Pain and Its Assessment
Chronic or intermittent pain is a primary symptom of many pediatric rheumatic diseases, especially arthritis. Patients often report mild to moderate pain. About 25% to 30% report moderate to severe…
Pharmacology: Biologics
Biologics are different from nonbiologic disease-modifying antirheumatic drugs (DMARDs) in that they are produced by biologic processes rather than chemical syntheses and target specific, well-defined molecules expressed on cells or…
Managing Children with Rheumatic Diseases
Rheumatic diseases are chronic, multisystem disorders characterized by an unpredictable course with periods of exacerbation and remission. Optimal care requires the expertise of many disciplines ( Table 11-1 , Fig….
Assessment of Health Status, Function, and Quality of Life Outcomes
Pediatric rheumatic diseases influence many, if not all, aspects of a child’s life—not only physical, but also social, emotional, educational, and economic. The impact of pediatric rheumatic disease is not…
Trial Design, Measurement, and Analysis of Clinical Investigations
Evidence-Based Medicine and Clinical Investigation Today more than ever, clinicians are encouraged to practice evidence-based medicine (i.e., the conscientious, explicit, and judicious use of current best evidence in making decisions…
Inflammation and Its Mediators
The immune system, the function of which is to protect against infections, comprises two branches: a more primitive one called innate (natural, native) immunity and the more recently evolved one…
Structure and Function
Inflammation, the fundamental pathologic process in rheumatic diseases, may disrupt the anatomy and function of any structure or tissue. Those structures primarily affected in rheumatic diseases are the connective tissues,…
Integrative Genomics
When viewed from a clinical perspective, few of the common pediatric rheumatic diseases appear to be genetically determined. Family histories are rarely positive for diseases such as juvenile idiopathic arthritis…
Adaptive Immunity and Autoimmunity: Translation from Bench to Bedside
The Adaptive Immune Response Most childhood autoimmune diseases are complex, multifactorial diseases. Through interactions with a defined genetic susceptibility, other, mostly unknown, environmental factors play a role in the pathogenesis….
Pediatric Rheumatology: The Study of Rheumatic Diseases in Childhood and Adolescence
What are Rheumatic Diseases? Rheumatic diseases are a diverse group of chronic diseases united by the presence of chronic inflammation, usually of unknown cause, affecting structures of the musculoskeletal system,…
