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Biomedical subjects

W Sequeira

Publications and source records attributed to W Sequeira.

At least 19 recordsLinked to original sources
PubMed2001

Raynaud's phenomenon.

Raynaud's phenomenon is characterised by episodic vasospasm of the fingers and toes typically precipitated by exposure to cold. Mild Raynaud's is common and is not usually a harbinger of clinically important disability; its onset, however, can be startling and uncomfortable for patients, and the well recognised association in some cases with systemic rheumatic conditions often precipitates aggressive assessments for underlying diseases. Advances in vascular physiology have shed light on the role of the endothelium as well as endothelium-independent mechanisms in the altered vasoregulation of Raynaud's. We review clinical aspects of the disorder and new insights with respect to pathophysiology, and we discuss potential new therapeutics based on the disease mechanism, such as prostacyclin analogues, serotonin antagonists, and calcitonin gene-related peptides.

Raynaud Disease↗
PubMed2001

Coronary artery disease in systemic lupus erythematosus: A review of the literature.

CONTEXT: Coronary artery occlusive disease is a common though underappreciated complication of systemic lupus erythematosus (SLE), typically a disease of young women. A case of a premenopausal patient with SLE and an acute myocardial infarction is presented, and the etiology and management of coronary artery disease in SLE reviewed. OBJECTIVES: To review the incidence, risk factors, pathology and treatment of coronary artery disease in systemic lupus erythematosus. DATA SOURCES: MEDLINE search of articles in English-language journals from 1980 to 2000. The index words "systemic lupus erythematosus" and the following co-indexing terms were used: "coronary artery disease," "atherosclerosis," "vasculitis," "anticardiolipin antibodies," "antiphospholipid syndrome." SELECTION SYNTHESIS AND ABSTRACTION: Papers identified were reviewed and abstracted by the authors with a presentation of a summary. RESULTS: The prevalence of coronary artery disease among women with SLE between the ages of 35 and 44 years is at least 50-fold greater than among age-matched control subjects. Of these, coronary atherosclerosis accounts for the vast majority of cases; vasculitis of the coronary arteries and other causes generally believed to be more typical of SLE are comparatively rare. CONCLUSIONS: The evidence suggests that SLE is a significant risk factor for coronary atherosclerosis independent of the classic risk factors of hypertension, tobacco use, and hyperlipidemia.

Adult↗
PubMed2000

Osteoarticular tuberculosis: current diagnosis and treatment.

Tuberculous synovitis frequently presents as a monoarthritis of weight-bearing joints such as the hip, knee, or ankle. Owing to its low incidence in developed countries, the diagnosis is often delayed for months to years. Early diagnosis with a synovial biopsy permits prompt antituberculous therapy and substantially improves the prospect of preservation of joint structure and function. Initial treatment typically includes combination therapy with four drugs (isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol) because of the frequency of isoniazid resistance. Antimicrobial therapy should be of at least 9 months' duration, longer in immunocompromised hosts. Partial synovectomy and other surgical procedures should be restricted to joints with severe cartilage destruction, large abscesses, joint deformity, multiple drug resistance, or atypical mycobacteria.

Adult↗
PubMed2000

Scleroderma lung: pathogenesis, evaluation, and current therapy.

Interstitial lung disease (ILD) is now the most common cause of mortality in scleroderma, although its pathogenesis remains poorly understood. Management requires early detection and treatment before the onset of lung fibrosis. In a number of uncontrolled studies, the combination of daily oral cyclophosphamide and low-dose prednisone appears to be effective, although these conclusions have yet to be confirmed.

Adrenal Cortex Hormones↗
PubMed1994

Arthritis associated with hidradenitis suppurativa.

OBJECTIVE: To review the presentation and clinical findings of arthritis associated with hidradenitis suppurativa. METHOD: Medical records from the rheumatology clinics of two major teaching hospitals were reviewed for arthritis and hidradenitis suppurativa. The nine patient records fulfilling these criteria were reviewed and compared with 20 previous reports. RESULTS AND CONCLUSION: The arthritis associated with hidradenitis suppurativa is rare and most commonly affects the peripheral joints. The axial skeleton is less frequently involved and is often asymptomatic.

Acne Vulgaris↗
PubMed1991

Cocaine and scleroderma: is there an association?

Scleroderma is a multisystem disease of unknown etiology. A disease predominantly of women, it is distinctly rare in young men. A case of scleroderma in a young male cocaine user is presented, and the possibility that cocaine may play a part in its etiology is explored.

Adult↗
PubMed1990

Sparing effect of hemiplegia on scleroderma.

The paretic limb is spared in patients who develop rheumatic diseases after a hemiplegic stroke. This has been described previously in rheumatoid arthritis, gout, and osteoarthritis. A similar presentation in a case of scleroderma is described in this report. Scleroderma skin changes are absent in the completely paretic limb and were markedly reduced in the weak left leg. Inflammation may be modified either by neuropeptides or by an anatomical neurological lesion and this may explain the phenomenon.

Arm↗
PubMed1989

Clinical relapse in systemic lupus erythematosus: correlation with antecedent elevation of urinary free light-chain immunoglobulin.

This paper reports preliminary evidence suggesting that measurements of free light-chain Ig (FLIg) in urine may represent quantitative markers of in vivo polyclonal B-cell activation. Thus, longitudinal levels of urinary FLIg in patients with systemic lupus erythematosus (SLE) may be used to track or monitor the in vivo immunopathologic B-cell activity of SLE and be helpful in predicting a disease relapse. Our findings showed that dramatic rises in urinary FLIg occurred during asymptomatic intervals that preceded by 4-8 weeks the first symptomatic signs of acute SLE relapse. These results suggest that a sizable lead time may exist between the occurrence of immunopathologic B-cell stimulation and the resultant symptoms and tissue damage of immune complex-induced acute inflammation. In these studies the measurement of urinary FLIg was accomplished by an indirect method using ng-sensitive radioimmunoassays (RIAs) that measured isotypic IgG, IgA, IgM, total kappa-Ig, and total lambda-Ig. As a control for the assessment of renal tubular function and the excretion of low molecular weight proteins in SLE patients, longitudinal measurements of beta-2-microglobulin (B2M) and lysozyme were made using a novel solid-phase 3H-biotin RIA technique.

Adult↗
PubMed1989

Genetic analysis of the claret locus of Drosophila melanogaster.

The claret (ca) locus of Drosophila melanogaster comprises two separately mutable domains, one responsible for eye color and one responsible for proper disjunction of chromosomes in meiosis and early cleavage divisions. Previously isolated alleles are of three types: (1) alleles of the claret (ca) type that affect eye color only, (2) alleles of the claret-nondisjunctional (cand) type that affect eye color and chromosome behavior, and (3) a meiotic mutation, non-claret disjunctional (ncd), that affects chromosome behavior only. In order to investigate the genetic structure of the claret locus, we have isolated 19 radiation-induced alleles of claret on the basis of the eye color phenotype. Two of these 19 new alleles are of the cand type, while 17 are of the ca type, demonstrating that the two domains do not often act as a single target for mutagenesis. This suggests that the two separately mutable functions are likely to be encoded by separate or overlapping genes rather than by a single gene. One of the new alleles of the cand type is a chromosome rearrangement with a breakpoint at the position of the claret locus. If this breakpoint is the cause of the mutant phenotype and there are no other mutations associated with the rearrangement, the two functions must be encoded by overlapping genes.

Alleles↗
PubMed1986

Serum angiotensin-converting enzyme levels in sarcoid arthritis.

The serum angiotensin-converting enzyme (SACE) level is elevated in 75% of patients with sarcoidosis and often is associated with disease activity. In an attempt to correlate the SACE level with sarcoid arthritis, we did a retrospective chart review of 116 patients with sarcoidosis. Of the 24 patients who complained of arthritis, five were excluded from the study because they were receiving corticosteroids, SACE levels were not determined, or another cause for their arthritis was found. The mean SACE levels were 65 units/mL for the patients with acute arthritis and 51 units/mL for the patients with chronic arthritis. Levels of SACE may be helpful in the differential diagnosis of patients with "seronegative polyarthritis."

Adult↗
PubMed1985

Septic arthritis in childhood.

We studied retrospectively the pattern of septic arthritis in childhood at a major municipal hospital during a ten-year period. Hemophilus influenzae was the most common organism in septic arthritis in patients less than two years old and was associated with upper respiratory tract infections in nine of 12 patients (75%). Staphylococcus aureus was seen in seven of eight (87.5%) children above the age of five and was associated with history of trauma. All patients were black. Despite the high incidence of sickle cell disease in our hospital population, not one patient had sickle cell disease.

Adolescent↗