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Lupus Guidelines

Kimberly R Middleton, Steffany Haaz Moonaz, Sarfaraz A Hasni, Miriam Magaña López, Gladys Tataw-Ayuketah, Nicole Farmer, Gwenyth R Wallen
Systemic lupus erythematosus (SLE) is an autoimmune disease associated with widespread inflammation and tissue damage. It is more common and severe among Blacks, Hispanics, and Asians; with higher incidence in women. While the goals of medical treatment are to prevent flares and reduce organ damage, up to 50% of patients perceive their health to be suboptimal with unaddressed needs including fatigue and pain. Recent SLE treatment guidelines focus on improving quality of life. Yoga has shown improvements in quality-of-life and fatigue in various diagnoses...
December 2018: Complementary Therapies in Medicine
Linda Carmine
Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have developed, published, and updated evidence-based guidelines to support medical providers in the provision of contraceptives to patients with specific medical conditions or characteristics. The goal of these guidelines is to provide recommendations on the safe use of contraceptives with the goal of removing unnecessary medical barriers to access and use of contraceptives, thus decreasing the number of unintended pregnancies...
November 19, 2018: Current Problems in Pediatric and Adolescent Health Care
Annaliese Tisseverasinghe, Christine Peschken, Carol Hitchon
PURPOSE OF REVIEW: Optimal management of anxiety and mood disorders in patients with systemic lupus erythematosus (SLE) is limited by an incomplete understanding of their pathophysiology and a lack of treatment guidelines. This review aims to critically synthesize recent literature on these conditions in adults with SLE, focusing on their etiology, assessment, and management. RECENT FINDINGS: Along with psychosocial factors, there is growing evidence for a bidirectional interaction between inflammatory pathways and SLE-associated anxiety and mood disorders...
November 12, 2018: Current Rheumatology Reports
Chaigne Benjamin, Scirè Carlo Alberto, Talarico Rosaria, Alexander Tobias, Amoura Zahir, Avcin Tadej, Beretta Lorenzo, Doria Andrea, Guffroy Aurelien, Guimarães Vera, Hachulla Éric, Krieg Thomas, Launay David, Lepri Gemma, Moinzadeh Pia, Müller-Ladner Ulf, Rednic Simona, Rodrigues Ana, Tas Sander W, van Vollenhoven R F, Vieira Ana, Bombardieri Stefano, Fonseca João Eurico, Galetti Ilaria, Schneider Matthias, Smith Vanessa, Cutolo Maurizio, Mosca Marta, Fischer-Betz Rebecca
Mixed connective tissue disease (MCTD) is a complex overlap disease with features of different autoimmune connective tissue diseases (CTDs) namely systemic sclerosis, poly/dermatomyositis and systemic lupus erythematous in patients with antibodies targeting the U1 small nuclear ribonucleoprotein particle. In this narrative review, we summarise the results of a systematic literature research which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines (CPGs) or recommendations...
2018: RMD Open
April Jorge, Cindy Ung, Lucy H Young, Ronald B Melles, Hyon K Choi
Despite advances in therapy for rheumatic diseases, hydroxychloroquine remains almost universally recommended for the treatment of systemic lupus erythematosus (SLE), and is often used in the management of other rheumatic diseases such as rheumatoid arthritis (RA). However, the major dose-limiting toxicity of hydroxychloroquine is retinopathy that can lead to loss of vision. New highly sensitive screening methods can identify early stages of retinopathy, and studies that include these modalities have indicated a substantially higher prevalence of hydroxychloroquine retinopathy than was previously recognized, resulting in revisions to ophthalmology guidelines and the recommendation of a low dose of hydroxychloroquine for many patients...
November 6, 2018: Nature Reviews. Rheumatology
Oya Koker, Amra Adrovic, Sezgin Sahin, Mehmet Yildiz, Kenan Barut, Rukiye Eker Omeroglu, Ozgur Kasapcopur
The objective is to evaluate the walking distance and oxygen desaturation during the six-minute walk test and to establish correlations between the test results and other clinical findings so to assess the reliability of the test for evaluation of children with juvenile systemic sclerosis (jSSc). A total of 25 jSSc, 27 juvenile systemic lupus erythematosus (jSLE), and 30 healthy controls were included. The test is conducted according to the guidelines recommended by the American Thoracic Society, standardized in 2002...
October 26, 2018: Rheumatology International
M Cañadas-Garre, K Anderson, J McGoldrick, A P Maxwell, A J McKnight
BACKGROUND: Chronic kidney disease (CKD) is recognised as a global public health problem, more prevalent in older persons and associated with multiple co-morbidities. Diabetes mellitus and hypertension are common aetiologies for CKD, but IgA glomerulonephritis, membranous glomerulonephritis, lupus nephritis and autosomal dominant polycystic kidney disease are also common causes of CKD. MAIN BODY: Conventional biomarkers for CKD involving the use of estimated glomerular filtration rate (eGFR) derived from four variables (serum creatinine, age, gender and ethnicity) are recommended by clinical guidelines for the evaluation, classification, and stratification of CKD...
October 25, 2018: Journal of Translational Medicine
Bernardo A Pons-Estel, Eloisa Bonfa, Enrique R Soriano, Mario Humberto Cardiel, Ariel Izcovich, Gloria Vázquez, Graciela S Alarcón
No abstract text is available yet for this article.
October 23, 2018: Annals of the Rheumatic Diseases
Christine A Pellegrini, Sara M Powell, Nicholas Mook, Katherine DeVivo, Linda Ehrlich-Jones
PURPOSE OF REVIEW: The purpose of this review paper is to provide an overview of the recent research using physical activity monitors in rheumatic populations including those with osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia. RECENT FINDINGS: Recent research demonstrates increased use of physical activity monitors in these populations, especially in those with osteoarthritis. Results from cross-sectional, longitudinal, and intervention studies highlight that physical activity levels are below recommended guidelines, yet evidence suggests benefits such as improving pain, fatigue, function, and overall well-being...
October 6, 2018: Current Rheumatology Reports
Sheng-Xiao Zhang, Xiao-Wen Ma, Yu-Feng Li, Na-Ling Lai, Ze-Hao Huang, Kai Fan, Cai-Hong Wang, Xiao-Feng Li
Background: Accumulating evidence indicates that a deficiency in or dysfunction of regulatory T cells (Tregs) is involved in the pathogenesis of systemic lupus erythematosus (SLE). As different markers have been used to identify Tregs, recent studies on the proportions of Tregs in SLE patients have generated controversial results. To clarify the status of Tregs in such patients, we determined the proportions of Tregs present during development of the disease, with special consideration of controversial cellular markers...
2018: Journal of Immunology Research
Morton Scheinberg
No abstract text is available yet for this article.
September 25, 2018: Annals of the Rheumatic Diseases
Nathalie Berghen, Jean-Baptiste Vulsteke, Rene Westhovens, Jan Lenaerts, Ellen De Langhe
OBJECTIVES: To review the therapeutic option of Rituximab, a chimeric anti-CD20 antibody, in systemic autoimmune rheumatic diseases (SARDs) such as systemic lupus erythematosus, systemic sclerosis, primary Sjögren syndrome and idiopathic inflammatory myopathy. METHODS: A non-systematic review was conducted. RESULTS: The specific role and indication of rituximab in SARDs has been the subject of multiple trials in recent years. Evidence supports the use of rituximab in moderate-to-severe refractory systemic lupus erythematosus, diffuse skin involvement in systemic sclerosis and systemic involvement in primary Sjögren syndrome...
September 26, 2018: Acta Clinica Belgica
Huimin Li, Qian Tong, Lirong Guo, Shui Yu, Yuewei Li, Qinqin Cao, Jinwei Li, Feng Li
BACKGROUND: The association between chronic inflammation and the accelerated development of atherosclerosis is well recognized. However, it remains controversial as to whether the risk of coronary artery disease (CAD) is elevated in patients with systemic lupus erythematosus (SLE). The objective of this meta-analysis was to obtain a better estimate of the risk of CAD in patients with SLE. METHODS: An English-restricted literature review was conducted according to PRISMA guidelines using key databases, surveying all articles published through October 31, 2017...
November 2018: American Journal of the Medical Sciences
Vinicius Domingues, Benjamin A Levinson, Nicole Bornkamp, Judith D Goldberg, Jill Buyon, H Michael Belmont
Objectives: The study aimed to determine if serum albumin at 12 months predicts long-term renal outcome at 48 months. Data from the NYU SAMPLE (Specimen and Matched Phenotype Linked Evaluation) Lupus Registry were used to compare the performance of albumin, anti-double-stranded DNA, C3/C4, proteinuria and haematuria. Methods: 82 patients with SLE with data at time of renal biopsy, at 12 months and at a second visit, and up to 48 months were included. The significance of each biomarker as a predictor of an adverse renal outcome (ARO), defined as doubling of serum creatinine, as creatinine >4 mg/dL if initial >2...
2018: Lupus Science & Medicine
Cyril Jacquot, Geoffrey D Wool, Scott C Kogan
INTRODUCTION: The dilute Russell viper venom time (dRVVT) detects lupus anticoagulant (LA). International Society for Thrombosis and Haemostasis (ISTH) guidelines specify positivity criteria, which differ from the assay manufacturer's criteria. METHODS: Two years of dRVVT testing at our institution were reviewed. For patients with prolonged dRVVT screening times, we evaluated dRVVT results by ISTH and manufacturer's criteria and correlated with the results of other antiphospholipid syndrome (APS) testing (LA-sensitive activated partial thromboplastin time and antiphospholipid antibodies) and with history of thromboembolism and other APS manifestations...
September 8, 2018: International Journal of Laboratory Hematology
Alexandra Ladouceur, Sasha Bernatsky, Rosalind Ramsey-Goldman, Ann E Clarke
INTRODUCTION: Numerous studies have clearly demonstrated that there is an altered cancer risk profile in patients with systemic lupus erythematous (SLE) versus the general population. This includes a higher risk of certain cancers (e.g. hematologic, lung) and a decreased risk of others (e.g. breast cancer). Several determinants could be behind this altered risk; these include immunosuppressant drugs, viral exposures, genetic factors, and other variables. Area covered: We review what is known regarding specific risk profiles and risk factors for some key cancers in SLE, including hematologic malignancies and lung cancers...
October 2018: Expert Review of Clinical Immunology
Stephanie O Keeling, Zainab Alabdurubalnabi, Antonio Avina-Zubieta, Susan Barr, Louise Bergeron, Sasha Bernatsky, Josiane Bourre-Tessier, Ann Clarke, Alexandra Baril-Dionne, Jan Dutz, Stephanie Ensworth, Aurore Fifi-Mah, Paul R Fortin, Dafna D Gladman, Derek Haaland, John G Hanly, Linda T Hiraki, Sara Hussein, Kimberly Legault, Deborah Levy, Lily Lim, Mark Matsos, Emily G McDonald, Jorge Medina-Rosas, Jordi Pardo Pardi, Christine Peschken, Christian Pineau, Janet Pope, Tamara Rader, Jen Reynolds, Earl Silverman, Konstantinos Tselios, Manon Suitner, Murray Urowitz, Zahi Touma, Evelyne Vinet, Nancy Santesso
OBJECTIVE: To develop recommendations for the assessment of people with systemic lupus erythematosus (SLE) in Canada. METHODS: Recommendations were developed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. The Canadian SLE Working Group (panel of Canadian rheumatologists and a patient representative from Canadian Arthritis Patient Alliance) was created. Questions for recommendation development were identified based on the results of a previous survey of SLE practice patterns of members of the Canadian Rheumatology Association...
October 2018: Journal of Rheumatology
Megan E B Clowse, Amanda M Eudy, Elizabeth Kiernan, Matthew R Williams, Bonnie Bermas, Eliza Chakravarty, Lisa R Sammaritano, Christina D Chambers, Jill Buyon
Objective: To survey an international sample of providers to determine their current practices for the prevention, screening, and treatment of congenital heart block (CHB) due to maternal Ro/SSA antibodies. Methods: A survey was designed by the organizing committee of the 9th International Conference of Reproduction, Pregnancy and Rheumatic Diseases. It was sent to attendants of the conference and authors of recent publications or abstracts at ACR 2012, 2013 or 2014 on rheumatic diseases and pregnancy...
July 1, 2018: Rheumatology
Myriam Jean Cadet, Lorna Tucker
Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus, an autoimmune disease that results in multiple organ injuries. LN is challenging to manage because it mimics the clinical presentations of other diseases. This article highlights recommendations for the management of lupus erythematosus to improve quality of life. In addition, it provides NPs with evidence-based guidelines for managing patients with LN for positive health outcomes.
September 2018: Nurse Practitioner
Megha Garg, Naaima Mufti, Tara N Palmore, Sarfaraz A Hasni
Patients with Systemic Lupus Erythematosus (SLE) pose a unique dilemma pertaining to immunization against common pathogens. SLE patients are usually not immunized with vaccines based on the fear of either precipitating infection in this immunosuppressed patient population (with live vaccines) or aggravating autoimmunity and hence lupus flares (with any vaccines). However, elevated vulnerability to infection makes patients with SLE precisely the population that needs protection from vaccine-preventable diseases...
October 2018: Autoimmunity Reviews
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