Reumatismo https://www.reumatismo.org/index.php/reuma <p>Official <em>Journal Of The Italian Society Of Rheumatology</em>. Founded In 1949.</p> <p><strong>Reumatismo</strong> is the Official Journal of the Italian Society of Rheumatology (SIR). It publishes Abstracts and Proceedings of Italian Congresses and original papers concerning rheumatology. Reumatismo is published quarterly and is sent free of charge to the Members of the SIR who regularly pay the annual fee. Those who are not Members of the SIR as well as Corporations and Institutions may also subscribe to the Journal.</p> <p>This journal does not apply the article processing charge&nbsp;to Authors as it is supported by institutional funds.</p> PAGEPress Scientific Publications, Pavia, Italy en-US Reumatismo 0048-7449 <p>Authors who publish with this journal agree to the following terms:</p> <ol type="a"> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="http://creativecommons.org/licenses/by/3.0/" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> Spa therapy induces clinical improvement and protein changes in patients with chronic back pain https://www.reumatismo.org/index.php/reuma/article/view/1200 <p>This study is primarily aimed at assessing serum changes on a large panel of proteins in patients with chronic back pain following spa therapy, as well as evaluating different spa therapy regimens as a preliminary exploratory clinical study. Sixty-six patients with chronic back pain secondary to osteoarthritis were randomly enrolled and treated with daily mud packs and bicarbonate-alkaline mineral water baths, or a thermal hydrotherapy rehabilitation scheme, the combination of the two regimens or usual medication only (control group), for two weeks. Clinical variables were evaluated at baseline, after 2 and 12 weeks. One thousand serum proteins were tested before and after a two-week mud bath therapy. All spa treatment groups showed clinical benefit as determined by improvements in VAS pain, Roland Morris disability questionnaire and neck disability index at both time points. The following serum proteins were found greatly increased (≥2.5 fold) after spa treatment: inhibin beta A subunit (INHBA), activin A receptor type 2B (ACVR2B), angiopoietin-1 (ANGPT1), beta-2-microglobulin (B2M), growth differentiation factor 10 (GDF10), C-X-C motif chemokine ligand 5 (CXCL5), fibroblast growth factor 2 (FGF2), fibroblast growth factor 12 (FGF12), oxidized low density lipoprotein receptor 1 (OLR1), matrix metallopeptidase 13 (MMP13). Three proteins were found greatly decreased (≤0.65 fold): apolipoprotein C-III (Apoc3), interleukin 23 alpha subunit p19 (IL23A) and syndecan-1 (SDC1). Spa therapy was confirmed as beneficial for chronic back pain and proved to induce changes in proteins involved in functions such as gene expression modulation, differentiation, angiogenesis, tissue repair, acute and chronic inflammatory response.</p> M.M. Angioni A. Denotti S. Pinna C. Sanna F. Montisci G. Dessole A. Loi A. Cauli ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 119 131 10.4081/reumatismo.2019.1200 Prevalence of low back pain and its effect on health-related quality of life in 409 scholar adolescents from the Veneto region https://www.reumatismo.org/index.php/reuma/article/view/1229 <p>Low back pain (LBP) is a common condition with profound effects on well-being. We aimed to define the prevalence and the characteristics of LBP and to investigate its impact on the quality of life (QoL) of 409 students (265 females and 144 males), all high-school adolescents from the Veneto region. LBP was measured with a structured, self-report questionnaire, while the SF-36 questionnaire was used to measure physical and mental QoL. 253 students (61.3%) reported one or more episodes of LBP, with female predominance. Adolescents with LBP treated with drugs and rehabilitation cares have significantly poor belief in pain resolution (p=0.005), but more belief in a prevention program (p=0.006) than the others. After adjustment for sex, a significant association between the SF-36 dimension of vitality and the presence of LBP in males was observed. All SF-36 domains except mental health were significantly higher in females with LBP. Our study confirmed that LBP is frequent in Italian scholar adolescents and has an impact on QoL. Strategies for reducing the effects of LBP on QoL should be an important purpose for clinicians and health policy makers.</p> P. Galozzi I. Maghini L. Bakdounes E. Ferlito V. Lazzari M. Ermani M. Chia D. Gatti S. Masiero L. Punzi ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 132 140 10.4081/reumatismo.2019.1229 Acute effect of strength training on mood of patients with fibromyalgia syndrome https://www.reumatismo.org/index.php/reuma/article/view/1169 <p>Fibromyalgia syndrome (FM) is a musculoskeletal disorder characterized by chronic pain and frequently associated changes in mood states. The aim of this study was to analyze the acute effect of strength training (ST) sessions on the mood states of patients with fibromyalgia. A total of 110 FM patients were eligible for this study. After the inclusion criteria, twenty-eight women with FM (mean age: 51.88±10.22 years) performed three sessions of ST. Each training session worked the main muscle groups and lasted 60 min. Three sets of 12 repetitions were performed with 1-min intervals between them. Outcome measures were assessed at baseline, after one session, and after three ST sessions. The Brunel Mood Scale (BRUMS) was used to assess mood states, and the Wilcoxon test was used to verify differences in mood after one and three ST sessions. The ST practice had positive effects on the patients’ mood states after a single session. Reductions in anger, mental confusion, mood depression, fatigue, and tension were observed. The results of the 3rd ST session were similar. We concluded that a single ST session was sufficient to improve the mood states of patients with fibromyalgia.</p> A. Andrade R. de Azevedo Klumb Steffens S. Mendes Sieczkowska D. Reis Coimbra G. Torres Vilarino ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 141 147 10.4081/reumatismo.2019.1169 Validity and reliability study of the Turkish version of SACRAH (Score for Assessment and quantification of Chronic Rheumatic Affections of the Hands) https://www.reumatismo.org/index.php/reuma/article/view/1180 <p>Rheumatic diseases cause deformities in the hands and affect daily living activities. Therefore, assessment of hand disabilities is important in rheumatic disease. The aim of this study was to test the validity and reliability of the Turkish version of the A Score For Assessment and Quantification of Chronic Rheumatic Affections of the Hands (SACRAH). A translation and back-translation of the SACRAH were performed, according to the Beaton guidelines. Patients who were between 18-65 years old, who were literate in Turkish, who had rheumatic disease diagnosis and whose hands were affected, were included in the study. Patients who were using a splint during daytime were excluded from the study. They completed the Turkish version of Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH-T) once and the final version of the SACRAH Questionnaire twice with a 7 days’ interval. The internal consistency (Cronbach’s α) and reliability (test-retest reliability) of the questionnaire were assessed. Besides, correlations between SACRAH and DASH-T scores were analyzed using the Spearman correlation coefficient. One hundred and twenty patients participated in the study. The Turkish version of the SACRAH met set criteria of reliability and validity. Internal consistency was excellent (Cronbach’s α=0.88) and test-retest reliability were very good (r=0.73). SACRAH showed a positive and statistically significant correlation with DASH-T scores (r=0.83, p&lt;0.001). Our results show that the Turkish version of the SACRAH has excellent test-retest reliability and validity. As a result of this study we determined that SACRAH is a valid and reliable instrument for assessing functional status and subjective manual function in Turkish-speaking patients.</p> N.G. Tore F. Sari Z. Tuna O. Varan H. Babaoglu B. Goker D. Oskay ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 148 153 10.4081/reumatismo.2019.1180 Treat-to-target (T2T) of serum urate (SUA) in gout: a clinical audit in real-world gout patients https://www.reumatismo.org/index.php/reuma/article/view/1225 <p>Treat-to-target (T2T) for gout has been established recently to improve its management, which has been reported to be sub-optimal with significant gaps between the goals of treatment and day-to-day clinical practice. T2T recommended a goal of serum urate (SUA) target of &lt;360 μmoI/L in all patients with gout and &lt;300 μmoI/L in patients with tophaceous or severe gout. T2T strategy was applied in the management of gout patients in two Rheumatology clinics from 1 January 2016 onwards. We performed a clinical audit to assess T2T of SUA in gout patients and to identify causes for failure to achieve target SUA among them. There were a total of 304 patients for our analysis. They were of multi-ethnic origin with male predominance (88.8%). They had a mean age of 57.7+13.7 years and mean disease duration of 10.1+8.7 years. The most common comorbidities were hypertension (76.2%), dyslipidemia (52.5%) and diabetes mellitus (DM) (27.4%). Our patients’ body mass indexes showed that 47.7% were obese while 34.2% were overweight. Up to 62.4% of our patients had tophi and 42.6% had joint deformities. Only 34.9% of patients achieved target SUA. Nonadherence (52.3%) was the main reason identified for failure to achieve target SUA. The independent predictors for failure to achieve target SUA were nonadherence (HR=7.84, p=0.000) and presence of tophi (HR=1.95, p=0.001).</p> C.L. Teh Y.K. Cheong S.A. Wan G.R. Ling ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 154 159 10.4081/reumatismo.2019.1225 Don’t forget the jumper’s knee in the young sportsman: evaluation of patellar tendinopathy with a high frequency ultrasound probe https://www.reumatismo.org/index.php/reuma/article/view/1231 <p>Patellar tendinopathy, or Jumper’s knee, is a painful knee condition caused by inflammation of the patella tendon. This condition is most frequently observed in subjects who play sports that require repetitive regular jumping. Jumper’s knee is frequently misdiagnosed as a minor injury and many athletes, like our patient, keep on training and competing and either tend to ignore the injury or attempt to treat it themselves. However, jumper’s knee is a serious condition that requires a correct and timely diagnosis, which often necessitates ultrasound investigation in order to start the most appropriate treatment.</p> B. Ruaro M. Cutolo E. Alessandri F. Zaottini R. Picasso F. Pistoia G. Ferrari C. Martinoli ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 160 162 10.4081/reumatismo.2019.1231 Infliximab in the treatment of Budd-Chiari syndrome in Behçet’s disease https://www.reumatismo.org/index.php/reuma/article/view/1153 <p>Behçet’s disease is a chronic autoinflammatory disorder that usually presents with recurrent oral and genital ulcers, uveitis, skin lesions and arthritis. Any organ, however, can be involved and in a subgroup of patients the large vascular lesions are the predominant feature (vasculo-Behçet disease). We report a case of a 27-yearold man with Behçet’s disease who developed Budd-Chiari syndrome while on immunosuppressive therapy. Infliximab resulted in a rapid and total clinical remission. Literature data have shown that antitumor necrosis factor alpha (anti-TNF-α) agents including infliximab can suppress disease activity but there is no long-term experience on tapering and/or discontinuation of treatment under clinical remission. Our case supports the use of infliximab in vasculo-Behçet patients.</p> L.B. Santos J. Rigueira A.P. Vilas ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 163 165 10.4081/reumatismo.2019.1153 Late onset systemic sclerosis with seronegativity: a rare presentation of an uncommon disease https://www.reumatismo.org/index.php/reuma/article/view/1170 <p>Systemic sclerosis (SSc) is an uncommon connective tissue disorder characterized by multisystem involvement with fibrosis of skin and internal organs. Antibody formation is one of the hallmarks of SSc. Antinuclear antibodies (ANA) are positive in 97% of patients with SSc. We report a rare case where the patient was negative for ANA, Anti-topoisomerase I, Anti-centromere and Anti-RNA polymerase III antibodies.</p> D. Saxena D. Jain M. Yadav K. Giri T. Yadav P. jain ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 166 170 10.4081/reumatismo.2019.1170 Antibodies to extractable nuclear antigens (ENAS) in systemic lupus erythematosus https://www.reumatismo.org/index.php/reuma/article/view/1172 <p>Not available</p> B. Joob V. Wiwanitkit ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-10-24 2019-10-24 71 3 171 171 10.4081/reumatismo.2019.1172