Systemic lupus erythematosus in Europe at the change of the millennium: lessons from the "Euro-Lupus Project".

The "Euro-Lupus Cohort" is composed by 1000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium--the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.

Increment of the platelet count in temporal arteritis: response to therapy and ischemic complications.

Temporal arteritis (TA) is a vasculitis involving mainly cranial branches of the aorta that can lead to ischemic complications such as amaurosis or ischemic stroke. Increment in the platelet count has been described in the acute period of the disease. We studied retrospectively the platelet count in patients with TA, its association with ischemic complications and quantified its response to therapy. We found thrombocytosis in 44% of 34 patients with TA, with a mean reduction in the platelet count of 25.1% after therapy. We were also able to quantify the increment in the platelet count at the onset of the disease and its response to prednisone in a group of 5 patients. We did not find any relation between platelet count and ischemic complications of the disease or the result of the temporal artery biopsy. In conclusion TA is associated with an increase in the platelet count, with a 25% reduction after prednisone therapy. These two determinations are not related to ischemic complications of the disease.

Cyclosporine in the treatment of pure red cell aplasia.

We present a patient with severe idiopathic pure red cell aplasia who responded spectacularly to cyclosporin after failure of corticoid treatment and cyclophosphamide. We conclude that cyclosporin should be considered a viable therapeutic alternative to cytotoxic immunosuppressive treatments in this disease.

Chronic or recurrent headache in patients with systemic lupus erythematosus: a case control study.

Controversy exists concerning the prevalence of headache in systemic lupus erythematosus (SLE) and its importance as a neuropsychiatric manifestation, especially when it occurs independently of disease activity and with the typical characteristics of primary chronic headache. Most reports to date have either studied both types of headache, whether or not related to systemic lupus erythematosus, or have not used adequate controls. This study determines the prevalence and types of chronic primary headache in patients with systemic lupus erythematosus in a case-control study which we performed in a tertiary care hospital. We studied 71 consecutive patients with systemic lupus erythematosus and 71 healthy unrelated subjects matched for age and sex from the same geographical area. Clinical evaluation using a specific standard protocol for the presence and characteristics of headache according to the operative classification criteria of the International Headache Society. The overall prevalence of headache, tension-type headache, and migraine was similar among patients and controls [33 (46.5%), 17 (23.9%) and 16 (22.5%) vs 31 (43.7%), 17 (23.9%) and 13 (18.3%), respectively]. The mean age of onset of headache was higher in the patients (28.7 +/- 14.3 vs 18.5 +/- 5.6 y; P = 0.001) and the subjective response to analgesics was lower than in the controls [19 (63%) vs 28 (93.3%); P = 0.004]. There were no differences in the presence of precipitating factors or family history of headache. There were no relevant clinical or immunological differences among the patients regarding the presence or absence of tension-type headache or migraine. Patients with systemic lupus erythematosus do not differ from healthy controls for the presence and type of chronic or recurrent headache.

[Cancer of the lung in patients with HIV infection]. / Cáncer de pulmón en pacientes con infección por VIH.

OBJECTIVE: To know the characteristics of lung cancer among patients with HIV-1 infection. METHOD: The clinical records of patients infected with HIV-1 and lung cancer diagnosed at our institution from January 1991 to April 1995 were reviewed. The epidemiological, clinical, histological and evolutive factors were studied. RESULTS: A total of 1,258 patients were diagnosed of HIV-1 infection during that period of time. Seven patients out of those 1,258 had also a lung cancer. Six were males. All of them were smokers and had severe immunodepression. In four cases the histological diagnosis was epidermoid carcinoma, in two adenocarcinoma, and in one case undifferentiated large cell carcinoma. Five patients were on advanced stages at diagnosis, and lung cancer was the direct cause of death. CONCLUSION: The frequency of lung cancer among our patients with HIV-1 infection was 5.5 per thousand, with predominance of epidermoid carcinoma.

Lessons from the "Euro-Lupus Cohort".

The "Euro-Lupus Cohort" is composed by 1,000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium - the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.

Infarto muscular en paciente con diabetes mellitus / Muscle infarction in patients with diabetes mellitus

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Hiponatremia grave por oxcarbacepina en un anciano / Severe hyponatremia by oxcarbazepine in an elderly

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