Proceedings From the American College of Rheumatology Reproductive Health Summit: The Management of Fertility, Pregnancy, and Lactation in Women With Autoimmune and Systemic Inflammatory Diseases

2015 ◽  
Vol 67 (3) ◽  
pp. 313-325 ◽  
Author(s):  
Arthur Kavanaugh ◽  
John J. Cush ◽  
Mahmoud S. Ahmed ◽  
Bonnie L. Bermas ◽  
Eliza Chakravarty ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Inflammatory Diseases ◽  
American College Of Rheumatology ◽  
Pregnancy And Lactation

scholarly journals CLINICAL LABORATORY INVESTIGATION OF REPRODUCTIVE HEALTH OF WOMEN LIVING IN ECOLOGICALLY UNFAVORABLE REGIONS OF KAZAKHSTAN

2018 ◽  
Vol 97 (4) ◽  
pp. 297-300
Author(s):  
Ya. G. Turdybekova ◽  
A. A. Kelmyalene ◽  
Berikbai Zh. Kultanov
Keyword(s):  
Reproductive Health ◽  
Clinical Laboratory ◽  
Inflammatory Diseases ◽  
Ecological Factors ◽  
Aral Sea ◽  
Environmental Crisis ◽  
Anthropogenic Factors ◽  
Female Population ◽  
The Impact ◽  
Karaganda Region

In the area under study, mainly saline and solonetsous territories. The situation negatively affects the offspring of the population living in the region Continuing the work on assessing the impact of climatic and anthropogenic factors of the Aral region on the reproductive health of the female population, we compared the reproductive health of women living in five settlements of the Kyzylorda region and two settlements in the Karaganda region. There were observed 686 women in the zone of environmental crisis, 720 women living in the zone of environmental disaster and 388 women living in the Karaganda region in areas bordering the Aral Sea region. The examination was carried out on the basis of an integrated clinical-functional and laboratory examination, taking into account regional and environmental ecological factors. In the Kyzylorda region, there is a delayed onset of menarche occurred in girls older than 16 years (39%), there is a tendency to rejuvenate the age of the onset of menopause. In the Karaganda region, late menarche occurs only in 12% of cases. A third of the examined women suffered from inflammatory diseases of female genital organs in both regions. Perinatal losses, cases of spontaneous interruption and/or undeveloped pregnancies in the anamnesis are repeated many times, in zones of the ecological catastrophe and the environmental crisis there are frequent as one in four women. However, in the Karaganda region, this value figure was almost 3 times less (14%).

scholarly journals 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases

2020 ◽  
Vol 72 (4) ◽  
pp. 461-488 ◽  
Author(s):  
Lisa R. Sammaritano ◽  
Bonnie L. Bermas ◽  
Eliza E. Chakravarty ◽  
Christina Chambers ◽  
Megan E. B. Clowse ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Musculoskeletal Diseases ◽  
American College Of Rheumatology

Metabolic and cardiovascular benefits of hydroxychloroquine in patients with rheumatoid arthritis: a systematic review and meta-analysis

2017 ◽  
Vol 77 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Claire Rempenault ◽  
Bernard Combe ◽  
Thomas Barnetche ◽  
Cécile Gaujoux-Viala ◽  
Cédric Lukas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Diseases ◽  
Meta Analysis ◽  
Survival Rates ◽  
Cochrane Library ◽  
Diabetes Incidence ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Mean Differences ◽  
High Density Cholesterol

ObjectiveCardiovascular disease (CVD) is the leading cause of mortality in patients with rheumatoid arthritis (RA). Hydroxychloroquine (HCQ) has been shown to improve survival rates in other inflammatory diseases. We aimed to assess the available literature on the cardiovascular impact of HCQ in patients with RA.MethodsWe systematically searched for studies evaluating the effects of HCQ on cardiovascular outcomes of known risk factors for CVD in patients with RA. Databases searched were MEDLINE (via PubMed), EMBase, Cochrane Library and the American College of Rheumatology and European League Against Rheumatism annual meetings. A meta-analysis was performed with a random-effects model, estimating mean differences (MDs), HRs and 95% CIs. Data were extracted by one investigator and independently checked by another.ResultsThe literature search revealed 185 articles and abstracts of interest; further examination resulted in 16 studies fulfilling the criteria. The MDs between HCQ users and non-users in levels of total, low-density and high-density cholesterol and triglycerides were −9.8 (95% CI −14.0 to −5.6), −10.6 (95% CI −14.2 to −7.0), +4.1 (95% CI 2.2 to 6.0) and −19.2 (95% CI −27.2 to −11.1), respectively. Diabetes incidence was lower for HCQ ever users than never users (HR 0.59 (95% CI 0.49 to 0.70)). HCQ seemed to decrease insulin resistance and incidence of CVD, but data were too few for meta-analysis.ConclusionBesides its limited efficacy for disease activity and progression, HCQ may benefit the metabolic profile and to a lesser extent cardiovascular events in patients with RA, which suggests its usefulness combined with other conventional synthetic disease-modifying antirheumatic drugs.

Analysis of gynecological morbidity and the trend of development of stationary gynecological care in the Russian Federation

2020 ◽  
Vol 26 (4) ◽  
Author(s):  
Anna V. Fomina ◽  
Fatima G. Dzidzarija ◽  
Evgenia V. Bivol
Keyword(s):  
Reproductive Health ◽  
Russian Federation ◽  
Inflammatory Diseases ◽  
Reproductive Potential ◽  
Emergency Situation ◽  
Federal District ◽  
Federal State ◽  
The Russian Federation ◽  
Gynecological Care ◽  
The City

Background: Due to a quantitative decrease in the demographic reserve and a qualitative decrease in the reproductive potential of the country, protecting the reproductive health of women in Russia has now become an emergency situation. The obstetric and gynecological service is of major importance in maintaining reproductive health and conducting a comprehensive demographic policy. This study aimed to assess the dynamics of gynecological morbidity in the Russian Federation, the Central Federal District, the city of Moscow, and the organization of stationary gynecological care. Material and methods: The official statistics of the Federal State Statistics Service and the Ministry of Health of Russia for 20092018, as well as data from copies of the medical records (medical history, records of patients discharged from the hospital) of patients who received treatment in a gynecological day patient facility between 2015 and 2017. Results: A decrease in the number of gynecological beds by 32.2% over 10 years was noted. At the same time, the level of primary and general incidence of inflammatory diseases of the female pelvic organs did not decrease; between 2014 and 2018, there has been an increase in the incidence of primary female infertility. Non-inflammatory diseases of the female genital organs prevail (76.6%) as reason for admission in the day patient facility. Conclusion: The gynecological day patient facility manages female health; however, the nationwide and regional incidence rate of gynecological morbidity follows a negative trend and is increasing annually.

scholarly journals THU0261 NEW 2019 SLE EULAR/ACR CLASSIFICATION CRITERIA ARE VALID FOR IDENTIFYING SLE AMONG PATIENTS ADMITTED FOR PERICARDIAL EFFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 358.3-358
Author(s):  
L. Delaval ◽  
T. Goulenok ◽  
A. Dossier ◽  
T. Papo ◽  
K. Sacre
Keyword(s):  
Pericardial Effusion ◽  
Lupus Erythematosus ◽  
Inflammatory Diseases ◽  
Final Diagnosis ◽  
Biological Data ◽  
Classification Criteria ◽  
Diagnostic Purpose ◽  
American College Of Rheumatology ◽  
Acr Criteria ◽  
Senior Clinician

Background:The new 2019 SLE European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) have been recently published. Seritis is a prominent -often inaugural- feature of active SLE. Low titers of antinuclear antibodies (ANA) have been frequently reported in patients with idiopathic pericarditis. Of note, ANA positivity at a titer ≥1/80 is now mandatory as an entry criterion in the 2019 SLE EULAR/ACR classification criteria.Objectives:Although classification criteria have theoretically no individual diagnostic purpose, we aimed at testing this new criteria set in unselected patients with pericardial effusionMethods:In a retrospective study performed in the Department of Internal Medicine, University Paris Diderot, a French competence centre for rare systemic autoimmune diseases (AID), all consecutive adult patients hospitalized from January 2009 to January 2019 for pericardial effusion were reviewed. Clinical and biological data collected at time of the diagnosis of pericardial effusion were analyzed. The characteristics of the patients are listed in Table 1. Three sets of lupus criteria (SLE ACR-1997, SLE SLICC and 2019 SLE EULAR/ACR criteria) were applied in all ANA-positive patientsResults:Over a 10-year period, 137 patients were admitted for pericardial effusion. Search for ANA was systematically performed at diagnosis in all but 8 (n=129) and measured at a titer ≥ 1:80 on Hep-2 cells in 49 patients (38%) that were eventually separated in three groups: 17 (34.7%) patients with a final diagnosis of SLE based on senior clinician judgement, 6 (12.2%) patients with a final diagnosis of autoimmune disease (AID) other than SLE (primary Sjögren’s syndrome (n=2), undifferentiated connective-tissue disease (n=2) and systemic sclerosis (n=2)) and 26 (53.1%) patients with a diagnosis of idiopathic pericarditis after exclusion of malignancy, tuberculosis and systemic inflammatory diseases with a median 12.3 [1.6-29.8] months follow-upThe 2019 SLE EULAR/ ACR criteria were met in 100% of patients with SLE, 33.3% of patients with non-SLE AID and 11.5% of patients with idiopathic pericarditis. Thus this new set of criteria for SLE offered a higher sensitivity (100%) but a lower specificity (84.38%) as compared to the former criteria, for the diagnosis of SLE in patients with pericardial effusion. Interestingly, the 2019 SLE EULAR/ACR classification score was higher in SLE patients (median: 30 [11-45]) as compared to non-SLE AID (median: 8 [6-12], p=0.0006) and idiopathic pericarditis patients (median: 6 [5-12], p< 0.00001). Moreover, the 2019 classification set score strongly correlated with the SLEDAI activity score [6] as shown Figure S1 (R2=0.8105, p<0.00001). Setting the 2019 SLE EULAR/ACR classification threshold score >12 (out of a theoretical maximum of 51) instead of ≥10 increased the specificity of 2019 SLE EULAR/ ACR criteria from 84.38% to 100%. Overall, in patients with pericardial effusion and positive ANA, the diagnosis of SLE could be ruled out when 2019 SLE EULAR/ACR criteria score was < 10 and confirmed when the score was > 12.Conclusion:This study shows that the new 2019 SLE EULAR/ACR criteria for SLE are helpful in clinical practice for the diagnosis of SLE in patients admitted for pericardial effusionAcknowledgments:Jean-François Alexandra, Marie Berleur, Marie-Paule Chauveheid, Gregory Ducrocq, Damien van Gysel, Diane RouzaudDisclosure of Interests:None declared

scholarly journals Pelvic inflammatory diseases: clinical aspects of therapy and early rehabilitation of reproductive health

2020 ◽  
pp. 250-251
Author(s):  
V.O. Potapov
Keyword(s):  
Reproductive Health ◽  
Risky Sexual Behavior ◽  
Tissue Repair ◽  
Inflammatory Diseases ◽  
Subsequent Development ◽  
Clinical Aspects ◽  
Electrolyte Balance ◽  
Fallopian Tubes ◽  
Wide Range ◽  
Intestinal Pathogens

Background. Pelvic inflammatory diseases (PID) include the wide range of inflammatory processes in the upper reproductive tract of women. 70 % of PID occur in women under 25 years. Adverse consequences of PID include chronization and recurrence of the disease, purulent tuboovarian formations, obstruction of the fallopian tubes, and ectopic pregnancy. Objective. To describe the main aspects of PID treatment and rehabilitation of reproductive health. Materials and methods. Analysis of literature data on this topic. Results and discussion. Risk factors for PID include intrauterine interventions and contraceptives, surgery on uterine appendages, and risky sexual behavior. There are three main targets for PID therapy: infection, release of inflammatory mediators, and repair of damaged tissues. Etiotropic therapy is used to overcome infections, nonsteroidal anti-inflammatory drugs and detoxification drugs are used to prevent active inflammation, and microcirculation correction is used to promote tissue repair. Broad-spectrum antibiotics (ceftriaxone, doxycycline, metronidazole) are used for etiotropic therapy. Fluoroquinolones (levofloxacin) are especially relevant in modern PID treatment regimens because they are effective against 94 % of urogenital tract pathogens, penetrate cell membranes, and slowly cause resistance. The combination of levofloxacin + ornidazole is highly effective against mixed aerobic-anaerobic and protozoal-bacterial infections. A solution for intravenous administration containing a combination of levofloxacin and ornidazole is widely used to treat severe PID. Tobramycin is the drug of choice for PID, mainly caused by antibiotic-resistant intestinal pathogens. After an acute episode of PID, abnormal blood flow in the vessels of the uterus and ovaries is significantly more common. Circulatory disorders contribute to blood stagnation, fibrotization, and sclerosis with the subsequent development of infertility, anovulation, premenstrual syndrome, abnormal uterine bleeding, adhesions, and obstruction of the fallopian tubes. In order to accelerate the excretion of toxic substances and inflammatory metabolites and eliminate oxidative stress, infusion solutions based on sorbitol and L-arginine are prescribed. Sorbitol-based hyperosmolar solution promotes the opening of precapillary sphincters, improves the rheological properties of blood, corrects metabolic acidosis and normalizes water-electrolyte balance. L-arginine solution, in turn, causes dilatation of peripheral vessels, promoting better microcirculation. L-arginine also acts as a substrate for the NO formation. The latter has an antibacterial activity, promotes the migration of T-cells, and takes part in the regulation of the sex hormones synthesis in the ovaries. According to our own data, infusions of L-arginine in PID reduce the proportion of adhesions from 34 to 5.4 %. Conclusions. 1. PID is a spectrum of diseases with a number of adverse consequences, a significant part of which develops in young women. 2. The main components of PID treatment and restoration of reproductive health include elimination of the pathogen, blockade of inflammation and detoxification, correction of microcirculation and tissue repair. 3. Infusion solutions based on sorbitol and L-arginine are successfully used in the comprehensive therapy of PID.

scholarly journals Infections and reproductive health (Part I)

1999 ◽  
Vol 48 (2) ◽  
pp. 71-78
Author(s):  
E. F. Kira
Keyword(s):  
Reproductive Health ◽  
Health Problem ◽  
Reproductive System ◽  
Inflammatory Diseases ◽  
Reproductive Function ◽  
Direct Influence ◽  
Special Place ◽  
The World ◽  
Clinical Lecture

Infectious and inflammatory diseases of female genitals occupy a special place in structure of general morbidity on a planet. Their importance is caused first of all by the fact, that these illnesses involve organs and tissues concerning to reproductive system, and consequently have direct influence on reproductive function and continuation of a life in the world. In the first part of this clinical lecture ther are considered and are stated in details the modern aspects of a reproductive health problem.

scholarly journals IBD: reproductive health, pregnancy and lactation

2014 ◽  
Vol 6 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Philip Hendy ◽  
Georgina Chadwick ◽  
Ailsa Hart
Keyword(s):  
Reproductive Health ◽  
Pregnancy And Lactation
Sign in / Sign up

Export Citation Format

Share Document