Routine Assessment of Patient Index Data 3 (RAPID3) is a Valid Index for Routine Care in Patients with Osteoarthritis

Objective: To compare Routine Assessment of Patient Index Data 3 (RAPID3) on a Multidimensional Health Assessment Questionnaire (MDHAQ) with the Western Ontario and Mc-Master Universities Osteoarthritis Index (WOMAC) in patients with knee or hip osteoarthritis and to evaluate its reliability. Methods: 678 patients with hip or knee osteoarthritis were assessed in daily practice clinical care during 2009-2013. Patients completed an MDHAQ and so a RAPID3 was calculated (physical function, pain, patient global estimate). Pain, stiffness, and physical functions using the standard WOMAC indices for hip and knee osteoarthritis were assessed too; correlation between WOMAC total scores and RAPID3 scores were estimated with Spearman’s rho. Furthermore a linear regression model was developed with a coefficient of determination R2. Finally we evaluated validity and reliability of this index to evaluate that RAPID3 is not inferior to WOMAC. Results: RAPID3 and WOMAC were correlated significantly, with a global correlation Spearman’ rho index of 0.84 (P<0.01). Computing analysis for diagnosis the correlation index was 0.83 for hip osteoarthritis (p<0.01) and 0.87 for knee osteoarthritis. Conclusion: RAPID3 scores provide similar quantitative information to WOMAC in patients with hip or knee osteoarthritis

Calciphylaxis in a patient affected by rheumatoid arthritis, chronic renal failure, and hyperparathyroidism: a case report

Calciphylaxis, or calcific uremic arteriolopathy, is the tissue and vascular calcification that occurs mainly in chronic kidney disease. However, it can be secondary to parathyroid dysfunction and it has been described in rheumatic patients. We present a case of calciphylaxis in a woman with inactive rheumatoid arthritis, acute renal failure, and hyperparathyroidism

Pulmonary Localization of Phosphate Bone Agents in a Case of Metastatic Breast Carcinoma

A case of breast carcinoma with bone and cartilaginous metaplasia is reported. Metastatic pulmonary localizations were revealed through routine bone scan. Histologic rarity but, above all, the uncommon bone scan findings are emphasized. </jats:p

Successful Treatment of a Patient with Giant Cell Vasculitis (Horton Arteritis) with Tocilizumab a Humanized Anti-Interleukin-6 Receptor Antibody

Giant cell arteritis (GCA) is the most common form of systemic vasculitis in adults, affecting preferentially medium-large size arteries. Here we report a case of a female with a diagnosis of GCA based on temporal artery biopsy, successfully treated with tocilizumab, a humanized anti-interleukin-6 receptor antibody

The macrophages in rheumatic diseases

Macrophages belong to the innate immune system giving us protection against pathogens. However it is known that they are also involved in rheumatic diseases. Activated macrophages have two different phenotypes related to different stimuli: M1 (classically activated) and M2 (alternatively activated). M1 macrophages release high levels of pro-inflammatory cytokines, reactive nitrogen and oxygen intermediates killing microorganisms and tumor cells; while M2 macrophages are involved in resolution of inflammation through phagocytosis of apoptotic neutrophils, reduced production of pro-inflammatory cytokines, and increased synthesis of mediators important in tissue remodeling, angiogenesis, and wound repair. The role of macrophages in the different rheumatic diseases is different according to their M1/M2 macrophages phenotype

User preference for a portable syringe pump for iloprost infusion

PURPOSE: Administration of intravenous iloprost – a first-line European League Against Rheumatism (EULAR)-recommended choice for the treatment of scleroderma (SSc)-related digital vasculopathy – requires repeated treatment cycles of 6 hours per day in a hospital setting. During the infusion, patient mobility is considerably restricted due to the size and fixity of traditional syringe pumps. The aim of this study was to evaluate the satisfaction level of patients and nurses, after the introduction of a new portable syringe pump (Infonde(®), Italfarmaco S.p.A., Milan, Italy) at the Department of Rheumatology, Magenta Hospital, Milan, Italy. PATIENTS AND METHODS: Thirty-four consecutive SSc patients receiving stable therapy with iloprost, previously administered with a fixed pump, were treated using the portable Infonde(®) pump. Patients (n=34) and nurses (n=4) were asked to answer a nine- and six-item questionnaire, respectively, to assess the satisfaction of the administration comparing the new device versus the previous one. The health care staff of the ward developed the questionnaire, and the response scores ranged from 0 (fixed device better) to 10 (portable device better); thus a score >5 indicates a preference for Infonde(®). RESULTS: Patients’ answers indicated a preference towards the new portable syringe pump, versus the previous fixed pump. Questionnaires administered to patients generated a total of 306 responses, with over 95% of the responses in the range 8–10, of which 89% had a score equal to 10. The responses of nurses showed a score equal to 10 in 100% cases. No significant adverse events were recorded, indicating no change in the tolerability profile of the drug. CONCLUSION: Iloprost administration with Infonde(®) pump was preferred by both patients and health care professionals, and was well tolerated. The possibility to perform daily activities and the freedom of movement suggest a positive impact of Infonde(®) on the treatment, with a potential favorable effect on the quality of life of patients during the many hours spent receiving the infusion