RESUMO
This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and applied in rheumatologic centers in Latin America (LA). A retrospective, multicenter 1-year experience study was undertaken. Eighteen centers from eight countries were involved. The following information were collected: demographic data, indication to perform an US examination, physician that required the examination, and the anatomical region required for the examination. A total of 7167 patients underwent an US examination. The request for US examinations came most frequently from their own institution (5981 (83.45 %)) than from external referral (1186 (16.55 %)). The services that more frequently requested an US examination were rheumatology 5154 (71.91 %), followed by orthopedic 1016 (14.18 %), and rehabilitation 375 (5.23 %). The most frequently scanned area was the shoulder in 1908 cases (26.62 %), followed by hand 1754 (24.47 %), knee 1518 (21.18 %), ankle 574 (8.01 %), and wrist 394 (5.50 %). Osteoarthritis was the most common disease assessed (2279 patients (31.8 %)), followed by rheumatoid arthritis (2125 patients (29.65 %)), psoriatic arthritis (869 patients (12.1 %)), painful shoulder syndrome (545 (7.6 %)), connective tissue disorders (systemic sclerosis 339 (4.7 %), polymyositis/dermatomyositis 107 (1.4 %), Sjögren's syndrome 60 (0.8 %), and systemic lupus erythematosus 57 (0.8 %)). US evaluation was more frequently requested for diagnostic purposes (3981 (55.5 %)) compared to follow-up studies (2649 (36.9 %)), research protocols (339 (4.73 %)), and invasive guided procedures (198 (2.76 %)). US registered increasing applications in rheumatology and highlighted its positive impact in daily clinical practice. US increases the accuracy of the musculoskeletal clinical examination, influence the diagnosis, and the disease management.
Assuntos
Doenças Reumáticas/diagnóstico por imagem , Reumatologia/métodos , Ultrassonografia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto JovemRESUMO
Important advances from both therapeutic and clinical assessment have recently been reported in psoriatic arthritis (PsA). Moreover, the constant challenge to provide a more comprehensive assessment of this heterogeneous disease results in a variety of clinical instruments that help the clinician for a global evaluation of both disease activity and responsiveness. The current European League Against Rheumatism (EULAR) recommendations on the use of imaging suggest the use of ultrasound (US) in chronic arthritis to increase the diagnostic accuracy and improvement of its management as compared to clinical examination alone. Although US findings are not firmly established in daily clinical practice, it demonstrated several positive aspects such as good sensitivity and specificity, acceptable reliability, and adequate sensitivity to change, especially in the peripheral PsA. Additionally, recent works introduced the role of US in the assessment of skin and nails opening interesting area of research. The aim of this paper is to describe the potential role of US in the assessment of PsA and to discuss the current evidence supporting its application in daily clinical practice.
Assuntos
Artrite Psoriásica/diagnóstico por imagem , Artrite Psoriásica/terapia , Articulações/diagnóstico por imagem , Unhas/diagnóstico por imagem , Pele/diagnóstico por imagem , Tendões/diagnóstico por imagem , Gerenciamento Clínico , Progressão da Doença , Humanos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , UltrassonografiaRESUMO
INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Student's T test, Mann-Whitney U Test, c' or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89%), for lab tests was $45.5 (7%), for medical attention $12.5 (2%) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost.
Assuntos
Artrite Reumatoide/economia , Custos Hospitalares/estatística & dados numéricos , Hospitais Universitários , Análise de Variância , Argentina , Artrite Reumatoide/terapia , Feminino , Seguimentos , Humanos , Masculino , Estatísticas não Paramétricas , Fatores de TempoRESUMO
INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Student's T test, Mann-Whitney U Test, c' or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89 per cent), for lab tests was $45.5 (7 per cent), for medical attention $12.5 (2 per cent) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost.
Assuntos
Humanos , Masculino , Feminino , Artrite Reumatoide , Custos Hospitalares/estatística & dados numéricos , Hospitais Universitários , Análise de Variância , Argentina , Artrite Reumatoide , Seguimentos , Fatores de TempoRESUMO
INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Students T test, Mann-Whitney U Test, c or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89
), for lab tests was $45.5 (7
), for medical attention $12.5 (2
) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost.
RESUMO
INTRODUCTION: There are no medical publications with economic analysis of rheumatoid arthritis patients (RA) from Argentina are lacking. The objective of the present study is to determine the direct cost and its breakdown in patients with RA. MATERIAL AND METHODS: Fifty-two patients who met the American College of Rheumatology RA criteria were included. Direct cost was calculated over a follow-up period of 6 months during year 2001. Variables were analyzed with Students T test, Mann-Whitney U Test, c or ANOVA as corresponded. P values < 0.05 were considered significant. RESULTS: The mean monthly home income was $426.6 SD 272. The mean half-yearly direct costs was $677.5 SD 376.2. The components of the direct cost were identified and the mean for medication cost was $606.7 (89 per cent), for lab tests was $45.5 (7 per cent), for medical attention $12.5 (2 per cent) and other costs $2.4. No differences in total cost or in medication cost were found when compared considering age, evolution time of RA or HAQ scores. CONCLUSION: Half-yearly direct cost in RA is excessively high considering the monthly mean income of the patients being analyzed. The cost of medication was the principal component of the direct cost. (AU)