Publications by authors named "Szilvia Szamosi"

Article Synopsis
  • - Systemic sclerosis (SSc) is a complex autoimmune disease that leads to damage and fibrosis in various organs, making it challenging to diagnose and treat effectively due to its varied symptoms and limited treatment options.
  • - The review discusses the various forms of SSc, their survival rates, risk factors, and the current treatment landscape, emphasizing the struggle to manage "difficult-to-treat" cases based on existing literature.
  • - Despite improvements in treating certain symptoms, like interstitial lung disease, many treatments remain ineffective for issues such as Raynaud's phenomenon and digital ulcers, prompting the development of a scoring system to better address and categorize difficult-to-treat patients.
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  • Differentiating between granulomatosis with polyangiitis (GPA) and cocaine-induced midline destructive lesion (CIMDL) is challenging due to similar histopathological features and ANCA profiles.
  • A young woman was initially diagnosed with GPA, but further tests revealed she actually had CIMDL from cocaine use, prompting a reassessment to "cocaine-induced GPA mimic."
  • To properly diagnose similar cases, urine tests for cocaine and HNE ELISA are recommended, and the primary treatment is to avoid cocaine use.
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  • - Cardiovascular issues are common in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and natural autoantibodies (nAAbs) play a role in inflammation and atherosclerosis linked to these conditions.
  • - A study involving 53 patients treated with anti-TNF therapies over a year found improvements in vascular function and stabilization of vascular thickness, while also noting changes in nAAb levels.
  • - The research suggests that nAAbs may independently affect autoimmunity and vascular health in biologic-treated patients, highlighting a complex relationship between arthritis, inflammation, and cardiovascular risks.
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Introduction: In Hungary, the HUN-VE 3 study determined the comparative effectiveness of various primary and booster vaccination strategies during the Delta COVID-19 wave. That study included more than 8 million 18-100-year-old individuals from the beginning of the pandemic. Immunocompromised (IC) individuals have increased risk for COVID-19 and disease course might be more severe in them.

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  • The study investigates how 12 months of tofacitinib treatment affects the Renin-Angiotensin-Aldosterone system (RAAS) in rheumatoid arthritis patients, particularly focusing on angiotensin converting enzyme (ACE) and ACE2 levels.
  • Twenty-six RA patients completed the study, revealing that tofacitinib treatment significantly increased serum ACE levels and the ACE/ACE2 ratio after one year, while ACE2 activity only showed a temporary increase at six months.
  • The results suggest a link between baseline inflammation, disease duration, and specific biomarkers (like rheumatoid factor) with changes in the ACE/ACE2 ratio during the treatment period.
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  • The study aimed to assess the effects of tofacitinib therapy on angiogenic factors and vascular health in patients with rheumatoid arthritis (RA).
  • Over one year, 26 RA patients treated with tofacitinib showed significant reductions in certain inflammatory cytokines and growth factors, indicating a potential decrease in synovial and aortic inflammation.
  • The findings suggest that after one year of treatment, certain biomarkers like NT-proBNP and CathK may indicate vascular health, linking them to blood vessel function in RA patients.
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Fever of unknown origin is a common differential diagnostic problem in medicine. More than 60 years have passed since the first established definition of the disease, and despite constant development and improvement of diagnostic procedures, the differential diagnosis and choosing adequate therapy still remains a challenge in this patient population. The medical literature lists at least 200 diseases that may manifest with fever of unknown origin, and it encompasses a wide clinical spectrum.

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  • This study investigates how tofacitinib, a JAK inhibitor, impacts metabolic changes associated with rheumatoid arthritis (RA) over one year, focusing on arginine and methionine levels and their connection to inflammation and cardiovascular health.
  • Thirty RA patients were monitored for inflammatory markers, vascular function, and various amino acid levels before and after treatment, revealing significant decreases in inflammatory markers but no major changes in vascular function.
  • After 12 months, higher doses of tofacitinib increased certain amino acids like L-arginine and methionine, with mixed correlations noted between these amino acids and inflammation, but no overall improvement in vascular function metrics was observed.
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  • JAK inhibitor tofacitinib, used for treating rheumatoid arthritis (RA), shows a complex impact on lipids and metabolic markers related to cardiovascular health over a one-year period.
  • In a study involving 30 RA patients, several lipid and adipokine levels were monitored, revealing significant changes in certain markers like TC, HDL, LDL, and TSP-1, while others remained stable.
  • The study found correlations between metabolic indicators, clinical markers, and vascular functions, suggesting that tofacitinib therapy influences CV risk factors and highlights the need for comprehensive evaluations in RA patients.
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Coronavirus disease 2019 (COVID-19) is associated with autoimmunity and systemic inflammation. Patients with autoimmune rheumatic and musculoskeletal disease (RMD) may be at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, based on evidence from the literature, as well as international scientific recommendations, we review the relationships between COVID-19, autoimmunity and patients with autoimmune RMDs, as well as the basics of a multisystemic inflammatory syndrome associated with COVID-19.

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Introduction: Angiotensin-converting enzyme (ACE) and ACE2 have been implicated in the regulation of vascular physiology. Elevated synovial and decreased or normal ACE or ACE2 levels have been found in rheumatoid arthritis (RA). Very little is known about the effects of tumor necrosis factor α (TNF-α) inhibition on ACE or ACE2 homeostasis.

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Background: Cardiovascular (CV) morbidity, mortality, and metabolic syndrome are associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Here, lipids and other metabolic markers in relation to vascular function and clinical markers were evaluated in RA and AS patients undergoing one-year anti-TNF therapy.

Patients And Methods: Fifty-three patients including 36 RA patients treated with either etanercept (ETN) or certolizumab pegol (CZP) and 17 AS patients treated with ETN were included in a 12-month follow-up study.

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Cardiovascular (CV) disease and osteoporosis (OP) have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Bone and vascular biomarkers and parameters along with the effect of 1-year anti-TNF therapy on these markers were assessed in order to determine correlations between vascular pathophysiology and bone metabolism in RA and AS. Thirty-six patients treated with etanercept or certolizumab pegol and 17 AS patients treated with ETN were included in a 12-month follow-up study.

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Introduction: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with osteoporosis. There have not been many peripheral quantitative computed tomography (QCT) studies in patients receiving biologics. We assessed volumetric and areal bone mineral density (BMD) by forearm QCT and dual-energy X-ray absorptiometry (DXA), respectively in addition to laboratory biomarkers in these arthritides.

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Most rheumatic and musculoskeletal diseases (RMDs) can be placed along a spectrum of disorders, with autoinflammatory diseases (including monogenic systemic autoinflammatory diseases) and autoimmune diseases (such as systemic lupus erythematosus and antiphospholipid syndrome) representing the two ends of this spectrum. However, although most autoinflammatory diseases are characterized by the activation of innate immunity and inflammasomes and classical autoimmunity typically involves adaptive immune responses, there is some overlap in the features of autoimmunity and autoinflammation in RMDs. Indeed, some 'mixed-pattern' diseases such as spondyloarthritis and some forms of rheumatoid arthritis can also be delineated.

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Objective: The pathogenesis of calcinosis cutis, a disabling complication of SSc, is poorly understood and effective treatments are lacking. Inorganic pyrophosphate (PPi) is a key regulator of ectopic mineralization, and its deficiency has been implicated in ectopic mineralization disorders. We therefore sought to test the hypothesis that SSc may be associated with reduced circulating PPi, which might play a pathogenic role in calcinosis cutis.

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To investigate corneal microstructure of systemic sclerosis (SSc) patients using in vivo confocal microscopy (IVCM). 33 patients with SSc and 30 age-matched healthy subjects were recruited. All participants underwent comprehensive ophthalmic examination including IVCM (Heidelberg Retina Tomograph III, Heidelberg Engineering GmbH, Heidelberg, Germany) and ocular surface evaluation.

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Objective: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with cardiovascular disease. The treatment of arthritis by tumor necrosis factor-α (TNF-α) inhibitors may decrease the serum concentrations of vascular biomarkers. We determined circulating levels of oxidized low-density lipoprotein (oxLDL)/β glycoprotein I (β-GPI) complexes, antibodies to 60 kDa heat shock protein (anti-Hsp60), soluble urokinase plasminogen activator receptor (suPAR), and B-type natriuretic peptide (BNP) fragment in sera of RA and AS patients undergoing anti-TNF treatment.

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RELATIONSHIP BETWEEN MALIGNANCIES AND MUSCULOSKELETAL DISEASES: Oncorheumatology is the meeting point of tumor formation and rheumatic musculoskeletal diseases (RMD). Multiple interactions exist between these two medical specialties. One major field is the topic of malignancies associated with rheumatic diseases, while the other topic covers the development of musculoskeletal disease in cancer patients.

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Oncorheumatology is the meeting point of tumour formation and rheumatic diseases. Multiple interactions exist between these two medical specialties. One major field is the topic of malignancies associated with rheumatic diseases, while the other topic covers the development of musculoskeletal disease in cancer patients.

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Increased cardiovascular (CV) morbidity and mortality have been found in rheumatoid arthritis (RA). Tumour necrosis factor α (TNF-α) inhibitors may improve vascular function. In the first part of this study, we determined microcirculation during postoocclusive reactive hyperemia (PORH) representing endothelial function.

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Accelerated atherosclerosis, increased cardiovascular morbidity and mortality have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Vascular function, clinical and laboratory markers and the effects of anti-TNF therapy were assessed in arthritides. Fifty-three 53 patients including 36 RA patients treated with either etanercept (ETN) or certolizumab pegol and 17 AS patients treated with ETN were included in a 12-month follow-up study.

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