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sle guidelines

Hong-Wei Fan, Zhi-Xiang Ma, Jing Chen, Xing-Ye Yang, Jun-Lin Cheng, Ying-Bin Li
INTRODUCTION: Hydroxychloroquine (HCQ), 4-aminoquinoline, is an antimalarial drug and has become a basic therapy for rheumatic disease treatment. It can stabilize the condition of SLE patients and reduce the chances of patient relapse through its immunosuppressive function and antiinflammatory effects. This drug was absorbed completely and rapidly by oral administration, but has a prolonged half-life for elimination. The objective of this study was to evaluate the pharmacokinetic parameters and relative bioequivalence of a new generic (test) formulation with the branded (reference) formulation of HCQ in healthy Chinese male volunteers...
December 2015: Rheumatol Ther
A M Eudy, A M Siega-Riz, S M Engel, N Franceschini, A G Howard, M E B Clowse, M Petri
OBJECTIVE: The objective of this study was to estimate the proportion of pregnant women with systemic lupus erythematosus meeting Institute of Medicine guidelines for gestational weight gain and determine correlates of adherence to guidelines. METHODS: Singleton, live births in the Hopkins Lupus Pregnancy Cohort 1987-2015 were included. Pre-pregnancy weight was the weight recorded 12 months prior to pregnancy/first trimester. Final weight was the last weight recorded in the third trimester...
October 4, 2016: Lupus
L Cherry, B Alcacer-Pitarch, N Hopkinson, L S Teh, E M Vital, C J Edwards, A Blake, A E Williams
OBJECTIVE: The main aim of this survey was to determine the frequency of self-reported lower limb or foot and ankle complications experienced by participants with systemic lupus erythematosus (SLE). A secondary aim was to determine the frequency of treatments that have been received or that participants with SLE may like to receive if offered. METHOD: A quantitative, cross-sectional, self-reported survey design was utilized. The developed survey was checked for face and content validity prior to patient partner cognitive debriefing in order to ensure usability, understanding of the process of completion and of the questions posed...
September 29, 2016: Lupus
Junzo Nojima, Yukari Motoki, Kazusa Hara, Toshiyuki Sakata, Kiyoshi Ichihara
Antiphospholipid syndrome, which often complicates systemic lupus erythematosus (SLE), features high occurrence of arterial and/or venous thrombosis and recurrent fetal loss. However, which antibody subclass contributes to which clinical event remains uncertain. We newly developed an up-to-date enzyme immunoassay system using the AcuStar automated analyzer (Instrumentation Laboratory, Bedford, Massachusetts, USA) for parallel detection of six subclasses of antiphospholipid antibodies (aPLs): anticardiolipin antibodies (aCL) of IgG, IgM, and IgA and anti-β2-glycoprotein I antibodies (aβ2GPI) of IgG, IgM, and IgA...
September 24, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Zhang Lin, Qi Si, Zou Xiaoyi
PURPOSE: To investigate the association between systemic autoimmune diseases (SAD) and epilepsy and to determine whether the strength of this association is increased in the young. METHODS: A meta-analysis was done, analyzing the association between epilepsy and SAD using the available data in Medline and Embase through February 2016. We followed the recommendations of the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement and the MOOSE (meta-analysis of observational studies in epidemiology) guidelines...
October 2016: Seizure: the Journal of the British Epilepsy Association
Melinda Zsuzsanna Szabó, Emese Kiss
The authors present the latest guideline for the treatment of lupus nephritis and their own single-centre results with mycofenolate mofetil treated lupus nephritis. Lupus nephritis and mainly its proliferative form is a frequent and potentially life-threatening manifestation of systemic lupus erythematosus that can lead to end-stage renal disease. The treatment of lupus nephritis greatly improved in the last decades; mycofenolate mofetil has become an alternative of cyclophosphamide both in remission induction and as a maintenance regimen as well in the treatment of Class III and IV glomerulonephritis...
August 2016: Orvosi Hetilap
Kentaro Minowa, Hirofumi Amano, Seiichiro Ando, Takashi Watanabe, Michihiro Ogasawara, Shinya Kawano, Toshiyuki Kaneko, Shinji Morimoto, Ken Yamaji, Naoto Tamura, Yoshiaki Tokano, Hiroshi Hashimoto, Yoshinari Takasaki
OBJECTIVE: To clarify the clinical features of systemic lupus erythematosus (SLE) patients, factors associated with flares, and changes over time. METHODS: Patients with SLE with a visiting history were entered into the Juntendo University Database of Erythematosus. We included 423 cases in the long-term follow-up analysis, and 383 cases were followed for 10 years after the initiation of any therapeutic intervention (comparative analysis: 1973-1982, 82 cases; 1983-1992, 141, and 1993-2002, 160)...
August 19, 2016: Modern Rheumatology
Helena Borrell, Javier Narváez, Juan José Alegre, Ivan Castellví, Francesca Mitjavila, María Aparicio, Eulàlia Armengol, María Molina-Molina, Joan M Nolla
Shrinking lung syndrome (SLS) is a rare and less known complication mainly associated with systemic lupus erythematosus (SLE). In this study, we analyze the clinical features, investigation findings, approaches to management, and outcome in a case series of 9 adult patients with SLE and SLS diagnosed during a 35-year period in 3 referral tertiary care hospitals in Spain. Additionally, we reviewed 80 additional cases previously reported (PubMed 1965-2015). These 80 cases, together with our 9 patients, form the basis of the present analysis...
August 2016: Medicine (Baltimore)
Natasha Jordan, David D'Cruz
Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity...
2016: ImmunoTargets and Therapy
Andrew Schreiner, Kit Simpson
BACKGROUND: Primary care referrals to specialty physicians play an integral role in patient care and health care costs. Multiple factors play into the primary care physician's decision to refer, including comfort managing particular conditions. As the burden of chronic disease climbs, the relationship between patients, primary care physicians and specialists in accurately diagnosing, managing and treating chronic conditions needs clarity. The objective of this study is to assess the relationship between specialty physician involvement and the care of three chronic conditions: diabetes mellitus (DM), chronic kidney disease (CKD) and systemic lupus erythematosus (SLE)...
August 15, 2016: Journal of Evaluation in Clinical Practice
M Schneider
"The objective of Pitfall!™ is to guide Harry through a maze of jungle scenes, jumping over or avoiding many deadly dangers… Harry has three lives in each game." If you exchange Harry's adventures with "Life with SLE," patients have to be guided through the jungle having just one life and the deadly dangers are flares, organ manifestations, and, e.g., consequences of immunosuppressive medications, especially glucocorticoids. Monitoring and treatment in line with recommendations and guidelines may be supportive to survive the first 3 to 5 levels in most cases, but for higher levels of the reality game, creativity is needed and life becomes more risky...
August 2, 2016: Autoimmunity Reviews
P Mayser
Based on the technical information that oral terbinafine must be used with caution in patients with pre-existing psoriasis or lupus erythematosus, the literature was summarized. Terbinafine belongs to the drugs able to induce subcutaneous lupus erythematosus (SCLE)-with a relatively high risk. The clinical picture of terbinafine-induced SCLE may be highly variable and can also include erythema exsudativum multiforme-like or bullous lesions. Thus, differentiation of terbinafine-induced Stevens-Johnson syndrome or toxic epidermal necrolysis may be difficult...
September 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Manuel Garza-Leon, Diana Elsa Flores-Alvarado, Juan Manuel Muñoz-Bravo
Antimalarial drugs are widely used in several countries for control of rheumatologic diseases such as systemic lupus erythematosus and rheumatoid arthritis. They are still used in Mexico because of their low cost and few secondary effects, most of which are mild and reversible. Even so, at an ophthalmological level, they could produce irreversible visual damage, which is why it is important to have ophthalmological evaluation and proper follow up. We present a clinical case as an example of characteristic ophthalmological findings as well as risk factors for retinal toxicity...
2016: Medwave
Atsushi Sugiura, Nobusada Funabashi, Koya Ozawa, Yoshio Kobayashi
PURPOSE: We investigated the relationship of left ventricular (LV) diastolic dysfunction and LV mass index (LVMI) against pulmonary hypertension (PH) in systemic autoimmune disease (SAD). METHODS: A total of 84 SAD patients (68 females; 53±17years; systemic lupus erythematosus, 27%; scleroderma, 17%; vasculitis, 16%; mixed connective tissue disease, 13% and polymyositis/dermatomyositis complex, 10%) without significant pericardial effusion (PE) on TTE (Vivid E9, GE) were analyzed...
October 1, 2016: International Journal of Cardiology
Shila Haghighat, Alimohammad Fatemi, Somayeh Andalib
BACKGROUND: The aim of this study was to investigate autonomic nervous system (ANS) function by using electrophysiological tests in patients with systemic lupus erythematosus (SLE). MATERIALS AND METHODS: This descriptive analytical study was done on 28 individuals with a history of lupus and ten age- and sex-matched healthy objects were being selected randomly. The autonomy questionnaire has been used to determine clinical symptom of ANS involvement. The electrophysiological assessments of ANS function were performed by sympathetic skin response (SSR)...
2016: Advanced Biomedical Research
Paul J Hoover, Karen H Costenbader
Lupus nephritis is a common and severe manifestation of systemic lupus erythematosus that disproportionately affects nonwhites and those in lower socioeconomic groups. This review discusses recent data on the incidence, prevalence, and outcomes of patients with lupus nephritis with a focus on low-income US Medicaid patients. We also review recent guidelines on diagnosis, treatment, and screening for new onset and relapses of lupus nephritis. Finally, we discuss the management of lupus nephritis from a rheumatologist's perspective, including vigilance for the common adverse events related to disease and treatment, and we review prevention and new treatment strategies...
September 2016: Kidney International
J Sipurzynski, B Fahrner, R Kerbl, R Crazzolara, N Jones, G Ebetsberger, B Jauk, V Strenger, B Wohlmuther, W Schwinger, H Lackner, C Urban, W Holter, M Minkov, L Kager, M Benesch, M G Seidel
Chronic immune thrombocytopenia (cITP) is often associated with an underlying predisposition towards autoimmunity, recognition of which is relevant to guide treatment. International recommendations on diagnostic steps and therapeutic measures of cITP in childhood exist. However, due to the low prevalence (1-2/100,000) and a variation of availability of immunological and hematological tests and treatments across pediatric units, we postulated that these guidelines are not uniformly adhered to and that immune dysregulation syndromes remained undiscovered...
April 2016: Seminars in Hematology
Mumtaz Patel, Steven Agius, Jack Wilkinson, Leena Patel, Paul Baker
CONTEXT: In the UK, supervised learning events (SLE) replaced traditional workplace-based assessments for foundation-year trainees in 2012. A key element of SLEs was to incorporate trainee reflection and assessor feedback in order to drive learning and identify training issues early. Few studies, however, have investigated the value of SLEs in predicting doctors in difficulty. This study aimed to identify principles that would inform understanding about how and why SLEs work or not in identifying doctors in difficulty (DiD)...
July 2016: Medical Education
Xin Yu, Heyi Zheng
Adult-onset Still disease (AOSD) is a systemic autoimmune disease (AIID) that can develop after exposure to infectious agents. Genital human papillomavirus (HPV) infection has been reported to induce or exacerbate AIIDs, such as systemic lupus erythematosus (SLE). No guidelines are available for the management of genital warts in AOSD. Case report and literature review. We report a patient who was diagnosed AOSD in the setting of refractory and recurrent genital HPV infection, demonstrating a possible link between HPV infection and AOSD...
April 2016: Medicine (Baltimore)
Nina Sluiter, Erienne de Cuba, Riom Kwakman, Geert Kazemier, Gerrit Meijer, Elisabeth Atie Te Velde
Peritoneal dissemination is diagnosed in 10-25 % of colorectal cancer patients. Selected patients are treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. For these patients, earlier diagnosis, optimised selection criteria and a personalised approach are warranted. Biomarkers could play a crucial role here. However, little is known about possible candidates. Considering tumour cell adhesion as a key step in peritoneal dissemination, we aim to provide an overview of the functional importance of adhesion molecules in peritoneal dissemination and discuss the prognostic, diagnostic and therapeutic options of these candidate biomarkers...
June 2016: Clinical & Experimental Metastasis
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