RESUMEN
The most common types of chronic inflammatory arthritis are rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. In order to assess the activity of these diseases and tailor therapy, several outcome measures have been developed. They include composite scores based on clinical findings, biochemical markers and patient questionnaires. This article discusses the most commonly used outcome measures and looks at their limitations in quantifying the complex clinical features of different types of inflammatory arthritis, focusing in particular on rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.
Asunto(s)
Artritis Psoriásica , Artritis Reumatoide , Manejo de la Enfermedad , Evaluación de Resultado en la Atención de Salud/métodos , Espondilitis Anquilosante , Artritis Psoriásica/fisiopatología , Artritis Psoriásica/terapia , Artritis Reumatoide/fisiopatología , Artritis Reumatoide/terapia , Humanos , Proyectos de Investigación , Índice de Severidad de la Enfermedad , Espondilitis Anquilosante/fisiopatología , Espondilitis Anquilosante/terapia , Evaluación de Síntomas/métodosAsunto(s)
Complicaciones del Embarazo/diagnóstico , Enfermedad de Still del Adulto/diagnóstico , Adulto , Antiinflamatorios/uso terapéutico , Femenino , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Inflamación/diagnóstico , Inflamación/tratamiento farmacológico , Inflamación/inmunología , Metilprednisolona/uso terapéutico , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Complicaciones del Embarazo/inmunología , Enfermedad de Still del Adulto/tratamiento farmacológico , Enfermedad de Still del Adulto/inmunologíaRESUMEN
Despite often knowing the aetiology of sepsis and its clinical course there has not been the anticipated advances in treatment strategies. Cytokines are influential mediators of immune/inflammatory reactions and in patients with sepsis high circulating levels are implicated in the onset and perpetuation of organ failure. Antagonising the activities of pro-inflammatory cytokines enhances survival in animal models of sepsis but, so far, such a therapeutic strategy has not improved patient outcome. This article addresses the questions of why encouraging laboratory findings have failed to be translated into successful treatments of critically ill patients and whether modifying cytokine activity still remains a promising avenue for therapeutic advance in severe sepsis. In pursuing this task we have selected reports that we believe provide an incisive, critical and balanced view of the topic.