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1.
Lupus ; 23(4): 436-42, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24399814

RESUMO

INTRODUCTION: Renal involvement is the most common serious complication in patients with systemic lupus erythematosus (SLE). OBJECTIVE: The objective of this article is to investigate and determine the associated factors of disease damage among lupus nephritis (LN) patients. METHODS: Medical records of LN patients who attended regular follow-up for at least one year in the Nephrology/SLE Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), were reviewed. Their Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index scores were noted. Univariate analysis and multivariable regression analysis were performed to determine the independent factors of disease damage in LN. RESULTS: A total of 150 patients were included and their follow-up duration ranged from one to 20 years. Sixty (40%) LN patients had disease damage (SDI ≥1). In the univariate analysis, it was associated with age, longer disease duration, antiphospholipid syndrome (APS), higher maximum daily oral prednisolone dose (mg/day), lower mean C3 and C4, higher chronicity index and global sclerosis on renal biopsies (p < 0.05). Patients who received early (≤3 months after the SLE diagnosis) hydroxychloroquine (HCQ), optimum HCQ dose at 6.5 mg/kg/day and achieved early complete remission (CR) were less likely to have disease damage (p < 0.05). After adjustment for age, gender, disease duration and severity, multivariable regression analysis revealed that a higher maximum daily dose of oral prednisolone was independently associated with disease damage while early HCQ and CR were associated with lower disease damage. CONCLUSION: Higher maximum daily prednisolone dose predicted disease damage whereas treatment with early HCQ and early CR had a protective role against disease damage.


Assuntos
Síndrome Antifosfolipídica/epidemiologia , Hidroxicloroquina/uso terapêutico , Nefrite Lúpica/fisiopatologia , Prednisolona/uso terapêutico , Adulto , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Hidroxicloroquina/administração & dosagem , Nefrite Lúpica/epidemiologia , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prednisolona/administração & dosagem , Análise de Regressão , Indução de Remissão , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo
2.
BMJ Case Rep ; 20102010 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-22778377

RESUMO

Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.


Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Nocardiose/etiologia , Pneumonia Bacteriana/etiologia , Antibacterianos/uso terapêutico , Anticorpos Monoclonais Murinos/efeitos adversos , Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Nocardiose/diagnóstico , Nocardiose/tratamento farmacológico , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/tratamento farmacológico , Rituximab , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
3.
Med J Malaysia ; 63 Suppl A: 67-8, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19024987

RESUMO

Bone formation is an active process whereby osteoblasts are found on the surface of the newly formed bone. Adhesion to extracellular matrix is essential for the development of bone however not all surfaces are suitable for osteoblast adhesion and don't support osteoblastic functions. The objective of this study was to test the suitability of a collagen based microcarrier which would support osteoblastic functions.


Assuntos
Biomarcadores , Osso e Ossos/fisiologia , Moléculas de Adesão Celular/fisiologia , Técnicas de Cultura de Células , Colágeno , Matriz Extracelular/fisiologia , Osteoblastos , Osteogênese/fisiologia , Sobrevivência Celular , Humanos , Imunofenotipagem
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