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Article: Targeted Molecular Therapeutics for Pulmonary Diseases: Addressing the Need for Precise Drug Delivery.

Carneiro, Simone / Müller, Joschka T / Merkel, Olivia M

2024 Volume 284, Page(s) 313–328

Abstract: Respiratory diseases are a major concern in public health, impacting a large population worldwide. Despite the availability of therapies that alleviate symptoms, selectively addressing the critical points of pathopathways remains a major challenge. ... ...

Abstract	Respiratory diseases are a major concern in public health, impacting a large population worldwide. Despite the availability of therapies that alleviate symptoms, selectively addressing the critical points of pathopathways remains a major challenge. Innovative formulations designed for reaching these targets within the airways, enhanced selectivity, and prolonged therapeutic effects offer promising solutions. To provide insights into the specific medical requirements of chronic respiratory diseases, the initial focus of this chapter is directed on lung physiology, emphasizing the significance of lung barriers. Current treatments involving small molecules and the potential of gene therapy are also discussed. Additionally, we will explore targeting approaches, with a particular emphasis on nanoparticles, comparing targeted and non-targeted formulations for pulmonary administration. Finally, the potential of inhaled sphingolipids in the context of respiratory diseases is briefly discussed, highlighting their promising prospects in the field.
MeSH term(s)	Humans ; Drug Delivery Systems ; Lung Diseases/drug therapy ; Lung ; Administration, Inhalation ; Respiratory Tract Diseases
Language	English
Publishing date	2024-01-03
Publishing country	Germany
Document type	Journal Article
ISSN	0171-2004
ISSN	0171-2004
DOI	10.1007/164_2023_703
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danach: Sign. bei den Einzelbänden: Show issues

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Article: Challenging Diagnosis and Management: A Complex Case Following an Urgent Caeserean Section.

Tenreiro, Gabriela / Santos, Carolina / Machado, Elvira / Carneiro, Sandra

Cureus

2023 Volume 15, Issue 11, Page(s) e49227

Abstract: Hemodynamic changes during pregnancy are physiological adaptations to fulfill new demands. Although these adaptations are often well-tolerated, they may unmask or exacerbate underlying cardiovascular conditions, posing unique challenges for medical ... ...

Abstract	Hemodynamic changes during pregnancy are physiological adaptations to fulfill new demands. Although these adaptations are often well-tolerated, they may unmask or exacerbate underlying cardiovascular conditions, posing unique challenges for medical professionals. We present a case that outlines the evaluation and treatment of a 38-year-old woman who experienced health complications shortly after undergoing a Caesarean section. A 38-year-old woman who had a previous caeserean section presented for an urgent caeserean section at 39 weeks of gestational age due to non-reassuring cardiotocography. Shortly after spinal anesthesia and misoprostol administration, she developed cyanosis, confusion, mottling skin, tachycardia, tachypnea, and hypotension. The patient's clinical presentation led to a broad differential diagnosis, including cardiovascular complications, infection, medication reactions, and hemorrhage, being the ultimate diagnosis of a case of severe aortic stenosis. Successful management involved a multidisciplinary approach and coordinated effort, particularly involving the anesthesiology team, which was pivotal in timely diagnosis and intervention. The ultimate diagnosis of severe aortic stenosis emphasized the significance of accurate and coordinated healthcare. Successful management involves collaboration between obstetric, intensive care, and cardiac care teams, highlighting the potential for improved outcomes when healthcare professionals work together in complex clinical scenarios.
Language	English
Publishing date	2023-11-22
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.49227
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Article ; Online: Nontuberculous Mycobacteria in Portugal: Trends from the last decade.

Santos, A / Carneiro, S / Silva, A / Gomes, J P / Macedo, R

Pulmonology

2022

Abstract: Introduction and objectives: Nontuberculous mycobacteria (NTM) are opportunistic human pathogens found in the environment. The transmission seems to be associated with inhalation of aerosol droplets, ingestion or trauma events. Recent studies indicate ... ...

Abstract	Introduction and objectives: Nontuberculous mycobacteria (NTM) are opportunistic human pathogens found in the environment. The transmission seems to be associated with inhalation of aerosol droplets, ingestion or trauma events. Recent studies indicate that NTM disease is increasing worldwide, however, the true clinical impact of NTM infections is difficult to determine due to challenges in discriminating between disease and colonization as they are ubiquitous in the environment. In addition, understanding the epidemiology of NTM is difficult and has not yet been established. In this work, we used a country NTM representative collection from the National Reference Laboratory for Tuberculosis (NRL-TB) of the National Institute of Health (INSA), to characterize the circulation trends of NTM species in Portugal and the most affected regions, contributing to a better understanding of the NTM epidemiology. Material and methods: We conducted a nationwide retrospective study where all individuals with positive NTM cultures at the NRL-TB of the INSA from 2014 to December 2020 were included. Positive cultures were identified using GenoType Mycobacterium CM/AS® (Hain Lifescience) according to manufacturer's instructions, or hsp65 DNA sequencing as previously described. Social-demographic data from patients were also analyzed and patients classified into 3 groups according only to microbiological data, "definite NTM disease", "NTM colonization" and, "possible NTM disease". Results: In the period 2014-2020, the NRL-TB performed 50397 cultures. Among these, 1118 cultures were NTM positive retrieved from 944. Most of our cases were in patients whose mean age was 64±15.9 years, and no significant differences between gender was observed, although more frequent in male patients. Overall, from the 944 cases, we were able to identified 93 "definite NTM disease" cases and 79 "possible NTM disease". Mycobacterium avium complex (MAC) (40,8%), Mycobacterium abscessus-chelonae complex (MABC) (9,6%) and Mycobacterium fortuitum (6,3%) were responsible for most of the infections. The geographical distribution of NTM cases varied significantly and was possible to observe that was independent of population density. The region were most cases occurred was Lisbon Metropolitan Area (31,9%), followed by North (25,3%) and Centre (24,4%), however North region has the highest number of "definite NTM disease" cases (n=33). Conclusions: This is the first national wide epidemiological study on this subject, contributing to a better understanding of NTM dynamics in Portugal. MAC was the NTM species responsible for the majority of infections and, LMA the region with the highest number of cases. It was also possible to conclude that the number of NTM isolates is independent of the demography of the region.
Language	English
Publishing date	2022-02-23
Publishing country	Spain
Document type	Journal Article
ZDB-ID	3009651-0
ISSN	2531-0437 ; 2531-0429
ISSN (online)	2531-0437
ISSN	2531-0429
DOI	10.1016/j.pulmoe.2022.01.011
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Article: Recurrence of Post-dural Puncture Headache After a Successful Blood Patch.

Barbosa, João / Valentim, Maria / Almeida, Mariana / Carneiro, Sara / Vasconcelos, Lúcia

Cureus

2023 Volume 15, Issue 11, Page(s) e48497

Abstract: The obstetric population is at a higher risk of experiencing post-dural puncture headache (PDPH), which is a frequent complication that can occur following spinal anesthesia or unintended dural puncture during epidural catheter placement. If conservative ...

Abstract	The obstetric population is at a higher risk of experiencing post-dural puncture headache (PDPH), which is a frequent complication that can occur following spinal anesthesia or unintended dural puncture during epidural catheter placement. If conservative treatment fails to resolve symptoms, the epidural blood patch (EBP) is the definitive treatment for PDPH. We present the case of a 35-year-old nulliparous woman who developed PDPH and underwent treatment with an EBP. There was immediate resolution of symptoms and she was discharged home. However, three days later, the symptoms recurred, and subdural hygromas were found on a cerebral CT scan. This case report emphasizes the importance of a multidisciplinary approach involving anesthesiology, obstetrics, and neurology in managing PDPH and the associated complications in postpartum patients.
Language	English
Publishing date	2023-11-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.48497
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Article: Prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-neutrophil (PN) index in locally advanced rectal cancer patients: a retrospective cohort study.

Morais, Marina / Fonseca, Telma / Machado-Neves, Raquel / Honavar, Mrinalini / Coelho, Ana Rita / Lopes, Joanne / Guerreiro, Emanuel / Carneiro, Silvestre

Annals of medicine and surgery (2012)

2024 Volume 86, Issue 5, Page(s) 2474–2480

Abstract: Introduction: In locally advanced rectal cancers (LARC), tumour node metastasis (TNM) staging is far from optimal. The authors aimed to investigate the value of previously described circulating biomarkers as predictors of prognosis.: Methods: ... ...

Abstract	Introduction: In locally advanced rectal cancers (LARC), tumour node metastasis (TNM) staging is far from optimal. The authors aimed to investigate the value of previously described circulating biomarkers as predictors of prognosis. Methods: Retrospective analysis of 245 LARC patients diagnosed between January 2010 and December 2022, who underwent neoadjuvant chemoradiotherapy and surgery at two centres. A Cox regression and Kaplan-Meier analysis were performed. Results: Post-treatment platelet-to-lymphocyte ratio (PLR) predicted pathological complete response. The neutrophil-to-lymphocyte ratio (NLR) in two timepoints of the treatment significantly predicted overall survival, whereas the platelet-neutrophil (PN) index significantly predicted disease-free survival. In pathological stage II, the PN index predicted patients with a higher risk of disease-free survival. Conclusion: Blood parameters might allow the definition of subgroups of risk beyond TNM for the application of different therapeutic strategies.
Language	English
Publishing date	2024-03-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000001297
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Article ; Online: The "Sniffin' Kids-PT" test: A smell test variant for Portuguese children.

Carneiro, J P / Carvalho, J C / Carneiro, S P / Eloi, I / Silva, C / Silva, L / Hummel, T / Ribeiro, J C

European annals of otorhinolaryngology, head and neck diseases

2024 Volume 141, Issue 2, Page(s) 69–75

Abstract: Objective: Olfactory tests tailored for children are essential, as diagnosing olfactory dysfunction at these ages can be challenging. The 16-item "Sniffin' Sticks" is reliable and easy to perform. To the best of our knowledge, there is currently no ... ...

Abstract	Objective: Olfactory tests tailored for children are essential, as diagnosing olfactory dysfunction at these ages can be challenging. The 16-item "Sniffin' Sticks" is reliable and easy to perform. To the best of our knowledge, there is currently no validated olfactory test for the Portuguese pediatric population. This study aimed to adapt and validate the "Sniffin' Sticks" olfactory test for the Portuguese pediatric population. Methods: Between August 2020 and September 2021, 354 children aged between 6 and 17years old enrolled in the study, 336 healthy children with a normal sense of smell, and 18 anosmic children with Kallmann syndrome. The study consisted of two parts. Firstly, the "Sniffin' Sticks" olfactory identification test was applied to healthy children and the odors with statistically significant low identification rates were excluded. A modified version of "Sniffin' Sticks" was defined and named "Sniffin' Kids-PT" test. Secondly, normative data were assessed and test-retest and validation tests were performed. Results: Apple and Cloves odors were identified with a low rate and were excluded from the "Sniffin' Sticks" olfactory test. In the modified 14-item "Sniffin' Kids-PT", scoring <6 (from 6-8years old), <7 (from 9-11years old) or <8 (from 12-14years old and 15-17years old) was indicative of olfactory dysfunction. The test-retest reliability was good (r=0.81; P<0.001) and the differences between scores of healthy children and anosmic children were statistically significant (U213=13.00; P<0.001). Conclusion: The modified "Sniffin' Kids-PT" is a reliable test to discriminate between normosmia and olfactory dysfunction in Portuguese children over 5years old.
MeSH term(s)	Humans ; Child ; Adolescent ; Smell ; Olfaction Disorders/diagnosis ; Portugal ; Reproducibility of Results ; Odorants ; Sensory Thresholds
Language	English
Publishing date	2024-01-17
Publishing country	France
Document type	Journal Article
ZDB-ID	2558008-5
ISSN	1879-730X ; 1879-7296
ISSN (online)	1879-730X
ISSN	1879-7296
DOI	10.1016/j.anorl.2023.12.003
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Article ; Online: Seroprevalence of meningococcal serogroup C bactericidal antibodies in the Portuguese population, a decade after vaccine introduction in the National Immunisation Programme.

Gonçalves, Paulo / Sáez-López, Emma / Carneiro, Sofia / Simões, Maria João

PloS one

2021 Volume 16, Issue 4, Page(s) e0250103

Abstract: Background: The incidence of invasive meningococcal disease due to serogroup C (MenC) decreased in Portugal since the introduction of the conjugate vaccine (MCC) in the free market in 2001 and in the National Immunisation Plan in 2006. Considering the ... ...

Abstract	Background: The incidence of invasive meningococcal disease due to serogroup C (MenC) decreased in Portugal since the introduction of the conjugate vaccine (MCC) in the free market in 2001 and in the National Immunisation Plan in 2006. Considering the potential waning of the antibody response reported in the literature, the different vaccination schemes that were used in our country over the past decade, and that Neisseria meningitidis serogroup C continues to circulate, the Portuguese population may currently be at increased risk of infection. In the absence of national data, we evaluated the seroprotection level of the Portuguese population against MenC, in order to identify the protected fraction of the population and ponder on the necessity of a booster dose of the MCC vaccine. Methods: We measured serum bactericidal antibody levels against MenC in a representative sample of the population (n = 1500) aged 2-64 years who participated in the 2015/2016 National Serological Survey. Results: A total of 31.1% (466/1500, 95%CI: 29-33%) of the individuals studied were protected against MenC. The geometric mean titre was 6.5. The proportion of seroprotected was particularly low in children aged 2-4 years (<16%) who received a single dose of the vaccine at 12 months of age (vaccination strategy since 2012). The proportion of seroprotected was higher (44.7% to 53.5%) in adolescent and young adults (15-24 years of age), resulting from vaccination during the catch-up campaign at 5-15 years of age. The highest protection rates were observed when the vaccine was administered during adolescence. Conclusion: The small fraction of population seroprotected, combined with the already known waning effect of the antibody response over time, may indicate that the Portuguese population will become progressively more exposed to the risk of infection. Taking in consideration our results, we recommend to change the current vaccination strategy and introduce a booster dose of the MCC vaccine during adolescence.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Immunization Programs ; Male ; Meningococcal Infections/epidemiology ; Meningococcal Infections/immunology ; Meningococcal Infections/prevention & control ; Meningococcal Vaccines/immunology ; Neisseria meningitidis, Serogroup C/immunology ; Portugal ; Retrospective Studies ; Seroepidemiologic Studies ; Young Adult
Chemical Substances	Meningococcal Vaccines
Language	English
Publishing date	2021-04-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0250103
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Article ; Online: Adverse effects of polychemotherapy for leprosy in 13 years of follow-up at a university hospital.

Tortelly, Violeta Duarte / Daxbacher, Egon Luiz / Brotas, Arles Martins / Carneiro, Sueli

Anais brasileiros de dermatologia

2021 Volume 96, Issue 2, Page(s) 224–227

Abstract: Leprosy is one of the neglected diseases in the world and Brazil is the second country with more cases. A retrospective study was conducted based on the medical records of 196 leprosy patients diagnosed during the course of 13 years at a university ... ...

Abstract	Leprosy is one of the neglected diseases in the world and Brazil is the second country with more cases. A retrospective study was conducted based on the medical records of 196 leprosy patients diagnosed during the course of 13 years at a university hospital. The aim was to describe the adverse effects of polychemotherapy, as well the most prevalent and most vulnerable populations. In the study, dapsone was the most implicated drug, especially in women, and the risk increased with age. The authors conclude that with this patient profile, greater vigilance should be taken regarding possible adverse effects, especially anemia.
MeSH term(s)	Brazil ; Clofazimine/therapeutic use ; Dapsone/adverse effects ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Leprostatic Agents/adverse effects ; Leprosy/drug therapy ; Retrospective Studies ; Rifampin/therapeutic use
Chemical Substances	Leprostatic Agents ; Dapsone (8W5C518302) ; Clofazimine (D959AE5USF) ; Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2021-01-29
Publishing country	Spain
Document type	Case Reports
ZDB-ID	433655-0
ISSN	1806-4841 ; 0365-0596
ISSN (online)	1806-4841
ISSN	0365-0596
DOI	10.1016/j.abd.2020.07.005
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Zs.A 359: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 344: Show issues

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Article ; Online: ctDNA on liquid biopsy for predicting response and prognosis in locally advanced rectal cancer: A systematic review.

Morais, Marina / Pinto, Diogo Melo / Machado, José Carlos / Carneiro, Silvestre

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2021 Volume 48, Issue 1, Page(s) 218–227

Abstract: Background: The management of locally advanced rectal cancer (LARC) requires a multidisciplinary approach, with an increasing interest for non-operative strategies. Liquid biopsy for obtaining circulating tumor DNA (ctDNA) can provide information on ... ...

Abstract	Background: The management of locally advanced rectal cancer (LARC) requires a multidisciplinary approach, with an increasing interest for non-operative strategies. Liquid biopsy for obtaining circulating tumor DNA (ctDNA) can provide information on neoadjuvant chemoradiotherapy (nCRT) pathological response and cancer-specific prognosis, and therefore might be a promising guide for these treatments. Methods: A systematic review of the studies available in literature has been performed to assess the role of ctDNA as a predictive and prognostic biomarker in LARC patients. Results: We retrieved 21 publications, of which 17 full-text articles and 4 abstracts. Results have been labelled into two groups: predictive and prognostic. Data about the usefulness of liquid biopsy in this setting is still inconclusive. However, baseline higher levels of longer fragments of cell-free DNA and integrity index, tumor-specific mutations and certain methylated genes could predict non-responders. Also, undetectable baseline ctDNA and decrease of common rectal cancer mutations throughout treatment (dynamic monitoring) were predictive factors of pathological complete response. The continuous detection of ctDNA in different timepoints of treatment (minimal residual disease) was consistently associated with worse prognosis. Conclusions: ctDNA is a promising biomarker that could assist predicting treatment response to nCRT and prognosis in patients with LARC. The ideal methods and timings for the liquid biopsy still have to be defined.
MeSH term(s)	Carcinoma/blood ; Carcinoma/pathology ; Carcinoma/therapy ; Chemoradiotherapy ; Circulating Tumor DNA/blood ; Humans ; Liquid Biopsy ; Mesentery/surgery ; Neoadjuvant Therapy ; Proctectomy ; Prognosis ; Rectal Neoplasms/blood ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy
Chemical Substances	Circulating Tumor DNA
Language	English
Publishing date	2021-09-03
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2021.08.034
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 549: Show issues

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Article ; Online: Association of HLA Alleles and HLA Haplotypes with Psoriasis, Psoriatic Arthritis and Disease Severity in a Miscegenated Population

Cassia FF / Cardoso JF / Porto LC / Ramos-e-Silva M / Carneiro S

Psoriasis : Targets and Therapy, Vol Volume 11, Pp 41-

2021 Volume 51

Abstract: Flavia de Freire Cassia,1 Juliana Fernandes Cardoso,2 Luiz Cristovao Porto,3 Marcia Ramos-e-Silva,1 Sueli Carneiro4 1Sector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de ... ...

Abstract	Flavia de Freire Cassia,1 Juliana Fernandes Cardoso,2 Luiz Cristovao Porto,3 Marcia Ramos-e-Silva,1 Sueli Carneiro4 1Sector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 2Histocompatibility Section, Special Techniques Laboratory, Albert Einstein Israelite Hospital- HIAE, São Paulo, Brazil; 3Histocompatibility and Cryopreservation Laboratory, Rio de Janeiro State University, Rio de Janeiro, Brazil; 4Sector of Dermatology, University Hospital and School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, BrazilCorrespondence: Flavia de Freire CassiaSector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rua Jardim Botanico, 700 /416, Rio de Janeiro, 22461-000, BrazilTel +55 21999640406Email flaviafcassia@gmail.comBackground: The study of HLA classes I and II in Brazilian psoriasis patients may contribute to a better understanding of their association with the disease.Objective: To describe HLA classes I and II of Brazilian patients with psoriasis, with or without arthritis, compare them to controls and correlate HLA markers with epidemiological and evolutional aspects of psoriasis.Methods: A total of 55 patients with more than 5 years of psoriasis, with or without arthritis, answered a questionnaire on ethnic background and disease severity. A total of 134 bone marrow donors were controls. HLA class I and II genotyping was determined by PCR-SSP.Results: Mean age was 42.4 years; 23 women and 32 men. HLA-B57 was present in 23.6% patients and in 7.5% controls (p=0.00200, OR= 3.8381), and HLA-C06 in 29.1% patients and in 16.4% controls (p= 0.04832, OR=2.0886). HLA-B57 and HLA-C18 were significantly present in patients with arthritis (p=0.00104, OR=6.6769 and p=0.00269, OR=16.50, respectively). HLA-B57 was significantly present in patients with history of erythroderma (p=0.00548, OR= 5.1059), as was HLA-C06 (p=0.02158, OR=3.0545). HLA-B57 was also frequent in patients with history of hospital internment due to psoriasis (p= 0.00094, OR=7.8909) and in the ones with history of systemic treatment for psoriasis (p= 0.00011, OR= 5.3733). Haplotype HLA-A02 B57 C06 DRB107DQB103 was the most common among the patients (p= 0.00069, OR= 3.528).Conclusion: HLA-B57 and HLA-C06 were significantly increased in the patients indicating risk for psoriasis. HLA-B57 remained high in patients with history of erythroderma, hospital internment, systemic treatment, and psoriatic arthritis, showing association with disease severity. HLA-C18 was significantly high only in patients with psoriatic arthritis. HLA-B57 and HLA-C06 and haplotype HLA-A02B57Cw06DRB107 DQB103 seen in this study were already described before, associated with psoriasis. HLA-Cw18 was not described in other populations in association with psoriasis.Keywords: psoriasis, psoriatic arthritis, HLA, population study
Keywords	psoriasis ; psoriatic arthritis ; hla ; population study ; Specialties of internal medicine ; RC581-951
Subject code	610 ; 616
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
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