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[PMID]:29309110
[Au] Autor:Jianu DC; Jianu SN; Munteanu M; Vlad D; Rosca C; Petrica L
[Ti] Título:Color Doppler imaging features in patients presenting central retinal artery occlusion with and without giant cell arteritis.
[So] Source:Vojnosanit Pregl;73(4):397-401, 2016 Apr.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Central retinal artery obstruction (CRAO) represents an abrupt diminution of blood flow through the CRA that is severe enough to cause ischemia of the inner retina with permanent unilateral visual loss. We presented the role of color Doppler imaging (CDI) of orbital vessels and of extracranial duplex sonography (EDS) in the etiological diagnosis of CRAO in two patients with clinical suspicion of unilateral CRAO. Case Report: Patients were examined following the protocol which included CDI of orbital vessels and EDS. Both patients had no emboli visible on ophthalmoscopy. The B-scan ultrasound evaluation of the first patient found a small round, moderately reflective echo within the right optic nerve, 1.5 mm behind the optic disc (emboli of cholesterol). CDI of retrobulbar vessels revealed the normal right ophthalmic artery (OA) hemodynamic parameters, but the first patient had no arterial flow signal on CDI at the distance of 1.5 mm behind the right optic disc. In contrast, the left eye had the normal aspect on CDI of retrobulbar vessels. The right internal carotid artery EDS identified a severe stenosis at its origin as CRA's emboli source. The second patient had characteristic CDI findings for giant cell arteritis (GCA) with eye involvement: severe diminished blood flow velocities, especially end-diastolic velocities, in both CRAs. Less abnormalities were observed in the posterior ciliary arteries, and in the ophthalmic arteries. The second patient had no systemic symptoms or signs of GCA. Conclusion: In the presented cases, the ultrasound investigation enabled prompt differentiation between central retinal artery occlusion of embolic mechanism and CRAO caused by GCA.
[Mh] Termos MeSH primário: Arterite de Células Gigantes/diagnóstico por imagem
Oclusão da Artéria Retiniana/diagnóstico por imagem
Ultrassonografia Doppler em Cores
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE
[do] DOI:10.2298/VSP140814087C


  2 / 5459 MEDLINE  
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[PMID]:29182827
[Au] Autor:Bakula M; Cerovec M; Mayer M; Huic D; Anic B
[Ti] Título:GIANT CELL AORTITIS DIAGNOSED WITH PET/CT - PARANEOPLASTIC SYNDROME?
[So] Source:Lijec Vjesn;138(5-6):152-158, 2016 May.
[Is] ISSN:0024-3477
[Cp] País de publicação:Croatia
[La] Idioma:eng
[Ab] Resumo:Vasculitides are heterogenic group of autoimmune connective tissue diseases which often present difficulties in early diagnosing. Giant cell arteritis is vasculitis of large and medium arteries. It predominantly presents with symptoms of affection of the external carotid artery branches. Furthermore, the only symptoms can be constitutional. In clinical practice, vasculitides are sometimes considered as paraneoplastic, but no definite association with malignancies has been established and the mechanisms are still debated. The gold standard for diagnosing giant cell arteritis is a positive temporal artery biopsy, but the results can often be false negative. Additionally, more than half of the patients have aorta and its main branches affected. Considering aforementioned, imaging studies are essential in confirming large-vessel vasculitis, amongst which is highly sensitive PET/CT. We present the case of a 70-year-old female patient with constitutional symptoms and elevated sedimentation rate. After extensive diagnostic tests, she was admitted to our Rheumatology unit. Aortitis of the abdominal aorta has been confirmed by PET/CT and after the introduction of glucocorticoids the disease soon went into clinical and laboratory remission. Shortly after aortitis has been diagnosed, lung carcinoma was revealed of which the patient died. At the time of the comprehensive diagnostics, there was no reasonable doubt for underlying malignoma. To the best of our knowledge, there are no recent publications concerning giant cell arteritis and neoplastic processes in the context of up-to-date non-invasive diagnostic methods (i.e. PET/CT). In the light of previous research results, we underline that the sensitivity of PET/CT is not satisfactory when estimating cancer dissemination in non-enlarged lymph nodes and that its value can at times be overestimated.
[Mh] Termos MeSH primário: Aorta Abdominal/diagnóstico por imagem
Carcinoma
Arterite de Células Gigantes
Glucocorticoides/administração & dosagem
Neoplasias Pulmonares
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
[Mh] Termos MeSH secundário: Idoso
Aorta Abdominal/patologia
Sedimentação Sanguínea
Carcinoma/diagnóstico
Carcinoma/patologia
Evolução Fatal
Feminino
Arterite de Células Gigantes/diagnóstico
Arterite de Células Gigantes/tratamento farmacológico
Arterite de Células Gigantes/etiologia
Arterite de Células Gigantes/fisiopatologia
Seres Humanos
Neoplasias Pulmonares/diagnóstico
Neoplasias Pulmonares/patologia
Síndromes Paraneoplásicas/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  3 / 5459 MEDLINE  
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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:28745999
[Au] Autor:Stone JH; Tuckwell K; Dimonaco S; Klearman M; Aringer M; Blockmans D; Brouwer E; Cid MC; Dasgupta B; Rech J; Salvarani C; Schett G; Schulze-Koops H; Spiera R; Unizony SH; Collinson N
[Ad] Endereço:From the Massachusetts General Hospital Rheumatology Unit, Harvard Medical School, Boston (J.H.S., S.H.U.); Roche Products, Welwyn Garden City (K.T., S.D., N.C.), and Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea (B.D.) - both in the United Kingdom; Genentech, South San Francis
[Ti] Título:Trial of Tocilizumab in Giant-Cell Arteritis.
[So] Source:N Engl J Med;377(4):317-328, 2017 07 27.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Giant-cell arteritis commonly relapses when glucocorticoids are tapered, and the prolonged use of glucocorticoids is associated with side effects. The effect of the interleukin-6 receptor alpha inhibitor tocilizumab on the rates of relapse during glucocorticoid tapering was studied in patients with giant-cell arteritis. METHODS: In this 1-year trial, we randomly assigned 251 patients, in a 2:1:1:1 ratio, to receive subcutaneous tocilizumab (at a dose of 162 mg) weekly or every other week, combined with a 26-week prednisone taper, or placebo combined with a prednisone taper over a period of either 26 weeks or 52 weeks. The primary outcome was the rate of sustained glucocorticoid-free remission at week 52 in each tocilizumab group as compared with the rate in the placebo group that underwent the 26-week prednisone taper. The key secondary outcome was the rate of remission in each tocilizumab group as compared with the placebo group that underwent the 52-week prednisone taper. Dosing of prednisone and safety were also assessed. RESULTS: Sustained remission at week 52 occurred in 56% of the patients treated with tocilizumab weekly and in 53% of those treated with tocilizumab every other week, as compared with 14% of those in the placebo group that underwent the 26-week prednisone taper and 18% of those in the placebo group that underwent the 52-week prednisone taper (P<0.001 for the comparisons of either active treatment with placebo). The cumulative median prednisone dose over the 52-week period was 1862 mg in each tocilizumab group, as compared with 3296 mg in the placebo group that underwent the 26-week taper (P<0.001 for both comparisons) and 3818 mg in the placebo group that underwent the 52-week taper (P<0.001 for both comparisons). Serious adverse events occurred in 15% of the patients in the group that received tocilizumab weekly, 14% of those in the group that received tocilizumab every other week, 22% of those in the placebo group that underwent the 26-week taper, and 25% of those in the placebo group that underwent the 52-week taper. Anterior ischemic optic neuropathy developed in one patient in the group that received tocilizumab every other week. CONCLUSIONS: Tocilizumab, received weekly or every other week, combined with a 26-week prednisone taper was superior to either 26-week or 52-week prednisone tapering plus placebo with regard to sustained glucocorticoid-free remission in patients with giant-cell arteritis. Longer follow-up is necessary to determine the durability of remission and safety of tocilizumab. (Funded by F. Hoffmann-La Roche; ClinicalTrials.gov number, NCT01791153 .).
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/uso terapêutico
Arterite de Células Gigantes/tratamento farmacológico
Glucocorticoides/administração & dosagem
Prednisona/administração & dosagem
Receptores de Interleucina-6/antagonistas & inibidores
[Mh] Termos MeSH secundário: Idoso
Anticorpos Monoclonais Humanizados/efeitos adversos
Método Duplo-Cego
Esquema de Medicação
Quimioterapia Combinada
Feminino
Glucocorticoides/efeitos adversos
Seres Humanos
Injeções Subcutâneas
Masculino
Meia-Idade
Prednisona/efeitos adversos
Indução de Remissão
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); 0 (Glucocorticoids); 0 (Receptors, Interleukin-6); 0 (interleukin-6 receptor alpha); I031V2H011 (tocilizumab); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170727
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1613849


  4 / 5459 MEDLINE  
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[PMID]:29224203
[Au] Autor:Sait MR; Lepore M; Kwasnicki R; Allington J; Srinivasaiah N
[Ad] Endereço:Department of Surgery, West Middlesex University Hospital, Isleworth, London, UK.
[Ti] Título:Temporal artery biopsy: time matters!
[So] Source:Intern Med J;47(12):1465, 2017 12.
[Is] ISSN:1445-5994
[Cp] País de publicação:Australia
[La] Idioma:eng
[Mh] Termos MeSH primário: Arterite de Células Gigantes
Artérias Temporais
[Mh] Termos MeSH secundário: Biópsia
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180119
[Lr] Data última revisão:
180119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE
[do] DOI:10.1111/imj.13636


  5 / 5459 MEDLINE  
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[PMID]:29217029
[Au] Autor:Weis E; Toren A; Jordan D; Patel V; Gilberg S
[Ad] Endereço:Department of Ophthalmology, University of Alberta, Edmonton, Alta; Department of Surgery, University of Calgary, Calgary, Alta. Electronic address: ezekiel_weis@post.harvard.edu.
[Ti] Título:Development of a predictive model for temporal artery biopsies.
[So] Source:Can J Ophthalmol;52(6):599-605, 2017 Dec.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Temporal artery biopsy is a critical, relatively safe, and reliable test in the diagnosis of temporal arteritis. Yet, a clarification of the pre-test probabilities may provide clarity on which patients with suspected giant cell arteritis would benefit from this invasive diagnostic procedure. DESIGN: A prospective case series PARTICIPANTS: A consecutive case series of patients referred to the Ophthalmology service for temporal artery biopsy. METHODS: All subjects underwent standardized serum testing, and signs and symptoms assessment. Predictive models were created and evaluated. RESULTS: 119 patients were analyzed. This exploratory study found that a simple model including platelet count, erythrocyte sedimentation rate, and c-reactive protein was able to define a subset of patients with a pre-test probability of a positive biopsy of 0% or 100%. 40% (95% confidence interval 31%-49%) of patients fell into this category. CONCLUSIONS: Utilizing a simple clinically applicable predictive model of the pretest probability of a temporal artery biopsy in patients with suspected giant cell arteritis, up to 31%-49% of temporal artery biopsies may be avoided. This study was a single site exploratory study with data-driven thresholds - therefore these results need to be validated with an independent sample prior to clinical use.
[Mh] Termos MeSH primário: Arterite de Células Gigantes/diagnóstico
Modelos Teóricos
Artérias Temporais/patologia
[Mh] Termos MeSH secundário: Idoso
Biópsia
Sedimentação Sanguínea
Proteína C-Reativa/metabolismo
Feminino
Seres Humanos
Masculino
Contagem de Plaquetas
Valor Preditivo dos Testes
Estudos Prospectivos
Sensibilidade e Especificidade
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  6 / 5459 MEDLINE  
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[PMID]:29211675
[Au] Autor:Kelly NP; Gerhard-Herman M; Desai AS; Miller AL; Loscalzo J
[Ad] Endereço:From the Department of Medicine, Brigham and Women's Hospital, and the Department of Medicine, Harvard Medical School - both in Boston.
[Ti] Título:An Unusual Cause of Leg Pain.
[So] Source:N Engl J Med;377(23):2267-2272, 2017 12 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Arterite de Células Gigantes/diagnóstico
Claudicação Intermitente/etiologia
Dor/etiologia
Artérias Temporais/patologia
[Mh] Termos MeSH secundário: Idoso
Biópsia
Ponte de Artéria Coronária
Estenose Coronária/complicações
Estenose Coronária/cirurgia
Feminino
Arterite de Células Gigantes/complicações
Arterite de Células Gigantes/tratamento farmacológico
Arterite de Células Gigantes/patologia
Glucocorticoides/uso terapêutico
Seres Humanos
Perna (Membro)
Doença Arterial Periférica/complicações
Doença Arterial Periférica/diagnóstico
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcps1703534


  7 / 5459 MEDLINE  
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[PMID]:29022332
[Au] Autor:Akiyama M
[Ad] Endereço:Keio University School of Medicine, Tokyo, Japan hhhirooo@hotmail.com
[Ti] Título:Trial of Tocilizumab in Giant-Cell Arteritis.
[So] Source:N Engl J Med;377(15):1493-4, 2017 10 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados
Arterite de Células Gigantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); I031V2H011 (tocilizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171013
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711031


  8 / 5459 MEDLINE  
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[PMID]:29022331
[Au] Autor:Gonzáles-Gay MA; Loricera J; Blanco R
[Ad] Endereço:Hospital Universitario Marqués de Valdecilla, Santander, Spain
[Ti] Título:Trial of Tocilizumab in Giant-Cell Arteritis.
[So] Source:N Engl J Med;377(15):1493, 2017 10 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados
Arterite de Células Gigantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); I031V2H011 (tocilizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171013
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711031


  9 / 5459 MEDLINE  
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[PMID]:29020600
[Au] Autor:Stone JH; Klearman M; Collinson N
[Ad] Endereço:Massachusetts General Hospital, Boston, MA jhstone@mgh.harvard.edu.
[Ti] Título:Trial of Tocilizumab in Giant-Cell Arteritis.
[So] Source:N Engl J Med;377(15):1494-1495, 2017 10 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados
Arterite de Células Gigantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); I031V2H011 (tocilizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711031


  10 / 5459 MEDLINE  
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[PMID]:29020599
[Au] Autor:Walker UA
[Ad] Endereço:Universitätsspital Basel, Basel, Switzerland ulrich.walker@usb.ch
[Ti] Título:Trial of Tocilizumab in Giant-Cell Arteritis.
[So] Source:N Engl J Med;377(15):1493, 2017 10 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados
Arterite de Células Gigantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); I031V2H011 (tocilizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711031



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