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Review of Systems

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125401. Central nervous system and cardiac effects from long-acting amide local anesthetic toxicity in the intact animal model. Full Text available with Trip Pro

Central nervous system and cardiac effects from long-acting amide local anesthetic toxicity in the intact animal model. With the development of the newer long-acting amide local anesthetics,ropivacaine and levobupivacaine, numerous animal studies of LA systemic toxicity have emerged. Because of the complex nature of the human response to LA intoxication, the task of designing and interpreting these animal studies of LA toxicity can be difficult. Accordingly, this report will review (...) the selection of an animal model for the study of LA toxicity; examine the pertinent in vivo animal studies that compare the central nervous system toxicity, cardiovascular toxicity, and the ease of resuscitation of the single enantiomer local anesthetics to racemic bupivacaine; and extrapolate these findings to the clinical setting.

2003 Regional Anesthesia and Pain Medicine

125402. The epidemiology of systemic lupus erythematosus. (Abstract)

The epidemiology of systemic lupus erythematosus. Systemic lupus erythematosus (SLE) is the most diverse of the autoimmune diseases because it may affect any organ of the body and display a broad spectrum of clinical and immunological manifestations. Although previously considered a rare disease, SLE now appears to be relatively common in certain groups of the population. This is probably due to the development of several immunological tests that have allowed the description of many atypical (...) or benign cases that otherwise might not be diagnosed. Furthermore, with the introduction since 1982 of a set of more sensitive criteria for SLE classification, more cases can nowadays be detected. In the present article, we review the most important data regarding the incidence and prevalence of this disease in the general population, the epidemiologic information on the patterns of disease expression in specific subsets and the studies on mortality in SLE. An important amount of information comes from

2003 Clinical Reviews in Allergy & Immunology

125403. Cardiac involvement in systemic autoimmune diseases. (Abstract)

Cardiac involvement in systemic autoimmune diseases. The heart and the vascular system are frequent and characteristic targets of several systemic autoimmune diseases, in particular Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc). In this chapter we review the classic cardiac abnormalities and the more recent data about cardiovascular involvement as part of a major disease complication determining a substantial morbidity and mortality. In addition (...) to the classic cardiac abnormalities involving the heart structures, acute and chronic ischemic heart disease and cerebrovascular accidents are threatening clinical manifestations of SLE and RA associated to an early accelerated atherosclerosis. Immune-mediated inflammation is now recognized as an important factor involved in the pathogenesis of atherosclerosis. Ongoing clinical studies are being devised to find specific risk factors associated with systemic autoimmune diseases and/or treatment regimens

2002 Clinical Reviews in Allergy & Immunology

125404. Newly recognized components of the renin-angiotensin system: potential roles in cardiovascular and renal regulation. Full Text available with Trip Pro

Newly recognized components of the renin-angiotensin system: potential roles in cardiovascular and renal regulation. The renin-angiotensin system (RAS) is a coordinated hormonal cascade in the control of cardiovascular, renal, and adrenal function that governs body fluid and electrolyte balance, as well as arterial pressure. The classical RAS consists of a circulating endocrine system in which the principal effector hormone is angiotensin (ANG) II. ANG is produced by the action of renin (...) is reviewed and discussed in light of these newly recognized components.

2003 Endocrine Reviews

125405. The matrix metalloproteinase system: changes, regulation, and impact throughout the ovarian and uterine reproductive cycle. Full Text available with Trip Pro

changes in the ovarian and uterine extracellular architecture are regulated, in part, by the matrix metalloproteinase (MMP) system. The MMP system acts to control connective tissue remodeling processes throughout the body and is comprised of both a proteolytic component, the MMPs, and a regulatory component, the associated tissue inhibitors of metalloproteinases. The current review will highlight the key features of the MMPs and tissue inhibitors of metalloproteinases, focus on the changes (...) The matrix metalloproteinase system: changes, regulation, and impact throughout the ovarian and uterine reproductive cycle. The ovary and uterus undergo extensive tissue remodeling throughout each reproductive cycle. This remodeling of the extracellular environment is dependent upon the cyclic hormonal changes associated with each estrous or menstrual cycle. In the ovary, tissue remodeling is requisite for growth and expansion of the follicle, breakdown of the follicular wall during

2003 Endocrine Reviews

125406. Systemic and local regulation of the growth plate. Full Text available with Trip Pro

as crucial regulators of chondrocyte proliferation and differentiation. In this review, we present an update on the present perception of growth plate function and the regulation of chondrocyte proliferation and differentiation by systemic and local regulators of which most are now related to human growth disorders. (...) Systemic and local regulation of the growth plate. The growth plate is the final target organ for longitudinal growth and results from chondrocyte proliferation and differentiation. During the first year of life, longitudinal growth rates are high, followed by a decade of modest longitudinal growth. The age at onset of puberty and the growth rate during the pubertal growth spurt (which occurs under the influence of estrogens and GH) contribute to sex difference in final height between boys

2003 Endocrine Reviews

125407. The renin-angiotensin system and the long-term complications of diabetes: pathophysiological and therapeutic considerations. (Abstract)

The renin-angiotensin system and the long-term complications of diabetes: pathophysiological and therapeutic considerations. The relationship between the renin-angiotensin system (RAS) and the progression of diabetic renal disease has been a major focus of investigation over the past 20 years. More recently, experimental and clinical studies have also suggested that the RAS may have a pathogenetic role at other sites of micro- and macrovascular injury in diabetes. Complementing major advances (...) into the understanding of the local, as distinct from the systemic RAS, a number of large clinical trials have examined whether blockade of the RAS might provide protection from the long-term complications of diabetes, beyond that due to blood pressure reduction alone. While some controversy remains, these studies have, in general, suggested that angiotensin converting enzyme (ACE) inhibition and more recently, angiotensin receptor blockade reduce the development and progression of diabetic nephropathy

2003 Diabetic Medicine

125408. Systemic therapies for psoriasis: understanding current and newly emerging therapies. (Abstract)

Systemic therapies for psoriasis: understanding current and newly emerging therapies. The treatment of moderate to severe psoriasis is a rapidly expanding area. Recent insights into the pathogenesis of this disease as a T-cell mediated process has led to a greater understanding of the mechanisms of action of conventional FDA-approved systemic therapies such as methotrexate, cyclosporine, acitretin, and psoralen with ultraviolet A phototherapy. It has also led to the development of rationally (...) targeted therapies against key components of the immune process critical in the generation of the psoriatic plaque. Safety and efficacy data from clinical studies of 4 biologic agents furthest along in their development are reviewed. These results are promising, adding to the armamentarium for treating this disease.

2003 Seminars in Cutaneous Medicine and Surgery

125409. False positive VDRL (BFP-STS) and systemic lupus erythematosus; new data in clinico-laboratory associations. (Abstract)

False positive VDRL (BFP-STS) and systemic lupus erythematosus; new data in clinico-laboratory associations. To investigate the relationships between clinical features and serological parameters in systemic lupus erythematosus (SLE) patients with false positive venereal disease research laboratory (VDRL) test (BFP-STS) and those without.The records of 74 patients with SLE were reviewed. These were divided on the basis of the presence of a biologically false positive serological test (BFP-STS (...) of BFP-STS in lupus patients may vary from those described in relation to other antiphospholipid determinants. Our patients appeared to have sparing of certain major organ systems, yet there was a greater tendency to developing Antiphospholipid (APL) syndrome and hemolytic anaemia.

2002 International Journal of Dermatology

125410. Management of drug rash with eosinophilia and systemic symptoms (DRESS syndrome): an update. (Abstract)

Management of drug rash with eosinophilia and systemic symptoms (DRESS syndrome): an update. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rather distinct severe adverse drug reaction characterised by skin rash, fever, lymph node enlargement and internal organ involvement. Our aim was to review the available data regarding the management of this probably underrecognised subset of drug reaction. So far, the only undisputed way to treat severe hypersensitivity reactions (...) is prompt withdrawal of the offending drug. The use of systemic corticosteroids remains controversial. The benefit of therapies aimed at accelerating the elimination of the causative drug deserves further studies. In the absence of a well-established therapy, primary and secondary prevention have a key role in the management of DRESS syndrome.Copyright 2003 S. Karger AG, Basel

2003 Dermatology

125411. Etanercept-induced systemic lupus erythematosus. (Abstract)

arthritis and juvenile chronic arthritis. A number of studies report the development of antinuclear and anti-double-stranded DNA antibodies in patients treated with TNF antagonists for rheumatoid arthritis. There are few reports of the development of clinical features of discoid, subacute or systemic lupus erythematosus. We present one of the first reported cases of etenercept-induced systemic lupus erythematosus and review the literature of lupus and TNF antagonists. (...) Etanercept-induced systemic lupus erythematosus. Tumour necrosis factor (TNF) is a pro-inflammatory cytokine with a role in the pathogenesis of a number of conditions including rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis and Crohn's disease. Etanercept (Enbrel; Immunex Corp., Seattle, WA, USA) is a recombinant soluble fusion protein of TNF-alpha type II receptor and IgG which acts by blocking the action of TNF-alpha. It is licensed for use in rheumatoid

2003 Clinical & Experimental Dermatology

125412. Endocrine status in patients with optic nerve hypoplasia: relationship to midline central nervous system abnormalities and appearance of the hypothalamic-pituitary axis on magnetic resonance imaging. Full Text available with Trip Pro

Endocrine status in patients with optic nerve hypoplasia: relationship to midline central nervous system abnormalities and appearance of the hypothalamic-pituitary axis on magnetic resonance imaging. We here: 1) describe the phenotypic spectrum, including magnetic resonance imaging (MRI) appearances of the pituitary stalk and anterior and posterior pituitary [H-P (hypothalamic-pituitary) axis], in children with optic nerve hypoplasia (ONH) with or without an abnormal septum pellucidum (SP (...) ); and 2) define endocrine dysfunction according to the MRI findings. Medical records of 55 children with ONH who had been assessed by ophthalmology and endocrine services were reviewed. All had MRI of the brain and H-P axis. Forty-nine percent of the ONH patients had an abnormal SP on MRI, and 64% had a H-P axis abnormality. Twenty-seven patients (49%) had endocrine dysfunction, and 23 of these had H-P axis abnormality. The frequency of endocrinopathy was higher in patients with an abnormal SP (56

2003 Journal of Clinical Endocrinology and Metabolism

125413. Hyponatremia in patients with central nervous system disease: SIADH versus CSW. (Abstract)

. This review emphasizes the need for CSW to be included in the differential diagnosis of hyponatremia in a patient with central nervous system disease. Distinguishing between these two disorders is of crucial importance because therapy indicated for one disorder but used in the other can result in negative clinical consequences. (...) Hyponatremia in patients with central nervous system disease: SIADH versus CSW. The syndromes of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting (CSW) are two potential causes of hyponatremia is patients with disorders of the central nervous system. Distinguishing between these two causes can be challenging because there is considerable overlap in the clinical presentation. The primary distinction lies in the assessment of the effective arterial blood volume (EABV

2003 Trends in Endocrinology and Metabolism

125414. Long-term safety aspects of systemic therapy with fumaric acid esters in severe psoriasis. (Abstract)

Long-term safety aspects of systemic therapy with fumaric acid esters in severe psoriasis. Therapy with fumaric acid esters (FAE) has been shown to be safe and effective in patients with severe psoriasis in several clinical studies with limited follow-up periods. In view of the chronic character of psoriasis, long-term safety aspects are of major importance in determining the suitability of a drug during prolonged periods of treatment.To investigate adverse events of therapy with systemic FAE (...) with follow-up periods of up to 14 years, in order to determine safety aspects of their long-term use in patients with severe psoriasis.Current and/or past therapeutic use of FAE was reviewed in 66 patients with severe psoriasis.Forty-one of 66 patients had received FAE for at least 1 year, and 12 of these 41 patients had received FAE for between 10 and 14 years. Adverse events were reported in 73% of the patients. These were usually mild and mainly consisting of flushing (55%), diarrhoea (42%), nausea

2003 British Journal of Dermatology

125415. New evidence on the importance of the renin-angiotensin system in the treatment of higher-risk patients with hypertension. (Abstract)

New evidence on the importance of the renin-angiotensin system in the treatment of higher-risk patients with hypertension. We reviewed the drug treatment of hypertension in the light of recent trials. beta-Blockers and diuretics clearly reduce mortality, strokes, and coronary heart disease (CHD) in hypertension. Recent trials assessed whether newer agents that block the renin-angiotensin-aldosterone system, or calcium blockers, offer any additional advantage, or have benefits in high-risk (...) are responsible. Recent results of the Prospective Studies Collaboration show lower risk, even in the normal blood pressure range; high-risk patients will benefit further from ACE inhibitors and ARBs (and beta-blockers after myocardial infarction). Data for other blood pressure decreasing agents are unavailable in such populations. We conclude that blood pressure decreasing per se is of clinical benefit, but drugs that block the renin-angiotensin system offer additional advantages. Drug choice is best

2003 Journal of Hypertension

125416. Atherosclerotic plaque rupture: local or systemic process? Full Text available with Trip Pro

are mostly referred to as plaque rupture. In the first part of this review, we will focus on the definition of true plaque rupture and the definitions of other phenotypes of plaque instability, especially on intraplaque hemorrhage, and discuss the phenotypes of available animal models of plaque instability. The second part of this review will address the pathogenesis of plaque rupture from a local and a systemic perspective. Plaque rupture is thought to occur because of changes in the plaque itself (...) Atherosclerotic plaque rupture: local or systemic process? It is generally established that the unstable plaque is the major cause of acute clinical sequelae of atherosclerosis. Unfortunately, terms indicating lesions prone to plaque instability, such as "vulnerable plaque," and the different phenotypes of unstable plaques, such as plaque rupture, plaque fissuring, intraplaque hemorrhage, and erosion, are often used interchangeably. Moreover, the different phenotypes of the unstable plaque

2003 Thrombosis and Vascular Biology

125417. Plasminogen activator/plasmin system: a major player in wound healing? (Abstract)

biological processes, including cell adhesion, cell migration, cell-cell signaling, tumor invasion and metastasis, ovulation, and wound healing. In this review, we present evidence in the current literature that the plasminogen activator/plasmin system does have a role in wound healing, looking at both normal and abnormal healing. Furthermore, the invaluable insights provided by numerous transgenic animal experiments are summarized. (...) Plasminogen activator/plasmin system: a major player in wound healing? The role of the plasminogen activator/plasmin system in fibrinolysis has been well established. Indeed, clinicians worldwide have successfully utilized recombinant tissue-type plasminogen activator as first-line treatment of acute myocardial infarction for almost 2 decades. Outside the field of cardiology, there has been increasing excitement regarding the possible contribution of this system in many other important

2003 Wound Repair and Regeneration

125418. Successful treatment of multiple bursal cysts in systemic sclerosis. (Abstract)

Successful treatment of multiple bursal cysts in systemic sclerosis. Bursitis frequently occurs in the various conditions of autoimmune disorders including rheumatoid arthritis, but there have been few cases of effusive bursitis in systemic sclerosis.To present a case of systemic sclerosis with multiple bursitis on upper, lower extremities, and trunk with or without joint involvement.Case report and review of the literature.Multiple asymptomatic cystic masses contained yellow and chalky sterile (...) fluid, all of which were diagnosed as effusive bursitis. Most of them were treated with a surgical resection, a continuous drainage, and an injection of highly concentrated ethanol into their internal spaces. However, an intrabursal injection of emulsified triamcinolone acetonide was the only effective treatment for the giant mass that occurred on the right chest wall.Successful treatment of multiple bursal cysts with systemic sclerosis was presented.

2002 Dermatologic Surgery

125419. Folliculotropic mycosis fungoides with central nervous system involvement: demonstration of tumor clonality in intrafollicular T cells using laser capture microdissection. (Abstract)

case in which laser capture microdissection was used to show that the atypical lymphocytes within the hair-follicle epithelium were part of the same tumor clone present in other tissue compartments.In reviewing the literature describing atypical lymphocytes infiltrating hair-follicle epithelium relative to the epidermis, we encourage the use of the term folliculotropic mycosis fungoides. Our case also supports previous findings that central nervous system involvement can occur in advanced MF (...) Folliculotropic mycosis fungoides with central nervous system involvement: demonstration of tumor clonality in intrafollicular T cells using laser capture microdissection. Folliculotropic mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma, MF type, characterized by atypical lymphocytes preferentially infiltrating the hair-follicle epithelium relative to the epidermis.We describe a rare case of folliculotropic MF involving the central nervous system. This is also the first

2003 Journal of American Academy of Dermatology

125420. Frequency and severity of systemic disease in patients with subacute cutaneous lupus erythematosus. (Abstract)

Frequency and severity of systemic disease in patients with subacute cutaneous lupus erythematosus. To compare the frequency and severity of systemic disease in patients with subacute cutaneous lupus erythematosus (SCLE) followed up in a dermatology practice vs patients with systemic lupus erythematosus (SLE) followed up in a rheumatology practice.Case-control comparison of patients matched for age, sex, and ethnicity.University-affiliated dermatology and rheumatology practices.Seventy-six (...) patients with SCLE were compared with 24 patients with SLE.All medical records were reviewed and the patients were interviewed.Systemic and serologic findings were compared between patients with SCLE and those with SLE.Hematologic disorders were present in 6 patients (8%) with SCLE and in 13 patients (54%) with SLE (P<.001). Serositis was present in 1 patient (1%) with SCLE and in 3 patients (12%) with SLE (P =.04). Renal involvement was present in 12 patients (16%) with SCLE and in 6 patients (25

2002 Archives of Dermatology

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