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Article ; Online: T cell involvement in antiphospholipid syndrome.

Tektonidou, Maria G / Vlachogiannis, Nikolaos I / Sfikakis, Petros P

2024 Volume 263, Page(s) 110218

Abstract: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by arterial and venous thrombosis, and obstetric complications in the presence of antiphospholipid antibodies (aPL), including lupus anticoagulant, anticardiolipin and anti- ... ...

Abstract	Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by arterial and venous thrombosis, and obstetric complications in the presence of antiphospholipid antibodies (aPL), including lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein I antibodies. APS manifests as single, often as recurrent events, and rarely as a catastrophic condition. Most studies of APS pathogenesis to date have focused on the prothrombotic role of aPL, while innate immune responses such as monocyte, complement and neutrophil activation have been also recognized as part of the thrombo-inflammatory cascade in APS. While the presence of autoreactive T cells against β2-glycoprotein I has been long known, less data are available on their pathogenetic role in APS. In this review, we summarize current knowledge on the involvement of T cells in APS pathophysiology, alterations of T cell subsets in peripheral blood, and clinical associations. We also highlight potential therapeutic opportunities by targeting T helper-B cell interactions in these patients.
Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1459903-x
ISSN	1521-7035 ; 1521-6616
ISSN (online)	1521-7035
ISSN	1521-6616
DOI	10.1016/j.clim.2024.110218
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Article ; Online: Cortisol and DHEAS in COVID-19.

Yavropoulou, Maria P / Sfikakis, Petros P

Hormones (Athens, Greece)

2022 Volume 22, Issue 1, Page(s) 13–14

MeSH term(s)	Humans ; Hydrocortisone ; COVID-19 ; Dehydroepiandrosterone Sulfate ; Dehydroepiandrosterone
Chemical Substances	Hydrocortisone (WI4X0X7BPJ) ; Dehydroepiandrosterone Sulfate (57B09Q7FJR) ; Dehydroepiandrosterone (459AG36T1B)
Language	English
Publishing date	2022-11-14
Publishing country	Switzerland
Document type	Letter ; Comment
ZDB-ID	2075912-5
ISSN	2520-8721 ; 1109-3099
ISSN (online)	2520-8721
ISSN	1109-3099
DOI	10.1007/s42000-022-00417-3
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Article ; Online: 7-year follow-up atherosclerotic plaque progression in patients with antiphospholipid syndrome versus diabetes mellitus and healthy controls.

Evangelatos, Gerasimos / Tentolouris, Nikolaos / Sfikakis, Petros P / Tektonidou, Maria G

Rheumatology (Oxford, England)

2024

Abstract: Objectives: Patients with antiphospholipid syndrome (APS) carry a substantial burden of cardiovascular disease and subclinical atherosclerosis. We aimed to assess a 7-year follow-up atherosclerotic plaque progression in APS patients vs diabetes mellitus ...

Abstract	Objectives: Patients with antiphospholipid syndrome (APS) carry a substantial burden of cardiovascular disease and subclinical atherosclerosis. We aimed to assess a 7-year follow-up atherosclerotic plaque progression in APS patients vs diabetes mellitus (DM) and healthy controls (HC). Methods: Eighty-six patients with thrombotic APS, 86 with DM and 86 HC (all age- and sex-matched) who underwent a baseline ultrasound of carotid and femoral arteries were invited for a 7-year follow-up ultrasonography examination. We compared atherosclerosis progression among the three groups and examined determinants of plaque progression in APS patients. Results: Sixty-four APS patients (75% females, 43.8% with primary APS), 58 patients with DM and 66 HC were included in the 7-year ultrasound re-evaluation. New plaque was detected in 51.6%, 36.2% and 25.8% of APS, DM and HC subjects, respectively. After adjusting for traditional cardiovascular risk factors (CVRFs) and baseline plaque presence, APS patients showed a 3-fold (OR = 3.07, p= 0.007) higher risk for atherosclerosis progression vs HC and 2-fold (OR = 2.25, p= 0.047) higher risk than DM patients. In multivariate analysis in the APS group, plaque progression was independently associated with systemic lupus erythematosus (SLE) co-existence (OR = 7.78, p= 0.005) and number of CVRFs (OR = 3.02, p= 0.002), after adjusting for disease-related parameters and CVRF-related medications. Sustained low-density lipoprotein target attainment reduced plaque progression risk (OR = 0.34, p= 0.021). Conclusion: Half of APS patients develop new atherosclerotic plaques over a 7-year follow-up, having a three-times higher risk vs HC. Concomitant SLE and number of traditional CVRFs are associated with plaque progression, supporting the need for thorough CVRF assessment and control.
Language	English
Publishing date	2024-02-06
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/keae097
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Article ; Online: Comment on: Beneficial effects of nintedanib on cardiomyopathy in patients with systemic sclerosis: a pilot study.

Sfikakis, Petros P / Panopoulos, Stylianos / Mavrogeni, Sofia

Rheumatology (Oxford, England)

2023 Volume 62, Issue 9, Page(s) e276–e277

MeSH term(s)	Humans ; Pilot Projects ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/drug therapy ; Lung Diseases, Interstitial ; Cardiomyopathies/drug therapy ; Cardiomyopathies/etiology
Chemical Substances	nintedanib (G6HRD2P839)
Language	English
Publishing date	2023-01-26
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/kead036
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Article ; Online: Lipid management in systemic lupus erythematosus according to risk classifiers suggested by the European Society of Cardiology and disease-related risk factors reported by the EULAR recommendations.

Drosos, George C / Konstantonis, George / Sfikakis, Petros P / Tektonidou, Maria G

RMD open

2023 Volume 9, Issue 1

Abstract: Background: The European Alliance of Associations for Rheumatology recommended that lipid-lowering therapy (LLT) in systemic lupus erythematosus (SLE) should follow general population guidelines. We examined the eligibility for LLT in SLE according to ... ...

Abstract	Background: The European Alliance of Associations for Rheumatology recommended that lipid-lowering therapy (LLT) in systemic lupus erythematosus (SLE) should follow general population guidelines. We examined the eligibility for LLT in SLE according to Systematic Coronary Risk Evaluation (SCORE), with and without the addition of vascular ultrasound (VUS) and disease-related features. Methods: 210 patients with SLE without prior cardiovascular events, diabetes or antiphospholipid syndrome underwent cardiovascular risk assessment with SCORE. LLT eligibility was evaluated in low-risk and moderate-risk patients following European Society of Cardiology (ESC) guidelines. Atherosclerotic plaques on carotid ultrasound (cUS)) and carotid and femoral ultrasound (cfUS), prolonged disease duration (PDD, ≥10 years), failure to achieve lupus low disease activity state (LLDAS Results: Plaques were detected in 9.9% of low-risk cases and 54.6% of moderate-risk cases. SCORE alone would indicate 0% of low-risk patients and 3% of moderate-risk patients for LLT eligibility. According to SCORE+cfUS, 9.9% of low-risk patients and 57.6% of moderate-risk patients, respectively, would be eligible for LLT based on ESC guidelines. Ιn low-risk/moderate-risk patients, phi values for SCORE+PDD, GC Conclusion: Disease-related and VUS features, in addition to SCORE, may help to improve LLT decision making in SLE. GC
MeSH term(s)	Humans ; Risk Factors ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/drug therapy ; Plaque, Atherosclerotic ; Antibodies, Antiphospholipid ; Cardiology ; Lipids
Chemical Substances	Antibodies, Antiphospholipid ; Lipids
Language	English
Publishing date	2023-01-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2812592-7
ISSN	2056-5933 ; 2056-5933
ISSN (online)	2056-5933
ISSN	2056-5933
DOI	10.1136/rmdopen-2022-002767
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Article ; Online: Application of EULAR and European Society of Cardiology recommendations with regard to blood pressure and lipid management in antiphospholipid syndrome.

Drosos, George C / Konstantonis, George / Sfikakis, Petros P / Tektonidou, Maria G

RMD open

2023 Volume 9, Issue 3

Abstract: Background: To examine blood pressure (BP) and lipid treatment eligibility in antiphospholipid syndrome (APS) according to European Alliance of Associations for Rheumatology (EULAR) and European Society of Cardiology (ESC) recommendations.: Methods: ... ...

Abstract	Background: To examine blood pressure (BP) and lipid treatment eligibility in antiphospholipid syndrome (APS) according to European Alliance of Associations for Rheumatology (EULAR) and European Society of Cardiology (ESC) recommendations. Methods: Systematic Coronary Risk Evaluation (SCORE), modified-SCORE, diabetes mellitus (DM)-equivalent risk classifiers (DIME) and disease-related classifiers -type of thrombotic events (APS Results: SCORE underestimated high/very-high-AR in >50% of cases. SCORE-guided BP/lipid treatment eligibility was 4.2%/12.6% for high, 10.5%/16.8% for very-high AR patients, while 5.3% of low-moderate AR cases were eligible for lipid-lowering therapy. For BP treatment, MCC was higher using DIME for low-moderate and very-high-risk (0.33 and 0.32, respectively), and using modified-SCORE+APS Conclusion: Multimodal risk assessment including disease-related and cardiometabolic features used for high-risk diseases such as DM can improve CVR management in APS.
MeSH term(s)	Humans ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnosis ; Antiphospholipid Syndrome/drug therapy ; Risk Factors ; Blood Pressure ; Rheumatology ; Cardiology ; Lipids
Chemical Substances	Lipids
Language	English
Publishing date	2023-08-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2812592-7
ISSN	2056-5933 ; 2056-5933
ISSN (online)	2056-5933
ISSN	2056-5933
DOI	10.1136/rmdopen-2023-003326
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Article ; Online: Cardiovascular risk assessment in patients with antiphospholipid syndrome: a cross-sectional performance analysis of nine clinical risk prediction tools.

Drosos, George C / Konstantonis, George / Sfikakis, Petros P / Tektonidou, Maria G

RMD open

2023 Volume 9, Issue 4

Abstract: Objectives: This study aimed to assess the performance of cardiovascular risk (CVR) prediction models reported by European Alliance of Associations for Rheumatology and European Society of Cardiology recommendations to identify high-atherosclerotic CVR ( ...

Abstract	Objectives: This study aimed to assess the performance of cardiovascular risk (CVR) prediction models reported by European Alliance of Associations for Rheumatology and European Society of Cardiology recommendations to identify high-atherosclerotic CVR (ASCVR) patients with antiphospholipid syndrome (APS). Methods: Six models predicting the risk of a first cardiovascular disease event (first-CVD) (Systematic Coronary Risk Evaluation (SCORE); modified-SCORE; Framingham risk score; Pooled Cohorts Risk Equation; Prospective Cardiovascular Münster calculator; Globorisk), three risk prediction models for patients with a history of prior arterial events (recurrent-CVD) (adjusted Global APS Score (aGAPSS); aGAPSS Results: Spiegelhalter's z-test p values 0.47-0.57, area under the receiver-operating characteristics curve (AUROC) 0.56-0.75 and Matthews correlation coefficient (MCC) 0.01-0.35 indicated moderate calibration, poor-to-acceptable discrimination and negligible-to-moderate classification accuracy, respectively, for all risk models. Among recurrent-CVD tools, SMART and aGAPSS Conclusion: Clinical CVR prediction tools underestimate actual high ASCVR in APS. VUS may help to improve CVR assessment and optimal risk factor management.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnosis ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Risk Factors ; Prospective Studies ; Cross-Sectional Studies ; Heart Disease Risk Factors
Language	English
Publishing date	2023-11-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2812592-7
ISSN	2056-5933 ; 2056-5933
ISSN (online)	2056-5933
ISSN	2056-5933
DOI	10.1136/rmdopen-2023-003601
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Article ; Online: Metabolic syndrome in antiphospholipid syndrome versus rheumatoid arthritis and diabetes mellitus: Association with arterial thrombosis, cardiovascular risk biomarkers, physical activity, and coronary atherosclerotic plaques.

Bolla, Eleana / Tentolouris, Nikolaos / Sfikakis, Petros P / Tektonidou, Maria G

Frontiers in immunology

2023 Volume 13, Page(s) 1077166

Abstract: Background: Cardiovascular disease (CVD) is the foremost cause of morbidity and deaths in antiphospholipid syndrome (APS), driven by thrombo-inflammation and atherothrombosis mechanisms. Metabolic syndrome (MetS) is a proinflammatory and prothrombotic ... ...

Abstract	Background: Cardiovascular disease (CVD) is the foremost cause of morbidity and deaths in antiphospholipid syndrome (APS), driven by thrombo-inflammation and atherothrombosis mechanisms. Metabolic syndrome (MetS) is a proinflammatory and prothrombotic state characterized by increased CVD risk. We aimed to evaluate the prevalence of MetS in APS patients compared to rheumatoid arthritis (RA) and diabetes mellitus (DM) and its associations with clinical and laboratory patient characteristics and vascular ultrasound (US) markers of subclinical atherosclerosis. Methods: We included 414 patients in our study: 138 patients with APS (median age: 44.9 years, females 70%) and matched 1:1 for age and sex RA and DM subjects. Three sets of criteria were used for MetS diagnosis: Joint Interim Statement (JIS), International Diabetes Federation (IDF) and modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). The demographic, clinical and laboratory characteristics of all participants were recorded and carotid and femoral US was performed in patients with APS. Multivariate regression models were applied. Results: Prevalence of MetS was 23.9%, 23.2%, 20.3% (based on JIS, IDF, modified NCEP-ATPIII criteria, respectively) in APS versus 17.4%, 17.4%, 13% in RA (p=0.181, p=0.231, p=0.106, respectively), and 44.2%, 44.2%, 40.6% in DM patients. In multivariate analysis, patients with systemic lupus erythematosus- related APS had an approximately 2.5-fold higher risk of MetS versus RA patients. MetS in APS was independently associated with arterial thrombosis (Odds ratio 3.5, p=0.030). Odds ratio for MetS was 1.16 for each one unit increase in C-reactive protein levels according to JIS and IDF criteria, and 1.49 and 1.47 for each one unit increase in uric acid levels using the IDF and modified NCEP-ATPIII models, respectively. APS patients with atherosclerotic carotid plaques had 4 to 6.5-fold increased risk of MetS. Odds for MetS were decreased by 26% with an increase in physical activity by one hour per week. Conclusions: MetS is present in approximately one-fourth of APS patients at a comparable prevalence to that observed in patients with RA. MetS in APS is associated with arterial thrombosis, cardiovascular risk biomarkers, physical activity, and subclinical atherosclerosis, supporting its role in cardiovascular risk stratification and management in APS.
MeSH term(s)	Adult ; Female ; Humans ; Middle Aged ; Antiphospholipid Syndrome/complications ; Arthritis, Rheumatoid/complications ; Arthritis, Rheumatoid/epidemiology ; Atherosclerosis/epidemiology ; Atherosclerosis/complications ; Biomarkers ; Cardiovascular Diseases/etiology ; Diabetes Mellitus ; Exercise ; Heart Disease Risk Factors ; Metabolic Syndrome/epidemiology ; Plaque, Atherosclerotic/epidemiology ; Risk Factors ; Thrombosis/epidemiology ; Thrombosis/complications ; Male
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-01-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.1077166
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Article: Microwave Radiometry for the Diagnosis and Monitoring of Inflammatory Arthritis.

Laskari, Katerina / Siores, Elias / Tektonidou, Maria M / Sfikakis, Petros P

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 4

Abstract: The ability of microwave radiometry (MWR) to detect with high accuracy in-depth temperature changes in human tissues is under investigation in various medical fields. The need for non-invasive, easily accessible imaging biomarkers for the diagnosis and ... ...

Abstract	The ability of microwave radiometry (MWR) to detect with high accuracy in-depth temperature changes in human tissues is under investigation in various medical fields. The need for non-invasive, easily accessible imaging biomarkers for the diagnosis and monitoring of inflammatory arthritis provides the background for this application in order to detect the local temperature increase due to the inflammatory process by placing the appropriate MWR sensor on the skin over the joint. Indeed, a number of studies reviewed herein have reported interesting results, suggesting that MWR is useful for the differential diagnosis of arthritis as well as for the assessment of clinical and subclinical inflammation at the individual large or small joint level and the patient level. MWR showed higher agreement with musculoskeletal ultrasound, used as a reference, than with clinical examination in rheumatoid arthritis (RA), while it also appeared useful for the assessment of back pain and sacroiliitis. Further studies with a larger number of patients are warranted to confirm these findings, taking into account the current limitations of the available MWR devices. This may lead to the production of easily accessible and inexpensive MWR devices that will provide a powerful impetus for personalized medicine.
Language	English
Publishing date	2023-02-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13040609
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Article: Original research on Behçet's syndrome: a bibliometric analysis over 20 years (2000-2019).

Bolla, Eleana / Chatzidionysiou, Katerina / Tektonidou, Maria G / Sfikakis, Petros P

Clinical and experimental rheumatology

2023 Volume 41, Issue 10, Page(s) 1985–1990

Abstract: Objectives: We aimed to perform a bibliometric analysis of original research articles on Behçet's syndrome (BS) published over the last 20 years prior to the COVID-19 pandemic, and to systematically describe their characteristics and citation records.!## ...

Abstract	Objectives: We aimed to perform a bibliometric analysis of original research articles on Behçet's syndrome (BS) published over the last 20 years prior to the COVID-19 pandemic, and to systematically describe their characteristics and citation records. Methods: The PubMed database was searched for any article published on BS between 2000 and 2019. We identified all original research articles and categorised them by country of origin and type of research, i.e., clinical, translational and basic. Each article's impact was assessed using the individual citation numbers from Google Scholar search engine; we also calculated the median annual citation rates (ACRs), both per country and research type. Results: Of a total of 2,381 retrieved original articles from 51 countries, the majority reported on clinical (52.6%), followed by translational (46.0%) and basic research (1.4%). Turkey had the highest number of publications (39% of articles) followed by four countries (Korea, China, Japan, Italy) where BS is also relatively prevalent. However, regarding median ACRs, France was first, followed by the United Kingdom, Germany and Collaboration. Although the number of articles has almost doubled between 2010-2019 versus 2000-2009, median ACRs across either clinical or translational research had a downwards trend. Conclusions: Researchers from countries where BS is prevalent are more productive, albeit their work is of lower impact compared to countries with generally higher research budgets. A considerable increase of original research articles on BS is observed over time but further funding may be warranted for a parallel increase in the respective scientific impact.
MeSH term(s)	Humans ; Behcet Syndrome/diagnosis ; Behcet Syndrome/epidemiology ; Pandemics ; Bibliometrics ; Germany ; China ; Biomedical Research
Language	English
Publishing date	2023-02-14
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
DOI	10.55563/clinexprheumatol/rq72g6
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