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Valvular Heart Disease and Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Kali Polytarchou, Constantina Aggeli
Medical therapy includes angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and beta-blockers, especially for patients with collagen disease. Losartan in combination with beta-blocker is indicated for patients with Marfan syndrome. Vasodilators and inotropes are used only as bridges to surgery.
Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Patients with fibrosing alveolitis type changes in association with collagen diseases (e.g. systemic sclerosis) appear to have a better prognosis, and although they may look pathologically and radiologically similar, they have a different biological behaviour, with only about a quarter of the mortality seen with fibrosing alveolitis per se. However patients with systemic sclerosis + pulmonary hypertension tend to die more quickly (these also tend to lose their normal anterior/posterior density gradient on CT).
Eye
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
In practice, the problem is either easily treated by the GP (e.g. conjunctivitis or foreign body) or usually requires urgent referral. The GP’s role in investigating the painful red eye is therefore very limited. Swab of discharge for microbiology: very occasionally helpful in conjunctivitis not settling with usual treatment.Blood: raised WCC and ESR/CRP may support diagnosis of inflammatory disorders. Rheumatoid factor in suspected rheumatoid arthritis (RA); HLA-B27 usually positive in ankylosing spondylitis. The latter investigations would normally be performed at leisure rather than in the acute situation, when an underlying collagen disease is suspected (e.g. iritis).Intraocular pressure measurement is essential if acute glaucoma is suspected. Usually done by a specialist.
A case of adenoviral covid-19 vector vaccine possibly linked to severe but reversible interstitial lung injury post-vaccination
Published in Infectious Diseases, 2022
George D. Liatsos, Andreas Mavroudis, Panayiotis Iliakis, Maria Karmpalioti, Emmanouil Koullias, Dimitrios Vassilopoulos
A non-identified infectious pathogen could have been responsible for patient’s respiratory failure. Since severe deterioration of his clinical picture occurred, a wide spectrum empirical coverage for common and atypical bacteria, fungal infections and pneumocystis jirovecii was administered, not actually based on some scientific evidence but mostly reflecting physicians’ anguish for the patient’s undiagnosed, unknown, life-threatening disease. In any case, wide-spectrum antibiotics were administered for five days only, as pulsed steroids showed a dramatic improvement, therefore such a short duration regimen would be inadequate to treat any possible severe infection. Subsequently, antibiotic coverage was shifted to ceftriaxone plus doxycycline, mostly as prophylaxis for possible secondary infections due to the high dose steroids administered. In addition, extended laboratory work-up excluded most of the potential infectious agents that could have been responsible for such clinical syndrome (shown in Table 1). Collagen diseases with pulmonary involvement were placed low in the differential diagnosis list. Even if the patient suffered such a disease, it would have probably recurred after discontinuation of the short-term steroid scheme administered, in the absence of any other immunosuppressive medication.
Clinical phenotypes and genetic analyses for diagnosis of systemic autoinflammatory diseases in adult patients with unexplained fever
Published in Modern Rheumatology, 2021
Yukiko Hidaka, Kyoko Fujimoto, Norikazu Matsuo, Takuma Koga, Shinjiro Kaieda, Satoshi Yamasaki, Munetoshi Nakashima, Kiyoshi Migita, Manabu Nakayama, Osamu Ohara, Tomoaki Hoshino, Ryuta Nishikomori, Hiroaki Ida
In total, 179 patients with unexplained fever treated between March 2011 and March 2017 at 56 Japanese hospitals, including Kurume University Hospital in Japan were enrolled in this study after taking the informed consent. We excluded 18 patients who were clinically diagnosed with other conditions, such collagen disease, infection, malignant tumor, immunodeficiency, myelodysplastic syndrome (MDS), and trisomy 8 (Figure 1). The 11 cases of collagen diseases included 4 cases of adult-onset Still’s disease, 1 case of aortitis, 1 case of vasculitis, 1 case of spondyloarthropathy, 1 case of mixed connective tissue disease, 1 case of central nervous system lupus, 1 case of dermatomyositis, and 1 case of incomplete type of Behçet disease. FMF was diagnosed if the patient met 1 or more major criteria, or 2 or more minor criteria of the modified Tel-Hashomer criteria [10]. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Kurume University (No. 337).
A patent review of discoidin domain receptor 1 (DDR1) modulators (2014-present)
Published in Expert Opinion on Therapeutic Patents, 2020
Fibrosis is a consequence of the synthesis and accumulation of extracellular matrix in the corresponding tissues. DDR1 binds all types of collagens and is widely expressed in a variety of tissues, including vascular smooth muscle, mesangial, and renal epithelial cells and macrophages [34,35]. DDR1 null mice have been reported to protect against renal vascular lesions induced by a long-term infusion of angiotensin II, a model in which hemodynamic alterations and vascular remodeling play a major role. It was observed that angiotensin II treated mice developed serious perivascular, interstitial inflammation, and fibrosis. Whereas, DDR1-deficient mice displayed reduced accumulation of fibrillar collagen and transforming growth factor expression. This study underlined a major role of DDR1 in kidney disease progression [36]. Another study also investigated the role of DDR1 in cell–matrix interaction involved in the pathogenesis of Alport syndrome including renal inflammation and fibrosis. It was shown that loss of DDR1-expression in kidney delayed renal fibrosis and inflammation in hereditary type IV collagen disease [37].