Objective The primary objective was to evaluate the additional benefits of contrast-enhanced ultrasound (CEUS) compared to unenhanced Doppler ultrasound (DUS) for the identification of active synovitis in rheumatoid arthritis (RA). Methods We searched PubMed/MEDLINE and EMBASE (February 2024) for all English-written published reports of human studies including the use of CEUS for the study of synovitis in RA. T...
Background: The gut microbiota has been implicated in the onset and progression of Rheumatoid Arthritis (RA). It has been proposed that gut dysbiosis impairs gut barrier function, leading to alterations in mucosal integrity and immunity. This disruption allows bacterial translocation, contributing to the perpetuation of the inflammatory process. Since diet is recognised as a key environmental factor influencing...
In this study, we optimized the dissociation of synovial tissue biopsies for single-cell omics studies and created a single-cell atlas of human synovium in inflammatory arthritis. The optimized protocol allowed consistent isolation of highly viable cells from tiny fresh synovial biopsies, minimizing the synovial biopsy drop-out rate. The synovium scRNA-seq atlas contained over 100,000 unsorted synovial cells fr...
A 25-year-old woman with a recent diagnosis of SSc (anti-topo 1), expressed by progressive scleroderma, oesophageal dysmotility, serositis and RP, presented with bilateral shoulder pain and limited mobilization. The complaints prompted an US scan, which showed no synovitis or tendinopathy. However, intra-articular calcium deposits stood out, adhering to the hyaline cartilage of both humerus heads and moving wit...
A 64-year-old male presented with a 6-month history of symmetric polyarthritis involving proximal interphalangeal joints and metacarpophalangeal joints of the hands, wrists, and ankles. Associated symptoms included vomiting, progressive fatigue, and weight loss. Laboratory results showed microcytic anemia, leukocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, and rheumato...
Objective: To study the efficacy, tolerability, safety, and sampling variation of ultrasound (US)-guided synovial biopsies performed in clinical practice and research. Methods: We included all patients who had a US-guided synovial needle biopsy from November 2013 to January 2018. Patients were evaluated for procedure safety and tolerability. Usefulness of synovial biopsy was considered based on contribution for...
Background and objective: The number of older patients with rheumatoid arthritis is increasing, but data on drug effectiveness and safety in these patients are scarce. This study assessed the effectiveness and safety of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis. Methods: This prospective cohort study was based on data recorded in the Rheumatic Diseases Portuguese...
Introduction: Ultrasound (US) is a relatively cheap, easily available and reliable method to improve the care of rheumatic patients. However, its use in rheumatology practice is very heterogeneous and needs to be standardized. Objectives: To develop recommendations for the use of US in rheumatic diseases endorsed by the Portuguese Society of Rheumatology. Methods: A systematic literature review of the available...
Nos últimos anos, com o surgimento de algumas infraestruturas de investigação nacional, tem existido um crescimento substancial do número de publicações, assim como da qualidade e impacto científico das mesmas. O médico, enquanto prestador de cuidados de saúde, é por natureza curioso e um investigador potencial por excelência. Contudo, e dada a ainda incipiente profissionalização e ao conflito com atividades de...
Background: The use of TNF-inhibitors and/or the IL-6 receptor antagonist, tocilizumab, in rheumatoid arthritis (RA) have pleiotropic effects that also involve circulating B-cells. The main goal of this study was to assess the effect of TNF-inhibitors and tocilizumab on B-cell phenotype and gene expression in RA. Methods: Blood samples were collected from untreated early RA (ERA) patients, established RA patien...