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https://www.readbyqxmd.com/read/29665757/severe-brady-arrhythmias-in-systemic-lupus-erythematosus-prevalence-etiology-and-associated-factors
#1
K Tselios, D D Gladman, P Harvey, J Su, M B Urowitz
Background Severe brady-arrhythmias, requiring a permanent pacemaker (PPM), have been sparsely reported in systemic lupus erythematosus (SLE). The aim of this study was to describe the characteristics of such arrhythmias in a defined lupus cohort. Patients and methods The database of the Toronto Lupus Clinic ( n = 1366) was searched for patients who received a PPM. Demographic, clinical, immunological and therapeutic variables along with electrocardiographic (ECG) and echocardiographic findings (based on the last available test prior to PPM) were analyzed...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29652832/sympathetic-nerve-hyperactivity-in-the-spleen-causal-for-nonpathogenic-driven-chronic-immune-mediated-inflammatory-diseases-imids
#2
REVIEW
Denise L Bellinger, Dianne Lorton
Immune-Mediated Inflammatory Diseases (IMIDs) is a descriptive term coined for an eclectic group of diseases or conditions that share common inflammatory pathways, and for which there is no definitive etiology. IMIDs affect the elderly most severely, with many older individuals having two or more IMIDs. These diseases include, but are not limited to, type-1 diabetes, obesity, hypertension, chronic pulmonary disease, coronary heart disease, inflammatory bowel disease, and autoimmunity, such as rheumatoid arthritis (RA), Sjőgren's syndrome, systemic lupus erythematosus, psoriasis, psoriatic arthritis, and multiple sclerosis...
April 13, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29642752/lupus-myocarditis-a-single-center-experience-and-a-comparative-analysis-of-observational-cohort-studies
#3
J Tanwani, K Tselios, D D Gladman, J Su, M B Urowitz
Background Lupus myocarditis (LM) is reported in 3-9% of patients with systemic lupus erythematosus (SLE) but limited evidence exists regarding optimal treatment and prognosis. This study aims to describe LM in a defined lupus cohort as compared with the existing literature. Patients and methods Patients with LM were identified from the University of Toronto Lupus Clinic database. Diagnosis was based on clinical manifestations and electrocardiographic, imaging, and biochemical criteria. Demographic, clinical, diagnostic and therapeutic variables and outcomes were collected in a standardized data retrieval form...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29617782/epicardial-permanent-pacemaker-implantation-in-the-retrosternal-space-of-a-2-3-kg-infant
#4
Bongyeon Sohn, Jae Gun Kwak, Jae Hong Lim, Woong-Han Kim
Permanent pacemaker implantation in small infants can be challenging because of patient size and expected somatic growth. In our case, we used the retrosternal space as a generator pocket for an extremely low-birth-weight premature baby with autoantibody-associated congenital heart block born to a systemic lupus erythematosus mother.
March 29, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29610603/myasthenia-gravis-and-associated-diseases
#5
Nikolina Tanovska, Gabriela Novotni, Slobodanka Sazdova-Burneska, Igor Kuzmanovski, Bojan Boshkovski, Goran Kondov, Marija Jovanovski-Srceva, Anita Kokareva, Rozalinda Isjanovska
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease caused by the action of specific antibodies to the postsynaptic membrane of the neuromuscular junction, leading to impaired neuromuscular transmission. Patients with MG have an increased incidence of other autoimmune diseases. AIM: to determine the presence of other associated diseases in patients with MG. METHOD: A group of 127 patients with MG followed in 10 years period, in which the presence of other associated diseases has been analysed...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29609225/social-determinants-of-mortality-in-u-s-lupus-patients
#6
Nitasha Khullar, Johnson Ukken, Mary Froehlich, A Jeff Caseja, Takashi Yamashita, Xibei Liu, Ji Won Yoo
We read with interest the study by Yelin et al.1 that poverty results in higher mortality in lupus patients by increasing disease damage accumulation. We suggest some alternative mechanisms for the contribution of poverty to higher mortality. First, cardiovascular disease (CVD) is the leading cause of death in lupus patients, and lupus itself is an independent CVD risk factor.2 Risk of CVD-specific death has declined and is projected to continue declining due to better control of risk factors such as hypertension and diabetes...
April 2, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29600108/hydroxychloroquine-induced-cardiomyopathy-and-heart-failure-in-twins
#7
Hang Zhao, Joyce Wald, Michael Palmer, Yuchi Han
Hydroxychloroquine (HCQ)-induced cardiomyopathy is one of the rare but severe complications following prolonged HCQ use. However, the exact mechanism of HCQ cardiotoxicity remains unclear and it is difficult to identify risk factors. We present a case of twin sisters who both suffered from systemic lupus erythematosus (SLE) and HCQ-induced cardiomyopathy presenting with decompensated heart failure (HF), suggesting that genetic predisposition might be a factor in HCQ-induced cardiomyopathy.
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29571422/atherosclerotic-heart-disease-in-women-with-autoimmune-rheumatologic-inflammatory-conditions
#8
REVIEW
Reto D Kurmann, Rekha Mankad
Women have a higher prevalence of several inflammatory rheumatologic conditions. These include systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SSc) to name a few. These conditions are all associated with higher rates of cardiovascular (CV) morbidity and mortality, which is driven primarily by atherosclerotic heart disease. Traditional risk factors are important considerations in the assessment of CV risk in the rheumatologic patient; however, these factors do not appear to impart a similar weight of risk in women with inflammatory autoimmune rheumatologic conditions...
April 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29566672/characteristics-of-exercise-capacity-in-female-systemic-lupus-erythematosus-associated-pulmonary-arterial-hypertension-patients
#9
Bigyan Pudasaini, Guo-Ling Yang, Chen Yang, Jian Guo, Ping Yuan, Yang Wen-Lan, Rui Zhang, Lan Wang, Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Tian-Xiang Chen, Xiong Wei, Jin-Ming Liu
BACKGROUND: To study the oxygen uptake efficiency and determine usefulness of submaximal parameters of oxygen uptake in systemic lupus erythematosus associated pulmonary arterial hypertension (SLE PAH) on performing a cardiopulmonary exercise test (CPET). METHODS: CPET was performed in 21 SLE PAH patients, equal number of idiopathic pulmonary arterial hypertension (IPAH) patients and controls. Peak VO2 , anaerobic threshold (AT), oxygen uptake efficiency slope (OUES) and oxygen uptake efficiency plateau (OUEP) and other CPET parameters were examined...
March 23, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29557269/acute-diffuse-alveolar-haemorrhage-accompanied-by-gastrointestinal-bleeding-in-a-patient-with-serious-systemic-lupus-erythematosus-a-case-report
#10
Jing Du, Ying Wang, Yan-Chun Li, Tong-Tong Wang, Yong-Lie Zhou, Zhen-Hua Ying
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29549933/antiphospholipid-antibodies-and-heart-valve-disease-in-systemic-lupus-erythematosus
#11
Daniel Ruiz, Jim C Oates, Diane L Kamen
Evaluation of antiphospholipid antibodies (aPL) and correlation with heart valve abnormalities among patients with systemic lupus erythematosus (SLE). Nested case-control study was conducted with 70 patients with SLE selected from a longitudinal database based on levels of aPL and presence or absence of valve disease by echocardiogram. Valvular abnormalities observed were regurgitation (52), other (14), artificial valves (4), stenosis (2), thickening (2) and no Libman-Sacks endocarditis (0). The mitral valve was the most commonly affected (30 abnormalities), followed by the tricuspid (20 abnormalities)...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29531959/rationale-and-design-of-the-screening-of-pulmonary-hypertension-in-systemic-lupus-erythematosus-sophie-study
#12
Duo Huang, Yang-Yang Cheng, Pak-Hei Chan, Jojo Hai, Kai-Hang Yiu, Hung-Fat Tse, Ka-Lam Wong, Katherine Fan, Ying Wah Li, Woon-Leung Ng, Cheuk-Wan Yim, Cheuk-Hon John Wong, Lai-Shan Tam, Priscilla C H Wong, Chi-Yuen Wong, Chup-Hei Ho, Alexander M H Leung, Chi-Chiu Mok, Ho Lam, Chak-Sing Lau, Tommy Cheung, Carmen Ho, Sharon W Y Law, Esther W Chan, Li-Xue Yin, Wen-Sheng Yue, Toi Meng Mok, Mario Alberto Evora, Chung-Wah Siu
Current guideline-recommended screening for pulmonary hypertension in patients with systemic sclerosis has not been evaluated in systemic lupus erythematosus (SLE), which is disproportionately prevalent in Asians. This multicentre, cross-sectional screening study aims to study the prevalence of pulmonary hypertension among SLE patients using these guidelines, and identify independent predictors and develop a prediction model for pulmonary hypertension in SLE patients. SLE patients from participating centres will undergo an echocardiography- and biomarker-based pulmonary hypertension screening procedure as in the DETECT study...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29523280/can-thrombophilia-worsen-maternal-and-perinatal-outcomes-in-cases-of-severe-preeclampsia
#13
Fernanda Spadotto Baptista, Maria Rita de Figueiredo Lemos Bortolotto, Fabiola Roberta Marim Bianchini, Vera Lucia Jornada Krebs, Marcelo Zugaib, Rossana Pulcinelli Vieira Francisco
OBJECTIVE: To evaluate whether thrombophilia worsens maternal and foetal outcomes among patients with severe preeclampsia (PE). METHOD: From October 2009 to October 2014, an observational retrospective cohort study was performed on pregnant women with severe PE diagnosed before 34 weeks of gestation and their newborns hospitalized at the Clinics Hospital, FMUSP. Patients who had no heart disease, nephropathies, pre-gestational diabetes, gestational trophoblastic disease, foetal malformation, or twin pregnancy and who underwent thrombophilia screening during the postnatal period were included...
January 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29520672/features-associated-with-pulmonary-arterial-hypertension-in-chinese-hospitalized-systemic-lupus-erythematosus-patients
#14
Shu-Zhen Xu, Yan Liang, Xiang-Pei Li, Xiao-Mei Li, Zong-Wen Shuai, Rui-Xue Leng, Hai-Feng Pan, Dong-Qing Ye
Pulmonary arterial hypertension (PAH) is an increasingly recognized complication of systemic lupus erythematosus (SLE). This study aims to estimate the point prevalence of PAH and identify risk factors for PAH in a large cohort of hospitalized SLE patients. We have collected the medical records of patients hospitalized with SLE at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital. Resting transthoracic echocardiography (TTE) was used to estimate pulmonary artery pressure (PAP) and PAH was defined as systolic PAP (PASP) > 30 mmHg...
March 8, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29501815/human-gene-expression-microarray-analysis-of-the-hpv-6be7-hacat-stable-cell-line
#15
Boya Zhang, Xianzhen Chen, Qiang Zhou, Yinjing Song, Siyuan Sun, Hao Cheng
OBJECTIVE: Human papillomavirus (HPV) is the most common sexually transmitted agent in the world. HPV6b is a low-risk type of HPVs that causes benign verrucous hyperplastic lesions of the skin and anal genital mucosa. Previous research has indicated that HPV genotype 6 is sometimes associated with high-grade lesions and anal cancer. The pathogenesis of low-risk HPV infection and its relationship to high-risk HPV is not clear at present. The E7 protein, which is encoded by HPV early -expressing genes, plays an important role in HPV infection...
March 1, 2018: Gene
https://www.readbyqxmd.com/read/29491296/treatment-of-class-iv-lupus-nephritis-with-mycophenolate-mofetil-monotherapy-a-case-report
#16
Takashi Nawata, Makoto Kubo, Shohei Fujii, Kosaku Shiragami, Tadayoshi Ikegami, Shigeki Kobayashi, Satoshi Hisano, Masafumi Yano
Lupus nephritis (LN) occurs in up to 60% of systemic lupus erythematosus patients. Combination therapy involving a corticosteroid and cyclophosphamide or mycophenolate mofetil (MMF) has been a standard therapy for LN. However, clinicians generally prefer to minimize steroid use in LN treatment. We herein report the case of a Japanese man with LN whose severe chronic heart failure prevented us from using steroid therapy. Instead, his LN was successfully treated with MMF monotherapy. Based on our experience with this case, we suggest that MMF monotherapy may represent a feasible LN treatment option in patients who cannot tolerate steroid therapy...
February 28, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29468569/illness-identity-in-adults-with-a-chronic-illness
#17
Leen Oris, Koen Luyckx, Jessica Rassart, Liesbet Goubert, Eva Goossens, Silke Apers, Seher Arat, Joris Vandenberghe, René Westhovens, Philip Moons
The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one's identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22-78 year old; n = 276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17-81 year old; n = 241)...
February 21, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29452403/mechanisms-controlling-nucleic-acid-sensing-toll-like-receptors
#18
Kensuke Miyake, Takuma Shibata, Umeharu Ohto, Toshiyuki Shimizu, Shin-Ichiroh Saitoh, Ryutaro Fukui, Yusuke Murakami
Nucleic acid (NA)-sensing Toll-like receptors (TLRs) respond to DNA/RNA derived from pathogens and dead cells. Structural studies have revealed a variety of molecular mechanisms by which TLRs sense NAs. Double-stranded RNA and single-stranded DNA directly bind to TLR3 and TLR9, respectively, whereas TLR7 and 8 bind to nucleosides and oligoribonucleotides derived from RNAs. Activation of ligand-bound TLRs is influenced by the functional status of TLRs. Proteolytic cleavage of NA-sensing TLRs enables ligand-dependent TLR dimerization...
February 14, 2018: International Immunology
https://www.readbyqxmd.com/read/29434588/gata3-hdac6-and-bcl6-regulate-foxp3-treg-plasticity-and-determine-treg-conversion-into-either-novel-antigen-presenting-cell-like-treg-or-th1-treg
#19
Keman Xu, William Y Yang, Gayani Kanchana Nanayakkara, Ying Shao, Fan Yang, Wenhui Hu, Eric T Choi, Hong Wang, Xiaofeng Yang
We conducted an experimental database analysis to determine the expression of 61 CD4+ Th subset regulators in human and murine tissues, cells, and in T-regulatory cells (Treg) in physiological and pathological conditions. We made the following significant findings: (1) adipose tissues of diabetic patients with insulin resistance upregulated various Th effector subset regulators; (2) in skin biopsy from patients with psoriasis, and in blood cells from patients with lupus, effector Th subset regulators were more upregulated than downregulated; (3) in rosiglitazone induced failing hearts in ApoE-deficient (KO) mice, various Th subset regulators were upregulated rather than downregulated; (4) aortic endothelial cells activated by proatherogenic stimuli secrete several Th subset-promoting cytokines; (5) in Treg from follicular Th (Tfh)-transcription factor (TF) Bcl6 KO mice, various Th subset regulators were upregulated; whereas in Treg from Th2-TF GATA3 KO mice and HDAC6 KO mice, various Th subset regulators were downregulated, suggesting that Bcl6 inhibits, GATA3 and HDAC6 promote, Treg plasticity; and (6) GATA3 KO, and Bcl6 KO Treg upregulated MHC II molecules and T cell co-stimulation receptors, suggesting that GATA3 and BCL6 inhibit Treg from becoming novel APC-Treg...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29417312/lessons-learned-from-splenic-infarcts-with-fever-of-unknown-origin-fuo-culture-negative-endocarditis-cne-or-malignancy
#20
REVIEW
Burke A Cunha, Bertamaria Dieguez, Alena Varantsova
Culture negative endocarditis (CNE) is a common concern in patients with fever, heart murmur, cardiac vegetation, and negative blood cultures. The diagnosis of CNE is not based only on negative blood cultures and a cardiac vegetation. The clinical definition of CNE is based on negative blood cultures plus the findings of culture positive infective endocarditis (IE), e.g., fever, cardiac vegetation, splenomegaly, peripheral manifestations. Because embolic splenic infarcts may occur with culture positive IE, some may assume that splenic infarcts are a sign of CNE...
February 7, 2018: European Journal of Clinical Microbiology & Infectious Diseases
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