Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to...Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patientassessed) and proportions of treatment cost to household income.Methods:This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients’ treatment satisfaction.Results:When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 13.183, P = 0.004). For biological diseasemodifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups ( F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 8.794, P = 0.032). Conclusion:Higher disease severity and higher financial burden were associated with lower patient satisfaction.展开更多
A physician in clinical practice does not usually order autoantibody testing to aid subsequent diagnosis or for monitoring disease activity in patients with psoriasis or psoriatic arthritis(PsA),although a variety of ...A physician in clinical practice does not usually order autoantibody testing to aid subsequent diagnosis or for monitoring disease activity in patients with psoriasis or psoriatic arthritis(PsA),although a variety of autoantibodies are present in these patients.Our understanding of autoantibodies in psoriasis and PsA is limited.Early investigations of autoantibodies in psoriasis were focused on the known autoantibodies in rheumatic diseases.For instance,anti-nuclear antibodies(ANAs)are often found in patients with psoriasis or PsA,but anti-double-stranded DNA or anti-extractable nuclear antigens are rarely identified.Therefore,ANAs have not been considered valuable in diagnosing PsA or predicting prognosis to manage PsA.Moreover,the roles of ANAs in the pathogenesis of PsA remain unknown.[1,2]Autoantibodies associated with rheumatoid arthritis(RA)have been investigated in PsA for their presence and association with the disease.For instance,antibodies against citrullinated proteins(ACPAs),which are highly specific to RA,are found in 5.0%to 17.5%of PsA patients.In several studies,a more erosive disease has been observed in PsA patients with ACPAs than in ACPA-negative PsA patients.[3,4]These findings imply that ACPAs in patients with PsA may be capable of inducing bone loss,which has been observed in RA patients with antibodies against citrullinated vimentin.展开更多
Objective To report a case of benign mature cystic teratoma of fallopian tube along with endometrial ovarian cyst, occasionally found during the operation. Methods A 30-year-old patient complained of mild dysmenorrhea...Objective To report a case of benign mature cystic teratoma of fallopian tube along with endometrial ovarian cyst, occasionally found during the operation. Methods A 30-year-old patient complained of mild dysmenorrhea and gradual enlargement of bilateral adnexal cysts in the past one year. At the age of 27 she had undergone a laparoscopic right ovarian endometrial cyst ablation. Before the second operation, pelvic ultrasound revealed recurrence of bilateral cysts in the adnexal regions, as well as serum concentrations of CA19-9 and CA125 above normal limits. Laparotomy revealed a 7 cm cystic mass of the right ovary, tightly adhesive to the lateral pelvic; a 10 cm-large mass on the left adnexal region embedded among intestines. The left adnexal mass appeared to be attached to the fimbriated end of the left fallopian tube with the ipsi-lateral ovary. However the left fallopian tube was obscure because of severe synechia. After separating the adhesion, we found the left hydrosalpinx. Results During laparotomy, both the cyst on the right ovary and the left fallopian tube were removed. Grossly, it revealed enlargement of the left fallopian tube in diameter 1.3 cm, with 2 neoplasms, in diameter 0.6 cm and off-white and smooth appearance. This mass was considered to be a mature solid teratoma arising in the left fallopian tube. At the same time it indicated left hydrosalpinx. Conclusion Although mature cystic teratomas are derived from ovarian germ cells （in proportion of 16%-20%）, mature teratoma of the fallopian tube is very rare. Once diagnosis, the operation will be recommended. This case was revealed during the laparotomy accidentally. The prognosis was good.展开更多
Objective To report a case of ovarian hemorrhage after transvaginal ultrasoundguided oocyte retrieval combined with severe ovarian hyperstimulation syndrome （OHSS）. Methods A 26-year-old woman who was on therapy for...Objective To report a case of ovarian hemorrhage after transvaginal ultrasoundguided oocyte retrieval combined with severe ovarian hyperstimulation syndrome （OHSS）. Methods A 26-year-old woman who was on therapy for infertility presented with abdominal distension and a decrease of urine after transvaginal ultrasound-guided oocyte retrieval for in vitro fertilization-embryo transfer （IVF-ET）. Initial clinical presentation, ultrasound, and lab results were consistent with the diagnosis of severe OHSS. However with 4 d conservative treatments there seemed no recovery and the patient became more serious for her hemoglobin fell from 169.0 g/L to 60.2 g/L along with more abdominal fluid and a decrease of urine. Ultrasound guided paracentesis revealed an ovarian hemorrhage, and the patient underwent emergent surgery. Results The patient underwent emergent laparotomy for oophoroplasty and preservation of ovary. She got twin pregnancy in the second frozen-thawed embryo transfer （FET） cycle and delivered two female babies. Conclusion It is important to distinguish the OHSS from ovarian hemorrhage, because the ovarian hemorrhage with hemoperitoneum requires immediate operative management, whereas OHSS is nearly always managed conservatively. Clinicians must be aware that ovarian hemorrhage may be delayed in women presenting OHSS.展开更多
基金This work was supported by grants from the Chinese National Key Research R&D Program(Nos.2017YFC0907601,2017YFC0907604)。
文摘Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patientassessed) and proportions of treatment cost to household income.Methods:This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients’ treatment satisfaction.Results:When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 13.183, P = 0.004). For biological diseasemodifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups ( F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 8.794, P = 0.032). Conclusion:Higher disease severity and higher financial burden were associated with lower patient satisfaction.
文摘A physician in clinical practice does not usually order autoantibody testing to aid subsequent diagnosis or for monitoring disease activity in patients with psoriasis or psoriatic arthritis(PsA),although a variety of autoantibodies are present in these patients.Our understanding of autoantibodies in psoriasis and PsA is limited.Early investigations of autoantibodies in psoriasis were focused on the known autoantibodies in rheumatic diseases.For instance,anti-nuclear antibodies(ANAs)are often found in patients with psoriasis or PsA,but anti-double-stranded DNA or anti-extractable nuclear antigens are rarely identified.Therefore,ANAs have not been considered valuable in diagnosing PsA or predicting prognosis to manage PsA.Moreover,the roles of ANAs in the pathogenesis of PsA remain unknown.[1,2]Autoantibodies associated with rheumatoid arthritis(RA)have been investigated in PsA for their presence and association with the disease.For instance,antibodies against citrullinated proteins(ACPAs),which are highly specific to RA,are found in 5.0%to 17.5%of PsA patients.In several studies,a more erosive disease has been observed in PsA patients with ACPAs than in ACPA-negative PsA patients.[3,4]These findings imply that ACPAs in patients with PsA may be capable of inducing bone loss,which has been observed in RA patients with antibodies against citrullinated vimentin.
文摘Objective To report a case of benign mature cystic teratoma of fallopian tube along with endometrial ovarian cyst, occasionally found during the operation. Methods A 30-year-old patient complained of mild dysmenorrhea and gradual enlargement of bilateral adnexal cysts in the past one year. At the age of 27 she had undergone a laparoscopic right ovarian endometrial cyst ablation. Before the second operation, pelvic ultrasound revealed recurrence of bilateral cysts in the adnexal regions, as well as serum concentrations of CA19-9 and CA125 above normal limits. Laparotomy revealed a 7 cm cystic mass of the right ovary, tightly adhesive to the lateral pelvic; a 10 cm-large mass on the left adnexal region embedded among intestines. The left adnexal mass appeared to be attached to the fimbriated end of the left fallopian tube with the ipsi-lateral ovary. However the left fallopian tube was obscure because of severe synechia. After separating the adhesion, we found the left hydrosalpinx. Results During laparotomy, both the cyst on the right ovary and the left fallopian tube were removed. Grossly, it revealed enlargement of the left fallopian tube in diameter 1.3 cm, with 2 neoplasms, in diameter 0.6 cm and off-white and smooth appearance. This mass was considered to be a mature solid teratoma arising in the left fallopian tube. At the same time it indicated left hydrosalpinx. Conclusion Although mature cystic teratomas are derived from ovarian germ cells （in proportion of 16%-20%）, mature teratoma of the fallopian tube is very rare. Once diagnosis, the operation will be recommended. This case was revealed during the laparotomy accidentally. The prognosis was good.
文摘Objective To report a case of ovarian hemorrhage after transvaginal ultrasoundguided oocyte retrieval combined with severe ovarian hyperstimulation syndrome （OHSS）. Methods A 26-year-old woman who was on therapy for infertility presented with abdominal distension and a decrease of urine after transvaginal ultrasound-guided oocyte retrieval for in vitro fertilization-embryo transfer （IVF-ET）. Initial clinical presentation, ultrasound, and lab results were consistent with the diagnosis of severe OHSS. However with 4 d conservative treatments there seemed no recovery and the patient became more serious for her hemoglobin fell from 169.0 g/L to 60.2 g/L along with more abdominal fluid and a decrease of urine. Ultrasound guided paracentesis revealed an ovarian hemorrhage, and the patient underwent emergent surgery. Results The patient underwent emergent laparotomy for oophoroplasty and preservation of ovary. She got twin pregnancy in the second frozen-thawed embryo transfer （FET） cycle and delivered two female babies. Conclusion It is important to distinguish the OHSS from ovarian hemorrhage, because the ovarian hemorrhage with hemoperitoneum requires immediate operative management, whereas OHSS is nearly always managed conservatively. Clinicians must be aware that ovarian hemorrhage may be delayed in women presenting OHSS.
