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  1. Article ; Online: The 2022 ACR/EULAR classification criteria for Takayasu arteritis predict mortality better than the 1990 ACR classification criteria.

    Misra, Durga Prasanna / Rathore, Upendra / Jagtap, Swapnil / Singh, Kritika

    Rheumatology (Oxford, England)

    2024  

    Language English
    Publishing date 2024-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keae169
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  2. Article ; Online: Prevalence, predictors, and prognosis of serious infections in Takayasu arteritis - a cohort study.

    Misra, Durga Prasanna / Rathore, Upendra / Jagtap, Swapnil / Mishra, Prabhaker / Thakare, Darpan R / Singh, Kritika / Qamar, Tooba / Singh, Deeksha / Dixit, Juhi / Behera, Manas Ranjan / Jain, Neeraj / Ora, Manish / Bhadauria, Dharmendra Singh / Gambhir, Sanjay / Agarwal, Vikas / Kumar, Sudeep

    The Journal of rheumatology

    2024  

    Abstract: Objective: To describe the incidence, risk factors, and outcomes associated with serious infections in patients with Takayasu arteritis (TAK).: Methods: Serious infections (defined as infections resulting in hospitalization or death or unusual ... ...

    Abstract Objective: To describe the incidence, risk factors, and outcomes associated with serious infections in patients with Takayasu arteritis (TAK).
    Methods: Serious infections (defined as infections resulting in hospitalization or death or unusual infections like tuberculosis) were identified from a cohort of patients with TAK. Corticosteroids and disease-modifying anti-rheumatic drug (DMARD) use at the time of serious infection was noted. Demographic characteristics, clinical presentation, angiography, and disease activity at presentation and the use of DMARDs during follow-up were compared between patients with TAK with or without serious infections. Mortality in patients with TAK who developed serious infections was compared with those without was compared using hazard ratios (HR, with 95%CI).
    Results: Of 238 patients with TAK, 38 (15.97%) had developed serious infections (50 episodes, multiple episodes in 8, three episodes resulted in death). Among the 38 initial episodes, 11/38 occurred in those not on corticosteroids and 14/38 in those not on DMARDs. Pneumonia (n=19) was the most common infection, followed by tuberculosis (n=12). Patients with TAK who developed serious infections vs those without had higher disease activity at presentation (active disease 97.37% vs 69.50%, ITAS2010 12.66±7.29 vs 10.16±7.02, DEI.TAK 11.21± 6.14 vs 8.76±6.07) and more frequently were initiated on corticosteroids or DMARDs. Hazard ratios calculated using exponential parametric regression survival-time model revealed increased mortality rate in patients with TAK who developed serious infections (HR 5.52, 95%CI 1.75-17.39).
    Conclusion: Serious infections, which occurred in the absence of immunosuppressive treatment in about one-fifth, were associated with increased mortality in patients with TAK.
    Language English
    Publishing date 2024-04-01
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.2023-1254
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  3. Article ; Online: Increased mortality rate in Takayasu arteritis is largely driven by cardiovascular disease-a cohort study.

    Jagtap, Swapnil / Mishra, Prabhaker / Rathore, Upendra / Thakare, Darpan R / Singh, Kritika / Dixit, Juhi / Qamar, Tooba / Behera, Manas Ranjan / Jain, Neeraj / Ora, Manish / Bhadauria, Dharmendra Singh / Gambhir, Sanjay / Kumar, Sudeep / Agarwal, Vikas / Misra, Durga Prasanna

    Rheumatology (Oxford, England)

    2023  

    Abstract: Objectives: To analyze the risk, causes, and predictors of mortality in Takayasu arteritis (TAK).: Methods: Survival was assessed in a cohort of patients with TAK using Kaplan-Meier curves. Age- and sex-standardized mortality ratio (SMR = observed: ... ...

    Abstract Objectives: To analyze the risk, causes, and predictors of mortality in Takayasu arteritis (TAK).
    Methods: Survival was assessed in a cohort of patients with TAK using Kaplan-Meier curves. Age- and sex-standardized mortality ratio (SMR = observed: expected deaths) for TAK were calculated by applying age- and sex-specific mortality rates for the local population to calculate expected deaths. Hazard ratios (HR with 95%CI) for predictors of mortality based on demographic characteristics, presenting features, baseline angiographic involvement, disease activity, number of immunosuppressive medications used, procedures related to TAK, and any serious infection were calculated using Cox regression or exponential parametric regression models.
    Results: Among 224 patients with TAK (159 females, mean follow-up duration 44.36 months), survival at 1, 2, 5, and 10 years was 97.34%, 96.05%, 93.93%, and 89.23%, respectively. Twelve deaths were observed, most of which were due to cardiovascular disease (heart failure, myocardial infarction, stroke). Mortality risk was significantly higher with TAK (SMR 17.29, 95%CI 8.95-30.11) than the general population. Earlier age at disease onset (HR 0.90, 95%CI 0.83-0.98; or pediatric-onset vs adult-onset disease, HR 5.51, 95%CI 1.57-19.32), higher disease activity scores (ITAS2010: HR 1.15, 95%CI 1.05-1.25, DEI.TAK: HR 1.18, 95%CI 1.08-1.29), any serious infections (HR 5.43, 95%CI 1.72-17.12), heart failure (HR 7.83, 95%CI 2.17-28.16), or coeliac trunk involvement at baseline (HR 4.01, 95%CI 1.26-12.75) were associated with elevated mortality risk.
    Conclusion: Patients with TAK had an elevated risk of mortality as compared with the general population. Cardiovascular disease was the leading cause of death in TAK.
    Language English
    Publishing date 2023-11-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kead584
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  4. Article ; Online: Pre-Pulseless Takayasu Arteritis is Associated with Distinct Clinical and Angiographic Features but Similar Outcomes - A Cohort Study.

    Misra, Durga Prasanna / Rathore, Upendra / Jagtap, Swapnil / Mishra, Prabhaker / Thakare, Darpan R / Singh, Kritika / Qamar, Tooba / Singh, Deeksha / Dixit, Juhi / Behera, Manas Ranjan / Jain, Neeraj / Ora, Manish / Bhadauria, Dharmendra Singh / Gambhir, Sanjay / Agarwal, Vikas / Kumar, Sudeep

    Mediterranean journal of rheumatology

    2023  Volume 34, Issue 4, Page(s) 427–435

    Abstract: Objectives: To compare the presentation, angiographic features, evolution, and prognosis of prepulseless Takayasu arteritis (TAK) with TAK with pulse loss.: Methods: Pre-pulseless TAK (defined as without pulse loss in the upper limbs, lower limb, ... ...

    Abstract Objectives: To compare the presentation, angiographic features, evolution, and prognosis of prepulseless Takayasu arteritis (TAK) with TAK with pulse loss.
    Methods: Pre-pulseless TAK (defined as without pulse loss in the upper limbs, lower limb, carotid, or subclavian arteries) were identified from a cohort of TAK. Demographic characteristics, clinical features, angiographic involvement, baseline and longitudinal patterns of disease activity, medication use, and mortality rates were compared between pre-pulseless TAK and TAK with pulse loss. Adjusted odds ratios (aOR, with 95%CI) for categorical variables between pre-pulseless TAK and TAK with pulse loss were computed using multivariable-adjusted logistic regression models. Time-to-event data was compared using hazard ratios (HR) with 95%CI.
    Results: Compared with TAK with pulse loss, pre-pulseless TAK (91/238, 38.24%) more frequently had deranged renal function (aOR 4.43, 95%CI 1.58-12.37) and Hata's type IV disease (aOR 8.02, 95%CI 2.61-24.65), and less often had pulse or blood pressure asymmetry (aOR 0.34, 95%CI 0.18-0.63), limb claudication (aOR for upper limb 0.38, 95%CI 0.18-0.82, for lower limb 0.28, 95%CI 0.12-0.68), right subclavian (aOR 0.45, 95%CI 0.23-0.90) or left carotid artery involvement (aOR 0.42, 95%CI 0.21-0.84). Only two patients with pre-pulseless TAK developed pulse loss on follow-up. Despite fewer pre-pulseless TAK having active disease at presentation, similar proportions of patients in both groups had active disease on follow-up. Survival was similar in both groups (HR for mortality 0.41, 95%CI 0.09-1.90).
    Conclusion: Pulse loss on follow-up is uncommon in those with prepulseless TAK. Pre-pulseless TAK is associated with similar long-term outcomes to TAK with pulse loss.
    Language English
    Publishing date 2023-12-30
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 3019943-8
    ISSN 2529-198X ; 2459-3516
    ISSN (online) 2529-198X
    ISSN 2459-3516
    DOI 10.31138/mjr.301223.ppt
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  5. Article ; Online: Effect of immunosuppression on pathogenesis of peste des petits ruminants (PPR) virus infection in goats.

    Jagtap, Swapnil Pandurang / Rajak, Kaushal Kishor / Garg, Umesh Kumar / Sen, Arnab / Bhanuprakash, Veerakyathappa / Sudhakar, Shashi Bhusan / Balamurugan, Vinayagamurthy / Patel, Arun / Ahuja, Anuj / Singh, Raj Kumar / Vanamayya, Pothukuchi Rama

    Microbial pathogenesis

    2012  Volume 52, Issue 4, Page(s) 217–226

    Abstract: In this study an attempt to address the effects of immunosuppression on pathogenesis of peste des petits ruminants (PPR) virus infection was undertaken. Cyclophosphamide and dexamethasone were used to immunosuppress the animals. The drug treated animals ... ...

    Abstract In this study an attempt to address the effects of immunosuppression on pathogenesis of peste des petits ruminants (PPR) virus infection was undertaken. Cyclophosphamide and dexamethasone were used to immunosuppress the animals. The drug treated animals exhibited severe leukopaenia and lymphopaenia; one of the indicators of immunosuppression. Experimental peste des petits ruminants virus (PPRV) infection was then given to both drug-induced immunosuppressed and non-immunosuppressed goats and observed their effects. Findings indicated that, the immunosuppressed goats had a short period of viremia, more extensive and severe disease advancement and higher mortality rate than the non-immunosuppressed goats. PPRV antigen distribution in both ante-mortem and post-mortem materials was extensive and diffused in immunosuppressed animals than that of non-immunosuppressed. Some of the atypical organ(s)/tissues like liver, kidney, heart etc showed more antigen load than non-immunosuppressed group. Histopathological and immunohistochemical studies of tissues from the two groups showed that pathological changes in the non-immunosuppressed animals were confined only to gastrointestinal tract, whereas in the immunosuppressed animals histopathological changes and PPRV antigen distribution were more extensive and diffused. The present study indicated that immunosuppression increased the extent and severity of the pathological lesions associated with peste des petits ruminants virus infection.
    MeSH term(s) Animals ; Goat Diseases/chemically induced ; Goat Diseases/immunology ; Goat Diseases/virology ; Goats ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/pharmacology ; Peste-des-Petits-Ruminants/chemically induced ; Peste-des-Petits-Ruminants/immunology ; Peste-des-Petits-Ruminants/veterinary ; Peste-des-Petits-Ruminants/virology ; Peste-des-petits-ruminants virus/drug effects ; Peste-des-petits-ruminants virus/immunology ; Peste-des-petits-ruminants virus/pathogenicity ; Peste-des-petits-ruminants virus/physiology
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2012-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 632772-2
    ISSN 1096-1208 ; 0882-4010
    ISSN (online) 1096-1208
    ISSN 0882-4010
    DOI 10.1016/j.micpath.2012.01.003
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  6. Article: Effect of immunosuppression on pathogenesis of peste des petits ruminants (PPR) virus infection in goats

    Jagtap, Swapnil Pandurang / Rajak, Kaushal Kishor / Garg, Umesh Kumar / Sen, Arnab / Bhanuprakash, Veerakyathappa / Sudhakar, Shashi Bhusan / Balamurugan, Vinayagamurthy / Patel, Arun / Ahuja, Anuj / Singh, Raj Kumar / Vanamayya, Pothukuchi Rama

    Microbial pathogenesis

    Volume v. 52,, Issue no. 4

    Abstract: In this study an attempt to address the effects of immunosuppression on pathogenesis of peste des petits ruminants (PPR) virus infection was undertaken. Cyclophosphamide and dexamethasone were used to immunosuppress the animals. The drug treated animals ... ...

    Abstract In this study an attempt to address the effects of immunosuppression on pathogenesis of peste des petits ruminants (PPR) virus infection was undertaken. Cyclophosphamide and dexamethasone were used to immunosuppress the animals. The drug treated animals exhibited severe leukopaenia and lymphopaenia; one of the indicators of immunosuppression. Experimental peste des petits ruminants virus (PPRV) infection was then given to both drug-induced immunosuppressed and non-immunosuppressed goats and observed their effects. Findings indicated that, the immunosuppressed goats had a short period of viremia, more extensive and severe disease advancement and higher mortality rate than the non-immunosuppressed goats. PPRV antigen distribution in both ante-mortem and post-mortem materials was extensive and diffused in immunosuppressed animals than that of non-immunosuppressed. Some of the atypical organ(s)/tissues like liver, kidney, heart etc showed more antigen load than non-immunosuppressed group. Histopathological and immunohistochemical studies of tissues from the two groups showed that pathological changes in the non-immunosuppressed animals were confined only to gastrointestinal tract, whereas in the immunosuppressed animals histopathological changes and PPRV antigen distribution were more extensive and diffused. The present study indicated that immunosuppression increased the extent and severity of the pathological lesions associated with peste des petits ruminants virus infection.
    Keywords dexamethasone ; heart ; immunohistochemistry ; viremia ; histopathology ; pathogenesis ; Peste-des-petits-ruminants virus ; goats ; cyclophosphamide ; kidneys ; peste des petits ruminants ; mortality ; viruses ; liver ; antigens ; gastrointestinal system
    Language English
    Document type Article
    ISSN 0882-4010
    Database AGRIS - International Information System for the Agricultural Sciences and Technology

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