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Neurovisceral Syndrome in a Patient with Monoclonal Gammopathy of Undetermined Significance: A Confirmed Case of Variegate Porphyria.

Variegate porphyria (VP) is a rare disorder presenting with cutaneous, neurological, and systemic symptoms. We report a 53-year-old man initially hospitalized for a depressive episode, during which blistering lesions and facial flushing were noted. He was misdiagnosed and treated for cellulitis and contact dermatitis without improvement. Repeated misdiagnoses led to extensive autoimmune, infectious, and hematologic workup, revealing coexisting monoclonal gammopathy of undetermined significance (MGUS). Over the following months, he developed abdominal pain, mood swings, cognitive impairment, ne

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… Over the following three months, the patient experienced episodic symptoms of abdominal pain, pleurisy-like chest pain, mood instability, fatigue, tremors, and cognitive dysfunction described as “brain fog.” …

Maternal protein restriction during early lactation induces changes on neutrophil activation and TNF-alpha production of adult offspring.

Maternal nutritional environmental in early life has been often associated with long term effects on the immune response in adulthood. The effects of maternal protein deprivation during early lactation on neutrophil-mediated innate immunity were investigated in adult rats, offspring of dams fed with a protein-free diet during the first days of lactation (PD), and compared to controls (22% protein diet). Inflamed PD animals showed an inhibited neutrophil migration and an impaired recruitment of leukocytes from bone marrow pool to circulation. In resting conditions, blood neutrophils from PD pre

[Pneumoconiosis and mycobacterial infection].

This symposium was organized to provide recent informations concerning pneumoconiosis and mycobacterial diseases in Japan. Pneumoconiotic workers have been decreasing in number and in severity because of change in industrial structure and improvement of occupational health measures. But radiological figures of dust exposed worker are going to be complex and be difficult for diagnosis due to aging, smoking and of complicated respiratory and non-respiratory diseases. Major complications such as pulmonary tuberculosis and tuberculous pleurisy are decreasing but non-tuberculous mycobacterial infec…

Serum levels of the soluble haemoglobin scavenger receptor CD163 in MPO-ANCA-associated renal vasculitis.

OBJECTIVES: The contribution of infections to the mortality of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is important, and early and careful infection control is necessary. We investigated the usefulness of the serum-soluble haemoglobin scavenger receptor CD163 for detecting the presence of infectious complications regardless of disease activity. METHOD: Soluble CD163 in serum obtained from 45 Japanese patients with myeloperoxidase (MPO)-AAV was measured by an enzyme-linked immunosorbent assay (ELISA). We evaluated 36 samples from active-vasculitis

Possible new role for NF-kappaB in the resolution of inflammation.

Inflammation involves the sequential activation of signaling pathways leading to the production of both pro- and anti-inflammatory mediators. Although much attention has focused on pro-inflammatory pathways that initiate inflammation, relatively little is known about the mechanisms that switch off inflammation and resolve the inflammatory response. The transcription factor NF-kappaB is thought to have a central role in the induction of pro-inflammatory gene expression and has attracted interest as a new target for the treatment of inflammatory disease. We show here that NF-kappaB activation in

Role of TNF-alpha in lung tight junction alteration in mouse model of acute lung inflammation.

In the present study, we used tumor necrosis factor-R1 knock out mice (TNF-alpha R1KO) to understand the roles of TNF-alpha on epithelial function in models of carrageenan-induced acute lung inflammation. In order to elucidate whether the observed anti-inflammatory status is related to the inhibition of TNF-alpha, we also investigated the effect of etanercept, a TNF-alpha soluble receptor construct, on lung TJ function. Pharmacological and genetic TNF-alpha inhibition significantly reduced the degree of (1) TNF-alpha production in pleural exudates and in the lung tissues, (2) the inflammatory

Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment.

As a systemic autoimmune disease, rheumatoid arthritis (RA) usually causes damage not only to joints, but also to other tissues and organs including the heart, kidneys, lungs, digestive system, eyes, skin, and nervous system. Excessive complications are closely related to the prognosis of RA patients and even lead to increased mortality. This article summarizes the serious complications of RA, focusing on its incidence, pathogenesis, clinical features, and treatment methods, aiming to provide a reference for clinicians to better manage the complications of RA.

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… pulmonary function tests, and high-resolution computed tomography (HRCT) are valuable tools for the diagnosis and evaluation of RA-ILD ( 76 ), and HRCT can accurately capture UIP cellular and traction bronchiectasis as well as reticular abnormalities and the “ground glass opacity” in NSIP ( 77 ). 3.1.2 Pleurisy … and pleural effusion Pleurisy and pleural effusion are the most common pleural manifestations observed in RA patients, with only 3-5% of patients presenting with clinical symptoms such as cough, dyspnea, chest pain, and fever, which means the majority of RA patients with the pleural disease are with …

PD-1+CXCR5-CD4+T cells are correlated with the severity of systemic lupus erythematosus.

OBJECTIVES: PD-1+CXCR5-CD4+T peripheral helper (Tph) cells, a recently identified T cell subset, are proven to promote B cell responses and antibody production in rheumatoid arthritis, but their role in the pathogenesis of SLE is unknown. We explored the role of Tph in lupus disease development. METHODS: This cohort study included 68 patients with SLE and 41 age- and sex-matched healthy individuals. The frequency of PD-1+CXCR5-CD4+T cells was analysed in peripheral blood by flow cytometry. Inducible T-cell costimulator, CD38, MHC-II, IL-21, CXCR3 and CCR6 expression were measured in Tph cells

Daratumumab monotherapy for patients with intermediate-risk or high-risk smoldering multiple myeloma: a randomized, open-label, multicenter, phase 2 study (CENTAURUS).

Current guidelines for smoldering multiple myeloma (SMM) recommend active monitoring until the onset of multiple myeloma (MM) before initiating treatment or enrollment in a clinical trial. Earlier intervention may delay progression to MM. In CENTAURUS, 123 patients with intermediate-risk or high-risk SMM were randomly assigned to daratumumab 16 mg/kg intravenously on extended intense (intense), extended intermediate (intermediate), or short dosing schedules. At the prespecified primary analysis (15.8-month median follow-up), the complete response (CR) rates (co-primary endpoint) were 2.4%, 4.9

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… (2.4) 0 0 0 Lymphopenia 0 0 1 (2.4) 0 0 0 Angina pectoris 0 0 0 0 1 (2.5) 1 (2.5) Unstable angina 0 0 0 0 1 (2.5) 1 (2.5) Sepsis 0 0 0 0 1 (2.5) 1 (2.5) Abdominal discomfort 0 0 0 0 1 (2.5) 0 Cough 0 0 0 0 1 (2.5) 0 Breast disorder 0 1 (2.4) 0 0 0 0 Embolism 0 1 (2.4) 0 0 0 0 Fall 0 1 (2.4) 0 0 0 0 Pleurisy … Unstable angina | 0 | 0 | 0 | 0 | 1 (2.5) | 1 (2.5) Sepsis | 0 | 0 | 0 | 0 | 1 (2.5) | 1 (2.5) Abdominal discomfort | 0 | 0 | 0 | 0 | 1 (2.5) | 0 Cough | 0 | 0 | 0 | 0 | 1 (2.5) | 0 Breast disorder | 0 | 1 (2.4) | 0 | 0 | 0 | 0 Embolism | 0 | 1 (2.4) | 0 | 0 | 0 | 0 Fall | 0 | 1 (2.4) | 0 | 0 | 0 | 0 Pleurisy …

Yerba Mate (Ilex paraguariensis) Ameliorates Experimental Autoimmune Encephalomyelitis by Modulating Regulatory T Cell Function.

Background/Objectives: In Latin America, yerba mate (YM) is a popular infusion processed from the leaves and stems of Ilex paraguariensis. YM has been shown to have anti-inflammatory properties in several studies, although the effect of YM on multiple sclerosis (MS) remains elusive. The purpose of this study was to examine the effect of YM on the development of MS, by using the experimental autoimmune encephalomyelitis (EAE) mouse model while also evaluating its effect over infiltration of immune cells into the central nervous system (CNS) and regulatory T cell (Treg) function. Methods: YM or

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… YM has also immunomodulatory properties, with studies showing a reduction in proinflammatory cytokines produced by Th1/Th17 cells and decreased leukocyte migration and overall inflammation when YM is administrated in animal models of pleurisy and chronic smoke exposition [ 15 , 16 ]. …

Clinical characteristics and risk factors of patients with eosinophilic fasciitis associated with pleural effusion.

To investigate the risk factors of eosinophilic fasciitis (EF) associated with pleural effusion (PE). A retrospective analysis was performed on 22 patients with EF diagnosed by skin biopsy in our hospital, and they were divided into EF-PE and EF according to chest computed tomography examination. The clinical characteristics, clinical manifestations, comorbidities and laboratory test indicators of the two groups were collected and compared, and the risk factors for occurring PE in patients with EF were determined by multivariate logistic regression analysis. Among 22 patients with EF, 8 had PE

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… patients were excluded: (a) Patients secondary to scleroderma, vascular syndrome, systemic sclerosis and other connective tissue diseases; (b) Diseases with other causes have been confirmed to lead to pleural effusion, such as potential malignancies, congestive heart failure, cirrhosis, tuberculosis and pleurisy …

Development of a Metastatic Spinal Tumor Frailty Index (MSTFI) Using a Nationwide Database and Its Association with Inpatient Morbidity, Mortality, and Length of Stay After Spine Surgery.

OBJECTIVE: The aim of this study was to develop a perioperative metastatic spinal tumor frailty index (MSTFI) that could predict morbidity, mortality, and length of stay. METHODS: A large inpatient hospitalization database was searched from 2002 to 2011 to identify 4583 patients with spinal metastasis from breast (21.1%), lung (34.1%), thyroid (3.8%), renal (19.9%), and prostate (21.1%) cancer who underwent surgery. A multiple logistic regression model identified 9 independent parameters that were used to construct the MSTFI: anemia, chronic lung disease, coagulopathy, electrolyte abnormaliti

A Critical Appraisal of the Application of Frailty and Sarcopenia in the Spinal Oncology Population.

Study designSystematic review and clinimetric analysis.ObjectivesFrailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we sought to identify frailty and sarcopenia tools applied in spinal oncology and appraise their clinimetric properties.MethodsA systematic review was conducted from January 1st, 2000, until June 2022. Study characteristics, frailty tools, and measures of sarcopenia were recorded. Component domains, individual items, cut-off values, and measurem

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… Complication rates: Pleurisy, pneumothorax, or pulmonary collapse (5.8%); acute respiratory distress syndrome (3.7%); reintubation (1.4%); pneumonia (1.4%). Others had an incidence of <.1%. … and 24.2% for patients with no frailty, mild frailty, moderate frailty, and severe frailty, respectively ( P = .094); the ROC AUC for the mortality model was .565 Overall peri-op complication rate: 882 patients (19.3%) who developed at least 1 perioperative complication, with the most common being pleurisy …

Early Diagnosis of Herpes Zoster Neuralgia: A Narrative Review.

BACKGROUND: Early intervention reduces the incidence of postherpetic neuralgia (PHN). Typical shingles are easy to diagnose; however, there is no clear diagnostic method for neuralgia symptoms manifested before the onset of the rash, which can easily cause misdiagnosis. This not only increases the patient's pain, medical expenses, and mental burden, but more importantly, delays the valuable time for early treatment of shingles, and increases the probability of complications and PHN. OBJECTIVE: In this paper, the diagnostic methods of preherpetic neuralgia were summarized and analyzed, and the

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… These patients are often misdiagnosed with migraine, myocardial infarction, pleurisy, intercostal neuralgia, cholelithiasis, appendicitis, and gastric ulcer, depending on the nerve involved [ 1 , 11 – 13 ]. …

Chest and Mediastinum

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… Intrathoracic causes include subpulmonary effusion, atelectasis, phrenic nerve paralysis, pleurisy, or pleural thickening ( . Fig. 19.25 ). Fig. 19.24 Chest X-ray analysis. Depressed flattened diaphragm. Slender elongated heart shadow Fig. 19.25 Subphrenic abscess. …

Intrathoracic manifestations of hematologic malignancies: a narrative review.

BACKGROUND AND OBJECTIVE: Although the global incidence of hematologic malignancies is decreasing, the risk of developing these cancers is increasing due to increased lifespan and modern treatments including targeted therapy, chemotherapy, and radiation. Intrathoracic manifestations of hematologic malignancies may be the presenting sign leading to diagnosis or result from various treatment toxicity. The most common respiratory manifestation of hematologic malignancies is infectious, but up to half of pulmonary findings are from non-infectious etiologies. We aim to summarize the current literat

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… Clinical presentation may vary depending on the size of the effusion and symptoms can include dyspnea, chest pain or pleurisy, fever, arrhythmia, and in severe cases, hypotension and/or shock. …

Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer

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… Infection, anemia, hypoxia, pleurisy, pericarditis, and cardiomyopathy are all potential complications of cancer and cancer treatment and are all are potential triggers of AF [ 32 ]. More rarely, AF may be triggered by the metastatic involvement of the heart [ 25 ]. …

Percutaneous coronary intervention and 30-day unplanned readmission with chest pain in the United States (Nationwide Readmissions Database).

Percutaneous coronary intervention (PCI) improves anginal chest pain in most, but not all, treated patients. PCI is associated with unplanned readmission for angina and non-specific chest pain within 30-days of index PCI. Patients with an index hospitalization for PCI between January-November in each of the years 2010-2014 were included from the United States Nationwide Readmissions Database. Of 2 723 455 included patients, the 30-day unplanned readmission rate was 7.2% (n = 196 581, 42.3% female). This included 9.8% (n = 19 183) with angina and 11.1% (n = 21 714) with non-specific chest pain.

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… Outcomes . 2016 ; 9 : 600 ‐ 604 . 27553598 10.1161/CIRCOUTCOMES.116.003086 TABLE A1 Classification of clinic classification software codes for readmissions causes Causes of readmission | CCS code | Diagnosis Respiratory | 127 | Chronic obstructive pulmonary disease and bronchiectasis 128 | Asthma 130 | Pleurisy …

Extraglandular Manifestations of Sjögren’s Syndrome (SS): Dermatologic, Arthritic, Endocrine, Pulmonary, Cardiovascular, Gastroenterology, Renal, Urology, and Gynecologic Manifestations

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… Pulmonary • Interstitial pneumonitis • Pleurisy and pleural effusions including lymphomatous • Pulmonary hypertension and occult pulmonary emboli • Lymphoproliferative manifestations [BALT (bronchial MALT lymphoma) will be covered in 10.1007/978-1-60327-957-4_20] • Laryngotracheal reflux and motility … Pulmonary • Interstitial pneumonitis • Pleurisy and pleural effusions including lymphomatous • Pulmonary hypertension and occult pulmonary emboli • Lymphoproliferative manifestations [BALT (bronchial MALT lymphoma) will be covered in 10.1007/978-1-60327-957-4_20] • Laryngotracheal reflux and motility …