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  • 1
    In: Journal of Investigative Medicine, SAGE Publications, Vol. 69, No. 8 ( 2021-12), p. 1417-1425
    Abstract: Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by the formation of antigen–antibody complexes which trigger an immune response. We investigate certain autoantibodies including nucleosome, double-stranded DNA (dsDNA), Smith, ribonucleoprotein, and Sjögren's syndrome-related antigens, and examine their associations with disease activity, damage accrual, and SLE-related clinical and serological manifestations in patients with SLE. We conducted a cross-sectional study with a total 293 patients (90.4% female, mean age 46.87±12.94 years) and used the Systemic Lupus Erythematosus Disease Activity Index 2000 and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) to evaluate disease activity and disease-related damage, respectively. Systemic Lupus Erythematosus Disease Activity Index scores were significantly higher in anti-nucleosome-positive (3.87±2.72 vs 2.52±2.76, p=0.004) and anti-dsDNA-positive (3.08±2.91 vs 2.04±2.48, p=0.010) patients compared with patients without these antibodies. SDI scores were also significantly higher in anti-nucleosome-positive patients (1.61±1.99 vs 0.89±1.06, p=0.004). The presence of antinucleosome (p=0.019) and anti-dsDNA antibodies (p=0.001) both correlated significantly with the incidence of nephritis; anti-La antibodies were associated with arthritis (p=0.022), and we also observed a relationship between the presence of antinucleosome antibodies and leukopenia (p=0.011). Patients with antinucleosome or anti-dsDNA antibodies had a higher disease activity and were likely to have nephritis. Antinucleosome was also associated with more damage accrual. A greater understanding of these autoantibodies could lead to the development of new approaches to more accurate assessments of SLE.
    Type of Medium: Online Resource
    ISSN: 1081-5589 , 1708-8267
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 2
    In: Biological Research For Nursing, SAGE Publications, Vol. 22, No. 2 ( 2020-04), p. 169-177
    Abstract: Chronic inflammation coupled with cardiovascular disease (CVD) risk factors influences the progression of atherosclerosis in systemic lupus erythematosus (SLE). High-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) are associated with the risk of CVD in the general population, but their associations with CV risk and disease activity in SLE are unclear. In this cross-sectional study ( N = 139 SLE patients, mean age = 45.27 ± 13.18 years), we investigated associations between hs-CRP and Hcy levels and disease activity, damage accrual, and CVD risk in SLE. Disease activity and damage accrual were measured with the SLE Activity Index 2000 (SLEDAI-2K), the Systemic Lupus Erythematosus International Collaborating Clinics Group/American College of Rheumatology damage index (SDI), and anti-double-stranded DNA antibodies (anti-dsDNA). CVD risk factors of obesity, diabetes mellitus, hypertension, blood lipids, and ankle–brachial index were collected. Linear regression analysis and one-way analysis of variance were used to analyze relationships of hs-CRP and Hcy with SLE activity, damage accrual, and CVD risk factors. Results: hs-CRP correlated significantly with SLEDAI-2K ( p = .036), SDI ( p = .00), anti-dsDNA titers ( p = .034), diabetes ( p = .005), and obesity ( p = .027). hs-CRP and Hcy correlated with triglyceride (TG) levels ( p = .032 and p 〈 .001, respectively), TG/high-density lipoprotein cholesterol index ( p = .020 and p = .001, respectively), and atherogenic index of plasma ( p = .006 and p = .016, respectively). hs-CRP levels 〉 3 mg/L correlated with SDI score ( p = .012) and several CVD risk factors. Discussion: Findings suggest SLE patients with elevated hs-CRP and/or Hcy have a higher prevalence of CVD risk factors.
    Type of Medium: Online Resource
    ISSN: 1099-8004 , 1552-4175
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2070503-7
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  • 3
    In: Nutrients, MDPI AG, Vol. 11, No. 3 ( 2019-03-16), p. 638-
    Abstract: The prognostic nutritional index (PNI), controlling nutritional status (CONUT) score and nutritional risk index (NRI) have been described as useful screening tools for patient prognosis in several diseases. The aim of this study was to examine the relationship between PNI, CONUT and NRI with clinical disease activity and damage in 173 patients with systemic lupus erythematous (SLE). Disease activity was assessed with the SLE disease activity index (SLEDAI-2K), and disease-related organ damage was assessed using the SLICC/ACR damage index (SDI) damage index. PNI and NRI were significantly lower in active SLE patients than in inactive SLE patients (p 〈 0.001 and p = 0.012, respectively). PNI was inversely correlated with the SLEDAI score (p 〈 0.001) and NRI positively correlated with SLEDAI and SDI scores (p = 0.027 and p 〈 0.001). Linear regression analysis adjusting for age, sex and medications showed that PNI was inversely correlated with SLEDAI (β (95% CI) = −0.176 (−0.254, −0.098), p 〈 0.001) and NRI positively correlated with SLEDAI (β (95% CI) = 0.056 (0.019, 0.093), p = 0.003) and SDI (β (95% CI) = 0.047 (0.031, 0.063), p 〈 0.001). PNI (odds ratio (OR) 0.884, 95% confidence interval (CI) 0.809–0.967, p = 0.007) and NRI ((OR) 1.067, 95% CI 1.028–1.108, p = 0.001) were independent predictors of active SLE. These findings suggest that PNI and NRI may be useful markers to identify active SLE in clinical practice.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2518386-2
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  • 4
    In: Biological Research For Nursing, SAGE Publications, Vol. 23, No. 3 ( 2021-07), p. 455-463
    Abstract: Vitamin D has immunosuppressive properties and is considered a therapeutic option, although there is controversy about the role of this vitamin in the pathogenesis of systemic lupus erythematosus (SLE). We aimed to determine the prevalence of vitamin D insufficiency and deficiency and their potential association with disease activity, damage accrual, SLE-related clinical manifestations, and cardiovascular risk factors in SLE patients. A cross-sectional study of 264 patients was conducted (89.4% females; mean age 46.7 ± 12.9 years). The SLE Disease Activity Index (SLEDAI-2 K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. The mean 25(OH)D value was 25.1 ± 13.0 ng/ml. Eleven patients (4.2%) had 25(OH)D 〈 10 (deficiency) and 178 patients (70.6%) had 25(OH)D 〈 30 (insufficiency). In the 25(OH)D deficiency group, SLEDAI was significantly higher than the insufficiency ( p = 0.001) and normal groups ( p 〈 0.001). Also, patients with vitamin D deficiency presented significantly higher SDI scores than patients with 25(OH)D insufficiency ( p = 0.033) and 25(OH)D normal levels ( p = 0.029). There is a high prevalence of both vitamin D deficiency and insufficiency in Caucasian SLE patients and this status was associated with higher SLEDAI and SDI scores, supporting the impact of vitamin D levels on disease activity and damage accrual in SLE patients. Longitudinal studies on the relationship between vitamin D status and disease activity and progression are therefore required.
    Type of Medium: Online Resource
    ISSN: 1099-8004 , 1552-4175
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2070503-7
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  • 5
    In: Rheumatology, Oxford University Press (OUP), Vol. 60, No. 1 ( 2021-01-05), p. 160-169
    Abstract: To analyse the influence of the Mediterranean diet (Med Diet) on SLE activity, damage accrual and cardiovascular disease risk markers. Methods A cross-sectional study was conducted on 280 patients with SLE [46.9 (12.85) years]. Med Diet adherence was assessed through a 14-item questionnaire on food consumption frequency and habits (total score from 0 to 14 points; higher score is greater adherence to the Med Diet). CRP, homocysteine, SLEDAI-2K (SLE disease activity), and SLICC/ACR and SDI (damage accrual) were measured. Obesity, diabetes mellitus, hypertension and blood lipids, among others, were considered cardiovascular disease risk factors. Results Greater adherence to the Med Diet was significantly associated with better anthropometric profiles, fewer cardiovascular disease risk factors, and lower disease activity and damage accrual scores (P ≤ 0.001 for SLEDAI and SDI). An inverse relationship between the Med Diet score and SLEDAI (P ≥ 0.001; β = −0.380), SDI (P ≤ 0.001; β = −0.740) and hsCRP (P = 0.039; β = −0.055) was observed. The odds ratio for having active SLE (SLEDAI ≥5) or the presence of damage (SDI ≥1) was lower among patients whose Med Diet score was higher (P ≤ 0.001). Finally, greater consumption of Med Diet foods (olive oil, fruits, vegetables, fish, etc.) and abstaining from red meat and meat products, sugars and pastries was associated with less SLE clinical activity and damage. Conclusion Greater adherence to the Med Diet seems to exert a beneficial effect on disease activity and cardiovascular risk in SLE patients. To confirm these findings, further longitudinal studies would be of interest.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1474143-X
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  • 6
    In: Journal of the Academy of Nutrition and Dietetics, Elsevier BV, Vol. 120, No. 2 ( 2020-02), p. 280-287
    Type of Medium: Online Resource
    ISSN: 2212-2672
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2646137-7
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  • 7
    In: Nutrients, MDPI AG, Vol. 12, No. 4 ( 2020-04-15), p. 1094-
    Abstract: Diet has been closely associated with inflammatory autoimmune diseases, including systemic lupus erythematosus (SLE). Importantly, the consumption of dietary sugars has been positively linked to elevated levels of some inflammation markers, but the potential role of their consumption on the prognosis of autoimmune diseases has not yet been examined. The aim of this study was to evaluate the association between the dietary intake of free sugars and clinical parameters and cardiovascular (CVD) risk markers in patients with SLE. A cross-sectional study including a total of 193 patients with SLE (aged 48.25 ± 12.54 years) was conducted. The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to asses disease activity and disease-related damage, respectively. Levels of C-reactive protein (CRP; mg/dL), homocysteine (Hcy; µmol/L), anti-double stranded DNA antibodies (anti-dsDNA) (IU/mL), complement C3 (mg/dL), and complement C4 (mg/dL), among other biochemical markers, were measured. The main factors we considered as risk factors for CVD were obesity, diabetes mellitus, hypertension, and blood lipids. The dietary-intrinsic sugar and added-sugar content participants consumed were obtained via a 24-h patient diary. Significant differences were observed in dietary sugar intake between patients with active and inactive SLE (in grams: 28.31 ± 24.43 vs. 38.71 ± 28.87; p = 0.035) and free sugar intake (as a percentage: 6.36 ± 4.82 vs. 8.60 ± 5.51; p = 0.020). Linear regression analysis revealed a significant association between free sugars intake (by gram or percentage) and the number of complications (β (95% CI) = 0.009 (0.001, 0.0018), p = 0.033)); (β (95% CI) = 0.046 (0.008, 0.084), p = 0.018)), and SLEDAI (β (95% CI) = 0.017 (0.001, 0.034), p = 0.043)); (β (95% CI) = 0.086 (0.011, 0.161), p = 0.024)) after adjusting for covariates. Free sugars (g and %) were also associated with the presence of dyslipidaemia (β (95% CI) = −0.003 (−0.005, 0.000), p = 0.024)) and (β (95% CI) = −0.015 (−0.028, −0.002), p = 0.021)). Our findings suggest that a higher consumption of free sugars might negatively impact the activity and complications of SLE. However, future longitudinal research on SLE patients, including dietary intervention trials, are necessary to corroborate these preliminary data.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518386-2
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  • 8
    Online Resource
    Online Resource
    Sociedad Espanola de Medicina Interna (SEMI) ; 2018
    In:  Revista Española de Casos Clínicos en Medicina Interna Vol. 3, No. 2 ( 2018-08-31), p. 90-92
    In: Revista Española de Casos Clínicos en Medicina Interna, Sociedad Espanola de Medicina Interna (SEMI), Vol. 3, No. 2 ( 2018-08-31), p. 90-92
    Abstract: La anticoagulación es el pilar fundamental del tratamiento de la enfermedad tromboembólica venosa. En las situaciones en las que el tratamiento anticoagulante está contraindicado, como ocurre en una hemorragia activa, o cuando fracasa dicha terapia con recurrencias de la embolia de pulmón, se debe plantear la colocación de un filtro de vena cava inferior. Presentamos el manejo de un caso de enfermedad tromboembólica en un paciente oncológico que desarrolló un hemoperitoneo.
    Type of Medium: Online Resource
    ISSN: 2530-0792
    Language: Unknown
    Publisher: Sociedad Espanola de Medicina Interna (SEMI)
    Publication Date: 2018
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  • 9
    Online Resource
    Online Resource
    Sociedad Espanola de Medicina Interna (SEMI) ; 2018
    In:  Revista Española de Casos Clínicos en Medicina Interna Vol. 3, No. 2 ( 2018-08-31), p. 99-101
    In: Revista Española de Casos Clínicos en Medicina Interna, Sociedad Espanola de Medicina Interna (SEMI), Vol. 3, No. 2 ( 2018-08-31), p. 99-101
    Abstract: La enfermedad tromboembólica venosa es una de las complicaciones más frecuentes y graves de los pacientes oncológicos. La incidencia es mayor en tumores con enfermedad metastásica y su desarrollo se relaciona con una menor supervivencia. La anticoagulación, que es el tratamiento indicado, en la gran mayoría de los casos debe mantenerse a largo plazo, con el riesgo hemorrágico que esto conlleva. Además, la trombosis venosa asociada al cáncer presenta una elevada tasa de recurrencias pese a la anticoagulación. El manejo de la trombosis venosa en el cáncer es complejo y precisa una aproximación multidisciplinar. Presentamos el caso de un varón de 55 años con un carcinoma renal de células claras y enfermedad tromboembólica venosa asociada.
    Type of Medium: Online Resource
    ISSN: 2530-0792
    Language: Unknown
    Publisher: Sociedad Espanola de Medicina Interna (SEMI)
    Publication Date: 2018
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  • 10
    Online Resource
    Online Resource
    Sociedad Espanola de Medicina Interna (SEMI) ; 2018
    In:  Revista Española de Casos Clínicos en Medicina Interna Vol. 3, No. 2 ( 2018-08-31), p. 96-98
    In: Revista Española de Casos Clínicos en Medicina Interna, Sociedad Espanola de Medicina Interna (SEMI), Vol. 3, No. 2 ( 2018-08-31), p. 96-98
    Abstract: El síndrome antifosfolípido es una enfermedad autoinmune sistémica que se define por la trombosis en cualquier lecho vascular y/o la morbilidad obstétrica. Dada la variabilidad en sus manifestaciones clínicas, podemos hablar de dos variantes de una misma entidad, síndrome antifosfolípido trombótico y síndrome antifosfolípido obstétrico, cuyo manejo presenta diferentes matices en cuanto a seguimiento y tratamiento. Presentamos un caso de una gestación en el contexto de un síndrome antifosfolípido completo (trombótico y obstétrico). La planificación del embarazo y el parto, el seguimiento cercano y coordinado, así como la individualización del tratamiento resultaron esenciales para llevar a buen término la gestación.
    Type of Medium: Online Resource
    ISSN: 2530-0792
    Language: Unknown
    Publisher: Sociedad Espanola de Medicina Interna (SEMI)
    Publication Date: 2018
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