Publications by authors named "Rachel S Wallwork"

Article Synopsis
  • Adult and juvenile dermatomyositis (DM) are rare autoimmune diseases characterized by skin rashes and muscle weakness, with interferon signaling playing a significant role in their pathology.
  • Janus kinase inhibitors (jakinibs) show promise as targeted therapies for DM and have been the focus of recent literature, including safety evaluations and comparisons between adult and juvenile cases.
  • Ongoing Phase 2 and 3 trials are expected to provide crucial insights into the effectiveness of jakinibs, potentially altering the treatment approach for dermatomyositis in the near future.
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Objective: Immune checkpoint inhibitor (ICI) therapies have dramatically improved outcomes in multiple cancers. ICI's mechanism of action involves immune system activation to augment anti-tumor immunity. Patients with pre-existing autoimmune diseases, such as systemic sclerosis (SSc), were excluded from initial ICI clinical trials due to concern that such immune system activation could precipitate an autoimmune disease flare or new, severe immune related adverse events (irAE).

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Article Synopsis
  • Systemic sclerosis (SSc) is typically seen as a contraindication for radiation therapy, but this study evaluates the outcomes of patients with both SSc and locally advanced head and neck (H&N) cancer treated with radiation.
  • Thirteen SSc patients who underwent radiation therapy were analyzed, revealing a five-year survival rate of 54%, with notable side effects including skin thickening and reduced neck motion in many cases, yet no significant progression of SSc-related lung disease.
  • Treatment strategies like pentoxifylline and vitamin E were employed to combat radiation-induced fibrosis, indicating that while there are risks, effective management is possible during radiation therapy for these patients.
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Objective: To define the clinical phenotype of SSc patients with antibodies against Sjogren's syndrome (SS)/scleroderma autoantigen 1 (SSSCA1), and to examine the association between these antibodies and cancer in SSc patients.

Methods: We conducted a case-control study using data from 209 patients with SSc and cancer, and 205 SSc patients without cancer. All were randomly selected from the Johns Hopkins Scleroderma Center Research Registry.

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Many rheumatology providers, including fellows-in-training, responded to the immediate need for maintaining patient access to care via telerheumatology during the COVID-19 pandemic. The rapidity of this transition did not permit an intentional approach to integrating fellow education and training into virtual patient care. Virtual patient care has since become an integrated, and perhaps, an embedded part of rheumatology practice that will likely endure beyond the COVID-19 pandemic.

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Background: The efficacy of interleukin-6 receptor blockade in hospitalized patients with coronavirus disease 2019 (Covid-19) who are not receiving mechanical ventilation is unclear.

Methods: We performed a randomized, double-blind, placebo-controlled trial involving patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hyperinflammatory states, and at least two of the following signs: fever (body temperature >38°C), pulmonary infiltrates, or the need for supplemental oxygen in order to maintain an oxygen saturation greater than 92%. Patients were randomly assigned in a 2:1 ratio to receive standard care plus a single dose of either tocilizumab (8 mg per kilogram of body weight) or placebo.

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Ambient air pollution and temperature have been linked with cardiovascular morbidity and mortality. Metabolic syndrome and its components-abdominal obesity, elevated fasting blood glucose concentration, low high-density lipoprotein cholesterol concentration, hypertension, and hypertriglyceridemia-predict cardiovascular disease, but the environmental causes are understudied. In this study, we prospectively examined the long-term associations of air pollution, defined as particulate matter with an aerodynamic diameter less than or equal to 2.

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