Abstract:
:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of manifestations and potential to affect several organ systems. Complications arise from both disease and medications especially glucocorticoids, significantly contributing to overall morbidity and mortality. SLE predominantly affects patients during their prime productive years resulting in substantial economic burden on the patient, caregivers, and society due to direct, indirect, and intangible costs. This illness burden is compounded in developing countries with limited resources due to various disparities in healthcare delivery. Physician education and practical referral and endorsement guidelines adapted to the local setting reinforce continuity and coordinated care. Likewise, patient education, self-help programs, and shared decision-making are essential best practice in the clinics. Both physician education and patient education improve overall outcomes in chronic diseases like SLE. As a developing country with very few rheumatologists and/or lupus specialists, efficient healthcare delivery for most Filipino lupus patients remains elusive. We describe our experience in confronting these challenges through development of strategies which focus on physician and patient education. KEY POINTS: • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a highly variable course, requiring specialized, individualized, and coordinated care by a healthcare team. • Health disparities and limited resources significantly contribute to illness burden on the patient, family, and society. • Physician education on SLE must commence at undergraduate medical school, be integrated in Internal Medicine and Pediatrics, and reinforced through specialized training in Rheumatology and related specialties. • Patient education and empowerment are integral to improving healthcare outcomes especially in a resource-limited setting.
journal_name
Clin Rheumatoljournal_title
Clinical rheumatologyauthors
Navarra SV,Zamora LD,Collante MTMdoi
10.1007/s10067-019-04795-9subject
Has Abstractpub_date
2020-03-01 00:00:00pages
697-702issue
3eissn
0770-3198issn
1434-9949pii
10.1007/s10067-019-04795-9journal_volume
39pub_type
杂志文章,评审abstract::Sustained cough is a frequent complaint in methotrexate (MTX) treatment for rheumatoid arthritis and can be a symptom of incipient MTX-induced pneumonitis. This study was performed to characterize MTX-associated cough clinically and to clarify by which means this condition can be distinguished from incipient MTX pneum...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02229707
更新日期:1996-05-01 00:00:00
abstract::Multilevel studies have gained importance for highlighting social inequalities in health. These associations have been reported previously in diseases such as arthritis and chronic pain. We conducted a cross-sectional study using multilevel analysis to identify individual and contextual factors associated with the var...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-014-2776-y
更新日期:2016-01-01 00:00:00
abstract::This study was designed to explore the profile of immune cell subsets, including T, B, natural killer (NK), and NKT cells, in systemic lupus erythematosus (SLE) patients, and to determine their relationships with the clinical index and the effects of cyclophosphamide (CYC) and mycophenolate mofetil (MMF) treatment. SL...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-012-1958-8
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:Antibody against cyclic citrullinated protein (ACPA) is counted as one of the most important biomarkers in diagnosis, classification, and prognosis of rheumatoid arthritis (RA). We examined the evolution of ACPA during disease course and assess predictive value of time-weighted cumulative ACPA titer on rad...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04554-w
更新日期:2019-09-01 00:00:00
abstract::The aim of the study was to assess mean platelet volume (MPV) in children with systemic lupus erythematosus (SLE) at the active and inactive stages. Twenty children with SLE and 30 age- and gender-matched controls were enrolled. Demographic data, SLE disease activity index (SLEDAI), erythrocyte sedimentation rate (ESR...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-014-2540-3
更新日期:2014-05-01 00:00:00
abstract::Bacteroides fragilis is a rare cause of septic arthritis. Most patients with B. fragilis septic arthritis have a chronic joint disease, particularly rheumatoid arthritis, and sources of infection are lesions of the gastrointestinal tract and the skin. We report a 69-year-old male, who developed B. fragilis septic arth...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02247808
更新日期:1997-11-01 00:00:00
abstract:INTRODUCTION:Immunoglobulin A vasculitis (IgAV) is the most common form of childhood systemic vasculitis. It is mostly self-limiting and characterized by skin, joint, gastrointestinal tract, and kidney involvement. Microribonucleic acids (miRNAs) are 18-25 base-long non-coding RNA group acting on gene expression. They ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05441-5
更新日期:2020-10-10 00:00:00
abstract::Erythema nodosum is an unusual manifestation of Hodgkin's lymphoma. One patient with long remission of Hodgkin's disease manifested persistent erythema nodosum beginning one and three months before relapse was clinically evident. So, the diagnosis of Hodgkin's disease should be considered in patients with unexplained ...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/BF02114402
更新日期:1990-09-01 00:00:00
abstract::The aim of this study was to evaluate whether corticosteroid use is the etiological agent in acute pancreatitis in patients with systemic lupus erythematosus, or whether it is related to the underlying connective tissue disorder. Hospital admissions at Thomas Jefferson University Hospital between 1982 and 2002 that ca...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-003-0793-3
更新日期:2004-04-01 00:00:00
abstract::Systemic lupus erythematosus (SLE) has rarely being reported among African Blacks, in contrast with African-Americans. Such reports have been mostly case reports. Our encounter with new cases shows that this disease may not be rare after all. The objective of this study was to study the clinical presentations, laborat...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-009-1139-6
更新日期:2009-06-01 00:00:00
abstract::Until recently, renal crisis was the most significant cause of morbidity and mortality in patients with scleroderma (SSc). Nowadays, following the introduction of angiotensin-converting enzyme inhibitors used in renovascular hypertension, pulmonary fibrosis and pulmonary hypertension have become the most common causes...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/s100670050138
更新日期:1999-01-01 00:00:00
abstract::Behçet's disease is a systemic vasculitic syndrome with unknown etiology. The aim of the present study was to compare the Helicobacter pylori seropositivity and cytotoxin associated gene-A status in patients with Behçet's disease. Ninety-one patients with Behçet's disease and 83 age- and sex-matched persons with or wi...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-006-0416-x
更新日期:2007-06-01 00:00:00
abstract::The presence of nail changes was investigated in 102 patients with nodal osteoarthritis of the hand. Nail lesions were seen in 14/102 patients (13.7%), a prevalence higher than that observed in 96 controls (4/96, 4.2%; chi square 4.37, p = 0.036). An increased risk of nail changes was associated with osteoarthritis of...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02249013
更新日期:1994-06-01 00:00:00
abstract::Bone loss in patients with rheumatoid arthritis (RA) varies at different skeletal sites. The aim of the study was to evaluate whether bone mineral density (BMD) of the forearm is significantly different in patients with RA and controls and may correlate to BMD or other parameters of inflammation or bone resorption. We...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-009-1211-2
更新日期:2009-10-01 00:00:00
abstract::Biological agents, particularly anti-Tumour Necrosis Factor (TNF)-α agents, have emerged as an effective treatment in patients with chronic inflammatory diseases. An association between anti-TNF-α antibodies and reactivation of latent tuberculosis infection (LTBI) has been established. Appropriate screening for TB inf...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-012-1938-z
更新日期:2012-05-01 00:00:00
abstract::A patient presenting with interstitial lung disease was predicted to have underlying polymyositis when found to be anti-Jo-1 antibody positive. When myopathy developed later with elevated serum creatine phosphokinase and myoglobin levels, the electromyogram was nonmyopathic, and polymyositis was confirmed by muscle bi...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02201038
更新日期:1987-06-01 00:00:00
abstract::The purpose of this report is to describe the overall safety profile of both short- and longer-term duloxetine treatment of fibromyalgia. Data from four double-blind, randomized, placebo-controlled studies (two with 6-month open-label extension phases) and a 1-year, open-label safety study were included. Safety measur...
journal_title:Clinical rheumatology
pub_type: 杂志文章,meta分析
doi:10.1007/s10067-009-1203-2
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:Decreased natural killer (NK) cells have been reported in systemic lupus erythematosus (SLE) patients. However, the role of NK cells in the pathogenesis of SLE is not well understood. In this study, we aimed to characterize NK cell subsets, phenotypes, and cytokine-secreting functions and investigate the cli...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05306-x
更新日期:2020-08-14 00:00:00
abstract:OBJECTIVE:We aimed to evaluate the effect on renal functions and blood pressure of the addition of low dose aspirin (LDA) to cyclooxygenase-2 (COX-2) inhibitors or nonselective NSAIDs. METHODS:Two groups each containing 14 patients with one group using celecoxib and the other indomethacin regularly for at least 1 week...
journal_title:Clinical rheumatology
pub_type: 临床试验,信件
doi:10.1007/s10067-005-1167-9
更新日期:2006-02-01 00:00:00
abstract:INTRODUCTION:The prevalence of herpes zoster (HZ) is high in patients with rheumatologic diseases. The incidence in patients with rheumatoid arthritis (RA) is at least twice as high as in healthy people. Nevertheless, little is known about humoral immunity against varicella zoster virus (VZV), in particular in patients...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04563-9
更新日期:2019-09-01 00:00:00
abstract::Tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF), all of endothelial origin and active in the haemostasis, were analysed in 74 patients with rheumatoid arthritis. The concentrations were related to extra-articular disease and to the incidence of thromboembol...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02231572
更新日期:1993-09-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-006-0255-9
更新日期:2007-02-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04759-z
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:In people with rheumatoid arthritis (RA), mental health problems are common, but often not recognized or treated, contributing to increased morbidity and mortality. Most studies examining the impact of mental health problems in RA have focused on depression. We aimed to determine the association between anxi...
journal_title:Clinical rheumatology
pub_type: 杂志文章,meta分析
doi:10.1007/s10067-019-04900-y
更新日期:2020-05-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-006-0446-4
更新日期:2007-07-01 00:00:00
abstract::Total body bone mineral (TBBM) measured by dual photon absorptiometry and local bone mineral (BMC) measured by single photon absorptiometry were determined in 55 patients with definite or classical rheumatoid arthritis. All of them had been on a steady dose of anti-inflammatory drugs for at least 12 months, and furthe...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02041401
更新日期:1983-09-01 00:00:00
abstract::The study aims to analyze the effects of induction treatment with cyclophosphamide (CYC) pulse therapy followed by maintenance treatment with other mild immunosuppressive agents on lung function in scleroderma (SSc) patients. Thirty patients with SSc (mean age 52 years, mean disease duration < 2 years) with forced vit...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-018-4266-0
更新日期:2018-11-01 00:00:00
abstract::The lactogenic hormone prolactin is produced in part by cells of the immune system and serves as an upregulator of immune function. Hyperprolactinemia is common in patients with systemic lupus erythematosus (SLE), raising the possibility that the hormone contributes to the excessive immune response in the disease. The...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-005-0117-x
更新日期:2006-07-01 00:00:00
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journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-020-05234-w
更新日期:2020-09-01 00:00:00
abstract::In the past decade, lung ultrasound (LUS) B-lines and serum Krebs von den Lungen-6 (KL-6) antigen have been recognized as biomarkers of the connective tissue disease-associated interstitial lung diseases (CTD-ILDs). Robust data have demonstrated that B-lines total numbers and KL-6 levels are correlated with high-resol...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04462-z
更新日期:2019-05-01 00:00:00