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https://www.readbyqxmd.com/read/28414152/rituximab-for-immunologic-renal-disease-what-the-nephrologist-needs-to-know
#1
REVIEW
Andreas Kronbichler, Martin Windpessl, Herwig Pieringer, David R W Jayne
Rituximab (RTX), a chimeric, monoclonal anti-CD20 antibody, is increasingly used in immune-mediated renal diseases. While licensed in the induction treatment of ANCA-associated vasculitis, it represents one of the most commonly prescribed off-label drugs. Much of the information regarding its safety has been drawn from experience in hematology and rheumatology. Ample evidence illustrates the safety of RTX, however, rare but serious adverse events have emerged that include progressive multifocal leucoencephalopathy and hepatitis B reactivation...
April 13, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28345393/inhibitory-effects-of-3%C3%AE-hydroxy-lup-20-29-en-23-28-dioic-acid-on-lipopolysaccharide-induced-tnf-%C3%AE-il-1%C3%AE-and-the-high-mobility-group-box-1-release-in-macrophages
#2
Xiang-Qian Liu, Qin-Peng Zou, Jian-Jun Huang, Chang-Soo Yook, Wan-Kyunn Whang, Hyeong-Kyu Lee, Ok-Kyoung Kwon
We investigated the anti-inflammatory effects of 3α-hydroxy-lup-20(29)-en-23, 28-dioic acid (HLEDA)-a lupane-type triterpene isolated from leaves of Acanthopanax gracilistylus W. W.Smith (AGS), as well as the underlying molecular mechanisms in lipopolysaccharide (LPS)-induced RAW264.7 cells. Our results demonstrated that HLEDA concentration-dependently reduced the production of nitric oxide (NO), significantly suppressed LPS-induced expression of TNF-α and IL-1β at the mRNA and protein levels in RAW264...
March 27, 2017: Bioscience, Biotechnology, and Biochemistry
https://www.readbyqxmd.com/read/28260595/a-danish-nationwide-questionnaire-study-of-hepatitis-b-virus-screening-before-immunosuppressive-therapy
#3
Kristine Ifigenia Bunyoz, Henrik Krarup, Nina Weis
INTRODUCTION: Difficulty in identifying patients who are at risk for hepatitis B virus (HBV) reactivation makes it import-ant to screen for HBV before initiating immunosuppressive therapy. The aim of this study was to investigate screening procedures for HBV infection before initiation of immunosuppressive therapy and to explore HBV treatment strategies. METHODS: All Danish units of haematology, oncology, dermatology, rheumatology and gastroenterology using immunosuppressive agents were invited to fill out a questionnaire for The Danish Database for Hepatitis B and C...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28219691/hepatitis-b-reactivation-associated-with-immune-suppressive-and-biological-modifier-therapies-current-concepts-management-strategies-and-future-directions
#4
REVIEW
Rohit Loomba, T Jake Liang
Hepatitis B reactivation associated with immune-suppressive and biological therapies is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to hepatitis B virus (HBV) infection. The population at risk for HBV reactivation includes those who either currently are infected with HBV or have had past exposure to HBV. Because curative and eradicative therapy for HBV is not currently available, there is a large reservoir of individuals at risk for HBV reactivation in the general population...
February 20, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28211296/recommendations-for-the-medical-management-of-chronic-venous-disease-the-role-of-micronized-purified-flavanoid-fraction-mpff
#5
REVIEW
Ronald Bush, Anthony Comerota, Mark Meissner, Joseph D Raffetto, Steven R Hahn, Katherine Freeman
Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema...
April 2017: Phlebology
https://www.readbyqxmd.com/read/28152949/improving-screening-and-prophylaxis-of-hepatitis-b-in-immunosuppressed-patients
#6
Violeta Rabrenovich, David M Baer, Joanne E Schottinger
139 Background: Kaiser Permanente (KP) is an integrated health care delivery system that provides clinical services to over 10 million members in nine states and the District of Columbia. Since 2007, KP oncology community collaborates at the national level to systematically improve safety and quality of care. Our improvements are accelerated by rapid adoption of evidence based protocols, leveraging of EMR and integration of quality improvement methods into clinical operations. METHODS: KP created a team that included oncologists, hepatologists, rheumatologist, pharmacy, and quality improvement experts to evaluate safety of existing practice...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149645/new-insights-into-hcv-related-rheumatologic-disorders-a-review
#7
REVIEW
Patrice Cacoub, Cloé Comarmond
Hepatitis C virus (HCV) infected patients are known to be exposed to major liver complications i.e. cirrhosis and hepatocellular carcinoma. In addition, many extrahepatic manifestations including rheumatologic disorders have been reported in up to two-third of HCV infected patients. These manifestations include frank auto-immune and rheumatic diseases (such as arthralgia, myalgia, arthritis, sicca syndrome and vasculitis) which may dominate the course of infection. Until recently, the standard of care of HCV has been the use of interferon-alpha based regimens, which not only had limited effectiveness in HCV cure but were poorly tolerated...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28133957/efficacy-and-safety-of-vaccination-in-pediatric-patients-with-systemic-inflammatory-rheumatic-diseases-a-systematic-review-of-the-literature
#8
Sandra Sousa, Ana Catarina Duarte, Inês Cordeiro, Joana Ferreira, Maria João Gonçalves, Tiago Meirinhos, Teresa Martins Rocha, Vasco C Romão, Maria José Santos
INTRODUCTION: Children and adolescents with systemic rheumatic diseases have an increased risk of infections. Although some infections are vaccine-preventable, immunization among patients with juvenile rheumatic diseases is suboptimal, partly due to some doubts that still persist regarding its efficacy and safety in this patient population. OBJECTIVES: To review the available evidence regarding the immunological response and the safety of vaccination in children and adolescents with systemic inflammatory rheumatic diseases (SIRD)...
January 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/27990777/polyarteritis-nodosa-in-north-india-clinical-manifestations-and-outcomes
#9
Aman Sharma, Benzeeta Pinto, Aadhaar Dhooria, Manish Rathi, Manphool Singhal, Varun Dhir, Kusum Sharma, Mahesh Parkash, Manish Modi, Rajesh Vijayvergiya, Saroj K Sinha, Ritambhra Nada, Ranjana Walkar Minz, Surjit Singh
OBJECTIVE: There has been a significant decrease in the number of published reports of classical polyarteritis nodosa (PAN) in the post-Chapel Hill consensus conference (CHCC) nomenclature era with only two series published from Asia. We report a case series of PAN from north India. PATIENTS AND METHODS: A retrospective study of all patients diagnosed to have PAN according to American College of Rheumatology criteria/CHCC nomenclature. The details of clinical presentation, investigation findings, treatment details and outcomes were noted from the records...
December 19, 2016: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/27974925/new-pharmacological-strategies-in-rheumatic-diseases
#10
REVIEW
R E Schiotis, A D Buzoianu, D F Mureșanu, S Suciu
Targeting the pathogenic pathway of chronic inflammation represents an unmet challenge for controlling disease activity, preventing functional disability, and maintaining an adequate quality of life in patients with rheumatic diseases. Abatacept, a novel molecule that inhibits co-stimulation signal, induces an inhibitory effect on the T-cells. This will further interfere with the activity of several cell lines, leading to the normalization of the immune response. In the latest years, abatacept has been extensively investigated in studies of rheumatoid arthritis for which it was recently approved as a second line biologic treatment in Romania...
July 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27888342/putting-recommendations-into-practice-australian-rheumatologists-opinions-on-leflunomide-use-in-rheumatoid-arthritis
#11
Ashley M Hopkins, Michael D Wiese, Catherine E O'Doherty, Susanna M Proudman
Leflunomide is the most recently introduced conventional disease-modifying anti-rheumatic drugs in Australia. It has several unique methods for initiation, unique monitoring recommendations and a distinctive cessation protocol in the event of serious toxicity. The aim of this study was to evaluate initiation and monitoring practices of Australian rheumatologists using leflunomide. A survey was emailed twice, approximately 3 months apart to 332 rheumatologist members of the Australian Rheumatology Association...
November 25, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27847520/a-complicated-course-of-acute-viral-induced-pharyngitis-icteric-hepatitis-acalculous-cholecystitis-and-skin-rash
#12
Fereshte Sheybani, HamidReza Naderi, Seddigheh Sadat Erfani, Masoumeh Gharib
This case reveals the complexities and challenges in the diagnosis of acute Epstein-Barr virus (EBV) infection, indicating the potential relationship between EBV infection and severe icteric hepatitis, acalculous cholecystitis, and lymphocytic vasculitis. We suggest including EBV infectious mononucleosis in the list of differential diagnoses when any of these clinical syndromes (or a combination thereof) occurs without apparent cause, especially in the presence of lymphocytosis. To our knowledge, this is the first report to suggest the possible role of EBV in the pathogenesis of cutaneous lymphocytic vasculitis...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27842627/polyarteritis-nodosa-presenting-as-a-bladder-outlet-obstruction
#13
M Borkum, H Y Abdelrahman, R Roberts, A A Kalla, I G Okpechi
Polyarteritis nodosa (PAN) of the urinary tract is rare. An unusual case of systemic PAN involving the bladder neck is described. A 27-year-old man, with known diastolic hypertension diagnosed 2 years earlier, was admitted with chronic urinary obstruction complicated by hydronephrosis. He had symptoms of myalgia and weight loss, was afebrile but had an elevated erythrocyte sedimentation rate and acute-on-chronic renal impairment. All virological and serological tests including hepatitis B and anti-neutrophil cytoplasmic antibody were negative...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27761646/-viral-arthritis-and-vasculitis
#14
U Sixdorf, E Märker-Hermann
Viral arthritis and vasculitis are important differential diagnoses primarily in patients with acute polyarticular arthritis in association with fever and rash, in populations specially at risk and in returning travellers. Parvovirus B19 is the most frequent cause of viral arthritis in Europe, whereas rubella, hepatitis B and C viruses have become less common. Due to worldwide tourism arthritogenic alphaviruses, which are transmitted by mosquito vectors have come into the focus of tropical medicine and rheumatology...
November 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27721549/hepatic-and-hematological-adverse-effects-of-long-term-low-dose-methotrexate-therapy-in-rheumatoid-arthritis-an-observational-study
#15
Lily Dubey, Suparna Chatterjee, Alakendu Ghosh
OBJECTIVES: Methotrexate (MTX) is the most commonly used cost-effective disease-modifying antirheumatoid drug (DMARD). Its main dose-limiting adverse effects are hepatic and hematopoietic. This cross-sectional, observational study evaluated the prevalence of hepatic and hematological adverse effects with long-term low-dose MTX therapy. MATERIALS AND METHODS: Rheumatoid arthritis (RA) patients taking ≤15 mg/week MTX for at least 2 years were enrolled from the rheumatology outpatient department...
September 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/27709857/distribution-of-diseases-causing-liver-function-test-abnormality-in-children-and-natural-recovery-time-of-the-abnormal-liver-function
#16
Mirinae Jang, Min Su Oh, Se Cheol Oh, Ki Soo Kang
Although liver function test abnormality is frequently noted in children, there is no report about the distribution of the etiology and natural recovery time of the abnormal liver function. From March 2005 to February 2014, clinical information was retrospectively collected from 559 children who had abnormal liver function and were hospitalized or visited the outpatient clinic at the Jeju National University Hospital. The etiology of abnormal liver function was classified into groups and the natural recovery time of abnormal liver function was analyzed...
November 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27708965/viral-hepatitis-screening-guideline-before-biological-drug-use-in-rheumatic-patients
#17
REVIEW
Ömer Karadağ, Timuçin Kaşifoğlu, Birol Özer, Sabahattin Kaymakoğlu, Yeşim Kuş, Murat İnanç, Gökhan Keser, Sedat Kiraz
Biological drugs (tumor necrosis factor inhibitors, rituximab, tocilizumab, abatacept, and tofacitinib) are important treatment alternatives in rheumatology, particularly for resistant patients. However, they may cause hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation; for instance, HBV reactivation may occur in a patient who is an inactive hepatitis B surface antigen (HBsAg) carrier or who has resolved HBV infection. Therefore, the screening of patients before biological treatment and the application of a prophylactic treatment, particularly with respect to latent HBV infections, are recommended when necessary...
March 2016: European Journal of Rheumatology
https://www.readbyqxmd.com/read/27708953/current-antiviral-practice-and-course-of-hepatitis-b-virus-infection-in-inflammatory-arthritis-a-multicentric-observational-study-a-hbv-study
#18
Umut Kalyoncu, Hakan Emmungil, Ahmet Mesut Onat, Sedat Yılmaz, Timuçin Kaşifoglu, Servet Akar, Nevsun İnanç, Fatih Yıldız, Orhan Küçükşahin, Ömer Karadağ, Rıdvan Mercan, Cemal Bes, Veli Yazısız, Barış Yılmazer, Mustafa Özmen, Şükran Erten, Soner Şenel, Ayten Yazıcı, Koray Taşçılar, Melike Kalfa, Sedat Kiraz, Bünyamin Kısacık, Yavuz Pehlivan, Levent Kılıç, İsmail Şimşek, Ayşe Çefle, Nurullah Akkoç, Haner Direskeneli, Eren Erken, Murat Turgay, Mehmet Akif Öztürk, Mehmet Soy, Kenan Aksu, Ayhan Dinç, İhsan Ertenli
OBJECTIVE: The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis. MATERIAL AND METHODS: Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included...
December 2015: European Journal of Rheumatology
https://www.readbyqxmd.com/read/27708728/hepatitis-b-serology-in-patients-with-rheumatic-diseases
#19
Martin Feuchtenberger, Arne Schäfer, Axel Philipp Nigg, Michael Rupert Kraus
BACKGROUND: Only limited data are available on the prevalence of hepatitis B in patients with proven rheumatic diseases and thus the risk of reactivation under immunosuppressive therapy. OBJECTIVE: To analyse hepatitis B serology in patients with rheumatic diseases prior to therapy. METHOD: In total, 1,338 patient records were analysed for HBsAg, HBsAb and HBcAb in a cross-sectional, single-centre study between 2011 and 2015 at first presentation...
2016: Open Rheumatology Journal
https://www.readbyqxmd.com/read/27660934/safety-of-corticosteroid-treatment-in-rheumatologic-patients-with-markers-of-hepatitis-b-viral-infection-pilot-evaluation-study
#20
Yolanda Braun-Moscovici, Marius Braun, Tarek Saadi, Doron Markovits, Menahem A Nahir, Alexandra Balbir-Gurman
BACKGROUND: Immunosuppressive agents may induce hepatitis B flares. The minimal corticosteroid dose and duration of therapy leading to HBV reactivation is unknown. OBJECTIVE: To assess whether short-term corticosteroid therapy for rheumatologic diseases induces HBV reactivation. METHODS: The records of all HBsAg or HBcore antibodies positive, anti-HBs negative patients who were hospitalized in the rheumatology department during 2001-2014 and treated with corticosteroids were reviewed...
October 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
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