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ObjectivePatients with rheumatic diseases often have multiple comorbidities which may impact well‐being leading to high psychosocial complexity. This scoping review was undertaken to identify complexity measures/tools used in rheumatology that could help in planning and coordinating care.MethodsMEDLINE, EMBASE and CINAHL were searched from database inception to 14 December 2019 using keywords and Medical Subject Headings for “care coordination”, “complexity” and selected rheumatic diseases and known complexity measures/tools. Articles describing the development or use of complexity measures/tools in patients with adult rheumatologic diagnoses were included regardless of study design. Included articles were evaluated for risk of bias where applicable.ResultsThe search yielded 407 articles, 37 underwent full‐text review and 2 were identified during a hand search with 9 included articles. Only 2 complexity tools used in populations of adult patients with rheumatic disease were identified: the SLENQ and the INTERMED. The SLENQ is a 97‐item patient needs questionnaire developed for patients with systemic lupus (n = 1 study describing tool development) and applied in 5 cross‐sectional studies. Three studies (a practice article, trial and a cross‐sectional study) applied the INTERMED, a clinical interview to ascertain complexity and support coordinated care, in patients with rheumatologic diagnoses.ConclusionsThere is limited information on the use of patient complexity measures/tools in rheumatology. Such tools could be applied to coordinate multidisciplinary care and improve patient experience and outcomes.Patient contributionThis scoping review will be presented to patient research partners involved in co‐designing a future study on patient complexity in rheumatic disease.  相似文献   
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《REV BRAS REUMATOL》2014,54(3):172-178
IntroductionOtorhinolaryngological manifestations of rheumatologic diseases represent a great challenge not only to the generalistphysician but also to the ENT doctor andrheu‐ matologist. They often represent early manifestations of an autoimmune disorder which requires prompt and aggressive immunosuppressive treatment. Auditory, nasal, laryngeal and eye symptoms can be the first manifestation of rheumatic diseases and their proper assessment helps the doctor to identify signs of disease activity. The objective of this study is to identify the ENT manifestations in patients with rheumatic diseases in a high com‐ plexity hospital, regarding facilitating an early diagnosis and treatment.MethodsWe performed clinical and complete otorhinolaryngological evaluations in pa‐ tients selected from the outpatient rheumatology in a standardized manner by the use of a standardized form filling during the secondhalf of 2010.ResultsIn the study group, systemic lupus erythematosus (SLE) patients had predomi‐ nantly laryngeal manifestations, while patients with Sjögren's syndrome showed a higher prevalence of otologic manifestations. Changes in audiometric tests were found in 53% of Wegener's granulomatosis (WG) patients, 80% of relapsing polychondritis (RP), 33% of systemic lupus erythematosus (SLE) and 50% of Churg‐Strauss syndrome (SCS). Regarding nasal alterations, these were found so prevalent in all conditions, especially Churg‐Strauss syndrome.Discussion and conclusionThis study demonstrated that most patients treated in our hospi‐ tal has the ENT signs and symptoms commonly associated in previous studies on rheumat‐ ic diseases, but further studies with a larger number of patients must be made to establish such relations.  相似文献   
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A patient with scleroderma who presented with pericarditis and effusion is described. Aspirates from this pericardial effusion had the characteristics of an exudate with no evidence of autoantibodies, immune complexes or complement depletion. These findings suggest that the mechanisms operating in the production of pericardial effusion in scleroderma may be different from those found in rheumatoid arthritis and systemic lupus erythematosus.  相似文献   
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目的 探讨个性化护理对风湿免疫科无痛病房患者疼痛的影响.方法 随机选取2011年3月一2014年10月中国医科大学附属第一医院风湿免疫科无痛病房收治的患者80例,分为观察组(n=40)和对照组(n=40).对照组患者进行常规护理,观察组患者进行个性化护理,然后对二组患者的疼痛程度和对护理工作的满意度进行统计分析.结果 组内比较,二组患者护理后的NRS评分均显著低于护理前(P<0.05);组间比较,护理前二组患者的NRS评分之间差异无统计学意义(P>0.05),护理后观察组患者的NRS评分显著低于对照组(P<0.05);观察组患者中很满意21例,满意15例,对护理工作的满意度为90.0%(36/40);对照组患者中很满意14例,满意11例,对护理工作的满意度为62.5%(25/40).观察组患者对护理工作的满意度显著高于对照组(P<0.05).结论 个性化护理能够有效缓解风湿免疫科无痛病房患者疼痛,同时显著提高对护理工作满意度.  相似文献   
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Synovial fluid leukocytosis. A study of extremes.   总被引:3,自引:0,他引:3  
Three hundred and eighty-eight synovial fluids from 310 patients with definite diagnoses were reviewed. Seventy per cent of the patients with culture-proved infections in the joint space had leukocyte counts above 50,000/mm3 whereas 12.5 per cent of the patients with gout, 10 per cent of those with pseudogout and 4 per cent of those with rheumatoid arthritis had leukocyte counts in this high range.White cell counts ranged from 6,000 to 46,000/mm3 in 30 per cent of the patients with infectious arthritis. However, their fluids contained 90 per cent neutrophils and poor mucin clots, and within 12 to 48 hours repeat aspirations of the same joint showed large increases in the leukocyte count. These patients were divided into two groups, one with mild infections due to Neisseria gonorrhea and Diplococcus pneumoniae, and another consisting of patients with complicated underlying diseases whose infections, usually due to more virulent organisms, were poorly controlled and whose mortality rate was 25 per cent within days of synovial fluid analysis.In one fourth of the fluids with sodium urate crystals and one third of the fluids with calcium pyrophosphate crystals, leukocyte counts were below 2,500/mm3. Compared to patients with gouty arthritis, a larger number of patients with pseudogout had normal mucin precipitates despite higher numbers of leukocytes. These data document the magnitude of overlap at extremes of synovial fluid leukocytosis in common forms of arthritis and suggest a need for a careful search for crystals in fluids with high as well as low leukocyte counts.  相似文献   
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Antinuclear antibody and in vivo capillary patterns were studied in 33 patients with Raynaud's phenomenon only and in 68 patients with scleroderma spectrum disorders; the results were correlated with clinical and laboratory findings. In addition, antinuclear antibody results in the groups with Raynaud's phenomenon only and scleroderma spectrum disorders were compared with those found in 70 patients with systemic lupus erythematosus (SLE). Distinct antinuclear antibody profiles were observed in the three diagnostic groups. Comparison of patients with anticentromere antibodies with others in the group with scleroderma spectrum disorders demonstrated that anticentromere antibody-positive patients tended to have a milder disease: less skin and visceral involvement, less frequent presence of hypertension, anemia, and elevated sedimentation rate. These differences did not, however, reach statistical significance. Comparison of patients with scleroderma spectrum disorders according to in vivo capillary patterns revealed that those with an "active" pattern had significantly more extensive skin involvement than those with a "slow" pattern. Visceral involvement tended to be greater in all organ systems in the group with an "active" pattern and reached statistical significance for muscle and kidney. Hypertension was also significantly more frequent in the group with an "active" pattern than in the group with a "slow" one. The latter was positively correlated with the presence of anticentromere antibody.  相似文献   
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《Reumatología clinica》2022,18(8):486-489
ObjectivesTo determine the number of rheumatologists per 100,000 inhabitants working in public or private centres in Spain as a whole, and by Autonomous Community and their distribution by age and sex.Material and methodCross-sectional study based on the information contained in the database of the Spanish Society of Rheumatology. Quality control was performed by contact (e-mail and telephone call) with the heads of the clinical services of each of the hospitals (public and private). The information analysed was the age, sex and place of work of active rheumatologists in February 2020. The rates of rheumatologists per 100,000 inhabitants were calculated from population data from the National Institute of Statistics.ResultsThe rate of rheumatology specialists per 100,000 inhabitants in Spain was estimated at 2.17. The percentage of women was 59.7%, with a higher female/male ratio at younger ages. The lowest proportion of specialists per 100,000 inhabitants was in the community of Valencia (1.6), and the highest in Cantabria (3.2).ConclusionsVariations were found in the rate of rheumatologists per 100,000 inhabitants among the Autonomous Communities. The distribution by age and sex showed a tendency towards female rheumatologists, especially in the younger age strata.  相似文献   
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