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Topic Review
Mechanisms Linking Hyperuricemia and Kidney Disease Progression
Gout is highly prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), owing to impaired uric acid excretion. However, treating gout in this population is challenging due to concerns about medication safety and efficacy with reduced kidney function. The 2020 American College of Rheumatology (ACR) guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and systemic glucocorticoids to treat acute gout flares. These can also be used as prophylaxis when starting urate-lowering therapy (ULT) to prevent flares. For ULT drugs like allopurinol, febuxostat, probenecid, benzbromarone, lesinurad, and pegloticase, key efficacy outcomes per most guidelines include: achieving target serum urate levels (<6 or <5 mg/dL), resolving tophi, reducing gout flares over time, improving quality of life, and radiographic changes. 
  • 56
  • 19 Mar 2024
Topic Review
Immune Bases of Juvenile Idiopathic Arthritis
Juvenile Idiopathic Arthritis (JIA) is an immune-mediated disease affecting children under sixteen for at least six weeks. It manifests with joint inflammation, stiffness, and restricted movement. Unlike adult rheumatoid arthritis, JIA is often outgrown, but it may impact bone development in those still growing. Juvenile Idiopathic Arthritis (JIA) is currently the most common chronic rheumatic disease in children. It is known to have no single identity, but a variety of diagnoses. 
  • 49
  • 14 Mar 2024
Topic Review
MDA-5 Dermatomyositis and Associated Interstitial Lung Disease
Anti-melanoma differentiation-associated gene 5 (MDA-5) dermatomyositis (DM) is noteworthy for its association with rapidly progressive interstitial lung disease (RP-ILD), vasculopathy, and distinctive cutaneous features. First identified in a Japanese cohort in 2005, MDA-5 DM carries a significant mortality risk, emphasizing the crucial need for early diagnosis. 
  • 40
  • 08 Mar 2024
Topic Review
Pathogenetic Mechanism in Giant Cell Arteritis
Giant cell arteritis (GCA) is an autoimmune disease affecting large vessels in patients over 50 years old. It is an exemplary model of a classic inflammatory disorder with IL-6 playing the leading role.
  • 72
  • 06 Mar 2024
Topic Review
Stem Cell-Derived Extracellular Vesicles in Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that affects nearly 3.41 million people globally, with 90% of the cases affecting women of childbearing age. Extracellular vesicles (EVs) can reduce the pro-inflammatory cytokines and increase the anti-inflammatory cytokines. Moreover, EVs can increase the levels of regulatory T cells, thus reducing inflammation. EVs also have the potential to regulate B cells to alleviate SLE and reduce its adverse effects. 
  • 315
  • 05 Mar 2024
Topic Review
The Contribution of Innate Immunity in Large-Vessel Vasculitis
Large-vessel vasculitis (LVV) are granulomatous vasculitis affecting medium- and large-sized arteries, especially the aorta and its main branches. They are mainly represented by giant cell arteritis (GCA) and Takayasu arteritis (TAK), both marked by vessel wall inflammation and remodeling, accounting for arterial stenosis and subsequent ischemic manifestations or aortic aneurysms and dissection.
  • 62
  • 18 Feb 2024
Topic Review
Antinuclear Antibodies
The discovery of antinuclear antibodies (ANAs) in the mid-20th century during studies on systemic lupus erythematosus (SLE) marked a significant breakthrough.
  • 91
  • 05 Feb 2024
Topic Review
Giant Cell Arteritis
Giant cell arteritis (GCA) is a noninfectious granulomatous vasculitis of unknown etiology affecting individuals older than 50 years. Two forms of GCA have been identified: a cranial form involving the medium-caliber temporal artery causing temporal arteritis (TA) and an extracranial form involving the large vessels, mainly the thoracic aorta and its branches. GCA generally affects individuals with a genetic predisposition, but several epigenetic (micro)environmental factors are often critical for the onset of this vasculitis.
  • 164
  • 05 Feb 2024
Topic Review
Anti-DFS70 in Systemic Autoimmune Rheumatic Diseases
The diagnosis of systemic autoimmune rheumatic disease (SARD) or its exclusion is carried out taking into account the results of immunological studies, primarily antinuclear antibodies (ANA) and specific autoantibodies. Often, during ANA analysis via indirect immunofluorescence reaction on cellular and tissue substrates, a dense fine speckled 70 (DFS70) fluorescence pattern is observed.
  • 70
  • 30 Jan 2024
Topic Review
Dysuricemia on the Path toward Normouricemia
The disease concept of “dysuricemia” includes hyperuricemia and hypouricemia. Both influence diseases in humans. Uric acid plays dual roles in oxidative stress: it has both an anti-oxidative protective effect and a pro-oxidative and/or a harmful crystal-forming effect. Extensive research on the relationship between the serum urate (SU) level and several common disease risks show characteristic patterns that are broadly classifiable into three patterns: the “gout pattern,” “neurodegenerative disease (ND) pattern,” and “chronic kidney disease (CKD) and cardiovascular disease (CVD) pattern”. In short, “the lower, the better” is incorrect; the ideal is to maintain normouricemia, or an optimal SU level, to reduce the risks of the common diseases associated with dysuricemia.
  • 80
  • 22 Jan 2024
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