systemic autoimmune rheumatic disease

全身性自身免疫性风湿病
  • 文章类型: Journal Article
    据报道,自身免疫性风湿性疾病(ARD)患者出现了许多长冠状病毒病(长COVID)病例。尽管对一般人群中长型COVID的临床表现进行了综述,对ARD患者的系统评价很少。在这里,我们对ARD患者中长型COVID的患病率和特点进行了系统评价和荟萃分析.
    我们搜索了截至2022年12月27日在PubMed和Embase中的文献。队列,我们收集了ARD患者中与长COVID相关的横断面研究和病例对照研究.还根据COVID感染的严重程度和风湿性疾病的亚型[系统性自身免疫性风湿性疾病(SARD)与非自身免疫性风湿性疾病(NARD)]进行了分层。Meta分析采用随机效应模型。
    从文献中确定了总共15项相关研究。2995例患者中长型COVID的患病率为56%(95%CI34,76)。住院COVID患者的长COVID比例高于非住院患者。SARD和NARD患者的长COVID患病率相似。就症状而言,疲劳,关节痛和疼痛常见于患有ARDs的长COVID患者。
    ARD患者的长COVID特征通常与普通人群相似,尽管患病率更高,关节痛和疼痛的比例更高。
    UNASSIGNED: Numerous cases of long coronavirus disease (long COVID) have been reported in patients with autoimmune rheumatic diseases (ARDs). Despite the reviews on clinical manifestations of long COVID in the general population, systematic reviews on ARD patients are scarce. Herein, we conducted a systematic review and meta-analysis on the prevalence and characteristics of long COVID in ARD patients.
    UNASSIGNED: We searched the literature in PubMed and Embase as of 27 December 2022. Cohort, cross-sectional and case-control studies relevant to long COVID in ARD patients were collected. Stratification based on the severity of COVID infection and subtypes of rheumatic diseases [systemic autoimmune rheumatic disease (SARD) vs non-autoimmune rheumatic disease (NARD)] was also undertaken. A random-effects model was used in the meta-analysis.
    UNASSIGNED: A total of 15 relevant studies were identified from the literature. The prevalence of long COVID was 56% (95% CI 34, 76) in 2995 patients. Hospitalized COVID patients had a higher proportion of long COVID than non-hospitalized patients. The prevalence of long COVID was similar between SARD and NARD patients. In terms of symptoms, fatigue, arthralgia and pain were commonly reported in long COVID patients with ARDs.
    UNASSIGNED: The characteristics of long COVID in ARD patients are generally similar to those in the general population despite a higher prevalence and a higher proportion of arthralgia and pain.
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  • 文章类型: Journal Article
    背景:护士在全身性自身免疫性风湿性疾病患者的治疗中起着重要作用。关于护士主导的干预措施对该人群患者报告结果的有效性知之甚少。这项系统评价的目的是检查护士主导的系统性自身免疫性风湿性疾病干预的证据。
    方法:使用系统评价和荟萃分析指南的首选报告项目,在PubMed进行了全面的文献检索,护理和相关健康文献的累积指数,PsycINFO,和Embase从数据库开始到2022年9月发表的研究。如果这些研究以英文发表在同行评审的期刊上,并使用随机对照试验设计评估了护士主导的干预措施在患有全身性自身免疫性风湿性疾病的成年人中的有效性。筛选,全文回顾,和质量评估由两名独立审核员进行。
    结果:总共有162篇文章被确定为可能包括在内,其中包括五项研究。五项研究中有四项(80%)是在系统性红斑狼疮中进行的。护士主导的干预措施类型存在显着差异;大多数包括护士的教育课程和后续咨询(n=4)。最常见的患者报告的结果是健康相关的生活质量(n=3),疲劳(n=3),心理健康(包括焦虑和抑郁)(n=2),和自我效能感(n=2)。干预的持续时间从12周到6个月不等。所有研究都包括一名受过专业培训和教育的护士,并显示其主要结果显着改善。大多数研究(60%)被认为是高方法学质量。
    结论:本系统综述为在系统性自身免疫性风湿性疾病中使用护士主导的干预措施提供了新的证据。我们的发现强调了护士在提供非药物策略以帮助患者更好地管理疾病和改善健康结果方面的重要作用。
    BACKGROUND: Nurses play an important role in the management of patients with systemic autoimmune rheumatic diseases. Little is known about the effectiveness of nurse-led interventions on patient-reported outcomes in this population. The aim of this systematic review was to examine the evidence of nurse-led interventions in systemic autoimmune rheumatic diseases.
    METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Embase for studies published from database inception to September 2022. Studies were included if they were published in a peer-reviewed journal in English and evaluated the effectiveness of a nurse-led intervention using a randomized controlled trial design in adults with a systemic autoimmune rheumatic disease. Screening, full-text review, and quality appraisal were conducted by two independent reviewers.
    RESULTS: A total of 162 articles were identified for possible inclusion, of which five studies were included. Four of five studies (80%) were conducted in systemic lupus erythematosus. There was significant variability in the types of nurse-led interventions; the majority included educational sessions and follow up counseling by a nurse (n = 4). The most common patient-reported outcomes were health-related quality of life (n = 3), fatigue (n = 3), mental health (including anxiety and depression) (n = 2), and self-efficacy (n = 2). The duration of the interventions varied from 12 weeks to 6 months. All studies included a nurse with specialized training and education and showed significant improvements in their primary outcomes. The majority of the studies (60%) were considered high methodological quality.
    CONCLUSIONS: This systematic review provides emerging evidence for the use of nurse-led interventions in systemic autoimmune rheumatic diseases. Our findings emphasize the important role of nurses in providing nonpharmacological strategies to help patients better manage their disease and improve health outcomes.
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  • 文章类型: Review
    未经证实:全身性自身免疫性风湿性疾病可在潜在恶性肿瘤的背景下作为副肿瘤现象发生。我们提出了三个说明性的临床病例和一个叙述性文献综述,重点是系统性硬化症。皮肌炎和手掌筋膜炎和多关节炎综合征。
    UNASSIGNED:回顾性地、匿名地获取并审查了来自鲁汶大学医院的三名患者的医学数据。进行了叙述性审查,搜索PubMed的数据库,Embase和Cochrane图书馆。
    未经证实:系统性硬化症,皮肌炎和手掌筋膜炎和多关节炎综合征是全身性自身免疫性风湿性疾病,可表现为副肿瘤现象。系统性自身免疫性风湿病通常与特异性自身抗体的存在有关,一些与潜在恶性肿瘤的可能性很高有关。抗核糖核酸聚合酶III抗体和抗转录中间因子1γ抗体的存在表明系统性硬化症和皮肌炎中潜在癌症的风险增加,分别。通过早期发现潜在的恶性肿瘤可以改善个体患者的预后,因此,充分的癌症筛查的重要性。
    未经证实:一些全身性自身免疫性风湿性疾病可以表现为副肿瘤现象,由此已知特异性自身抗体的存在与潜在恶性肿瘤的可能性有关。我们强调临床医生对这些不同特征的知识的重要性,因为它有助于早期发现和治疗潜在的恶性肿瘤,从而改善个体患者的预后。
    UNASSIGNED: Systemic autoimmune rheumatic diseases can occur as paraneoplastic phenomena in the context of underlying malignancies. We present three illustrative clinical cases and a narrative literature review focusing on systemic sclerosis, dermatomyositis and palmar fasciitis and polyarthritis syndrome.
    UNASSIGNED: Medical data of three patients from the University Hospitals Leuven were retrospectively and anonymously obtained and reviewed. A narrative review was performed, searching the databases of PubMed, Embase and Cochrane Library.
    UNASSIGNED: Systemic sclerosis, dermatomyositis and palmar fasciitis and polyarthritis syndrome are systemic autoimmune rheumatic diseases that can present as paraneoplastic phenomena. Systemic autoimmune rheumatic diseases are often associated with the presence of specific autoantibodies, some associated with a high likelihood of underlying malignancy. The presence of anti-ribonucleic acid polymerase III antibodies and anti-transcription intermediary factor 1 gamma antibodies indicates an increased risk of underlying cancer in systemic sclerosis and dermatomyositis, respectively. Individual patient prognosis can be improved through early detection of underlying malignancy, hence the importance of adequate cancer screening.
    UNASSIGNED: Some systemic autoimmune rheumatic diseases can appear as paraneoplastic phenomena, whereby the presence of specific autoantibodies is known to be related to the likelihood of underlying malignancy. We highlight the importance of clinician\'s knowledge of these distinct features, as it facilitates early detection and treatment of underlying malignancy, thereby improving individual patient prognosis.
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  • 文章类型: Journal Article
    Anti-DFS70 antibodies have been proposed as a marker to exclude systemic autoimmune rheumatic disease (SARD). We conducted this systematic diagnostic test accuracy review and meta-analysis to determine the performance of anti-DFS70 antibodies in patients with a positive anti-nuclear antibody (ANA) test result to exclude SARD. We searched PubMed, Embase, Web of Science, Scopus and the Cochrane Library up to 22 February 2021, and included studies examining the diagnostic accuracy of anti-DFS70 antibodies in patients with a positive ANA test result. The results were pooled using a hierarchical bivariate model and plotted in summary receiver operating characteristic curves. R software and Stata Statistical Software were used for the statistical analysis. Eight studies with 4168 patients were included. The summary sensitivity was 0.19 (95% confidence interval: 0.12-0.28) and the specificity was 0.93 (95% confidence interval: 0.88-0.96). The area under the curve was 0.69 (95% confidence interval: 0.64-0.72). The meta-regression analysis showed that targeting only ANA-associated rheumatic disease was associated with higher specificity. In addition, the studies with a non-SARD prevalence of <80% and using a chemiluminescence assay were associated with higher specificity. Anti-DFS70 antibodies have high specificity for the exclusion of SARD among patients presenting with a positive ANA test, but the sensitivity is low.
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