Medicina clinica
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Review
Effect of antiresorptive and bone forming treatments in bone erosions in rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that can cause joint destruction and marked disability. Early treatment with disease-modifying drugs, including biological therapy, is the principal treatment to prevent the structural damage associated with this entity. Some studies have indicated that concomitant treatment with antiresorptives, such as bisphosphonates or denosumab, could prevent erosive lesions in this process, and it has even been suggested that treatment with a bone forming agent, such as teriparatide, could revert previously established erosive lesions. In this article we review the evidence available on the efficacy of treatment with antiresorptives and bone forming agents in the prevention and/or treatment of bone erosions associated with RA.
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Faced with the suspicion of pulmonary embolism (PE), the guidelines recommend the use of clinical probability scales, measurement of D-dimer and, in certain cases, confirmation by pulmonary angiography by computed tomography (CTPA) or scintigraphy. Recently, it has been proposed to adjust the D-dimer according to age or use simpler scales (YEARS algorithm) for a better selection of patients. ⋯ The current diagnostic models for PE lead to a large number of unnecessary explorations. The new models could reduce the number of APTC although with a minimum risk of false negatives.
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Case Reports
Predictive risk factors for autoimmune thyroid diseases in patients with pernicious anemia.
Patients with pernicious anemia (PA) have a higher prevalence of other autoimmune diseases. We assessed the correlation between PA and autoimmune thyroid diseases (AITD), and evaluated the risk factors for this association. ⋯ PA and AITD are frequently associated, suggesting all patients with PA should be investigated for occult thyroid disease, especially those with weight loss, diabetes mellitus and gastric autoantibodies.