Arterial stiffness is said to be a novel predictor of cardiovascular events. This study investigated the correlation between arterial stiffness parameters and the estimated cardiovascular disease risk (RISK) in a Polish cohort of patients divided by age, sex, and body-mass index (BMI). The cross-sectional study enrolled 295 patients who met the inclusion criteria. Subjects were divided into three age groups, four weight groups, and by gender. The stiffness of the vessels was assessed by the measurement of the stiffness index (SI) and reflection index (RI). An individual 10-year RISK was calculated for each patient using the Heart Risk Calculator algorithm by the American Heart Association. A correlation between the SI and estimated RISK was observed (rS 0.42, p < 0.05). The strongest relationship was presented for women, the age group 40–54, and individuals with normal weight. The correlation between RI and calculated RISK was observed (rS 0.19, p < 0.05), the highest correlation was noticed for people aged 40–54 and obese. In conclusion, both SI and RI are correlated with estimated cardiovascular risk, however SI seems to be more useful than RI to predict the individual risk of future cardiovascular events. Both of these can be measured using non-invasive techniques, which demonstrates their potential utility in clinical practice.
Background and Objectives: Autoimmune bullous diseases (AIBDs) may be treated with intravenous immunoglobulin (IVIG) infusions. This study aimed to evaluate the benefits and safety profiles of high-dose IVIG therapy in AIBD patients, as determined by clinical remission, the glucocorticosteroid-sparing effect, and adverse events at 12 months follow-up in a Central European university dermatology department setting. Materials and Methods: Our case series included 10 patients: five patients with pemphigus vulgaris, one with pemphigus herpetiformis, one with pemphigus foliaceus, one with bullous pemphigoid, two with epidermolysis bullosa acquisita. They underwent 4–12 monthly cycles of IVIG therapy at a dose of 2 g/kg per cycle. Results: The prednisone dosage reduction after 2, 6, and 12 months following the final IVIG course was 65.45%, 70.91%, and 76.37%, respectively. During the 12-month observation period, disease relapse was observed in 20% of patients, while others achieved complete or partial remission without or with minimal therapy. Side effects were seen in 80% of patients; they were transient and did not necessitate discontinuation of IVIG. Conclusions: IVIG demonstrates effectiveness as a treatment with a favorable safety profile. Nevertheless, its high cost remains a significant drawback, particularly in low-income countries. IVIG should be considered, especially in patients opposed to standard therapies or with contraindications to their use.
BackgroundNeuropsychiatric systemic lupus erythematosus (NPSLE) is defined as wide range of neurological and psychiatric symptoms due to inflammation and ischemic processes. It is difficult to recognize primary NPSLE because of multiple central and peripheral symptoms.ObjectivesThe aim of the study was to identified and classified the group of NPSLE patients with evaluation of disease activity.MethodsWe observed clinical neuropsychiatric (NP) manifestations in the cohort of 128 Polish patients with SLE. All patients with suspicion of NP symptoms had neuropsychological and imaging examinations. Symptoms of NPSLE were observed in 38 (30%) patients (34 female and 4 male) with average age 38±6 years (range 18–61 yrs), average disease duration 6,6±5,6 years (range 1,0 - 18,0 yrs). Patients were treated with oral and pulse glucocorticoids (GC) and 89% of them standard immunosuppressive drugs (CYC, MMF, AZA,MTX, CsA). As a background therapy 82% of these patients were on chloroquine or hydroksychloroquine (CQ/HCQ). All patients were assessed according to Systemic Lupus Erythematosus Disease Activity Index by SLEDAI (version 2000), Physical Global Assessment (PGA) and damage index (SDI).ResultsCentral and peripheral NPSLE symptoms were recognized and categorized (Tab 1). All NPSLE patients had symptoms from central nervous system, but only 16% (n=6) of them had peripheral lupus manifestations. Mean SLEDAI score at NP event was very high 29±9,6, but mean SLEDAI score without NP symptoms was 15±8,3 and was connected with musculoskeletal, mucocutaneous, renal and hematological domains respectively n=29, 76%; n=23, 60%; n=11, 29%; n=8, 21%. Low disease activity was estimated at 3% of patients examined.Most of lupus patients (n=37, 97%) had moderate or high disease activity regardless of NP symptoms. In our study group lupus patients during NPSLE symptoms were immunologically active with increased anti-dsDNA antibodies (n=30, 78%) and/or lower complements C3 and/or C4 levels (n=21, 55%).ConclusionsIn Polish lupus cohort we observed more frequently lupus-related primary neuropsychiatric symptoms from central nervous system, especially cognitive dysfunctions, mood disorders, cerebrovascular events. Clinical activity of NPSLE patients was rather high and definitely most of patients were immunologically active despite aggressive immunosuppressive treatment and with standard background therapy.Disclosure of InterestNone declared
Rosacea is a chronic dermatosis, manifesting with erythema, papular or pustular eruptions located in the facial area. The authors present a case of an 84-year-old woman with a long-term history of rosacea who had a mycotic infection of the facial skin imitating aggravation of the underlying disease. The case presented by us can be regarded as a variant of "tinea incognito", i.e., undiagnosed mycosis, misdiagnosed as another dermatosis, which is often aggravated by the patient by using local glucocorticosteroids or other local immunomodulators, which hinders proper diagnosis. It may be diagnostically relevant to consider other comorbidities in elderly patients with rosacea. StReSZCZenie Trądzik różowaty jest przewlekłą dermatozą, która objawia się występowaniem wykwitów rumieniowych, grudkowych lub krostkowych w obrębie skóry twarzy. Autorzy przedstawiają przypadek 84-letniej kobiety z wieloletnim wywiadem w kierunku trądziku różowatego, u której rozpoznano grzybicze zakażenie skóry twarzy imitujące nasilenie choroby podstawowej. Prezentowany przez nas przypadek można uznać za odmianę tinea incognito, tj. grzybicę błędnie rozpoznaną jako inna dermatoza. Przypadki tego typu często są powodowane przez samych pacjentów, którzy stosują miejscowe glikokortykosteroidy lub inne miejscowe immunomodulatory, co utrudnia właściwą diagnozę. U pacjentów z trądzikiem różowatym w starszym wieku możliwe jest współwystępowanie nużycy i nadkażenie innymi patogenami.
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