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Rheumato
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Feature Papers to Celebrate the Inaugural Issue of Rheumato
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Feature Papers to Celebrate the Inaugural Issue of Rheumato

A special issue of Rheumato (ISSN 2674-0621).

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 28056

Special Issue Editor

Prof. Dr. Bruce M. Rothschild

E-Mail Website
Guest Editor
Department of Medicine, Indiana University Ball, Memorial Hospital, Muncie, IN, USA
Interests: rheumatology; skeletal impact of disease; skeletal radiology; paleopathology; history of disease; examination of premises utilized in recognition of disease in skeletons
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Perhaps a good way to introduce a new journal is to delineate its aims and scope and the unique niche it fulfills. While rheumatology as a field has matured, corporate “interpositions” and time constraints have compromised our ability to pursue the obsessive/compulsive patient evaluations and interventions that characterized our past approaches.

An explosion of pertinent basic science and technological advancements has augmented the data base essential to the field, while opportunities to teach/educate have contracted. Severe time constraints on bedside teaching have further compromised clinical education. Thus, a need is perceived for this vehicle, Rheumato, to transcend these challenges.

Thus, the following are offered (as an incomplete list of options) for submission topics:

  • The premises inherent to rheumatology.
  • The history of rheumatology and its principals.
  • The character of diseases affecting bones and joints.
  • The character of immunologic/autoimmune diseases.
  • The character of the rare and multisystem diseases.
  • Pattern recognition aspects of differential diagnosis.
  • Patterns of disease as population phenomena.
  • Technical aspects of utilizable diagnostic modalities.
  • Critical analysis of therapeutic interventions and their pros and cons.
  • Technical aspects of utilizable therapeutic modalities.
  • Archeological/zoological/paleontological evidence of/correlates with disease.
  • Pro and con opinion pieces.
  • Statistical methodology and its premises for rheumatologists.

I hope I can inspire your participation in this endeavor and look forward to learning of your perspectives.

Prof. Dr. Bruce Rothschild
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Rheumato is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (11 papers)

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Editorial

Jump to: Research, Review, Other

2 pages, 186 KiB  
Editorial
Rheumato at Day 1
by Bruce Rothschild
Rheumato 2022, 2(4), 112-113; https://doi.org/10.3390/rheumato2040015 - 02 Nov 2022
Viewed by 1013
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
3 pages, 340 KiB  
Editorial
Return to the Basics: Examination for Birefringence and Its Direction Is Critical to Diagnosis of Gout
by Bruce M. Rothschild
Rheumato 2021, 1(1), 2-4; https://doi.org/10.3390/rheumato1010002 - 27 Oct 2021
Cited by 1 | Viewed by 2417
Abstract
In the spirit of initiating a new journal for Rheumato, it is pertinent to review the attention to the basics that first established the field as an evidence-based approach to recognition and treatment of arthritis and multisystem diseases and the reputation of [...] Read more.
In the spirit of initiating a new journal for Rheumato, it is pertinent to review the attention to the basics that first established the field as an evidence-based approach to recognition and treatment of arthritis and multisystem diseases and the reputation of its disciples as resources for solving diagnostic dilemmas [...] Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)

Research

Jump to: Editorial, Review, Other

10 pages, 1493 KiB  
Article
Diagnosis of Kawasaki Disease Presenting with Limited and Faint Principal Clinical Features
by Yuichi Nomura, Yuta Mikami, Kiminori Masuda, Yoshikazu Kato, Naho Nakazaki, Hiromi Ikeda, Masako Hirabayashi, Ryo Kusubae and Koji Sameshima
Rheumato 2022, 2(1), 24-33; https://doi.org/10.3390/rheumato2010004 - 01 Mar 2022
Cited by 1 | Viewed by 1954
Abstract
Background: We examined the characteristics of Kawasaki disease (KD) patients who presented with limited and faint principal clinical features. Methods: We retrospectively reviewed the clinical records of 62 KD patients who presented with limited and faint clinical features at admission. A clinical feature [...] Read more.
Background: We examined the characteristics of Kawasaki disease (KD) patients who presented with limited and faint principal clinical features. Methods: We retrospectively reviewed the clinical records of 62 KD patients who presented with limited and faint clinical features at admission. A clinical feature that was recognizable by even junior doctors was defined as a definite feature (d-Feature), and a feature that was faint and recognizable by only experienced doctors was defined as a faint feature (f-Feature). Results: At admission, 82% of patients presented with fever and ≤1 d-Feature. Two days later, the d-Features increased in number and diagnoses of KD were established in 32 patients with fever and ≥4 d-Features. In 30 patients with ≤3 d-Features, experienced doctors recognized f-Features and diagnosed KD in 22 patients because of fever and ≥4 features. Among eight patients with ≤3 features, experienced doctors diagnosed six patients as incomplete KD considering their faint abnormal echocardiographic findings. For the remaining two patients, experienced doctors decided to commence KD treatments considering the patients’ clinical course. Conclusions: Sufficient clinical experience is essential during the diagnosis of KD in patients presenting with limited and f-Features. Educational programs for junior doctors on how to recognize f-Features and evaluate faint abnormal coronary artery findings are necessary. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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9 pages, 1217 KiB  
Article
Angiotensin-Converting Enzyme Activity May Predict Disease Severity in Psoriasis
by Matilde Bandeira, Ângela Gil, Ana Carolina Santos, Vasco C. Romão, Mário Rui Mascarenhas, Paulo Filipe, João Eurico Fonseca and Manuel Bicho
Rheumato 2022, 2(1), 15-23; https://doi.org/10.3390/rheumato2010003 - 14 Feb 2022
Cited by 1 | Viewed by 2520
Abstract
Psoriasis is a multifactorial disease, with many genetic risk factors, one of which seems to be the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism. ACE activity has been shown to be higher in psoriatic patients and it suggests an oxidative stress state, as seen [...] Read more.
Psoriasis is a multifactorial disease, with many genetic risk factors, one of which seems to be the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism. ACE activity has been shown to be higher in psoriatic patients and it suggests an oxidative stress state, as seen in many cardiovascular disorders. We aimed to explore the association between ACE activity and polymorphisms and cardiovascular risk amongst psoriatic patients. We included 64 psoriatic patients and 1091 controls and compared ACE I/D polymorphism genotype and serum activity for both groups. ACE genotypes were similar in psoriatic patients and controls. Notably, serum ACE activity was higher in psoriatic patients (19.09 ± 2.86 U/mL) compared to controls (11.85 ± 0.40 U/mL), p = 0.015. Non-HDL cholesterol was significantly lower in II polymorphism (p = 0.037). Psoriatic activity (PASI) was associated with a higher cardiovascular risk estimated by lower HDL concentrations (r = −0.496, p = 0.007), and higher triglyceride levels (r = 0.421, p = 0.020) and TC/HDL and LDL/HDL ratios (r = 0.612, p < 0.001 and r = 0.437, p = 0.023, respectively). Patients with psoriasis have higher ACE activity levels, independent of ACE genotype. Moreover, disease activity correlated with cardiovascular risk. This could support the eventual role of ACE as a possible biomarker for disease severity and cardiovascular risk in psoriasis patients. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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13 pages, 2641 KiB  
Article
Ultrasound Features across Subtypes of Juvenile Idiopathic Arthritis
by Doaa Mosad Mosa, Ashraf M. Abdelrahman and Amany S. El-Bahnasawy
Rheumato 2022, 2(1), 2-14; https://doi.org/10.3390/rheumato2010002 - 29 Jan 2022
Cited by 2 | Viewed by 2681
Abstract
Objective: The aim of this study was to evaluate musculoskeletal ultrasound (MSUS) features across categories of juvenile idiopathic arthritis (JIA). Methods: In this cross-sectional study, all patients were subjected to full history taking, clinical examination including disease assessment parameters and laboratory investigations. In [...] Read more.
Objective: The aim of this study was to evaluate musculoskeletal ultrasound (MSUS) features across categories of juvenile idiopathic arthritis (JIA). Methods: In this cross-sectional study, all patients were subjected to full history taking, clinical examination including disease assessment parameters and laboratory investigations. In addition, all children were examined by both grayscale (GS) and power Doppler (PD) MSUS images. Results: By MSUS, the number of joints with synovial effusion was 697 of a total 2400 examined joints (29%) and joints with synovial thickening counted 673 (28%). The number of joints with positive PD signals was 446 (18.6%). There was a significant difference among JIA subtypes as regards different MSUS features. Moreover, there was a discrepancy regarding synovial effusion (p = 0.018), hypertrophy scores (p = 0.013), and the total US severity score (p = 0.026). This divergence was attributed to the significant difference between systemic juvenile idiopathic arthritis (SJIA) and other categories. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MSUS in JIA and its subtypes were calculated. Conclusion: MSUS is a highly sensitive method for detecting synovitis, tenosynovitis, and erosive bone disease, and it helps to make proper therapeutic decisions. There was a significant difference among JIA subtypes regarding MSUS features. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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9 pages, 873 KiB  
Article
The Efficacy of Sequential Biologic Agents in Refractory Rheumatoid Arthritis after Failure of Initial DMARD and anti-Tumor Necrosis Factor Therapy
by Antonio Giovanni Versace, Caterina Oriana Aragona, Daniela La Rosa, Marianna Chiappalone, Maria Concetta Tringali, Alberta De Gaetano, Charles Frederick Moore, Jr., Donatella Sangari, William Neal Roberts and Gianluca Bagnato
Rheumato 2021, 1(1), 22-30; https://doi.org/10.3390/rheumato1010005 - 21 Dec 2021
Cited by 2 | Viewed by 2753
Abstract
Introduction/Objective: The efficacy of biologic therapy in the treatment of rheumatoid arthritis (RA) has been well-established but, in practice, a quarter of patients will either not respond to the first biologic agent or will suffer an adverse event requiring a switch to a [...] Read more.
Introduction/Objective: The efficacy of biologic therapy in the treatment of rheumatoid arthritis (RA) has been well-established but, in practice, a quarter of patients will either not respond to the first biologic agent or will suffer an adverse event requiring a switch to a different drug. While clinical guidelines exist to help guide therapy and previous studies have examined sequential use of anti-TNF agents, there is little data to inform a multiple switch strategy. Our aim was to measure the efficacy of multiple switches of biologic in severe refractory RA. Methods: We enrolled 111 patients whose therapy with one anti-TNF agent had failed in this open-label observational study. These patients were all treated with a second biologic agent and 27 ultimately required treatment with a third. The response to the therapy and disease activity were assessed at 6 and 12 months after each switch. Results: The remission rates at 6 months were lower than previously reported and the initiation of a second biologic agent resulted in significant improvement at 12 months, including DAS remission in 36% of patients. The response in those receiving a third biologic was less pronounced, as might be expected in this relatively treatment-refractory population. In this group, only patients treated with tocilizumab had maintained remission at one year. Conclusion: Patients who do not respond to an anti-TNF agent often benefit from being switched to a second, or even third, biologic. Importantly, it may take longer than expected to fully assess the effectiveness of a second or third agent in patients with refractory disease. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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Review

Jump to: Editorial, Research, Other

13 pages, 924 KiB  
Review
Immunopathology of Behcet’s Disease: An Overview of the Metagenomic Approaches
by Jun Shimizu, Masanori A. Murayama, Yoshishige Miyabe and Noboru Suzuki
Rheumato 2022, 2(3), 74-86; https://doi.org/10.3390/rheumato2030010 - 02 Sep 2022
Cited by 4 | Viewed by 2173
Abstract
The impact of the microbiota residing in the body on local and systemic immune responses has been increasingly recognized. The major gut microbe metabolites’ short-chain fatty acids (SCFAs) are suggested to regulate the balance between regulatory (Treg) cells and helper T 17 (Th17) [...] Read more.
The impact of the microbiota residing in the body on local and systemic immune responses has been increasingly recognized. The major gut microbe metabolites’ short-chain fatty acids (SCFAs) are suggested to regulate the balance between regulatory (Treg) cells and helper T 17 (Th17) cells in physiological and pathological conditions by enhancing regulatory T (Treg) cell function through epigenetic modifications. Patients with Behcet’s disease (BD) exhibited enhanced Th17 cell-mediated immune responses and decreased intestinal relative abundances of SCFA-producing bacteria. Causal correlations between aberrant immune responses and gut microbial composition in patients with BD have been reported in Italy, the Netherlands, Turkey, China, and Japan. We reported that the gut and oral microbiota profiles of patients with BD shared some common features. Immune responses against both commensal and pathogenic microbes may play a crucial role in BD development. This review summarizes the current literature, which was retrieved from public databases, such as PubMed and MEDLINE using search terms, including Behcet’s disease, helper T cells, and microbiota, during 1970–2022, on the potential functional correlation between immune cells and microbiota in patients with BD. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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6 pages, 233 KiB  
Review
Fine Wine and Gout
by Kenneth P. H. Pritzker and Andrea R. Pritzker
Rheumato 2022, 2(2), 46-51; https://doi.org/10.3390/rheumato2020006 - 31 May 2022
Cited by 1 | Viewed by 1946
Abstract
From ancient times to the present day, gout has been associated in the popular and scientific literature with wealthy men who overindulge in fancy foods, fine wine, and debauchery. Curiously, amongst diseases, gout was thought to be good, a malady to be accepted [...] Read more.
From ancient times to the present day, gout has been associated in the popular and scientific literature with wealthy men who overindulge in fancy foods, fine wine, and debauchery. Curiously, amongst diseases, gout was thought to be good, a malady to be accepted because of otherwise beneficial effects on health, and longevity. This narrative review critically examines the history of these associations and explores in detail the pathogenic factors contributing to development of gout prior to the 20th century. While lead toxicity has been previously implicated with wine, the specific association of gout and fine wine can be attributed to lead complexes in products such as sapa, a grape extract used to sweeten wine, in addition to lead nanoparticles leached from crystal glassware and lead glazed dinner plates. The health benefits of gout can be attributed to lead complexes in fine wine and lead nanoparticles from glazed dinnerware. These compounds have excellent antibacterial properties, thereby inhibiting the presence of pathogenic bacteria in foodstuffs. Probing the association of gout and fine wine provides a very well documented example of how the pathogenesis of disease becomes better understood with the passage of time and continuing, persistent scientific enquiry. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
12 pages, 347 KiB  
Review
Kawasaki Disease: Management Challenges during COVID-19 Pandemic with an Upsurge in Multisystem Inflammatory Syndrome in Children
by Gillian Hendriks and Suresh Chandran
Rheumato 2022, 2(2), 34-45; https://doi.org/10.3390/rheumato2020005 - 02 Apr 2022
Cited by 2 | Viewed by 2541
Abstract
Kawasaki disease (KD) is an acute febrile illness, principally affecting children under 5 years, due to a systemic vasculitis of obscure etiology. In 2017, the American Heart Association published the diagnostic criteria for KD in their scientific statement. Following the emergence of coronavirus [...] Read more.
Kawasaki disease (KD) is an acute febrile illness, principally affecting children under 5 years, due to a systemic vasculitis of obscure etiology. In 2017, the American Heart Association published the diagnostic criteria for KD in their scientific statement. Following the emergence of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there has been an upsurge in the reports of KD as well as a novel multisystem inflammatory syndrome in children (MIS-C). Clinical manifestations of MIS-C are similar to KD and toxic-shock syndrome, making the clinical diagnosis challenging. Studies have shown promising results to differentiate KD from MIS-C using epidemiological, clinical, hematological, and immunological characteristics. Serological evidence may be negative in these patients at presentation, as MIS-C is a late manifestation of SARS-CoV-2 exposure. However, diagnosis and management challenges currently exist due to a gap in knowledge of these conditions. Further research is warranted to identify diagnostic tools to differentiate KD and MIS-C and optimize the therapeutic strategy, reducing morbidity and mortality related to these phenotypically similar diseases. This review aims to highlight the best available evidence for managing children with KD and MIS-C in the background of the ongoing COVID-19 pandemic. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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12 pages, 278 KiB  
Review
The Influence of Dietary Intervention in Connective Tissue Diseases: Evidence from Randomized Clinical Trials
by Francesca Oliviero, Paola Galozzi, Elisabetta Zanatta, Mariele Gatto, Paolo Spinella and Andrea Doria
Rheumato 2021, 1(1), 5-16; https://doi.org/10.3390/rheumato1010003 - 29 Nov 2021
Cited by 1 | Viewed by 4064
Abstract
The aim of this review is to identify and discuss randomized clinical trials conducted in patients with connective tissue diseases, including systemic lupus erythematosus, idiopathic inflammatory myopathies, vasculitis, Sjögren’s syndrome, and systemic sclerosis. Although limited, the results obtained with bioactive compounds, namely n-3 [...] Read more.
The aim of this review is to identify and discuss randomized clinical trials conducted in patients with connective tissue diseases, including systemic lupus erythematosus, idiopathic inflammatory myopathies, vasculitis, Sjögren’s syndrome, and systemic sclerosis. Although limited, the results obtained with bioactive compounds, namely n-3 polyunsaturated and short-chain fatty acids, demonstrate that dietary intervention and nutritional counseling might have an important role as adjuvant therapy in patients with connective tissue diseases, particularly in the light of the comorbidities which characterize these conditions. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)

Other

5 pages, 4824 KiB  
Case Report
An Unusual Case of “Conjugal” Polymyalgia Rheumatica after SARS-CoV-2 Vaccination
by Elena Vanni, Jacopo Ciaffi, Luana Mancarella and Francesco Ursini
Rheumato 2021, 1(1), 17-21; https://doi.org/10.3390/rheumato1010004 - 30 Nov 2021
Cited by 4 | Viewed by 2925
Abstract
The rare occurrence of polymyalgia rheumatica (PMR) in married couples has been reported in the literature. Susceptibility to PMR is contributed by genetic and environmental factors and cases of PMR developing after influenza vaccine have also been described, in a debated phenomenon known [...] Read more.
The rare occurrence of polymyalgia rheumatica (PMR) in married couples has been reported in the literature. Susceptibility to PMR is contributed by genetic and environmental factors and cases of PMR developing after influenza vaccine have also been described, in a debated phenomenon known as ‘ASIA’ syndrome. We report the case of two cohabitating married patients developing PMR few weeks after the first dose of ChAdOx1-S SARS-CoV-2 vaccine. Both patients presented with typical symptoms suggestive of PMR. Laboratory findings and ultrasound examination confirmed the diagnosis. Glucocorticoid therapy led to rapid improvment of symptoms. Anti-receptor-binding domain IgG titre was tested and, eight weeks after vaccination, both patients showed no antibody response. It has been suggested that vaccines might trigger autoimmune or inflammatory states in predisposed individuals and various hypotheses have been made regarding the pathogenesis of PMR. Although the causative effect of vaccines cannot be determined, the close temporal correlation observed in our case supports the potential role of environmental factors in triggering the onset of PMR. However, the literature indicates that post-COVID19 vaccination immune-mediated or inflammatory adverse events are extremely rare and vaccination should be encouraged since the benefit largely outweighs possible risks. Full article
(This article belongs to the Special Issue Feature Papers to Celebrate the Inaugural Issue of Rheumato)
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