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1.
World J Clin Cases ; 12(12): 2128-2133, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38680264

RESUMO

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease primarily affecting young females. SLE can invade any organ, and various forms of splenic invasion have been reported. Manifestations include splenomegaly and splenic infarction, rupture, and calcification. The study encountered a rare case of splenic involvement, with nodules of various sizes without calcifications or ruptures. CASE SUMMARY: A 15-year-old girl presented with arthralgia, weight loss, fever, increased levels of inflammatory markers, and positive antinuclear antibody test results. The patient was diagnosed with SLE. She was asymptomatic while taking steroids and hydroxychloroquine. Ten months after discharge, the patient developed a fever and abdominal pain. Lupus enteritis was suspected, and abdominopelvic computed tomography (AP-CT) was performed. There were no specific findings in the gastrointestinal tract, but multiple splenic nodules were observed. Infection or hemangioma was considered; however, no specific radiological findings were observed. A biopsy of the spleen was performed to determine the possibility of malignancy. The histological findings of the spleen included extensive periarteriolar necrosis with hematoxylin bodies and numerous karyorrhectic debris. Based on the biopsy results, the patient was diagnosed with an SLE flare-up and was maintained on high-dose steroids and immunosuppressants. CONCLUSION: As disease activity increased, multiple nodules in the spleen that were previously unseen were observed using AP-CT and histologically confirmed. Spleen invasion by SLE can appear in multiple nodular forms and patterns. Therefore, physicians should consider these findings when differentiating these nodules from infections and malignancies.

2.
J Rheumatol ; 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37778763

RESUMO

OBJECTIVE: Methotrexate (MTX) is an anchor drug for most patients with rheumatoid arthritis (RA); however, its use may be limited depending on renal function. Therefore, this study aimed to examine the discrepancy in the estimated glomerular filtration rate (eGFR) using conventional serum creatinine (SCr)-, cystatin C-, and MTX-associated toxicities in patients with RA. METHODS: In total, 436 patients were enrolled, and eGFR was evaluated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation based on both cystatin C and SCr levels. The CKD and MTX dosing stages were classified according to eGFR. MTX-associated toxicities were also evaluated. RESULTS: The mean eGFR using CKD-EPI cystatin C (CKD-EPIcys) was 89.44 mL/min/1.73 m2, lower than the eGFR using CKD-EPI SCr (CKD-EPISCr) of 95.55 mL/min/1.73 m2. After converting eGFR to CKD-EPIcys by CKD-EPISCr, 29.8% of patients were reclassified to a higher stage according to the Kidney Disease: Improving Global Outcomes CKD stage. Also, according to the MTX guidelines, 6.4% of the group with an eGFR > 50 mL/min/1.73 m2 were reclassified to eGFR 10-50 mL/1.73 m2, requiring dose adjustment. The incidence of MTX-associated toxicities, such as anemia, leukopenia, and nephrotoxicity, was significantly higher in the CKD stage-changed group than in the nonstage-changed group. CONCLUSION: Our results showed that eGFR based on SCr was overestimated compared with eGFR based on cystatin C. In addition, we demonstrated that MTX-associated toxicities were significantly increased in the group with a changed stage when the eGFR was converted from CKD-EPISCr to CKD-EPIcys.

3.
Rheumatol Int ; 42(2): 291-302, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34086074

RESUMO

OBJECTIVE: We investigated the prevalence of metabolic syndrome (MetS) in all or nonobese patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and compared it with age- and gender-matched controls. Also, we assessed the effect of variables at diagnosis on the risk of cardiovascular disease (CVD) in all or nonobese AAV patients. METHODS: In this study, 173 AAV patients and 344 controls were included and MetS was defined by the National Cholesterol Education Program Adults Treatment Panel III criteria. The obesity based on body mass index (BMI) was defined as BMI ≥ 25 kg/m2. The follow-up duration was defined as the period from diagnosis to the last visit or to each poor outcome occurrence. RESULTS: The median age of AAV patients was 58.7 years and 57 patients were men. The prevalence of MetS was 50.9% in all AAV patients and 46.5% in nonobese AAV patients, which were significantly higher than 37.8% in all controls and 28.2% in nonobese controls. In Kaplan-Meier survival analysis, Mets at diagnosis significantly reduced the cumulative CVD-free survival rate in both all and nonobese AAV patients. In the multivariable Cox hazards model analysis, CVD during follow-up was significantly associated with both Birmingham vasculitis activity score (BVAS) (HR 1.159) and MetS at diagnosis (HR 9.036) in nonobese AAV patients. CONCLUSIONS: The prevalence of MetS at diagnosis in all or nonobese AAV patients was significantly higher than those in all or nonobese controls. Furthermore, both BVAS and MetS at diagnosis increased the risk of CVD in nonobese AAV patients.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos
4.
J Korean Med Sci ; 36(18): e120, 2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-33975396

RESUMO

BACKGROUND: We investigated and compared the initial clinical features at diagnosis and the poor outcomes during follow-up in Korean patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) based on sex. METHODS: The medical records of 223 immunosuppressive drug-naïve patients with AAV were reviewed. Age, body mass index (BMI), smoking history, AAV subtypes, ANCA positivity, clinical manifestations, Birmingham vasculitis activity score (BVAS), five-factor score (FFS), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) at diagnosis were collected. All-cause mortality, end-stage renal disease (ESRD), cerebrovascular accident (CVA) and cardiovascular disease (CVD) were assessed as the poor outcomes of AAV during follow-up. RESULTS: The median age was 59.0 years and 74 of 223 AAV patients (33.2%) were men. Among variables at diagnosis, male patients exhibited higher BMI than female. However, there were no differences in other demographic data, AAV subtypes, ANCA positivity, BVAS, FFS, ESR and CRP between the two groups. Male patients received cyclophosphamide more frequently, but there were no significant differences in the frequencies of the poor outcomes of AAV between the two groups. Male patients exhibited a significantly lower cumulative patients' survival rate than female patients during the follow-up period based on all-cause mortality (P = 0.037). In the multivariable analysis, both male sex (hazard ratio [HR], 2.378) and FFS (HR, 1.693) at diagnosis were significantly and independently associated with all-cause mortality during follow-up. CONCLUSION: Male sex is a significant and independent predictor of all-cause mortality in AAV patients.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/mortalidade , Idoso , Sedimentação Sanguínea , Índice de Massa Corporal , Proteína C-Reativa , Doenças Cardiovasculares/complicações , Feminino , Humanos , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Acidente Vascular Cerebral/complicações , Taxa de Sobrevida
5.
Yonsei Med J ; 62(2): 149-158, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33527794

RESUMO

PURPOSE: We investigated whether antineutrophil cytoplasmic antibody (ANCA) positivity is associated with vascular manifestations at diagnosis of Behçet's disease (BD) and poor outcomes during follow-up. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 1060 patients with BD. Among them, 808 patients could be diagnosed with BD based on the revised version of the International Criteria for Behçet's Disease (ICBD) in 2014 (2014 ICBD criteria) and 588 patients could be diagnosed with BD based on the International Study Group (ISG) criteria proposed in 1990 (1990 ISG criteria). We examined the sites and patterns of vascular involvement in the BD patients at diagnosis and evaluated adverse outcomes during follow up, such as all-cause mortality, acute coronary syndrome, and deep vein thrombosis. RESULTS: Among the 808 patients with BD based on the 2014 ICBD criteria, the rate of ANCA positivity at diagnosis was 2.2%. ANCA-positive BD patients exhibited a higher frequency of overall vascular manifestations (22.2% vs. 6.1%) and higher frequencies of vascular involvement in the upper extremities and visceral arteries than ANCA-negative BD patients (5.6% vs. 0.1% and 5.6% vs. 0.1%). Among the 588 BD patients based on the 1990 ISG criteria, similarly, ANCA-positive BD patients exhibited a higher frequency of vascular manifestations than ANCA-negative BD patients. ANCA positivity, however, did not seem to be associated with poor outcomes in BD patients during follow up. CONCLUSION: ANCA positivity in BD patients was found to be associated with cross-sectional vascular involvement in the upper extremities and visceral arteries at diagnosis but was not predictive of poor outcomes during follow-up.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos/imunologia , Síndrome de Behçet/imunologia , Vasos Sanguíneos/patologia , Adulto , Síndrome de Behçet/diagnóstico , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos
6.
Clin Exp Med ; 21(3): 399-406, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33611672

RESUMO

We previously reported that fibrosis-4 (FIB-4) was associated with poor outcomes of microscopic polyangiitis (MPA) and granuloma with polyangiitis (GPA). We also investigated the potential of FIB-5, a novel index, in predicting all-cause mortality and end-stage renal disease (ESRD) during follow-up in patients with MPA and GPA without substantial liver diseases. Clinical and laboratory data at diagnosis were collected by reviewing the medical records of 180 patients with MPA and GPA. FIB-5 was obtained by a following equation: FIB-5 = (serum albumin (g/L) × 0.3 + platelet count (109/L) × 0.05) - (alkaline phosphatase (IU/L) × 0.014 + aspartate aminotransferase/alanine aminotransferase ratio × 6 + 14). The median age of the patients at diagnosis was 61.0 years. FIB-5 at diagnosis could not reflect the cross-sectional vasculitis activity. The cutoffs of FIB-5 for poor outcomes was set as 0.82 (the lowest tertile) and -0.42 (the lowest quartile) at diagnosis. In Kaplan-Meier survival analysis, patients with FIB-5 < 0.82 and those with FIB-5 < -0.42 exhibited lower ESRD-free survival rates than those without. However, it could not predict all-cause mortality. In multivariable Cox hazards analysis, both FFS (Hazard ratio (HR) 1.554) and FIB-5 < 0.82 (HR 2.096) as well as both FFS (HR 1.534) and FIB-5 < -0.42 (HR 2.073) at diagnosis independently predicted ESRD during follow-up. In conclusion, FIB-5 < 0.82 and FIB-5 < -0.42 at diagnosis could predict the occurrence of ESRD, but not all-cause mortality, during follow-up in patients with MPA and GPA without substantial liver diseases.


Assuntos
Granulomatose com Poliangiite/patologia , Falência Renal Crônica/diagnóstico , Poliangiite Microscópica/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fibrose , Granulomatose com Poliangiite/sangue , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/mortalidade , Humanos , Estimativa de Kaplan-Meier , Falência Renal Crônica/sangue , Falência Renal Crônica/mortalidade , Falência Renal Crônica/patologia , Masculino , Poliangiite Microscópica/sangue , Poliangiite Microscópica/complicações , Poliangiite Microscópica/mortalidade , Pessoa de Meia-Idade , Contagem de Plaquetas , Albumina Sérica Humana/metabolismo , Análise de Sobrevida
7.
Korean J Intern Med ; 36(5): 1221-1232, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32806878

RESUMO

BACKGROUND/AIMS: Measures of body composition, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle area (SMA), are considered important prognostic factors in chronic diseases. The association of these measures with auto-inflammatory disorders, such as anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), remains unclear. We investigated the clinical significance of VAT, SAT, and SMA in patients with AAV. METHODS: Patients with AAV subjected to chest computed tomography (CT), abdominal CT, or positron emission tomography-CT on diagnosis of AAV were evaluated. Quantitative assessment of VAT, SAT, and SMA was performed at the third lumbar vertebral level and computed by summing the pixel attenuation for tissue-specific Hounsfield units in the corresponding region. Associations of VAT, SAT, and SMA with clinical and laboratory data and clinical outcome measures were evaluated. RESULTS: Of the 117 patients, 61 (52.1%) were classified as having microscopic polyangiitis, 28 (23.9%) as granulomatosis with polyangiitis, and 28 (23.9%) as eosinophilic granulomatosis with polyangiitis. VAT significantly correlated with age, weight, body mass index (BMI), and Birmingham Vasculitis Activity Score, whereas SAT correlated with weight, BMI, and creatinine levels. A significant association was found between SMA and age, height, weight, BMI, and the Five-Factor Score. Cox proportional hazards analysis showed that creatinine levels (odds ratio [OR], 1.346; 95% confidence interval [CI], 1.034 to 1.753; p = 0.027) and high VAT (OR, 7.137; 95% CI, 1.343-37.946; p = 0.021) were independently associated with all-cause mortality during follow-up. CONCLUSION: Evaluation of VAT using CT is useful for estimating disease activity and all-cause mortality in patients with AAV.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos , Síndrome de Churg-Strauss , Granulomatose com Poliangiite , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico por imagem , Composição Corporal , Índice de Massa Corporal , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
8.
Yonsei Med J ; 61(8): 712-719, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32734735

RESUMO

PURPOSE: There has been no extensive study to compare the efficacy between rituximab originator (Mabthera®) and its biosimilar (Truxima®) for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). Here, we investigated the clinical effects of rituximab on poor outcomes of MPA and GPA in Korean patients, and compared those between Mabthera® and Truxima®. MATERIALS AND METHODS: We retrospectively reviewed the medical records of a total of 139 patients, including 97 MPA patients and 42 GPA patients. At diagnosis, antineutrophil cytoplasmic antibody positivity and comorbidities were assessed. During follow-up, all-cause mortality, relapse, end-stage renal disease, cerebrovascular accident and acute coronary syndrome were evaluated as poor outcomes. In this study, rituximab was used as either Mabthera® or Truxima®. RESULTS: The median age at diagnosis was 60.1 years and 46 patients were men (97 MPA and 42 GPA patients). Among poor outcomes, patients receiving rituximab exhibited a significantly lower cumulative relapse-free survival rate compared to those not receiving rituximab (p=0.002). Nevertheless, rituximab use did not make any difference in other poor outcomes of MPA and GPA except for relapse, which might be a rebuttal to the fact that rituximab use after relapse eventually led to better prognosis. There were no significant differences in variables at diagnosis and during follow-up between patients receiving Mabthera® and those receiving Truxima®. Patients receiving Truxima® exhibited a similar pattern of the cumulative survival rates of each poor outcome to those receiving Mabthera®. CONCLUSION: Truxima® prevents poor outcomes of MPA and GPA as effectively as does Mabthera®.


Assuntos
Medicamentos Biossimilares/uso terapêutico , Granulomatose com Poliangiite/tratamento farmacológico , Poliangiite Microscópica/tratamento farmacológico , Rituximab/uso terapêutico , Feminino , Granulomatose com Poliangiite/mortalidade , Humanos , Masculino , Poliangiite Microscópica/mortalidade , Pessoa de Meia-Idade , Prognóstico , Recidiva , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
9.
ACS Appl Mater Interfaces ; 12(37): 41674-41686, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32794695

RESUMO

To resolve the inherent trade-off issue between responsivity and detectivity in FA0.9Cs0.1PbI3 perovskite photodetectors, this paper proposes a novel strategy using multifunctional self-combustion additives (urea and ammonium nitrate). During the early stages of crystallization, urea allows for the formation of a strong Lewis complex-derived low-dimensional intermediate phase; this suppresses the formation of perovskite nuclei, while ammonium ions assist the preferred grain growth along the [110] direction. During the high-temperature annealing steps, a self-combusting exothermic reaction occurs between urea as a fuel and NH4NO3 as an oxidizer, through which a locally supplied heat facilitates the removal of residual urea and byproducts. These multifunctional roles of self-combustible additives facilitate the production of high-quality, enlarged grain-structured perovskite films with improved optoelectronic properties, as confirmed by various analyses, including impedance spectroscopy and intensity-modulated photocurrent spectroscopy. The resulting FA0.9Cs0.1PbI3-based photodiode-type photodetectors exhibit outstanding performance, such as a high responsivity (0.762 A W-1) and specific detectivity (over 5.08 × 1013 Jones) at a very low external reverse bias (-0.5 V). Our findings clearly suggest that the multifunctional self-combustion additives strategy could help realize the full potential of FA1-xCsxPbI3 as a photodiode-type photodetector.

10.
Tohoku J Exp Med ; 251(2): 117-123, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32581191

RESUMO

Mannose-binding lectin (MBL) is a soluble pattern-recognition molecule, which plays a crucial role in the innate immune system and the activation of lectin complement pathway. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune disease affecting the small vasculatures and is characterized by the alteration of innate and adaptive immunity and complement activation. In this study, we investigated whether serum MBL is associated with disease activity of AAV, which was measured by ELISA. Associations between serum MBL and AAV-specific indices, as well as clinical and laboratory data were assessed using Kendall's tau. Among the 80 patients, 42 (52.5%), 21 (26.3), and 17 (21.3%) patients were classified as microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA), respectively. The median values of erythrocyte sedimentation rate, C-reactive protein, and serum MBL were 36.5 (normal range < 20) mm/h, 2.4 (normal range < 8) mg/dL, and 8.6 ng/mL, respectively. The median serum levels of MBL in MPA, GPA, and EGPA patients were 8.4, 9.3, and 8.2 ng/mL. Correlation analysis showed that serum MBL was associated with Birmingham Vasculitis Activity Score (BVAS) (R = 0.169, p = 0.027), but not with other AAV-specific indices and clinical and laboratory data. In addition, serum MBL was significantly associated with the pulmonary manifestation score based on BVAS (R = 0.247, p = 0.001). In summary, among the AAV-specific indices and clinical and laboratory variables analyzed, serum MBL is correlated with BVAS and pulmonary manifestation score based on the BVAS.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/sangue , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/patologia , Lectina de Ligação a Manose/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/epidemiologia , Síndrome de Churg-Strauss/sangue , Síndrome de Churg-Strauss/epidemiologia , Síndrome de Churg-Strauss/patologia , Estudos de Coortes , Progressão da Doença , Feminino , Granulomatose com Poliangiite/sangue , Granulomatose com Poliangiite/epidemiologia , Granulomatose com Poliangiite/patologia , Humanos , Masculino , Poliangiite Microscópica/sangue , Poliangiite Microscópica/epidemiologia , Poliangiite Microscópica/patologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença
11.
J Cardiol ; 76(4): 407-412, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32482328

RESUMO

BACKGROUND: No study has provided evidence of the clinical significance of the antineutrophil cytoplasmic antibody (ANCA) in patients with Takayasu arteritis (TAK). Therefore, we investigated the frequency of ANCA positivity and its clinical implications in patients with TAK. METHODS: We retrospectively reviewed the medical records of 121 patients with established TAK, who had results for ANCA status at diagnosis. We collected demographic and clinical data and the ANCA results at diagnosis. Additionally, we obtained information on patients' medications and complications during follow-up. Early coronary arterial occlusive disease (CAOD) and late CAOD were defined based on a 30-day interval after TAK classification. The chi-square test, Fisher's exact test, Mann-Whitney test, and Kaplan-Meier survival analysis were used to analyze the data. RESULTS: The patients' mean age was 44.6 years, and 21 patients were men (17.4%). ANCA was detected in 8 patients (6.6%), of which 2 had both the myeloperoxidase ANCA (or perinuclear ANCA) and proteinase 3 ANCA (or cytoplasmic ANCA). Early CAOD was observed in 10 patients (8.3%), and late CAOD was found in 9 patients (7.4%). In the comparative analysis, the proportion of late CAOD exhibited a tendency to increase in the ANCA-positive group compared to that in the ANCA-negative group. Kaplan-Meier analysis showed that patients with ANCA exhibited a lower cumulative late CAOD-free survival rate than those without ANCA (p=0.012). When the algorithm for the classification of ANCA-associated vasculitis (AAV) proposed by the European Medicine Agency in 2007 was applied to 8 patients with ANCA, all were not reclassified as having AAV. CONCLUSIONS: ANCA can be detected in a minority of patients with established TAK, and it may not contribute to the reclassification of AAV. Furthermore, ANCA positivity may be associated with late CAOD in patients with TAK.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos/sangue , Doença da Artéria Coronariana/sangue , Arterite de Takayasu/sangue , Adulto , Doença da Artéria Coronariana/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Mieloblastina/imunologia , Peroxidase/imunologia , Arterite de Takayasu/mortalidade
12.
Rheumatol Int ; 40(7): 1089-1099, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32314011

RESUMO

Current evidence suggests that high uric acid levels are associated with accelerated renal damage. However, the clinical impact of serum uric acid level on patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) is unknown. We aimed to evaluate the impact of hyperuricemia on such patients. A retrospective study was performed to obtain patients' demographic, clinical, and laboratory data from when they were diagnosed with MPA and GPA. Multivariable logistic regression and Cox hazard model analyses were performed to evaluate factors associated with hyperuricemia at diagnosis and predictive factors of end-stage renal disease (ESRD) development. Among 156 patients, 35 (22.4%) had hyperuricemia at baseline. Hyperuricemic patients had renal manifestation and impaired renal function more frequently than non-hyperuricemic patients. Logistic regression analysis revealed that serum creatinine was significantly associated with hyperuricemia at diagnosis [odds ratio 1.995; 95% confidence interval (CI), 1.503-2.648; P < 0.001]. Cox hazard model analysis revealed that body mass index and serum creatinine were significantly associated with ESRD when all variables were included, but hyperuricemia was independently associated with ESRD [hazard ratio (HR), 3.799; 95% CI 1.719-8.222; P < 0.001) when serum creatinine was excluded. Additionally, in a subgroup analysis of patients with decreased glomerular filtration rates (GFRs), serum uric acid was the sole predictor of ESRD (HR, 1.243; 95% CI 1.048-1.475; P = 0.013). Hyperuricemia is associated with renal damage and ESRD occurrence in MPA and GPA patients. Serum uric acid level is associated with ESRD occurrence in patients with decreased GFRs.


Assuntos
Granulomatose com Poliangiite/epidemiologia , Hiperuricemia/epidemiologia , Falência Renal Crônica/epidemiologia , Poliangiite Microscópica/epidemiologia , Idoso , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Estudos de Casos e Controles , Feminino , Taxa de Filtração Glomerular , Granulomatose com Poliangiite/imunologia , Granulomatose com Poliangiite/metabolismo , Humanos , Hiperuricemia/metabolismo , Falência Renal Crônica/metabolismo , Modelos Logísticos , Masculino , Poliangiite Microscópica/imunologia , Poliangiite Microscópica/metabolismo , Pessoa de Meia-Idade , Mieloblastina/imunologia , Peroxidase/imunologia , Modelos de Riscos Proporcionais , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/metabolismo , Estudos Retrospectivos , Fatores de Risco
14.
ACS Appl Mater Interfaces ; 12(12): 13824-13835, 2020 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-32134237

RESUMO

Flexible perovskite solar cells (PSCs) have attracted significant interest as promising candidates for portable and wearable devices. Copper nanowires (CuNWs) are promising candidates for transparent conductive electrodes for flexible PSCs because of their excellent conductivity, flexibility, and cost-effectiveness. However, because of the thermal/chemical instability of CuNWs, they require a protective layer for application in PSCs. Previous PSCs with CuNW-based electrodes generally exhibited poor performances compared with their indium tin oxide-based counterparts because of the neglect of the interfacial energetics between the electron transport layer (ETL) and CuNWs. Herein, an Al-doped ZnO (AZO) protective layer fabricated using atomic layer deposition is introduced. The AZO/CuNW-based composite electrode exhibits improved thermal/chemical stability and favorable band alignment between the ETL and CuNWs, based on the Al dopant concentration tuning. As a result, the Al content gradient AZO (g-AZO), composed of three successively deposited AZO layers, leads to highly efficient flexible PSCs with a power conversion efficiency (PCE) of 14.18%, whereas the PCE of PSCs with a non-g-AZO layer is 12.34%. This improvement can be attributed to the efficient electron extraction and reduced charge recombination. Furthermore, flexible PSCs based on g-AZO-based composite electrodes retain their initial PCE, even after 600 bending cycles, demonstrating excellent mechanical stability.

15.
Int J Clin Pract ; 74(1): e13431, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31573728

RESUMO

BACKGROUND: Chronic paranasal sinusitis (CPS) has been known as a surrogate marker for granulomatosis with polyangiitis (GPA). We investigated whether CPS at diagnosis may have an influence on the classification and outcomes of microscopic polyangiitis (MPA). METHODS: We retrospectively reviewed the medical records of 106 immunosuppressive drug-naïve patients with MPA. We compared variables at diagnosis of MPA patients with CPS with either MPA patients without CPS or 29 GPA patients with CPS. We applied the algorithm for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) proposed by the European Medicine Agency to 22 MPA patients with CPS and reclassify them. Death, relapse and end-stage renal disease were assessed as the poor outcomes. RESULTS: Except for ENT manifestations, only pulmonary manifestation was more frequently observed in MPA patients with CPS than those without (77.3% vs 47.6%). No proteinase 3-ANCA was detected in all MPA patients with CPS. Meanwhile, general (63.6% vs 27.6%) and renal manifestations (81.8% vs 44.8%) more often developed in MPA patients with CPS than GPA patients with CPS. Of 22 MPA patients with CPS, 21 patients underwent biopsies. When CPS was not considered as a surrogate marker for GPA, all patients with CPS were reclassified as MPA. Ground glass opacity and reticulation on high-resolution computed tomography and renal vasculitis were helpful clues supporting the classification of MPA in patients with CPS. CPS at diagnosis was not associated with the outcomes of MPA. CONCLUSION: CPS might not be a sufficient surrogate marker for GPA in the classification of AAV.


Assuntos
Granulomatose com Poliangiite/diagnóstico , Poliangiite Microscópica/classificação , Poliangiite Microscópica/diagnóstico , Sinusite/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Doença Crônica , Feminino , Granulomatose com Poliangiite/classificação , Granulomatose com Poliangiite/complicações , Humanos , Falência Renal Crônica/etiologia , Masculino , Poliangiite Microscópica/complicações , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
16.
Small ; 15(21): e1900219, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30946524

RESUMO

All-inorganic cesium lead triiodide (CsPbI3 ) perovskite is considered a promising solution-processable semiconductor for highly stable optoelectronic and photovoltaic applications. However, despite its excellent optoelectronic properties, the phase instability of CsPbI3 poses a critical hurdle for practical application. In this study, a novel stain-mediated phase stabilization strategy is demonstrated to significantly enhance the phase stability of cubic α-phase CsPbI3 . Careful control of the degree of spatial confinement induced by anodized aluminum oxide (AAO) templates with varying pore sizes leads to effective manipulation of the phase stability of α-CsPbI3 . The Williamson-Hall method in conjunction with density functional theory calculations clearly confirms that the strain imposed on the perovskite lattice when confined in vertically aligned nanopores can alter the formation energy of the system, stabilizing α-CsPbI3 at room temperature. Finally, the CsPbI3 grown inside nanoporous AAO templates exhibits exceptional phase stability over three months under ambient conditions, in which the resulting light-emitting diode reveals a natural red color emission with very narrow bandwidth (full width at half maximum of 33 nm) at 702 nm. The universally applicable template-based stabilization strategy can give in-depth insights on the strain-mediated phase transition mechanism in all-inorganic perovskites.

17.
ACS Nano ; 12(11): 11088-11097, 2018 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-30358980

RESUMO

Solar-energy conversion by photoelectrochemical (PEC) devices is driven by the separation and transfer of photogenerated charge carriers. Thus, understanding carrier dynamics in a PEC device is essential to realizing efficient solar-energy conversion. Here, we investigate time-resolved carrier dynamics in emerging low-cost Sb2Se3 nanostructure photocathodes for PEC water splitting. Using terahertz spectroscopy, we observed an initial mobility loss within tens of picoseconds due to carrier localization and attributed the origin of carrier localization to the rich surface of Sb2Se3 nanostructures. In addition, a possible recombination at the interface between Sb2Se3 and the back contact is elucidated by time-resolved photoluminescence analysis. We also demonstrated the dual role of the RuO x co-catalyst in reducing surface recombination and enhancing charge transfer in full devices using intensity-modulated spectroscopy. The relatively low onset potential of the Sb2Se3 photocathode is attributed to the sluggish charge transfer at a low applied bias rather than to fast surface recombination. We believe that our insights on carrier dynamics would be an important step toward achieving highly efficient Sb2Se3 photocathodes.

18.
ACS Appl Mater Interfaces ; 10(36): 30337-30347, 2018 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-30118211

RESUMO

Organic-inorganic hybrid perovskite solar cells (PSCs) have recently attracted tremendous attention because of their excellent efficiency and the advantage of a low-cost fabrication process. As a transparent electrode for PSCs, the application of copper nanowire (CuNW)-network was limited because of its thermal/chemical instability, despite its advantages in terms of high optical/electrical properties and low-cost production. Here, the copper-nickel core-shell nanowire (Cu@Ni NW)-based composite electrode is proposed as a bottom window electrode for PSCs, without the involvement of a high-cost precious metal and vacuum process. The dense and uniform Ni protective shell for CuNWs is attainable by simple electroless plating, and the resulting Cu@Ni NWs exhibit outstanding chemical stability as well as thermal stability compared with bare CuNWs. When the Ni layer with the optimal thickness is introduced, the Cu@Ni NW electrode shows a high transmittance of 80.5% AVT at 400-800 nm, and a sheet resistance of 49.3 ± 5 Ω sq-1. Using the highly stable Cu@Ni NWs, the composite electrode structure is fabricated with sol-gel-derived Al-doped zinc oxide (AZO) over-layer for better charge collection and additional protection against iodine ions from the perovskite. The PSCs fabricated with AZO/Cu@Ni NW-based composite electrode demonstrate a power conversion efficiency (PCE) of 12.2% and excellent long-term stability maintaining 91% of initial PCE after being stored for 500 h at room temperature. Experimental results demonstrate the potential of highly stable Cu@Ni NW-based electrodes as the cost-effective alternative transparent electrode, which can facilitate the commercialization of PSCs.

19.
ACS Nano ; 12(5): 4233-4245, 2018 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-29676893

RESUMO

Organometal halide perovskite materials have become an exciting research topic as manifested by intense development of thin film solar cells. Although high-performance solar-cell-based planar and mesoscopic configurations have been reported, one-dimensional (1-D) nanostructured perovskite solar cells are rarely investigated despite their expected promising optoelectrical properties, such as enhanced charge transport/extraction. Herein, we have analyzed the 1-D nanostructure effects of organometal halide perovskite (CH3NH3PbI3- xCl x) on recombination and charge carrier dynamics by utilizing a nanoporous anodized alumina oxide scaffold to fabricate a vertically aligned 1-D nanopillared array with controllable diameters. It was observed that the 1-D perovskite exhibits faster charge transport/extraction characteristics, lower defect density, and lower bulk resistance than the planar counterpart. As the aspect ratio increases in the 1-D structures, in addition, the charge transport/extraction rate is enhanced and the resistance further decreases. However, when the aspect ratio reaches 6.67 (diameter ∼30 nm), the recombination rate is aggravated due to high interface-to-volume ratio-induced defect generation. To obtain the full benefits of 1-D perovskite nanostructuring, our study provides a design rule to choose the appropriate aspect ratio of 1-D perovskite structures for improved photovoltaic and other optoelectrical applications.

20.
ACS Appl Mater Interfaces ; 10(17): 14649-14658, 2018 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-29620844

RESUMO

Organic-inorganic hybrid perovskite solar cells (PSCs) are considered promising materials for low-cost solar energy harvesting technology. An electron transport layer (ETL), which facilitates the extraction of photogenerated electrons and their transport to the electrodes, is a key component in planar PSCs. In this study, a new strategy to concurrently manipulate the electrical and optical properties of ETLs to improve the performance of PSCs is demonstrated. A careful control over the Ti alkoxide-based sol-gel chemistry leads to a craterlike porous/blocking bilayer TiO2 ETL with relatively uniform surface pores of 220 nm diameter. Additionally, the phase separation promoter added to the precursor solution enables nitrogen doping in the TiO2 lattice, thus generating oxygen vacancies. The craterlike surface morphology allows for better light transmission because of reduced reflection, and the electrically conductive craterlike bilayer ETL enhances charge extraction and transport. Through these synergetic improvements in both optical and electrical properties, the power conversion efficiency of craterlike bilayer TiO2 ETL-based PSCs could be increased from 13.7 to 16.0% as compared to conventional dense TiO2-based PSCs.

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