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Definition, Classification, Activity and Damage Indices in Systemic Lupus Erythematosus
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Jennifer M. Grossman, Kenneth C. Kalunian
SELENA-SLEDAI was adapted from the SLEDAI for use in a multicenter safety study of estrogens in women with SLE; it has been validated through its prospective use in the ongoing study.27 SELENA-SLEDAI differs from SLEDAI in the definitions of some descriptors for clarification and attribution. The definition of the seizure descriptor has been expanded to exclude seizures resulting from past, irreversible central nervous system damage. Scleritis and episcleritis have been added to the definition of the visual disturbance descriptor, and vertigo has been added to the cranial nerve disorder descriptor. The cerebrovascular accident descriptor excludes hypertensive causes in SELENA-SLEDAI. The rash, alopecia, and mucosal ulcer descriptors have been modified to include ongoing presence of the descriptors, rather than the SLEDAI definitions of new or recurrent activity. The alopecia and mucosal ulcer descriptors also have been modified in SELENA-SLEDAI to attribute the manifestations to active lupus; attribution is meant to be a clinical decision. The pleurisy and pericarditis descriptors have been modified as well; rather than defining pleurisy as pleuritic chest pain with pleural rub or effusion or pleural thickening, SELENA-SLEDAI defines this descriptor as classic and severe pleuritic chest pain, pleural rub, effusion, or new pleural thickening with attribution to lupus. Pericarditis is similarly redefined; instead of pericardial pain with rub, effusion, ECG, or echocardiographic confirmation, SELENA-SLEDAI defines this descriptor as classic and severe pericardial pain, rub, effusion, or ECG confirmation. In addition, the proteinuria descriptor in SELENA-SLEDAI simplifies the SLEDAI descriptor. The SELENA-SLEDAI definition of proteinuria is the new onset or recent increase of more than 0.5 g per 24 hour, whereas the SLEDAI definition can be interpretated to include all patients with proteinuria of greater than 0.5 g per 24 hours.
Vasculitis induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Michiel De Vries, Marjolein Drent, Jan-Wil Cohen Tervaert
The syndrome is characterized by arthralgia, myalgia, pleurisy, rash and fever in association with antinuclear antibodies (ANA) in the serum. Central nervous system and renal involvement are rare in DIL.100 Pulmonary infiltrates occur in isolation in a small minority of patients.
TFET-Based Sensor Design for Healthcare Applications
Published in Balwinder Raj, Brij B. Gupta, Jeetendra Singh, Advanced Circuits and Systems for Healthcare and Security Applications, 2023
Tulika Chawla, Mamta Khosla, Balwinder Raj
In the field of medical health care, there has been a growth in demand for gadgets based on nano-sensors that are user-friendly and have a quick reaction time for diagnosing various ailments in the human population. By creating new medical gadgets with novel technologies integrated with various nano-sensors, the healthcare industry is moving toward improving society's health condition. Medical healthcare equipment's major goal is to be able to evaluate health state, illness onset, and sequencing. Early detection of syndromes is critical for patient survival and accurate illness prognosis; therefore, biosensors must have great sensitivity and a practical structure. Sensor-based medical devices that are implanted as well as wearables have become a reality due to advancements in medical technology. These devices are becoming more common in society over time. The primary issue is to create low-noise, low-power, low-area nano-sensor devices while keeping patient safety in mind. A gas sensor can also be used to identify illnesses. Changes in the quantities of the trace species can indicate the presence of a disease. The volatile organic molecule acetone can be used to distinguish between healthy and diabetic people in the case of diabetes [1]. Pulse oximetry, which measures the amount of oxygen in the blood (see “Optical Sensors in Pulse Oximetry”), heart-rate monitors, blood diagnostics such as blood glucose monitoring, urine analysis, and dental color matching are all examples of current medical applications that use optoelectronic sensors. Pulse oximetry is a cutting-edge non-invasive method for detecting the proportion of hemoglobin (Hb) saturated with oxygen, which is crucial for providing anesthesia, assessing the function of the respiratory system, or diagnosing diseases including pneumonia, pleurisy, and asthma [2]. Sensor technology offers a lot of potential in the medical business; for example, sensors in cancer therapy, non-invasive detection, and other areas have shown a lot of promise. Furthermore, as the threat of bioterrorism grows, devices embedded with different sensors are needed that can identify contaminated bioagents in the atmosphere rapidly, reliably, and correctly is critical in order to control the infection through virus and treatment [3].
Case series: rheumatological manifestations attributed to exposure to Libby Asbestiform Amphiboles
Published in Journal of Toxicology and Environmental Health, Part A, 2018
Roger Diegel, Brad Black, Jean C. Pfau, Tracy McNew, Curtis Noonan, Raja Flores
The patient was first seen at the CARD in 2003. He reported coughing up phlegm each day, having suffered shortness of breath for several years and was experiencing sharp chest pains with a recent episode of pleurisy. He was diagnosed with asbestos-related pleural disease at this time. The patient was last in clinic October of 2015 when he reported still experiencing a chronic cough with phlegm production, dyspnea, wheezing and chest pain. Over time the patient’s pulmonary function showed a decline in DLCO (66%). The patient was diagnosed with polymyalgia rheumatica in 2000 and placed on prednisone. In 2001, he developed swelling in his peripheral joints, hands, wrists, ankles and feet and was diagnosed with seronegative rheumatoid arthritis with negative serology labs, negative ANA, negative rheumatoid factor, negative CCP. X-rays revealed no erosions. He was placed on methotrexate with prednisone, but after 6 months, developed hair loss and oral ulcers, and methotrexate was discontinued. He was placed on leflunomide, did well with leflunomide, and was able to taper off the prednisone. He was taking leflunomide for 1-l/2 years, but then started developing fluid around his heart and leflunomide was discontinued. The patient then went back on prednisone 20–25 mg daily from the early 2000s until 2014. In September 2014, he weaned off prednisone, so he could have a knee replacement. After the knee replacement in 2014, the patient started taking Lipitor, and the arthritis with swelling in his hands, wrists, ankles, and feet returned. The patient was placed back on prednisone at 10 mg with tapering doses and 10 mg weekly of methotrexate with good control of his arthritis symptoms. No other autoimmune diseases were present in the patient. The patient had been seen by different rheumatologists from 2000 until 2015, who concurred with the diagnosis of seronegative rheumatoid arthritis. However, subsequent testing showed a positive ANA at 1:2560 titer.