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INTERNAL MEDICINE (180 journals)                     

Showing 1 - 180 of 180 Journals sorted alphabetically
Abdomen     Open Access  
ACP Hospitalist     Full-text available via subscription   (Followers: 9)
ACP Internist     Full-text available via subscription   (Followers: 10)
ACP Journal Club     Full-text available via subscription   (Followers: 11)
Acta Clinica Belgica     Hybrid Journal   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 9)
Advances in Hepatology     Open Access   (Followers: 4)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
African Journal of Thoracic and Critical Care Medicine     Open Access  
American Family Physician     Full-text available via subscription   (Followers: 38)
American Journal of Hypertension     Hybrid Journal   (Followers: 31)
Anales de Medicina Interna     Open Access   (Followers: 1)
Anatomy & Physiology : Current Research     Open Access   (Followers: 9)
Angiology     Hybrid Journal   (Followers: 5)
Annals of Colorectal Research     Open Access   (Followers: 1)
Annals of Internal Medicine     Full-text available via subscription   (Followers: 392)
AORN Journal     Hybrid Journal   (Followers: 27)
Apollo Medicine     Open Access  
Archives of Drug Information     Hybrid Journal   (Followers: 5)
Archivos de Medicina Interna     Open Access   (Followers: 1)
Asia Oceania Journal of Nuclear Medicine & Biology     Open Access   (Followers: 4)
Asian Pacific Journal of Tropical Disease     Full-text available via subscription   (Followers: 3)
Australasian Physical & Engineering Sciences in Medicine     Hybrid Journal   (Followers: 1)
BMI Journal : Bariátrica & Metabólica Iberoamericana     Open Access   (Followers: 1)
BMJ Open Diabetes Research & Care     Open Access   (Followers: 35)
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
Bone & Joint Journal     Hybrid Journal   (Followers: 138)
Brain Communications     Open Access   (Followers: 4)
Brain Science Advances     Open Access  
Canadian Journal of General Internal Medicine     Open Access   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Case Reports in Internal Medicine     Open Access   (Followers: 1)
Cell Death & Disease     Open Access   (Followers: 3)
Cellular and Molecular Gastroenterology and Hepatology     Open Access   (Followers: 3)
Cephalalgia     Hybrid Journal   (Followers: 8)
Cephalalgia Reports     Open Access   (Followers: 4)
Chronic Diseases and Injuries in Canada     Free   (Followers: 1)
Clinical Ethics     Hybrid Journal   (Followers: 13)
Clinical Liver Disease     Open Access   (Followers: 5)
Clinical Nutrition     Hybrid Journal   (Followers: 98)
Clinical Thyroidology     Full-text available via subscription   (Followers: 1)
CNE Pflegemanagement     Hybrid Journal  
Communication Law and Policy     Hybrid Journal   (Followers: 5)
Current Diabetes Reports     Hybrid Journal   (Followers: 30)
Current Hepatology Reports     Hybrid Journal  
Current Research: Integrative Medicine     Open Access  
CVIR Endovascular     Open Access   (Followers: 1)
Der Internist     Hybrid Journal   (Followers: 12)
Diabetes     Full-text available via subscription   (Followers: 603)
Diabetes Care     Full-text available via subscription   (Followers: 578)
Diabetes Internacional     Open Access  
Diabetes Spectrum     Full-text available via subscription   (Followers: 17)
Diagnosis     Hybrid Journal   (Followers: 1)
Egyptian Journal of Bronchology     Open Access  
Egyptian Journal of Internal Medicine     Open Access   (Followers: 1)
Egyptian Journal of Neurosurgery     Open Access  
Egyptian Liver Journal     Open Access   (Followers: 2)
Egyptian Spine Journal     Open Access  
EMC - Aparato Locomotor     Hybrid Journal  
Endovascular Neuroradiology / Ендоваскулярна нейрорентгенохірургія     Open Access   (Followers: 1)
eNeuro     Open Access   (Followers: 3)
Ergonomics     Hybrid Journal   (Followers: 24)
European Journal of Inflammation     Open Access   (Followers: 2)
European Journal of Internal Medicine     Full-text available via subscription   (Followers: 10)
European Journal of Translational Myology     Open Access  
European Radiology Experimental     Open Access   (Followers: 2)
Head and Neck Tumors     Open Access   (Followers: 1)
Health Sociology Review     Hybrid Journal   (Followers: 14)
HemaSphere     Open Access   (Followers: 2)
Hepatology Communications     Open Access  
Hepatoma Research     Open Access   (Followers: 3)
Human Physiology     Hybrid Journal   (Followers: 5)
ImmunoHorizons     Open Access  
Immunological Medicine     Open Access  
Infectious Diseases: Research and Treatment     Open Access   (Followers: 5)
Inflammation and Regeneration     Open Access   (Followers: 2)
Inflammatory Intestinal Diseases     Open Access  
Innere Medizin up2date     Hybrid Journal   (Followers: 1)
Internal and Emergency Medicine     Hybrid Journal   (Followers: 5)
Internal Medicine Journal     Hybrid Journal   (Followers: 9)
International Journal of Abdominal Wall and Hernia Surgery     Open Access   (Followers: 1)
International Journal of Anatomy and Research     Open Access   (Followers: 2)
International Journal of Angiology     Hybrid Journal  
International Journal of Artificial Organs     Hybrid Journal   (Followers: 3)
International Journal of Hyperthermia     Open Access  
International Journal of Internal Medicine     Open Access   (Followers: 3)
International Journal of Noncommunicable Diseases     Open Access  
International Journal of Psychiatry in Clinical Practice     Hybrid Journal   (Followers: 6)
Iranian Journal of Neurosurgery     Open Access   (Followers: 1)
Italian Journal of Anatomy and Embryology     Open Access   (Followers: 1)
JAC-Antimicrobial Resistance     Open Access   (Followers: 4)
JAMA Internal Medicine     Full-text available via subscription   (Followers: 364)
JCSM Clinical Reports     Open Access   (Followers: 3)
JHEP Reports     Open Access  
JIMD Reports     Open Access  
JMV - Journal de Médecine Vasculaire     Hybrid Journal   (Followers: 1)
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
JOP. Journal of the Pancreas     Open Access   (Followers: 2)
Journal of Basic & Clinical Physiology & Pharmacology     Hybrid Journal   (Followers: 1)
Journal of Bone Oncology     Open Access   (Followers: 1)
Journal of Cancer & Allied Specialties     Open Access  
Journal of Clinical and Experimental Hepatology     Full-text available via subscription   (Followers: 3)
Journal of Clinical Movement Disorders     Open Access   (Followers: 3)
Journal of Community Hospital Internal Medicine Perspectives     Open Access  
Journal of Cutaneous Immunology and Allergy     Open Access  
Journal of Developmental Origins of Health and Disease     Hybrid Journal   (Followers: 2)
Journal of Endoluminal Endourology     Open Access  
Journal of Gastroenterology and Hepatology Research     Open Access   (Followers: 4)
Journal of General Internal Medicine     Hybrid Journal   (Followers: 23)
Journal of Hypertension     Hybrid Journal   (Followers: 14)
Journal of Infectious Diseases     Hybrid Journal   (Followers: 48)
Journal of Interdisciplinary Medicine     Open Access  
Journal of Internal Medicine     Hybrid Journal   (Followers: 11)
Journal of Liver : Disease & Transplantation     Hybrid Journal   (Followers: 7)
Journal of Medical Internet Research     Open Access   (Followers: 24)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 46)
Journal of Pancreatic Cancer     Open Access  
Journal of Renal and Hepatic Disorders     Open Access  
Journal of Solid Tumors     Open Access   (Followers: 1)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of the American Board of Family Medicine     Open Access   (Followers: 11)
Journal of the European Mosquito Control Association     Open Access  
Journal of Translational Internal Medicine     Open Access  
Jurnal Vektor Penyakit     Open Access  
La Revue de Medecine Interne     Full-text available via subscription   (Followers: 3)
Lege artis - Das Magazin zur ärztlichen Weiterbildung     Hybrid Journal   (Followers: 1)
Liver Cancer International     Open Access  
Liver Research     Open Access  
Molecular Diagnosis & Therapy     Hybrid Journal   (Followers: 3)
Molecular Therapy - Oncolytics     Open Access  
Multiple Sclerosis and Demyelinating Disorders     Open Access   (Followers: 7)
MYOPAIN. A journal of myofascial pain and fibromyalgia     Hybrid Journal   (Followers: 18)
Neuro-Oncology Advances     Open Access   (Followers: 1)
Neurobiology of Pain     Open Access   (Followers: 2)
Neurointervention     Open Access   (Followers: 6)
Neuromuscular Diseases     Open Access  
Nigerian Journal of Gastroenterology and Hepatology     Full-text available via subscription  
OA Alcohol     Open Access   (Followers: 5)
Oncological Coloproctology     Open Access  
Open Journal of Internal Medicine     Open Access  
Pleura and Peritoneum     Open Access  
Pneumo News     Full-text available via subscription  
Polish Archives of Internal Medicine     Full-text available via subscription   (Followers: 2)
Preventing Chronic Disease     Free   (Followers: 2)
Progress in Transplantation     Hybrid Journal   (Followers: 1)
Prostate International     Open Access   (Followers: 2)
Psychiatry and Clinical Psychopharmacology     Open Access   (Followers: 1)
Pulmonary Therapy     Open Access   (Followers: 2)
Quality of Life Research     Hybrid Journal   (Followers: 20)
Research and Practice in Thrombosis and Haemostasis     Open Access  
Revista Chilena de Fonoaudiología     Open Access   (Followers: 1)
Revista de la Sociedad Peruana de Medicina Interna     Open Access   (Followers: 4)
Revista del Instituto de Medicina Tropical     Open Access  
Revista Hispanoamericana de Hernia     Open Access   (Followers: 1)
Revista Médica Internacional sobre el Síndrome de Down     Full-text available via subscription   (Followers: 1)
Revista Virtual de la Sociedad Paraguaya de Medicina Interna     Open Access   (Followers: 1)
Romanian Journal of Diabetes Nutrition and Metabolic Diseases     Open Access   (Followers: 1)
Romanian Journal of Internal Medicine     Open Access  
Russian Journal of Child Neurology     Open Access   (Followers: 1)
Scandinavian Journal of Primary Health Care     Open Access   (Followers: 8)
Schlaf     Hybrid Journal  
Schmerzmedizin     Hybrid Journal  
Scientific Journal of the Foot & Ankle     Open Access   (Followers: 1)
SciMedicine Journal     Open Access   (Followers: 3)
SEMERGEN - Medicina de Familia     Full-text available via subscription   (Followers: 1)
The Journal of Critical Care Medicine     Open Access   (Followers: 9)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 8)
Therapeutic Advances in Musculoskeletal Disease     Hybrid Journal   (Followers: 6)
Thieme Case Report     Hybrid Journal   (Followers: 1)
Tijdschrift voor Urologie     Hybrid Journal  
Tissue Barriers     Hybrid Journal   (Followers: 1)
Transactions of the Royal Society of Tropical Medicine and Hygiene     Hybrid Journal   (Followers: 3)
Transgender Health     Open Access   (Followers: 3)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)
US Cardiology Review     Open Access  
Vascular and Endovascular Review     Open Access   (Followers: 1)
Ожирение и метаболизм     Open Access  


Similar Journals
Journal Cover
Therapeutic Advances in Chronic Disease
Journal Prestige (SJR): 1.895
Citation Impact (citeScore): 6
Number of Followers: 8  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2040-6223 - ISSN (Online) 2040-6231
Published by Sage Publications Homepage  [1151 journals]
  • Serum-derived exosomes containing NEAT1 promote the occurrence of
           rheumatoid arthritis through regulation of miR-144-3p/ROCK2 axis

    • Authors: Rui Liu, Chunbo Jiang, Jingjing Li, Xiaoru Li, Lin Zhao, Haifeng Yun, Weiwei Xu, Weijian Fan, Qiuhong Liu, Hongli Dong
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Evidence has demonstrated that non-coding RNAs (ncRNAs) could be delivered efficiently to recipient cells using exosomes as a carrier. Additionally, long ncRNA nuclear enriched abundant transcript 1 (NEAT1) is emerging as a vital regulatory molecule in the progression of rheumatoid arthritis (RA). The aim of this study was to identify the NEAT1/miR-144-3p/Rho-associated protein kinase 2 (ROCK2) functional network regulating the WNT signaling pathway in RA.Methods:In vivo, a collagen-induced arthritis (CIA) model was established to analyze the effects of blood exosomes on the incidence, clinical score, and bone degradation of RA. In vitro, the CD4+T cells were characterized by flow cytometry and the cell activities were analyzed in the presence of exosome treatment alone or in combination with altered expression of NEAT1, miR-144-3p or Rho-associated protein kinase 2 (ROCK2). The expression of NEAT1, miR-144-3p, ROCK2, and corresponding proteins in the WNT signaling pathway was detected by RT-qPCR and western blot techniques. The binding profile of NEAT1 to miR-144-3p was evaluated via a combination approach of luciferase activity assay, RNA immunoprecipitation, and RNA pull-down experiments.Results:Blood exosomes extracted from RA patients increased the incidence of RA and bone destruction significantly. Overexpression of NEAT1 or ROCK2 promoted immune cell (CD4+T cells) proliferation, Th17 cell differentiation, and cell migration in response to stimulus, whereas knockout of the NEAT1 gene induced the expression of miR-144-3p in CD4+T cells. ROCK2 exogenous expression inhibited the expression of miR-144-3p, inducing activation of the WNT signaling pathway.Conclusion:A novel regulatory pathway NEAT1/miR-144-3p/ROCK2/WNT in RA was investigated as a potential target for RA therapy.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-27T10:09:17Z
      DOI: 10.1177/2040622321991705
      Issue No: Vol. 12 (2021)
  • MicroRNA-21 from bone marrow mesenchymal stem cell-derived extracellular

    • Authors: Guo-Qing Li, Yu-Xuan Fang, Ying Liu, Fan-Ru Meng, Xia Wu, Chun-Wang Zhang, Yu Zhang, Yan-Qing Liu, Dan Liu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Accumulating evidence has demonstrated that bone marrow mesenchymal stem cells (BMSCs)-derived extracellular vesicles (EVs) can be used effectively to transfer drugs and biomolecules to target lesions. Meanwhile, BMSCs have been reported to be beneficial in the treatment of rheumatoid arthritis (RA). In this study, we employ gain- and loss-of-function experiments to determine how BMSCs-derived EVs alleviate RA in vitro and in vivo.Methods:We isolated EVs from BMSCs and characterized them by transmission electron microscopy and western blot analysis. The regulatory relationship between miR-21 and TET1 was predicted by bioinformatics analysis and validated by dual luciferase assay. Next, we utilized bisulfite sequencing PCR to decipher how TET1 promoted KLF4 transcription. Then, we established an RA mouse model and determined the role of miR-21 in RA progression. Functional assays were used to validate the role the miR-21-TET1-KLF4 regulatory axis in controlling mouse fibroblast-like synoviocytes (mFLS) cell proliferation and inflammatory cytokines secretion in vitro.Results:RT-qPCR results revealed that miR-21 was highly expressed in BMSCs-derived EVs, and confirmed that BMSCs-derived EVs transferred miR-21 into mFLS cells. Bioinformatic analysis predicted that TET1 was the directly downstream target of miR-21, which was further validated by dual luciferase assay. TET1 promoted KLF4 promoter methylation to increase its expression. Collectively, BMSCs-derived EVs relieved RA by delivering miR-21, while the exosomal miR-21 alleviated RA through targeting the TET1/KLF4 regulatory axis.Conclusion:miR-21 from BMSCs-derived EVs suppresses KLF4 to relive RA by targeting TET1.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-24T07:10:27Z
      DOI: 10.1177/20406223211007369
      Issue No: Vol. 12 (2021)
  • Tolvaptan treatment in an adult Fontan patient with protein-losing
           enteropathy: a serial 23Na-MRI investigation

    • Authors: Julia Moosmann, Okan Toka, Peter Linz, Anke Dahlmann, Armin M. Nagel, Mario Schiffer, Michael Uder, Robert Cesnjevar, Sven Dittrich, Christoph Kopp
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Protein-losing enteropathy (PLE) is a severe complication of the univentricular Fontan circulation and associated with disturbances in salt and water homeostasis. Fontan patients with PLE have a poor prognosis, with increased morbidity and mortality. Due to limited therapeutic strategies, patients are often treated only symptomatically.Methods:We report our first experience of Tolvaptan (TLV) treatment in a Fontan patient with PLE, severe volume retention and hyponatraemia, refractory to conventional diuretic therapy. In addition to clinical parameters, we monitored drug effects including tissue sodium and volume status via serial 23Na-magnetic resonance imaging (23Na-MRI) and bioimpedance spectroscopy compared with age-matched controls.Results:23Na-MRI identified elevated tissue sodium, which decreased under TLV treatment, as well as volume status, while serum sodium increased and the patient’s symptoms improved. During long-term treatment, we were able to differentiate between sodium and volume status in our patient, suggesting that TLV uncoupled body sodium from water.Conclusion:TLV in addition to loop diuretics improved clinical symptoms of PLE and lowered tissue sodium overload. Long-term effects should be further evaluated in Fontan patients.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-16T11:25:27Z
      DOI: 10.1177/20406223211004005
      Issue No: Vol. 12 (2021)
  • EZH2 is involved in psoriasis progression by impairing miR-125a-5p
           inhibition of SFMBT1 and leading to inhibition of the TGFβ/SMAD pathway

    • Authors: Shengming Qu, Zhe Liu, Bing Wang
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aims:In this study, we aimed to decipher the impact of enhancer of zeste homolog 2 (EZH2) in psoriasis as well as the underlying mechanism.Methods:A mouse model of psoriasis was developed by means of imiquimod induction, with the expression of EZH2, microRNA-125a-5p (miR-125a-5p), and SFMBT1 determined. The role of EZH2, miR-125a-5p, and SFMBT1 in malignant phenotypes of HaCaT cells and the development of psoriasis in vivo was subsequently investigated through gain- and loss-of-function experiments. Chromatin immunoprecipitation assay and dual-luciferase reporter assay were conducted to explore the relationship between EZH2 or SFMBT1 and miR-125a-5p. Finally, the effects of EZH2 and miR-125a-5p on the transforming growth factor β (TGFβ)/SMAD pathway were analyzed.Results:Overexpressed SFMBT1 and EZH2 was detected while miR-125a-5p were downregulated in psoriasis tissues and human keratinocyte (HaCaT) cells. EZH2 increased the levels of IL-17A-induced cytokines and promoted the malignant phenotypes of HaCaT cells. Functionally, EZH2 reduced miR-125a-5p expression while miR-125a-5p targeted SFMBT1 to activate the TGFβ/SMAD pathway in vitro. Knockdown of EZH2 or up-regulation of miR-125a-5p inhibited cell proliferation and the levels of IL-17A-induced cytokines, but increased the expression of TGFβ1 and the extent of smad2 and smad3 phosphorylation in HaCaT cells. Notably, EZH2 contributed to the development of psoriasis in vivo by inhibiting the TGFβ/SMAD pathway via impairment of miR-125a-5p-mediated SFMBT1 inhibition.Conclusion:Taken together, the results of the current study highlight the ability of EZH2 to potentially inactivate the TGFβ/SMAD pathway via upregulation of miR-125a-5p-dependent SFMBT1during the progression of psoriatic lesions.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-15T08:52:19Z
      DOI: 10.1177/2040622320987348
      Issue No: Vol. 12 (2021)
  • Corrigendum to “Drug-induced liver injury after switching from tamoxifen
           to anastrozole in a patient with a history of breast cancer being treated
           for hypertension and diabetes”

    • Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.

      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-13T06:24:42Z
      DOI: 10.1177/20406223211002790
      Issue No: Vol. 12 (2021)
  • A retrospective comparative study on arthroscopic suture anchors repair
           and tendon debridement versus arthroscopic tendon debridement for
           treatment of recalcitrant lateral epicondylitis

    • Authors: Xu Li, Tong Zheng, Yue Li, Hailong Zhang, Yi Lu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aim:To compare the outcomes between the arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon alone and repairs to the ECRB tendon with suture anchor for the treatment of refractory lateral epicondylitis (LE).Methods:We retrospectively reviewed our patients who underwent arthroscopic surgical treatment for refractory LE by a single surgeon from January 2008 to June 2018 with a minimum follow-up of 12 months. The visual analog scale (VAS), the Mayo Elbow Performance Score (MEPS), the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, the Verhaar scoring system and the time of back to work were compared between two groups.Results:Both groups showed a significant postoperative improvement regarding the VAS, MEPS, DASH, PRTEE and the Verhaar scoring system (p 
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-05T10:00:55Z
      DOI: 10.1177/20406223211005596
      Issue No: Vol. 12 (2021)
  • Benefit of a pharmacist-led intervention for medication management of
           renal transplant patients: a controlled before-and-after study

    • Authors: Jeremy Chambord, Lionel Couzi, Pierre Merville, Karine Moreau, Fabien Xuereb, Sarah Djabarouti
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aims:To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort.Methods:We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), n = 44] versus those who did not [control group (CG), n = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure.Results:At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% versus 72.2%, p = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2.Conclusions:Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-04-05T10:00:39Z
      DOI: 10.1177/20406223211005275
      Issue No: Vol. 12 (2021)
  • Nomenclature and clinical phenotypes of atopic dermatitis

    • Authors: Giampiero Girolomoni, Marjolein de Bruin-Weller, Valeria Aoki, Kenji Kabashima, Mette Deleuran, Luis Puig, Ashish Bansal, Ana B. Rossi
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Atopic dermatitis is a heterogeneous disease and resists classification. In this review, we discuss atopic dermatitis nomenclature and identify morphologic phenotypes, which will facilitate correct diagnoses and development of treatment strategies. We support using the term ‘atopic dermatitis’ rather than eczema, because it describes the allergic background and inflammation (‘itis’) as drivers of the disease. Atopic dermatitis has many morphologic manifestations that vary by topographic area affected, age, or race and require consideration in differential diagnosis. Different phenotypes based on morphology and topographic location, ethnicity, and age are discussed. A better-defined phenotype identification for atopic dermatitis will facilitate earlier and correct diagnosis of this complex condition and inform selection of the most appropriate treatment choice in an era in which targeted therapies may generate more individualized patient care.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-26T10:42:08Z
      DOI: 10.1177/20406223211002979
      Issue No: Vol. 12 (2021)
  • Characteristics and outcomes of patients with chronic thromboembolic
           pulmonary hypertension in the era of modern therapeutic approaches: data
           from the Polish multicenter registry (BNP-PL)

    • Authors: Grzegorz Kopeć, Olga Dzikowska-Diduch, Ewa Mroczek, Tatiana Mularek-Kubzdela, Łukasz Chrzanowski, Ilona Skoczylas, Michał Tomaszewski, Małgorzata Peregud-Pogorzelska, Danuta Karasek, Ewa Lewicka, Wojciech Jacheć, Zbigniew Gąsior, Piotr Błaszczak, Katarzyna Ptaszyńska-Kopczyńska, Katarzyna Mizia-Stec, Andrzej Biederman, Dariusz Zieliński, Roman Przybylski, Piotr Kędzierski, Marcin Waligóra, Marek Roik, Marek Grabka, Joanna Orłowska, Aleksander Araszkiewicz, Marta Banaszkiewicz, Sylwia Sławek-Szmyt, Szymon Darocha, Wojciech Magoń, Alicja Dąbrowska-Kugacka, Jakub Stępniewski, Kamil Jonas, Karol Kamiński, Jarosław D. Kasprzak, Piotr Podolec, Piotr Pruszczyk, Adam Torbicki, Marcin Kurzyna
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Significant achievements in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) have provided effective therapeutic options for most patients. However, the true impact of the changed landscape of CTEPH therapies on patients’ management and outcomes is poorly known. We aimed to characterize the incidence, clinical characteristics, and outcomes of CTEPH patients in the modern era of CTEPH therapies.Methods:We analyzed the data of CTEPH adults enrolled in the prospective multicenter registry.Results:We enrolled 516 patients aged 63.8 ± 15.4 years. The incidence rate of CTEPH was 3.96 per million adults per year. The group was burdened with several comorbidities. New oral anticoagulants (n = 301; 58.3%) were preferred over vitamin K antagonists (n = 159; 30.8%). Pulmonary endarterectomy (PEA) was performed in 120 (23.3%) patients and balloon pulmonary angioplasty (BPA) in 258 (50%) patients. PEA was pretreated with targeted pharmacotherapy in 19 (15.8%) patients, and BPA in 124 (48.1%) patients. Persistent CTEPH was present in 46% of PEA patients and in 65% of patients after completion of BPA. Persistent CTEPH after PEA was treated with targeted pharmacotherapy in 72% and with BPA in 27.7% of patients. At a mean time period of 14.3 ± 5.8 months, 26 patients had died. The use of PEA or BPA was associated with better survival than the use of solely medical treatment.Conclusions:The modern population of CTEPH patients comprises mostly elderly people significantly burdened with comorbid conditions. This calls for treatment decisions that are tailored individually for every patient. The combination of two or three methods is currently a frequent approach in the treatment of CTEPH.Clinical Trial
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-25T09:31:32Z
      DOI: 10.1177/20406223211002961
      Issue No: Vol. 12 (2021)
  • Coronary artery bypass graft surgery versus stenting for patients with
           chronic kidney disease and complex coronary artery disease: a systematic
           review and meta-analysis

    • Authors: Kongyong Cui, Hong Liu, Fei Yuan, Feng Xu, Min Zhang, Mingduo Zhang, Wei Wang, Dongfeng Zhang, Jinfan Tian, Shuzheng Lyu, Kefei Dou
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:The relative role of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stent implantation in patients with chronic kidney disease (CKD) and complex coronary artery disease (CAD) remains debatable due to the lack of randomized controlled trials (RCTs). We therefore performed this meta-analysis to compare the outcomes of the two strategies in CKD patients with multivessel and/or left main disease.Methods:Electronic databases including PubMed, EMBASE and Cochrane Library were comprehensively searched to identify the eligible subgroup analysis of RCTs and propensity-matched registries. The primary endpoint was all-cause mortality during the longest follow-up.Results:Five subgroup analyses of RCTs and six propensity-matched registries involving 26,441 patients were analyzed. Overall, the strategy of CABG was associated with lower risks of long-term mortality [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.74–0.93], myocardial infarction (OR, 0.41; 95% CI, 0.27–0.62), and repeat revascularization (OR, 0.25; 95% CI, 0.16–0.39) compared with PCI in CKD patients with complex CAD. However, CABG was slightly associated with higher risk of stroke than PCI (OR, 1.33; 95% CI, 1.00–1.77). Nonetheless, the higher stroke risk in the CABG group no longer existed during long-term follow-up (OR, 0.92; 95% CI, 0.37–2.25) (>3 years).Conclusion:This meta-analysis supports the current guideline advising CABG for patients with CKD and complex CAD. At the expense of slightly increased risk of stroke, CABG reduces the incidences of long-term all-cause death, myocardial infarction and repeat revascularization compared with PCI.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-23T07:28:34Z
      DOI: 10.1177/2040622321990273
      Issue No: Vol. 12 (2021)
  • Efficacy of the use of unaffected hand containment in unimanual intensive
           therapy to increase visuomotor coordination in children with hemiplegia: a
           randomized controlled pilot study

    • Authors: Rocío Palomo-Carrión, Elisabeth Bravo-Esteban, Sara Ando-La Fuente, Purificación López-Muñoz, Inés Martínez-Galán, Helena Romay-Barrero
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:The capacity of children with hemiplegia to be engaged in anticipatory action planning is affected. There is no balance among spatial, proprioceptive and visual information, thus altering the affected upper limb visuomotor coordination. The objective of the present study was to assess the improvement in visuomotor coordination after the application of a unimanual intensive therapy program, with the use of unaffected hand containment compared with not using unaffected hand containment.Methods:A simple blind randomized clinical trial was realized. A total of 16 subjects with congenital infantile hemiplegia participated in the study with an age mean of 5.54 years old (SD:1.55). Two intensive protocols for 5 weeks of modified constraint-induced movement therapy (mCIMT) or unimanual therapy without containment (UTWC) were executed 5 days per week (2 h/day). Affected upper limb visuomotor coordination (reaction time, task total time, active range, dynamic grasp) was measured before–after intensive therapy using a specific circuit with different slopes (10°/15°).Results:Statistically significant inter-group differences were found after the intervention, with clinically relevant results for the mCIMT group not seen in UTWC, in the following variables: reaction time 10°slope (p = 0.003, d = 2.44), reaction time 15°slope (p = 0.002, d = 2.15) as well as for the task total time 10°slope (p = 0.002, d = 2.25), active reach 10°slope (p = 0.002, d = 2.7), active reach 15°slope (p = 0.003, d = 2.29) and dynamic grasp 10°/15°slopes (p = 
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-22T05:52:43Z
      DOI: 10.1177/20406223211001280
      Issue No: Vol. 12 (2021)
  • Segmental involvement of the corpus callosum in C9orf72-associated ALS: a
           tract of interest-based DTI study

    • Authors: Hans-Peter Müller, Dorothée Lulé, Francesco Roselli, Anna Behler, Albert C. Ludolph, Jan Kassubek
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:C9orf72 hexanucleotide repeat expansions are associated with widespread cerebral alterations, including white matter alterations. However, there is lack of information on changes in commissure fibres. Diffusion tensor imaging (DTI) can identify amyotrophic lateral sclerosis (ALS)-associated patterns of regional brain alterations at the group level. The objective of this study was to investigate the structural connectivity of the corpus callosum (CC) in ALS patients with C9orf72 expansions.Methods:DTI-based white matter mapping was performed by a hypothesis-guided tractwise analysis of fractional anisotropy (FA) maps for 25 ALS patients with C9orf72 expansion versus 25 matched healthy controls. Furthermore, a comparison with a patient control group of 25 sporadic ALS patients was performed. DTI-based tracts that originate from callosal sub-areas I to V were identified and correlated with clinical data.Results:The analysis of white matter integrity demonstrated regional FA reductions for tracts of the callosal areas II and III for ALS patients with C9orf72 expansions while FA reductions in sporadic ALS patients were observed only for tracts of the callosal area III; these reductions were correlated with clinical parameters.Conclusion:The tract-of-interest-based analysis showed a microstructural callosal involvement pattern in C9orf72-associated ALS that included the motor segment III together with frontal callosal connections, as an imaging signature of the C9orf72-associated overlap of motor neuron disease and frontotemporal pathology.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-22T05:48:46Z
      DOI: 10.1177/20406223211002969
      Issue No: Vol. 12 (2021)
  • Effect of TO901317 on GF to promote the differentiation of human bone
           marrow mesenchymal stem cells into dopamine neurons on Parkinson’s

    • Authors: Miaomiao Li, Junqing Yang, Oumei Cheng, Zhe Peng, Yin Luo, Dongzhi Ran, Yang Yang, Pu Xiang, Haifeng Huang, Xiaodan Tan, Hong Wang
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Human bone marrow mesenchymal stem cells (hBMSCs) could differentiate into dopamine-producing cells and ameliorate behavioral deficits in Parkinson’s disease (PD) models. Liver X receptors (LXRs) are involved in the maintenance of the normal function of central nervous system myelin. Therefore, the previous work of our team has found the induction of cocktail-induced to dopaminergic (DA) phenotypes from adult rat BMSCs by using sonic hedgehog (SHH), fibroblast growth factor 8 (FGF8), basic fibroblast growth factor (bFGF), and TO901317 (an agonist of LXRs) with 87.42% of efficiency in a 6-day induction period. But we did not verify whether the induced cells had the corresponding neural function.Methods:Expressions of LXRα, LXRβ, and tyrosine hydroxylase (TH) were detected by immunofluorescence and western blot. Adenosine triphosphate-binding cassette transporter A1 (ABCA1) was detected by quantitative real-time PCR. The induced cells were transplanted into PD rats to study whether the induced cells are working.Results:The induced cells can release the dopamine transmitter; the maximum induction efficiency of differentiation of hBMSCs into DA neurons was 91.67% under conditions of combined use with TO901317 and growth factors (GF). When the induced-cells were transplanted into PD rats, the expression of TH in the striatum increased significantly, and the behavior of PD rats induced by apomorphine was significantly improved.Conclusion:The induced cells have the function of DA neurons and have the potential to treat PD. TO901317 promoted differentiation of hBMSCs into DA neurons, which may be related to activation of the LXR-ABCA1 signaling pathway.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-19T10:28:20Z
      DOI: 10.1177/2040622321998139
      Issue No: Vol. 12 (2021)
  • Outcomes of coronavirus 2019 infection in patients with chronic kidney
           disease: a systematic review and meta-analysis

    • Authors: Yi-Chih Lin, Tai-Shuan Lai, Shuei-Liong Lin, Yung-Ming Chen, Tzong-Shinn Chu, Yu-Kang Tu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Information on coronavirus disease 2019 (COVID-19) infection in patients with chronic kidney disease (CKD) remains limited. To understand the influence of COVID-19 infection in patients with pre-existing CKD, we conducted a systematic review and meta-analysis to evaluate and compare the risks of all-cause mortality, hospitalization, and critical progression between patients with and without CKD.Methods:We selected randomized controlled trials (RCTs), prospective or retrospective observational, case-control, cross-sectional, and case-series studies analyzing outcomes of COVID-19 infection in patients with pre-existing CKD from the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases published on the Internet before 16 July 2020.Results:A total of 27 studies comprising 77,856 patients with COVID-19 infection was identified; 3922 patients with pre-existing CKD were assigned CKD group, and 73,934 patients were assigned to the non-CKD group. The pooled analysis showed that patients with CKD had a significantly higher risk of all-cause mortality and hospitalization than those without CKD [odds ratio (OR) 2.25, 95% confidence interval (CI) 1.91–2.66, p 
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-19T10:25:02Z
      DOI: 10.1177/2040622321998860
      Issue No: Vol. 12 (2021)
  • Proteomic analysis reveals rotator cuff injury caused by oxidative stress

    • Authors: Tao Yuan, Hong Qian, Xin Yu, Jia Meng, Cheng-Teng Lai, Hui Jiang, Jian-Ning Zhao, Ni-Rong Bao
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background and aims:Rotator cuff tendinopathy is common and is related to pain and dysfunction. However, the pathological mechanism of rotator cuff injury and shoulder pain is unclear. Objective: to investigate the pathological mechanism of rotator cuff injury and shoulder pain, and screen out the marker proteins related to rotator cuff injury by proteomics.Methods:Subacromial synovium specimens were collected from patients undergoing shoulder arthroscopic surgery. The experimental group were patients with rotator cuff repair surgery, and the control group were patients with habitual dislocation of the shoulder joint. Pathological examination was performed, and then followed by non-labeled quantitative proteomic detection. Finally, from analysis of the biological information of the samples, specific proteins related to rotator cuff injury and shoulder pain were deduced by functional analysis of differential proteins.Results:All the patients in experimental groups were representative. A large number of adipocytes and inflammatory cells were found in the pathological sections of the experimental group; the proteomics analysis screen identified 80 proteins with significant differences, and the analysis of protein function revealed that S100A11 (p = 0.011), PLIN4 (p = 0.017), HYOU1 (p = 0.002) and CLIC1 (p = 0.007) were closely related to oxidative stress and chronic inflammation.Conclusion:Rotator cuff injury is closely related to oxidative stress and chronic inflammatory response, and the results suggest that the expression of S100A11, PLIN4, HYOU1 and CLIC1 in the synovium of rotator cuff injury provides a new marker for the study of its pathological mechanism.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-17T09:41:48Z
      DOI: 10.1177/2040622320987057
      Issue No: Vol. 12 (2021)
  • Advances and caveats in modern achalasia management

    • Authors: Marcella Pesce, Rami Sweis
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Achalasia is a rare esophageal motility disorder characterized by the incomplete relaxation of the lower esophageal sphincter (LES) and impaired peristaltic activity. The advent of high-resolution manometry (HRM) and the rapidly evolving role of therapeutic endoscopy have revolutionized the approach to the diagnosis and management of achalasia patients in the last decade. With advances in HRM technology and methodology, fluoroscopy and EndoFlip, achalasia can be differentiated into therapeutically meaningful phenotypes with a high degree of accuracy. Further, the newest treatment option, per-oral endoscopic myotomy (POEM), has become a staple therapy following the last 10 years of experience, and recent randomized trials appear to show no difference between POEM, graded pneumatic dilatation and surgical Heller myotomy in terms of short- and long-term efficacy or complication rate. On the other hand, how treatment outcomes are measured as well as the risk of reflux following therapy remain areas of contention. This review aims to summarize the recent advancements in achalasia testing and therapy, describes the recent randomized clinical trials as well as their potential setbacks, and touches on the future of personalizing achalasia treatment.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-12T10:28:10Z
      DOI: 10.1177/2040622321993437
      Issue No: Vol. 12 (2021)
  • Lack of association between erythropoietin treatment and risk of
           depression in patients with end-stage kidney disease on maintenance
           dialysis: a nationwide database study in Taiwan

    • Authors: Pao-Yen Lin, Lung-Chih Li, Liang-Jen Wang, Yao-Hsu Yang, Chih-Wei Hsu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Patients with end-stage kidney disease (ESKD), have been associated with higher risk of developing depression. Erythropoietin (EPO), frequently used for the treatment of anemia in ESKD patients, has been shown to have neuroprotective and antidepressant effects. In this study, we examined whether EPO treatment changed the risk of depression in ESKD patients.Methods:In a nationwide population-based cohort in Taiwan from 1998 to 2013, patients with a diagnosis of ESKD on maintenance dialysis and aged greater than 18 years were classified into EPO treatment group or non-EPO treatment group. All patients were followed up until the diagnosis of depressive disorder or the end of the study period.Results:In this cohort (13,067 patients in the EPO and 67,258 patients in the non-EPO group), 5569 patients were diagnosed as depressive disorder in the follow-up period. We found the risk of depression in EPO group was not significantly different from that in non-EPO group (adjusted hazard ratio = 0.98, 95% confidence interval 0.92–1.04, p = 0.499) after adjusting for sex, age, certification year of catastrophic illness for ESKD, physical co-morbidities, and use of benzodiazepines.Conclusion:In summary, using the nationwide reimbursement data in Taiwan, we found that EPO treatment in ESKD patients was not associated with their general risk of developing depression.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-05T09:26:34Z
      DOI: 10.1177/2040622321995690
      Issue No: Vol. 12 (2021)
  • The role of pre-emptive Transjugular Intrahepatic Portosystemic Shunt in
           acute variceal bleeding: a literature review

    • Authors: Charelle Manning, Amera Elzubeir, Syed Alam
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      The development of portal hypertension has serious implications in the natural history of liver cirrhosis, leading to complications such as ascites, hepatic encephalopathy and variceal bleeding. The management of acute variceal bleeding has improved in the last two decades, but despite the advances in endoscopic methods the overall prognosis remains poor, particularly within a subgroup of patients with more advanced disease. The role of Transjugular Intrahepatic Portosystemic Shunt (TIPSS) is a well-established method of achieving haemostasis by immediate portal decompression; however, its use in an emergency setting as a rescue strategy is still associated with high mortality. It has been shown that ‘early’ use of TIPSS as a pre-emptive strategy in a patient with acute variceal bleed in addition to the standard of care confers superior survival outcomes in a subgroup of patients at high risk of treatment failure and death. The purpose of this review is to appraise the literature around the indications, patient selection, utility, complications and economic considerations of pre-emptive TIPSS.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-05T09:24:13Z
      DOI: 10.1177/2040622321995771
      Issue No: Vol. 12 (2021)
  • Association of core body temperature and peripheral blood flow of the
           hands with pain intensity, pressure pain hypersensitivity, central
           sensitization, and fibromyalgia symptoms

    • Authors: Antonio Casas-Barragán, Francisco Molina, Rosa María Tapia-Haro, María Carmen García-Ríos, María Correa-Rodríguez, María Encarnación Aguilar-Ferrándiz
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Our aim was to analyse body core temperature and peripheral vascular microcirculation at skin hypothenar eminence of the hands and its relationship to symptoms in fibromyalgia syndrome (FMS). A total of 80 FMS women and 80 healthy women, matched on weight, were enrolled in this case–control study. Thermography and infrared thermometer were used for evaluating the hypothenar regions and core body temperature, respectively. The main outcome measures were pain pressure thresholds (PPTs) and clinical questionnaires. Significant associations were observed between overall impact [β = 0.033; 95% confidence interval (95%CI) = 0.003, 0.062; p = 0.030], daytime dysfunction (β = 0.203; 95%CI = 0.011, 0.395; p = 0.039) and reduced activity (β = 0.045; 95%CI = 0.005, 0.085; p = 0.029) and core body temperature in FMS women. PPTs including greater trochanter dominant (β = 0.254; 95%CI = 0.003, 0.504; p = 0.047), greater trochanter non-dominant (β = 0.650; 95%CI = 0.141, 1.159; p = 0.013), as well as sleeping medication (β = −0.242; 95%CI = −0.471, −0.013; p = 0.039) were also associated with hypothenar eminence temperature. Data highlighted that FMS women showed correlations among body core temperature and hand temperature with the clinical symptoms.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-03-05T09:19:58Z
      DOI: 10.1177/2040622321997253
      Issue No: Vol. 12 (2021)
  • Exploring polypharmacy phenomenon in newly diagnosed relapsing–remitting
           multiple sclerosis: a cohort ambispective single-centre study

    • Authors: Aurora Zanghì, Emanuele D’Amico, Salvatore Lo Fermo, Francesco Patti
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aims:We aimed to examine the frequency of polypharmacy in a large cohort of patients at the time of diagnosis of relapsing–remitting multiple sclerosis (RRMS) and to explore its effects on discontinuation of first disease-modifying treatment (DMT) using survival analysis.Methods:This was a cohort ambispective single-centre study. We enrolled RRMS patients starting their first DMT between 1st January 2013 and 31st December 2015. According to the number of medicines prescribed (except DMTs), we divided the patients into three groups: no-poly RRMS, minor-poly RRMS (from one to three medications), and major-poly RRMS (more than three medications).Results:A total of 392 RRMS patients were enrolled (mean age 41.1). The minor-poly RRMS group included 61 patients (15.6%) and the major-poly RRMS group included 112 (28.6%). Individuals in these groups were older and had higher median body mass index (BMI) than patients in the no-poly RRMS group (p 
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-27T10:42:36Z
      DOI: 10.1177/2040622320983121
      Issue No: Vol. 12 (2021)
  • Decreased numbers and sex-based differences of circulating regulatory T
           cells in patients with seropositive undifferentiated arthritis

    • Authors: Hong-Qing Niu, Chenrui Yuan, Chenglan Yan, Na Li, Yuan-Sheng Lei, Xuxu Li, Jinli Ru, Xiao-Feng Li
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aims:CD4+ T cells play crucial roles as both mediators and regulators of the pathogenesis of rheumatoid arthritis (RA). However, the characteristics of CD4+ T cell subpopulations in the earliest stage of RA development remain unclear. Hence, we determined the proportions and absolute counts of circulating CD4+ T cell subsets in patients with seropositive undifferentiated arthritis (SUA), the early and preclinical stage of RA.Methods:Peripheral blood samples and clinical information were collected from 177 patients with SUA, 104 patients with RA, and 120 healthy controls. All patients were newly diagnosed and untreated. Proportions and absolute counts of CD4+ T cell subpopulations were determined by flow cytometric analysis.Results:In patients with SUA, percentages and absolute counts of circulating regulatory T (Treg) cells were decreased significantly and Th17/Treg cell ratios were abnormally increased, whereas Th17 cell numbers were similar to those in healthy controls. In addition, sex-based differences in circulating Treg cells were observed, with female SUA patients having lower proportions and absolute counts of Treg cells than those in males. Moreover, female patients with SUA had higher erythrocyte sedimentation rates and 28-joint Disease Activity Scores than those in males.Conclusion:Immune tolerance deficiency resulting from an abnormal reduction in circulating Treg cells might be the most crucial immunological event in the earliest stage of RA. The sex-specific disparity in Treg cells should also be considered for immunoregulatory and preventive strategies targeting early RA.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-25T07:08:09Z
      DOI: 10.1177/2040622320986721
      Issue No: Vol. 12 (2021)
  • Twelve-month effects of everolimus on renal and lung function in lung
           transplantation: differences in chronic lung allograft dysfunction

    • Authors: Filippo Patrucco, Elias Allara, Massimo Boffini, Mauro Rinaldi, Cristina Costa, Carlo Albera, Paolo Solidoro
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Chronic lung allograft dysfunction (CLAD), a complication affecting the survival of lung transplanted patients, includes two clinical phenotypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Everolimus is used in CLAD because of its antiproliferative mechanism. In lung transplant patients treated with everolimus, the clinical course of renal and lung function has not yet been assessed systematically in CLAD, BOS and RAS patients for more than 6 months.Methods:We retrospectively evaluated the 12-month follow-up of renal and lung function of lung-transplanted patients switched to everolimus and evaluated the reduction in immunosuppressant dosage (ISD) and mortality. Subgroups were based on indication for everolimus treatment: CLAD and non-CLAD patients, BOS and RAS among CLAD patients.Results:We included 26 patients, 17 with CLAD (10 BOS, seven RAS). After 1 year from the everolimus switch, we observed renal function improvement (serum creatinine −17%, estimated glomerular filtration rate +24%) and stable pulmonary function [forced expiratory volume in the first second (FEV1) −0.5%, forced vital capacity (FVC) +0.05%]. RAS patients had progressive functional loss, whereas BOS patients had FEV1 improvement and FVC stability. All-cause mortality was higher in the CLAD versus non-CLAD group (41% versus 11%), without differences between BOS and RAS patients (p > 0.05). All patients had significant and persistent ISD reduction.Conclusion:Lung transplant patients treated with everolimus had improvements in renal function and reduced ISD. We observed sustained improvements in lung function for CLAD related to BOS subgroup results, whereas RAS confirmed the 1-year worsening functional trend. Data seem to suggest one more piece of the puzzle in CLAD phenotyping.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-25T07:05:52Z
      DOI: 10.1177/2040622321993441
      Issue No: Vol. 12 (2021)
  • Relationship between long head of the biceps tendon histopathology and
           long-term functional results in smokers. A time to reevaluate the Bonar

    • Authors: Jan Zabrzyński, Maciej Gagat, Łukasz Łapaj, Łukasz Paczesny, Alper Yataganbaba, Dawid Szwedowski, Gazi Huri
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aim:The purpose of this study was to investigate whether there is an association between smoking, the extent of the degeneration process in the biceps tendinopathy, including cells and extracellular matrix (ECM) alterations, and long-term surgical results.Methods:This study comprised 40 consecutive patients admitted for shoulder arthroscopy due to symptomatic biceps tendinopathy and classified into three groups based on smoking status: active smokers, former smokers, and non-smokers. According to the classical Bonar score criteria, the histopathologic evaluation of the harvested intra-articular portion of the tendon was done. The follow-up examination was based on the American Shoulder and Elbow Surgeons Score (ASES).Results:A cohort of 32 patients was enrolled in the final follow-up examination; mean 37.56 months. Histopathological evaluation according to the classical Bonar score revealed degeneration of the tendinous tissue in each group but there was no correlation between the extent of degeneration, smoking indexes and the ASES. After revision of Bonar scale within the vascularity criterion, we found a correlation between the extent of degeneration of tendinous tissue, smoking data, ASES score, and the severity of rotator cuff injury.Conclusion:In this paper, we indicate the ambiguous role of the neovascularization in the biceps tendinopathy, and it was used for modification of the classical Bonar score. Consequently, recalculated, modified Bonar score was correlated positively with smoking indexes and functional outcomes. Furthermore, the morphological alterations of rotator cuff tendons also correlated positively with the extent of biceps tendon degeneration, measured according to the modified scoring system.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-24T12:10:27Z
      DOI: 10.1177/2040622321990262
      Issue No: Vol. 12 (2021)
  • Optimal cut-off points for adherence measure among patients with type 2
           diabetes in primary care clinics: a retrospective analysis

    • Authors: Ming Tsuey Lim, Norazida Ab Rahman, Xin Rou Teh, Chee Lee Chan, Shantini Thevendran, Najwa Ahmad Hamdi, Ka Keat Lim, Sheamini Sivasampu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Medication adherence measures are often dichotomized to classify patients into those with good or poor adherence using a cut-off value ⩾80%, but this cut-off may not be universal across diseases or medication classes. This study aimed to examine the cut-off value that optimally distinguish good and poor adherence by using the medication possession ratio (MPR) and proportion of days covered (PDC) as adherence measures and glycated hemoglobin (HbA1c) as outcome measure among type 2 diabetes mellitus (T2DM) patients.Method:We used pharmacy dispensing data of 1461 eligible T2DM patients from public primary care clinics in Malaysia treated with oral antidiabetic drugs between January 2018 and May 2019. Adherence rates were calculated during the period preceding the HbA1c measurement. Adherence cut-off values for the following conditions were compared: adherence measure (MPR versus PDC), assessment period (90-day versus 180-day), and HbA1c target (⩽7.0% versus ⩽8.0%).Results:The optimal adherence cut-offs for MPR and PDC in predicting HbA1c ⩽7.0% ranged between 86.1% and 98.3% across the two assessment periods. In predicting HbA1c ⩽8.0%, the optimal adherence cut-offs ranged from 86.1% to 92.8%. The cut-off value was notably higher with PDC as the adherence measure, shorter assessment period, and a stricter HbA1c target (⩽7.0%) as outcome.Conclusion:We found that optimal adherence cut-off appeared to be slightly higher than the conventional value of 80%. The adherence thresholds may vary depending on the length of assessment period and outcome definition but a reasonably wise cut-off to distinguish good versus poor medication adherence to be clinically meaningful should be at 90%.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-17T11:27:51Z
      DOI: 10.1177/2040622321990264
      Issue No: Vol. 12 (2021)
  • Identification of mortality-risk-related missense variant for renal clear
           cell carcinoma using deep learning

    • Authors: Jin-Bor Chen, Huai-Shuo Yang, Sin-Hua Moi, Li-Yeh Chuang, Cheng-Hong Yang
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Introduction:Kidney renal clear cell carcinoma (KIRCC) is a highly heterogeneous and lethal cancer that can arise in patients with renal disease. DeepSurv combines a deep feed-forward neural network with a Cox proportional hazards function and could provide optimized survival results compared with convenient survival analysis.Methods:This study used an improved DeepSurv algorithm to identify the candidate genes to be targeted for treatment on the basis of the overall mortality status of KIRCC subjects. All the somatic mutation missense variants of KIRCC subjects were abstracted from TCGA-KIRC database.Results:The improved DeepSurv model (95.1%) achieved greater balanced accuracy compared with the DeepSurv model (75%), and identified 610 high-risk variants associated with overall mortality. The results of gene differential expression analysis also indicated nine KIRCC mortality-risk-related pathways, namely the tRNA charging pathway, the D-myo-inositol-5-phosphate metabolism pathway, the DNA double-strand break repair by nonhomologous end-joining pathway, the superpathway of inositol phosphate compounds, the 3-phosphoinositide degradation pathway, the production of nitric oxide and reactive oxygen species in macrophages pathway, the synaptic long-term depression pathway, the sperm motility pathway, and the role of JAK2 in hormone-like cytokine signaling pathway. The biological findings in this study indicate the KIRCC mortality-risk-related pathways were more likely to be associated with cancer cell growth, cancer cell differentiation, and immune response inhibition.Conclusion:The results proved that the improved DeepSurv model effectively classified mortality-related high-risk variants and identified the candidate genes. In the context of KIRCC overall mortality, the proposed model effectively recognized mortality-related high-risk variants for KIRCC.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-15T12:13:31Z
      DOI: 10.1177/2040622321992624
      Issue No: Vol. 12 (2021)
  • Rheumatic immune-related adverse events associated with immune checkpoint
           inhibitors compared with placebo in oncologic patients: a systemic review
           and meta-analysis

    • Authors: Shuo Zhang, Ziyue Zhou, Li Wang, Mengtao Li, Fengchun Zhang, Xiaofeng Zeng
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Objective:We aim to characterize the incidence and relative risk of rheumatic and systemic immune-related adverse effects (irAEs) among immune checkpoint inhibitor (ICI) therapy compared with those after placebo treatment.Methods:Randomized clinical trial studies with placebo control with the following keywords were searched from Embase, PubMed, Cochrane databases: immune checkpoint inhibitors, neoplasms, randomized controlled trials, and adverse effects.Results:Among the 5444 published and 316 registration records, nine placebo-controlled randomized clinical trials met our selection criteria, and included data from 5560 patients. Compared with placebo use, using ICIs increases the risk of overall-rheumatic irAEs. The incidence and relative risk of all-grade rheumatic irAEs were 18.40% [95% confidence interval (CI) 12.16–25.59%, p 
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-12T09:55:32Z
      DOI: 10.1177/2040622320976996
      Issue No: Vol. 12 (2021)
  • Mesenchymal stem cell-based treatment in autoimmune liver diseases:
           underlying roles, advantages and challenges

    • Authors: Chengmei He, Yanlei Yang, Kunyu Zheng, Yiran Chen, Suying Liu, Yongzhe Li, Qin Han, Robert Chunhua Zhao, Li Wang, Fengchun Zhang
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Autoimmune liver disease (AILD) is a series of chronic liver diseases with abnormal immune responses, including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). The treatment options for AILD remain limited, and the adverse side effects of the drugs that are typically used for treatment frequently lead to a low quality of life for AILD patients. Moreover, AILD patients may have a poor prognosis, especially those with an incomplete response to first-line treatment. Mesenchymal stem cells (MSCs) are pluripotent stem cells with low immunogenicity and can be conveniently harvested. MSC-based therapy is emerging as a promising approach for treating liver diseases based on their advantageous characteristics of immunomodulation, anti-fibrosis effects, and differentiation to hepatocytes, and accumulating evidence has revealed the positive effects of MSC therapy in AILD. In this review, we first summarize the mechanisms, safety, and efficacy of MSC treatment for AILD based on work in animal and clinical studies. We also discuss the challenges of MSC therapy in clinical applications. In summary, although promising data from preclinical studies are now available, MSC therapy is currently far for being applied in clinical practice, thus developing MSC therapy in AILD is still challenging and warrants further research.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-12T09:44:48Z
      DOI: 10.1177/2040622321993442
      Issue No: Vol. 12 (2021)
  • Chinese traditional medicine (GuiZhi-ShaoYao-ZhiMu decoction) as an add-on
           medication to methotrexate for rheumatoid arthritis: a meta-analysis of
           randomized clinical trials

    • Authors: Chenxi Feng, Rongrong Chen, Keer Wang, Chengping Wen, Zhenghao Xu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:GuiZhi-ShaoYao-ZhiMu decoction (GSZD), a traditional Chinese herbal medication, has been frequently used as an add-on medication to methotrexate (MTX) for rheumatoid arthritis (RA) treatment in China. This meta-analysis evaluated the efficacy and safety of adding GSZD to MTX for RA treatment.Methods:We performed a systematic search of PubMed, Web of Science, EMBASE, and the Cochrane Library (all databases) for English-language studies and WanFang, VIP, and CNKI for Chinese-language studies up to 28 July 2020. Data from selected studies, mainly the response rates and rate of adverse events (AEs), were extracted independently by two authors, and a random-effects model (Mantel–Haenszel method) was used for the meta-analysis.Results:A total of 14 randomized controlled trials and 1224 patients were included (623 patients in the GSZD + MTX group and 601 patients in the MTX group). For efficacy, the meta-analysis found that combining GSZD with MTX increased the effective rate [relative risk (RR) = 1.24, 95% confidence interval (CI): 1.18–1.30, based on 1069 patients], defined as >30% efficacy, American College of Rheumatology 20, or a decrease of disease activity score 28 >0.6. Adding GSZD reduced the swollen and tender joint counts, the duration of morning stiffness, the levels of C-reactive protein and rheumatoid factor, and erythrocyte sedimentation rate. The adjuvant therapeutic effect of GSZD was independent of the dose of MTX or the combined utilization of other drugs in both groups. For safety, adding GSZD was associated with a lower rate of total AEs (RR = 0.46, 95% CI: 0.26–0.83, based on 615 patients) and gastrointestinal tract AEs (RR = 0.46, 95% CI: 0.24–0.88, based on 537 patients).Conclusion:Combining GSZD with MTX may be a more efficacious and safer strategy for treating RA compared with MTX alone. Further large studies are warranted to investigate the long-term efficacy and safety of adding GSZD to MTX for RA treatment.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-12T09:40:28Z
      DOI: 10.1177/2040622321993438
      Issue No: Vol. 12 (2021)
  • Urinary sodium potassium ratio is associated with clinical success after
           adrenalectomy in patients with unilateral primary aldosteronism

    • Authors: Ming-Jse Lee, Chiao-Yin Sun, Ching-Chu Lu, Yuan-Shian Chang, Heng-Chih Pan, Yen-Hung Lin, Vin-Cent Wu, Jeff S. Chueh
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:The urinary sodium potassium (NaK) ratio is associated with dietary sodium and potassium intake and blood pressure, and it also reflects the activity of aldosterone. Herein we evaluated the value of the urinary NaK ratio in predicting the surgical outcomes of patients with unilateral primary aldosteronism (uPA).Methods:This non-concurrent prospective cohort study was conducted from 2011 to 2017 and included 241 uPA patients who had undergone adrenalectomy. Predictors of successful clinical outcomes were analyzed using logistic regression.Results:Among the 241 uPA patients, 197 (81.7%) achieved clinical complete or partial success. A urinary sodium potassium ratio
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-12T09:37:07Z
      DOI: 10.1177/2040622321990274
      Issue No: Vol. 12 (2021)
  • Accessing behavioral health care during COVID: rapid transition from
           in-person to teleconferencing medical group visits

    • Authors: Maria Juarez-Reyes, Heather Z. Mui, Samantha M.R. Kling, Cati Brown-Johnson
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background and aim:Effective and safe behavioral health interventions in primary care are critical during pandemic and other disaster situations. California shelter-in-place orders necessitated rapid transition of an effective mindfulness-based medical group visit (MGV) program from in-person to videoconferenced sessions (VCSs). Aim: to Describe procedures, acceptability, and feasibility of converting from in-person to VCS.Patients and methods:Methods: qualitative. Dataset: primary care. Intervention: a six-session 2-h MGV program with educational and mindfulness components was converted. Four in-person sessions and two VCSs were held. General Anxiety Disorder and Patient Health Questionnaire-9 were administered at first and last sessions. A semi-structured focus group was conducted after session six. Population studied: six primary care patients (42 ± 11 years) with stress, anxiety, or depression participated.Results:Procedural changes included remote material distribution, scheduling, hosting, and facilitation functions using the Zoom platform. The focus group revealed that patients preferred in-person sessions during initial visits, but appreciated transitioning to VCS, which provided continued support during a challenging time. Instruction on technical (e.g. logging on) and social (e.g. signaling next speaker) aspects of VCS was suggested. Building relationships through conversations was an important part before and after in-person sessions missing from VCS. Patients suggested combining in-person and VCS to allow relationship building while also improving access.Conclusion:While many procedural changes were needed to facilitate conversion to VCS, primary care patients seeking stress, anxiety, and depression interventions found VCS acceptable during COVID-19. Future iterations of this program are proposed which incorporate procedural changes and facilitate relationship building between patients in VCS.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-12T09:33:29Z
      DOI: 10.1177/2040622321990269
      Issue No: Vol. 12 (2021)
  • Early fibroproliferative signs on high-resolution CT are associated with

    • Authors: Zhilin Zeng, Min Xiang, Hanxiong Guan, Yiwen Liu, Huilan Zhang, Liming Xia, Juan Zhan, Qiongjie Hu
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Objectives:To investigate the chest high-resolution computed tomography (HRCT) findings in coronavirus disease 2019 (COVID-19) pneumonia patients with acute respiratory distress syndrome (ARDS) and to evaluate its relationship with clinical outcome.Materials and methods:In this retrospective study, 79 COVID-19 patients with ARDS were recruited. Clinical data were extracted from electronic medical records and analyzed. HRCT scans, obtained within 3 days before clinical ARDS onset, were evaluated by three independent observers and graded into six findings according to the extent of fibroproliferation. Multivariable Cox proportional hazard regression analysis was used to assess the independent predictive value of the computed tomography (CT) score and radiological fibroproliferation. Patient survival was determined by Kaplan–Meier analysis.Results:Compared with survivors, non-survivors showed higher rates of lung fibroproliferation, whereas there were no significant differences in the area of increased attenuation without traction bronchiolectasis or bronchiectasis. A HRCT score
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-09T08:46:55Z
      DOI: 10.1177/2040622320982171
      Issue No: Vol. 12 (2021)
  • Anti-cyclic-citrullinated-protein-antibodies in psoriatic arthritis
           patients: how autoimmune dysregulation could affect clinical
           characteristics, retention rate of methotrexate monotherapy and first line
           biotechnological drug survival. A single center retrospective study.

    • Authors: Cinzia Rotondo, Addolorata Corrado, Daniela Cici, Stefano Berardi, Francesco Paolo Cantatore
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aim:Occasional findings of anti-cyclic-citrullinated-protein-antibodies (anti-CCP) were rarely observed in psoriatic arthritis (PsA). The aim of our study is to evaluate whether the presence of anti-CCP can determine different clinical subsets and influence methotrexate monotherapy survival, and biotechnological drug retention rate.Methods:We conducted a retrospective study on PsA patients. All patients were required to fulfill the CASPAR criteria for PsA, and to present juxta-articular osteo-proliferative signs at X-ray. The exclusion criteria were age less than 18 years old, satisfaction of rheumatoid arthritis classification criteria, and seropositivity for rheumatoid factor. Clinical characteristics, anti-CCP titer, drug survival and comorbidities information were recorded for each patient. Statistical significance was set at p ⩽ 0.05.Results:Of 407 patients with PsA screened 113 were recruited. Twelve patients were anti-CCP positive. Methotrexate monotherapy survival was shorter in patients with anti-CCP (150 ± 48.3 weeks versus 535.3 ± 65.3 weeks; p = 0.026) [discontinuation risk hazard ratio (HR) = 2.389, 95% confidence interval (CI) 1.043, 5.473; p = 0.039] than those without. Significant shorter survival of first-line biotechnological drugs (b-DMARDs) was observed in the anti-CCP positive group than in that without (102.05 ± 24.4 weeks versus 271.6 ± 41.7 weeks; p = 0.005) with higher discontinuation risk (HR = 3.230, 95% CI 1.299, 8.028; p = 0.012). A significant higher rate of multi-failure (more than second-line b-DMARDs) was found in anti-CCP positive patients than in those without (50% versus 14%, p = 0.035).Conclusion:Anti-CCP in PsA could be suggestive of more severe disease, with worse drug survival of both methotrexate monotherapy and first-line b-DMARDs, and higher chance to be b-DMARDs multi-failure. So, they can be considered for more intensive clinical management of these patients.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-02-02T05:14:12Z
      DOI: 10.1177/2040622320986722
      Issue No: Vol. 12 (2021)
  • The neurological symptoms of COVID-19: a systematic overview of systematic
           reviews, comparison with other neurological conditions and implications
           for healthcare services

    • Authors: Tamar Wildwing, Nicole Holt
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Aims:In response to the rapid spread of COVID-19, this paper provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called ‘Long Covid’ on neurological services and primary care and similarities with other neurological disorders are discussed.Methods:Firstly, a systematic overview of current reviews of neurological symptoms of COVID-19 was conducted. Secondly, the implications of these findings are discussed in relation to the potential effect on neurological services and the similarities in the experience of patients with COVID-19 and those with other neurological disorders. A total of 45 systematic reviews were identified within seven databases, published between 11 April 2020 and 15 October 2020, following a search in June 2020, updated on 20 October 2020.Results:The results indicated that COVID-19 exhibits two types of neurological symptoms; life-threatening symptoms such as Guillain–Barre Syndrome (GBS) and encephalitis, and less devastating symptoms such as fatigue and myalgia. Many of these so-called lesser symptoms appear to be emerging as longer-term for some sufferers and have been recently labelled Long Covid. When compared, these less devastating symptoms are very similar to other neurological conditions such as chronic fatigue syndrome (CFS) and functional neurological disorder (FND).Conclusion:Implications for neurological healthcare services in the United Kingdom (UK) may include longer waiting times and a need for more resources (including more qualified health professionals). There is also a possible change-effect on health professionals’ perceptions of other neurological conditions such as CFS and FND. Future research is recommended to explore changes in health professionals’ perceptions of neurological symptoms because of COVID-19.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-01-28T11:43:29Z
      DOI: 10.1177/2040622320976979
      Issue No: Vol. 12 (2021)
  • Cardiac manifestations of eosinophilic granulomatosis with polyangiitis
           from a single-center cohort in China: clinical features and associated

    • Authors: Suying Liu, Ling Guo, Zhaocui Zhang, Mengtao Li, Xiaofeng Zeng, Li Wang, Yongtai Liu, Fengchun Zhang
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Cardiac manifestations are common and life-threatening in eosinophilic granulomatosis with polyangiitis (EGPA), which remains poorly studied in China. We aim to investigate its clinical features, associated factors, treatment, and outcomes.Methods:We reviewed the clinical records of 110 EGPA patients and examined the independent factors associated with cardiac manifestations using multivariate logistic regression. Receiver operating characteristic curves determined the cut-off values, and survival was calculated via Kaplan–Meier curves.Results:Cardiac involvement was present in 36.4% (40/110) of EGPA patients, which mainly manifested as pericardial effusion (16.4%, 18/110), myocardial involvement (13.6%, 15/110), and heart failure (8.2%, 9/110). The mean age was 42.1 ± 14.23 years with no female/male predominance. Compared with the cardiac-unaffected group, the cardiac-affected group showed a lower rate of biopsy-proved vasculitis (0% versus 20%, p = 0.002). The eosinophil count [odds ratio (OR) = 1.142, 95% confidence interval (CI) 1.029–1.267] was independently associated with cardiac manifestations in EGPA, with a cut-off value of 3.66 × 109/L [area under the curve (AUC) = 0.692, p = 0.001]. Regarding treatment, the cardiac-affected group displayed a higher ratio of glucocorticoid pulse combined with intravenous cyclophosphamide (CYC-IV) (40% versus 21.4%, p = 0.037), and intravenous immunoglobulin combined with glucocorticoid plus CYC-IV (17.5% versus 4.3%, p = 0.035) than the control group. Outcomes (p = 0.131) and survival (p = 0.1972) were not significantly different between the groups.Conclusion:In this single-center Chinese EGPA cohort, cardiac manifestations are observed in 36.4% of patients, which primarily presents as myocardial involvement, pericardial effusion, and heart failure, independently associated with eosinophil count. Glucocorticoid combined with cyclophosphamide is the treatment cornerstone for EGPA patients with cardiac manifestations.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-01-23T06:24:00Z
      DOI: 10.1177/2040622320987051
      Issue No: Vol. 12 (2021)
  • The five-repetition sit-to-stand test is a predictive factor of severe
           exacerbations in COPD

    • Authors: Francesc Medina-Mirapeix, Roberto Bernabeu-Mora, Elisa Valera-Novella, Mariano Gacto-Sánchez, Myriam Bernabeu-Mora, María Piedad Sánchez-Martínez
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:Although the six-minute-walk test (6MWT) has been used to predict chronic obstructive pulmonary disease (COPD) exacerbations, additional research is necessary to identify more rapid, simpler tests that are directly associated with exacerbations, such as the five-repetition sit-to-stand (5STS) test and 4-m gait speed (4MGS) test.Aims:To determine the ability of the 5STS and 4MGS tests in predicting severe exacerbations in stable COPD over the following year, and to assess the ability of the best prognostic test to identify patients at high risk of hospital admission correctly.Methods:This prospective study included 137 patients with stable COPD. Multiple logistic regression models were constructed to assess whether the 6MWT, 5STS, and 4MGS tests were associated with severe exacerbations in the year following the test. Receiver-operating characteristic curves and the area under the curve (AUC) were evaluated to determine the accuracy of each test for identifying patients with severe exacerbations.Results:Scores of
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-01-23T06:12:40Z
      DOI: 10.1177/2040622320986718
      Issue No: Vol. 12 (2021)
  • Understanding racial differences of COPD patients with an ecological
           model: two large cohort studies in the US and Korea

    • Authors: Hye Yun Park, Hyun Lee, Danbee Kang, Hye Sook Choi, Yeong Ha Ryu, Ki-Suck Jung, Don D. Sin, Juhee Cho, Kwang Ha Yoo
      Abstract: Therapeutic Advances in Chronic Disease, Volume 12, Issue , January-December 2021.
      Background:There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts.Methods:We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study (n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]).Results:Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities.Conclusion:There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.
      Citation: Therapeutic Advances in Chronic Disease
      PubDate: 2021-01-23T05:17:38Z
      DOI: 10.1177/2040622320982455
      Issue No: Vol. 12 (2021)
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Heriot-Watt University
Edinburgh, EH14 4AS, UK
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