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Letter to the Editor gomery-Asberg Depression Rating Scale, the Brief Psychiatric Rating Scale and the SLE Disease Activity Index (SLEDAI) During the course of the study, 5 patients were admitted with SLE and catatonia. These 5 patients, all female, met the inclusion criteria. All of them (or their families on their behalf) agreed to PE. Three of the patients were teenagers who had been hospitalized for several weeks without any improvement, receiving a treatment regimen combining psychotropic medications, corticoids and immunosuppressors. Three patients exhibited life-threatening complications: 2 were severely malnourished and the third had a pulmonary infection and skin lesions due to immobility. One patient showed a severe renal involvement. The last patient was included because of resistance after 3 weeks of treatment. The mean number of PE that patients received was 7.2 (range: 3-11). We found a significant improvement for all clinical variables. Mean CRS and SLEDAI scores before PE were 15 (range: 11-16) and 18.8 (range: 12-22), respectively. Both scores dramatically decreased after PE to a mean of 1.2 (range: 0-6) and 3.4 (range: 0-12), respectively (Wilcoxon paired test: Z = -2.032, p = 0.042). In particular, 3 patients very much improved on the Clinical Global Impression Scale after the first week of PE. The biological variables paralleled clinical improvement. At follow-up, 4 patients were still doing well; in particular, all the teenagers were able to return to school with minimal treatment for SLE. The last patient (case 4) died in her local hospital as a consequence of a septic shock 3 months after discharge. To date, only a few case studies have reported the possible use of PE in neuropsychiatric SLE The consecutive patients were recruited at Pitié-Salpêtrière Hospital from 2001 to 2004. For inclusion, the diagnosis of SLE was based on the revised criteria of the American College of Rheumatolog

Anti-inflammatory and immunosuppressive drugs and reproduction

Rheumatic diseases in women of childbearing years may necessitate drug treatment during a pregnancy, to control maternal disease activity and to ensure a successful pregnancy outcome. This survey is based on a consensus workshop of international experts discussing effects of anti-inflammatory, immunosuppressive and biological drugs during pregnancy and lactation. In addition, effects of these drugs on male and female fertility and possible long-term effects on infants exposed to drugs antenatally are discussed where data were available. Recommendations for drug treatment during pregnancy and lactation are given

Cent scientifiques répliquent à SEA (Suppression des Expériences sur l’Animal vivant) et dénoncent sa désinformation

La lutte contre la maltraitance animale est sans conteste une cause moralement juste. Mais elle ne justifie en rien la désinformation à laquelle certaines associations qui s’en réclament ont recours pour remettre en question l’usage de l’expérimentation animale en recherche

Treatment adherence in systemic lupus erythematosus and rheumatoid arthritis: time to focus on this important issue.

Treatment adherence in SLE and RA. RA and SLE are both chronic diseases, and non-adherence to treatment impairs their management. Generally, non-adherence rates in chronic diseases are surprisingly high. A Canadian study assessed primary non-adherence in various conditions and found that as many as 31% of the 37 506 first prescriptions were not filled in at all in the 9 months that followed [1]. Figures for the long-term take-up persistence are even worse; the non-adherence at 1 year ranged from 46 to 82% among 167 907 patients treated with drugs including statins and oral antidiabetics [2]. These numbers may be even higher in some countries without health insurance, too few specialists or other access issues. This non-adherence is referred to as unintentional and is strongly associated with social determinants of health (low literacy, inadequate or no health insurance, language discordance between provider and patient). In this editorial, we focus primarily on intentional, including forgetful, non-adherence by RA and SLE patients receiving care. [...

Treatment of hepatitis C-associated mixed cryoglobulinemia vasculitis.

International audiencePURPOSE OF REVIEW: Hepatitis C virus infection is the main cause of mixed cryoglobulinemia vasculitis. The disease expression of mixed cryoglobulinemia vasculitis is variable, ranging from mild clinical symptoms (purpura, arthralgia) to fulminant life-threatening complications (glomerulonephritis, widespread vasculitis). Treatment of hepatitis C virus-mixed cryoglobulinemia vasculitis may target either the viral trigger (hepatitis C virus) or the downstream B-cell arm of autoimmunity. This review focuses on recent advances in our understanding of the treatment of hepatitis C virus-mixed cryoglobulinemia vasculitis. RECENT FINDINGS: Aggressive antiviral therapy with Peg-IFNalpha and ribavirin should be considered as induction therapy for hepatitis C virus-mixed cryoglobulinemia vasculitis with mild to moderate disease severity and activity. In patients presenting with severe disease, an induction phase of immunosuppression is often necessary while awaiting the generally slow response to antiviral treatments. Combination therapy with rituximab and Peg-IFNalpha plus ribavirin appears logical as it may target both the viral trigger (hepatitis C virus) and cryoglobulin-producing B-cells. SUMMARY: Antiviral therapy and rituximab are the main therapeutic options in hepatitis C virus-mixed cryoglobulinemia vasculitis. Further studies are needed to better define the therapeutic strategy

Les plaques séniles: position dans l'épaisseur du cortex et contenu en amylose en fonction de l'efficience intellectuelle au cours du vieillissement et de la maladie d'Alzheimer.

info:eu-repo/semantics/publishe

Relationship between tau, paired helical filaments, amyloid and the intellectual deterioration in the neocortex in normal aging and in senile demetia of the Alzheimer type.

info:eu-repo/semantics/publishe