Editorial
Raynaud’s phenomenon: Sentinel event in rheumatology
Fenómeno de Raynaud: Evento centinela en reumatología
Read
238
Timeswas read the article
68
Total PDF
170
Total HTML
Share statistics
array:23 [ "pii" => "S2444440523000237" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2023.03.002" "estado" => "S300" "fechaPublicacion" => "2023-04-01" "aid" => "2037" "copyright" => "Asociación Colombiana de Reumatología" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Colomb Reumatol. 2023;30:79-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0121812322000858" "issn" => "01218123" "doi" => "10.1016/j.rcreu.2022.12.001" "estado" => "S300" "fechaPublicacion" => "2023-01-01" "aid" => "2027" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Colomb Reumatol. 2023;30:1-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "¿Cómo está la medicina traslacional sobre enfermedades autoinmunes en Colombia?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "3" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "How is translational medicine on autoimmune diseases in Colombia?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1597 "Ancho" => 1750 "Tamanyo" => 142303 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Retos operacionales en la investigación traslacional en el campo de la reumatología.</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Fuente: elaboración propia.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Lechuga-Ortiz, Gerardo Quintana-López" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "Lechuga-Ortiz" ] 1 => array:2 [ "nombre" => "Gerardo" "apellidos" => "Quintana-López" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2444440523000237" "doi" => "10.1016/j.rcreue.2023.03.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440523000237?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812322000858?idApp=UINPBA00004N" "url" => "/01218123/0000003000000001/v2_202303231305/S0121812322000858/v2_202303231305/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2444440523000420" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2021.07.004" "estado" => "S300" "fechaPublicacion" => "2023-04-01" "aid" => "1942" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Colomb Reumatol. 2023;30:81-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Investigation</span>" "titulo" => "Prevalence of inflammatory myopathies in Colombia: Demographic analysis from the National Health Registry 2012–2018" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "86" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de las miopatías inflamatorias en Colombia: análisis demográfico a partir del Registro Nacional de Salud de 2012 a 2018" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1595 "Ancho" => 3167 "Tamanyo" => 244722 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Geographic distribution of the prevalence of inflammatory myopathy for the period by departments by gender and age group adjusted to Colombian population. Prevalence is calculated with the average population of the period as denominator per 100,000 population. (A) Female. (B) Male.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Santiago Bernal-Macías, Daniel G. Fernández-Ávila, Diana N. Rincón-Riaño, Juan M. Gutiérrez, Diego Rosselli" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Santiago" "apellidos" => "Bernal-Macías" ] 1 => array:2 [ "nombre" => "Daniel G." "apellidos" => "Fernández-Ávila" ] 2 => array:2 [ "nombre" => "Diana N." "apellidos" => "Rincón-Riaño" ] 3 => array:2 [ "nombre" => "Juan M." "apellidos" => "Gutiérrez" ] 4 => array:2 [ "nombre" => "Diego" "apellidos" => "Rosselli" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440523000420?idApp=UINPBA00004N" "url" => "/24444405/0000003000000002/v1_202307240956/S2444440523000420/v1_202307240956/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Raynaud’s phenomenon: Sentinel event in rheumatology" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "79" "paginaFinal" => "80" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Carlos Jaime Velásquez-Franco" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Carlos Jaime" "apellidos" => "Velásquez-Franco" "email" => array:1 [ 0 => "carjaivel@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Rheumatology Service, Clínica Universitaria Bolivariana, Universidad Pontificia Bolivariana, Medellín, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Member of the European Microcirculation Group, EULAR" "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fenómeno de Raynaud: Evento centinela en reumatología" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Raynaud’s phenomenon is a common condition that affects between 3 and 5% of the general population. In 80% of the cases it is primary and, in general, patient education and non-pharmacological measures are sufficient for its control. In contrast, the remaining 20% is due to secondary causes such as systemic diseases, medications or structural alterations. Within the systemic conditions, autoimmune diseases, especially systemic sclerosis, are the most frequently associated entities; in this scenario, Raynaud’s phenomenon can lead to complications such as digital ulcers, necrosis, and ischemia, for which its identification is crucial to avoid them.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The first step for the identification of Raynaud’s phenomenon is a correct anamnesis, considering the clinical similarity with other acrovascular syndromes. The most practical tool is the application of the screening questions proposed by Maverakis et al. in an international consensus of experts, to subsequently assign a specific score.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A second step in this process would be to perform a videocapillaroscopy of the nail bed, a gold standard to differentiate between a primary and secondary Raynaud’s phenomenon. The capillaroscopy service of the <span class="elsevierStyleItalic">Clínica Universitaria Bolivariana</span>, located in Medellín (Colombia), has performed more than 2200 videocapillaroscopies since the year 2015. Four basic capillary aspects are evaluated in this procedure: density per millimeter, dimension, alterations in morphology and presence of microhemorrhages. A single megacapillary (capillary with an apical diameter greater than or equal to 50 μm), in a clinical context suspicious of systemic sclerosis, confirms on many occasions this diagnosis, and this finding substantially helps its early detection.</p><p id="par0020" class="elsevierStylePara elsevierViewall">If a primary Raynaud’s phenomenon is confirmed with a normal capillaroscopy, the need for multiple unnecessary diagnostic aids that increase costs and create distress for both clinicians and patients can be obviated.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Other “indications” for this procedure would be the high titles of antibodies, especially patterns related to systemic sclerosis (nucleolar, centromere, AC-3, 8, 9, 29) and the follow-up of subjects with undifferentiated connective tissue disease who have Raynaud’s phenomenon.</p><p id="par0030" class="elsevierStylePara elsevierViewall">When videocapillaroscopy of the nail bed is compared with other imaging tools (ophthalmoscope, dermatoscope, USB devices, stereomicroscope), which are less expensive and require only basic training, there is a good correlation with the key findings that make us suspect, especially, systemic sclerosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Taking into account that videocapillaroscopy offers fundamentally structural information, work has been done on techniques that allow a complementary functional evaluation, and in this context thermography has emerged as a method that illustrates the dynamics of the vascular response, because it makes evident the absence of recovery of normal temperature in patients with secondary Raynaud’s phenomenon. Initially, thermography devices were only found in research centers, but they have subsequently become more widespread thanks to the mobile devices, which has generated greater affordability and use.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In this issue of the Colombian Journal of Rheumatology (<span class="elsevierStyleItalic">Revista Colombiana de Reumatología</span>), Chaparro et al. carried out a rigorous, complete and updated systematic review of the literature on capillaroscopy and thermography for the detection of vascular changes in Raynaud’s phenomenon. The main conclusion of this interesting work is that it is not possible to compare the results of both techniques. Likewise, the authors highlight the role of thermography in differentiating healthy patients from individuals with Raynaud’s phenomenon and they consider that this technique could offer an advantage in the evaluation of pediatric patients, avoiding the technical difficulties of performing videocapillaroscopy in this population group, in addition to the high frequency of artifacts that prevent its performance in children.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Current evidence suggests that both techniques (capillaroscopy and thermography) are synergistic in both the structural and functional evaluation of Raynaud’s phenomenon and that thermography could become an outcome measure in the characterization of primary and secondary Raynaud’s phenomenon, as well as in the measurement of the efficacy of different pharmacological measures.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The future research agenda on this subject should include the definition of homogeneous thermographic functional patterns, in addition to studying the correlation of the different instruments used to perform this functional technique, which could show a propitious panorama to position thermography as the technique of choice in the functional evaluation of Raynaud’s phenomenon, which, without a doubt, is a sentinel event in rheumatology.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Part I: epidemiology, pathophysiology, and clinical considerations of primary and secondary Raynaud’s phenomenon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Curtiss" 1 => "K. Svigos" 2 => "Z. Schwager" 3 => "K. Lo Sicco" 4 => "A.G. Franks Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2022.06.1199" "Revista" => array:2 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2022" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International consensus criteria for the diagnosis of Raynaud’s phenomenon" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Maverakis" 1 => "F. Patel" 2 => "D.G. Kronenberg" 3 => "L. Chung" 4 => "D. Fiorentino" 5 => "Y. Allanore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaut.2014.01.020" "Revista" => array:5 [ "tituloSerie" => "J Autoimmun" "fecha" => "2014" "volumen" => "48–49" "paginaInicial" => "60" "paginaFinal" => "65" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Capilaroscopia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Mesa" 1 => "C.J. Velásquez-Franco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "editores" => "L.M.Gómez-Vargas, A.Ávila-Álvarez" "titulo" => "La uña: de lo superficial a lo profundo" "paginaInicial" => "523" "paginaFinal" => "544" "serieFecha" => "2019" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of capillaroscopy and thermography in the assessment and management of Raynaud’s phenomenon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.L. Herrick" 1 => "A. Murray" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.autrev.2017.11.036" "Revista" => array:6 [ "tituloSerie" => "Autoimmun Rev" "fecha" => "2018" "volumen" => "17" "paginaInicial" => "465" "paginaFinal" => "472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29526628" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24444405/0000003000000002/v1_202307240956/S2444440523000237/v1_202307240956/en/main.assets" "Apartado" => array:4 [ "identificador" => "53600" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/24444405/0000003000000002/v1_202307240956/S2444440523000237/v1_202307240956/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440523000237?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 1 | 6 |
| 2024 October | 6 | 3 | 9 |
| 2024 September | 13 | 4 | 17 |
| 2024 August | 20 | 5 | 25 |
| 2024 July | 21 | 13 | 34 |
| 2024 June | 12 | 4 | 16 |
| 2024 May | 7 | 2 | 9 |
| 2024 April | 13 | 4 | 17 |
| 2024 March | 12 | 6 | 18 |
| 2024 February | 6 | 7 | 13 |
| 2024 January | 14 | 3 | 17 |
| 2023 December | 3 | 1 | 4 |
| 2023 July | 2 | 1 | 3 |
| 2023 June | 4 | 5 | 9 |
| 2023 May | 21 | 8 | 29 |
| 2023 April | 11 | 1 | 12 |
Show all
