Rheumatoid arthritis (RA) is among the most prevalent and debilitating autoimmune inflammatory chronic diseases. Although it is primarily characterized by destructive peripheral arthritis, it is a systemic disease, and RA-related extraarticular manifestations (EAMs) can affect almost every organ, exhibit a multitude of clinical presentations, and can even be asymptomatic. Importantly, EAMs largely contribute to the quality of life and mortality of RA patients, particularly substantially increased risk of cardiovascular disease (CVD) which is the leading cause of death in RA patients. In spite of known risk factors related to EAM development, a more in-depth understanding of its pathophysiology is lacking. Improved knowledge of EAMs and their comparison to the pathogenesis of arthritis in RA could lead to a better understanding of RA inflammation overall and its initial phases. Taking into account that RA is a disorder that has many faces and that each person experiences it and responds to treatments differently, gaining a better understanding of the connections between the joint and extra-joint manifestations could help to create new treatments and improve the overall approach to the patient.

The diaphragm is the most important muscle in respiration. Nevertheless, its function is rarely evaluated. Patients with systemic sclerosis (SSc) could be at risk of diaphragmatic dysfunction because of multiple factors. These patients often develop interstitial lung disease (SSc-ILD) and earlier studies have indicated that patients with different ILDs have decreased diaphragmatic mobility on ultrasound (US). This study aimed to evaluate diaphragmatic function in SSc patients using US with regard to the ILD, evaluated with the Warrick score on high-resolution computed tomography (HRCT), and to investigate associations between ultrasonic parameters and dyspnea, lung function, and other important clinical parameters. In this cross-sectional study, we analyzed diaphragm mobility, thickness, lung function, HRCT findings, Modified Medical Research Council (mMRC) dyspnea scale, modified Rodnan skin score (mRSS), autoantibodies, and esophageal diameters on HRCT in patients with SSc. Fifty patients were enrolled in the study. Patients with SSc-ILD had lower diaphragmatic mobility in deep breathing than patients without ILD. The results demonstrated negative correlations between diaphragmatic mobility and mMRC, mRSS, anti-Scl-70 antibodies, esophageal diameters on HRCT, and a positive correlation with lung function. Patients with SSc who experience dyspnea should be evaluated for diaphragmatic dysfunction for accurate symptom phenotyping and personalized pulmonary rehabilitation treatment.

. Background: Some of the hospitalized patients after severe COVID-19 pneumonia experience persistent radiological pulmonary sequelae, respiratory symptoms, and decreased lung function despite optimal treatment according to the guidelines. Because of immune dysregulation in COVID-19 there are indications that prolonged corticosteroids could be considered in treating patients for persistent radiological sequelae and respiratory symptoms. Objectives: to investigate lung function and lung sequelae on high-resolution CT (HRCT) in COVID-19 patients who were treated with glucocorticoid therapy in two dose regimens with a control group of patients who did not receive additional glucocorticoid therapy. Methods: In this prospective cohort research patients discharged from the hospital after being hospitalized because of severe COVID-19 pneumonia received corticosteroid therapy in two dose regimens: for 14 days and for 3 months. The control group of patients did not receive additional corticosteroid therapy. Lung function, post-COVID-19 symptoms, and lung abnormalities on HRCT scans were analyzed in three months follow-up. Results: Patients who received prolonged corticosteroid therapy for three months did not have better HRCT findings of lung abnormalities, lung function, or symptoms recovery in comparison to the patients with 14 days of therapy and the control group of patients. Onwards, the control group had significantly fewer dyspnea symptoms (Chi-square test, p=0,04) and higher DLCO (Kruskal Wallis test, p=0,03). Conclusions: Supplementary corticosteroid therapy for patients after severe COVID-19 pneumonia with lung abnormalities did not improve lung function, symptoms or lung lesions on CT.

In patients with neurological symptoms when other neurological causes are excluded, a differential diagnosis of neurosarcoidosis should be considered taking into account the clinical picture, radiological and laboratory findings.https://bit.ly/3oMSBap

Background: Some patients after severe COVID-19 pneumonia (B.1.1.7 variant SARS-CoV-2) experienced prolongled oxygen desaturation. According to some studies corticosteroids could be considered for treatment of persistent radiological sequelae and respiratory symptoms. Aims and objectives: to investigate lung function, symptoms, and lung sequelae on CT in patients treated with corticosteroid therapy in two dose regimens with control group of patients without additional corticosteroid therapy. Methods: Study included 93 patients who were hospitalized for severe pneumonia with prolonged respiratory insufficiency (for 20 days from the symptoms onset). Group I (N 30) received prednisone 40 mg with dose tapering for 14 days after discharge from the hospital, group II (N 40) received prednisone 40 mg for 3 months with dose tapering, and control group consisted of 19 patients who did not receive additional therapy. Lung function (FVC, FEV1, DLCO, KCO, TLC), symptoms, and lung abnormalities were scored in three months follow-up. Consolidations, crazy paving, ground glass opacities, and residual fibrotic-like abnormalities were evaluated on CT. Results: Patients who received corticosteroid therapy for three months did not have better CT findings, lung function, or dyspnea symptoms in comparison to the patients treated with 14 days of therapy or with control group of patients. Onwards, control group had significantly fewer dyspnea symptoms (Chi-square test, p=0,04) and higher DLCO (Kruskal Wallis test, p=0,03). Conclusions: Prolonged corticosteroid therapy did not have positive impact on lung function, dyspnea symptoms or lung sequelae on CT.