Rheumato, Volume 2, Issue 4 (December 2022) – 6 articles

Current lifestyle and environmental factors contribute to obesity development, leading to low-grade chronic inflammation (LGCI). Apart from obesity, LGCI is also related to rheumatic diseases such as osteoporosis (OP) and osteoarthritis (OA). In these, an excessive accumulation of adipose tissue has been linked to an excessive production of proinflammatory factors, such as adipokines. This work’s aim is to stablish the effect of obesity-associated LGCI in major rheumatic diseases and to determine optimal strategies to reduce it. Obesity is a risk factor for developing OA, where a systemic LGCI state has been found. Concretely, obesity-associated LGCI has been described as an OA instauration and progression promoter. To avoid this, several therapeutical approaches (diet control, physical exercise, or nutraceuticals) have been tested. OP is another major rheumatic disease where a basal LGCI has been described, being worsened by obesity. As in OA, diet management and supplementation with vitamin D or probiotics have been proposed as approaches to treat obesity-associated LGCI in this pathology. Currently, the increase in the prevalence of rheumatic diseases is unstoppable. Nonetheless, obesity is a risk factor that can be controlled. Thus, the study of new interventions to control the impact of obesity-associated LGCI is a challenge for the management of patients with rheumatic diseases. Full article

The inaugural issue of Rheumato exhibits the gamut of phenomenology that is inherent to why we became rheumatologists: our reliance on fundamentals, the quest to decipher apparently disparate findings, problem solving, hypothesis formation as to mechanisms and relationships, assessing the applicability and adaptability of new technologies and exploring the validity of old concepts/perspectives, and constantly reviewing our perspectives and performance [...] Full article

Background: Efforts to increase acceptance and reduce avoidance behaviors in patients who suffer from chronic pain are likely to have additional beneficial effects on pain management. The primary aim of the current study was to evaluate whether a sequential approach to treatment, where acceptance-based coping strategies are taught prior to problem-focused coping strategies using manualized group therapies, improves pain-related outcomes. Methods: The current investigation is a single-group, longitudinal ex post facto study. A sample of 168 Veterans participated in the current study at a midwestern VA medical center. All participants were administered a standard pre- and post-intervention assessment battery. The primary outcome analysis was a 4 × 2 repeated-measures multivariate analysis of variance. Results: The current study did not find a significant interaction effect for intervention x time but did find a significant main effect for time. All treatment conditions were associated with decreases in pain severity, pain interference, illness-focused coping strategies, catastrophizing behaviors, and global distress. Participation in both of the combined groups did not produce significantly different pain-related outcomes compared to participation in one group. Conclusion: These findings reinforce common factors theory in psychotherapy and provide insight into treatment dosage for patients who suffer from chronic pain. The current findings underline the importance of researching pain management, as it is a fundamental aspect of clinical practice, training, and research in rheumatology. Full article

Systemic Lupus Erythematosus (SLE) is a chronic multisystem autoimmune disease. Serositis occurs in 16% of SLE patients, and while cardiac tamponade and acute peritonitis with ascites can occur during the course of the disease, they are rare as the first presentation. A 25-year-old woman presented to the emergency department in Tishreen Hospital with complaints of dyspnea, fever, chills, and chest and abdominal pain. Two months prior, she suffered from musculoskeletal pain, fatigue, anorexia, weight loss of about 15 kg, severe hair loss, and recurrent oral aphthous. On clinical examination, the patient was pale and tired with dyspnea and pitting edema (grade 3–4). Pericardiocentesis was emergently performed because there were signs of cardiac tamponade. Three days later, the patient developed an acute surgical abdomen due to acute peritonitis and ascites. Later, the patient was diagnosed with SLE after excluding malignant and infectious diseases. Consequently, methylprednisolone pulses, azathioprine, and hydroxychloroquine 200 mg/day were introduced immediately. The clinical status of the patient dramatically improved, and three months later, the patient was symptom-free with normal laboratory tests. In conclusion, although cardiac tamponade and acute surgical abdomen because of acute peritonitis and ascites as the initial presentation of SLE are very rare, they can occur coincidently. Full article