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[PMID]:29297205
[Au] Autor:Barnes H; Holland AE; Westall GP; Goh NS; Glaspole IN
[Ad] Endereço:Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Commercial Rd, Melbourne, Australia, 3004.
[Ti] Título:Cyclophosphamide for connective tissue disease-associated interstitial lung disease.
[So] Source:Cochrane Database Syst Rev;1:CD010908, 2018 Jan 03.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Approximately one-third of individuals with interstitial lung disease (ILD) have associated connective tissue disease (CTD). The connective tissue disorders most commonly associated with ILD include scleroderma/systemic sclerosis (SSc), rheumatoid arthritis, polymyositis/dermatomyositis, and Sjögren's syndrome. Although many people with CTD-ILD do not develop progressive lung disease, a significant proportion do progress, leading to reduced physical function, decreased quality of life, and death. ILD is now the major cause of death amongst individuals with systemic sclerosis.Cyclophosphamide is a highly potent immunosuppressant that has demonstrated efficacy in inducing and maintaining remission in autoimmune and inflammatory illnesses. However this comes with potential toxicities, including nausea, haemorrhagic cystitis, bladder cancer, bone marrow suppression, increased risk of opportunistic infections, and haematological and solid organ malignancies.Decision-making in the treatment of individuals with CTD-ILD is difficult; the clinician needs to identify those who will develop progressive disease, and to weigh up the balance between a high level of need for therapy in a severely unwell patient population against the potential for adverse effects from highly toxic therapy, for which only relatively limited data on efficacy can be found. Similarly, it is not clear whether histological subtype, disease duration, or disease extent can be used to predict treatment responsiveness. OBJECTIVES: To assess the efficacy and adverse effects of cyclophosphamide in the treatment of individuals with CTD-ILD. SEARCH METHODS: We performed searches on CENTRAL, MEDLINE, Embase, CINAHL, and Web of Science up to May 2017. We handsearched review articles, clinical trial registries, and reference lists of retrieved articles. SELECTION CRITERIA: We included randomised controlled parallel-group trials that compared cyclophosphamide in any form, used individually or concomitantly with other immunomodulating therapies, versus non-cyclophosphamide-containing therapies for at least six months, with follow-up of at least 12 months from the start of treatment. DATA COLLECTION AND ANALYSIS: We imported studies identified by the search into a reference manager database. We retrieved the full-text versions of relevant studies, and two review authors independently extracted data. Primary outcomes were change in lung function (change in forced vital capacity (FVC) % predicted and diffusing capacity of the lung for carbon monoxide (DLCO) % predicted), adverse events, and health-related quality of life measures. Secondary outcomes included all-cause mortality, dyspnoea, cough, and functional exercise testing. When appropriate, we performed meta-analyses and subgroup analyses by severity of lung function, connective tissue disease diagnosis, and radiological pattern of fibrosis. We assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and created 'Summary of findings' tables. MAIN RESULTS: We included in the analysis four trials with 495 participants (most with systemic sclerosis). We formed two separate comparisons: cyclophosphamide versus placebo (two trials, 195 participants) and cyclophosphamide versus mycophenolate (two trials, 300 participants). We found evidence to be of low quality, as dropout rates were high in the intervention groups, and as we noted a wide confidence interval around the effect with small differences, which affected the precision of results.The data demonstrates significant improvement in lung function with cyclophosphamide compared with placebo (post-treatment FVC % mean difference (MD) 2.83, 95% confidence interval (CI) 0.80 to 4.87; P = 0.006) but no significant difference in post-treatment DLCO (% MD -1.68, 95% CI -4.37 to 1.02; P = 0.22; two trials, 182 participants).Risk of adverse effects was increased in the cyclophosphamide treatment groups compared with the placebo groups, in particular, haematuria, leukopenia, and nausea, leading to a higher rate of withdrawal from cyclophosphamide treatment. The data demonstrates statistically significant improvement in one-measure of quality of life in one trial favouring cyclophosphamide over placebo and clinically and statistically significant improvement in breathlessness in one trial favouring cyclophosphamide compared with placebo, with no significant impact on mortality.Trialists reported no significant impact on lung function when cyclophosphamide was used compared with mycophenolate at 12 months (FVC % MD -0.82, 95% CI -3.95 to 2.31; P = 0.61; two trials, 149 participants; DLCO % MD -1.41, 95% CI -10.40 to 7.58; P = 0.76; two trials, 149 participants).Risk of side effects was increased with cyclophosphamide versus mycophenolate, in particular, leukopenia and thrombocytopenia.The data demonstrates no significant impact on health-related quality of life, all-cause mortality, dyspnoea, or cough severity in the cyclophosphamide group compared with the mycophenolate group. No trials reported outcomes associated with functional exercise tests.We performed subgroup analysis to determine whether severity of lung function, connective tissue disease diagnosis, or radiological pattern had any impact on outcomes. One trial reported that cyclophosphamide protected against decreased FVC in individuals with worse fibrosis scores, and also showed that cyclophosphamide may be more effective in those with worse lung function. No association could be made between connective tissue disease diagnosis and outcomes. AUTHORS' CONCLUSIONS: This review, which is based on studies of varying methodological quality, demonstrates that overall, in this population, small benefit may be derived from the use of cyclophosphamide in terms of mean difference in % FVC when compared with placebo, but not of the difference in % DLCO, or when compared with mycophenolate. Modest clinical improvement in dyspnoea may be noted with the use of cyclophosphamide. Clinical practice guidelines should advise clinicians to consider individual patient characteristics and to expect only modest benefit at best in preserving FVC. Clinicians should carefully monitor for adverse effects during treatment and in the years thereafter.Further studies are required to examine the use of cyclophosphamide; they should be adequately powered to compare outcomes within different subgroups, specifically, stratified for extent of pulmonary infiltrates on high-resolution computed tomography (HRCT) and skin involvement in SSc. Studies on other forms of connective tissue disease are needed. Researchers may consider comparing cyclophosphamide (a potent immunosuppressant) versus antifibrotic agents, or comparing both versus placebo, in particular, for those with evidence of rapidly progressive fibrotic disease, who may benefit the most.
[Mh] Termos MeSH primário: Doenças do Tecido Conjuntivo/tratamento farmacológico
Ciclofosfamida/uso terapêutico
Imunossupressores/uso terapêutico
Doenças Pulmonares Intersticiais/tratamento farmacológico
[Mh] Termos MeSH secundário: Doenças do Tecido Conjuntivo/complicações
Ciclofosfamida/efeitos adversos
Seres Humanos
Imunossupressores/efeitos adversos
Pulmão/efeitos dos fármacos
Doenças Pulmonares Intersticiais/complicações
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Escleroderma Sistêmico
Capacidade Vital/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 8N3DW7272P (Cyclophosphamide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010908.pub2


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[PMID]:28469101
[Au] Autor:Wang L; Mei XL
[Ad] Endereço:Department of Dermatology, Allergy and Clinical Immunology Centre, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
[Ti] Título:Retrospective Analysis of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in 88 Chinese Patients.
[So] Source:Chin Med J (Engl);130(9):1062-1068, 2017 May 05.
[Is] ISSN:0366-6999
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases with high mortality rates. This study was designed to analyze the pathogenic factors, clinical manifestations, complications, treatment, and prognosis of SJS/TEN and to explore the differences between surviving and deceased patients. METHODS: SJS/TEN patients admitted to Beijing Friendship Hospital from January 2006 to December 2015 were included in the study. Patients' data were retrospectively analyzed. Comparative studies were performed on the survival group and the deceased group, and Fisher's exact probability test was used for statistical analysis. RESULTS: Among the 88 patients included, 40 (45.5%) were male with a mean age of 45 ± 18 years. Forty-eight (54.5%) had SJS, 34 (38.6%) had SJS/TEN, and 6 (6.8%) had TEN. Fifty-three (60.2%) cases were caused by medications, mainly antibiotics (n = 24) followed by traditional Chinese medicines (n = 7). Forty-two cases (47.7%) developed visceral damage. Eighty-two patients improved or recovered and were discharged from hospital, and six patients died. Comparative studies on the survival group and the deceased group showed that the presence of malignant tumor ( χ2 = 27.969,P < 0.001), connective tissue diseases ( χ2 = 9.187, P= 0.002), previous abnormal liver/kidney functions ( χ2 = 6.006, P= 0.014), heart rate >100 times/min ( χ2 = 6.347, P= 0.012), detached skin area >20% ( χ2 = 5.594, P= 0.018), concurrent mucosal involvement at the mouth, eyes, and external genitals ( χ2 = 4.945, P= 0.026), subsequent accompanying liver/kidney damage ( χ2 = 11.839, P= 0.001, and χ2 = 36.302,P < 0.001, respectively), and SCORTEN score >2 ( χ2 = 37.148,P < 0.001) increased the risk of death. CONCLUSIONS: SJS/TEN is mainly caused by medications, and nearly half of patients develop visceral damage. Multiple factors increase the mortality risk.
[Mh] Termos MeSH primário: Síndrome de Stevens-Johnson/metabolismo
Síndrome de Stevens-Johnson/patologia
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/uso terapêutico
Doenças do Tecido Conjuntivo/metabolismo
Doenças do Tecido Conjuntivo/patologia
Olho/patologia
Feminino
Genitália/patologia
Seres Humanos
Rim/metabolismo
Rim/patologia
Fígado/metabolismo
Fígado/patologia
Masculino
Meia-Idade
Boca/patologia
Estudos Retrospectivos
Pele/metabolismo
Pele/patologia
Síndrome de Stevens-Johnson/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.4103/0366-6999.204929


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[PMID]:28461123
[Au] Autor:Tanizawa K; Handa T; Nakashima R; Kubo T; Hosono Y; Watanabe K; Aihara K; Ikezoe K; Sokai A; Nakatsuka Y; Taguchi Y; Hatta K; Noma S; Kobashi Y; Yoshizawa A; Oga T; Hirai T; Chin K; Nagai S; Izumi T; Mimori T; Mishima M
[Ad] Endereço:Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
[Ti] Título:The long-term outcome of interstitial lung disease with anti-aminoacyl-tRNA synthetase antibodies.
[So] Source:Respir Med;127:57-64, 2017 Jun.
[Is] ISSN:1532-3064
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Anti-aminoacyl transfer RNA synthetase antibodies (anti-ARS) are a group of myositis-specific autoantibodies that are detected in the sera of patients with polymyositis and dermatomyositis (PM/DM) and also in those of patients with idiopathic interstitial pneumonias without any connective tissue disease (CTD), including PM/DM. Although we reported the clinical characteristics of interstitial lung disease with anti-ARS antibodies (ARS-ILD) with and without PM/DM, the long-term prognosis of ARS-ILD remains undetermined. As our previous studies revealed that ARS-ILD without PM/DM was similar to CTD-associated ILD, and that ARS-ILD with PM/DM was radiologically suggestive of a nonspecific interstitial pneumonia (NSIP) pathological pattern, we hypothesized that the prognosis of ARS-ILD might be distinct from that of idiopathic pulmonary fibrosis (IPF) without anti-ARS. OBJECTIVES: To elucidate the long-term outcome of ARS-ILD with and without PM/DM and compare it to that of IPF. METHODS: A two-center retrospective study was conducted. The study population comprised 36 patients with ARS-ILD (8 with PM, 12 with DM, and 16 without myositis throughout the course), 100 patients with IPF without anti-ARS, and 7 patients with NSIP without anti-ARS. The presence of anti-ARS was determined by RNA immunoprecipitation using the sera obtained at the time of diagnosis before specific treatment. MEASUREMENTS AND MAIN RESULTS: During the observational period (median 49 months; range, 1-114 months), 7 patients with ARS-ILD (19%; 3 with PM, 1 with DM, and 3 without PM/DM) and 51 patients with IPF (51%) died. Patients with ARS-ILD had better overall survival than those with IPF (log-rank test, P < 0.001) and similar survival compared to those with NSIP (log-rank test, P = 0.59). The prognosis for patients with ARS-ILD was similar between those with and without myositis (log-rank test, P = 0.91). At the median follow-up time of 76.5 months, 14 of the 36 patients with ARS-ILD had deteriorated. Both a decline in forced vital capacity or an initiation of long-term oxygen therapy during the course (odds ratio [OR], 5.34) and acute exacerbation (OR, 28.4) significantly increased the mortality risk. CONCLUSIONS: The long-term outcome of ARS-ILD was significantly better than that of IPF regardless of the presence or absence of myositis.
[Mh] Termos MeSH primário: Aminoacil-tRNA Sintetases/imunologia
Autoanticorpos/sangue
Dermatomiosite/complicações
Fibrose Pulmonar Idiopática/imunologia
Doenças Pulmonares Intersticiais/imunologia
Miosite/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Autoanticorpos/imunologia
Doenças do Tecido Conjuntivo/complicações
Doenças do Tecido Conjuntivo/diagnóstico
Doenças do Tecido Conjuntivo/imunologia
Doenças do Tecido Conjuntivo/mortalidade
Dermatomiosite/imunologia
Dermatomiosite/mortalidade
Feminino
Seres Humanos
Oxigenação Hiperbárica/métodos
Fibrose Pulmonar Idiopática/complicações
Fibrose Pulmonar Idiopática/diagnóstico por imagem
Doenças Pulmonares Intersticiais/diagnóstico por imagem
Doenças Pulmonares Intersticiais/mortalidade
Masculino
Meia-Idade
Mortalidade
Miosite/mortalidade
Estudos Observacionais como Assunto
Avaliação de Resultados (Cuidados de Saúde)
Prognóstico
RNA/imunologia
Estudos Retrospectivos
Análise de Sobrevida
Capacidade Vital/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 63231-63-0 (RNA); EC 6.1.1.- (Amino Acyl-tRNA Synthetases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29221579
[Au] Autor:Jog NR; James JA
[Ad] Endereço:Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Okla.
[Ti] Título:Biomarkers in connective tissue diseases.
[So] Source:J Allergy Clin Immunol;140(6):1473-1483, 2017 Dec.
[Is] ISSN:1097-6825
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Autoimmune connective tissue diseases are clinically variable, making biomarkers desirable for assessing future disease risk, supporting early and accurate diagnosis, monitoring disease activity and progression, selecting therapeutics, and assessing treatment response. Because of their correlations with specific clinical characteristics and often with disease progression, autoantibodies and other soluble mediators are considered potential biomarkers. Additional biomarkers might reflect downstream pathologic processes or appear because of ongoing inflammation and damage. Because of overlap between diseases, some biomarkers have limited specificity for a single autoimmune connective tissue disease. This review describes select current biomarkers that aid in the diagnosis and treatment of several major systemic autoimmune connective tissue disorders: systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, and anti-neutrophil cytoplasmic antibody-associated vasculitides. Newly proposed biomarkers that target various stages in disease onset or progression are also discussed. Newer approaches to overcome the diversity observed in patients with these diseases and to facilitate personalized disease monitoring and treatment are also addressed.
[Mh] Termos MeSH primário: Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico
Artrite Reumatoide/diagnóstico
Doenças do Tecido Conjuntivo/diagnóstico
Lúpus Eritematoso Sistêmico/diagnóstico
Escleroderma Sistêmico/diagnóstico
[Mh] Termos MeSH secundário: Animais
Autoanticorpos/metabolismo
Biomarcadores/metabolismo
Seres Humanos
Medicina de Precisão
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Biomarkers)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171210
[St] Status:MEDLINE


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[PMID]:29248123
[Au] Autor:Glebova NO; Black JH
[Ad] Endereço:Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 East 17(th) Avenue, Room 5409, Mail Stop C312, Aurora, CO 80045. Electronic address: Natalia.Glebova@UCDenver.edu.
[Ti] Título:Current management of infected aortic grafts in patients with connective tissue disorders.
[So] Source:Semin Vasc Surg;30(2-3):75-79, 2017 Jun - Sep.
[Is] ISSN:1558-4518
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients with connective tissue disorder present a particular clinical challenge in the treatment of aortic graft infections. Specific complexities arise in patients with connective tissue disorders when reoperation for aortic graft infection is required. Herein we describe current management of infected aortic grafts in patients with connective tissue disorders using homograft and rifampin-coated graft replacements using in situ replacement therapy, which is associated with improved outcome compared to graft excision and extra-anatomic bypass.
[Mh] Termos MeSH primário: Anti-Infecciosos/administração & dosagem
Aorta/cirurgia
Implante de Prótese Vascular/efeitos adversos
Prótese Vascular/efeitos adversos
Materiais Revestidos Biocompatíveis
Doenças do Tecido Conjuntivo/complicações
Remoção de Dispositivo
Infecções Relacionadas à Prótese/cirurgia
Rifampina/administração & dosagem
[Mh] Termos MeSH secundário: Implante de Prótese Vascular/instrumentação
Doenças do Tecido Conjuntivo/diagnóstico
Seres Humanos
Desenho de Prótese
Infecções Relacionadas à Prótese/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Coated Materials, Biocompatible); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171218
[St] Status:MEDLINE


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[PMID]:28451992
[Au] Autor:Sambataro D; Sambataro G; Dal Bosco Y; Campagna D; Polosa R
[Ad] Endereço:Artroreuma srl, Outpatient of Rheumatology Accredited with National Health System, Corso San Vito 53, 95030, Mascalucia, CT, Italy. d.sambataro@hotmail.it.
[Ti] Título:Is there any role for thoracic ultrasound for interstitial lung disease underlying rheumatologic conditions? Reply.
[So] Source:Intern Emerg Med;12(6):905-906, 2017 09.
[Is] ISSN:1970-9366
[Cp] País de publicação:Italy
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças do Tecido Conjuntivo
Doenças Pulmonares Intersticiais
[Mh] Termos MeSH secundário: Artrite Reumatoide
Seres Humanos
Pulmão
Ultrassonografia
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1007/s11739-017-1669-x


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[PMID]:28467309
[Au] Autor:Zheng B; Li E; Zhu H; Lu J; Shi X; Zhang J; Li M
[Ad] Endereço:.
[Ti] Título:Automated antinuclear immunofluorescence antibody analysis is a reliable approach in routine clinical laboratories.
[So] Source:Clin Chem Lab Med;55(12):1922-1930, 2017 Oct 26.
[Is] ISSN:1437-4331
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Indirect immunofluorescence (IIF) assays are recommended as the gold standard method for the detection of antinuclear antibodies (ANAs). This study aimed to investigate the reliability of an automated system. METHODS: We compared 3745 serum samples using NOVA View archived images with manual analysis via microscopy. A custom cutoff value was established to distinguish ANA titers and was validated in two clinical laboratories. The automatic ANA pattern recognition system was evaluated, and all ANA-positive sera were subjected to two commercial ANA IIF kits to compare the consistency of the pattern interpretation results. For inconsistent patterns, a third ANA IIF testing kit was utilized. RESULTS: Agreement of the interpretation of the ANA IIF test using the platform of NOVA View and manual microscopy was 96.9%. The local cutoff value to discriminate ANA titers in four main ANA patterns was calculated based on 1390 serum samples. In our laboratory, the titer prediction accuracy was superior to the preset cutoff in NOVA View (p<0.01); the performance was similar in another laboratory (p=0.11). The automatic pattern recognition accuracies of speckled, homogeneous, centromere, nucleolar and nuclear dot patterns were 62.7%, 57.4%, 92.6%, 30.5% and 27.3%, respectively. The consistency of the pattern interpretation results between INOVA and MBL kits was 95.3%. CONCLUSIONS: It is necessary to establish a custom value-added ANA report. However, confirmation of the digital immunofluorescence images by expert technicians was essential, and suspect results of an ANA pattern should be reconfirmed by another commercial ANA IIF kit to achieve more reliable results.
[Mh] Termos MeSH primário: Anticorpos Antinucleares/sangue
Automação/normas
Técnicas de Laboratório Clínico/normas
Doenças do Tecido Conjuntivo/sangue
Testes Diagnósticos de Rotina/normas
Técnica Indireta de Fluorescência para Anticorpo/normas
[Mh] Termos MeSH secundário: Doenças do Tecido Conjuntivo/diagnóstico
Seres Humanos
Controle de Qualidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antinuclear)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171129
[Lr] Data última revisão:
171129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:28457080
[Au] Autor:Levy Y; Ruhrman-Shahar N
[Ad] Endereço:Department of Medicine E, Meir Medical Center, Kfar Saba, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:The Ongoing Debate regarding Long-Term Safety of Silicone Breast Augmentation Rages.
[So] Source:Isr Med Assoc J;18(12):754-755, 2016 Dec.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Implante Mamário/efeitos adversos
Implantes de Mama/efeitos adversos
Géis de Silicone/efeitos adversos
[Mh] Termos MeSH secundário: Implante Mamário/métodos
Doenças do Tecido Conjuntivo/etiologia
Doenças do Tecido Conjuntivo/patologia
Feminino
Seres Humanos
Desenho de Prótese
Falha de Prótese
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Silicone Gels)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


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[PMID]:28931060
[Au] Autor:Jardel S; Fabien N; Hot A; Vukusic S; Tebib J; Cottin V; Sève P; Laville M; Belot A; Durieu I; Garnier L; Coutant F; Reynaud Q; Lega JC
[Ad] Endereço:Department of Internal and Vascular Medicine, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Claude Bernard University Lyon 1, University of Lyon, Lyon, France.
[Ti] Título:Isolated positive anti-SS-B autoantibodies are not related to clinical features of systemic autoimmune diseases: Results from a routine population survey.
[So] Source:PLoS One;12(9):e0185104, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess in clinical practice the frequency and diagnosis associated with the SS-B-positive/SS-A negative autoantibody profile. METHODS: We analyzed a one-year consecutive population of 624 patients referred by clinicians to the immunology laboratory to investigate anti-SS-A and/or anti-SS-B autoantibodies, who were detected using luminex technology. Data were analyzed for patients with isolated anti-SS-B autoantibodies. The clinical characteristics and diagnosis of connective tissue diseases (CTD) were retrieved according to the international criteria. RESULTS: Among 1173 sera positive for anti-SS-A and/or anti-SS-B autoantibodies from 624 patients, we identified 84 patients (13.5%) that had isolated anti-SS-B. Among the 75 patients positive for anti-SS-B with known clinical data, 15 were diagnosed with a CTD (20%) including 4 systemic lupus erythematosus (5%), 4 rheumatoid arthritis (5%), 2 idiopathic inflammatory myositis (3%), 1 primary Sjögren's syndrome pSS (1%), 1 systemic sclerosis (1%), 2 undefined CTD (3%), and 1 mixed CTD (1%). Among the 60 other patients, 18 had non-CTD autoimmune diseases and 42 had non-autoimmune diseases. Within the CTD population, the presence of isolated anti-SS-B was not significantly associated to characteristic indicating a specific syndrome. There was no association between diagnosis of CTD and level of anti-SS-B autoantibodies (p = 0.70). Arthralgia was the more frequent sign and encountered in 10 patients (67%), of whom 3 had arthritis. CONCLUSION: The presence of anti-SS-B, without anti-SS-A autoantibodies using luminex technology, was not associated with CTD, especially pSS, in daily clinical practice. Our data suggests that the SS-B serological profile is not contributive for the classification criteria of pSS.
[Mh] Termos MeSH primário: Anticorpos Antinucleares/imunologia
Autoanticorpos/imunologia
Doenças do Tecido Conjuntivo/diagnóstico
Doenças do Tecido Conjuntivo/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Anticorpos Antinucleares/sangue
Artrite Reumatoide/imunologia
Autoanticorpos/sangue
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antinuclear); 0 (Autoantibodies); 0 (SS-A antibodies); 0 (SS-B antibodies)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185104


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[PMID]:28816943
[Au] Autor:Zhou Y; Chai X; Zheng H; Song R; Qin X
[Ad] Endereço:Department of Spinal Surgery, Luoyang Orthopaedic Hospital of Henan Province, Luoyang, Henan, China.
[Ti] Título:Spinal cord compression syndrome caused by intraspinal epidural fibrous cord: Three case reports.
[So] Source:Medicine (Baltimore);96(33):e7592, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The spinal cord compression caused by intraspinal epidural fibrous cord. PATIENT CONCERNS: All patients in this study had spinal cord compression syndrome caused by an intraspinal epidural fibrous cord, manifested as abnormally increased epidural adipose tissue by imaging. DIAGNOSE: These abnormal fibrous connective tissue strips were not identical to the known pathological tissue such as "meningovertebral ligament." Instead, it might be a novel pathogenic cause for the spinal cord compression. INTERVENTIONS: The intraspinal exploratory operation. OUTCOMES: the first case has expected effect, the remaining two need further test. LESSONS SUBSECTIONS: The disease could be easily misdiagnosed as spinal epidural lipoma or lipomatosis before the operation. However, the overt intraoperative finding was the indefinite starting and ending points of the epidural adipose mass in addition to the increased amount of adipose tissue. The obvious compression on the spinal cord could be found as the extraordinarily large and broad hypertrophic fibrous connective tissue strips.Further studies are needed to elucidate whether it is different from, or associated with, lipoma and epidural lipomatosis, which is a serious issue to be considered by both clinicians and radiologists. Therefore, early discovery,diagnosis, and treatment should be the prerequisites to achieve a satisfactory effect.
[Mh] Termos MeSH primário: Doenças do Tecido Conjuntivo/complicações
Doenças do Tecido Conjuntivo/patologia
Compressão da Medula Espinal/diagnóstico
Compressão da Medula Espinal/etiologia
[Mh] Termos MeSH secundário: Adulto
Criança
Diagnóstico Diferencial
Feminino
Seres Humanos
Lipoma/diagnóstico
Lipomatose Simétrica Múltipla/diagnóstico
Masculino
Meia-Idade
Compressão da Medula Espinal/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007592



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