Background: Recurrence risk of systemic lupus erythematosus (SLE)-associated venous thromboembolism (VTE) is unclear.
Aim: To determine the recurrence risk of SLE-associated VTE overall and by presence of provoking factors and SLE flares.
Methods: A multicenter, retrospective cohort study was conducted among patients with first SLE-associated VTE who discontinued anticoagulation. SLE flares were defined as Systemic Lupus Erythematosus Disease Activity Index 2000 greater than 4. The primary outcome was recurrent VTE. Incidence rates and cumulative incidences were calculated by presence of provoking factors and antiphospholipid syndrome (APS) at index VTE. The hazard ratio (HR) for recurrence after SLE flare-associated index VTE was estimated with Cox regression, adjusted for provoking factor presence and APS.
Results: Eighty patients were included with 21 recurrent VTEs in median 8 years. For provoked index VTE, the recurrence rate in patients without APS was 1.1 per 100 person-years (PY; 95% confidence interval [CI], 0.1-3.1) and in the presence of APS 3.5 per 100 PY (95% CI, 0.9-8.9), yielding cumulative incidences of 7.5% (95% CI, 1.2%-21.7%) and 31.4% (95% CI, 6.3%-61.6%) respectively. For unprovoked index VTE, these analogous rates were 3.8 per 100 PY (95% CI, 1.2-9.0) and 16.7 per 100 PY (95% CI, 4.5-42.7), with cumulative incidences of 33.7% (95% CI, 10.7%-58.9%) and 54.2% (95% CI, 10.7%-84.5%), respectively. Forty-six index VTEs were flare associated, and the adjusted HR for recurrence was 0.4 (95% CI, 0.1-1.8) compared to those without flares at their index VTE.
Conclusion: Antiphospholipid syndrome is the main determinant for recurrence risk of SLE-associated VTE irrespective of presence of a provoking factor. Future research should attempt to confirm that flare-associated VTE has a lower recurrence risk.
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http://dx.doi.org/10.1002/rth2.12839 | DOI Listing |
Transfusion
December 2024
School of Pharmacy, IMU University, Kuala Lumpur, Malaysia.
Introduction: Acute myocardial infarction (AMI) poses a significant global health burden, warranting meticulous management strategies, particularly in patients with concurrent anemia. Blood transfusion strategies play a pivotal role in optimizing oxygen delivery while minimizing transfusion-related risks. Two contrasting approaches, liberal and restrictive transfusion strategies, have emerged, yet their comparative effectiveness remains uncertain due to conflicting evidence.
View Article and Find Full Text PDFJpn J Clin Oncol
December 2024
Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Objective: This study aimed to assess the oncological outcomes of the subtype of urothelial carcinoma (SUC), including divergent differentiation and histologic subtype, in comparison with those of pure urothelial carcinoma (PUC) in nonmuscle-invasive bladder cancer.
Methods: We retrospectively evaluated patients who were initially treated with transurethral resection of the bladder tumor (TURBT) between March 2005 and August 2020 at a single institution. Patients with PUC and SUC were compared in terms of recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS).
World J Surg Oncol
December 2024
Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No.7 Weiwu Road, Zhengzhou, Henan, 450003, China.
Background: We aim to explore the impact of excessive glutathione (GSH) intake on chemotherapy sensitivity in breast cancer.
Methods: Clinicopathological data were collected from 460 breast cancer patients who underwent adjuvant chemotherapy from January 2016 to December 2019 from Zhengzhou University People's Hospital. The clinicopathological characteristics following GSH treatment were collected and compared with those in Non-GSH group after 1:2 propensity score matching (PSM).
J Voice
December 2024
Phoniatrics Unit-Department of ENT, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt. Electronic address:
Objectives: This study conducted a subjective 6-month follow-up to evaluate voice and swallowing changes after thyroid surgery in patients without clinical evidence of recurrent nerve injury.
Methods: In this prospective cohort study, voice and swallowing alterations were assessed in 56 adult patients who underwent thyroidectomy, compared to 59 patients with laryngeal conditions and 60 controls. Voice and swallowing changes were measured using auditory perceptual assessment, laryngoscopy, the Arabic Thyroidectomy‑related voice and symptom questionnaire (A-TVSQ), the Arabic VHI (A-VHI), and Swallowing Impairment Scores (SIS-6).
Surv Ophthalmol
December 2024
Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Systematic review and meta-analysis We assessed the efficacy of deep anterior lamellar keratoplasty (DALK) and penetrating (PK) for macular corneal dystrophy (MCD) We searched on 4 databases for articles published up to the end of April 2024. The study's outcome was postoperative visual acuity and other factors that may affect visual outcomes (e.g.
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