Clinical rheumatology
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Clinical rheumatology · Aug 2020
Meta AnalysisClinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials.
To compare the effects of platelet-rich plasma (PRP) injection versus placebo (saline injection) on pain and joint function in lateral epicondylitis in randomized placebo-controlled trials. Randomized controlled trials that evaluated pain (visual analog scale [VAS] and patient-rated tennis elbow evaluation [PRTEE]) and/or functional improvement (PRTEE; disability of the arm, shoulder, and hand [DASH]; and Roles-Maudsley score [RMS]) in patients diagnosed with lateral epicondylitis and compared PRP with placebo injections were considered. The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched from inception to October 2019. ⋯ PRP injection was not superior to placebo for relieving pain and joint functionality in chronic lateral epicondylitis. However, patients reported improvement after both interventions in such clinical parameters. Further randomized trials are required to determine whether PRP injection is clinically more effective than placebo (saline injection).
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Clinical rheumatology · Aug 2020
ReviewHydroxychloroquine and chloroquine in COVID-19: should they be used as standard therapy?
The pandemic of the new coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has urged the nations to an unprecedented world-wide reaction, including an accelerated exploration of therapeutic options. In the absence of a vaccine and specifically designed antivirals, the medical community has proposed the use of various previously available medications in order to reduce the number of patients requiring prolonged hospitalizations, oxygen therapy, and mechanical ventilation and to decrease mortality from coronavirus disease 2019 (COVID-19). Hydroxychloroquine and chloroquine are among the proposed drugs and are the most widely used so far, despite the lack of robust evidence on their usefulness. The objective of this article is to review and discuss the possible role of these drugs in the therapy of COVID-19.
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Clinical rheumatology · Jul 2020
YouTube as a source of information on COVID-19 and rheumatic disease link.
The current 2019 novel coronavirus outbreak is continuing to spread rapidly despite all efforts. Patients with rheumatic disease may have higher levels of anxiety due to their disease characteristics and medications. The web-based platforms are widely used sources for gaining medical information. YouTube presents a wide range of medical information, but there are concerns on its quality. Therefore, we aimed to evaluate the quality of the YouTube videos about COVID-19 and rheumatic diseases link. ⋯ Besides high-quality videos, there were substantially low-quality videos that could cause misleading information to spread rapidly during the pandemic. Videos from trustworthy sources such as universities, academics, and physicians should be kept in the foreground.Key Points•Web-based platforms have become an important source of health-related information. One of the most important online sources is YouTube because it is easy accessible and free.•Of the videos evaluating the link between COVID-19 and rheumatic diseases, 41.4% (n = 19) were of high quality.•The main sources of high-quality videos were academics/universities and physicians.•The most frequently discussed topics in videos were the place of hydroxychloroquine in the treatment of COVID-19 and whether to continue the use of existing rheumatological drugs.
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Clinical rheumatology · Jul 2020
ReviewCytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment.
COVID-19 infection has a heterogenous disease course; it may be asymptomatic or causes only mild symptoms in the majority of the cases, while immunologic complications such as macrophage activation syndrome also known as secondary hemophagocytic lymphohistiocytosis, resulting in cytokine storm syndrome and acute respiratory distress syndrome, may also occur in some patients. According to current literature, impairment of SARS-CoV-2 clearance due to genetic and viral features, lower levels of interferons, increased neutrophil extracellular traps, and increased pyroptosis and probable other unknown mechanisms create a background for severe disease course complicated by macrophage activation syndrome and cytokine storm. ⋯ Anti-rheumatic drugs, which are tried for managing immunologic complications of COVID-19 infection, will also be discussed including chloroquine, hydroxychloroquine, JAK inhibitors, IL-6 inhibitors, IL-1 inhibitors, anti-TNF-α agents, corticosteroids, intravenous immunoglobulin (IVIG), and colchicine. Early recognition and appropriate treatment of immunologic complications will decrease the morbidity and mortality in COVID-19 infection, which requires the collaboration of infectious disease, lung, and intensive care unit specialists with other experts such as immunologists, rheumatologists, and hematologists.