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Biomedical subjects

M B Urowitz

Publications and source records attributed to M B Urowitz.

168 records · Page 10Linked to original sources
PubMedDate not supplied

Cranial computerized tomography in systemic lupus erythematosus.

Twelve patients with active central nervous system systemic lupus erythematosus (CNS SLE) and 11 patients without CNS involvement, all taking corticosteroids, were studied by computerized tomography (CT). Thirty CT scans on 23 individuals were performed and read blindly and independently by 2 neuroradiologists with an 86% correlation. Minimal to moderate atrophy was the most frequent finding, both in CNS SLE and controls, severe atrophy seen in 1 patient only, and no atrophy in 3 patients and a single control. Of the 6 patients who had repeated scans, 4 showed no change in the degree of atrophy, 1 had more and 1 less atrophy. Three patients had evidence of multiple brain infarcts on scan with or without associated cerebral atrophy. Sequential scans in 1 of these patients showed total resolution of the infarcts after 30 months. Thus, there was no correlation between the presence of cerebral atrophy on CT scan and CNS SLE. Rather our findings suggest that steroids may be the cause of atrophy.

Adolescent↗
PubMedDate not supplied

Systemic lupus erythematosus and pregnancy.

In a review of 250 patients with systemic lupus erythematosus (SLE), there were 24 pregnancies among 18 women. Of these, there were 16 completed pregnancies, 1 stillbirth, 1 spontaneous abortion, and 6 therapeutic abortions. Fetal loss, excluding therapeutic abortion, was 16.6%. Of the 13 patients with active disease at conception, SLE remained active in 11, and became inactive in 2. Of the 11 women with inactive disease at conception, disease remained inactive in 10. Even in the cases of previously serious renal or central nervous system involvement, inactive disease at conception was not associated with disease recurrence. Such patients may attempt pregnancy with favorable prognosis for both mother and child.

Abortion, Incomplete↗
PubMedDate not supplied

Lack of correlation among the 3 outcomes describing SLE: disease activity, damage and quality of life.

OBJECTIVE: The aim of the this study was to correlate three outcome measures in patients with SLE, namely disease activity, damage, and quality of life. METHODS: One hundred and five SLE patients completed the Medical Outcome Survey (MOS) SF-20 during their regular clinic visit. Disease activity (SLEDAI) and damage (SLICC/ACR Damage Index) were assessed according to a standard protocol. Statistical analyses included the Pearson correlation coefficients, a logistic regression, and a linear regression analysis. RESULTS: There was no correlation between the SLEDAI and SLICC/ACR DI. There was no correlation between the SLICC/ACR DI and any of the MOS domains by Pearson correlation. Although a statistical correlation was demonstrated between the SLEDAI score and the social functioning and health perception domains of the MOS SF-20, there were not clinically important. CONCLUSION: Thus, the three outcomes of disease activity, accumulated damage, and health status remain important independent outcome measures in the assessment of prognosis in patients with SLE.

Adolescent↗
PubMedDate not supplied

Detection and modification of risk factors for coronary artery disease in patients with systemic lupus erythematosus: a quality improvement study.

OBJECTIVE: To assess the detection and control of risk factors for atherosclerosis in patients with SLE who subsequently develop acute coronary events. METHODS: Patients followed at the University of Toronto Lupus Clinic who developed a myocardial infarction (MI) or acute coronary insufficiency (ACI) and who had 2 years of follow-up prior to their event were identified and their case notes reviewed. The management of potentially reversible risk factors in this cohort was assessed. RESULTS: Twenty-four patients (18 female, 6 male) were studied. The mean age at the coronary event was 50 years and the mean duration of SLE was 13.5 years. Nineteen patients had MI and 5 had ACI. Risk factors identified were hypertension (16), obesity/Cushing's (19), smoking (16), hypercholesterolaemia (11), steroid use (22), hyperglycaemia (4) and cardiac involvement with SLE (4). In the two years prior to the event, hypertension and cardiac involvement were appropriately managed in almost all cases. Sixty percent had attempts made to reduce or stop their steroid therapy. Two of four cases with hyperglycaemia and 5 of 11 patients with hypercholesterolaemia had no appropriate action noted. No smoking advice was recorded, while one obese patient had weight reduction advice recorded. CONCLUSION: SLE patients who develop coronary events have potentially reversible risk factors prior to the event. Rheumatologists perform well when optimizing the control of SLE, minimizing the steroid dose and managing hypertension. Other risk factors are less favorably managed. Physicians managing lupus patients need to play a primary role in screening for and managing cardiac risk factors.

Adult↗