ABSTRACT
La ecografía es una técnica de amplia implantación en reumatología que implica una gran interacción entre paciente y profesional. La pandemia COVID-19 hace necesario un cambio en nuestra práctica clínica, mediante estrategias que permitan la asistencia integral de nuestros pacientes, garantizando la seguridad tanto de los pacientes como de los profesionales sanitarios. Objetivo: Desarrollar unas recomendaciones prácticas, consensuadas entre un panel de expertos, sobre el uso y seguridad de la ecografía reumatológica durante la pandemia COVID-19. Métodos: Analizando la literatura disponible se realizaron unas recomendaciones preliminares, posteriormente consensuadas con un panel de expertos mediante el método Delphi con una escala Likert 1-5. Resultados: Se elaboraron y consensuaron por el panel 5 principios fundamentales y 28 recomendaciones. El consenso del grupo se logró en el 100% de ítems (acuerdo para cada recomendación ≥4 en escala de Likert del 75% de componentes del panel). Conclusiones: El documento proporciona información de utilidad acerca de medidas preventivas en la práctica de ecografía en reumatología en tiempos de pandemia COVID-19 de acuerdo a la experiencia y literatura disponible hasta el momento.(AU)
Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. Objetive: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. Methods: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. Results:5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. Conclusions: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.(AU)
Subject(s)
Humans , Coronavirus Infections , Pandemics , Severe acute respiratory syndrome-related coronavirus , Ultrasonography , Diagnostic Imaging , Rheumatology , Rheumatic DiseasesABSTRACT
Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. OBJETIVE: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. METHODS: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. RESULTS: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. CONCLUSIONS: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.
Subject(s)
COVID-19/prevention & control , Infection Control/standards , Pandemics , Rheumatology/methods , Ultrasonography , COVID-19/transmission , Disinfection/methods , Disinfection/standards , Equipment Contamination/prevention & control , Gels , Humans , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Microscopic Angioscopy/instrumentation , Microscopic Angioscopy/methods , Oils , Personal Protective Equipment , Rheumatic Diseases/diagnostic imaging , SARS-CoV-2 , Ultrasonography/instrumentation , Ultrasonography/methodsABSTRACT
Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. Objetive: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. Methods: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. Results: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. Conclusions: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.
ABSTRACT
La ecografía es una técnica de amplia implantación en reumatología que implica una gran interacción entre paciente y profesional. La pandemia COVID-19 hace necesario un cambio en nuestra práctica clínica, mediante estrategias que permitan la asistencia integral de nuestros pacientes, garantizando la seguridad tanto de los pacientes como de los profesionales sanitarios. OBJETIVO: Desarrollar unas recomendaciones prácticas, consensuadas entre un panel de expertos, sobre el uso y seguridad de la ecografía reumatológica durante la pandemia COVID-19. MÉTODOS: Analizando la literatura disponible se realizaron unas recomendaciones preliminares, posteriormente consensuadas con un panel de expertos mediante el método Delphi con una escala Likert 1-5. RESULTADOS: Se elaboraron y consensuaron por el panel 5 principios fundamentales y 28 recomendaciones. El consenso del grupo se logró en el 100% de ítems (acuerdo para cada recomendación ≥4 en escala de Likert del 75% de componentes del panel). CONCLUSIONES: El documento proporciona información de utilidad acerca de medidas preventivas en la práctica de ecografía en reumatología en tiempos de pandemia COVID-19 de acuerdo a la experiencia y literatura disponible hasta el momento
Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. OBJECTIVE: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. METHODS: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. RESULTS: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. CONCLUSIONS: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date
Subject(s)
Humans , Coronavirus Infections/prevention & control , Pneumonia, Viral/prevention & control , Pandemics , Societies, Medical , Rheumatic Diseases/diagnostic imaging , Ultrasonography/standards , SpainABSTRACT
El dolor miofascial tiene un posible componente de contractura muscular. Objetivos: Dado que la toxina botulínica ha resultado beneficiosa en enfermedades asociadas a hipertonía, se quiso evaluar la eficacia de la toxina botulínica en la reducción del dolor en el síndrome miofascial (SM). Métodos: Se realizó una revisión sistemática con búsqueda en Medline, EMBASE y Cochrane Library Plus de todos los ensayos clínicos de toxina botulínica en dolor regional. Además, se efectuó una búsqueda manual entre los resúmenes de los congresos del ACR y EULAR de los últimos 3 años. Los estudios seleccionados fueron revisados y analizados de forma independiente por 2 revisoras. Resultados: Ocho estudios cumplían los criterios de inclusión, y la calidad metodológica general fue baja. Toxina botulínica se comparó frente a solución salina fisiológica en 6 estudios, frente a esteroides en 2 y frente a lidocaína y aguja seca en 1 (brazo de 1 estudio). La población estudiada incluía cervicalgia (n = 3), lumbalgia (n = 2), síndrome piriforme (n = 2), puntos gatillo varios (n = 1) y voluntarios sanos a los que se provocaba dolor (n = 1). Toxina botulínica mostró una cierta ventaja sobre placebo y corticoides. Un metaanálisis de los 3 estudios con medidas de eficacia agrupables dio como resultado una diferencia media ponderada en una escala visual analógica de dolor de 0- 10 de 2,72 (intervalo de confianza del 95%, 3,86 a 1,58). Sin embargo, toxina botulínica no mostró superioridad frente a lidocaína (p > 0,016). Conclusiones: La evidencia en esta revisión no permite confirmar la efectividad de toxina botulínica A o B en el tratamiento del SM. Son necesarios estudios rigurosos, de mayor calidad y a largo plazo dado el alto coste de la toxina botulínica(AU)
Myofascial pain syndrome (MPS) may have an intrinsic muscle spasm component. Aim: Since botulinum toxin has been successfully used to reduce hypertonicity in several neurological disorders, we analyzed the efficacy of botulinum toxin A or B in reducing pain in MPS. Methods: We performed a systematic review through an electronic search in MEDLINE, EMBASE, and Cochrane Library Plus. All clinical trials of botulinum toxin and regional pain were selected. In addition, the abstracts of the ACR and EULAR meetings in the previous 3 years were searched manually. The studies identified were reviewed and analyzed by 2 independent reviewers. Results: Eight studies met the inclusion criteria. The methodological quality was generally low. Botulinum toxin was compared to saline solution (6 studies), to steroids (2 studies), and to lidocaine and dry needle (1 study arm). The population studied included persons with neck pain (n = 3), low back pain (n = 2), piriformis syndrome (n = 2), several trigger points (n = 1), and healthy volunteers in whom pain was provoked (n = 1). Botulinum toxin showed a certain advantage over saline solution and steroids in pain control. A meta-analysis of the 3 studies with efficacy measures that could be combined showed a weighted mean difference in pain on a 0-10 visual analogue scale of -2.72 (95% CI: 3.86; 1.58). However, botulinum toxin showed no advantage over lidocaine (p > 0.016). Conclusions: Currently, there is insufficient evidence to confirm the real efficacy of botulinum toxin A and B in the treatment of MPS. Given the high cost of botulinum toxin, long-term high quality studies are required(AU)
Subject(s)
Humans , Facial Pain/drug therapy , Botulinum Toxins/administration & dosage , Case-Control Studies , Steroids/therapeutic use , Lidocaine/therapeutic use , Placebos/therapeutic use , Adrenal Cortex Hormones/therapeutic useABSTRACT
UNLABELLED: Myofascial pain syndrome (MPS) may have an intrinsic muscle spasm component. AIM: Since botulinum toxin has been successfully used to reduce hypertonicity in several neurological disorders, we analyzed the efficacy of botulinum toxin A or B in reducing pain in MPS. METHODS: We performed a systematic review through an electronic search in MEDLINE, EMBASE, and Cochrane Library Plus. All clinical trials of botulinum toxin and regional pain were selected. In addition, the abstracts of the ACR and EULAR meetings in the previous 3 years were searched manually. The studies identified were reviewed and analyzed by 2 independent reviewers. RESULTS: Eight studies met the inclusion criteria. The methodological quality was generally low. Botulinum toxin was compared to saline solution (6 studies), to steroids (2 studies), and to lidocaine and dry needle (1 study arm). The population studied included persons with neck pain (n=3), low back pain (n=2), piriformis syndrome (n=2), several trigger points (n=1), and healthy volunteers in whom pain was provoked (n=1). Botulinum toxin showed a certain advantage over saline solution and steroids in pain control. A meta-analysis of the 3 studies with efficacy measures that could be combined showed a weighted mean difference in pain on a 0-10 visual analogue scale of -2.72 (95% CI: -3.86; -1.58). However, botulinum toxin showed no advantage over lidocaine (p>0.016). CONCLUSIONS: Currently, there is insufficient evidence to confirm the real efficacy of botulinum toxin A and B in the treatment of MPS. Given the high cost of botulinum toxin, long-term high quality studies are required.
