ARTHROSCOPY LEARNING IN VIRTUAL REALITY: SYSTEMATIC REVIEW AND METANALYSIS.

There is a reduction in the workload of medical residency in orthopedics and a perception that residents can improve their surgical skills without the need to expose patients to risks. Arthroscopies are among the most frequent surgeries in orthopedics and can be trained in a Virtual Reality environment. Our objective is to evaluate the ability of Virtual Reality to develop arthroscopic skills in medical students and orthopedic residents.

Intravenous Golimumab in Children With Polyarticular-Course Juvenile Idiopathic Arthritis: Long-Term Extension of an Open-Label Phase III Study.

J Rheumatol 2024; doi: 10.3899/jrheum.2024-0298 Following the initial publication of this article, the study team became aware of additional nonserious adverse events (AEs) that occurred during the long-term extension study.

Engage, Escape and Evolve: Simulation Escape Rooms as a Transformative Pedagogy in Health Professions Education.

Background: Simulation escape rooms (SERs) in health professions education are an innovative pedagogical strategy designed to actively develop crucial graduate competencies addressing limitations of traditional teaching. Despite reported benefits, there is a research gap regarding their efficacy, especially with control group studies. Thus, we designed, implemented and evaluated a SER module, recognizing the need for more innovative strategies in our curriculum.

Safety of Accelerated Rituximab Infusion in Rheumatic Diseases: A Systematic Review.

Objective: To systematically evaluate the safety and feasibility of rapid rituximab (RTX) infusion protocols in patients with autoimmune rheumatic diseases.

Methods: A comprehensive literature review was conducted using PubMed, LILACS, and Scielo databases from 1965 to May 2024 without language restrictions. Studies reporting infusion reactions associated with accelerated RTX protocols (infusion over 90 to 120 min) in rheumatologic conditions were included.

Treatment of polyarticular juvenile idiopathic arthritis in Latin America: recommendations from the Pan-American League of Associations for Rheumatology.

To develop evidence-based treatment guidelines for non-systemic polyarticular-juvenile idiopathic arthritis (poly-JIA) in Latin America, endorsed by the Pan-American League of Associations for Rheumatology (PANLAR), a panel of paediatric rheumatologists from Latin America formulated clinically relevant questions regarding polyarthritis treatment, using the Population, Intervention, Comparator, and Outcome (PICO) format. Following the Grading of Recommendations Assessment, Development, and Evaluation methodology, a team of methodologists conducted a systematic literature review, extracted and summarised intervention effect estimates, and assessed the quality of evidence. The panel of paediatric rheumatologists voted on each PICO question and formulated recommendations, requiring a consensus of at least 70% amongst the voting members.

Dysautonomia in systemic lupus erythematosus: when to suspect and how to investigate.

Introduction: Among the neuropsychiatric manifestations of Systemic lupus erythematosus (SLE), there are manifestations related to the peripheral nervous system (PNS). The autonomic nervous system, a subdivision of the PNS, is poorly studied in patients with SLE, and most often not recognized in clinical practice. However, it's possible that autonomic impairment is more common than we thought and many manifestations without a clear pathophysiology may be explained by autonomic impairment.

Improving TMJ MRI diagnostics in juvenile idiopathic arthritis: a comparative evaluation of image enhancement filters.

Objectives: To assess the effectiveness of two enhancement filters for magnetic resonance images of temporomandibular joint (TMJ) in patients with juvenile idiopathic arthritis (JIA).

Material: Magnetic resonance image (MRI) of 44 patients with JIA (15 males and 29 females) was analysed using OnDemand 3D software. Two experienced evaluators who were previously calibrated and blinded to the images assessed them subjectively regarding the use of Sharpen 1 and Sharpen 2 filters.

Chorea associated with systemic lupus erythematosus- a systematic review.

ObjectiveChorea is one of the 19 neuropsychiatric manifestations observed in systemic lupus erythematosus (SLE). This article reviews the literature to determine the prevalence and clinical and laboratory features associated with chorea in SLE.MethodsWe performed a literature review following the PRISMA guidelines and using the following MESH terms in the search and analysis: "Chorea", "movement disorders", "systemic lupus erythematosus", "SLE", "neuropsychiatric manifestations", "neuropsychiatric lupus (NPSLE)", with full articles in English, Portuguese, and Spanish, between September 1999 and January 2024, in PubMed and Scielo.

Association of Elevated Serum S100A8/A9 Levels and Cognitive Impairment in Patients With Systemic Lupus Erythematosus.

Objective: Cognitive impairment (CI) is common in patients with systemic lupus erythematosus (SLE). Despite its prevalence, the immune mechanisms are not well understood. We previously reported elevated serum levels of S100A8/A9 and matrix metalloproteinase 9 (MMP-9) in patients with SLE and CI.

EULAR/American College of Rheumatology Classification Criteria for Pediatric Chronic Nonbacterial Osteomyelitis.

Objective: To develop and validate classification criteria for pediatric chronic nonbacterial osteomyelitis (CNO) jointly supported by EULAR and the American College of Rheumatology (ACR).

Methods: This international initiative had 4 phases: (1) candidate items were proposed in a survey of pediatric rheumatologists, (2) criteria definition and reduction by Delphi and nominal group technique exercises, (3) criteria weighting using multicriteria decision analysis, and (4) refinement of weights and threshold score in a development cohort of 441 patients and validation in another cohort of 514 patients.

Results: The new EULAR/ACR classification criteria for CNO require typical radiographic or magnetic resonance imaging findings and bone pain as an obligatory entry criterion and exclusion criteria of malignancy, infection, vitamin C deficiency, and hypophosphatasia, followed by additive weighted criteria in 5 clinical (site of bone lesions, pattern of bone lesions, age at onset, coexisting conditions, fever) and 4 pathology/laboratory domains (bone biopsy findings if done, anemia, C-reactive protein level, and erythrocyte sedimentation rate).

Developing consensus outcome measures in juvenile systemic sclerosis: a global survey of pediatric rheumatologists and literature review.

Background: Juvenile systemic sclerosis (JSSc) is a rare multisystemic disease with high morbidity and mortality rates. Treatment options remain limited, and there is a significant unmet need for effective therapies. This study aims to address this gap by investigating current JSSc management practices and identifying key outcome measures that can be used to inform the development of standardized assessment tools for future clinical trials.

Advances in pharmacotherapy of juvenile idiopathic arthritis.

Introduction: Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in childhood. More therapeutic options are available for the treatment of JIA with more children achieving minimal active disease or inactive disease status.

Areas Covered: This review summarizes the major novel treatment options for children with non-systemic JIA, including current evidence supporting the safety and efficacy of biologic treatments.

Can conventional brain MRI support the attribution process in neuropsychiatric SLE? A multicentre retrospective study.

Objectives: We aimed to investigate which elementary lesions, identified through conventional brain MRI, correlated with the attribution of neuropsychiatric (NP) manifestations of SLE as determined by clinical judgement (CJ) and a validated attribution algorithm (AA).

Methods: We conducted a multicentre, retrospective cohort study of patients with SLE (1999-2018) from four tertiary SLE centres. Patients were assessed using American College of Rheumatology nomenclature and underwent MRI at their first NP event.

Predicting anxiety and depression in systemic lupus erythematosus: the role of inflammation, sociodemographic variables and clinical factors.

Objectives: Characterizing the contribution of specific pro-inflammatory mediators (analytes) to depression and anxiety in systemic lupus erythematosus (SLE) is a crucial step in illuminating the mechanisms of these disabling symptoms. The aims of this study were to investigate i) the relationship between depression and anxiety symptoms with relevant clinical and sociodemographic variables and neuroinflammation-associated analytes in a cohort of SLE patients, and ii) the ability of models including these sociodemographic, clinical and biological variables to discriminate between SLE patients with and without clinically significant depression or anxiety.

Methods: This is a cross-sectional study of baseline data from participants enrolled in a longitudinal study of cognition in SLE (N = 238).

Idiopathic Inflammatory Myopathies: Recent Evidence Linking Pathogenesis and Clinical Features.

Idiopathic inflammatory myopathies are rare and complex representatives of systemic connective tissue diseases. Described initially as only two entities, recent advances in molecular and imaging techniques now divide them into many subtypes, each with unique pathogenesis and clinical phenotypes. Dermatomyositis and its juvenile form are the most prevalent subtypes and are characterized by systemic vasculopathy and humoral autoimmunity.

High-Resolution Vessel Wall Images and Neuropsychiatric Lupus: A Scoping Review.

: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder. Neuropsychiatric manifestations are frequently observed and are associated with increased morbidity and reduced quality of life. Magnetic resonance imaging (MRI) is the neuroimaging procedure of choice for investigation.

Scoping literature review to identify candidate domains for the OMERACT Systemic Lupus Erythematosus core outcome set.

Objective: To identify candidate Systemic Lupus Erythematosus (SLE) domains from the literature for consideration towards the development of the SLE Core Outcome Set.

Methods: This was a comprehensive scoping literature review of SLE clinical trials and systematic reviews published since 2010. Studies were identified from 5 databases and were screened for eligibility.

EULAR/ACR classification criteria for paediatric chronic nonbacterial osteomyelitis (CNO).

Objectives: To develop and validate classification criteria for paediatric chronic nonbacterial osteomyelitis (CNO) jointly supported by the European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR).

Methods: This international initiative had 4 phases: (1) candidate items were proposed in a survey of paediatric rheumatologists, (2) criteria definition and reduction by Delphi and nominal group technique exercises, (3) criteria weighting using multicriteria decision analysis, and (4) refinement of weights and threshold score in a development cohort of 441 patients and validation in another cohort of 514 patients.

Results: The new EULAR/ACR classification criteria for CNO require typical radiographic or magnetic resonance imaging findings and bone pain as an obligatory entry criterion and exclusion criteria of malignancy, infection, vitamin C deficiency, and hypophosphatasia, followed by additive weighted criteria in 5 clinical (site of bone lesions, pattern of bone lesions, age at onset, coexisting conditions, fever) and 4 pathology/laboratory domains (bone biopsy findings if done, anaemia, C-reactive protein level, and erythrocyte sedimentation rate).

Recommendations on neurologic, cognitive, and psychiatric manifestations in patients with Sjögren's disease by the Brazilian Society of Rheumatology.

Background: Neurological and psychiatric manifestations occur in patients with primary Sjogren's disease (SjD) with a wide-ranging clinical presentation, affecting quality of life, social participation, and prognosis. Despite this, neither central nor peripheral neurological symptoms are systematically evaluated in the context of autoimmunity or identified as manifestations of SjD. The EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI) covers only part of them in the neurological domain.

Expert consensus recommendations for the diagnosis and treatment of chronic non-bacterial osteitis (CNO) in adults.

Background: There is considerable practice variation in labelling, diagnosis and treatment of adults with sterile bone inflammation. We developed a expert consensus recommendations on the disease definition, diagnosis and treatment of this rare condition.

Methods: Systematic literature review and Grading of Recommendations, Assessment, Development and Evaluations-based appraisal of evidence, two Delphi surveys and three digital and in-person consensus meetings with a multidisciplinary expert panel and patient representatives.

The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study.

Importance: Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field.

Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally.

Evidence Review: A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework.

Neuropsychiatric manifestations in systemic lupus erythematosus and Sjogren's disease.

Introduction: Autoimmune diseases often present in a systemic manner, affecting various organs and tissues. Involvement of the central and peripheral nervous system is not uncommon in these conditions and is associated with high morbidity and mortality. Therefore, early recognition of the neuropsychiatric manifestations associated with rheumatologic diseases is essential for the introduction of appropriate therapies with the objective of providing a better quality of life for individuals.

New Insights on Childhood Lupus Nephritis.

Approximately one in five patients with systemic lupus erythematosus (SLE) has disease-onset during childhood (cSLE). Lupus nephritis is more common in cSLE than adult-onset SLE and is associated with significant and increased morbidity and mortality. In this article, we review lupus nephritis in cSLE, including pathogenesis, diagnosis, biomarkers, and management through PUBMED search between July and December 2024.

Communication skills in pediatrics: perception of medical students.

Background: Effective communication with patients and their families is a fundamental skill for medical students to cultivate during their undergraduate training. However, communicating with pediatric patients presents unique challenges. This study investigated the perceptions, attitudes, and confidence levels of undergraduate medical students regarding communication skills in pediatrics.