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Rheumatic Diseases and Related Conditions in Healthcare

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 16866

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Special Issue Editor

Dr. Arnulfo Hernan Nava-Zavala

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Guest Editor

1. Unidad de Investigación Epidemiológica y en Servicios de Salud, Centro Médico Nacional de Occidente, OOAD Jalisco Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico
2. Programa Internacional Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
3. Servicio de Inmunología y Reumatología, División de Medicina Interna, Hospital General de Occidente, Secretaria de Salud Jalisco, Zapopan 45170, Mexico
Interests: autoantibodies; autoimmune diseases; inflammation; research design; rheumatology; hematologic neoplasms

Special Issue Information

Dear Colleagues,

Rheumatic diseases entail physical and mental wear and tear on the patients who suffer from them. These conditions are chronic, non-transmissible diseases, and have no curative treatment. As these diseases progress, they affect and restrict the autonomy of the people who suffer from them. In the same way, they are pathologies that contribute an essential expense for governments since they affect a large percentage of people in their productive stage, who have to limit their activities when there is a reactivation of their disease (relapses can become frequent and prolonged).

Therefore, it is of particular interest to know more about rheumatic diseases and their coexistent pathologies, such as cardiometabolic, hematological, or malignant diseases. We aim to publish works addressing this in the present Special Issue. It is also desirable to publish papers dealing with other diseases that may share several effectory or pathological mechanisms with rheumatic diseases, as happens with several hematological malignancies or infectious diseases expressing autoimmunity. This includes works using molecular biology procedures for detection. Furthermore, this Issue has a broad scope including the exploration of the role of medical care in order to help patients by shortening convalescence time and improving patient quality of life, in addition to reducing or delaying the sequelae that these pathologies can generate, considering all areas from primary care with early diagnosis to tertiary care with patient management and rehabilitation.

Considering the above, for this Special Issue, we request manuscripts that consider topics related to rheumatic diseases in medical care. Original research and review articles are welcome which evaluate rheumatologic disorders and their coexistence with other conditions such as cancer, cardiometabolic diseases, or hematologic diseases. Work which include treatment methods are welcome. An additional and equally important consideration will be given to studies that focus on the education and prevention of a diverse array of rheumatologic diseases.

This Special Issue aims to provide an updated perspective on rheumatic diseases in health care, with a focus on emerging issues, health promotion, and appropriate therapeutic management.

Dr. Arnulfo Hernan Nava-Zavala
Guest Editor

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Keywords

rheumatic diseases
healthcare
osteoarthritis
rheumatoid arthritis
systemic autoimmune diseases
prevention
autoantibodies
prothrombotic stages
infectious diseases

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Published Papers (8 papers)

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13 pages, 998 KiB

Open AccessArticle

Effects of a Multicomponent Preventive Intervention in Women at Risk of Sarcopenia: A Pilot Study

by Violeta Rios-Escalante, Juan Carlos Perez-Barba, Maria Claudia Espinel-Bermudez, Ana Bertha Zavalza-Gomez, Elva Dolores Arias-Merino, Maria G. Zavala-Cerna, Sergio Sanchez-Garcia, Xochitl Trujillo and Arnulfo Hernan Nava-Zavala

Healthcare 2024, 12(12), 1191; https://doi.org/10.3390/healthcare12121191 - 13 Jun 2024

Viewed by 1361

Abstract

Sarcopenia is defined by the presence of decreased skeletal muscle mass, strength, and functionality in older people. Multicomponent interventions represent an alternative to non-pharmacological treatment for preventing disease progression. This study aimed to evaluate the effects of a multicomponent intervention approach in women at risk of sarcopenia. Methods: A quasi-experimental pilot study of 12 weeks was conducted, with 24 sessions of dancing and resistance exercises and 12 sessions of nutritional education. The outcomes were changes in muscle mass, grip strength, gait speed, and body composition. The project was registered on Clinical Trials: NCT06038500 (14 September 2023). Results: Twelve women aged 55–75 years participated in this study; after the intervention, changes were found in the following variables: grip strength, from 18.70 (17.98–19.23) at baseline to 21.57 (20.67–23.16) kg (p = 0.002); gait speed, from 0.95 (0.81–1.18) at baseline to 1.34 (1.20–1.47) m/s (p = 0.003); and hip circumference, from 99.75 (94.75–110.37) at baseline to 97.65 (93.92–109.50) cm (p = 0.023). Other measurements that appeared without changes were appendicular skeletal muscle mass, from 21.17 (18.58–22.33) at baseline to 20.77 (18.31–22.39) kg (p = 0.875), and the appendicular skeletal muscle mass index, from 8.64 (8.08–9.35) at baseline to 8.81 (7.91–9.38) kg/m² (p = 0.875) after the intervention. Conclusions: The three-month multicomponent intervention in women at risk of sarcopenia improved their grip strength and gait speed. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

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11 pages, 261 KiB

Open AccessArticle

Complementary Therapies and Their Association with Problems in Therapeutic Adherence to Conventional Synthetic DMARDs in Rheumatoid Arthritis: A Cross-Sectional Study

by Aline Priscilla Santiago-Garcia, Jorge Ivan Gamez-Nava, Felipe Alexis Avalos-Salgado, Sergio Cerpa-Cruz, Edna Lizeth Amaya-Cabrera, Sergio Gutierrez-Ureña, Cesar Arturo Nava-Valdivia, Sergio Gonzalez-Vazquez, Diana Esperanza Arevalo-Simental, Jose Jorge Gomez-Camarena, Juan Manuel Ponce-Guarneros, Norma Alejandra Rodriguez-Jimenez, Ana Miriam Saldaña-Cruz, Ernesto German Cardona-Muñoz and Laura Gonzalez-Lopez

Healthcare 2024, 12(1), 49; https://doi.org/10.3390/healthcare12010049 - 25 Dec 2023

Cited by 1 | Viewed by 1784

Abstract

The use of complementary therapies is highly prevalent among patients with rheumatoid arthritis (RA). Nevertheless, the use of complementary medicine could involve problems in the following of scientifically accepted treatments. To date, there is limited information regarding the association of nonconventional therapies with problems regarding compliance with the treatment. Therefore, the objective of this study was to identify whether the utilization of complementary therapies is associated with a high risk of problems regarding therapeutic adherence to conventional synthetic disease-modifying anti-rheumatic drugs (cs-DMARDs) in RA patients. A survey was performed with RA patients in an outpatient rheumatology clinic in a university hospital; the use of complementary therapies, as well as their type, was identified. To assess problems with therapeutic adherence, we used the four-item Morisky–Green scale. A comprehensive assessment of clinical and therapeutic characteristics was performed. Univariable and multivariable models were performed to identify the risk of problems with therapeutic adherence in users of complementary therapies. In total, 250 RA patients were included; 92% used complementary therapies. Of them, the most frequently used were herbal medicine (65%), homeopathy (64%), and cannabis and its derivatives (51%). In the univariable logistic regression analysis, the factors associated with problems in the therapeutic adherence to cs-DMARDs were age (p = 0.019), the presence of other comorbidities (p = 0.047), and the use of complementary therapies (p = 0.042). After controlling for potential confounders, the use of complementary therapies increased the risk of problems with therapeutic adherence to cs-DMARDs (adjusted OR = 2.84, 95% CI = 1.06–7.63, p = 0.037). We concluded that the use of complementary therapies increases the risk of problems with therapeutic adherence. Therefore, for physicians and healthcare professionals, the early identification of the use of nonconventional therapies in their RA patients is required, followed by a directed discussion with their patients about the risks and benefits to which they could be exposed to complementary therapies. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

10 pages, 298 KiB

Open AccessArticle

The Hypertriglyceridemic Waist Phenotype Is Associated with Several Cardiovascular Risk Factors in Women with Rheumatoid Arthritis

by Guadalupe Mendoza-Vázquez, Sandra Guzmán-Silahua, Jorge I. Gamez-Nava, Laura Gonzalez-Lopez, Mario Salazar-Paramo, Francisco Espinoza-Gómez, Carlos Riebeling-Navarro, María Claudia Espinel-Bermúdez and Arnulfo Hernán Nava-Zavala

Healthcare 2023, 11(3), 405; https://doi.org/10.3390/healthcare11030405 - 31 Jan 2023

Cited by 1 | Viewed by 2319

Abstract

Rheumatoid arthritis (RA) associates with cardiovascular risk factors (CVRF) such as dyslipidemias and systemic inflammation. Cardiovascular Disease (CVD) is the leading cause of mortality. The hypertriglyceridemic waist phenotype (HTWP) identifies increased CVRF; however, information about HTWP on RA is scarce. Objective: To evaluate the association of HTWP with CVRF in RA. Material and methods: Cross-sectional study. Women (125) with RA were included (ACR, 1987). Anthropometry, bioimpedance, body mass index (BMI), disease activity score 28 (DAS28), and health assessment questionnaire disability index (HAQ-Di) were determined. The lipid profile determination includes the atherogenic index (AI) (TC/HDL) and Framingham Risk Score. HTWP is defined as a waist circumference ≥88 cm and triglycerides ≥ 150 mg/dL. Chi-squared and Student’s t-tests were applied for comparisons. Results: HTWP was found in 38 (30.4%) patients. The subgroup with HTWP had a greater frequency of arterial hypertension (AHT) (57.9 vs. 37.9, p = 0.04), Type 2 DM (23.7 vs. 8.0, p= 0.02), BMI (29.7 ± 3.2, vs. 26.8 ± 4.3, p < 0.001), fat mass (39.3 ± 4.8 vs. 34.7 ± 6.8, p < 0.001), and AI (4.7 ± 1.2 vs. 3.7 ± 1.0, p < 0.001). No differences between DAS28 and HAQ-Di were found. HTWP was associated with the presence of MetS and CVR (p < 0.001 and p = 0.012, respectively). Conclusion: The HTWP in RA is associated with CVRF, and its potential predictive role should be evaluated in longitudinal studies. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

10 pages, 267 KiB

Open AccessArticle

Risk Factors of Muscle Wasting in Women with Rheumatoid Arthritis: Relevance of the Persistent Failure of Conventional Combination Therapy

by Eli E. Gomez-Ramirez, Melissa Ramirez-Villafaña, Jorge I. Gamez-Nava, Fidencio Cons-Molina, Norma A. Rodriguez Jimenez, Ana M. Saldaña-Cruz, Ernesto G. Cardona-Muñoz, Sylvia E. Totsuka-Sutto, Juan M. Ponce-Guarneros, Xochitl Trujillo, Miguel Huerta, Alfonso J. Cruz-Jentoft and Laura Gonzalez-Lopez

Healthcare 2022, 10(10), 2004; https://doi.org/10.3390/healthcare10102004 - 11 Oct 2022

Cited by 2 | Viewed by 1841

Abstract

Background: Muscle wasting, also known as myopenia, is frequent in rheumatoid arthritis (RA). To date, it is still unknown if the failure of pharmacologic therapies increases the risk of myopenia in RA. Objective: To identify if treatment failure with conventional synthetic DMARDs (csDMARDs) constitutes an independent risk factor of muscle wasting in women with RA. Methods: This was a cross-sectional study. We included 277 women with RA. Assessments in RA patients included: clinical, epidemiological, and therapeutic variables. The skeletal muscle index (SMI) was estimated by DXA, and myopenia was diagnosed if they had an SMI < 5.45 kg/m². Multivariable logistic regression models identified risk factors of myopenia. Results: Muscle wasting was observed in 28.2% of patients with RA. The risk factors of myopenia in RA were menopausal (OR: 4.45, 95% CI: 1.86 to 10.64) and failure of combined therapy with csDMARDs (OR: 2.42, 95% CI: 1.15 to 5.07). The increased body mass index was protective (OR:0.81, 95% CI: 0.75 to 0.87). Conclusions: Around one of four patients with RA presented muscle wasting. Muscle wasting is related to treatment failure of combined csDMARDs; other factors influencing the presence of muscle wasting is being postmenopausal, whereas, the body mass index was a protective factor. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

10 pages, 290 KiB

Open AccessArticle

Prevalence of Sexual Dysfunction in Mexican Women with Rheumatoid Arthritis

by Wendoline Rojo-Contreras, Valeria Diaz-Rizo, Xochitl Trujillo, Miguel Huerta, Alberto D. Rocha-Muñoz, Benjamin Trujillo-Hernandez, Alicia Rivera-Cameras, Ingrid P. Dávalos-Rodríguez and Mario Salazar-Páramo

Healthcare 2022, 10(10), 1825; https://doi.org/10.3390/healthcare10101825 - 21 Sep 2022

Cited by 5 | Viewed by 2445

Abstract

We estimate the prevalence and identified the associated factors of sexual dysfunction in Mexican women with rheumatoid arthritis (RA). A cross-sectional survey was applied to 100 women with RA and compared with 100 healthy, sexually active, adult women. Assessments included an interview using the Female Sexual Function Index (FSFI). Assessment of factors related to sexual dysfunction included gynecologic characteristics, disease activity (DAS-28), and functioning questionnaire (HAQ-DI). Mann-Whitney U test and the Chi-square test were used to compare medians and proportions between the groups. A multivariate logistic regression was performed using sexual dysfunction according to impairments shown by the FSFI. A higher proportion of RA patients had sexual dysfunction compared with controls. Domains with higher impairment in RA patients were desire, arousal, lubrication, and orgasm. A decrease in sexual function correlated with age (r = −0.365 p < 0.001) and higher scores in HAQ-DI (r = −0.261 p = 0.009). Those patients with a higher disability had higher impairments in desire, arousal, lubrication, and satisfaction. In the multivariate analysis, menopause was associated with sexual dysfunction (OR: 10.02; 95% CI: 1.05–95.40, p = 0.04), whereas use of methotrexate was a protective factor (OR: 0.32; 95% CI: 0.11–0.92, p = 0.03). Sexual dysfunction is highly prevalent in Mexican women with RA. Clinicians should systematically evaluate the impairment in sexual function in women with RA. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

11 pages, 1175 KiB

Open AccessArticle

Sulphurous Crenotherapy Is Effective at Reducing Pain and Disability in Overweight/Obese Patients Affected by Chronic Low Back Pain from Spine Osteoarthritis

by Maria Costantino, Valeria Conti, Graziamaria Corbi, Irene Ciancarelli, Giovanni Morone and Amelia Filippelli

Healthcare 2022, 10(9), 1800; https://doi.org/10.3390/healthcare10091800 - 19 Sep 2022

Cited by 3 | Viewed by 2041

Abstract

Crenotherapy is recognized as being effective in patients with osteoarthritis of the spine, but to date there is no indication if it is effective for patients who are overweight or obese. The aim of this study is to evaluate the efficacy of sulphurous crenotherapy on pain and disability in overweight/obese subjects affected by chronic low back pain from spine osteoarthritis. Forty-three patients (63 ± 8.8 years) affected by chronic low back pain from lumbar spine osteoarthritis were enrolled in this study. Subjects were treated with 2 weeks of sulphurous creno-treatments. Subjective pain was measured by a numerical rating scale score (NRS), and functional mobility of the lumbar spine was measured using the Oswestry Disability Index (ODI) before and after crenotherapy. Both crenotherapy groups (normal weight: A1; overweight/obese: A2) experienced significantly improved NRS and ODI scores (A1: p < 0.001 and p = 0.001; A2: p = 0.001 and p = 0.001). At end of the treatment, significant improvements were observed as a result of the crenotherapy in overweight/obese subjects in terms of pain reduction measured with NRS (p = 0.03) and in terms of function mobility of the lumbar spine measured with ODI (p = 0.006). This study highlights the beneficial effect of sulphurous crenotherapy on the painful symptomatology and disability in both normal weight and overweight/obese patients suffering from chronic low back pain associated with lumbar spine osteoarthritis. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

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10 pages, 521 KiB

Open AccessCommunication

Exploratory Analysis of Outpatient Visits for US Adults Diagnosed with Lupus Erythematosus: Findings from the National Ambulatory Medical Care Survey 2006–2016

by Salena Marie Preciado, Khaled A. Elsaid, Souhiela Fawaz, Lawrence Brown, Enrique Seoane-Vazquez, Marc Fleming and Yun Wang

Healthcare 2022, 10(9), 1664; https://doi.org/10.3390/healthcare10091664 - 31 Aug 2022

Viewed by 2124

Abstract

The study aims to assess office-based visit trends for lupus patients and evaluate their medication burden, chronic conditions, and comorbidities. This cross-sectional study used data from the National Ambulatory Medical Care Survey (NAMCS), a survey sample weighted to represent national estimates of outpatient visits. Adult patients diagnosed with lupus were included. Medications and comorbidities that were frequently recorded were identified and categorized. Descriptive statistics and bivariate analyses were used to characterize visits by sex, age, race/ethnicity, insurance type, region, and reason for visit. Comorbidities were identified using diagnosis codes documented at each encounter. There were 27,029,228 visits for lupus patients from 2006 to 2016, and 87% them were on or were prescribed medications. Most visits were for female (88%), white (79%), non-Hispanic (88%) patients with private insurance (53%). The majority of patients were seen for a chronic routine problem (75%), and 29% had lupus as the primary diagnosis. Frequent medications prescribed were hydroxychloroquine (30%), prednisone (23%), multivitamins (14%), and furosemide (9%). Common comorbidities observed included arthritis (88%), hypertension (25%), and depression (13%). Prescription patterns are reflective of comorbidities associated with lupus. By assessing medications most frequently prescribed and comorbid conditions among lupus patients, we showcase the complexity of disease management and the need for strategies to improve care. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

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7 pages, 945 KiB

Open AccessCase Report

Neuromyelitis Optica Spectrum Disorder with Sick Sinus Syndrome: Two Cases and a Literature Review

by Huiting Lin, Xinyi Duan, Lina Li, Jinhao Ye and Haibing Xiao

Healthcare 2023, 11(21), 2810; https://doi.org/10.3390/healthcare11212810 - 24 Oct 2023

Cited by 1 | Viewed by 1751

Abstract

Background and objective: Neuromyelitis optica spectrum disorder (NMOSD) is a rare immune-mediated demyelinating disease of the central nervous system (CNS). There is a lack of reports of sick sinus syndrome (SSS) associated with NMOSD; thus, we hereby report two cases of patients with NMOSD who developed SSS. Cases presentation: The patients were both male and presented with area postrema syndrome. Brain MRI showed lesions in the dorsal part of their medulla oblongata. They were diagnosed with NMOSD when aquaporin-4 antibodies were found in their serum. Slow heart rates and several episodes of syncope were also observed in case 1 during hospitalization, while Holter monitoring showed sinus pauses (10–11 s) and SSS was diagnosed. A pacemaker was fitted. Case 2 had a respiratory arrest followed by a subsequent cardiac arrest. He was successfully resuscitated with epinephrine injection and cardiopulmonary resuscitation. Through immunotherapy, their neurological functions became stable and heart rate and blood pressure returned to the baseline. Conclusions: Since sick sinus syndrome is a life-threatening complication, serious heart arrhythmias should be considered as a potential result of area postrema syndrome associated with NMOSD. Full article

(This article belongs to the Special Issue Rheumatic Diseases and Related Conditions in Healthcare)

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