arthritis in the adult population in Spain? A population-based cross-sectional study. PLoS One 2020; 15:e0234556. [PMID: 32555622 PMCID: PMC7299392 DOI: 10.1371/journal.pone.0234556] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/28/2020] [Indexed: 02/08/2023] Open
Abstract
Objective The prevalence of psoriatic arthritis (PsA) is very heterogeneous. There are no data on its frequency in the general population in Spain. The aim of EPISER2016 study was to estimate the prevalence of PsA in people aged ≥20 years in Spain. Methods Cross-sectional multicenter population-based study. Subjects from all the autonomous communities in Spain were randomly selected using multistage stratified cluster sampling. Participants in each of the municipalities randomly selected for the study were administered a telephone-based questionnaire to screen for the study diseases. If the participant reported being previously diagnosed, rheumatologists from the participant’s reference hospital confirmed the diagnosis based on a review of the clinical history. Subjects not previously diagnosed but whose screening result was positive based on symptoms received a second telephone call from the investigating rheumatologist in order to evaluate the suspicion. If the suspicion remained, an appointment was made at the reference hospital to complete the diagnostic confirmation process according to CASPAR criteria. To calculate the prevalence and its 95% confidence interval (CI), the sample design was taken into account and weighing was calculated considering age, sex and geographic origin. Results The sample comprised 4916 subjects. The prevalence of PsA was 0.58% (95%CI: 0.38–0.87). All but 1 of the 27 cases (96.30%) had been diagnosed prior to EPISER2016. Conclusion The prevalence of PsA in Spain was among the highest reported to date, only below that reported in Norway (0.67%) and slightly higher than that reported in Italy (0.42%).
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Affiliation(s)
| | - Rubén Queiro
- Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Daniel Seoane-Mato
- Research Unit, Spanish Society of Rheumatology, Madrid, Spain
- * E-mail: (SBR); (DSM)
| | - Eduard Graell
- Department of Rheumatology, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Eugenio Chamizo
- Department of Rheumatology, Hospital de Mérida, Mérida, Badajoz, Spain
| | | | | | - Jordi Pons Dolset
- Department of Rheumatology, Fundación Hospital Calahorra, Calahorra, La Rioja, Spain
| | | | | | - Cristina Macía-Villa
- Department of Rheumatology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Ana Cruz-Valenciano
- Department of Rheumatology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | | | | | - Federico Díaz-González
- Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain
- Department of Rheumatology, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Sagrario Bustabad-Reyes
- Department of Rheumatology, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
- * E-mail: (SBR); (DSM)
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The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: A single-blind, prospective, randomized-controlled study. Turk J Phys Med Rehabil 2020; 66:73-83. [PMID: 32318678 DOI: 10.5606/tftrd.2020.3089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 01/23/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives In this study, we aimed to evaluate the effect of physical therapy modalities on pain, sleep, mental status, and quality of life of patients with osteoarthritis (OA). Patients and methods Between January 2017 and June 2017, a total of 40 patients (9 males, 31 females; mean age 56.6±8.9 years; range, 40 to 70 years) who were diagnosed with knee OA according to the American College of Rheumatology (ACR) criteria and were in Kellgren- Lawrence Grade 2-3 were included in the study. The patients were divided into two groups equally. Both groups received 15 sessions of exercise therapy, whereas the intervention group also received 10 consecutive physical therapy sessions in the form of hot pack, therapeutic ultrasound (US), and transcutaneous electrical nerve stimulation (TENS) by a single physiotherapist. Isometric and isotonic exercises were planned as 10 reps for three times a day as a home-based program. Clinical assessments were performed using the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Beck Depression Inventory (BDI), Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Short Form 36 (SF-36) before and after treatment. Results Pre-treatment VAS, ESS, PQSI, BDI, WOMAC, and SF-36 scores showed no significant difference between the groups, whereas post-treatment scores showed a significant difference in the intervention group (p<0.05). The difference between the pre- and post-treatment VAS, ESS, PQSI, BDI, WOMAC, and SF-36 scores were significantly higher in the intervention group, compared to the controls (p<0.05). Conclusion Our study results show positive effects of exercise and physical therapy modalities on pain, disease activity, sleep quality, depression, and quality of life in knee OA patients.
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Blasco F, García A Á, Martos MD, Muñoz S. Atypical familial mediterranean fever with PFAPA-Like symptoms and psoriasis. REUMATOLOGIA CLINICA 2020; 17:S1699-258X(20)30028-0. [PMID: 32265159 DOI: 10.1016/j.reuma.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/28/2020] [Accepted: 02/22/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Felipe Blasco
- Unidad de Diagnóstico Médico y Enfermedades Minoritarias, Servicio de Medicina Interna, Hospital Universitario de Torrevieja, Torrevieja, Alicante, España.
| | - Ángel García A
- Servicio de Reumatología, Hospital Universitario de Torrevieja, Torrevieja, Alicante, España
| | - María Dolores Martos
- Servicio de Alergia, Hospital Universitario de Torrevieja, Torrevieja, Alicante, España
| | - Sandra Muñoz
- Servicio de Medicina Interna, Hospital Quirón Torrevieja, Torrevieja, Alicante, España
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Lee H, Ford JA, Jin Y, Cho SK, Santiago Ortiz AJ, Tong AY, Kim SC. Validation of claims-based algorithms for psoriatic arthritis. Pharmacoepidemiol Drug Saf 2019; 29:404-408. [PMID: 31849154 DOI: 10.1002/pds.4950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/27/2019] [Accepted: 12/06/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE An increasing number of new medications are being developed and approved for psoriatic arthritis (PsA). To generate real-world evidence on comparative safety and effectiveness of these drugs, a claims-based algorithm that can accurately identify PsA is greatly needed. METHODS To identify patients with PsA, we developed seven claims-based algorithms based on a combination of diagnosis codes and medication dispensing using the claims data from Medicare parts A/B/D linked to electronic medical records (2012-2014). Two physicians independently conducted a chart review using the treating physician's diagnosis of PsA as the gold standard. We calculated the positive predictive value (PPV) and 95% confidence intervals of each algorithm. RESULTS Of the total 2157 records identified by the seven algorithms, 45% of the records had relevant clinical data to determine the presence of PsA. The PPV of the algorithms ranged from 75.2% (algorithm 1: ≥2 diagnosis codes for PsA and ≥1 diagnosis code for psoriasis) to 88.6% (algorithm 7: ≥2 diagnosis codes for PsA with ≥1 code by rheumatologist and ≥1 dispensing for PsA medication). Having ≥2 diagnosis codes and ≥1 dispensing for PsA medications (algorithm 6) also had PPV of 82.4%. CONCLUSIONS All seven claims-based algorithms demonstrated a moderately high PPV of 75% to 89% in identifying PsA. The use of ≥2 diagnosis codes plus ≥1 prescription claim for PsA appears to be a valid and efficient tool in identifying PsA patients in the claims data, while broader algorithms based on diagnoses without a prescription claim also have reasonably good PPVs.
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Affiliation(s)
- Hemin Lee
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Julia A Ford
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yinzhu Jin
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Soo-Kyung Cho
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - Adrian J Santiago Ortiz
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Angela Y Tong
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Seoyoung C Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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24
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Kösekahya P, Üçgül Atılgan C, Atılgan KG, Koç M, Tekin K, Çağlayan M, Göker YŞ. Corneal Endothelial Morphology and Thickness Changes in Patients with Gout. Turk J Ophthalmol 2019; 49:178-182. [PMID: 31486603 PMCID: PMC6761378 DOI: 10.4274/tjo.galenos.2018.01947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives: To investigate corneal endothelial cell density (ECD), morphology, and central corneal thickness (CCT) in patients with gout compared with healthy subjects. Materials and Methods: Fifty eyes of 50 gout patients and 50 eyes of 50 healthy subjects without gout or any other systemic disease were included in this study. After detailed ophthalmologic examination, specular microscopy (Tomey EM-4000; Tomey Corp) measurement was performed for all participants. ECD, average cell area (ACA), coefficient of variation (CV), hexagonality ratio, and CCT values were recorded. Results: Mean ECD and hexagonality ratio were lower (p=0.004 and p=0.002) and CV, ACA, and CCT values were higher (p=0.001, p=0.007, and p=0.001) in patients with gout when compared to healthy subjects. There were significant correlations between gout disease duration and CD and hexagonality ratio (p=0.019 and p=0.043) and also between uric acid value and hexagonality ratio and CCT (p=0.044 and p=0.003). Conclusion: Altered corneal endothelial function was found in patients with gout when compared to healthy subjects and the alteration increased as gout duration and uric acid value increased.
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Affiliation(s)
- Pınar Kösekahya
- Ulucanlar Eye Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey
| | | | | | - Mustafa Koç
- Ulucanlar Eye Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Kemal Tekin
- Van Erciş State Hospital, Ophthalmology Clinic, Van, Turkey
| | - Mehtap Çağlayan
- Gazi Yaşargil Training and Research Hospital, Ophthalmology Clinic, Diyarbakır, Turkey
| | - Yasin Şakir Göker
- Ulucanlar Eye Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey
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25
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Atas N, Armagan B, Bodakci E, Satis H, Sari A, Bilge NSY, Salman RB, Yardımcı GK, Babaoglu H, Guler AA, Karadeniz H, Kilic L, Ozturk MA, Goker B, Haznedaroglu S, Kalyoncu U, Kasifoglu T, Tufan A. Familial Mediterranean fever is associated with a wide spectrum of inflammatory disorders: results from a large cohort study. Rheumatol Int 2019; 40:41-48. [PMID: 31392498 DOI: 10.1007/s00296-019-04412-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/31/2019] [Indexed: 12/28/2022]
Abstract
Familial Mediterranean fever (FMF) is characterized by recurrent short-lived/self-limiting inflammatory attacks. Besides these, a substantial number of patients with FMF present with a variety of other inflammatory diseases; however, this issue has not been systematically studied previously. Hence, we aimed to investigate the frequency of inflammatory comorbid diseases in a large FMF cohort. All patients were recruited from "FMF in Central Anatolia (FiCA) Cohort", comprising 971 (mean age 35.3 ± 12 years, 61.5% female) adult subjects. All patients fulfilled Tel Hashomer criteria. Demographic data, FMF disease characteristics, MEFV gene mutations, and comorbid inflammatory diseases were meticulously questioned, and laboratory features and genotype data were retrieved from hospital records. There were comorbid inflammatory diseases in 205 (21.1%) patients. The most common inflammatory disease was spondyloarthritis (12.9%). Other remarkable inflammatory disorders were psoriasis, immunoglobulin A vasculitis/Henoch-Schönlein purpura, Behçet's disease and inflammatory bowel diseases. Cryptogenic organizing pneumonia is a newly defined entity in our cohort which is seemed to be associated with FMF (0.3%). Number of patients with persistent inflammation was higher in those with comorbid diseases (p < 0.001). Our results suggest that FMF is commonly associated with other inflammatory diseases. Therefore, clinicians should be cautious about comorbid inflammatory diseases in FMF patients, particularly in those with persistent inflammation. Identification of pathogenic pathways linking FMF to these diseases warrants further investigations.
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Affiliation(s)
- Nuh Atas
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey.
| | - Berkan Armagan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erdal Bodakci
- Division of Rheumatology, Department of Internal Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Hasan Satis
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Alper Sari
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nazife Sule Yasar Bilge
- Division of Rheumatology, Department of Internal Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Reyhan Bilici Salman
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Gozde Kubra Yardımcı
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hakan Babaoglu
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Aslihan Avanoglu Guler
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Hazan Karadeniz
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Levent Kilic
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Akif Ozturk
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Berna Goker
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Seminur Haznedaroglu
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Timucin Kasifoglu
- Division of Rheumatology, Department of Internal Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Abdurrahman Tufan
- Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, 06100, Ankara, Turkey
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Evaluation of co-existing diseases in children with familial Mediterranean fever. Rheumatol Int 2019; 40:57-64. [PMID: 31352561 DOI: 10.1007/s00296-019-04391-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/21/2019] [Indexed: 01/03/2023]
Abstract
Familial Mediterranean fever (FMF) is A common periodic fever syndrome. The causative gene of the FMF is named Mediterranean Fever gene (MEFV). Increased inflammation in FMF may play a role as a trigger for the development of some diseases. The objective of the study is to evaluate the frequency of comorbid disorders in children followed up with diagnosis of FMF. Additionally, we aimed to assess the association between FMF and other inflammatory conditions in a large pediatric FMF cohort. A total of 686 FMF patients were included in the cross-sectional study. A questionnaire including questions about characteristics of fever episodes, presence of arthralgia, arthritis, abdominal pain, chest pain during and co-existence of any other disease diagnosed by a physician was filled out by face-to-face interviews with patients or their parents. Female-male ratio was 0.85. Median age at the time of study, age at disease onset and at the time of diagnosis were 12.9 (1.7-22.3), 3 (0.08-17), and 6 (0.75-17) years, respectively. In 130 (18.9%) FMF patients we detected co-existing inflammatory condition. The most common co-existing diseases were: juvenile idiopathic arthritis 42 (6.1%), asthma/reactive airway disease 29 (4.2%), Henoch-Schönlein purpura 20 (2.9%), uveitis 12 (1.7%) and inflammatory bowel disease 10 (1.4%). Except for asthma/reactive airway disease and inflammatory bowel disease, there was no significant difference regarding the type of MEFV gene mutation. We have reported increased frequencies of various inflammatory conditions and decreased frequency of asthma in patients with FMF.
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Abstract
Familial Mediterranean Fever (FMF) is the oldest and the most frequent of all described hereditary periodic fever syndromes. The populations originating from Mediterranean basin carry the highest risk for FMF however it is being increasingly recognized in many parts of the world. It is an autoinflammatory disease with an autosomal recessive transmission. In the majority of the patients it is related with mutations in the MEFV gene that encodes a protein named pyrin. This protein has been shown to act as a regulator of inflammation mediated by IL-1β, which plays a major role in the pathogenesis of FMF. Approximately one-third of the patients have either a single or no mutation which raise questions about its mode of inheritance. FMF is a clinical diagnosis and characterized by self-limited bouts of fever and serositis. The main long-term complication of the disease is AA amyloidosis. The mainstay of treatment is life-long colchicine given daily to prevent the recurrence of febrile attacks and the development of amyloidosis. Patients with insufficient response to colchicine may be treated with anti IL-1 agents.
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Affiliation(s)
- Thorvardur Jon Love
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Arthur Kavanaugh
- Department of Medicine, Division of Rheumatology, Allergy, Immunology, The University of California, San Diego, CA, USA
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The relationship between bristol rheumatoid arthritis fatigue scales and disease activity of patients with rheumatoid arthritis. Clin Rheumatol 2018; 37:2927-2932. [PMID: 30062448 DOI: 10.1007/s10067-018-4224-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/27/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
Abstract
Fatigue is a symptom that affects the 40-80% of patients with rheumatoid arthritis (RA) and impairs the quality of life. The aim of this study was to assess multidimensional fatigue scales, the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ) and the Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scale (BRAF-NRS) and to evaluate their relationship with disease activity in Turkish RA patients. The study included 180 patients with RA. The Disease Activity Score (DAS28), Clinical Disease Activity Index (CDAI), and Simplified Disease Activity Index (SDAI) were used to evaluate disease activity. The participants comprised of 142 females and 38 males. The mean ± standard deviations of DAS28, CDAI, and SDAI were 3 ± 1.24, 9.51 ± 7.96, and 10.5 ± 8.38 respectively. All scales except the emotional subscale were correlated with disease activity. The emotional subscale correlated with CDAI and SDAI but not with DAS28. The results of the study indicated that fatigue and disease activity were correlated. Fatigue is a symptom that impairs the quality of life but it can be easily coped with by controlling disease activity. Thus, it should be assessed in a multidimensional perspective.
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30
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Prevalence and incidence of psoriatic arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2018; 48:28-34. [DOI: 10.1016/j.semarthrit.2018.01.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/10/2017] [Accepted: 01/02/2018] [Indexed: 02/08/2023]
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Barut K, Pamuk G, Adrovic A, Şahin S, Kaplan A, Güler M, Kasapçopur Ö. Comparison of familial Mediterranean fever and juvenile idiopathic arthritis patients according to family origin. Turk Arch Pediatr 2018; 53:31-36. [PMID: 30083072 DOI: 10.5152/turkpediatriars.2018.5818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/29/2017] [Indexed: 11/22/2022]
Abstract
Aim Familial Mediterranean fever is an inherited condition that is more prevalent in some regions of Turkey. Juvenile idiopathic arthritis is the most common chronic arthritis of childhood. There is lack of studies on the frequency of mentioned conditions across different regions of Turkey. We aimed to compare the Familial Mediterranean fever and juvenile idiopathic arthritis patients according to their family origin. Material and Methods Patients with diagnosis of familial Mediterranean fever and juvenile idiopathic arthritis followed up at the Division of Pediatric Rheumatology were assessed. Data regarding the family origin of patients were noted from their medical records. Both groups were compared according to their origins. Results A total of 704 patients with Familial Mediterranean fever, 204 patients with juvenile idiopathic arthritis were enrolled. The main age of the patients at the study time was 12.3±4.4 years and 12.1±4.8 years, respectively. The frequency of familial Mediterranean fever was significantly higher in subjects with the origin of Black Sea and Central Anatolia regions (z score 2.69, and 3.69, respectively). Juvenile idiopathic arthritis was significantly more common in subjects from Marmara and Southeastern Anatolia regions (z score -4.11 and -2.54, respectively). Conclusion The familial Mediterranean fever is more common among subjects from the Black Sea and Central Anatolia regions of Turkey, especially Kastamonu, Sivas and Tokat provinces. Whereas, patients with juvenile idiopathic arthritis more commonly originate from Marmara and Southeastern Anatolia regions of Turkey.
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Affiliation(s)
- Kenan Barut
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - Gizem Pamuk
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - Amra Adrovic
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - Sezgin Şahin
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - Aslı Kaplan
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - Mürüvet Güler
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - Özgür Kasapçopur
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatrics, Division of Pediatric Rheumatology, Istanbul, Turkey
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Erden A, Batu ED, Seyhoğlu E, Sari A, Sönmez HE, Armagan B, Demir S, Bilgin E, Kilic L, Karadag O, Akdogan A, Bilginer Y, Ertenli I, Kiraz S, Apras Bilgen S, Kalyoncu U. Increased psoriasis frequency in patients with familial Mediterranean fever. Ups J Med Sci 2018; 123:57-61. [PMID: 29363386 PMCID: PMC5901469 DOI: 10.1080/03009734.2017.1423425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Familial Mediterranean fever (FMF) is a periodic fever syndrome caused by MEFV mutations. FMF may be associated with psoriasis in some cases. The prevalence of psoriasis in the normal Turkish population is 0.42%. We aimed to investigate the prevalence of psoriasis among FMF patients and their relatives. METHODS FMF patients followed at Hacettepe University Adult and Pediatric Rheumatology Departments between January and August 2016 were included. FMF patients/their relatives were accepted to have psoriasis if the diagnosis was made by a dermatologist. RESULTS A total of 351 FMF patients (177 adults; 174 children) were included. The median (min-max) age of adult and pediatric patients was 35 (19-63) and 10 (2-18) years, respectively. Thirteen (3.7%) FMF patients (11 adults, 2 children) had psoriasis. Psoriasis was more common in adult than pediatric patients (p = 0.02). Psoriasis was present in 22 (12.4%) of adult and 9 (5.2%) of pediatric patients' relatives (p = 0.023). The frequency of psoriasis in ≥1 relatives of FMF patients was found to be 8.8%. Abdominal pain and fever were significantly higher, and arthralgia, arthritis, pleural chest pain, and pericarditis were significantly less frequent in the pediatric group than in adults (p < 0.05). CONCLUSION Psoriasis was more common in FMF patients than in the normal population. Thus, FMF patients should be questioned and carefully examined for psoriasis lesions and psoriasis family history. Prospective multicenter studies may be important to find the incidence of psoriasis in FMF.
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Affiliation(s)
- Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
- CONTACT Abdulsamet Erden Hacettepe University Hospital, Department of Internal Medicine, Division of Rheumatology, Sihhiye Ankara 06100, Turkey
| | - Ezgi Deniz Batu
- Division of Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey, and
| | - Emrah Seyhoğlu
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Alper Sari
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hafize Emine Sönmez
- Division of Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey, and
| | - Berkan Armagan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Selcan Demir
- Division of Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey, and
| | - Emre Bilgin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Kilic
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Omer Karadag
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Akdogan
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Bilginer
- Division of Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey, and
| | - Ihsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sule Apras Bilgen
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Eder L, Cohen AD, Feldhamer I, Greenberg-Dotan S, Batat E, Zisman D. The epidemiology of psoriatic arthritis in Israel - a population-based study. Arthritis Res Ther 2018; 20:3. [PMID: 29329596 PMCID: PMC5795280 DOI: 10.1186/s13075-017-1497-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 12/08/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There is limited information on the epidemiology of psoriatic arthritis (PsA) in general and in Middle Eastern populations in particular. The aims of this study were to estimate the prevalence and incidence rates of PsA and their temporal trends in the general population in Israel. METHODS In this study, a cohort of adult patients with PsA was derived from the database of Clalit Health Services (CHS), Israel's largest health fund, with over 4.4 million members. The crude and age- and sex-standardized prevalence and incidence rates of PsA from 2006 to 2015 in the general population were calculated. The variation in PsA prevalence was assessed in relation to several demographic factors. RESULTS Among the 2,931,199 individuals aged 18 years and older registered in the CHS database in 2015, 4490 patients had a diagnosis of PsA (322 incident cases), resulting in overall crude prevalence and incidence rates of 0.153% (95% CI 0.149%, 0.158%) and 10.9 (95% CI 9.8, 12.3) per 100,000 population, respectively. The reported prevalence of PsA in Israel has doubled between 2006 and 2015 (from 0.073% to 0.153%). In contrast, the global incidence rate remained stable, with a gradual increase in incidence among individuals aged 51 to 70 years. PsA is associated with Jewish ethnicity, high socioeconomic status, and higher body mass index. CONCLUSIONS The prevalence and incidence of PsA in Israel are within the range of previous estimates from Southern European populations. An increase in the reported prevalence of PsA was observed over the past decade in the general population in Israel.
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Affiliation(s)
- Lihi Eder
- Women's College Research Institute, Women's College Hospital, Suite 6326, 76 Grenville St, Toronto, Ontario, M5S 1B2, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Arnon Dov Cohen
- Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Ilan Feldhamer
- Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel
| | - Sari Greenberg-Dotan
- Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel
| | - Erez Batat
- Chief Physician's Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel
| | - Devy Zisman
- Department of Rheumatology, Carmel Medical Center, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W. The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology (Oxford) 2017; 56:1945-1961. [PMID: 28968809 DOI: 10.1093/rheumatology/kex260] [Citation(s) in RCA: 399] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Indexed: 01/26/2023] Open
Abstract
Objectives The aim was to review the worldwide incidence and prevalence of SLE and variation with age, sex, ethnicity and time. Methods A systematic search of MEDLINE and EMBASE search engines was carried out using Medical Subject Headings and keyword search terms for Systemic Lupus Erythematosus combined with incidence, prevalence and epidemiology in August 2013 and updated in September 2016. Author, journal, year of publication, country, region, case-finding method, study period, number of incident or prevalent cases, incidence (per 100 000 person-years) or prevalence (per 100 000 persons) and age, sex or ethnic group-specific incidence or prevalence were collected. Results The highest estimates of incidence and prevalence of SLE were in North America [23.2/100 000 person-years (95% CI: 23.4, 24.0) and 241/100 000 people (95% CI: 130, 352), respectively]. The lowest incidences of SLE were reported in Africa and Ukraine (0.3/100 000 person-years), and the lowest prevalence was in Northern Australia (0 cases in a sample of 847 people). Women were more frequently affected than men for every age and ethnic group. Incidence peaked in middle adulthood and occurred later for men. People of Black ethnicity had the highest incidence and prevalence of SLE, whereas those with White ethnicity had the lowest incidence and prevalence. There appeared to be an increasing trend of SLE prevalence with time. Conclusion There are worldwide differences in the incidence and prevalence of SLE that vary with sex, age, ethnicity and time. Further study of genetic and environmental risk factors may explain the reasons for these differences. More epidemiological studies in Africa are warranted.
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Affiliation(s)
- Frances Rees
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham.,Rheumatology Department, Nottingham University Hospitals NHS Trust
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham
| | - Matthew J Grainge
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Peter Lanyon
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham.,Rheumatology Department, Nottingham University Hospitals NHS Trust
| | - Weiya Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham
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Prevalence of Rheumatoid Arthritis and Spondyloarthritis in Turkey: A Nationwide Study. Arch Rheumatol 2017; 33:128-136. [PMID: 30207568 DOI: 10.5606/archrheumatol.2018.6480] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/11/2017] [Indexed: 12/25/2022] Open
Abstract
Objectives This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania. Material and methods The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0±13.1 years; range 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5±16.8 years; range 16 to 97 years) by trained general practitioners across the country, in 25 prov- inces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis. Results In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%). Conclusion The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.
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Geoepidemiology and Immunologic Features of Autoinflammatory Diseases: a Comprehensive Review. Clin Rev Allergy Immunol 2017; 54:454-479. [DOI: 10.1007/s12016-017-8613-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
INTRODUCTION Systemic lupus erythematosus (SLE) is a disease distributed worldwide, which occurs in both genders, and across racial/ethnic and age groups; however, higher rates are observed in adults, in women and in non-Caucasians. Genetic, environmental, sociodemographic and methodological issues are responsible not only for these differences but for the variable course and outcome of the disease. Non-Caucasians have a more severe disease with a higher risk for early mortality and damage accrual. Males also have a more severe disease; however, a negative impact of male gender on lupus outcomes has not been firmly established. Childhood-onset is associated with a more severe disease; moreover, it is also associated with higher damage and diminished survival; finally, late-onset lupus is mild but it is associated with higher damage accrual and a diminished survival. Areas covered: In this review, we discuss the incidence and prevalence of SLE, the impact of age, gender and race/ethnicity in SLE and in the survival of those affected. Expert commentary: Age, gender and race/ethnicity impact disease expression in SLE patients; despite improvements in survival, mortality in SLE remains almost three times higher than in the general population.
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Affiliation(s)
- Guillermo J Pons-Estel
- a Department of Autoimmune Diseases , Institut Clinic de Medicina I Dermatologia, Hospital Clinic , Barcelona , Catalonia , Spain.,b Division of Rheumatology and Autoimmune Diseases , Sanatorio Parque, Grupo Oroño , Rosario , Argentina
| | - Manuel F Ugarte-Gil
- c Servicio de Reumatología , Hospital Nacional Guillermo Almenara Irigoyen, EsSalud , Lima , Perú.,d School of Medicine , Universidad Científica del Sur , Lima , Perú
| | - Graciela S Alarcón
- e Division of Clinical Immunology and Rheumatology, School of Medicine , The University of Alabama at Birmingham , Birmingham , AL , USA.,f Department of Medicine, School of Medicine , Universidad Peruana Cayetano Heredia , Lima , Perú
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Özkan SG, Yazısız H, Behlül A, Gökbelen YA, Borlu F, Yazısız V. Prevalence of metabolic syndrome and degree of cardiovascular disease risk in patients with Psoriatic Arthritis. Eur J Rheumatol 2017; 4:40-45. [PMID: 28293452 DOI: 10.5152/eurjrheum.2017.16052] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 11/17/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the prevalence of metabolic syndrome (MetS) and degree of cardiovascular disease (CVD) risk in patients with psoriatic arthritis (PsA). MATERIAL AND METHODS We performed a cross-sectional study on 102 adult patients with PsA and a control group of 102 patients with rheumatoid arthritis (RA). MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) criteria. The Framingham risk scores of 10-year risk of CVDs and coronary heart disease (CHD) were also calculated. RESULTS The prevalence of MetS was higher in patients with PsA than in those with RA, according to the NCEP-ATP III (40.6% vs. 24.7%, respectively; p=0.019) and IDF (46.8% vs. 27.9%, respectively; p=0.05) criteria. The prevalence of MetS was higher in female patients with PsA (p=0.009) than in male patients. A significantly increased prevalence of hypertriglyceridemia was determined in patients with PsA (p=0.019). No significant difference existed between the two groups with respect to 10-year CVD (p=0.333) and CHD (p=0.798) risks. Additionally, there were no significant differences between the clinical subtypes of PsA with regard to MetS (p=0.229). CONCLUSION MetS prevalence increased in patients with PsA compared with those with RA, whereas the risks were similar for CVDs and CHD. For this reason, optimal protection measures should be taken and guidelines should be applied to achieve adequate metabolic control in patients with PsA.
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Affiliation(s)
- Sıdıka Gülkan Özkan
- Department of Internal Medicine, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Hatice Yazısız
- Department of Microbiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ahmet Behlül
- Department of Internal Medicine, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Yüksel Aslı Gökbelen
- Department of Internal Medicine, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Fatih Borlu
- Department of Internal Medicine, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Veli Yazısız
- Department of Internal Medicine, Şişli Etfal Training and Research Hospital, İstanbul, Turkey; Division of Rheumatology, Department of Internal Medicine, Akdeniz University School of Medicine, Antalya, Turkey
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Maldini C, Druce K, Basu N, LaValley MP, Mahr A. Exploring the variability in Behçet’s disease prevalence: a meta-analytical approach. Rheumatology (Oxford) 2017; 57:185-195. [DOI: 10.1093/rheumatology/kew486] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Indexed: 01/01/2023] Open
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Rydén-Aulin M, Boumpas D, Bultink I, Callejas Rubio JL, Caminal-Montero L, Castro A, Colodro Ruiz A, Doria A, Dörner T, Gonzalez-Echavarri C, Gremese E, Houssiau FA, Huizinga T, Inanç M, Isenberg D, Iuliano A, Jacobsen S, Jimenéz-Alonso J, Kovács L, Mariette X, Mosca M, Nived O, Oristrell J, Ramos-Casals M, Rascón J, Ruiz-Irastorza G, Sáez-Comet L, Salvador Cervelló G, Sebastiani GD, Squatrito D, Szücs G, Voskuyl A, van Vollenhoven R. Off-label use of rituximab for systemic lupus erythematosus in Europe. Lupus Sci Med 2016; 3:e000163. [PMID: 27651920 PMCID: PMC5013507 DOI: 10.1136/lupus-2016-000163] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/22/2016] [Accepted: 07/31/2016] [Indexed: 11/24/2022]
Abstract
Objectives Rituximab (RTX) is a biological treatment used off-label in patients with systemic lupus erythematosus (SLE). This survey aimed to investigate the off-label use of RTX in Europe and compare the characteristics of patients receiving RTX with those receiving conventional therapy. Methods Data on patients with SLE receiving RTX were taken from the International Registry for Biologics in SLE retrospective registry and complemented with data on patients with SLE treated with conventional therapy. For nationwide estimates of RTX use in patients with SLE, investigators were asked to provide data through case report forms (CRFs). Countries for which no data were submitted through CRFs, published literature and/or personal communication were used, and for European countries where no data were available, estimates were made on the assumption of similarities with neighbouring countries. Results The estimated off-label use of RTX in Europe was 0.5%–1.5% of all patients with SLE. In comparison with patients with SLE on conventional therapy, patients treated with RTX had longer disease duration, higher disease activity and were more often treated with immunosuppressives. The most frequent organ manifestations for which either RTX or conventional therapy was initiated were lupus nephritis followed by musculoskeletal and haematological. The reason for treatment was, besides disease control, corticosteroid-sparing for patients treated with conventional therapy. Conclusions RTX use for SLE in Europe is restrictive and appears to be used as a last resort in patients for whom other reasonable options have been exhausted.
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Affiliation(s)
- Monica Rydén-Aulin
- Unit of Clinical Therapy Research, Inflammatory Diseases, Department of Medicine , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden
| | - Dimitrios Boumpas
- Joint Academic Rheumatology Program and 4th Department of Medicine , Medical School, National and Kapodestrian University of Athens, Attikon University Hospital , Athens , Greece
| | - Irene Bultink
- Department of Rheumatology , Amsterdam Rheumatology and Immunology Center , Amsterdam , The Netherlands
| | | | - Luis Caminal-Montero
- Autoimmune Systemic Diseases Unit, Internal Medicine Department , Hospital Universitario Central de Asturias , Oviedo , Spain
| | - Antoni Castro
- Internal Medicine Department , University Hospital Sant Joan de Reus, Rovira i Virgili University (URV)-IISPV , Reus , Spain
| | | | - Andrea Doria
- Rheumatology Unit, Department of Medicine , University of Padova , Padova , Italy
| | - Thomas Dörner
- Department of Medicine/Rheumatology and Clinical Immunology , Charite Universitaetsmedizin Berlin , Berlin , Germany
| | - Cristina Gonzalez-Echavarri
- Autoimmune Diseases Research Unit, Department of Internal Medicine , BioCruces Health Research Institute, Cruces University Hospital, University of the Basque Country , Barakaldo , Spain
| | - Elisa Gremese
- Institute of Rheumatology and Affine Sciences (IRSA), Catholic University of the Sacred Heart , Rome , Italy
| | - Frederic A Houssiau
- Service de Rhumatologie , Cliniques Universitaires Saint-Luc, Pôle de Pathologies Rhumatismales Inflammatoires et Systémiques, Université Catholique de Louvain , Brussels , Belgium
| | - Tom Huizinga
- Department of Rheumatology , C1-41, Leiden University Medical Center , Leiden , The Netherlands
| | - Murat Inanç
- Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University , Istanbul , Turkey
| | - David Isenberg
- University College London, The Rayne Building , London , UK
| | | | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, University of Copenhagen, Rigshospitalet , Copenhagen , Denmark
| | - Juan Jimenéz-Alonso
- Internal Department , Universitary 'Virgen de las Nieves' Hospital , Granada , Spain
| | - Lászlo Kovács
- Department of Rheumatology, Faculty of Medicine , Albert Szent-Györgyi Health Centre, University of Szeged , Szeged , Hungary
| | - Xavier Mariette
- Rhumatologie Responsable de l'Unité de Recherche Clinique, Hôpitaux Universitaire Paris-Sud, Université Paris-Sud, INSERM U1184 , Paris , France
| | | | - Ola Nived
- Rheumatology Clinic, Skåne University Hospital , Lund , Sweden
| | - Joaquim Oristrell
- Internal Medicine Department , Hospital de Sabadell, Universitat Autonoma de Barcelona , Catalunya , Spain
| | - Manuel Ramos-Casals
- Department of Autoimmune Diseases , ICMiD, Josep Font Autoimmune Lab, CELLEX-IDIBAPS , Barcelona , Spain
| | - Javier Rascón
- Carrer de les Sabateres, 9-1, Alaró , Islas Baleares , Spain
| | - Guillermo Ruiz-Irastorza
- Autoimmune Diseases Research Unit, Department of Internal Medicine , BioCruces Health Research Institute, Cruces University Hospital, University of the Basque Country , Barakaldo , Spain
| | - Luis Sáez-Comet
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario Miguel Servet de Zaragoza, Paseo Isabel la Católica , Zaragoza , Spain
| | - Gonzalo Salvador Cervelló
- Department of Internal Medicine, Inmunopathological and Autoimmune Area , Hospital Universitario y Politecnico La Fe , Valencia , Spain
| | | | - Danilo Squatrito
- Department of Sperimental and Clinical Medicine , University of Florence , Firenze , Italy
| | - Gabriella Szücs
- Department of Rheumatology , Institute of Medicine, University of Debrecen , Debrecen , Hungary
| | - Alexandre Voskuyl
- Amsterdam Rheumatology and Immunology Center (ARC), VU University Medical Center , Amsterdam , The Netherlands
| | - Ronald van Vollenhoven
- Unit of Clinical Therapy Research, Inflammatory Diseases, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Rheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden; Amsterdam Rheumatology and Immunology Center ARC, AMC mail F4-105, Amsterdam, The Netherlands
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Carter EE, Barr SG, Clarke AE. The global burden of SLE: prevalence, health disparities and socioeconomic impact. Nat Rev Rheumatol 2016; 12:605-20. [PMID: 27558659 DOI: 10.1038/nrrheum.2016.137] [Citation(s) in RCA: 273] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can potentially lead to serious organ complications and even death. Its global burden - in terms of incidence and prevalence, differential impact on populations, economic costs and capacity to compromise health-related quality of life - remains incompletely understood. The reported worldwide incidence and prevalence of SLE vary considerably; this variation is probably attributable to a variety of factors, including ethnic and geographic differences in the populations being studied, the definition of SLE applied, and the methods of case identification. Despite the heterogeneous nature of the disease, distinct patterns of disease presentation, severity and course can often be related to differences in ethnicity, income level, education, health insurance status, level of social support and medication compliance, as well as environmental and occupational factors. Given the potential for the disease to cause such severe and widespread organ damage, not only are the attendant direct costs high, but these costs are sometimes exceeded by indirect costs owing to loss of economic productivity. As an intangible cost, patients with SLE are, not surprisingly, likely to endure considerably reduced health-related quality of life.
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Affiliation(s)
- Erin E Carter
- University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada
| | - Susan G Barr
- University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7, Canada
| | - Ann E Clarke
- University of Calgary, Health Research Innovation Centre, 3280 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
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Baş Y, Seçkin HY, Kalkan G, Takcı Z, Önder Y, Çıtıl R, Demir S, Şahin Ş. Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey. Balkan Med J 2016; 33:390-5. [PMID: 27606133 DOI: 10.5152/balkanmedj.2016.15101] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 08/17/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The Recurrent Aphthous Stomatitis (RAS) is the most frequently observed painful pathology of the oral mucosa in the society. It appears mostly in idiopathic form; however, it may also be related with systemic diseases like Behçet's Disease (BD). AIMS Determining the prevalence of RAS and BD in the Northern Anatolian Region, which is one of the important routes on the Antique Silk Road. STUDY DESIGN Cross-sectional study. METHODS Overall, 85 separate exemplification groups were formed to reflect the population density, and the demographic data of the region they represent. In the first stage, the individuals, who were selected in random order, were invited to a Family Physician Unit at a certain date and time. The dermatological examinations of the volunteering individuals were performed by only 3 dermatology specialists. In the second stage, those individuals who had symptoms of BD were invited to our hospital, and the Pathergy Test and eye examinations were performed. RESULTS The annual prevalence of RAS was determined as 10.84%. The annual prevalence was determined to be higher in women than in men (p=0.000). It was observed that the prevalence was at the peak level in the 3(rd) decade, and then decreased proportionally in the following decades (p=0.000). It was also observed that the aphtha recurrence decreased in the following decades (p=0.048). The Behçet's prevalence was found to be 0.60%. The prevalence in women was found to be higher than in men (0.86% female, 0.14% male; p=0.022). CONCLUSION While the RAS prevalence ratio was at an average value when compared with the other societies; the BD prevalence was found as the highest ratio in the world according to the literature.
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Affiliation(s)
- Yalçın Baş
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Havva Yıldız Seçkin
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Göknur Kalkan
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Zennure Takcı
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Yalçın Önder
- Department of Public Health, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Rıza Çıtıl
- Department of Public Health, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Selim Demir
- Department of Ophthalmology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Şafak Şahin
- Department of Internal Medicine, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
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Pamuk ÖN, Dönmez S, Calayır GB, Pamuk GE. The epidemiology of antineutrophil cytoplasmic antibody-associated vasculitis in northwestern Turkey. Clin Rheumatol 2016; 35:2063-2071. [DOI: 10.1007/s10067-016-3232-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 03/09/2016] [Indexed: 01/25/2023]
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Ndiaye M, Sow AS, Valiollah A, Diallo M, Diop A, Alaoui RA, Diatta BA, Ly F, Niang SO, Dieng MT, Kane A. Behçet's disease in black skin. A retrospective study of 50 cases in Dakar. J Dermatol Case Rep 2015; 9:98-102. [PMID: 26848317 DOI: 10.3315/jdcr.2015.1213] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/29/2015] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Although Behçet's disease is well-documented in Eastern populations, epidemiologic data in Sub-Saharan African population is scarce. The aim of this study was to define the epidemiologic and therapeutic aspects as well as clinical course of Behçet's disease in African black population. RESULTS The study included 50 patients with Behçet's disease. The average age was 32 (18-67) years. A total of 31 patients were men and 19 were women. Two patients had a positive family history of Behçet's disease. The oral and genital aphthous lesions were present in 100% of patients. The pathergy test was positive in 16 patients (32%). Following skin conditions were observed: pseudofolliculitis in 15 patients (30%), acneiform papules in 6 patients (12%), erythema nodosum in 4 patients (8%) and leg ulcers in one patient. Ocular involvement was reported in 22 patients (44%) and joint involvement in 20 patients (40%). Neurological abnormalities were noted in 12 patients (24%). Gastrointestinal involvement with wide and deep ulcerations in the ileocecal region was observed in a patient. As treatment, a combination of oral corticosteroids and colchicine was used in 97% of our patients. Thalidomide was introduced in 3 patients and anticoagulation treatment in 19 patients. Clinical improvement was noted in 25 patients (50%), recurrence in 14 patients (28%) and 3 patients were lost to follow (6%). CONCLUSION The Behçet's disease is not uncommon in black skin and generally affects young adults. Severe aphthous ulcers of the oral cavity and genital area are the most consistent finding.
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Affiliation(s)
- Maodo Ndiaye
- Department of Dermatology, Aristide Le Dantec Hospital, Dakar, Sénégal
| | | | | | - Moussa Diallo
- Department of Dermatology, Aristide Le Dantec Hospital, Dakar, Sénégal
| | - Assane Diop
- Department of Dermatology, IHS Dakar Hospital, Dakar, Sénégal
| | | | | | - Fatimata Ly
- Department of Dermatology, IHS Dakar Hospital, Dakar, Sénégal
| | | | | | - Assane Kane
- Department of Dermatology, Aristide Le Dantec Hospital, Dakar, Sénégal
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Oliver J, Baker MG, Pierse N, Carapetis J. Comparison of approaches to rheumatic fever surveillance across Organisation for Economic Co-operation and Development countries. J Paediatr Child Health 2015; 51:1071-7. [PMID: 26174709 DOI: 10.1111/jpc.12969] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2015] [Indexed: 11/29/2022]
Abstract
AIM Rheumatic fever (RF) prevention, control and surveillance are increasingly important priorities in New Zealand (NZ) and Australia. We compared RF surveillance across Organisation for Economic Co-operation and Development (OECD) member countries to assist in benchmarking and identifying useful approaches. METHODS A structured literature review was completed using Medline and PubMed databases, investigating RF incidence rates. Surveillance methods were noted. Health department websites were searched to assess whether addressing RF was a Government priority. RESULTS Of 32 OECD member countries, nine reported RF incidence rates after 1999. Highest rates were seen in indigenous Australians, and NZ Māori and Pacific peoples. NZ and Australian surveillance systems are highly developed, with notification and register data compiled regularly. Only these two Governments appeared to prioritise RF surveillance and control. Other countries relied mainly on hospitalisation data. There is a lack of standardisation across incidence rate calculations. Israel and Italy may have relatively high RF rates among developed countries. CONCLUSIONS RF lingers in specific populations in OECD member countries. At a minimum, RF registers are needed in higher incidence countries. Countries with low RF incidences should periodically review surveillance information to ensure rates are not increasing.
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Affiliation(s)
- Jane Oliver
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jonathan Carapetis
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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Abstract
Psoriatic arthritis (PsA) is a chronic systemic inflammatory disorder characterized by joint and entheseal inflammation with a prevalence of 0.05% to 0.25% of the population and 6% to 41% of patients with psoriasis. PsA is a highly heterogeneous inflammatory arthritis. In this review, current knowledge is discussed regarding the epidemiology of PsA, including disease manifestations, classification criteria for adult and juvenile PsA, methods for recognizing early PsA, including use of screening tools and knowledge of risk factors for PsA, and medical comorbidities associated with PsA.
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Affiliation(s)
- Alexis Ogdie
- Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, White Building, Room 5024, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | - Pamela Weiss
- Division of Rheumatology, Children's Hospital of Philadelphia, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 3535 Market Street, Room 1526, Philadelphia, PA 19104, USA
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Pamuk ON, Balci MA, Donmez S, Tsokos GC. The incidence and prevalence of systemic lupus erythematosus in Thrace, 2003–2014: A 12-year epidemiological study. Lupus 2015; 25:102-9. [DOI: 10.1177/0961203315603141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/05/2015] [Indexed: 02/01/2023]
Abstract
Background We estimated the prevalence and incidence, clinical features, treatment, and prognosis of systemic lupus erythematosus (SLE) patients in the Thrace region of Turkey. Methods We retrospectively evaluated 331 patients (307 female, 24 male, mean age 38.5 years) diagnosed with SLE between 2003 and 2014. Clinical features, treatments, and response to various treatment modalities were recorded. Our hospital has been the only tertiary referral center for rheumatological diseases for a mixed rural and urban population of 620,477 people (306,036 females, 314,411 males) for more than 16 years. Results The mean annual incidence of SLE was 4.44/100,000 (females, 8.4/100,000; males, 0.6/100,000). The overall prevalence of SLE was 51.7/100,000 (females, 97.7/100,000; males, 7/100,000). Major organ involvement was present in the following percentages: neurologic involvement: 20.1%; renal involvement: 28.2%; autoimmune hemolytic anemia: 9.6%; thrombocytopenia: 14.7%. Seventeeen SLE patients (13 females, four males) died at a median follow-up of 48 months. The five-year survival was 94.5%, and the ten-year survival was 89.9%. According to Kaplan–Meier survival analysis, poor prognostic factors were: male gender ( p = 0.015); smoking ( p = 0.02); pleural involvement ( p = 0.011); thrombocytopenia ( p = 0.021); myocarditis ( p = 0.028); renal involvement ( p = 0.037); treatment with cyclophosphamide ( p = 0.011); and an initial high SLEDAI score (>4) ( p = 0.02). Lymphopenia at the time of diagnosis appeared as a favorable prognostic factor ( p = 0.008). Cox regression analysis revealed myocarditis (OR: 20.4, p = 0.018) and age at diagnosis (OR: 1.11, p = 0.035) to be poor, and lymphopenia at the time of diagnosis to be good prognostic factors (OR:0.13, p = 0.031). Conclusions The annual incidence and prevalence of SLE in the Thrace region of Turkey is lower than those reported in North America, however they are similar to those reported for European countries. Clinical manifestations appear to be milder, whereas survival was similar to those recorded in Western countries.
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Affiliation(s)
- O N Pamuk
- Division of Rheumatology, Trakya University Medical Faculty, Edirne, Turkey
| | - M A Balci
- Division of Rheumatology, Trakya University Medical Faculty, Edirne, Turkey
| | - S Donmez
- Division of Rheumatology, Trakya University Medical Faculty, Edirne, Turkey
| | - G C Tsokos
- Division of Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
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Kuo CF, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol 2015; 11:649-62. [PMID: 26150127 DOI: 10.1038/nrrheum.2015.91] [Citation(s) in RCA: 715] [Impact Index Per Article: 79.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gout is a crystal-deposition disease that results from chronic elevation of uric acid levels above the saturation point for monosodium urate (MSU) crystal formation. Initial presentation is mainly severely painful episodes of peripheral joint synovitis (acute self-limiting 'attacks') but joint damage and deformity, chronic usage-related pain and subcutaneous tophus deposition can eventually develop. The global burden of gout is substantial and seems to be increasing in many parts of the world over the past 50 years. However, methodological differences impair the comparison of gout epidemiology between countries. In this comprehensive Review, data from epidemiological studies from diverse regions of the world are synthesized to depict the geographic variation in gout prevalence and incidence. Key advances in the understanding of factors associated with increased risk of gout are also summarized. The collected data indicate that the distribution of gout is uneven across the globe, with prevalence being highest in Pacific countries. Developed countries tend to have a higher burden of gout than developing countries, and seem to have increasing prevalence and incidence of the disease. Some ethnic groups are particularly susceptible to gout, supporting the importance of genetic predisposition. Socioeconomic and dietary factors, as well as comorbidities and medications that can influence uric acid levels and/or facilitate MSU crystal formation, are also important in determining the risk of developing clinically evident gout.
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Affiliation(s)
- Chang-Fu Kuo
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan 333, Taiwan
| | - Matthew J Grainge
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK
| | - Weiya Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK
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Kucuk A, Gezer IA, Ucar R, Karahan AY. Familial Mediterranean Fever. ACTA MEDICA (HRADEC KRÁLOVÉ) 2015; 57:97-104. [DOI: 10.14712/18059694.2014.47] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Familial Mediterranean Fever is an autosomal recessive inherited disease with a course of autoinflammation, which is characterized by the episodes of fever and serositis. It affects the populations from Mediterranean basin. Genetic mutation of the disease is on MEFV gene located on short arm of Chromosome 16. The disease is diagnosed based on clinical evaluation. Amyloidosis is the most important complication. The only agent that decreases the development of amyloidosis and the frequency and severity of the episodes is colchicine, which has been used for about 40 years. In this review, we aimed to discuss especially the most recent advances about Familial Mediterranean Fever which is commonly seen in our population.
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