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Összefoglaló. Az ultrahang-elasztográfia az elmúlt évek során egyre növekvő figyelmet kapott a lágyszövetek elaszticitásának vizsgálatában. A módszer használatát az teszi szükségessé, hogy egyes, a mechanikai tulajdonságaikban különböző szövetek hasonló echogenitásúak lehetnek, valamint hogy egy adott szövet megváltozott struktúrája vagy mechanikai tulajdonsága nem minden esetben jár együtt a szövet hagyományos ultrahangképének megváltozásával. Az elmúlt évtizedben a deformációs és a nyírási ultrahang-elasztográfia vált széles körben elérhetővé. Ezen új képalkotási technika egyre nagyobb szerepet tölt be a szülészeti-nőgyógyászati ultrahang-diagnosztikában is. A nőgyógyászatban szerephez juthat az endometriosis és az adenomyosis kimutatásában, valamint a benignus és a malignus cervicalis és ovarialis képletek elkülönítésében. A nőgyógyászathoz hasonlóan a szülészetben is jelentős változást hozhat az ultrahang-elasztográfia alkalmas lehet a szülésindukció sikerességének, a koraszülés bekövetkezésének és a praenduction and preterm birth, and in the evaluation of preeclampsia are emerging. Orv Hetil. 2021; 162(18) 690-695.

Due to the recent pandemic, in person scheduled rheumatology appointments in many countries have been reserved for urgent cases only. Here we report the development of a multidimensional, patient completed disease assessment tool for use in psoriatic arthritis (PsA).

A focus group development and education method was used, followed by a paired observation design to assess feasibility and validity. The psoriatic arthritis disease activity score (PASDAS) was used as the basis for the clinical assessments but elements of this tool were modified during the focus group sessions.

A preliminary tool assessed tender and swollen joint counts, enthesitis, dactylitis, area of skin involved by psoriasis, and scores for global disease activity, fatigue and spinal pain. In parallel assessments good agreement was found between subject and health professional assessors, though overall disease activity was low.

A self-assessment tool for disease activity in psoriatic arthritis has been developed in conjunction with patients demonstrating generally good agreement between patients and health professionals but more validation work is needed before it can be recommended for clinical practice.

A self-assessment tool for disease activity in psoriatic arthritis has been developed in conjunction with patients demonstrating generally good agreement between patients and health professionals but more validation work is needed before it can be recommended for clinical practice.The conceptual paradigm of axial spondyloarthritis (axSpA) has evolved and now comprises an expanded spectrum that includes more females and patients with little or no radiographic changes in sacroiliitis or syndesmophyte formation in the spine.1 This broadened paradigm is often, but not always, characterized by an inflammatory magnetic resonance imaging (MRI) signature.

Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life. We investigated the effect of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire-Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and the correlation between the PtGA and physician global assessment (PGA) in SSc.

We undertook posthoc analyses using baseline data obtained from the Raynaud Symptom Study (RSS). The PtGA, Coping Strategies Questionnaire, Pain Catastrophizing Scale, and Scleroderma Health Assessment Questionnaire were collected alongside the PGA, clinical characteristics, and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PGA.

Of the 107 patients with SSc enrolled in the RSS, there were sufficient data available for the analysis of 91 participants. The mean PtGA was 40/100 (SD 27) and the mean HAQ-DI was 0.87/3.0 (SD 0.73). check details After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (

< 0.05 for both), but not the PGA.

The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.

The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.

To evaluate the safety of the methotrexate (MTX)-leflunomide (LEF) combination in rheumatoid arthritis (RA), comparing it with other therapeutic schemes involving conventional synthetic (cs-) and biologic (b-) disease-modifying antirheumatic drugs (DMARDs) or Janus kinase inhibitors ( JAKi).

Patients with RA starting a treatment course with a csDMARD (without previous use of bDMARD or JAKi) or their first bDMARD/JAKi were followed up in a registry-based, multicentric cohort study in Brazil (BiobadaBrasil). The primary outcome was the incidence of serious adverse events (SAEs); secondary outcomes included serious infections. Multivariate Cox proportional hazards models and propensity score matching analysis (PSMA) were used for statistical comparisons.

In total, 1671 patients (5349 patient-years [PY]) were enrolled; 452 patients (1537 PY) received MTX + LEF. The overall incidence of SAEs was 5.6 per 100 PY. The hazard of SAEs for MTX + LEF was not higher than for MTX or LEF (adjusted HR [aHR] 1.00, 95% CI 0.76-1.31,

= 0.98). MTX + LEF presented a lower hazard of SAEs (aHR 0.56, 95% CI 0.36-0.88,

= 0.01) and infectious SAEs (aHR 0.48, 95% CI 0.25-0.94,

= 0.03) than bDMARDs/JAKi with MTX or LEF. MTX + LEF presented lower hazard of SAEs than MTX + sulfasalazine (SSZ; aHR 0.33, 95% CI 0.16-0.65,

= 0.002). Analysis using PSMA confirmed the results obtained with traditional multivariate Cox analysis.

In our study, MTX + LEF presented a relatively good overall safety profile in comparison to MTX + SSZ and schemes involving advanced therapies in RA.

In our study, MTX + LEF presented a relatively good overall safety profile in comparison to MTX + SSZ and schemes involving advanced therapies in RA.