Takayasu arteritis in childhood: misdiagnoses at disease onset and associated diseases

AbstractJuvenile-Takayasu arteritis (j-TA) is a difficult diagnosis and some patients develop uncommon manifestations and associated diseases that may contribute to the delayed diagnosis. Our aim was to identify the misdiagnoses, the associated diseases and the atypical manifestations observed in a j-TA Brazilian multicentre study. 71 children and adolescents who met the classification criteria for j-TA were included. The misdiagnoses, the associated diseases and the atypical manifestations were evaluated. 19 (26.8%) patients had misdiagnoses. The most common of them was aortic coarctation in six (8.4%) patients, followed by rheumatic fever in five (7.0%) and one patient presented with both former diagnoses. Limb pain (two patients), spondyloarthropathy, juvenile idiopathic arthritis (JIA), spinal arteriovenous malformation, polyarteritis nodosa (PAN) and fever of unknown origin (FUO) were other misdiagnoses. Patients who had misdiagnoses previously to j-TA diagnosis presented a trend to have a longer diagnosis delay. 11 (15.5%) patients had 14 TA-associated diseases, such as pulmonary tuberculosis (5 patients), rheumatic fever (2 patients), spondyloarthropathy, polyarticular JIA, Crohn ’s disease, Prader–Willi disease, diabetes mellitus, Moyamoya and primary immunodeficiency. 7 (9.9%) patients presented 10 atypical manifestations, such as pyoderma gangrenosum, erythema nodosum, myositis, chorea, enthesitis, episcleritis, uveitis, hepatomegaly, splenomegaly and ne...
Source: Rheumatology International - Category: Rheumatology Source Type: research

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Publication date: Available online 21 October 2018Source: American Journal of Preventive MedicineAuthor(s): Soham Gupta, Alexander P. Cole, Maya Marchese, Ye Wang, Jacqueline M. Speed, Sean A. Fletcher, Junaid Nabi, Sebastian Berg, Stuart R. Lipsitz, Toni K. Choueiri, Steven L. Chang, Adam S. Kibel, Annemarie Uhlig, Quoc-Dien TrinhIntroductionWith improvements in early detection and treatment, a growing proportion of the population now lives with a personal history of a cancer. Although many cancer survivors are in excellent health, the underlying risk factors and side effects of cancer treatment increase the risk of medic...
Source: American Journal of Preventive Medicine - Category: International Medicine & Public Health Source Type: research
ConclusionsAlthough increasing, the rate of GP referral to exercise physiologists was low and associated with patient and GP characteristics. Education of GPs about the role of exercise physiologists in the prevention and management of chronic diseaseconditions is needed.
Source: Journal of Science and Medicine in Sport - Category: Sports Medicine Source Type: research
Publication date: November–December 2018Source: Spine Deformity, Volume 6, Issue 6Author(s): Jun S. Kim, Varun Arvind, Eric K. Oermann, Deepak Kaji, Will Ranson, Chierika Ukogu, Awais K. Hussain, John Caridi, Samuel K. ChoAbstractStudy DesignCross-sectional database study.ObjectiveTo train and validate machine learning models to identify risk factors for complications following surgery for adult spinal deformity (ASD).Summary of Background DataMachine learning models such as logistic regression (LR) and artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex data sets. AN...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Publication date: November–December 2018Source: Spine Deformity, Volume 6, Issue 6Author(s): Sayf S.A. Faraj, Toon F.M. Boselie, Alba Vila-Casademunt, Marinus de Kleuver, Roderick M. Holewijn, Ibrahim Obeid, Emre Acaroglu, Ahmet Alanay, Frank Kleinstück, Francisco S. Pérez-Grueso, Ferran Pellisé, European Spine Study GroupAbstractStudy DesignRetrospective study of prospectively collected data.ObjectivesThe purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in pa...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
ConclusionsSpinal deformity is the most common musculoskeletal manifestation of NF1. Cervical lesions are frequently asymptomatic, but patients with thoracolumbar scoliosis, dystrophic features, or a history of laminectomy should have the cervical spine carefully evaluated. For severe and progressive kyphotic deformities, most authors recommend a period of traction followed by a combined anterior-posterior fusion that is instrumented from parallel to parallel vertebra (or six or more levels). Close follow-up is very important because complications and progression are frequent.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
This study assessed changes in HRQOL prospectively and compared them to those occurring in AIS.Summary of Background DataThere has been limited evaluation of patient-reported HRQOL changes with operative management of SK.MethodsMedian SRS values for the SK and AIS cohorts were compared using a repeated measure of analysis of variance with age as a covariate and using a Mann-Whitney U nonparametric comparison.ResultsKyphosis was corrected from 73.9° to 45.8° (p
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Conclusions/interpretation: Circulating Pro-NT is not independently associated with GDM, but is with HOMA-IR, creatinine, and FFA even after adjustment for pregnancy status.
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
s P Abstract Besides providing the majority of ATP production in cells, mitochondria are also involved in many other cellular functions and are central for cellular stress signaling. Mitochondrial dysfunction induces not only inherited mitochondrial disorders but also contributes to neurodegenerative diseases, cancer, diabetes, and metabolic syndrome. The HSP60/HSP10 molecular chaperone complex facilitates folding of mitochondrial proteins and is thus an important factor for many mitochondrial functions. To model different degrees of oxidative stress and mitochondrial dysfunction we here describe a HEK293 derived ...
Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
In conclusion, combination of pro-angiogenic small molecule DFO and HSYA in hydrogel provides a promising strategy to productively promote diabetic wound healing as well as better the repair quality. PMID: 30338719 [PubMed - in process]
Source: Drug Delivery - Category: Drugs & Pharmacology Tags: Drug Deliv Source Type: research
CONCLUSIONS: Most patients with moderate psoriasis receiving apremilast had improved at 6-month follow-up. Safety and tolerability were consistent with the safety profile of apremilast. PMID: 30339049 [PubMed - as supplied by publisher]
Source: Journal of Dermatological Treatment - Category: Dermatology Tags: J Dermatolog Treat Source Type: research
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