Elucidating the Intriguing Association Between Systemic Lupus Erythematosus and Cardiovascular Disease.

Systemic lupus erythematosus (SLE) patients have demonstrated a higher risk of developing cardiovascular disease (CVD), resulting in it being one of the leading causes of death in SLE patients. SLE itself acts as a sole risk factor influencing the prevalence and progression of CVD. However, conventional risk factors, such as age, hypertension, smoking, and obesity, play a crucial role as well. Therefore, this systematic review attempts to unravel the association of CVD in SLE patients while evaluating the role of conventional risk factors. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to search the PubMed database starting from March 2021 systematically. Original studies that evaluated the prevalence and progression of CVD in SLE patients were extracted by two reviewers independently. Quality in Prognostic Studies (QUIPS) tool was used to assess the risk of bias. Most studies have a moderate to low risk of bias. Among 3,653 studies identified by our search, 10 studies were included in the review. Strong epidemiologic evidence of SLE patients having an increased relative risk of CVD compared to controls was found. Traditional CVD risk factors, such as age, hypertension, obesity, and smoking, influence the prevalence of CVD among SLE patients. Several SLE-specific factors such disease activity, duration, and certain medications also acted as influencing factors. However, the relative risk of CVD was still higher in SLE patients after adjustment of certain risk factors. One study found that the odds of having a Coronary Artery Calcification (CAC) score greater than zero in women with SLE aged less than or equal to 45 years was 12.6 times higher than women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (95% CI 5.2 to 30.7) (participants of CARDIA cohort acted as control). This finding was made after age, hypertension, total cholesterol levels, and aspirin use were adjusted, and the study was restricted to women. Although conventional risk factors increase CVD prevalence, SLE itself also dramatically increases the prevalence of CVD. Therefore, we recommend that SLE should be treated as a "CVD risk equivalent." SLE patients should be managed more extensively with greater emphasis given to cardiac health for better clinical outcomes.

Evaluation of Sirtuin-3 probe quality and co-expressed genes using literature cohesion.

BACKGROUND: Gene co-expression studies can provide important insights into molecular and cellular signaling pathways. The GeneNetwork database is a unique resource for co-expression analysis using data from a variety of tissues across genetically distinct inbred mice. However, extraction of biologically meaningful co-expressed gene sets is challenging due to variability in microarray platforms, probe quality, normalization methods, and confounding biological factors. In this study, we tested whether literature derived functional cohesion could be used as an objective metric in lieu of 'ground truth' to evaluate the quality of probes and microarray datasets. RESULTS: We examined Sirtuin-3 (Sirt3) co-expressed gene sets extracted from either liver or brain tissues of BXD recombinant inbred mice in the GeneNetwork database. Depending on the microarray platform, there were as many as 26 probes that targeted different regions of Sirt3 primary transcript. Co-expressed gene sets (ranging from 100-1000 genes) associated with each Sirt3 probe were evaluated using the previously developed literature-derived cohesion p-value (LPv) and benchmarked against 'gold standards' derived from proteomic studies or Gene Ontology classifications. We found that the maximal F-measure was obtained at an average window size of 535 genes. Using set size of 500 genes, the Pearson correlations between LPv and F-measure as well as between LPv and mitochondrial gene enrichment p-values were 0.90 and 0.93, respectively. Importantly, we found that the LPv approach can distinguish high quality Sirt3 probes. Analysis of the most functionally cohesive Sirt3 co-expressed gene set revealed core metabolic pathways that were shared between hippocampus and liver as well as distinct pathways which were unique to each tissue. These results are consistent with other studies that suggest Sirt3 is a key metabolic regulator and has distinct functions in energy-producing vs. energy-demanding tissues. CONCLUSIONS: Our results provide proof-of-concept that literature cohesion analysis is useful for evaluating the quality of probes and microarray datasets, particularly when experimentally derived gold standards are unavailable. Our approach would enable researchers to rapidly identify biologically meaningful co-expressed gene sets and facilitate discovery from high throughput genomic data.

Magnetic resonance imaging of orbital tumors.

This contribution provides an overview of diseases of eye and orbit and their appearance on magnetic resonance imaging. In recent years the diagnosis of eye and orbit pathology has profited significantly from increasingly sophisticated technical developments in the field of tomographic methods. Due to the small size of the examination area the improvement in spatial resolution and soft tissue contrast leads to an increase in image quality. In most clinical questions concerning eye and orbit pathologies magnetic resonance imaging is superior to computed tomography and should be early performed.

[Appearance of orbital diseases on MRI]. / Orbitaerkrankungen und ihr Erscheinungsbild in der MRT.

We provide an overview of diseases of the orbit and their MR imaging appearance. Over recent years MRI has become established in the diagnosis of orbit diseases. There is a selection of different surface coils for examination. The choice of surface coil depends on the clinical question and the anatomical region under consideration. In addition, the significance of the different sequences and the value of contrast medium administration are discussed.

[Differential diagnosis of intraconal orbital masses using high-resolution MRI with surface coils in 78 patients]. / Differenzialdiagnostik intrakonaler orbitaler Raumforderungen unter Verwendung der hochauflösenden MRT mit Oberflächenspulen anhand von 78 Patienten.

PURPOSE: Over the last decade, MRI has become the standard procedure for the diagnosis of orbital masses. Purpose of the study was to evaluate criteria for differential diagnosis for intraconal masses on MRI in a large patient group. MATERIAL AND METHODS: In a retrospective study, MR examinations of 78 patients with intraconal masses were evaluated. All examinations were performed using surface coils for high spatial resolution. Signal behavior on T2-WI and T1-WI before and after contrast application as well as further tumor characteristics (i. e., shape, size, position, delineation and infiltration) were evaluated. Every diagnosis was proven by histopathological results from extirpation (n = 18) or biopsy (n = 22), or confirmed by other imaging modalities (n = 13) or clinical course (n = 25). RESULTS: Different tumor characteristics are helpful in the differentiation between cavernous hemangioma, lymphangioma, varices, AV malformations and solid tumors. Due to overlapping in the imaging appearance, the differentiation between inflammatory pseudotumor, lymphoma and orbital metastasis was more difficult. CONCLUSION: While high resolution MRI using surface coils allows differentiation between the typical vascular tumors, the differentiation between solid tumors is more difficult. Thus, a histopathologic verification of the diagnosis is necessary in solid tumors.

Using an Internet comanagement module to improve the quality of chronic disease care.

BACKGROUND: Web-based applications have the potential to support the ongoing care needs of patients with chronic disease. At the University of Washington, a diabetes care module was developed, and the feasibility of allowing patients with type 2 diabetes to comanage their disease from home was pilot tested. METHODS: The disease management module consisted of five Web sites that enabled patients to access their electronic medical records; upload blood glucose readings; enter medication, nutrition, and exercise data into an online diary; communicate with providers by using clinical e-mail; and browse an education site with endorsed content. All data could be viewed by patients and providers in online trended displays that a nurse practitioner case manager used to review cases weekly. RESULTS: "Proof-of-concept" was demonstrated by the three pilot participants who were the module's most active users. For example, one newly diagnosed patient was started on an oral hypoglycemic, underwent two upward dose adjustments, and achieved control (glycohemoglobin [HbA1c] from 8.0% to 6.1%). His treatment was conducted by exchanging 14 e-mails based on the 231 glucose-meter readings sent from home without requiring in-person follow-up visits. CONCLUSIONS: The Internet offers the opportunity to involve patients and providers in collaborative management of chronic diseases between office visits.

[MR-based volumetric analysis of small tumor volumes: accuracy of phantom examinations of simulated eye tumors]. / Evaluierung der MR-Volumetrie kleiner Volumina am Beispiel von Augentumoren mittels Phantomuntersuchungen.

PURPOSE: The determination of tumor volume in ocular tumors is very important for the planning and success of radiation therapy. This study uses an animal model to evaluate the accuracy of MR-based volumetry of ocular tumors. MATERIALS AND METHODS: In a total of 25 porcine eyes obtained from the slaughterhouse, ocular tumors were produced by injecting a mixture of hand creme and Gd-DTPA under ophthalmoscopic guidance. The injected volume varied between 0.05 ml and 2.7 ml. The eyes were examined with a 1.5 Tesla scanner and a 4 cm circular surface coil especially developed for ocular MRI. After data transfer to a separate workstation, volumetric analysis was carried out by three independent radiologists using semiautomated software. The determined volume was compared with the injected volume. RESULTS: Of the 25 prepared porcine eyes, 23 were suitable for volumetric analysis. The injection of the mixture of hand creme and Gd-DTPA produced two different types of tumors. Ophthalmoscopically, 14 ellipsoid and 9 lobulated to mushroom-shaped tumors were found and confirmed by MRI. Minor deviation was found between injected volume and volume calculated by MRI, with a correlation coefficient of 0.96. CONCLUSION: Using appropriate technique, MRI is capable of determining small tumor volumes with high accuracy in an animal model. Minor differences can be expected when transferring the results to clinical studies.

Feasibility of adjustment of insulin dose by insulin-requiring type II diabetic patients.

Type II (non-insulin-dependent) diabetes accounts for most of the diabetes morbidity and expense, yet no systematic study of the effects of intensification of treatment by such patients who require insulin treatment has been conducted. Therefore, patients were recruited from our diabetes clinics, and by random assignment, experimental and control groups were created (n = 26 and 27, respectively) that were not different at 0 mo regarding 20 demographic, physiological, and treatment variables. Experimental patients practiced an algorithm for adjustment of insulin dosage based on daily prebreakfast capillary blood glucose (CBG) measurements and any symptomatic hypoglycemia. At 2-, 4-, and 6-mo visits, records of CBG measurements were available to the physicians (n = 7), who changed insulin dosages of both groups ad libitum. Feasibility of the experimental treatment is evidenced by study completion by 87% of enrollers, monitoring on 88% of days, accuracy of CBG recording (recorded as percentage of memory meter value, 100.8), weight gain not exceeding that of control subjects, practice of treatment algorithm to effect changes in insulin dosage, modest increase in frequency of mild insulin reactions, and a decrease of glycosylated hemoglobin into the normal range.

Prevalence of radiologically defined osteoarthritis in the finger and wrist joints of adult residents of Tecumseh, Michigan, 1962-65.

Radiographs of the fingers and wrists of adult participants in the Tecumseh Community Health Study in 1962-65 were examined for signs of osteoarthritis (OA). The severity of OA for each of 32 joints of the fingers and wrists was recorded for each individual. Attention was restricted to the 3035 participants who were 32 years of age or older and for whom a diagnosis of OA was available for each of 32 joints. Joint-specific prevalence rates of OA increased sharply with age for both sexes, and at the older ages, the prevalence rates for most joints were higher for females. Older individuals with OA also had a greater number of affected joints, with females having a greater number of affected joints than males. Of those individuals aged 44 years or younger, only 6.2% had one or more joints affected with OA. The percentages were 21.6 and 42.0% for those aged 45-59 years and 60 or more years, respectively. The distal interphalangeal (DIP) joints were the most frequently affected joints in all age categories for both sexes and OA in the proximal interphalangeal (PIP) joints was positively associated with OA in the DIP joints. However, controlling for the number of affected DIP joints, the PIP joints of older subjects were more likely to exhibit OA than the PIP joints of younger subjects. Though there is an association between OA in the DIP and PIP joints, there was only a small, nonsignificant association (OR = 1.24, 95% CI = 0.83, 1.84) between disease in the DIP and PIP joints of the same finger.