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https://www.readbyqxmd.com/read/28815188/painless-aortic-dissection-diagnostic-dilemma-with-fatal-outcomes-what-do-we-learn
#1
Saeeda Fatima, Konika Sharma
Aortic dissection is the most catastrophic clinical condition that involves the aorta. It has a high mortality as well as high rate of misdiagnosis due to frequent unusual presentation. Typically, it presents with acute chest, back, and tearing abdominal pain. However, it can present atypically with minimal or no pain, making diagnosis difficult. Physicians should always suspect acute aortic dissection in patients with certain clinical conditions like difficult-to-control hypertension, giant cell arteritis, bicuspid aortic valve, intracranial aneurysms, simple renal cysts, family history of aortic disease, and Marfan syndrome, especially when a patient presents with ischemic symptoms involving multiple organ without an obvious cause...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28814389/equine-arteritis-virus-elicits-a-mucosal-antibody-response-in-the-reproductive-tract-of-persistently-infected-stallions
#2
Mariano Carossino, Bettina Wagner, Alan T Loynachan, R Frank Cook, Igor F Canisso, Lakshman Chelvarajan, Casey L Edwards, Bora Nam, John F Timoney, Peter J Timoney, Udeni B R Balasuriya
Equine arteritis virus (EAV) has the ability to establish persistent infection in the reproductive tract of the stallion (carrier) and is continuously shed in its semen. We have recently demonstrated that EAV persists within stromal cells and a subset of lymphocytes in the stallion accessory sex glands in the presence of a significant local inflammatory response. In the present study, we demonstrated that EAV elicits a mucosal antibody response in the reproductive tract during persistent infection with homing of plasma cells into accessory sex glands...
August 16, 2017: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/28811356/clinical-characteristics-of-heart-involvement-in-chinese-patients-with-takayasu-arteritis
#3
Jing Li, Hongchao Li, Fei Sun, Zhe Chen, Yunjiao Yang, Jiuliang Zhao, Mengtao Li, Xinping Tian, Xiaofeng Zeng
OBJECTIVE: To understand the characteristics of heart involvement in Chinese patients with Takayasu arteritis (TA). METHODS: The medical charts of 411 patients with TA (325 women, 86 men) were retrospectively reviewed. The comparison of clinical manifestations was carried out between the patients with TA with (n = 164) and without (n = 247) heart involvement. RESULTS: The median age at disease onset was 23.0 years (18.0-30.0) in 411 patients with TA, and 23...
August 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28810043/amalric-triangular-syndrome-associated-with-outer-nuclear-layer-infarction
#4
Sean T Garrity, Eric J Holz, David Sarraf
An 85-year-old man presented with temporal headache and bilateral paracentral scotomas. Clinical examination, laboratory testing, and temporal artery biopsy confirmed the diagnosis of giant cell arteritis. Fluorescein angiography illustrated Amalric triangular choroidal infarction of the left eye. Spectral-domain optical coherence tomography of the left eye demonstrated outer nuclear layer abnormalities adjacent to the choroidal infarct. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:668-670.].
August 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28806315/nonarteritic-jaw-claudication
#5
Christine A Petersen, Courtney E Francis
A 60-year-old woman with decreased visual acuity in her right eye and right-sided jaw claudication was found to have ocular ischemic syndrome secondary to complete occlusion of the brachiocephalic artery. Although jaw claudication is often considered to be pathognomonic for giant cell arteritis, it has a broad differential diagnosis including both vascular and nonvascular conditions.
September 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28803683/immune-response-in-takayasu-arteritis
#6
Tristan Mirault, Henri Guillet, Emmanuel Messas
Takayasu arteritis (TAK) is a vasculitis of the large arteries. The arterial wall, target of the immune reaction, is composed of vascular dendritic cells, endothelial cells, vascular smooth muscle cells and fibroblasts, which engage in an interaction with T cells and macrophages to, ultimately, cause luminal stenosis or aneurysmal wall damage of the vessel. A multitude of cytokines have been identified to increase in case of TAK and to be linked to disease activity. A better understanding of the physiopathological pathways and mechanisms involved, might enable a more tailored therapeutic approach in TAK...
August 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28801814/serum-amyloid-a-as-a-marker-of-disease-activity-and-treatment-response-in-takayasu-arteritis
#7
Aswin M Nair, Ruchika Goel, M Hindhumati, K Jayakanthan, J Visalakshi, George Joseph, Sumita Danda, Debashish Danda
Assessment of disease activity in Takayasu arteritis (TA) is challenging. We aimed to study utility of serum amyloid A (SAA) to assess disease activity and its association with SAA gene polymorphisms, if any, in our TA patients. Serum of 99 consecutive adult TA patients and 40 healthy controls were assayed for SAA. Depending on the ITAS2010 and ITAS-CRP score, patients were designated as having active disease if ITAS2010 ≥ 2 or ITAS-CRP ≥ 3 and stable disease if ITAS2010 = 0 or ITAS-CRP is ≤1. Clinical ITAS of 0 with raised inflammatory markers scoring a ITAS-CRP of 2 was considered as indeterminate for disease activity assessment...
August 11, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28800947/-from-pathogenesis-of-giant-cell-arteritis-to-new-therapeutic-targets
#8
M Samson, B Bonnotte
Giant cell arteritis (GCA) is the most common vasculitis in adults. GCA is a granulomatous large-vessel vasculitis involving the aorta and its major branches in people>50 years. Glucocorticoids (GC) remain the cornerstone of GCA treatment. Prednisone is usually started at 0.7 or 1mg/kg/day depending on the occurrence of ischemic complications. Then, GC are progressively tapered and stopped after a mean duration of 18 months. GC are very efficient but relapses often occur during their tapering. Moreover, GC-related side effects are very common during this long term GC therapy...
August 8, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28799318/giant-cell-arteritis-presenting-as-puo
#9
Sham Santhanam, Sampath Kumar Mani
Giant cell arteritis(GCA) is a primary granulomatous vasculitis affecting the large and medium sized arteries. We present here a case of GCA with pyrexia of unknown origin (PUO) as the presenting manifestation in the absence of other typical features. On evaluation, the patient had raised inflammatory markers with features of large vessel vasculitis on whole body PET-CT scan. The colour doppler ultrasonography(CDUS) of the temporal arteries showed bilateral halo sign. Since bilateral 'halo sign' is more specific for the diagnosis of GCA, temporal artery biopsy is not mandatory...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28795494/an-extended-high-frequency-ultrasound-protocol-for-detection-of-vessel-wall-inflammation
#10
H Zachrisson, C Svensson, A Dremetsika, P Eriksson
OBJECTIVE: The aim of this study was to evaluate an extended protocol of the large vessels using high-frequency duplex ultrasound (DUS) for detection of vessel wall inflammation. METHODS: Fifty-eight patients performed a DUS examination where arteritis could not be excluded. All DUS examinations were performed using ACUSON S2000 TM ultrasound system (Siemens Medical Solutions USA, Inc.). High-frequency linear transducers were used (18L6 MHz, 9L4MHz) or curve linear for the aortic arch (6C2 MHz)...
August 9, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28795032/extra-anatomic-ascending-aorta-to-abdominal-aorta-bypass-in-takayasu-arteritis-patients-with-mid-aortic-syndrome
#11
Hak Ju Kim, Jae-Woong Choi, Ho Young Hwang, Hyuk Ahn
BACKGROUND: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. METHODS: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was 43.5±12.2 years and the mean peak pressure gradient between the upper and lower extremities was 54.8±39...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28791802/a-26-week-feasibility-study-comparing-the-efficacy-and-safety-of-modified-release-prednisone-with-immediate-release-prednisolone-in-newly-diagnosed-cases-of-giant-cell-arteritis
#12
Charles Raine, Philip P Stapleton, Dimos Merinopoulos, Win Win Maw, Katerina Achilleos, Dawn Gayford, Sarah Mapplebeck, Craig Mackerness, Paul Schofield, Bhaskar Dasgupta
OBJECTIVE: A feasibility study to assess efficacy and safety of modified release (MR) prednisone (Lodotra™) compared to immediate release (IR) prednisolone in patients with newly diagnosed giant cell arteritis (GCA). METHODS: Twelve patients with new diagnosis of GCA were initially treated with high-dose prednisolone (40-60 mg) daily for 4 weeks and then randomized to two open arms to continue tapering steroid treatment with either standard IR prednisolone or MR prednisone...
August 9, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28791773/sarcoidosis-with-takayasu-arteritis-a-model-of-overlapping-granulomatosis-a-report-of-seven-cases-and-literature-review
#13
Catherine Chapelon-Abric, David Saadoun, Isabelle Marie, Cloé Comarmond, Anne Claire Desbois, Fanny Domont, Léa Savey, Patrice Cacoub
OBJECTIVE: To describe the features of exceptional coexisting Takayasu arteritis (TA) and sarcoidosis, two conditions of unknown cause associated with a common immunologic pattern. METHODS: We report seven cases of concomitant sarcoidosis-Takayasu or Takayasu-like vasculitis, observed in two referral centers between 1995 and 2015. RESULTS: All patients were female. The mean age at sarcoidosis diagnosis and TA diagnosis was 36 and 37 years, respectively...
August 8, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28783392/occult-giant-cell-arteritis-with-an-abnormal-temporal-artery-finding-and-normal-blood-markers
#14
Simon Madge, Emma Samia-Aly
No abstract text is available yet for this article.
August 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28774475/what-is-new-in-management-of-takayasu-arteritis
#15
Gokhan Keser, Kenan Aksu
Management of Takayasu arteritis (TAK) is challenging mostly due to difficulties in assessing actual disease activity. The rational of medical treatment is to suppress both vascular and systemic inflammation with appropriate systemic immunosuppression, including corticosteroids and conventional immunosuppressive (IS) agents. In case of refractory disease activity, biologic agents such as TNF inhibitors and tocilizumab may be tried. In selected cases, endovascular interventions and surgical procedures may be indicated and should be performed during inactive disease...
July 31, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28774474/classification-of-large-vessel-vasculitis-can-we-separate-giant-cell-arteritis-from-takayasu-arteritis
#16
Matthew J Koster, Kenneth J Warrington
The two main variants of large vessel vasculitis include Takayasu arteritis and giant cell arteritis. While these two conditions have historically been considered different conditions, recent evidence questions whether they are a spectrum of the same disease. Classification criteria are limited in distinguishing between cases with phenotypic overlap. The limitations of the current criteria and directions of future research are reviewed.
July 31, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28774422/polymyalgia-rheumatica
#17
REVIEW
Miguel A González-Gay, Eric L Matteson, Santos Castañeda
Polymyalgia rheumatica is an inflammatory disease that affects the shoulder, the pelvic girdles, and the neck, usually in individuals older than 50 years. Increases in acute phase reactants are typical of polymyalgia rheumatica. The disorder might present as an isolated condition or in association with giant cell arteritis. Several diseases, including inflammatory rheumatic and autoimmune diseases, infections, and malignancies can mimic polymyalgia rheumatica. Imaging techniques have identified the presence of bursitis in more than half of patients with active disease...
July 31, 2017: Lancet
https://www.readbyqxmd.com/read/28770707/pro-fibrotic-effect-of-il-6-via-aortic-adventitial-fibroblasts-indicates-il-6-as-a-treatment-target-in-takayasu-arteritis
#18
Xiufang Kong, Lili Ma, Zongfei Ji, Zhihui Dong, Zhigang Zhang, Jun Hou, Si Zhang, Lingying Ma, Lindi Jiang
OBJECTIVES: This study aimed to clarify potential mechanism of IL-6 involved in adventitial fibrosis via adventitial fibroblast in Takayasu arteritis (TAK). METHODS: Immunohistochemistry and double-labelled immunofluorescence were performed on vascular tissue from patients with TAK and controls. Human aorta adventitial fibroblast (AAF) was cultured and stimulated with interleukine 6 (IL-6)/IL-6 receptor (IL-6R). Real-time PCR, western blot, enzyme-linked immunosorbent assays, chromatin immunoprecipitation (ChIP) and reporter assay were conducted in vitro experiments to determine effect of IL-6/IL-6R on AAF...
July 6, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28768257/autoimmunity-in-the-elderly-insights-from-basic-science-and-clinics-a-mini-review
#19
Abdulla Watad, Nicola Luigi Bragazzi, Mohammad Adawi, Howard Amital, Elias Toubi, Bat-Sheva Porat, Yehuda Shoenfeld
Advancements in the field of biomedicine, including the control of infectious diseases through antibiotics and vaccination practices and the prevention of chronic disorders, have led to reduced mortality, increased life expectancy and, as such, growth of the older population. Ageing is accompanied by profound morphological and physiological alterations. In particular, the immune system undergoes a complex series of remodeling/restructuring events, involving almost all compartments - both the innate and the adaptive system...
July 29, 2017: Gerontology
https://www.readbyqxmd.com/read/28767581/diagnostic-value-of-pet-ct-for-giant-cell-arteritis-combined-with-pulmonary-embolism-presenting-case-report-and-literature-review
#20
Xiaoming Shu, Xiaoxiang Xu, Qinglin Peng, Xin Lu, Li Ma, Na Mi, Guochun Wang
RATIONALE: Giant cell arteritis (GCA) combined with concomitant pulmonary embolism (PE) is extremely difficult to diagnose because of its low incidence and atypical clinical presentations. PATIENT CONCERNS: A 62-year-old male developed fever of unknown origin. DIAGNOSES: Positron emission tomography/computed tomography (PET/CT) revealed increased glucose metabolism in the vascular walls of the ascending and descending aorta and pulmonary artery, leading to a diagnosis of GCA combined with PE...
August 2017: Medicine (Baltimore)
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