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Biomedical subjects

Leslie Schrieber

Publications and source records attributed to Leslie Schrieber.

6 recordsLinked to original sources
PubMed2005

Immunotherapy of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a remarkably heterogeneous multisystem autoimmune disease. Improved understanding of the immunopathogenesis of this disorder over the past two decades is now being applied to therapy, with treatment being directed at specific immunological targets. This review will focus on both new uses for established therapies as well as on the introduction of novel agents. It is premature to claim that any one agent has superior efficacy to current therapies. However, the willingness of investigators supported by the pharmaceutical and biotechnology industries to evaluate the efficacy and safety of new products in controlled clinical trials may provide answers.

Humans↗
PubMed2005

Cognitive bias in systemic lupus erythematosus.

Evidence of cognitive bias in depression and anxiety has sparked an increasing interest in the potential for pain-related bias in patients suffering from chronic pain and/or illness. Research to date has been somewhat inconsistent, and the vast majority has been conducted on just two patient populations: rheumatoid arthritis (RA) and chronic pain patients. The present study investigates cognitive bias in Systemic Lupus Erythematosus (SLE) patients, particularly in relation to disease activity and depression. Forty-three SLE patients are compared to RA patients and healthy controls on their endorsement and recall of pain/illness words relative to depression and control words. Patients are first divided according to their disease activity, and secondly according to depression. SLE and RA patients self-endorsed more negative illness words and fewer positive illness words than did healthy controls, regardless of disease activity or depression status. Groups did not differ in their recall patterns, although all groups demonstrated a recall bias for positive words and illness words. Post-hoc analyses revealed a significant recall bias for disability-related illness words compared to sensory pain words in ill, depressed patients compared to ill, non-depressed patients and healthy controls. Consistent with the most recent research, it appears to be both the nature of the illness stimuli and the depression status of the patient that determines cognitive bias in chronically ill populations.

Adult↗
PubMed2004

Patient education.

There are a wide range of opportunities for arthritis patient education including individual or group counselling, printed notes and the Internet. Over the past 20 years efforts have been made to evaluate patient education programmes and determine if they are effective and, more recently, whether they are cost-effective. In the short term (up to 6-12 months) structured educational programmes have been demonstrated to increase patient knowledge and improve desirable behaviours such as relaxation, exercise and compliance with medications. More controversial has been the long term outcome (>12 months) of these programmes. Some studies indicate continuing benefit, albeit at reduced levels, compared to earlier evaluation points. Other studies, including a recent Cochrane report suggest that the beneficial effects are not sustained. In conclusion, patient education programmes have a modest, but significant, benefit on patient knowledge and behaviour, at least in the short term.

Arthritis, Rheumatoid↗
PubMed2002

Isolated fascicular oculomotor nerve palsy as the initial presentation of the antiphospholipid syndrome.

This case report describes a 24-year-old female who presented with sudden onset of painless diplopia and ptosis in her left eye. Examination identified an isolated incomplete pupil-sparing left oculomotor nerve palsy. Magnetic resonance imaging demonstrated focal hyperintensity in the left midbrain with infarction suggested by diffusion-weighted imaging. A diagnosis of primary antiphospholipid syndrome was made with the demonstration of a positive lupus anticoagulant. Other autoimmune markers were present on initial assessment, but did not fulfil diagnostic criteria for systemic lupus erythematosus. Anticoagulation with warfarin was commenced, with gradual resolution of neurological deficits. This case illustrates an unusual initial manifestation of primary antiphospholipid syndrome causing midbrain stroke in a young woman.

Adult↗
PubMedDate not supplied

PRISM: Enmeshment of illness and self-schema.

BACKGROUND: The Pictorial Representation of Illness and Self Measure (PRISM) is a recently developed tool purported to assess burden of suffering due to illness. The nature of the PRISM task suggests a conceptual link to the illness self-schema construct hypothesised to be present in some individuals with chronic illness. This study investigates the relationship between PRISM and schema as measured by cognitive bias. METHODS: 43 patients with systemic lupus erythematosus (SLE) completed an information-processing task involving endorsement of positive and negative illness words as descriptors of themselves, followed by free recall of the words. The outcome measures were endorsement and recall bias for negative illness words. Patients also completed the PRISM task and were assessed on other physical and psychological variables. RESULTS: PRISM did not correlate significantly with age, depression, functional impairment or disease activity. In a multiple regression analysis, only recall bias made an independent contribution to PRISM. CONCLUSIONS: Illness self-schema appears to play a significant role in determining the way in which SLE patients complete the PRISM task. This is discussed in light of a schema enmeshment model recently proposed in the cognitive bias literature.

Adult↗