BackgroundCurrent recommendations for ANCA-associated vasculitis (AAV) support its management within a dedicated clinical service. Therapies for AAV are imperfect with many patients failing to achieve disease control and others experiencing disease relapse. Plasma exchange (PEX) may be beneficial especially when the kidney is involved.MethodsWithin a new, dedicated service we retrospectively assessed, over a 6-year period, the benefits of PEX in two patient cohorts, discriminated by PEX treatment alone. Patients received PEX alongside standard of care if they fulfilled any of the following criteria: 1. serum creatinine >500 μmol/l or dialysis-requiring renal failure, 2. alveolar haemorrhage, 3. renal biopsy showing ≥30 % focal and necrotising lesions ± cellular crescents. Outcome measures included disease remission and relapse, cumulative immunosuppression, and morbidity and mortality.ResultsOf 104 new patients, 58 patients received PEX at presentation, 46 did not. Cyclophosphamide and/or rituximab dosing was similar for both groups. Although patients receiving PEX had poorer renal function, a higher C-reactive protein and disease activity score at presentation disease remission rate was similar in both groups (no PEX vs. PEX: 96 % vs. 98 %). The PEX group entered remission quicker (no PEX vs. PEX: 3.9 ± 4.0 vs. 2.8 ± 1.3 months, p < 0.05), with a lower 3-month cumulative glucocorticoid dose (no PEX vs. PEX: 2.5 ± 0.4 vs. 2.3 ± 0.2 g, p < 0.001). Relapse was similar between groups but adverse events lower in the PEX group.ConclusionsPEX may be of benefit in AAV. Larger, longer randomised controlled trials are now needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0796-7) contains supplementary material, which is available to authorized users.
SUMMARY At present there are no reliable statistics on the relative prevalences of sexually transmitted diseases (STDs) in Spain. In a report of the first three years' experience in an STD diagnostic centre between 1977 and 1979 a total of 879 patients (534 men and 345 women) were seen. They mainly consisted of university students and the mean age was 22 years in 1977 and 23 years in the following two years. All the patients were examined for syphilis and all women for gonorrhoea and trichomoniasis. Investigations for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans, and Herpesvirus hominis infections were carried out according to the presenting symptoms. Non-specific genital infections occurred most commonly (25-70o); chlamydia were isolated from 30% of the patients with non-gonococcal urethritis (NGU). The second commonest infection was candidosis (13-5%). Gonorrhoea, which was found in 10 607o of the patients, was diagnosed more frequently in men (13' 5'%) than in women (6%).No strains of P-lactamase-producing Neisseria gonorrhoeae were detected and all were sensitive to penicillin. Syphilis was diagnosed in 4-4'0 of patients (2% women and 5% men). Condylomata acuminata were diagnosed in 2-8% of patients and more frequently in men (4Wo). Herpes genitalis and venereophobia were uncommon (Il 9% and 1-20o respectively) and were diagnosed only in men.
En las memorias de militantes de tres agrupaciones revolucionarias que tras la dictadura se mantuvieron activas en la transición chilena, se enfatiza cómo la maternidad y los vínculos familiares incidieron en las prácticas que ejercieron las mujeres en sus organizaciones. El artículo es fruto de una investigación situada desde los estudios de memoria y con perspectiva de género con entrevistas a ex militantes del Movimiento de Izquierda Revolucionario (MIR), del Lautaro y del Movimiento Patriótico Manuel Rodríguez Autónomo. A partir de un análisis crítico del discurso con perspectiva feminista (ACDF) se analizó cómo la construcción de la “maternidad” y la “familia” no sólo generaron reproducciones de imaginarios tradicionales sino también posibilidades estratégicas de acción militante, agencia y resistencia, tanto en quienes se opusieron al nuevo pacto democrático como también en algunas de las mujeres que cruzaron encarcelamiento. Asimismo, verificamos cierta “solidaridad afectiva” entre mujeres militantes y otras no militantes en determinados contextos.
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