1,720,968 research outputs found
Adult-onset still’s disease: Novel biomarkers of specific subsets, disease activity, and relapsing forms
No full textAdult-onset Still’s disease (AOSD) is a systemic inflammatory disease of unknown etiology. Recent studies have demonstrated that the hallmark of AOSD is a cytokine storm, which is characterized by the excessive production of interleukin (IL)-1, IL-6, IL-18, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ), suggesting how pro-inflammatory cytokines play an important role in the pathogenesis of this disease. Actually, a certain proportion of patients (around 17–32%) with severe clinical symptoms achieves only partial remission or is resistant to both first-line corticosteroids and second-line DMARDs. These patients are defined as refractory AOSD patients, requiring higher dosage glucocorticoids, longer treatment duration, or the simultaneous introduction of immunosuppressive drugs, further leading to AOSD relapses. In this narrative review, we will analyze the latest literature data to unravel potential pathogenetic factors associated with specific patterns of AOSD disease or relapses in order to identify biomarkers that may guide clinical decisions, eventually leading to new therapeutic options
Herpes zoster infection following mRNA COVID-19 vaccine in a patient with ankylosing spondylitis
No full textSince the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) pandemic outbreak, vaccines gained a growing role. Possible vaccine-related side effects range from minor local events to more prominent systemic manifestations up to anaphylactic reactions. A heterogeneous spectrum of cutaneous reactions has been reported, ranging from local injection site reactions to urticarial and morbilliform eruptions, pernio/chilblains and zoster flares. Here, we describe a case of varicella zoster virus reactivation following mRNA coronavirus 2019 vaccine and discuss the available literature upon the topic published so far
Reply to: “Herpes zoster seven days after SARS-CoV-2 vaccination in a patient with ankylosing spondylitis under adalimumab” by Josef Finsterer
No full textSeveral guidelines suggest investigating the incidence and prevalence of vaccine-preventable infections in adult patients with autoimmune or inflammatory diseases; consequently, the effect and safe-ty issues of vaccination are under careful examination. Moreover, immunosup-pression and immunodeficiency were con-traindications for the previously available vaccine in the past years, thus live zoster vaccine was originally recommended for immunocompetent adults aged ≥50 years, leading to an unmet need for vaccination against HZ in immunocompromised adults. Considering all these efforts and the current pandemic challenge, we be-lieve that now more than ever we are asked to quickly detect potential adverse events, even extremely rare and mild ones, and to face them, in order to support the robust pharmacovigilance campaign for SARS-CoV2 vaccination
The Role of Ultrasound in Temporomandibular Joint Disorders: An Update and Future Perspectives
No full textTemporomandibular joint (TMJ) disorder is the second most common chronic pain condition affecting the general population after back pain. It encompasses a complex set of conditions, manifesting with jaw pain and limitation in mouth opening, influencing chewing, eating, speaking, and facial expression. TMJ dysfunction could be related to mechanical abnormalities or underlying inflammatory arthropathies, such as rheumatoid arthritis (RA) or juvenile idiopathic arthritis (JIA). TMJ exhibits a complex anatomy, and thus a thorough investigation is required to detect the TMJ abnormalities. Importantly, TMJ involvement can be completely asymptomatic during the early stages of the disease, showing no clinically detectable signs, exposing patients to delayed diagnosis, and progressive irreversible condylar damage. For the prevention of JIA complications, early diagnosis is therefore essential. Currently, magnetic resonance imaging (MRI) is described in the literature as the gold standard method to evaluate TMJ. However, it is a high-cost procedure, not available in all centers, and requires a long time for image acquisition, which could represent a problem notably in the pediatric population. It also suffers restricted usage in patients with claustrophobia. Ultrasonography (US) has emerged in recent years as an alternative diagnostic method, as it is less expensive, not invasive, and does not demand special facilities. In this narrative review, we will investigate the power of US in TMJ disorders based on the most relevant literature data, from an early screening of TMJ changes to differential diagnosis and monitoring. We then propose a potential algorithm to optimize the management of TMJ pathology, questioning what would be the role of ultrasonographic study
PREDICTORS OF CARDIOVASCULAR RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS: CORRELATION BETWEEN THE PRESENCE OF CARDIOVASCULAR DISEASE AND CHARACTERISTICS OF THE JOINT DISEASE
No full textLATE-BREAKERS: SESSION 2: PDF Only
PREDICTORS OF CARDIOVASCULAR RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS
CORRELATION BETWEEN THE PRESENCE OF CARDIOVASCULAR DISEASE AND CHARACTERISTICS OF THE JOINT DISEASE
Borghi, C.; Bentivenga, C.; Cicero, A.F.; Trevisani, M.; Rossi, E.; Viviani, F.; Maranini, B.; Mulè, R.; Vukatana, G.; Buffa, A.; Corvaglia, S.; Malavolta, N.
Author Information
Journal of Hypertension 37():p e225-e226, July 2019. | DOI: 10.1097/01.hjh.0000572904.86052.da
Abstract
Objective:
Cardiovascular events represent the leading cause of death in patients with rheumatoid arthritis. Traditional cardiovascular risk factors alone do not adequately explain the phenomenon. This is probably due to other risk factors typical of joint disease, such as chronic inflammation and autoantibodies. Our study investigated the traditional cardiovascular risk factors and the characteristics of joint disease in a population of 374 patients with rheumatoid arthritis, in order to identify elements that allow a more adequate stratification and risk management.
Design and method:
A retrospective study was conducted that evaluated the traditional cardiovascular risk factors and characteristics of joint disease, ie disease duration, antibody profile and extra-articular manifestations. In addition, the therapy taken by patients for the treatment of rheumatoid arthritis was investigated and QRISK2 was calculated.
Results:
RF (Rheumatoid Factor) positive and ACPA (anti-citrullinated peptide antibodies) positive subjects have higher QRISK2 values than subjects who have either negative antibodies or either one positive (p = 0.038). Among patients with QRISK2 > 20% (high cardiovascular risk) 60% had RF and ACPA positive (p = 0.02). The correlations between antibody positivity (FR and ACPA), QRISK2 values and cardiovascular event were also compared; it was observed that statistically significant p values are obtained (p = 0.003).
Conclusions:
In our patient cohort, subjects at high cardiovascular risk, calculated on the basis of QRISK2, are predominantly FR and ACPA positive subjects. The addition of the autoantibody evaluation to QRISK2 increases the predictability of cardiovascular risk assessment in this patient population. We can suggest how further studies can support these hypotheses and we can support the evaluation of autoantibodies, easy to perform in the clinical setting, to the scoring systems currently used, to better outline the cardiovascular risk in patients suffering from rheumatoid arthritis, in order to implement also adequate prevention of cardiovascular events
microRNAs and Inflammatory Immune Response in SARS-CoV-2 Infection: A Narrative Review
Full text linkThe current SARS-CoV-2 pandemic has emerged as an international challenge with strong medical and socioeconomic impact. The spectrum of clinical manifestations of SARS-CoV-2 is wide, covering asymptomatic or mild cases up to severe and life-threatening complications. Critical courses of SARS-CoV-2 infection are thought to be driven by the so-called “cytokine storm”, derived from an excessive immune response that induces the release of proinflammatory cytokines and chemokines. In recent years, non-coding RNAs (ncRNAs) emerged as potential diagnostic and therapeutic biomarkers in both inflammatory and infectious diseases. Therefore, the identification of SARS-CoV-2 miRNAs and host miRNAs is an important research topic, investigating the host–virus crosstalk in COVID-19 infection, trying to answer the pressing question of whether miRNA-based therapeutics can be employed to tackle SARS-CoV-2 complications. In this review, we aimed to directly address ncRNA role in SARS-CoV-2-immune system crosstalk upon COVID-19 infection, particularly focusing on inflammatory pathways and cytokine storm syndromes
Temporomandibular joint involvement in psoriatic arthritis: a prospective clinical and ultrasonographic study
No full textOBJECTIVES: To evaluate the prevalence of temporomandibular disorders (TMD) in a monocentric cohort of patients affected by psoriatic arthritis (PsA), and to investigate the accuracy of temporomandibular joint (TMJ) ultrasound (US) compared with clinical evaluation and clinimetric composite index in assessing TMJ involvement. METHODS: We conducted a prospective cohort study of patients diagnosed with PsA who underwent at least one TMJ US examination and maxillofacial surgeon's evaluation between 2018 and 2021. The rheumatology physician's interpretation of each TMJ US exam (presence/absence of TMD) was compared with psoriatic arthritis disease activity indexes and maxillofacial surgeon's clinical judgement (presence/absence of TMD signs and/or symptoms). RESULTS: 142 psoriatic arthritis patients were included. 111 patients were totally asymptomatic for TMD, but 58.5% of them already showed TMJ US changes; moreover, 103 patients passed the maxillofacial surgeon's examination in the absence of any relevant findings but again, of these, 55.3% already presented US signs of TMD. Univariate analysis of subgroups with and without TMJ synovitis and with and without active power Doppler signal showed a significant prevalence of peripheral enthesitic involvement in patients affected by TMD (95.7% vs. 4.3%, p=0.001; and 72.2% vs. 27.3%, p=0.007, respectively). Multivariate regression analysis confirmed the results (p=0.01 and p=0.013, respectively). CONCLUSIONS: Peripheral enthesitic involvement may represent a potential risk factor for the development of TMJ synovitis in PsA patients. Since TMD often develops asymptomatically, TMJ US may detect early signs of TMD, ensuring precocious and adequate management
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Erythema nodosum after COVID-19 vaccine
No full textThe current coronavirus disease 2019 (COVID-19) pandemic is a global challenge with strong medical and socioeconomic implications. Hopes have been placed in the development of various vaccines. As the vaccination campaign is in progress, adverse effects need to be monitored closely. Possible side effects range from minor events to more serious manifestations. In this article, we describe two cases of erythema nodosum (EN) after COVID-19 vaccination in two previously healthy female patients of 59 and 51 years, respectively. Most of the usual etiologies of EN were excluded by laboratory testing. EN was successfully treated with corticosteroids. Remarkably, in the first case, a relapse occurred 48 hours after the second dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. In this case series, we describe two unusual occurrences of EN after vaccination with an mRNA COVID-19 vaccine and a viral vector vaccine, respectively, and we discuss the available related literature
- …
