[Management of bone metastasis in non-small cell lung cancer]. / Prise en charge des métastases osseuses du cancer pulmonaire non à petites cellules.

Lung cancer is notoriously known for its predisposition to metastasize to the bones. Diagnostic tools, including positron emission tomography coupled with computed tomography, offer increased sensitivity in detecting bone infiltration. Management strategies encompass a multidisciplinary approach, including pharmacological pain management, anti-resorptive therapy, radiotherapy, interventional techniques, and surgery. This article provides an in-depth analysis of the incidence and distribution of bone metastases, skeletal-related events (SRE), diagnostic imaging techniques, and contemporary therapeutic strategies to prevent SRE. Systemic anticancer therapy and pain management, although crucial for treating BM, are not discussed in this article.

Le cancer du poumon est notoirement connu pour sa prédisposition à métastaser dans les os. Les outils diagnostiques, notamment la tomographie par émission de positrons couplée à la tomodensitométrie, offrent une sensibilité accrue pour détecter l'infiltration osseuse. Les stratégies de prise en charge englobent une approche multidisciplinaire, comprenant le traitement médicamenteux de la douleur, la thérapie antirésorptive, la radiothérapie, les techniques interventionnelles ainsi que la chirurgie. Cet article propose une analyse approfondie de l'incidence et de la distribution des métastases osseuses (MO), des événements liés au squelette (SRE), des techniques d'imagerie diagnostique et des stratégies thérapeutiques contemporaines pour prévenir les SRE. Le traitement systémique anticancéreux et la gestion de la douleur, bien que cruciaux pour traiter les MO, ne sont pas discutés dans cet article.

Smart wearable devices in cardiovascular care: where we are and how to move forward.

Technological innovations reach deeply into our daily lives and an emerging trend supports the use of commercial smart wearable devices to manage health. In the era of remote, decentralized and increasingly personalized patient care, catalysed by the COVID-19 pandemic, the cardiovascular community must familiarize itself with the wearable technologies on the market and their wide range of clinical applications. In this Review, we highlight the basic engineering principles of common wearable sensors and where they can be error-prone. We also examine the role of these devices in the remote screening and diagnosis of common cardiovascular diseases, such as arrhythmias, and in the management of patients with established cardiovascular conditions, for example, heart failure. To date, challenges such as device accuracy, clinical validity, a lack of standardized regulatory policies and concerns for patient privacy are still hindering the widespread adoption of smart wearable technologies in clinical practice. We present several recommendations to navigate these challenges and propose a simple and practical 'ABCD' guide for clinicians, personalized to their specific practice needs, to accelerate the integration of these devices into the clinical workflow for optimal patient care.

Correction: Epidemiology and treatment patterns of rheumatoid arthritis in a large cohort of Arab patients.

[This corrects the article DOI: 10.1371/journal.pone.0208240.].

Epidemiology and treatment patterns of rheumatoid arthritis in a large cohort of Arab patients.

OBJECTIVES: There is limited information on the epidemiology and treatment patterns of rheumatoid arthritis (RA) across the Arab region. We aim in this study to describe the demographic characteristics, clinical profile, and treatment patterns of patients of Arab ancestry with RA. METHODS: This is a cross sectional study of 895 patients with established rheumatoid arthritis enrolled from five sites (Jordan, Lebanon, Qatar, Kingdom of Saudi Arabia (KSA), and United Arab Emirates). Demographic characteristics, clinical profile, and treatment patterns are compared between the five countries. RESULTS: The majority of our patients are women, have an average disease duration of 10 years, are married and non-smokers, with completed secondary education. We report a high (>80%) ever-use of methotrexate (MTX) and steroids among our RA population, while the ever-use of disease modifying anti-rheumatic drugs (DMARDs) and TNF-inhibitors average around 67% and 33%, respectively. There are variations in RA treatment use between the five country sites. Highest utilization of steroids is identified in Jordan and KSA (p-value < 0.001), while the highest ever-use of TNF-inhibitors is reported in KSA (p-value < 0.001). CONCLUSION: Disparities in usage of RA treatments among Arab patients are noted across the five countries. National gross domestic product (GDP), as well as some other unique features in each country likely affect these. Developing treatment guidelines specific to this region could contribute in delivering standardized therapies to RA patients.

Large Scale Metabolic Profiling identifies Novel Steroids linked to Rheumatoid Arthritis.

Recent metabolomics studies of Rheumatoid Arthritis (RA) reported few metabolites that were associated with the disease, either due to small cohort sizes or limited coverage of metabolic pathways. Our objective is to identify metabolites associated with RA and its cofounders using a new untargeted metabolomics platform. Moreover, to investigate the pathomechanism of RA by identifying correlations between RA-associated metabolites. 132 RA patients and 104 controls were analyzed for 927 metabolites. Metabolites were tested for association with RA using linear regression. OPLS-DA was used to discriminate RA patients from controls. Gaussian Graphical Models (GGMs) were used to identify correlated metabolites. 32 metabolites are identified as significantly (Bonferroni) associated with RA, including the previously reported metabolites as DHEAS, cortisol and androstenedione and extending that to a larger set of metabolites in the steroid pathway. RA classification using metabolic profiles shows a sensitivity of 91% and specificity of 88%. Steroid levels show variation among the RA patients according to the corticosteroid treatment; lowest in those taking the treatment at the time of the study, higher in those who never took the treatment, and highest in those who took it in the past. Finally, the GGM reflects metabolite relations from the steroidogenesis pathway.

Bibliometric analysis of rheumatology research in the Arab countries.

BACKGROUND: The Arab world has seen an increase in the burden of musculoskeletal diseases. No bibliometric studies have characterized rheumatology research in the Arab world. This study evaluates the productivity and impact of rheumatology research in the Arab world. METHODS: We searched the Web of Science Core Collection for rheumatology publications, from 1976 to 2014, for each of the Arab League (AL) countries, North America, Europe and Asia. For the AL countries, the overall trend of publications and citations was analyzed, while considering the paper type and collaborations. RESULTS: The AL countries published 944 rheumatology papers over the period studied. The number of publications increased by a factor of 2.77 (95 % CI, 2.75-2.78) each decade, and citations increased by a factor of 2.36 (95 % CI, 0.96-5.82). The absolute number of papers included in the top-10 rheumatology journals remained constant but the proportion decreased. Papers involving collaboration among AL countries were found to increase over time. CONCLUSIONS: Overall, the AL countries lag in research productivity and impact compared to other regions. Three countries are responsible for the majority of publications, while four countries receive the majority of citations.