bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serologic follow-up of children born to mothers with Ro/SSA autoantibodies
Authors: Klauninger R , Skog A , Horvath L , Winqvist O , Edner A , Bremme K , Sonesson SE , Wahren-Herlenius M 
Published: July 2009

Neonatal lupus erythematosus (NLE) develops in foetuses of mothers with Ro/SSA and La/SSB antibodies and may include foetal atrioventricular block and dermatologic manifestations. In this study, we investigated postnatal Ro and La IgG, IgA and IgM antibody levels up to 1 year of age in 32 children born to Ro/SSA positive mothers. Antibody levels were correlated with NLE manifestations, and the role of breast feeding in transfer of autoantibodies from mother to child was evaluated. Ro52, Ro60 and La IgG antibodies all transferred from the mothers to their foetus in utero and were present in the infant at birth as detected by enzyme-linked immunosorbent assay using recombinant antigens and a synthetic peptide. A significant decrease in Ro52, Ro60 and La IgG autoantibody levels of the infants was observed from birth to 4–5 weeks of age ( P < 0.05, P < 0.05 and P < 0.01). Ro- and La-specific IgA and IgM antibodies were detected in the serum from a subset of mothers. However, Ro- and La-specific IgA and IgM antibody levels were low or non-detectable in children raised both with and without breastfeeding. Furthermore, NLE skin lesions developed independently of breastfeeding. Our findings support a role for placental materno-foetal transfer of IgG autoantibodies in the pathogenesis of NLE and indicate that refraining from breastfeeding does not protect from NLE skin involvement.
Survival analysis and prognostic indicators of systemic lupus erythematosus in Pakistani patients
Authors: Rabbani MA , Habib HB , Islam M , Ahmad B , Majid S , Saeed W , Shah SMA , Ahmad A 
Published: July 2009

To aim of this study is to analyse the survival rate and prognostic indicators of systemic lupus erythematosus (SLE) in Pakistani population. A total of 198 patients with SLE diagnosed between 1992 and 2005 were reviewed retrospectively. Clinical features at presentation, subsequent evolving features, autoantibody profile, damage scores and mortality data were obtained. Prognostic factors for survival were studied by statistical analysis. Of 198 SLE patients studied, 174 were women and 24 were men. The women to men ratio was 7.2:1. Mean age at presentation was 31 years (range 14–76). Mean duration of symptoms before diagnosis was 2.8 years. Mean duration of follow-up was 34.21 months (±33.69). Mean disease duration was 15.6 years. At diagnosis, arthritis, malar rash, oral ulcers and alopecia were the commonest features. During the follow-up, the prevalence of nephritis, arthritis, neurological and hematological disease increased significantly. About 76% ( n = 151) of the patients had organ damage at the time of data analysis, and renal disease was the commonest cause. Univariate analysis revealed that renal disease ( P = 0.000), seizures ( P = 0.048), pleural involvement ( P = 0.019), alopecia ( P = 0.000) and discoid lesions ( P = 0.005) were predictors for damage. Multivariate model, however, revealed that only renal disease was independent risk factor for damage ( P = 0.002). During the study period, 47 patients (24%) died (five due to disease-related complications and rest as a result of infections). The 3-, 5-, 10-, 15- and 20-year survival rates of our cohort were 99, 80, 77, 75 and 75%, respectively. Cox regression analysis revealed that renal involvement ( P = 0.002) and infections ( P = 0.004) were independent risk factors for mortality. The survival of our Pakistani SLE patients was significantly lower compared to that of the Caucasian series reported in last decade. Nephritis not only contributes to organ damage but also acts a major determinant for survival. Infection remains the commonest cause of death. Renal involvement and infections are independent risk factors for mortality. Judicious use of immunosuppressive agents is necessary to improve the short-term survival of lupus patients.
Adipocytokines in systemic lupus erythematosus: relationship to inflammation, insulin resistance and coronary atherosclerosis
Authors: Chung CP , Long AG , Solus JF , Rho YH , Oeser A , Raggi P , Stein CM 
Published: July 2009

We tested the hypothesis that concentrations of adipocytokines are altered in SLE and associated with coronary atherosclerosis, insulin resistance and inflammation. Concentrations of resistin, leptin, adiponectin and visfatin were measured in 109 patients with SLE and 78 control subjects. Coronary calcification was measured using electron beam-computed tomography, and insulin resistance was defined by the homeostasis model assessment index. Concentrations of adiponectin (28.7 ± 17.9 vs 22.0 ± 15.3 μg/mL, P = 0.003), leptin (41.1 ± 49.9 vs 19.8 ± 24.6 ng/mL, P < 0.001) and visfatin (7.5 ± 10.5 vs 4.5 ± 2.8 ng/mL, P < 0.001) were higher in patients with SLE than in controls. These differences remained significant after adjustment for age, race, sex and body mass index (BMI; all P values < 0.02). Concentrations of resistin (10.7 ± 7.6 vs 9.1 ± 5.1 ng/mL, P = 0.41) did not differ in patients and controls. In patients with SLE, leptin was positively associated with BMI ( ρ = 0.80, P < 0.001), insulin resistance ( ρ = 0.46, P < 0.001) and C-reactive protein (CRP) ( ρ = 0.30, P = 0.002), whereas adiponectin was negatively associated with the same factors ( ρ = –0.40, P < 0.001; ρ = −0.38, P < 0.001; ρ = –0.22, P = 0.02, respectively). None of the adipocytokines were associated with coronary atherosclerosis in SLE. In conclusion, patients with SLE have increased concentrations of adiponectin, leptin and visfatin. Lower concentrations of adiponectin and higher concentrations of leptin are associated with insulin resistance, BMI and CRP in patients with SLE.
The causes and clinical significance of fever in systemic lupus erythematosus: a retrospective study of 487 hospitalised patients
Authors: Zhou WJ , Yang CD 
Published: July 2009

The causes of fever in systemic lupus erythematosus (SLE) are complicated. Differential diagnosis of fever in SLE is crucial for optimal management of these patients. To better understand the causes and characteristics of fever in SLE, the medical records of 1949 consecutive patients hospitalised for SLE from January 2002 to May 2007 were reviewed. A total of 487 SLE-hospitalised patients with fever were identified and retrospectively analysed. Among them, 265 patients had fever from infection, 206 had fever related to SLE, 8 had fever caused by both SLE activity and infections, 4 had fever caused by malignancies and 4 had fever ascribed to miscellaneous causes. The most common sites of infection were the respiratory tract (62.6%), urinary tract (8.6%), skin and mucosa (8.3%). A prednisone dose of ≤100 mg/d was able to suppress SLE fever in 80.6% of the patients, usually within 1–5 days. Compared to patients with infection fever, those with SLE fever were more likely to have lower serum complement C3 and a higher SLE Disease Activity Index score. Infection fever was found to be associated with the use of azathioprine within the last six months. In conclusion, infection and disease activity are the most common causes of fever in SLE. Those patients for whom SLE fever could not be suppressed by a higher dose of steroids usually had severe lupus encephalopathy or hemophagocytic syndrome.
Long-term follow-up after non-myeloablative transplant of bone and marrow in BXSB mice
Authors: Jones OY , Lacson A , Zeng X , Jones JM , Katti K , Cahill RA , Ahmed AA 
Published: July 2009

We present long-term outcomes of BXSB mice after non-myeloablative bone marrow transplants using major histocompatability complex (MHC)-matched cells. Groups differed in sources of donor lymphocytes or mesenchymal stromal cells (MSC). Unfractionated marrow cells from green fluorescent protein (GFP) transgenic (Tg) mice (BMT group) or from RAG1−/− B6 mice (RAG group) were injected intravenously (i.v.) into irradiated (550 cGy) hosts. As a source of mesenchymal cells, bone chips from GFP-Tg were injected intraperitoneally alone (MSC group) or along with i.v. bone marrow cells (BMT + MSC group). Controls were untreated mice (UnTx) or mice exposed to radiation only (Rad Cont). At 62 weeks post-transplant, surviving mice were harvested for histopathology, flow cytometry and real time polymerase chain reaction (RT-PCR). The mice from BMT + MSC group had the best outcomes for survival rates (71.4% vs. 43.8%), renal scores (2.9% vs. 28.8% glomerular sclerosis) and percent splenic monocytes (4.2 vs. 11.3%) compared with mice from Rad Cont. Improvement in RAG and BMT groups was less prominent but were comparable with one another. Although MSC alone were not sufficient to control the renal pathology, it limited the expansion of CD4−CD8− T cell populations without a change in Foxp3 expression. The results suggest the importance of the innate immune system in disease pathogenesis and a role for MSC in immunomodulation.
Time to neuropsychiatric damage occurrence in LUMINA (LXVI): a multi-ethnic lupus cohort
Authors: González LA , Pons-Estel GJ , Zhang J , Vilá LM , Reveille JD , Alarcón GS ,   for the LUMINA study group
Published: July 2009

The aims of this study were to examine the predictors of time to neuropsychiatric (NP) damage and its impact on mortality in 632 systemic lupus erythematosus African-American, Hispanic and Caucasian LUpus in MInorities: NAture versus Nurture (LUMINA) patients, age ≥ 16 years and disease duration ≤5 years at baseline (T0). Time-to-NP damage and its impact on mortality were examined by Cox proportional hazards regressions. A total of 185 (29.3%) patients developed NP damage over a mean (SD) disease duration of 5.6 (3.7) years. After adjusting for NP manifestations present, older age [Hazard ratio (HR) = 1.02; 95% Confidence interval (CI) 1.00–1.04], Caucasian ethnicity (HR = 1.87; 95% CI, 1.22–2.87), disease activity over the disease course (HR = 1.16; 95% CI, 1.12–1.21), diabetes (HR = 3.47; 95% CI, 1.44–8.38) and abnormal illness-related behaviours (HR = 1.05; 95% CI, 1.02–1.08) were associated with a shorter time-to-NP damage. Photosensitivity (HR = 0.65; 95% CI, 0.44–0.95), anaemia (HR = 0.56; 95% CI, 0.31–0.98), Raynaud’s phenomenon (HR = 0.49; 95% CI, 0.34–0.72), a medium dose of prednisone (HR = 0.56; 95% CI, 0.35–0.92) and hydroxychloroquine use (HR = 0.58; 95% CI, 0.36–0.93) were associated with a longer time. NP damage did not contribute to mortality. Older age, Caucasian ethnicity, disease activity and abnormal illness-related behaviours are associated with a shorter time-to-NP damage; hydroxychloroquine and a medium dose of prednisone with a longer time.
Dyspnoea in a young woman with active systemic lupus erythematosus
Authors: Todd DJ , Costenbader KH 
Published: July 2009

Diffuse alveolar haemorrhage (DAH) is a rare but life-threatening complication of systemic lupus erythematosus (SLE). We present the case of a 24-year-old Cambodian woman with SLE followed in the Brigham and Women’s Hospital Lupus Center in Boston, Massachusetts. She presented with dyspnoea and chest pain and was found to have DAH that required a prolonged hospitalization that was complicated by recurrent DAH episodes and multiple infections. We discuss the diagnostic approach and management of patients with SLE-associated DAH as well as treatment options for refractory disease. Emerging therapies include plasmapheresis, the anti-CD20 monoclonal antibody rituximab and recombinant activated Factor VII therapy. In addition, we review the literature to date and compile what is known about the epidemiology, presenting features, diagnostic findings, management and outcomes in this condition. We found that DAH has been reported in 1.9% of patients with SLE. These patients were mostly female (88%) and young (mean age 30.2 years). Common presenting features included dyspnoea (94%), anaemia (97%) and new radiographic chest infiltrate (99%). Bronchoscopy, when performed, identified DAH in 90% of cases. Corticosteroids were the mainstay of care, and usage of cyclophosphamide varied by report. Despite recent advances in therapy, mortality has not improved substantially (48% overall survival versus 53% survival in reports published since 1993).
Environmental risk factors and health outcomes in selected communities of the Niger delta area, Nigeria
Authors: Ana Godson REE , Sridhar Mynepalli KC , Bamgboye Elijah A 
Published: July 2009

Aims: The main aim of this study was to assess the prevalence of various health outcomes associated with exposure to environmental risk factors including industrial pollution in selected communities of Nigeria's oil-rich Niger delta area (NDA). Methods: The study involved both laboratory experiments and community health surveys using questionnaires and hospital records. A total of 14 air samples, 16 grab soil samples and 18 surface water samples were collected and analyzed for physicochemical parameters including heavy metals and polycyclic aromatic hydrocarbons (PAHs) using standard methods. A 77-item questionnaire was administered on randomly selected 349 subjects. A five-year record was collected from health facilities located in the two communities. Results: The laboratory results indicated that the median PAH level at Eleme as compared to Ahoada East was higher than the guideline limit 50 ng/l for surface waters. The mean TSP level at Eleme was higher than the level at Ahoada East and the guideline limit 100 µg/m3. The median PAH level at Eleme was higher than the level at Ahoada East and the guideline limit < 100 ng/m3 for air. The survey results showed that at Eleme air pollution in the community was significantly associated with painful body outgrowths ( p = 0.027) and the effect the air contaminants has was significantly associated with respiratory health problem ( p = 0.044). At Ahoada East commonly consumed aquatic food was highly significantly associated with painful body outgrowth ( p < 0.0001) while use of domestic cooking fuel types was also highly significantly associated with child deformities ( p < 0.0001). Hospital records showed high proportions of respiratory disorder among males (3.85%) and females (4.39%) at Eleme as compared to the proportion of respiratory disorder among males (3.68%) and females (4.18%) at Ahoada East. Conclusions: The study shows that industrial communities such as Eleme, which are exposed to higher levels of air pollution, are more predisposed to respiratory morbidities, skin disorders and other related health risks.
The impact of well-developed preventative strategies on the eradication of head lice
Authors: Ibarra Joanna , Fry Frances , Wickenden Clarice , Jenner Maryan , Franks Andrea 
Published: July 2009

In the 1970s Donaldson applied the principles of infectious disease surveillance to pediculosis capitis infestation with head lice. This provided a lasting insight into an effective strategy for prevention. Research in Teesside, UK, proved that the first step in breaking the chain of transmission is the engagement of parents in an intensive detection/treatment campaign. United action halved the infestation rate, even though failing lindane treatments were in use. Subsequently although effective malathion treatment was introduced, it became clear that the late detection of light cases of head lice still undermines eradication. This paper analyzes the development by the health charity, Community Hygiene Concern, of the Bug Busting programme based on this solid evidence. In the 1990s the charity solved the problem of detecting asymptomatic lice using a specially designed Bug Buster louse comb in wet, conditioned hair. It undertook the popularization of this method and the co-ordination of national detection days (Bug Busting Days) through primary schools. In 2004 this structured approach to prevention was adopted in Chester. It produced a 24% reduction in health authority spending on treatment products in the first year and appreciable savings in professional time. It is concluded that participation in the Bug Busting programme benefits community health providers and schools. Provision of dependable detection combs with the correct instructions to families at risk, empowers them to gain sustainable, cost-effective control of head lice.
Glycaemic control and restenosis after percutaneous coronary interventions in patients with diabetes mellitus: a report from the Insulin Diabetes Angioplasty study
Authors: Hage Camilla , Norhammar Anna , Grip Lars , Malmberg Klas , Sarkar Nondita , Svane Bertil , Rydén Lars 
Published: July 2009

Objective: We investigated the impact of glucose control on target lesion restenosis after PCI in patients with type 2 diabetes. Methods: Ninety-three consecutive patients with type 2 diabetes accepted for PCI were randomised to intensified glucose control based on insulin (I-group; n=44) or to continue ongoing glucose-lowering treatment (C-group; n=49).The treatment target was a FBG of 5—7 mmol/L and HbA1c <6.5%. Information on target lesion restenosis after six months was available in 82 patients. Results: At baseline HbA1c and FBG did not differ between the I- and C-groups, respectively (HbA1c: 6.5 vs. 6.5%; p=1.0 and FBG: 7.0 vs. 7.3 mmol/L; p=0.3). After six months there was no significant change in HbA1c or FBG in either group (change in HbA1c: -0.2 vs.-0.1%; p=0.3 and in FBG: +0.2 vs. -0.3 mmol/L; p=0.3 in the I- and C-groups, respectively). Target lesion restenosis at six months did not differ, I vs. C = 41 and 44% (p=0.8). Independent predictors for restenosis were previous myocardial infarction (OR 8.0, 95% CI 2.5—25.7; p=<0.001) and FBG at baseline (OR for an increase by 1 mmol/L = 1.4, 95% CI 1.1—1.9; p=0.015). Conclusions: Restenosis was predicted by baseline FBG suggesting that it would be of interest to target glucose normalisation in future trials. Intensified insulin treatment did not influence the rate of restenosis indicating that the main focus should be on lowering glucose rather than the tool to normalise glucose.
Transcutaneous carbon dioxide profile during sleep reveals metabolic risk factors in post-menopausal females
Authors: Aittokallio J. , Saaresranta T. , Virkki A. , Karppinen N. , Heinonen O. J. , Aittokallio T. , Polo O. 
Published: July 2009

The risks of metabolic syndrome and sleep-disordered breathing increase around the time of the menopause. We have previously shown that features of the nocturnal transcutaneous carbon dioxide (TcCO2) profile are associated with metabolic variables such as cholesterol, glycosylated haemoglobin A1C (GHbA1C) and blood pressure in patients with sleep apnoea. In the present study, we investigated whether these metabolic variables can be predicted using noninvasive TcCO2measurements during sleep in generally healthy post-menopausal females.22 post-menopausal females underwent an overnight polygraphic sleep study that involved the continuous monitoring of arterial oxygen saturation (Sa,O2) and TcCO2. Body composition, GHbA1C, plasma cholesterol and blood pressure were measured prior to the sleep study.Nocturnal TcCO2features were the most important predictors of lipoprotein cholesterols, triglycerides and blood pressure levels. A longer sleep period and higher TcCO2levels were linked with lower GHbA1C, and fragmented sleep with lower high-density lipoprotein cholesterol. Neither nocturnalSa,O2indices nor the apnoea/hypopnoea index had a predictive power.The results suggest that nocturnal TcCO2events revealed metabolic risk factors already present in healthy post-menopausal females.
Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study
Authors: Lam K-B. H. , Jordan R. E. , Jiang C. Q. , Thomas G. N. , Miller M. R. , Zhang W. S. , Lam T. H. , Cheng K. K. , Adab P. 
Published: July 2009

There is some evidence that chronic obstructive pulmonary disease (COPD) and metabolic syndrome may be related, perhaps through systemic inflammation, which is common to both. However, the association between the two conditions has not yet been clearly shown.The present study involved 7,358 adults aged ≥50 yrs from a population-based survey who underwent spirometry, a structured interview and measurement of fasting metabolic marker levels.Airflow obstruction (forced expiratory volume in 1 s/forced vital capacity ratio of less than the lower limit of normal) was present in 6.7%, and the International Diabetes Federation metabolic syndrome criteria were met by 20.0%. The risk of metabolic syndrome was higher in those with airflow obstruction than in those without (odds ratio (OR) 1.47; 95% confidence interval (CI) 1.12–1.92), after controlling for potential confounders. Of the five components of metabolic syndrome, only central obesity was significantly associated with airflow obstruction (OR 1.43; 95% CI 1.09–1.88) after adjusting for body mass index. A similar association was observed in both never and current smokers.In this Chinese sample, airflow obstruction was associated with metabolic syndrome, and, in particular, its central obesity component. This may help explain the increased risk of cardiovascular diseases in COPD, and so could guide future clinical practice.
Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?
Authors: Hoogendoorn M. , van Wetering C. R. , Schols A. M. , Rutten-van Mölken M. P. M. H. 
Published: July 2009

The study aimed to estimate the cost-effectiveness of interdisciplinary community-based chronic obstructive pulmonary disease (COPD) management in patients with COPD.We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. All-cause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs).The INTERCOM group had 30% (95% CI 3–56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01–0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07–1.78). Mean total 2-yr costs were €2,751 (95% CI -€632–€6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of €9,078 per additional patient with a relevant improvement in SGRQ or €32,425 per QALY.INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.