Clinical rheumatology
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Clinical rheumatology · Nov 2020
Multicenter StudyThe impact of COVID-19 pandemic on rheumatology practice: a cross-sectional multinational study.
To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on rheumatology practice. ⋯ The negative impact of the COVID-19 pandemic on rheumatology practice may compromise rheumatic diseases control. Better access to drugs and providing telemedicine platforms are recommended to improve the practice. Key Points • The COVID-19 pandemic had a significant negative impact on the rheumatology practice, including access to outpatient clinic, hospitalization, and to anchor drugs. • The compromised access to rheumatology care may jeopardize the control of chronic rheumatic diseases and the long-term prognosis. • Better access to drugs and providing telemedicine platforms are strongly recommended.
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Clinical rheumatology · Sep 2020
ReviewThrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad.
The pathogenesis of Coronavirus disease 2019 (COVID-19) is gradually being comprehended. A high number of thrombotic episodes are reported, along with the mortality benefits of heparin. COVID-19 can be viewed as a prothrombotic disease. ⋯ There is an urgent need to explore newer avenues like activated protein C, PAI-1 antagonists, and tissue plasminogen activators (tPA). These should be augmented with therapies targeting RAAS, antiplatelet drugs, repurposed antiinflammatory, and antirheumatic drugs. Key Points • Venous and arterial thromboses in COVID-19 can be viewed through the prism of Virchow's triad. • Endothelial dysfunction, platelet activation, hyperviscosity, and blood flow abnormalities due to hypoxia, immune reactions, and hypercoagulability lead to thrombogenesis in COVID-19. • There is an urgent need to stratify COVID-19 patients at risk for thrombosis using age, comorbidities, D-dimer, and CT scoring. • Patients with COVID-19 at high risk for thrombosis should be put on high dose heparin therapy.
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Clinical rheumatology · Dec 2021
Observational StudyAbility and willingness to utilize telemedicine among rheumatology patients-a cross-sectional survey.
This study aims to assess the patients' ability and willingness to utilize telemedicine (TM) along with identifying some of the barriers to a more widespread adoption of TM in rheumatology. ⋯ Out of necessity due to the COVID-19 pandemic, rheumatology clinics are increasingly turning to TM. The results of this study suggest that access and familiarity with technology may still be limited in certain demographics, particularly the elderly. Furthermore, this study helps to understand some of the additional barriers to more widespread adoption and patients' perceived limitations of TM. Key Points • This study aimed to assess rheumatology patients' willingness to utilize telemedicine (TM) while determining the factors and barriers that may exist for a more widespread adoption of TM, using a cross-sectional survey in the setting of a rheumatologic clinic. • The age of the patient was the most significant contributing factor in a patient's perception of TM, with older patients being less likely to think that the purpose of their rheumatology visits could be achieved over the phone or via videoconferencing. • The social trend of limited access to technology among the elderly population was reinforced by the results in this study. • Patients who had a greater commute to the clinic were more likely to willing to utilize TM consultations. • The results of this study highlight the elevated difficulty elderly patient populations have in utilizing TM. • With the current outbreak of COVID-19, the importance of utilizing TM specifically among the elderly population could prove vital. Future studies to focus on the elderly population and methods for helping these patients become familiar with TM would be beneficial. • Studies such as this can help to orchestrate future guidelines for TM in the field of rheumatology. Based on our study results, the new-patient encounter should be an in-person face-to-face encounter whenever possible, followed by TM visits for established patients who are able and open to using it, depending on the diagnosis and symptoms of the individual patients.
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Clinical rheumatology · Oct 2020
Cross-cultural adaption and validation of simplified Chinese version of the lower extremity function scale in patients with knee osteoarthritis.
The lower extremity function scale (LEFS) is widely used to investigate patients' functional status due to musculoskeletal dysfunction of the lower extremity. The aims of this study were to translate and cross-culturally adapt the LEFS into simplified Chinese (SC-LEFS) and evaluate the psychometric properties in patients with knee osteoarthritis (OA). ⋯ The SC-LEFS has been nicely adapted into simplified Chinese. It was proved to be reliable and valid for knee OA patients from China mainland who are undergoing arthroplasty. Furthermore, additional research should be conducted to assess these findings in other dysfunctions of lower extremity in a larger sample size. Key Points • The present study firstly cross-culturally adapted the lower extremity function scale (LEFS) into simplified Chinese and applied for patients with knee osteoarthritis in China mainland. • The psychometric properties including reliability, validity, and responsiveness were evaluated in SC-LEFS. • The SC-LEFS turned out to be a reliable and valid tool for clinical physicians and researchers assessing patients with knee osteoarthritis.
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Clinical rheumatology · Jan 2012
Multicenter Study Clinical TrialSafety and acceptability of suprascapular nerve block in rheumatology patients.
Suprascapular nerve block (SSNB) is a popular treatment for shoulder pain. To date, studies undertaken mainly describe the methods of performing the technique or are trials examining its efficacy. As a result, the numbers of blocks reported are small and therefore confidence in the safety of the procedure must be limited. ⋯ Patient satisfaction with the pain relief was high, with over 80% of respondents being satisfied or very satisfied with the result. SSNB is a very safe procedure in the outpatient setting, even among frail, elderly patients. Patients rate the satisfaction with the pain relief highly.