ABSTRACT
La gota es una enfermedad curable que se caracteriza por episodiosde artritis aguda y recurrente como consecuencia de la formacióny depósito de cristales de urato monosódico. Afecta más a varones,en una proporción 3:1. El manejo terapéutico de la gota,cuyo objetivo fundamental es eliminar los cristales de urato monosódicoprecisa de tratamiento farmacológico y no farmacológico,además de tener en consideración factores de comorbilidad asociados.Los cuidados enfermeros, en esta patología, pueden ser muyimportantes para facilitar el autocuidado y el afrontamiento eficazde la enfermedad y deberían estar centrados en programas estructuradosde Educación para la Salud dirigidos específicamente a estosenfermos.En este artículo, octavo de una serie dirigida a los cuidados enfermerosen reumatología, se presenta la gota, recorriendo generalidadesde esta patología, sus manifestaciones clínicas y manejo del régimenterapéutico en estos pacientes (AU)
Gout is a curable disease characterized by episodes of acute andrecurrent arthritis due to the formation and deposit of monosodiumurate crystals. It is more common in males than females, in a ratioof 3:1. Therapeutic management of gout, which aims mainly toeliminate the monosodium urate crystals, encompasses pharmacologicaland non-pharmacological treatment, while taking associatedcomorbidity factors into account. Nursing care in this pathologycan be very important to facilitate self-care and effective copingwith the disease and should be focused on structured health educationprograms aimed specifically at these patients.This article, eighth in a series focused on rheumatology nursing care,presents gout, covering the general characteristics of this pathology,its clinical manifestations and the management of the therapeuticregimen of these patients (AU)
Subject(s)
Humans , Gout/nursing , Arthritis, Gouty/nursing , Gout Suppressants/therapeutic use , Risk Factors , Health Education/trends , Hyperlipidemias/complications , Metabolic Syndrome/complicationsABSTRACT
OBJECTIVE: To investigate the impact of official recommendations regarding the management of latent tuberculosis (TB) infection on the rate of active TB in patients receiving treatment with tumor necrosis factor (TNF) antagonists. METHODS: Data on active TB rates and on screening and treatment of latent TB infection were extracted from the BIOBADASER (Spanish Society of Rheumatology Database on Biologic Products), a registry of patients with rheumatic conditions treated with TNF antagonists. The rates of active TB among the BIOBADASER patients were compared with those in the background Spanish population, and BIOBADASER patients with rheumatoid arthritis (RA) were compared with a cohort of RA patients from the EMECAR (Morbidity and Clinical Expression of Rheumatoid Arthritis) study who were not treated with TNF antagonists and were followed up for 5 years. RESULTS: Active TB developed in 34 patients, of whom 32 started taking TNF antagonists prior to the official recommendations on latent TB infection (pre-OR) and 2 began treatment after the recommendations were issued (post-OR). All cases of TB occurred during treatment with infliximab, and 28 of these patients had RA. Pre-OR, the active TB rate in BIOBADASER patients was 20.9-fold higher than in the background Spanish population, while RA patients in the BIOBADASER had rates 22.6- and 6.2-fold higher than the background and EMECAR populations, respectively. Post-OR, 324 patients with a tuberculin skin test result > or =5 mm and/or chest radiograph findings suggestive of past TB were treated for 9 months with isoniazid (INH). Post-OR, active TB rates among the BIOBADASER patients decreased by 78% (incidence risk ratio [IRR] 0.22, 95% confidence interval [95% CI] 0.03-0.88; P = 0.008), while among RA patients in the BIOBADASER, the rate dropped by 83% and reached the EMECAR rate (IRR 1.0, 95% CI 0.02-8.2). There were no INH treatment-related hospitalizations or deaths. CONCLUSION: Strategies to treat latent TB infection that are tailored to the at-risk population can effectively and safely lessen the likelihood of active TB in patients treated with TNF antagonists.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antirheumatic Agents/adverse effects , Rheumatic Diseases/drug therapy , Tuberculosis/etiology , Tuberculosis/prevention & control , Adalimumab , Adult , Aged , Antibodies, Monoclonal, Humanized , Arthritis, Rheumatoid/drug therapy , Etanercept , Female , Health Planning Guidelines , Humans , Immunoglobulin G/adverse effects , Infliximab , Male , Middle Aged , Receptors, Tumor Necrosis Factor , Secondary Prevention , Treatment Outcome , Tuberculosis/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
No disponible
Subject(s)
Male , Humans , Female , Adult , Appendix , Appendicitis , Granuloma , Cecal DiseasesABSTRACT
No disponible
Subject(s)
Humans , Antirheumatic Agents , Arthritis, Rheumatoid , Immunosuppressive AgentsABSTRACT
A quantification method for measuring whole saliva is described. This whole saliva test (WST) consists of a Whatman paper strip, is easily carried out, innocuous, low-cost and single use. Due to its characteristics, it could be considered as the oral equuivalent of Schirmer's tear test. A sample of 159 healthy subjects(81 males and 78 females; mean age 31.62 years) participated in this comparative study of this new procedure and two other tests, the draining and the swab test. Correlation was statistically positive among the three types of tests
