جستجوی مقالات مرتبط با کلیدواژه « systemic » در نشریات گروه « پزشکی »

</span></span> Systemic lupus erythematosus (SLE) affects women of childbearing age, leading to higher maternal and fetal morbidity and mortality. Disease flares during pregnancy complicate care. This study evaluates maternal and fetal outcomes in pregnancies complicated by SLE.</span></span></span></span></span></span>
</span></span> A retrospective analysis was conducted on 31 pregnancies complicated by SLE at the Department of Obstetrics and Gynaecology, TD Medical College, Alleppey, from January 2010 to December 2018. Data on maternal demographics, obstetric history, SLE manifestations, treatments, pregnancy outcomes, complications, disease flares, interventions, and delivery details were collected. Maternal complications, including gestational hypertension, pre-eclampsia/eclampsia, HELLP syndrome, diabetes, abruption, preterm birth, fetal growth restriction, lupus nephritis, and postpartum hemorrhage, were examined. Fetal outcomes were assessed based on perinatal morbidity and mortality and NICU admissions. </span></span></span></span></span></span>
</span></span> Among the 31 pregnancies, 67% of the women were aged 20-30 years. SLE was diagnosed during the current pregnancy in 45.2% of cases, with 53.3% of these diagnoses occurring in the first trimester. Preterm birth was the most common complication, observed in 48.4% of pregnancies, with 29% live born and 19.4% stillborn. Hypertensive disorders were prevalent, with 38.7% developing pre-eclampsia/eclampsia. Antiphospholipid antibody positivity was noted in 29% of patients. Severe SLE flares occurred in 12.9% of patients, all with nephropathy in the third trimester. </span></span></span></span></span></span>
</span></span> Favorable pregnancy outcomes are more likely in women whose SLE activity is quiescent for at least six months before conception, without lupus nephritis, antiphospholipid syndrome, or superimposed preeclampsia. The findings emphasize the need for vigilant monitoring and management of pregnancies complicated by SLE.</span></span></span></span></span></span>

Systemic Lupus Erythematosus (SLE) cases have been growing over the years, and the role of environmental agents are at the center of investigations. However, few studies have addressed the role of solvents. Therefore, we reported an SLE case in a patient with long-term low-level exposure to organic solvents in the workplace.

Case Report:

 A 58-year-old black female attended a teaching hospital evaluation due to oral ulcers, 14 kilos loss, and leukopenia. Her occupational history revealed a 24-year exposure to organic solvents with inadequate protection. After investigation, we made an SLE diagnosis related to solvents based on clinical presentation and laboratory tests (anemia, leukopenia, hypocomplementemia, positive antinuclear antibodies, and biomarkers of exposure). The patient’s treatment included corticosteroids, immunosuppressive, and antimalarial drugs. As a result, she gradually improved in clinical and laboratory conditions.

We addressed the potential role of solvents in developing SLE in this case report regarding a patient chronically exposed to them. SLE is a multifactorial disease triggered in genetically-prone individuals by environmental exposure. Although few studies have addressed the relationship between solvents and SLE with mixed results, strong evidence links them with other autoimmune diseases. There is biological plausibility for solvents triggering SLE, as autoimmune diseases share clinical presentation, genetic factors, and physiopathologic mechanisms. 

Our case highlights the potential role of solvents in developing SLE. Although there are mixed results on this relationship, strong evidence associates them with other autoimmune diseases. Considering the wide use of solvents in many contexts and the similarity between autoimmune diseases, we recommend further investigations.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, caused by abnormal innate and adaptive immune responses. Anti-nuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA) are reliable biomarkers for diagnosing SLE. Here, we aimed to investigate the serum levels of anti-dsDNA and ANA antibodies, their diagnostic utilities, and their relationship with disease activity and clinical/laboratory manifestations in patients with suspected.

We evaluated the plasma levels of ANA and anti-dsDNA antibodies in all individuals with suspected SLE (n=668) who had been referred to rheumatology clinics in Gorgan, Iran. The level of antibodies as well as C3, C4, and CH50 were determined using commercially available enzyme-linked immunosorbent assay kits.

The mean level of ANA and anti-dsDNA antibodies differed significantly between the ANA-positive and ANA-negative groups (p<0.001). However, there was no significant difference in the mean values of C3 (p=0.233), C4 (p=0.415, and CH50 (p=0.482) between the two groups. Moreover, there was a significant positive correlation between ANA and anti-dsDNA levels (p<0.001, r=0.50).

Our findings indicate that anti-dsDNA levels are higher in ANA-positive individuals, and there may be a positive correlation between ANA and anti-dsDNA levels. It is recommended to evaluate the diagnostic and prognostic values of ANA and anti-dsDNA antibodies in future studies.

Autoimmune myelofibrosis (AIMF) is considered as an infrequent cause of bone marrow fibrosis (BMF) and a rare complication of systemic lupus erythematosus (SLE). Due to its rarity, it is mistakenly diagnosed as primary myelofibrosis (MF).We describe the clinicopathologic features of a secondary form of AIMF in a 33- year- old female patient with an undiagnosed SLE which presented with acute bicytopenia. Absence of splenomegaly, leukopenia, anemia, BMF (grade MF-1), and presence of autoantibodies were some of noticeable features. Treatment with corticosteroid led to complete regeneration of the bone marrow and subsequently to an improved hematological status. Six- month follow-up showed that the patient was in good clinical condition.Identification of AIMF is a diagnostic challenge and pitfall and it is actually a diagnosis of exclusion. It could be the first and only presenting feature of SLE and results in hematologic disturbances. So, we should consider SLE-associated AIMF in the differential diagnosis of pancytopenia.

Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder that frequently manifests itself with renal and neurological involvements. Cardiac involvement, however, has been rarely reported. In this report, we present a rare case of acquired TTP with acute myocardial infarction (AMI) as the initial manifestation. Although AMI was successfully managed by percutaneous coronary intervention, the patient developed hemolytic anemia, fever, marked thrombocytopenia, oliguria, and renal dysfunction, requiring treatment with plasma exchange and corticosteroids. TTP, albeit extremely rare, should be considered in cases with unexpected thrombocytopenia during acute-phase treatment for AMI as it can be highly lethal if not treated immediately.

The Vitamin D receptor (VDR) polymorphisms are the candidate genetic variants for susceptibility to different disease including autoimmune disorders. In the present study, we aimed to assess the association between VDR polymorphisms and systemic lupus erythematosus (SLE) susceptibility in Southeast Iranian population.

One hundred and twenty‑seven patients with SLE and 139 controls were genotyped for VDR rs2228570, rs731236, and rs7975232 polymorphisms using polymerase chain reaction‑restriction fragment length polymorphism method.

The VDR rs2228570 polymorphism was associated with higher risk of SLE in codominant, dominant, and overdominant models. Moreover, higher risk of SLE was observed in individuals with VDR rs731236 polymorphism in codominant, dominant, overdominant, and allelic models. The tAf haplotype of rs731236/rs7975232/rs2228570 polymorphisms was associated with higher risk of SLE.

In conclusion, VDR rs2228570 and rs731236 polymorphisms and tAf haplotype were associated with SLE risk.

Cutaneous leishmaniasis is a prevalent parasitic infection in humans. According to the reports published in several localities across the world, leishmaniasis is an endemic disease in certain regions in Iran. Leishmaniasis is transmitted through sandfly bites and is often diagnosed through the smear examination of the affected area using a microscope. The treatments of choice for leishmaniasis involve the use of pentavalent antimony compounds, such as meglumine antimoniate and sodium stibogluconate. However, other medications have been proposed for the treatment of leishmaniasis, and there is ongoing research for effective, less harmful treatments. This narrative review aimed to summarize various systemic treatments for leishmaniasis.

There is limited evidence detailing the cost-effectiveness of psoriasis treatments in the Asian region. Therefore, this study is aimed to evaluate the cost-effectiveness of 3 psoriasis treatments tailored for moderate to severe psoriasis, namely topical and phototherapy (TP), topical and systemic (TS), and topical and biologic (TB) regimens, respectively. Methods This has been achieved by the participation of a prospective cohort involving a total of 90 moderate to severe psoriasis patients, which has been conducted at 5 public hospitals in Malaysia. The main outcome measures have been evaluated via cost and effectiveness psoriasis area severity index (PASI)-75 and/or body surface area (BSA)

Both scleroderma renal crisis and severe pericardial effusion are rare and life-threatening complications of systemic sclerosis. This article describes a case of scleroderma renal crisis heralded by severe pericardial effusion. The patient was a 39-year-old woman with a history of 8 years diffuse cutaneous scleroderma and extensive skin involvement who referred to Imam Khomeini Hospital Complex, Tehran, Iran, with worsening dyspnea and pleuritic chest pain. Echocardiography revealed severe pericardial effusion, which was drained by the pericardial window. Thereafter, the patient became gradually anuric and her blood pressure was uncontrolled despite maximum doses of antihypertensive agents, including captopril. The serum creatinine level was increased progressively; thus, hemodialysis started. Concomitantly, microangiopathic hemolytic anemia complicated the course of the disease, which responded to plasma exchange. Kidney biopsy revealed pieces of evidence indicating thrombotic microangiopathy. This case report denotes to a probable association between scleroderma the renal crisis and severe pericardial effusion. Therefore, physicians should be vigilant about the renal crisis in patients with systemic sclerosis and pericardial effusion.

This study aimed to explore the clinical characteristics of noninfectious fever in patients with systemic lupus erythematosus (SLE) and the underlying causes through multivariate analysis. Clinical data of 128 patients with SLE who were admitted to Affiliated Hospital of Nanjing Universi-ty of TCM, Nanjing 210029, P.R. China from January 2015 to December 2017 were retrospectively analyzed. The following factors were closely associated with fever: patient age, treatment history, SLEDAI score, enlarged liver, spleen and lymph nodes, low hemoglobin, leukopenia, CRP, complement C3, albumin, anti-dsDNA antibody, glucocorticoids, and cyclophosphamide. Multivariate logistic regression analysis showed that factors, such as enlarged liver, spleen and lymph nodes, digestive system involvement, low hemoglobin, leuko-penia, CRP, decreased albumin, anti-dsDNA antibody, glucocorticoids and cyclophosphamide, were closely as-sociated with noninfectious fever in SLE. Noninfectious fever is a common clinical manifestation of SLE. Factors, such as enlarged liver, spleen and lymph nodes, digestive system involvement, low hemoglobin, leukopenia, CRP, decreased albumin, anti-dsDNA antibody, glucocorticoids, and cyclophosphamide, were independent risk factors for noninfectious fever in SLE.

The present study aimed to investigate the prevalence, inductive agents, potential risk factors, and prognosis pertaining to the specific risk factors of fungal infections in the hospitalized children in the northwest of Iran.
This descriptive-analytical, retrospective study was conducted on all the children who were hospitalized in the Pediatric Hospital of Tabriz, Iran due to positive fungal culture during 23 August 2010-23 September 2013. The culture samples were collected from various positive fungal body fluids, secretions, and/or catheters.
In total, 40,638 patients were hospitalized during the study period, 191 of whom had fungal cultures and were enrolled in the study. Among the studied patients, 58% were male, and 42% were female. The prevalence of fungal infections in the pediatric healthcare center was 0.47% (approximately four infections per 1,000 cases). The most common comorbidities in the hospitalized children with positive fungal culture were aspiration pneumonia (15%), urinary tract infections (9%), and septicemia (7%). In addition, the most frequently infected area was the urinary system (37%). Candida albicans and mycelial fungi accounted for the most common varieties of the fungal isolates obtained from the patients. The mortality rate among the studied children with fungal infections was estimated at 27%.
According to the results, the main risk factors for fungal infections included the use of intravenous catheters, urinary catheters, intubation, and history of surgery. Therefore, it is recommended that the potential risk factors of these infections be screened and investigated in the patients admitted to the Pediatric Teaching Hospital of Tabriz.

A case of refractory systemic lupus erythematosus was admitted with repeated tonic colonic seizures, intractable vomiting, diarrhea, and headache. Neurologic examinations, lumbar puncture analysis, and electroencephalogram were normal but magnetic resonance imaging of the brain showed dilated ventricles and sulci. Despite standard induction therapy, the patient gradually entered a confusional state, disorientation that changed to abnormalities in verbal and working memory, and finally no verbal communication for several days and avoided eating food and taking oral drugs. The patient achieved partial remission of the disease (improved symptoms of psychosis and renal function despite a high titter of anti-double strand DNA and positive anti-nuclear antibodies) with plasmapheresis, intravenous immunoglobulin, and anti-psychotic medication. Our case is interesting because he was refractory not only to standard treatments, but also he did not respond to therapeutic options that are used in refractory systemic lupus erythematosus and presented with psychosis that is an unusual clinical presentation in SLE.

Bone marrow mesenchymal stem cells (BMSCs) are the key to regenerative wound healing. MSCs have spatial memory and respond to local environment. The goal of this study was to evaluate the use of systemic and intralesional transplantation of BMSCs for regeneration of oral mucosa in an in vivo dog model. Transplantation of undifferentiated green fluorescent protein (GFP)- labeled autologous BMSCs systemically, submucosally or vehicle (saline) was injected around the chemically induced oral ulcer in each group of 18 adult dogs. The healing process of the ulcer was monitored clinically and histopathologically. Gene expression of vascular endothelial growth factor (VEGF) and collagen genes was detected in biopsies from all ulcers. One way ANOVA was used to compare between means of the three groups. Results were considered significant at P < 0.05. Flow cytometric analysis of the MSCs at the passage 3 showed that these cells were negative for CD45 (2.39%). They expressed high levels of CD29 (98.34%). Frozen fluorescence microscopy of sections of the cell-treated oral tissue of all groups indicated that the GFP-transduced implanted cells were integrated within the transplanted tissues. The treatment resulted in dramatic wound edge activation and resurfacing of oral mucosa wound. Our results revealed that BMSCs may be labeled with (GFP), in order to know the distribution of these cells after administration, and suggest that intralesional administration is an appropriate procedure to achieve acceptable regeneration of the previously injured oral mucosa more than systemic route.

Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a molecule engaged in regulation of T cells. Polymorphisms in the CTLA-4 gene (CTLA4) are known to be associated with several autoimmune diseases, including Systemic lupus erythematosus.. To evaluate the potential influences of common SNP in CTLA-4 promoter region (-1661 A/G), a case-control study was performed on Iranian children..Patients and Genotypes of 31 patients and 50 healthy controls were investigated using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.. Our study showed that there were no statistically significant differences in the allele and genotype frequencies of -1661 A/G SNP between patients with SLE and healthy controls (P > 0.05).. In conclusion, we found no association between SNP-1661 A/G of the CTLA-4 promoter region and susceptibility to SLE in our population..

Mycobacterium tuberculosis (MTB) is one of the most common causes of disseminated granulomatous diseases especially in developing countries.. We present a patient who had an unusual type of tuberculosis who was misdiagnosed with some other common diseases such as infective endocarditis and collagen vascular diseases. Pathological examination helped us to make decision.. MTB can present with protean clinical manifestations and cause various laboratory abnormalities. In endemic areas, vigilance is essential to control this infection..

Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer’s disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

Periodontal disease is now increasingly believed to play a significant part in various systemic conditions. Likewise these systemic diseases and their severity have been found to have an impact on the morbidity of periodontal disease. A number of mechanisms specific to such interlink have been proposed and later established in numerous studies. The disorders with such bidirectional link with periodontal disease include cardiovascular, respiratory, neurological, and connective tissue diseases. The periodontal – systemic interlink has a vibrant effect on the management aspects and is of paramount topical interest to clinicians. We review the pertaining literature (Google scholar and pubmed).