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Catoggio C, Martínez Muñoz A, Chaparro Del Moral R, Klajn DS, Papasidero SB, Machado Escobar MA, Gonzalez Lucero L, Lucero E, Martinez L, Muñoz SA, Collado MV, Gomez GN, Sarano J, Marin J, Scolnik M, Romero J, Barreira JC, Zalazar MM, Rillo OL, Pisoni C. Validation and adaptation of the Spanish version of the systemic lupus activity questionnaire (S-SLAQ) in an Argentinean population. Lupus 2021; 30:2230-2236. [PMID: 34894851 DOI: 10.1177/09612033211061064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To validate the systemic lupus activity questionnaire (SLAQ) in Spanish language. METHODS The SLAQ questionnaire was translated and adapted in Spanish. Consecutive SLE patients from 8 centers in Argentina were included. A rheumatologist completed a Systemic Lupus Activity Measure (SLAM), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K, and a physician's assessment. Reliability was assessed by internal consistency (Cronbach's alpha), stability by test-retest reliability (intraclass correlation coefficient), and construct validity by evaluating the correlation with clinically relevant scores. Sensitivity and specificity for clinically significant disease activity (SLEDAI ≥6) of different S-SLAQ cut-off points were evaluated. RESULTS We included 97 patients ((93% female, mean age: 40 years (SD14.7)). Internal consistency was excellent (Cronbach's alpha = 0.84, p < 0.001), and the intraclass correlation coefficient was 0.95 (p < 0.001). Mean score of S-SLAQ was 8.2 (SD 7.31). Correlation of S-SLAQ was moderate with Patient NRS (r= 0.63 p< 0.001), weak with SLAM-no lab (r = 0.42, p <0.001) and SLAM (r = 0.38, p < 0.0001), and very weak with SLEDAI-2K (r = 0.15, p =0.1394). Using the S-SLAQ cutoff of five points, the sensitivity was 72.2% and specificity was 37.9%, for clinically significant disease activity. CONCLUSIONS The S-SLAQ showed good validity and reliability. A good correlation, similar to the original instrument, was observed with patient´s global disease activity. No correlation was found between S-SLAQ and gold standard disease activity measures like SLEDAI-2K and SLAM. The S-SLAQ cutoff point of 5 showed a good sensitivity to identify the active SLE population and therefore could be an appropriate screening instrument for disease activity in clinical and epidemiological studies.
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Affiliation(s)
- Cecilia Catoggio
- Rheumatology Section, 62883Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | | | - Diana S Klajn
- Rheumatology Section, 580023Hospital General de Agudos "Dr E. Tornú", Buenos Aires, Argentina
| | - Silvia B Papasidero
- Rheumatology Section, 580023Hospital General de Agudos "Dr E. Tornú", Buenos Aires, Argentina
| | | | | | - Eleonora Lucero
- Rheumatology Section, Hospital Angel C. Padilla, Tucumán, Argentina
| | - Liliana Martinez
- Internal Medicine, 62916Hospital General de Agudos "Dr Juan A Fernández", Buenos Aires, Argentina
| | - Sebastian A Muñoz
- Internal Medicine, 62916Hospital General de Agudos "Dr Juan A Fernández", Buenos Aires, Argentina
| | - María Victoria Collado
- Rheumatology Section, 207909Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Graciela N Gomez
- Rheumatology Section, 207909Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Judith Sarano
- Rheumatology Section, 207909Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Josefina Marin
- Rheumatology Section, 37533Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Marina Scolnik
- Rheumatology Section, 37533Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Julia Romero
- Rheumatology Section, 62870Hospital Británico, Buenos Aires, Argentina
| | | | - Maria M Zalazar
- Rheumatology Section, 58783Hospital General de Agudos "Dr Ignacio Pirovano", Buenos Aires, Argentina
| | - Oscar L Rillo
- Rheumatology Section, 58783Hospital General de Agudos "Dr Ignacio Pirovano", Buenos Aires, Argentina
| | - Cecilia Pisoni
- Rheumatology Section, 62883Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
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Abstract
Rheumatoid nodulosis is an entity that describes a particular variant of polyarthritis associated with early manifestations of palindromic rheumatism, radiologic subchondral bone cysts, and subcutaneous rheumatoid nodules. This study describes the clinical, radiologic, histologic, crystallographic, and laboratory findings, as well as the outcome in a group of 16 patients with rheumatoid nodulosis that were followed for a period of 1-12 years. Six of these patients had an aggressive course and developed classic erosive polyarticular rheumatoid arthritis, while the others continued having episodic arthritis without erosive disease. Seven patients had cholesterol crystals in olecranon bursae containing nodules. Second-line drugs used to control the articular manifestations did not improve the nodulosis, erosive, or cystic subchondral bone changes. Rheumatoid nodulosis mimics several other rheumatic diseases, and in about 40%, classic erosive rheumatoid arthritis develops. The presence of cholesterol crystals in rheumatoid nodules or affected bursae can increase the confusion with other crystal-induced arthritis, in particular, tophaceous monosodium urate gout or xanthomatosis.
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Abstract
OBJECTIVES The objectives of this study were to evaluate the frequency and characteristics of the peripheral musculoskeletal manifestations in polymyalgia rheumatica (PMR), evaluate if PMR with peripheral synovitis represents a subset with a more severe disease, and examine for clinical and laboratory characteristics at onset of PMR that might later predict rheumatoid arthritis (RA). PATIENTS AND METHODS Patients were diagnosed with PMR according to the 1982 Chuang criteria. Patients were followed up between 1990 and 2002. The following musculoskeletal manifestations at onset and during the follow up were considered: peripheral synovitis, distal extremity swelling with pitting edema, carpal tunnel syndrome, and distal tenosynovitis. RESULTS Thirty-eight of the 74 patients (51%) showed distal musculoskeletal symptoms: 29 (39%) had peripheral synovitis, 4 (5%) presented pitting edema, 4 (5%) experienced carpal tunnel syndrome, and one (1.3%) had distal tenosynovitis. These manifestations resolved completely after corticosteroid therapy was initiated. Peripheral synovitis was oligoarticular and often transient. The joints most frequently involved were the wrist, metacarpophalangeal, and knee. Erythrocyte sedimentation rate (ESR) was normal in 7 patients. When comparing patients with PMR with and without peripheral synovitis, no statistically significant differences were found in the studied variables. Through the first year of follow up, 7 patients fulfilled the American College of Rheumatology 1987 criteria for RA, 2 patients developed giant cell arteritis, and 3 had associated malignancy. Patients who developed RA had statistically significantly increased presence of persistent synovitis and a smaller decrease in mean ESR after treatment with corticosteroids. CONCLUSION Fifty-one percent of the patients with PMR presented distal musculoskeletal manifestations, with peripheral synovitis being the most frequent one. Patients with PMR with peripheral synovitis did not represent a high-risk subgroup with more severe disease. Seven patients who developed criteria for seronegative RA within the first year of follow up had presented statistically significant persistent synovitis compared with those who continued as PMR and also showed a smaller initial decrease in mean ESR after steroid treatment was initiated. The absence of persistent arthritis and the benign course of the arthritis permit the distinction of PMR from other inflammatory arthropathies.
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Rillo OL, Brosio D, Gusis S. Systemic lupus erythematosus: a reminder about noninflammatory synovial effusions during corticosteroid treatment. J Clin Rheumatol 1997; 3:122. [PMID: 19078140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- O L Rillo
- Section of Rheumatology and Clinical Department E. Tornú General Hospital Buenos Aires, Argentina
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Abstract
Among the idiopathic forms of osteoporosis, the one developing during pregnancy is the least common and scarcely studied. Poorly understood, it seems to stem from transient failure of calcitropic hormones and decreased osteoblast activity. A 25-year-old patient presented with coxofemoral pain during the last three months of pregnancy, followed by multiple vertebral compression fractures at postpartum. Laboratory, radiological, densitometric and histological examinations led to a diagnosis of idiopathic osteoporosis in pregnancy, once other causes of osteopenia had been ruled out. Bone densitometries performed 12 and 24 months later showed an increase in mineral density, thus demonstrating the self-limited nature of this entity.
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Affiliation(s)
- O L Rillo
- Rheumatology Department, Hospital Privado 24 de Septiembre, Buenos Aires, Argentina
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Rillo OL, Babini SM, Basnak A, Wainer E, Balbachan E, Cocco JA. Tendinous and ligamentous hyperlaxity in patients receiving longterm hemodialysis. J Rheumatol Suppl 1991; 18:1227-31. [PMID: 1941829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chronic renal insufficiency gives rise to osteoarticular and tendinous alterations, with tendinous rupture reaching 3.6% among patients receiving hemodialysis. To evaluate potential tendinous and ligamentous alterations, 39 consecutive patients receiving longterm hemodialysis (mean dialysis time 33 months) were studied prospectively by clinicoradiological methods. Of the 39 cases, atlantoaxial subluxation was found in 3 (7.7%). Tendinous or ligamentous hyperlaxity was present in 29 (74%) with patellar tendon elongation in 19 (49%), articular hypermobility in 20 (51%) and both in 10. Differences were significant (p less than 0.05) in patients with articular hypermobility with over 36 months' dialysis, and even more so (p less than 0.01) in those with over 48 months. Atlantoaxial subluxation was more frequent after 48 months' dialysis. Therefore, patients receiving longterm hemodialysis are prone to present tendinous or ligamentous hyperlaxity with atlantoaxial subluxation as well.
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Affiliation(s)
- O L Rillo
- Rheumatology Department, Hospital Privado 24 de Setiembre, Instituto Nacional de Rehabilitación, Buenos Aires, Argentina
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Rillo OL, Scheines EJ, Moreno C, Barreira JC, Porrini AA, Maldonado Cocco JA. Coexistence of diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis. Clin Rheumatol 1989; 8:499-503. [PMID: 2515022 DOI: 10.1007/bf02032103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To the best of our knowledge, only two patients with concurrent diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) have been reported so far. Here we present 3 patients in whom clinical and radiological findings indicative of DISH and AS coexisted. Two of these cases exhibited HLA B27. Although the presence of sacroiliitis would appear to exclude DISH, calcification and ossification of the anterior common vertebral ligament (ACVL) confirmed diagnosis of the latter disease.
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Affiliation(s)
- O L Rillo
- Department of Rheumatology, National Institute of Rehabilitation, Buenos Aires, Argentina
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Rillo OL, Rabadán A, Houssay R, Schillaci R, Pardal E. Atlantoaxial subluxation and hydrocephalus [corrected] in rheumatoid arthritis. J Rheumatol Suppl 1989; 16:121-5. [PMID: 2716000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We report a case of rheumatoid arthritis with anterior and vertical atlantoaxial subluxation. Our patient developed severe spastic quadriparesis and pyramidal tract signs. Cephalic computerized tomogram scan showed evidence of evolutive communicating hydrocephalus and the odontoid peg protruding in the posterior fossa. The patient recovered after cerebral spinal fluid ventricle-peritoneal shunting and occipitocervical arthrodesis. No other neurologic complications occurred during a 6-year followup.
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Affiliation(s)
- O L Rillo
- Hospital de Clínicas, Instituto de Neurocirugía y Neurología, Buenos Aires, Argentina
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