Distinct Subtypes of Microparticle-containing Immune Complexes Are Associated with Disease Activity, Damage, and Carotid Intima-media Thickness in Systemic Lupus Erythematosus.

Objective: Microparticles (MP) are small extracellular vesicles present in body fluids. MP originate from different cellular lineages, principally from platelets in blood, and may expose phosphatidylserine (PS). In systemic lupus erythematosus (SLE), MP harbor immunoglobulin G (IgG), thereby forming MP-containing immune complexes (mpIC).

Ten-year absolute fracture risk and hip bone strength in Canadian women with systemic lupus erythematosus.

Objective: Women with systemic lupus erythematosus (SLE) are at risk of osteoporosis (OP) and fractures because of SLE or its treatments. We aimed to determine in women with SLE (1) the prevalence of low bone mass (LBM) in those < 50 years of age and OP in those > 50 years of age; (2) the 10-year absolute fracture risk in those > 40 years of age using the Canadian Fracture Risk Assessment Tool (FRAX); (3) bone quality using hip structural analysis (HSA); and (4) the associations between HSA and age, SLE duration, and corticosteroid exposure.

Methods: Women without prior OP fractures were eligible.

Evaluation of clinical outcomes and renal vascular pathology among patients with lupus.

Background And Objectives: The objective of this study was to determine the clinical significance of renal vascular lesions in lupus nephritis.

Design, Setting, Participants, & Measurements: Renal vascular lesions defined as thrombotic microangiopathy, lupus vasculopathy, uncomplicated vascular immune deposits, and arterial sclerosis were evaluated in relation to renal and vascular morbidity and overall mortality.

Results: Biopsies from 161 patients revealed thrombotic microangiopathy (13), lupus vasculopathy (5), and arterial sclerosis (93).

Prevalence and risk factors for liver biochemical abnormalities in Canadian patients with systemic lupus erythematosus.

Objective: To determine the prevalence of abnormal liver enzymes in patients with systemic lupus erythematosus (SLE) and whether further investigations were done, and the differences in SLE-related and/or metabolic factors in patients with and without liver biochemical abnormalities.

Method: Patients from the University of Toronto Lupus Clinic who met at least 4 of the American College of Rheumatology classification criteria for SLE and had 1.5 times the upper limit for aspartate transaminase or alanine transaminase on 2 consecutive visits within a 2-year period were matched with controls for age, sex, and SLE duration.

Peripheral neuropathy in patients with systemic lupus erythematosus.

Objective: In patients with systemic lupus erythematosus (SLE), to determine 1) the prevalence and clinical features of peripheral neuropathies (PN) and whether they were SLE related, 2) whether there are associations between other SLE features and PN.

Methods: Patients who met the American College of Rheumatology case definition criteria for SLE peripheral neuropsychiatric syndromes were selected from the University of Toronto Lupus Clinic database. Demographic data and SLE-related clinical and laboratory data were extracted.

Non-alcoholic fatty liver disease in HIV infection associated with altered hepatic fatty acid composition.

Hepatic fatty acid (FA) composition, especially a reduction in n-3 polyunsaturated FA (PUFA) may contribute to the pathogenesis of non-alcoholic fatty liver disease (NAFLD), which is common in HIV-infection.. In a cross-sectional study we compared hepatic FA composition between 20 HIV-infected men with NAFLD (HIV/NAFLD), 21 HIV-negative men with NAFLD (NAFLD), and 7 healthy controls.

Alterations in circulating fatty acid composition in patients with systemic lupus erythematosus: a pilot study.

Introduction: Circulating fatty acids (FAs) may play a role in the disease pathogenesis of patients with systemic lupus erythematosus (SLE).

Objectives: To compare red blood cell (RBC) and plasma FA composition: (1) between female SLE patients and age-matched healthy female (HF) controls and in SLE with history of cardiovascular disease (CVD) and those with no history (SLE+CVD vs SLE-CVD); and (2) between SLE patients who were or were not receiving prednisone treatment at the time of blood sampling.

Methods: This cross-sectional study consisted of 33 female patients with SLE (11 SLE+CVD, 22 SLE-CVD) and 20 HF controls.

Thrombovascular events affect quality of life in patients with systemic lupus erythematosus.

Objective: To compare health-related quality of life (HRQOL) of patients with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) with and without previous thrombovascular events (TE).

Methods: The Medical Outcomes Study Short-Form 36 (SF-36) was used to assess HRQOL in 5 patient groups: (1) primary APS (PAPS; n = 35); (2) APS associated to SLE (SAPS; n = 37); (3) SLE+TE without persistent positive antiphospholipid antibody (SLE+TE-aPL; n = 75); (4) SLE-TE+aPL (n = 71); and (5) SLE-TE-aPL (n = 608).

Results: The data on both mental component summary and physical component summary (PCS) scores showed an impaired quality of life in all patient groups.

Healthcare cost and loss of productivity in a Canadian population of patients with and without lupus nephritis.

Objective: To compare the healthcare cost and loss of productivity in patients with systemic lupus erythematosus (SLE) with (LN) and without lupus nephritis (lupus nephritis-negative, LNN).

Method: Patients were classified into those with active (ALN and ALNN) and inactive disease (ILN and ILNN). Patients reported on visits to healthcare professionals and use of diagnostic tests, medications, assistive devices, alternative treatments, hospital emergency visits, surgical procedures, and hospitalizations as well as loss of productivity in the 4 weeks preceding enrollment.

Glomerular filtration rate predicts arterial events in women with systemic lupus erythematosus.

Objectives: To determine whether renal function predicts the development of cardiovascular disease and other arterial vascular events in patients with SLE.

Method: An inception cohort of 437 females was studied. Baseline estimated glomerular filtration rate (eGFR) was calculated using serum creatinine and the abbreviated Modification of Diet in Renal Disease Study Group formula.

Oxidative stress and nutritional factors in hepatitis C virus-positive liver recipients, controls, and hepatitis C virus-positive nontransplant patients.

Background: Hepatitis C virus (HCV) is the most common indication for liver transplantation, but HCV recurrence is frequent after 1 year and is associated with increased morbidity and mortality. Oxidative stress (OxS) is involved in the pathogenesis of HCV, but little is known about its presence prior to disease recurrence.

Aim: To determine if at 6 months HCV-positive liver recipients (HCV-OLT) without recurrence were oxidatively stressed.

Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus.

Objective: To determine whether serum albumin reflects disease activity in patients with systemic lupus erythematosus (SLE) with and without nephritis (LN, LNN), and whether serum albumin could be a surrogate marker of SLE disease activity overall. There is currently no clinical "gold standard" in the assessment of disease activity in SLE.

Methods: Patients with >or= 3 clinic visits within a maximum followup period of 10 years were selected from the University of Toronto Lupus Clinic database.

In patients with HIV-infection, chromium supplementation improves insulin resistance and other metabolic abnormalities: a randomized, double-blind, placebo controlled trial.

Chromium is an essential micronutrient; chromium deficiency has been reported to cause insulin resistance, hyperglycemia and hyperlipidemia. The aim was to investigate the effect of chromium supplementation on insulin-resistance, other metabolic abnormalities, and body composition in people living with HIV. This was a randomized, double-blind, placebo-controlled trial.

The use of micronutrient supplements is not associated with better quality of life and disease activity in Canadian patients with systemic lupus erythematosus.

Objective: Associations between the use of micronutrient supplements (MS) and disease activity, quality of life (QOL), and healthcare resource utilization were studied in a Canadian population of patients with systemic lupus erythematosus (SLE).

Methods: QOL was assessed by the Medical Outcomes Study 36-item Short Form. Healthcare resource utilization and disease activity/damage were determined.

Oxidative stress and nutritional intakes in lung patients with bronchiolitis obliterans syndrome.

Survival after lung transplantation is limited by bronchiolitis obliterans syndrome (BOS). Oxidative stress (OxS) can be associated with BOS due to chronic inflammation. The type of fat and antioxidant intakes may also contribute to OxS.

Hepatic lipid peroxidation and antioxidant micronutrients in hepatitis virus C liver recipients with and without disease recurrence.

Background: Hepatitis C virus (HCV) reinfection after liver transplantation is universal and progresses to cirrhosis in 10% to 30% of patients. Several risk factors are associated with progression. Oxidative stress may be involved because it has a role in the pathogenesis of HCV.

A survey on the usage of supplements in canadian patients living with HIV.

To assess the usage, knowledge and attitudes of Patients Living with HIV with respect to supplements. A questionnaire was mailed to people living with HIV via HIV/AIDS organizations in Ontario and distributed to those attending the HIV-clinic of the University Health Network. The survey was completed by 312 subjects (95 female, 207 male).

Lung transplantation: does oxidative stress contribute to the development of bronchiolitis obliterans syndrome?

Lung transplantation is the ultimate treatment of end-stage lung disease. After transplantation, the 1-year survival rate is 80%. However, 5-year survival rates drop to 50% due to bronchiolitis obliterans syndrome (BOS).

Hepatic fatty acid composition differs between chronic hepatitis C patients with and without steatosis.

Hepatic fatty acid (FA) composition may influence steatosis development in patients with chronic hepatitis C (CHC). In a cross-sectional study, we compared the hepatic FA profile in hepatitis C patients with (n = 9) and without (n = 33) steatosis (> or =5% of hepatocytes involved). FA composition of hepatic and RBC total lipids was measured by gas chromatography.

Dietary intake and physical activity in a Canadian population sample of male patients with HIV infection and metabolic abnormalities.

Objective was to assess dietary intake and physical activity in a Canadian population sample of male patients with HIV and metabolic abnormalities and to compare the data to Canadian recommendations. Sixty-five HIV-infected men with at least one feature associated with the metabolic syndrome (insulin resistance, dyslipidemia, central obesity, or lipodystrophy) were enrolled. Results from 7-day food records and activity logs were compared to the Dietary Reference Intakes and recommendations of Canada's Physical Activity Guide, respectively.

Nutritional assessment and hepatic fatty acid composition in non-alcoholic fatty liver disease (NAFLD): a cross-sectional study.

Background/aims: Low hepatic n-6 and n-3 polyunsaturated fatty acid (PUFA) may contribute to steatosis and steatohepatitis and can be affected by diet and oxidative stress.

Methods: Seventy-three patients referred for elevated liver enzymes and suspected NAFLD were assessed. Nutritional assessment, hepatic FA composition and oxidative stress were compared between these groups: simple steatosis (SS, n=18), steatohepatitis (NASH, n=38) and minimal findings on liver biopsy (MF, n=17).

Adequacy of nutritional intake in a Canadian population of patients with Crohn's disease.

Crohn's disease is frequently associated with nutritional deficiencies, often a result of disease activity and poor oral intake. This study investigated the adequacy of dietary intake, based on the Canadian Dietary Reference Intake, in ambulatory patients with Crohn's disease and a normal body mass index (BMI; calculated as kg/m(2)). This was a cross-sectional study of 74 patients with mean age of 35.

Dietary intake of elderly living in Toronto long-term care facilities: comparison to the dietary reference intake.

Objective: To compare the dietary intake of elderly living in 11 long-term care facilities (LTCFs) to the Estimated Average Requirement set as part of the Dietary Reference Intake for older adults.

Design: A cross-sectional assessment of dietary intake using a 3 days food record among 407 elderly with mean age of 85.2 +/- 7.

HIV-positive patients with nonalcoholic fatty liver disease have a lower body mass index and are more physically active than HIV-negative patients.

Objective: To determine whether the clinical and metabolic features associated with nonalcoholic fatty liver disease (NAFLD) are similar between HIV-positive and HIV-negative male subjects.

Methods: Twenty-six HIV-positive and 25 HIV-negative subjects with liver biopsy-proven NAFLD were compared for liver histology (extent of steatosis, steatosis grading, and fibrosis staging), blood biochemistry (glucose, insulin, C-peptide, hemoglobin A1c, and lipid profile), insulin resistance (IR) using a homeostasis model assessment, anthropometry (body mass index [BMI], waist circumference, and arm muscle area), dietary intake, and physical activity.

Results: The 2 groups were similar for age, liver histology, and IR.