scholarly journals Experience of using ustekinumab in the treatment of a patient with HIV-associated psoriasis and anogenital warts

2021 ◽  
Vol 97 (5) ◽  
pp. 94-100
Author(s):  
M. I. Babkova ◽  
M. I. Arshinsky ◽  
Z. V. Frolova ◽  
O. A. Chudina ◽  
J. S. Mitrofanova ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Hiv Infection ◽  
Clinical Picture ◽  
Laboratory Data ◽  
Anogenital Warts ◽  
Venereal Warts

The article presents an analysis of the literature of patients with HIV infection suffering from psoriasis. The clinical picture, laboratory data, and treatment of a patient suffering from psoriasis, psoriatic arthritis, anogenital venereal warts associated with HIV infection are described. Against the background of the use of an IL 12.23 inhibitor, regression of anogenital warts, resolution of psoriatic rashes, and relief of articular syndrome were noted.

Clinical manifestations, diagnosis and treatment of HIV infection of stage 4 (severely symptomatic stage) in the practice of a health professional

2020 ◽  
pp. 27-34
Author(s):  
A. Nikitina ◽  
A. Rusanova ◽  
A. Zhilenkova
Keyword(s):  
Hiv Infection ◽  
Health Professional ◽  
Clinical Picture ◽  
Clinical Manifestations ◽  
Significant Problem ◽  
Diagnosis And Treatment ◽  
Modern World ◽  
Infected People ◽  
Stage 4 ◽  
Future Practice

HIV infection is a significant problem in the modern world, because there are more and more infected people every year. This article will consider: the clinical picture, diagnosis and treatment of this disease in different countries. Based on these data, the following conclusions will be made to help doctors in their future practice correctly approach the diagnosis and treatment of patients with this disease.

HELIOTHERAPY IN THE TREATMENT OF PSORIATIC ARTHRITIS

2018 ◽  
Vol 28 (2) ◽  
pp. 483-487
Author(s):  
Snezhina Georgieva ◽  
Dilyana Zvezdova
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Picture ◽  
Local Therapy ◽  
Severe Form ◽  
Climatic Conditions ◽  
Joint Disease ◽  
Immune Mediated ◽  
Social Comfort ◽  
Pigment Type ◽  
Definition Of

Psoriatic arthritis is an inflammatory joint disease associated with psoriasis vulgaris, with routinely negative rheumatoid factors and the absence of rheumatoid nodules. This is an immune-mediated disease, according to generally accepted definition of Wright and Moll from 1973. American Association against Rheumatism classified psoriatic arthritis as an independent disease in 1964. Psoriatic arthritis is a single disease with a varied clinical picture. It belongs to the group of seronegative spondyloarthropathies with which there are general clinical features. It is believed that similar mechanisms determine the onset of psoriasis and psoriatic arthritis. The clinical picture includes various clinical forms that damage the peripheral and sacroiliac joints, spine, internal organs. The treatment of psoriatic arthritis is directed simultaneously to the influence of skin and joint changes. Purpose: Our study aims to summarize our long-standing experience in the treatment of psoriatic arthritis with heliotherapy. Subject of observation: Monitoring includes 132 patients with moderate and severe form of psoriasis treated at the sanatorium in town of Pomorie for 5 years in the period 2001-2006. Results and discussion: 132 patients with psoriasis with no effect on the local therapy and have proven psoriatic arthritis were selected. In our climatic conditions, heliotherapy is appointed during the warm half-year. Sun treatment was conducted under the conditions of a healing beach, which had shielding, radiation-protective devices. In patients with erythema - pigment and pigment type skin reactivity begins with 1-2 bioadoses reached to 8-10 biodoses, carried out in the area of overcomfort. Conclusion: The studies demonstrated that heliotherapy combined with medications significantly improves the prognosis of patients with this disease. The ultimate success would mean overcoming the frequent depression conditions, better survival and social comfort for patients with psoriatic arthritis.

scholarly journals Identification of the Clinical Features Distinguishing Psoriatic Arthritis and Fibromyalgia

2012 ◽  
Vol 39 (4) ◽  
pp. 849-855 ◽  
Author(s):  
ANTONIO MARCHESONI ◽  
FABIOLA ATZENI ◽  
ANTONIO SPADARO ◽  
ENNIO LUBRANO ◽  
GIUSEPPE PROVENZANO ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Features ◽  
Disease Duration ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Fibromyalgia Impact Questionnaire ◽  
Somatic Symptoms ◽  
Tender Point ◽  
Antiinflammatory Drugs ◽  
Associated Symptoms

Objective.To identify the clinical features that can help to distinguish between psoriatic arthritis (PsA) and fibromyalgia (FM).Methods.Our cross-sectional study was carried out in 10 Italian rheumatology centers between January and September 2009, and enrolled all consecutive patients with PsA and FM who agreed to participate. Standard clinical and laboratory data for PsA and FM were collected from all patients. Records were made of somatic symptoms, response to nonsteroidal antiinflammatory drugs (NSAID), self-evaluated pain, general health, disability, and responses to the Fibromyalgia Impact Questionnaire. Data were statistically analyzed by univariate and multivariate analyses, and receiver-operating characteristic curves. The analysis concentrated on the clinical features shared by the 2 conditions.Results.Two hundred sixty-six patients with PsA (mean age 51.7 yrs; disease duration 10.2 yrs) and 120 patients with FM (mean age 50.2 yrs; disease duration 5.6 yrs) were evaluated. Univariate analysis showed that patients with FM had higher mean tender point and enthesitis scores, more somatic symptoms, and responded less to NSAID. Multivariate analysis showed that the presence of ≥ 6 FM-associated symptoms and ≥ 8 tender points was the best predictor of FM.Conclusion.The shared clinical features of PsA and FM that had the greatest discriminating power for FM were the number of FM-associated symptoms and tender point count.

scholarly journals AB0830 LIPID PROFILE IN PSORIATIC ARTHRITIS. FREQUENCY AND ASSOCIATION WITH DISEASE ACTIVITY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1719.1-1720
Author(s):  
V. Savio ◽  
Y. Tissera ◽  
M. I. Quaglia ◽  
J. A. Albiero ◽  
C. G. Alonso ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Lipid Profile ◽  
Activity Index ◽  
Laboratory Data ◽  
Disease Index ◽  
Interleukin 12 ◽  
Joint Involvement ◽  
Apo B

Background:Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with higher risk of cardiovascular events and metabolic syndrome. The inflammation not only accelerates atherosclerosis, but also may influence cardiovascular (CV) risk factors such as lipid profile, blood pressure and insulin resistance. Lipid profile has previously been studied in PsA, however this association is still controversial.Objectives:To study the frequency of altered lipid profile in patients with PsA and its association with disease activity.Methods:We studied all the patients with diagnosis of PsA who consecutively attended to Rheumatology Unit at Cordoba Hospital from July 2018 to December 2019. PsA was diagnosed according CASPAR criteria. Clinical and laboratory data were collected. The activity of the disease was evaluated by PASI, MDA and DAPSA. Quantitative variables will be expressed in median and 1st and 3rd interquartile; qualitative variables expressed in frequency and percentage. Correlation analysis was calculated using Spearman’s rank correlation coefficient. P<0.05 was considered statistically significant.Results:42 PsA patients were included. Mean age was 56 years old (47.25-62.75) and 54.76% were female (n=23). 92.86% (n=39) of the patients had plaque Psoriasis and 87.8% (n=36) had peripheral joint involvement.Frequency of comorbidities in PsA are shown in Graphic 1. 31 (73.8%) of the patients were treated with topical therapy, 3 (7.14%) with phototherapy, 31 (73.8%) with Methotrexate and 17 (41.46%) with biologics and JAK inhibitor. Activity Disease Index and Lipid profile are shown in Table 1 and 2.There was not association between Apo B/Apo A coefficient with DAPSA (rho=0.013; p=0.940) and MDA (rho=-0.029; p=0.867).Conclusion:In spite of the presence of cardiovascular factors in the majority of PsA patients, lipid profile is not correlated with disease activity in this population.References:[1]Ahlehoff O, Gislason GH, Charlot M, et al. Psoriasis is associated with clinically significant cardiovascular risk: A Danish nationwide cohort study. J Intern Med 2011;270:147-57.[2]Mallbris, L., Ritchlin, C.T., Ståhle, M. “Metabolic disorders in patients with psoriasis and psoriatic arthritis.” Curr RheumatolRep.8(5): 355–363. 2006[3]Ng CY, Tzeng I-S, Liu S-H, Chang Y-C, Huang Y-H. Metabolic parameters in psoriatic patients treated with interleukin-12/23 blockade (Ustekinumab). J Dermatol 2018; 45:309–313[4]Kaur S, Kingo K, Zilmer M. Psoriasis and cardiovascular risk – do promising new biomarkers have clinical impact? Mediators Inflamm 2017; 2017: 7279818[5]Gentile M, Peluso R, Di Minno MN, et al. Association between small dense LDL and sub-clinical atherosclerosis in patients with psoriatic arthritis. ClinRheumatol 2016; 35: 2023-9.Graphic 1.Comorbidities in PsATable. 1.Activity Disease Index in PsAACTIVITY INDEXn=42DAPSA14.45 (9.72-23.92)DAPSA≤4 REMISSION3>4 y ≤14 low disease activity16>14 y ≤28 moderate disease activity17>28 high disease activity3cDAPSA14.00 (8.00-23.00)/41*MDA9 (25)/36PASI2.20 (0.20-6.80)/41**Expressed in median and interquartiles.Qualitative variables expressed in frequency and percentage.Table. 2.Lipid Profile in PsA patients.Cholesterol (mg/dl)194.5 (164.8-218.2)HDL (mg/dl)48.00 (37.00-57.00)LDL (mg/dl)114.5 (78.5-140.8)TG (mg/dl)139.50 (89.25-191.20)Expressed in median and interquartiles.Disclosure of Interests:None declared

scholarly journals Slow clinical improvement after treatment initiation in Leishmania/HIV coinfected patients

2012 ◽  
Vol 45 (2) ◽  
pp. 147-150 ◽  
Author(s):  
Guenael Freire de Souza ◽  
Fernando Biscione ◽  
Dirceu Bartolomeu Greco ◽  
Ana Rabello
Keyword(s):  
Hiv Infection ◽  
Clinical Response ◽  
Clinical Picture ◽  
Treatment Initiation ◽  
Early Recognition ◽  
Response To Treatment ◽  
Hiv Positive ◽  
Large Area ◽  
Belo Horizonte ◽  
Hiv Negative

INTRODUCTION: In Brazil there is a large area of overlap of visceral leishmaniasis (VL) and HIV infection, which favored a increased incidence of coinfection Leishmania/HIV. METHODS: This study evaluated 65 consecutive patients with VL and their clinical response to treatment in two health care settings in Belo Horizonte, Brazil. RESULTS: At baseline, the clinical picture was similar between both groups, although diarrhea and peripheral lymphadenomegaly were more frequent in HIV-infected subjects. HIV-positive patients had lower median blood lymphocyte counts (686/mm³ versus 948/mm³p = 0.004) and lower values of alanine aminotransferase (ALT) (48IU/L versus 75.6IU/L p = 0.016) than HIV-negative patients. HIV-positive status (hazard ratio = 0.423, p = 0.023) and anemia (HR = 0.205, p = 0.002) were independent negative predictors of complete clinical response following antileishmanial treatment initiation. CONCLUSIONS: This study reinforces that all patients with VL should be tested for HIV infection, regardless of their clinical picture. This practice would allow early recognition of coinfection with initiation of antiretroviral therapy and, possibly, reduction in treatment failure.

HIV Infection and Anogenital Warts

2013 ◽  
Vol 62 (3) ◽  
pp. e105-e106 ◽  
Author(s):  
Sónia Fernandes ◽  
Raquel Santos ◽  
Cândida Fernandes ◽  
Ana Rodrigues ◽  
Jorge Cardoso
Keyword(s):  
Hiv Infection ◽  
Anogenital Warts

scholarly journals Difficulties in primary diagnosis of HIV infection at the stages of health care settings

2020 ◽  
Vol 25 (1) ◽  
pp. 11-17
Author(s):  
Elena V. Esaulenko ◽  
Kseniya E. Novak ◽  
Thierry Ingabire ◽  
Sof’ya A. Semenova ◽  
Aleksandra O. Nikiforova
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Primary Care Physicians ◽  
Sexual Transmission ◽  
Laboratory Data ◽  
Primary Diagnosis ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Rapid Tests ◽  
First Time

Aim: to demonstrate the difficulties and timeliness of HIV diagnosis by primary care physicians, to carry out a clinical and epidemiological analysis of newly diagnosed cases of HIV infection. Materials and methods: The study evaluated the routing of diagnosis and analyzed the epidemiological and clinical and laboratory data of 85 patients with a newly diagnosed HIV infection hospitalized in the St. Petersburg Clinical Infectious Diseases Hospital named after S. P. Botkin during the period from November 2018 to October 2019. To confirm positive results, ELISA and western blot were used. Results: Among the observed patients, 71.3% were women and 28.7% were men. The average age was 39.3 2 years. Upon admission to the infectious diseases hospital with an established diagnosis of HIV infection, 49.5% were hospitalized in specialized departments (n = 42). Of them, nine (9) were referred by the polyclinic with an established diagnosis, in 20 patients the diagnosis was established in somatic hospitals, and emergency room doctors newly diagnosed HIV infection in 13 more patients. The remaining 50.5% (n = 43) were hospitalized in various departments with other diagnoses. Clinical and laboratory analysis of these patients showed that for the first time in life, an established diagnosis of HIV infection corresponded to both early (15.3%) and late (84.7%) stages of the disease with dominance of sexual transmission of the virus (43.6%). Conclusion: HIV infection at both early and late stages can manifest under the guise of various other diseases, which makes it necessary to expand testing of patients for HIV infection, including using rapid tests.

Cutaneous manifestations in systemic scleroderma

2021 ◽  
pp. 58-63
Author(s):  
Olga Alekseevna Petrishcheva
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Picture ◽  
Laboratory Data ◽  
Joint Damage ◽  
Specific Treatment ◽  
Systemic Scleroderma ◽  
Lower Gastrointestinal Tract ◽  
Internal Organs ◽  
Cutaneous Manifestations ◽  
Therapeutic Measures

Systemic scleroderma is a chronic disease, the etiology of which is not fully understood. In systemic scleroderma, there is a diffuse change in the skin with the development of fibrosis, as well as with damage to internal organs (in particular, the esophagus, lower gastrointestinal tract, heart, liver and kidneys). The disease can proceed in a generalized and focal form; it is also possible to develop a variant of scleroderma without affecting the skin. A typical clinical picture of the disease is characterized by damage to the skin, the occurrence of multiple joint damage, the development of dysphagia, and the appearance of heartburn, general swelling and the formation of digital contractures. In women, the disease occurs 4 times more often than in men, while it is very rare in children. The onset of the disease is usually observed between the ages of 30 and 50. The diagnosis is established on the basis of the clinical picture, taking into account laboratory data. There is no specific treatment; therapeutic measures are usually aimed at combating complications.

scholarly journals Immune Response Profiling of Patients with Anogenital Warts

2017 ◽  
Vol 21 (1) ◽  
pp. 11-16
Author(s):  
Manjula Singh ◽  
Deepshi Thakral ◽  
Hemanta K Kar ◽  
Narayan Rishi ◽  
Dipendra K Mitra
Keyword(s):  
Immune Response ◽  
T Cells ◽  
Mononuclear Cells ◽  
Anogenital Warts ◽  
Th2 Response ◽  
Peripheral Blood Mononuclear ◽  
Intracellular Cytokines ◽  
Venereal Warts ◽  
Near Future

ABSTRACT The incidence of anogenital warts, commonly caused by human papillomavirus (HPV-6 and HPV-11), is increasing worldwide. These infections are frequently associated with relapse, possibly due to weak host immunity. However, the role of cell-mediated immune players in combating infection is not clearly understood till date. Here, we attempted to understand the immune profile among patients with anogenital warts. In this study, we compared the T-helper cell (Th1 and Th2) response in patients with venereal warts due to HPV-6 and HPV-11 infection relative to healthy controls (HCs) in vitro. In the in vitro model, the peripheral blood mononuclear cells were stimulated with HPV peptide 6 or 11, stained for T-cell surface marker and intracellular cytokines (interferon [IFN]-□ and interleukin [IL]-4), and were analyzed by flow cytometry. In the present study, significant decrease was observed in the frequency of IFN-□ T cells as compared with HCs. On the contrary, frequency of T cells expressing IL-4 was significantly increased in the patients. The observed functional skewing of HPV-specific T cells from Th1 to Th2 response in patients indicated suppressed immunity against the HPVs. Findings of our study have potential in the near future for strategizing adjunct immunomodulation approaches with the standard treatment for early remission and prevention of recurrence. How to cite this article Singh M, Thakral D, Kar HK, Rishi N, Mitra DK. Immune Response Profiling of Patients with Anogenital Warts. Indian J Med Biochem 2017;21(1):11-16.

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