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Coronel L, Gouze H, Gudu T, Ruel-Gagné S, Padovano I, Costantino F, Vidal F, Breban M, Mahé E, D'Agostino MA. Prevalence of ultrasound and clinical findings suggestive of inflammatory arthritis in children with skin psoriasis. Rheumatology (Oxford) 2024; 63:1391-1396. [PMID: 37540167 DOI: 10.1093/rheumatology/kead398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE To evaluate the prevalence of clinical and US (grey-scale and Doppler) abnormalities in joints, periarticular structures and nails of children affected by skin psoriasis (PsO). METHODS We conducted a cross-sectional study including consecutive children affected by PsO. A systematic clinical and US evaluation of joints, entheses, tendons and nails were performed by independent examiners blinded to each other's assessment. RESULTS A total of 57 children [26 girls (46%)] with a mean age of 9 years (s.d. 4) were divided into two groups, asymptomatic (Asy, 42 children) and symptomatic (Sy, 15 children), according to musculoskeletal pain. Differences were observed between the two groups in relation to age [9 years (s.d. 3) vs 11 years (s.d. 4), P < 0.05], PsO duration [2.4 years (s.d. 2.4) vs 5.4 years (s.d. 3.9), P < 0.001], systemic treatment [23 (54.8%) vs 2 [13.3%], P < 0.01], tender joint count [0 vs 12 children (80%), P < 0.001], swollen joint count [0 vs 3 children (20%), P < 0.01] and entheseal pain [0 vs 10 (66.7%), P < 0.001] in Asy and Sy children, respectively. US evaluation showed statistically significant differences between the Asy and Sy groups for the presence of US abnormalities [16/42 (38%) vs 12/15 (80%)], synovitis [1/42 (2%) vs 4/15 (25%)] and enthesitis [4/42 (9.5%) vs 5/15 (33%)]. Three children in the Sy group were classified with juvenile PsA (JPsA). CONCLUSIONS US abnormalities were higher in the Sy group, with synovitis and enthesitis as the most prevalent findings. Asy patients were more frequently under systemic treatment. US and a systematic clinical evaluation are useful tools for detecting subclinical JPsA in children with PsO and musculoskeletal symptoms.
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Affiliation(s)
- Luis Coronel
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
- Rheumatology Division, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Hélène Gouze
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
- Inserm U1018, Center for Research in Epidemiology and Population Health "Integrative Respiratory Epidemiology" Team, Paris-Saclay University, Villejuif, France
| | - Tania Gudu
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
| | - Sophie Ruel-Gagné
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
| | - Ilaria Padovano
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
| | - Félicie Costantino
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
- Infection and Inflammation, UMR 1173, Inserm, UVSQ/Paris-Saclay University, Laboratory of Excellence INFLAMEX, Montigny-le-Bretonneux, France
| | - François Vidal
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
| | - Maxime Breban
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
- Infection and Inflammation, UMR 1173, Inserm, UVSQ/Paris-Saclay University, Laboratory of Excellence INFLAMEX, Montigny-le-Bretonneux, France
| | - Emmanuel Mahé
- Dermatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Maria-Antonietta D'Agostino
- Rheumatology Division, Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, France
- Infection and Inflammation, UMR 1173, Inserm, UVSQ/Paris-Saclay University, Laboratory of Excellence INFLAMEX, Montigny-le-Bretonneux, France
- Rheumatology Department, Catholic University of Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
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François P, Benoit A, Slimani L, Dufresne A, Gouze H, Attal JP, Mangione F, Dursun E. In vitro remineralization by various ion-releasing materials of artificially demineralized dentin: A micro-CT study. Dent Mater 2024; 40:520-526. [PMID: 38212175 DOI: 10.1016/j.dental.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the remineralizing properties of ion-releasing restorative materials on pH cycling-induced carious dentin. METHODS Fifty sound molars were freshly extracted. The occlusal surfaces were abraded using water-cooled sandpaper (800 grit). The residual crowns were embedded in self-cured acrylic resin with the flat dentin surface exposed. A mesio-distal trench was created using a calibrated 0.5 mm deep occlusal reduction burr, and artificial dentin caries were generated by pH cycling. Then, teeth were randomly assigned to five groups according to the ion-releasing material used. For each sample, micro-CT acquisitions were performed at various intervals. Remineralization was assessed by mean gray value (MGV) measurements after registration and segmentation of the region of interest with 3D Slicer software. One-way repeated-measures ANOVA followed by Tukey's post hoc test was used to investigate the difference in MGVs among the various groups. RESULTS Only Cention Forte showed significantly increased MGVs after 4 weeks compared to demineralized dentin. MGVs were higher, but not significantly, after placement of the restorative materials, including in the resin composite control group. These results can be explained by the radiopacity of the materials. SIGNIFICANCE Cention Forte, the material with the highest radiopacity, showed a significant increase in the MGVs of artificially carious dentin after 4 weeks. However, the study of dentin remineralization by micro-CT could be impacted by the radiopacity of the restorative materials used. The relevance of this examination for the study of dentinal remineralization should be investigated.
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Affiliation(s)
- Philippe François
- Department of Dental Materials, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Aurélie Benoit
- Department of Dental Materials, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Lotfi Slimani
- URP 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Ambre Dufresne
- URP 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Hélène Gouze
- CESP-INSERM, University Paris-Saclay, 16 avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Jean-Pierre Attal
- Department of Dental Materials, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Francesca Mangione
- URP 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Life Imaging Platform (PIV), University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; Department of Imagery, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Elisabeth Dursun
- URP 4462, Innovative Dental Materials and Interfaces Research Unit, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France; Department of Pediatric Dentistry, Faculty of Dental Surgery, University Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France.
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Caussin É, Qatramiz A, Guillemot C, Brukarz Y, Loré V, Jungo S, Gouze H, Le-Goff S, Dursun E, Attal JP, François P. Creation and evaluation of an educational escape room for preclinical training on 3D printing in dentistry. Eur J Dent Educ 2024. [PMID: 38419306 DOI: 10.1111/eje.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/30/2023] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION The benefit of pedagogical escape rooms for dental students' stimulation, interest and knowledge strengthening has been suggested by several studies. However, in previous studies, only a few students were evaluated. This study aims to confirm the purpose of this innovative pedagogical tool in terms of learning consolidation and team building from students' perceptions. We directly incorporated an educational escape game into the fundamental academic formation as a practical-work course for fifth-year dental students. MATERIALS AND METHODS The present escape game focused on 3D printing, whose implementation fit the different steps of an escape game well. This study was conducted in March 2022. All fifth-year dental students (n = 212) were divided into 5-6 student groups to match the conditions of an escape game. Before entering the room, each student had to complete a cross-sectional knowledge true/false test of 8 questions to assess their general level. Additionally, an 18-question appreciation survey was completed when leaving the room. RESULTS The students perceived the 3D-printing escape game to be relevant and especially expressed the benefit of being part of a team to exchange and build knowledge. These results suggest knowledge strengthening. The instructional benefit of this process seemed to exceed its mere fun and appealing aspect. CONCLUSION Our results with a large number of students showed that, from the students' perception, the educational escape game significantly improved knowledge and team-building. It created a supportive learning environment and increased students' motivation. It can provide a fun and effective way to diversify instruction.
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Affiliation(s)
- Élisa Caussin
- Department of Biomaterials, Faculty of Dental Surgery, University of Paris Cité, Paris, France
- Bretonneau Hospital, Paris, France
- URB2i, Université of Paris Cité, Montrouge, France
| | | | | | | | | | | | - Hélène Gouze
- CESP-INSERM, University of Paris Saclay, Paris, France
- Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - Stéphane Le-Goff
- Department of Biomaterials, Faculty of Dental Surgery, University of Paris Cité, Paris, France
- URB2i, Université of Paris Cité, Montrouge, France
| | - Elisabeth Dursun
- Department of Biomaterials, Faculty of Dental Surgery, University of Paris Cité, Paris, France
- URB2i, Université of Paris Cité, Montrouge, France
- Henri Mondor Hospital, Créteil, France
| | - Jean-Pierre Attal
- Department of Biomaterials, Faculty of Dental Surgery, University of Paris Cité, Paris, France
- URB2i, Université of Paris Cité, Montrouge, France
- Charles Foix Hospital, Ivry sur Seine, France
| | - Philippe François
- Department of Biomaterials, Faculty of Dental Surgery, University of Paris Cité, Paris, France
- Bretonneau Hospital, Paris, France
- URB2i, Université of Paris Cité, Montrouge, France
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Gouze H, Aegerter P, Gouyette Y, Breban M, D'Agostino MA. Risk of cardiovascular disease decreases over time in psoriatic arthritis but not in spondylarthritis: meta-analysis of longitudinal studies. Rheumatology (Oxford) 2024:keae080. [PMID: 38366949 DOI: 10.1093/rheumatology/keae080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES Spondyloarthritis (SpA) and psoriatic arthritis (PsA) represent two frequent inflammatory rheumatic disorders, characterized by an increased burden on quality of life, due to the association of several comorbidities, especially cardiovascular diseases (CVD). The estimated prevalence of CVD ranges from 12-19% and differ between the two diseases, however, its incidence is not completely known. We aimed to systematically review the literature (SLR) and perform a meta-analysis of controlled observational studies to assess the incidence rate of CVD over time, separately in SpA and PsA. METHODS We performed a SLR of longitudinal studies with a study period of at least 5 years, including SpA/PsA patients and general population. The main outcome was the occurrence of CVD, including ischemic heart disease, stroke, and death from CV cause. We then performed a random-effect model for meta-analysis. RESULTS The SLR included 34 articles, mainly focused on the association between SpA/PsA and CVD. Twenty-four articles were then selected for the meta-analysis. The overall incidence of CVD was increased in PsA (HR: 1.28, 95%CI: 1.15-1.43), and in SpA (HR: 1.45, 95%CI: 1.22-1.72) compared with the general population, with consistency across the different types of CVD; Interestingly the incidence tended to decrease over time in PsA, but not in SpA. CONCLUSION The SLR and meta-analysis confirmed the increased incidence of CVD in both SpA and PsA patients compared with the general population during the last years, although such increase seems to be less prominent in PsA than in SpA. Future studies are needed to confirm such tendence.
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Affiliation(s)
- Hélène Gouze
- Rheumatology Department, Ambroise Paré Hospital, AP-HP-Paris Saclay, Boulogne, France
- Centre for Research in Epidemiology and Population Health, U1018, Paris Saclay University, Paris, France
| | - Philippe Aegerter
- Centre for Research in Epidemiology and Population Health, U1018, Paris Saclay University, Paris, France
- Epidemiology and Public Health Service, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Yasmine Gouyette
- Rheumatology Department, Ambroise Paré Hospital, AP-HP-Paris Saclay, Boulogne, France
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, Montigny-le-Bretonneux, France
| | - Maxime Breban
- Rheumatology Department, Ambroise Paré Hospital, AP-HP-Paris Saclay, Boulogne, France
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, Montigny-le-Bretonneux, France
- Laboratoire d'Excellence Inflamex, Université Paris Cité, Paris, France
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Coronel L, Gouze H, Mahé E, D'Agostino MA. Comment on: Prevalence of ultrasound and clinical findings suggestive of inflammatory arthritis in children with skin psoriasis. Reply. Rheumatology (Oxford) 2024:keae017. [PMID: 38305585 DOI: 10.1093/rheumatology/keae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 12/28/2023] [Indexed: 02/03/2024] Open
Affiliation(s)
- Luis Coronel
- Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, Boulogne-Billancourt, France
- Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - Hélène Gouze
- Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, Boulogne-Billancourt, France
- Inserm | U1018-Center for Research in Epidemiology and Population Health (CESP) "Integrative Respiratory Epidemiology" Team, Paris-Saclay University, Villejuif, France
| | - Emmanuel Mahé
- Dermatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Maria-Antonietta D'Agostino
- Hôpital Ambroise-Paré, APHP-Université Paris-Saclay, Boulogne-Billancourt, France
- Catholic University of Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
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Gouze H, Carlier R, Breban M, Felter A. Clinical image: atypical calcification of dorsal spine. Ann Rheum Dis 2023; 82:1495. [PMID: 37100463 DOI: 10.1136/ard-2023-224138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023]
Affiliation(s)
- Hélène Gouze
- Rheumatology Department, Hôpital Ambroise-Pare, Boulogne-Billancourt, France
- Centre for Research in Epidemiology and Population Health, U1018, Paris Saclay University, CESP, Villejuif, France
| | - Robert Carlier
- APHP, GHU Paris Saclay, DMU Smart Imaging, Radiology Department, Ambroise Paré/Raymond Poincaré Teaching Hospitals, Boulogne-Billancourt/Garches, Paris, France
- End-iCap, UMR1179, Inserm, UVSQ/Paris Saclay University, Montigny-le-Bretonneux, France
| | - Maxime Breban
- Infection & Inflammation, UMR1173, Inserm, UVSQ/Paris Saclay University, Montigny-le-Bretonneux, France
- Laboratoire d'Excellence Inflamex, Paris-Centre University, Paris, France
| | - Adrien Felter
- APHP, GHU Paris Saclay, DMU Smart Imaging, Radiology Department, Ambroise Paré/Raymond Poincaré Teaching Hospitals, Boulogne-Billancourt/Garches, Paris, France
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Gouze H, Backhaus M, Balint P, Di Matteo A, Grassi W, Iagnocco A, Naredo E, Wakefield RJ, Østergaard M, Emery P, D'Agostino MA. Ultrasound in the Management of Patients With Psoriatic Arthritis: Systematic Literature Review and Novel Algorithms for Pragmatic Use. J Rheumatol 2023:jrheum.2023-0091. [PMID: 37714552 DOI: 10.3899/jrheum.2023-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
OBJECTIVE In 2015, the European Alliance of Associations for Rheumatology (EULAR) published recommendations for the use of imaging for the diagnosis and management of spondyloarthritis (SpA) in clinical practice. These recommendations included the use of ultrasound (US) in patients with psoriatic arthritis (PsA), but the management was not clearly distinguished from that of SpA. We aimed to systematically review the literature on the role of US for the management of PsA, and to propose pragmatic algorithms for its use in clinical practice. METHODS A group of 10 rheumatologists, experienced in imaging and musculoskeletal US, met with the objectives of formulating key questions for a systematic literature review (SLR), appraising the available evidence, and then proposing algorithms on the application of US in suspected or established PsA, based on both the literature and experts' opinions following a Delphi process. RESULTS The SLR included 120 articles, most of which focused on the diagnostic process. The elevated number of articles retrieved suggests the interest of rheumatologists in using US in the management of PsA. After a consensual discussion on literature data and expert opinion, the following 3 algorithms were developed to be used in practical situations: suspicion of PsA, management of PsA with good clinical response, and management of PsA with insufficient clinical response. CONCLUSION The SLR showed interest by rheumatologists in using US to objectively evaluate PsA for diagnosis and management. We propose 3 practical algorithms to guide its use in the clinical management of patients, from diagnosis to the assessment of treatment response. Further studies are needed to define remission and to assess the ability of US to predict disease severity.
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Affiliation(s)
- Hélène Gouze
- H. Gouze, MD, Rheumatology Department, Ambroise Paré Hospital, AP-HP Paris Saclay, Boulogne, and Centre for Research in Epidemiology and Population Health, U1018, Paris Saclay University, Villejuif, France
| | - Marina Backhaus
- M. Backhaus, MD, PhD, Department of Internal Medicine - Rheumatology and Clinical Immunology, Park-Klinik Weissensee, Berlin, Germany
| | - Peter Balint
- P. Balint, MD, PhD, 3rd Rheumatology Department, National Institute of Musculoskeletal Diseases, Budapest, Hungary
| | - Andrea Di Matteo
- A. Di Matteo, MD, PhD, NIHR Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK, and Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, "Carlo Urbani" Hospital, Jesi, Italy
| | - Walter Grassi
- W. Grassi, MD, PhD, Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, "Carlo Urbani" Hospital, Jesi, Italy
| | - Annamaria Iagnocco
- A. Iagnocco, MD, PhD, Academic Rheumatology Centre, AO Mauriziano Torino, DSCB Università degli Studi di Torino, Turin, Italy
| | - Esperanza Naredo
- E. Naredo, MD, PhD, Department of Rheumatology, Joint and Bone Research Unit, Hospital Universitario Fundación Jiménez Díaz, IIS Fundación Jiménez Díaz and Universidad Autónoma de Madrid, Madrid, Spain
| | - Richard J Wakefield
- R.J. Wakefield, MD, PhD, NIHR Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Mikkel Østergaard
- M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Paul Emery
- P. Emery, MD, PhD, NIHR Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Maria-Antonietta D'Agostino
- M.A. D'Agostino, MD, PhD, UOC di Reumatologia, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Università Cattolica del Sacro Cuore, Rome, Italy
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Bastard L, Hagege B, Breban M, Gouze H. Clinical image: bone erosions in a young man. Ann Rheum Dis 2022; 81:annrheumdis-2022-222609. [PMID: 35697488 DOI: 10.1136/annrheumdis-2022-222609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Léa Bastard
- Rheumatology Department, Hospital Ambroise-Pare, Boulogne-Billancourt, France
| | - Benjamin Hagege
- Rheumatology Department, Hospital Ambroise-Pare, Boulogne-Billancourt, France
| | - Maxime Breban
- Rheumatology Department, Hospital Ambroise-Pare, Boulogne-Billancourt, France
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/ Paris Saclay, Montigny-le-Bretonneux, France
| | - Hélène Gouze
- Rheumatology Department, Hospital Ambroise-Pare, Boulogne-Billancourt, France
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Gouze H, Aegerter P, Said-Nahal R, Zins M, Goldberg M, Morelle G, Schett G, Breban M, D'Agostino MA. Rheumatoid arthritis, as a clinical disease, but not rheumatoid arthritis-associated autoimmunity, is linked to cardiovascular events. Arthritis Res Ther 2022; 24:56. [PMID: 35209936 PMCID: PMC8867622 DOI: 10.1186/s13075-022-02722-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is characterized by increased cardiovascular (CV) mortality. CV events are particularly high in patients with RA-specific autoimmunity, including rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), raising the question whether RA-specific autoimmunity itself is associated with CV events. Methods New CV events (myocardial infarction, stroke or death by CV cause) were recorded in 20,625 subjects of the Electricité de France – Gaz de France (GAZEL) cohort. Self-reported RA cases in the GAZEL cohort were validated by phone interview on the basis of a specific questionnaire. In 1618 subjects, in whom plasma was available, RF and ACPA were measured. A piecewise exponential Poisson regression was used to analyze the association of CV events with presence of RA as well as RA-specific autoimmunity (without RA). Results CV events in GAZEL were associated with age, male sex, smoking, hypertension, hyperlipidemia, and diabetes mellitus (HR from 1.06 to 1.87, p < 0.05). Forty-two confirmed RA cases were identified. Confirmed RA was significantly associated with CV risk increase (HR of 3.03; 95% CI: 1.13–8.11, p = 0.03) independently of conventional CV risk factors. One hundred seventy-eight subjects showed RF or ACPA positivity without presence of RA. CV events were not associated with ACPA positivity (HR: 1.52, 95% CI: 0.47–4.84, p = 0.48) or RF positivity (HR: 1.15, 95% CI: 0.55–2.40, p = 0.70) in the absence of RA. Conclusions RA, as a clinical chronic inflammatory disease, but not mere positivity for RF or ACPA in the absence of clinical disease is associated with increased CV risk. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02722-z.
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Affiliation(s)
- Hélène Gouze
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France. .,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France. .,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Philippe Aegerter
- Inserm U1018 - Center for Research in Epidemiology and Population Health (CESP), Integrative Respiratory Epidemiology Team, Paris Saclay University, Villejuif, France
| | - Roula Said-Nahal
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France.,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France.,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marie Zins
- Population-based Cohorts Unit-UMS 011, Paris University, Villejuif, France
| | - Marcel Goldberg
- Population-based Cohorts Unit-UMS 011, Paris University, Villejuif, France
| | - Guillaume Morelle
- Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU), Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University (FAU), Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Maxime Breban
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France.,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France.,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Maria Antonietta D'Agostino
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France.,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France.,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Istituto di Reumatologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
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Al Tabaa O, Gouze H, Hamroun S, Bergé E, Belkhir R, Pavy S, Jousse-Joulin S, Mariette X. Normal salivary gland ultrasonography could rule out the diagnosis of Sjögren's syndrome in anti-SSA-negative patients with sicca syndrome. RMD Open 2021; 7:rmdopen-2020-001503. [PMID: 33510043 PMCID: PMC7845729 DOI: 10.1136/rmdopen-2020-001503] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/07/2021] [Accepted: 01/14/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the relevance of salivary gland ultrasound (SGUS) and its place in the diagnostic algorithm in patients referred with dry syndrome (DS) for a suspicion of Sjögren’s syndrome (SS). Methods We included all patients assessed at our dedicated DS clinic from June 2015 to September 2019 for which a SGUS has been carried out. Images were read blindly and the worst salivary gland was scored according to OMERACT classification. Clinical features, disease activity and treatments were collected. Results 337 patients were seen from June 2015 to September 2019. 269 patients underwent SGUS. 77 patients were diagnosed with SS and 192 did not meet the ACR/EULAR criteria for SS: non-Sjögren’s DS (NSDS). Of these 192 patients, 60 had another possible cause of DS, and 132 patients were diagnosed with SAPS (sicca, asthenia, polyalgia syndrome). SGUS abnormalities were significantly higher in patients with SS versus NSDS: 51% vs 8% for a score ≥2 (p<0.0001), and 43% vs 3% for a score ≥3 (p<0.0001). SGUS score ≥2 had a specificity (Sp) of 91%, sensitivity (Se) of 57%, positive predictive value (PPV) of 72% and negative predictive value (NPV) of 82% for SS diagnosis. SGUS’s characteristics in SSA-negative patients were similar to the whole population (Se=42%, Sp=91%, PPV=42%, NPV=92%). The high specificity and NPV in this population could avoid labial salivary gland biopsy (LSGB) in SSA-negative patients with normal SGUS (186 patients, 69%). Conclusion SGUS is useful for SS diagnosis. If anti-SSA antibodies are negative and SGUS score <2, the diagnosis of SS is very improbable and LSGB could be avoided.
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Affiliation(s)
- Omar Al Tabaa
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Hélène Gouze
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Sabrina Hamroun
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Elisabeth Bergé
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Rakiba Belkhir
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Stephan Pavy
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Sandrine Jousse-Joulin
- Rheumatology, University and Regional Hospital Centre Brest, Inserm, LBAI, UMR 1227, Brest, France
| | - Xavier Mariette
- Rheumatology, Assistance Publique - Hôpitaux de Paris, Hospital Bicetre, Le Kremlin-Bicetre, France .,Center for Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Université Paris-Saclay, Le Kremlin Bicêtre, France
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11
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Trickey J, Sahbudin I, Ammitzbøll-Danielsen M, Azzolin I, Borst C, Bortoluzzi A, Bruyn GA, Carron P, Ciurtin C, Filippou G, Fliciński J, Fodor D, Gouze H, Gutierrez M, Hammer HB, Hauge EM, Iagnocco A, Ikeda K, Karalilova R, Keen HI, Kortekaas M, La Paglia G, Leon G, Mandl P, Maruseac M, Milchert M, Mortada MA, Naredo E, Ohrndorf S, Pineda C, Rasch MNB, Reátegui-Sokolova C, Sakellariou G, Serban T, Sifuentes-Cantú CA, Stoenoiu MS, Suzuki T, Terslev L, Tinazzi I, Vreju FA, Wittoek R, D'Agostino MA, Filer A. Very low prevalence of ultrasound-detected tenosynovial abnormalities in healthy subjects throughout the age range: OMERACT ultrasound minimal disease study. Ann Rheum Dis 2021; 81:232-236. [PMID: 34407928 PMCID: PMC8762026 DOI: 10.1136/annrheumdis-2021-219931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
Objectives This study aimed to determine the prevalence of ultrasound-detected tendon abnormalities in healthy subjects (HS) across the age range. Methods Adult HS (age 18–80 years) were recruited in 23 international Outcome Measures in Rheumatology ultrasound centres and were clinically assessed to exclude inflammatory diseases or overt osteoarthritis before undergoing a bilateral ultrasound examination of digit flexors (DFs) 1–5 and extensor carpi ulnaris (ECU) tendons to detect the presence of tenosynovial hypertrophy (TSH), tenosynovial power Doppler (TPD) and tenosynovial effusion (TEF), usually considered ultrasound signs of inflammatory diseases. A comparison cohort of patients with rheumatoid arthritis (RA) was taken from the Birmingham Early Arthritis early arthritis inception cohort. Results 939 HS and 144 patients with RA were included. The majority of HS (85%) had grade 0 for TSH, TPD and TEF in all DF and ECU tendons examined. There was a statistically significant difference in the proportion of TSH and TPD involvement between HS and subjects with RA (HS vs RA p<0.001). In HS, there was no difference in the presence of ultrasound abnormalities between age groups. Conclusions Ultrasound-detected TSH and TPD abnormalities are rare in HS and can be regarded as markers of active inflammatory disease, especially in newly presenting RA.
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Affiliation(s)
- Jeanette Trickey
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Reserarch Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ilfita Sahbudin
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Reserarch Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Irene Azzolin
- Academic Rheumatology Center, MFRU, Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - Carina Borst
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria di Ferrara, Cona, Italy
| | - George Aw Bruyn
- MC Hospital Group, Lelystad, Netherlands.,Reumakliniek Flevoland, Lelystad, Netherlands
| | - Philippe Carron
- Department of Internal Medicine and Paediatrics, University Hospital Ghent, Ghent, Belgium.,VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology, Division of Medicine, University College London, London, UK
| | - Georgios Filippou
- University Hospital, Rheumatology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Jacek Fliciński
- Department of Internal Medicine, Rheumatology, Diabetes, Geriatrics and Clinical Immunology, Pomeranian Medical University, Szczecin, Poland
| | - Daniela Fodor
- 2nd Internal Medicine, UMF Iuliu Haţieganu Cluj-Napoca, Cluj-Napoca, Romania
| | - Hélène Gouze
- Hopital Ambroise-Pare, Boulogne-Billancourt, France
| | - Marwin Gutierrez
- Clinica Reumatologica, Università Politecnica delle Marche, Ancona, Italy.,Instituto Nacional de Rehabilitacion Luis Guillermo Ibarra Ibarra, Mexico, Mexico
| | - Hilde Berner Hammer
- Rheumatology, Diakonhjemmet Sykehus, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Università degli Studi di Torino, Turin, Italy
| | - Kei Ikeda
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Rositsa Karalilova
- University Hospital Kaspela, Medical University of Plovdiv Hospital, Plovdiv, Bulgaria
| | | | - Marion Kortekaas
- Leiden University Medical Center, Leiden, Netherlands.,Flevoziekenhuis, Almere, Netherlands
| | | | - Gustavo Leon
- Instituto Nacional de Rehabilitacion, Mexico, Mexico.,Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Peter Mandl
- Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Mihaela Maruseac
- Department of Rheumatology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Marcin Milchert
- Department of Internal Medicine, Rheumatology, Diabetes, Geriatrics and Clinical Immunology, Pomeranian Medical University, Szczecin, Poland
| | - Mohamed Atia Mortada
- Department of Rheumatology Rehabilitation and Physical Medicine, Zagazig University, Zagazig, Egypt
| | - Esperanza Naredo
- Rheumatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
| | - Carlos Pineda
- Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico, Mexico
| | | | - Cristina Reátegui-Sokolova
- Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico, Mexico.,Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Teodora Serban
- S.C. Reumatologia, ASL3 Genovese, Ospedale La Colletta, Genoa, Italy
| | - Cesar A Sifuentes-Cantú
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico
| | - Maria S Stoenoiu
- Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Rheumatology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Takeshi Suzuki
- Division of Allergy and Rheumatology, Japanese Red Cross Medical Center, Shibuya, Japan
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Ilaria Tinazzi
- Unit of Rheumatology, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Florentin Ananu Vreju
- Department of Rheumatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Ruth Wittoek
- VIB Center for Inflammation Research, Ghent University, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Maria-Antonietta D'Agostino
- Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Andrew Filer
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK .,NIHR Birmingham Biomedical Reserarch Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Coronel L, Mahé E, Gudu T, Ruel-Gagné S, Gouze H, Vidal F, Padovano I, Constantino F, Breban M, D’Agostino MA. Prévalence des anomalies échographiques des articulations et des enthèses chez des enfants atteints de psoriasis cutané. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, Gouze H, Doucet L, Berkani S, Oliosi E, Mallart E, Corre F, Zarrouk V, Moyer JD, Galy A, Honsel V, Fantin B, Nguyen Y. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect 2020; 81:e4-e6. [PMID: 32853602 PMCID: PMC7445491 DOI: 10.1016/j.jinf.2020.08.029] [Citation(s) in RCA: 604] [Impact Index Per Article: 151.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To assess post-discharge persistent symptoms and health-related quality of life (HRQoL) of patients hospitalized in a COVID-19 ward unit more than 100 days after their admission. METHODS All eligible patients were contacted by phone by trained physicians and were asked to answer to a dedicated questionnaire. Patients managed in hospital ward without needing intensive care were compared with those who were transferred in intensive care units (ICU). RESULTS We included 120 patients after a mean (±SD) of 110.9 (±11.1) days following admission. The most frequently reported persistent symptoms were fatigue (55%), dyspnoea (42%), loss of memory (34%), concentration and sleep disorders (28% and 30.8%, respectively). Comparisons between ward- and ICU patients led to no statistically significant differences regarding those symptoms. In both group, EQ-5D (mobility, self-care, pain, anxiety or depression, usual activity) was altered with a slight difference in pain in the ICU group. CONCLUSION Most patients requiring hospitalization for COVID-19 still have persistent symptoms. While there were few differences between HRQoL between ward and ICU patients, our findings must be confirmed in larger cohorts, including more severe patients.
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Affiliation(s)
- Eve Garrigues
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Paul Janvier
- Department of Radiology, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Yousra Kherabi
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Audrey Le Bot
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Antoine Hamon
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Hélène Gouze
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Lucile Doucet
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Sabryne Berkani
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Emma Oliosi
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Elise Mallart
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Félix Corre
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Virginie Zarrouk
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Jean-Denis Moyer
- Department of Anaesthesiology and Intensive Care, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Adrien Galy
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Vasco Honsel
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Bruno Fantin
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France
| | - Yann Nguyen
- Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France; Centre for Epidemiology and Population Health, INSERM U1018, Villejuif, France.
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Gudu T, Padovano I, Mahe E, Gouze H, Vidal F, Bourgault I, Lara/Gonzalez L, Guyot A, Philippe S, Amy de la Breteque M, Ruel-Gagné S, Coronel L, Costantino F, Hayem G, Breban M, D’agostino MA. THU0524 FACTORS EXPLAINING PATIENT PERSPECTIVE IN PSORIASIS AND PSORIATIC ARTHRITIS (PSA): THE ROLE OF INFLAMMATION AND STRUCTURAL DAMAGE DETECTED BY ULTRASOUND (THE ECHOPRO STUDY). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patient reported outcomes (PROs) reflect patients’ opinion on disease activity, impact of disease, quality of life (QoL) and are essential in the assessment of PsA patients. PROs may be influenced by several factors other than disease activity and severity. Ultrasound (US) is an objective tool to evaluate joint inflammation and structural damage in PsA.Objectives:This cross-sectional study aimed at evaluating the role of US-detected inflammation (synovitis, tenosynovitis, enthesitis) and structural damage (erosions, enthesophytes, osteophytes, cortical irregularities), to explain PROs in PsA and to compare that to psoriasis (PsO) patients with and without musculoskeletal (MSK) symptoms.Methods:PsA (CASPAR criteria) [1], PsO with MSK symptoms without fulfilling CASPAR criteria (symptoPsO) and PsO with no MSK symptoms (asymptoPsO) were included. Socio-demographic characteristics, comorbidities, disease duration and treatment were collected. All patients underwent to: a) dermatological and rheumatologic assessment: PsO severity, swollen joint count (SJC), tender JC (TJC), number of dactylitis and enthesitis; b) US evaluation of joints, tendons and entheses according to OMERACT definitions[2], (figure 1); c) PROs assessement: fatigue, disability (HAQ) and QoL (SF36). Variables were compared across groups (chi square or one-way ANOVA test). Correlations were evaluated using Spearman’s test.Results:208 patients (76 PsA, 64 symptoPsO and 68 asymptoPsO) with similar socio-demographic characteristics and PsO duration were included (table 1). Except for enthesophytes, all US changes were significantly higher in PsA, followed by symptoPsO patients.Table 1.Characteristics of the patients:PsAN= 76SymptoPsON=64AsymptoPsON=68pFemales, N (%)33 (43.4)39 (55.7)23 (37.1)NSAge55.58 ± 12.7152.16 ± 15.6150.03 ± 14.66NSPsoriasis duration18.76 ± 13.3719.47 ± 15.9815.03 ± 12.29NSPASI0 (0; 36)3 (0; 16)5.5 (0; 22.1)<0.00168 TJC4 (0; 30)2 (0; 23)0<0.00166 SJC0 (0; 23)0 (0; 3)0<0.001Number of enthesitis3 (0; 13)2 (0; 13)0<0.001Number of dactylitis0 (0; 5)00NSFibromyalgia, N (%)6 (7.9)4 (5.7)0NSN of joints with US synovitis1 (0; 32)0 (0; 7)0 (0; 6)0.001N of US enthesitis0 (0; 11)0 (0; 2)0 (0; 2)<0.001N of US tenosynovitis0 (0; 7)0 (0; 1)0 (0; 1)0.005N of joints with US osthephytes/cortical irregularities2 (0; 22)1 (0; 25)1 (0; 21)0.027N of joints with US erosions0 (0; 4)0 (0; 2)0 (0; 2)0.016N of US entheses with enthesopthytes/calcifications3 (0; 9)2 (0; 10)1 (0; 8)NSN of US enthesis with erosions0 (0; 5)0 (0; 1)0 (0; 2)0.001Fatigue (0-10)4.91 ± 3.083.46 ± 3.402.57 ± 2.86<0.001HAQ (0-3)1 (0; 2)0 (0; 2)0 (0; 1)<0.001SF36 PF61.31 ± 30.0877.46 ± 25.0289.35 ± 19.25<0.001Across all 3 groups, all PROs correlated mainly with demographic variables, comorbidities, TJC, clinical enthesitis, skin severity, depression and fibromyalgia points (r=0.24-0.72). SymptoPsO and PsA reported similar scores of fatigue and impact on most QoL domains, significantly higher than asymptoPsO. HAQ correlated with total number of joints with US irregularities/osteophytes in PsA (r= 0.23; p=0.05), and SF36 physical function with both US inflammatory and damage variables in all three groups (r=0.24-0.34).Conclusion:Quality of life, disability and fatigue were more impaired in PsA and symptoPsO patients than asymptoPsO. In all groups, PROs seem to be mostly associated with socio-demographic characteristics and comorbidities rather than objective measures such as US changes or clinical variables.References:[1]Taylor, Arthritis Rheum 2006[2]Bruyn,J Rheumatol 2019Acknowledgments:This work was supported by PARTNER fellowship.Disclosure of Interests:None declared
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Coronel L, Gudu T, Ruel-Gagné S, Gouze H, Vidal F, Padovano I, Constantino F, Breban M, Mahe E, D’agostino MA. SAT0499 PREVALENCE OF ULTRASOUND FINDINGS SUGGESTIVE OF INFLAMMATORY ARTHRITIS IN CHILDREN WITH SKIN PSORIASIS (ChildEchoPso). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The prevalence of psoriasis (PsO) in children is estimated between 0.5-1% (1), and can be associated with muskuloskeletal involvement, although the prevalence and typology of such involvement is unknown. (2)Over the last years ultrasound associated with Doppler (PDUS) has become an important tool for evaluating joint involvement in children with Juvenile Inflammatory arthritis (JIA). Several studies have shown the high sensitivity of this technique for detecting joint involvement, as well as high acceptability, due to the lack of radiation or of sedation (3).Objectives:To evaluate the prevalence of joints and entheses involvement in children affected by PsO.Methods:Observational cross-sectional study aiming at evaluating 150 consecutive children (≤16 years) affected by skin PsO and addressed by a dermatologist. For each child a standardized clinical and ultrasound evaluation of joint and entheses is performed at the following bilateral sites: a) Entheses: quadriceps tendon, proximal and distal patellar ligament, Achilles tendon, plantar fascia and extensor elbow tendon), b) joints: metacarpophalangeal, proximal and distal interphalangeal, wrist, elbow, knee, ankle, and metatarsophalangeal. PDUS evaluation is performed by an independent examiner, blinded to the clinical assessment of each subject.Results:41 patients were included until now, where 9 patients presented some kind of symptom (painful joint or enthesis), 24 patients have family history of psoriasis and none of them had family history of psoriatic arthritis. Demographic and clinical characteristics are shown in table 1, whilst PDUS findings in Table 2.Table 1.Demographic and clinical characteristics:Total (n=41)Asymptomatic (n=32)Symptomatic (n=9)pMales22 (53.7%)18 (56.3%)4 (44.4%)NSAge9.4 ± 3.98.91 ± 3.511.3 ± 4.6NSPso duration (years)3.5 ± 3.42.9 ± 2.95.6 ± 4.5<0.05PASI5 ± 4.34.8 ± 4.55.7 ± 3.56NSBSA4.3 ± 3.94.47 ± 4.34.1 ± 2.26NSNail involvement25 (61%)19 (59.4%)6 (66.7%)NSPlaques psoriasis20 (48.8%)14 (43.8%)6 (66.7%)NSTJC ≥1, n/tot (%)9 (22%)0 (0)9 (100%)<0.001SJC ≥1, n/tot (%)2 (4.9%)0 (0)2 (22.2%)<0.05Entheseal pain, n/tot (%)6 (14.6%)0 (0)6 (66.7%)<0.001Dactylitis000NAPASI: Psoriasis area severity index. BSA: Body surface area. TJC: Tender Joint Count. SJC: Swollen Joint Count.Table 2PDUS Findings:PatientsTotal (n=41)Asymptomatic (n=32)Symptomatic (n=9)p≥1 ultrasound abnormality, n/tot (%)19 (46.3%)13 (40.6%)6 (66.7%)NS≥1 joint effusion, n/tot (%)11 (26.8%)9 (28.1%)2 (22.2%)NS≥1 synovitis, n/tot (%)3 (7.3%)1 (3.1%)2 (22.2%)NS≥1enthesitis, n/tot (%)7 (17.1%)3 (9.4%)4 (44.4%)<0.05≥1 tenosynovitis, n/tot (%)0 (0)0 (0)0 (0)NA≥1 nail with modified structure, n/tot (%)22 (53.7%)19 (59.4%)3 (33.3%)NSConclusion:This study shows that the presence of ultrasound abnormalities was higher in the symptomatic group and considering the fact that the most frequent inflammatory ultrasound finding was enthesitis, we might consider the enthesis as a possible landmark for developing juvenile psoriatic arthritis.References:[1]Michalek et al. J Eur Acad Dermatol Venereol, 2017[2]Petty et al. J Rheumatol, 2004[3]Buchmann et al. Radiol Clin N Am, 2004Acknowledgments:This research was conducted while Luis Coronel was a PARTNER FellowDisclosure of Interests:None declared
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Gudu T, Mahé E, Padovano I, Gouze H, Vidal F, Lara Gonzalez L, Guyot A, Amy de la Bretèque M, Saiag P, Bourgault-Villada I, Ruel-Gagné S, Constantino F, Hayem G, Breban M, D’Agostino MA. Facteurs expliquant la perspective du patient dans le psoriasis et le rhumatisme psoriasique : le rôle de l’inflammation et de l’atteinte structurale mesurées par l’échographie. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mitrovic S, Gouze H, Schaeverbeke T, Gossec L, Fautrel B. Reply to the comment of Alkan Melikoglu ‘Joint manifestations can provide diagnostic clues in Morquio syndrome, a case report’. Joint Bone Spine 2019; 86:123-124. [DOI: 10.1016/j.jbspin.2018.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
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Gouze H, Noussair L, Padovano I, Salomon E, de Laroche M, Duran C, Felter A, Carlier R, Breban M, Dinh A. Veillonella parvula spondylodiscitis. Med Mal Infect 2018; 49:54-58. [PMID: 30385069 DOI: 10.1016/j.medmal.2018.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 10/03/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Veillonella parvula is an anaerobic Gram-negative coccus rarely involved in bone and joint infections. PATIENTS AND METHOD We report the case of a Veillonella parvula vertebral osteomyelitis (VO) in a female patient without any risk factor. RESULTS The 35-year-old patient was immunocompetent and presented with Veillonella parvula VO. She was admitted to hospital for inflammatory lower back pain. The discovertebral sample was positive for Veillonella parvula. Literature data on Veillonella VO is scarce. Reported cases usually occurred in immunocompromised patients. Diagnosis delay can be up to four months. Patients are usually afebrile. Outcome with antimicrobial treatment alone is favorable in half of cases. Other patients must undergo surgery. CONCLUSIONS Veillonella VO may occur in immunocompetent patients and have a clinical spectrum of mechanical lower back pain.
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Affiliation(s)
- H Gouze
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Département de rhumatologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - L Noussair
- Département de microbiologie, CHU Raymond-Poincaré, UVSQ, AP-HP, 104, boulevard R. Poincaré, 92380 Garches, France
| | - I Padovano
- Département de rhumatologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - E Salomon
- Laboratoire de microbiologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - M de Laroche
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - C Duran
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - A Felter
- Département de radiologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - R Carlier
- Département de radiologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - M Breban
- Département de rhumatologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - A Dinh
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
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Mitrovic S, Gouze H, Gossec L, Schaeverbeke T, Fautrel B. Mucopolysaccharidoses seen in adults in rheumatology. Joint Bone Spine 2017; 84:663-670. [PMID: 28196778 DOI: 10.1016/j.jbspin.2017.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
Abstract
Mucopolysaccharidoses are a group of rare lysosomal storage diseases including a great number of polymorph syndromes, each being related to a particular mutation responsible for a deficiency of glycosaminoglycan degrading enzymes, leading to an accumulation of glycosaminoglycans in tissues. Many of them are diagnosed in children or teenagers and have a severe prognosis because of organ failure, and are consequently usually not seen by the adult rheumatologist. However, some of them have a more progressive presentation, with musculoskeletal symptoms at the forefront and a lifespan that nearly reaches that of the general population. These milder forms are more likely to be diagnosed in adults, in patients who have suffered for years and sometimes even decades with unrecognized mucopolysaccharidosis. Indeed, they can sometimes mimic inflammatory rheumatic disorders, and therefore be misdiagnosed for a long time. Recognition and diagnosis of these attenuated forms can be a real challenge as they lead to moderate and/or nonspecific symptoms such as joint pain or stiffness. Hence, rheumatologists should know about them. Early diagnostic is essential since specific treatment, like enzyme replacement therapy, is now available for some subtypes and might, if given early, slow down the development of tissue damage, which is unfortunately irreversible. This article provides the opportunity to review the main clinical and radiographic features, the diagnostic strategy and the update of management, which should be multidisciplinary and led by an experienced physician in a reference centre. The contribution of the rheumatologist is important to ensure symptom control and prevent complications.
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Affiliation(s)
- Stéphane Mitrovic
- UPMC university Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Sorbonne universités, 75005 Paris, France; Department of rheumatology, Pitié-Salpêtrière hospital, AP-HP, 75013 Paris, France.
| | - Hélène Gouze
- UPMC university Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Sorbonne universités, 75005 Paris, France; Department of rheumatology, Pitié-Salpêtrière hospital, AP-HP, 75013 Paris, France
| | - Laure Gossec
- UPMC university Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Sorbonne universités, 75005 Paris, France; Department of rheumatology, Pitié-Salpêtrière hospital, AP-HP, 75013 Paris, France
| | - Thierry Schaeverbeke
- Department of rheumatology, Pellegrin hospital, Bordeaux university hospital, 33076 Bordeaux, France
| | - Bruno Fautrel
- UPMC university Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Sorbonne universités, 75005 Paris, France; Department of rheumatology, Pitié-Salpêtrière hospital, AP-HP, 75013 Paris, France
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