A novel approach to the treatment of recurrent non-atherosclerotic carotid stenosis in a patient with Takayasu arteritis.

PubMed

Tann, Stephen M; Pershad, Ashish

2012-08-01

Takayasu arteritis is a chronic inflammatory autoimmune disease of medium- and large-sized arteries which frequently affects the major supra-aortic vessels. Morbidity and mortality with both medical and surgical treatments for this disease are high. In the past decade, angioplasty and stenting has emerged as a reasonable alternative to treatment of stenoses in these patients. Restenosis rates of percutaneously treated Takayasu lesions have been higher than with non-inflammatory lesions. Novel approaches are being sought to treat restenoses in these patients, such as the use of a stent grafts. Such a case is described in this report. Copyright © 2012 Wiley Periodicals, Inc.

Iatrogenic Aorto-Cisterna Chyli Fistula During Percutaneous Balloon Aortoplasty in a Patient with Takayasu's Arteritis: A Case Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hwang, Hye Sun; Shin, Sung Wook, E-mail: swshin@smc.samsung.co.kr; Kim, Eun Hui

2007-04-15

We present a case of iatrogenic aorto-cisterna chyli fistula that developed during percutaneous transluminal aortoplasty in a 16-year old girl with Takayasu's arteritis. The aorto-cisterna chyli fistula was angiographically confirmed and treated using a stent-graft, which successfully occluded the fistula. Her claudication then improved, although follow-up CT angiography at 10 months revealed mild recurrent aortic stenosis.

Ostial left main stenosis due to takayasu arteritis: multimodality imaging and surgical ostioplasty.

PubMed

Bansal, Neeraj; Wang, Nan; Choo, Daniel; Bansal, Ramesh C

2011-01-01

Takayasu's arteritis is an inflammatory process, involving larger blood vessels-namely the aorta and its branches. The majority of these patients present with symptoms of vascular obstruction. We report a case of a 38-year-old Chinese female who presented with one month history of angina pectoris as the initial manifestation. Coronary angiography showed 99% ostial left main coronary stenosis. The diagnosis was first suspected in the operating room by TEE and subsequently supported by laboratory studies and aortic biopsy. The technique of myocardial revascularization was altered and she underwent patch ostioplasty of the left main coronary artery and aortic valve repair to correct aortic regurgitation. © 2010, Wiley Periodicals, Inc.

Rare case of Takayasu's arteritis associated with Crohn's disease.

PubMed

Kusunoki, Ryusaku; Ishihara, Shunji; Sato, Mariko; Sumita, Yoshiko; Mishima, Yoshiyuki; Okada, Mayumi; Tada, Yasumasa; Oka, Akihiko; Fukuba, Nobuhiko; Oshima, Naoki; Moriyama, Ichiro; Yuki, Takafumi; Sato, Shuichi; Amano, Yuji; Murakawa, Yohko; Kinoshita, Yoshikazu

2011-01-01

Takayasu's arteritis (TA) and Crohn's disease (CD) are chronic inflammatory diseases of uncertain etiology. Although co-existence of these rare diseases is estimated to occur in 1 in 10 billion individuals, a theoretically unexpected association has been reported in several patients and it is suggested that those associations may have been more than an unusual coincidence. Herein, we report a case of TA associated with clinically inactive CD. A Japanese woman was diagnosed with colonic CD at the age of 15, developed aortic valve regurgitation at 19, and then presented with general fatigue, low grade fever, and painful sensations in her left arm at 25. She was diagnosed with TA based on computed tomography scanning and magnetic resonance angiography findings, and treatments with prednisolone and cyclosporine were started. Thereafter, valve replacement and right coronary artery bypass graft surgery were performed. The possible pathophysiological mechanism responsible for concurrent existence of TA and CD may be associated with immune disorders. Early diagnosis of vascular lesions for patients with inflammatory bowel disease is highly encouraged.

In this issue: Nef, a lingering problem; are there better immunoglobulins for human use; and Takayasu arteritis, still a mystery.

PubMed

Bot, Adrian

2012-12-01

The current issue of the International Reviews of Immunology brings the latest in three different areas of basic and clinical immunology. First, there is the lingering question of residual HIV-related pathology in patients on chronic antiretroviral therapy. The specific role of Nef in the macrophage-mediated disease manifested through lymphoma, metabolic disease and neurological disorder, is extensively discussed. A second topic is a clinical immunology one, a critical perspective on the efficacy and safety profile of various preparations of immunoglobulin products currently prescribed for a range of immunodeficiencies. Surprisingly, the authors showed that while the available preparations are equivalent from efficacy standpoint, they differ from the standpoint of toxicity. The third subject is again, in the arena of clinical immunology and deals with a relatively rare yet extremely puzzling disease -Takayasu arteritis -with a pathogenesis that needs elucidation and a dire need for better treatments. The authors provide a state of the art in terms of genetic association, other factors possibly involved in the onset and progression of this unusual inflammatory disease of large arteries, and provide a perspective on current standard of care and potential usefulness of TNF-α blockade as therapy for Takayasu arteritis.

Recent advances in Takayasu arteritis.

PubMed

Terao, Chikashi; Yoshifuji, Hajime; Mimori, Tsuneyo

2014-03-01

Takayasu arteritis (TAK) is a relatively rare systemic vasculitis mainly affecting the aorta and its large branches. While patients with TAK are more frequently observed in Asian countries, we can find patients with TAK all over the world. This limited number of patients has made it difficult to collect large numbers of patients and perform detailed studies. However, recent progresses have led to the identification of susceptibility genes and novel susceptibility human leukocyte antigen (HLA) alleles as well as accumulation of clues for the pathophysiology of TAK. IL12B was shown to be a susceptibility gene beyond ethnicity. MLX and FCGR2A/3A were shown to be associated with TAK in Japanese and Turkish/American populations, respectively. HLA-B*52:01 and *67:01 are susceptibility alleles to TAK, and the 171st and 67th amino acid residues of HLA-B protein are suggested important for TAK susceptibility. HLA-DQB1/DRB1 is recently reported as an independent susceptibility locus. Although there are no standardized serum markers or composite measures for disease activity of TAK, Japanese and Italian groups showed pentraxin 3 as a novel biomarker for detecting and monitoring patients with TAK. Recently, an Indian group proposed a novel scoring system called ITAS to evaluate disease activity of TAK. Standardization of assessing disease activity would lead to clinical studies with high quality. Several groups reported results of treatment for refractory TAK with biological agents targeting tumor necrosis factor or interleukin-6R. The recent accumulation of research data should improve understanding of the basic pathophysiology of TAK and lead to better management of patients with TAK. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Relapses in three patients with Takayasu arteritis under tocilizumab treatment detected by contrast enhanced ultrasound.

PubMed

Czihal, Michael; Lottspeich, Christian; Schröttle, Angelika; Treitl, Karla Maria; Treitl, Marcus; Leipe, Jan; Schulze-Koops, Hendrik; Hoffmann, Ulrich; Dechant, Claudia

2018-02-01

Takayasu arteritis (TA) is a rare large vessel vasculitis, affecting the aorta and its major branches, typically in young women. In this case report, we present three cases of young women of Caucasian descent who experienced relapses while under treatment with the monoclonal humanized antibody to the interleukin 6 receptor, tocilizumab. Active vasculitic lesions of the supraaortic (common carotid and axillary) arteries were detected and characterized via high resolution contrast enhanced ultrasound. Based on these cases, we discuss the potential role of contrast enhanced ultrasound in the diagnosis and follow-up of TA as well as the current data on the efficacy of tocilizumab in the treatment of TA.

Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis.

PubMed

Matsumoto, Takatsugu; Ishizuka, Mitsuru; Iso, Yukihiro; Kita, Junji; Kubota, Keiichi

2015-04-01

Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply. A 51-year-old woman was admitted to our hospital with sustained fever and lower back pain. Physical examination showed that she had a discrepancies in blood pressure between both arms. Contrast-enhanced whole-body computed tomography showed stenosis of the thoracic aorta and an aneurysm located in the distal part of the superior mesenteric artery. The diameter of the aneurysm was 4.5 cm. The aneurysm was resected via 4-cm mini-laparotomy, and the vascularity of the intestine was successfully preserved. The postoperative course was uneventful, and the patient was diagnosed as having TA based on both clinical and pathologic findings. Additional corticosteroid therapy was started to treat the arteritis, and at 3-month follow-up she was without critical incidents. Mini-laparotomy is a safe and less-invasive approach to treat SMAA, especially when the lesion is located in the distal part of the artery.

Giant Cell Arteritis

MedlinePlus

... Keep me signed in Passwords are Case Sensitive. Ex. Enter smith as follows: Smith Forgot Username/Password? ... Erythematosus (Juvenile) Takayasu's Arteritis Tendinitis & Bursitis Tumor Necrosis Factor Receptor Associated Periodic Syndrome (Juvenile) Vasculitis Enfermedades y ...

Serum Bilirubin Concentrations in Patients With Takayasu Arteritis.

PubMed

Peng, You-Fan; Deng, Yi-Bin

2017-06-01

- Bilirubin has strong anti-inflammatory and antioxidative stress action. Progression of inflammation involving arteries is a crucial activator in pathogenesis of Takayasu arteritis (TA). - To investigate the relationship between serum bilirubin and TA. - Our study involved 115 consecutive TA patients. Patients with active-phase disease were followed and received prednisone therapy. - Lower concentrations of serum bilirubin were detected in TA patients compared with healthy subjects (0.6 ± 0.31 versus 0.7 ± 0.22 mg/dL, P = .02). Serum bilirubin concentrations in active TA patients were lower than those in inactive patients (0.5 ± 0.20 versus 0.8 ± 0.32 mg/dL, P < .001). In all patients with TA, serum bilirubin correlated positively with total protein (r = 0.193, P = .04) and negatively with C-reactive protein and erythrocyte sedimentation rate (r = -0.213, P = .03, and r = -0.532, P < .001, respectively). Multiple logistic regression analysis showed that each decrease of 1 mg/dL in serum bilirubin was associated with a 1.10 times increase in the odds for TA compared with the controls (odds ratio = 0.913, 95% CI, 0.856-0.974; P = .006). Serum bilirubin was correlated with erythrocyte sedimentation rate (β = -0.170, P < .001) in multiple linear regression analysis. The area under the curve for serum bilirubin in predicting active TA patients was 0.802. Serum bilirubin levels were found to be significantly increased after prednisone treatment (0.5 ± 0.20 versus 0.7 ± 0.15 mg/dL, P = .002). - Lower serum bilirubin levels are associated with TA, and serum bilirubin may be influenced by prednisone therapy in active TA patients. Serum bilirubin levels in TA patients correlate negatively with erythrocyte sedimentation rate.

Ghrelin and adipokines as circulating markers of disease activity in patients with Takayasu arteritis

PubMed Central

2012-01-01

Introduction The current markers of disease activity in Takayasu arteritis (TA) are insufficient for proper assessment. We investigated circulating levels of unacylated and acylated ghrelin, leptin and adiponectin and their relationships with disease activity in patients with TA. Methods This study included 31 patients with TA and 32 sex-, age- and body mass index-matched healthy controls. Disease activity was assessed in TA patients using various tools, including Kerr's criteria, disease extent index-Takayasu, physician's global assessment, radiological parameters, and laboratory markers. Plasma unacylated and acylated ghrelin, and serum leptin and adiponectin levels were measured using an enzyme-linked immunosorbent assay. Results Unacylated and acylated ghrelin levels were found to be significantly lower in TA patients than that in healthy controls. Patients with active disease had lower unacylated ghrelin levels than those with inactive disease and had lower acylated ghrelin levels than healthy controls. Ghrelin levels were negatively correlated with various parameters of disease activity. The leptin/ghrelin ratio was significantly higher in TA patients than controls. It was positively correlated with disease activity. There was a positive correlation between unacylated and acylated ghrelin and a negative correlation between leptin and ghrelin. There was no statistical difference in adiponectin levels between TA patients and controls. The radiological activity markers were positively correlated with other parameters of disease activity. Conclusions This study suggests that plasma unacylated and acylated ghrelin levels may be useful in monitoring disease activity and planning treatment strategies for patients with TA. The serum leptin level and leptin/ghrelin ratio may also be used to help assess the disease activity. PMID:23259466

[Susceptibility HLA alleles and amino acids to Takayasu arteritis].

PubMed

Terao, Chikashi; Yoshifuji, Hajime; Mimori, Tsuneyo; Matsuda, Fumihiko

2014-01-01

Takayasu arteritis (TAK) is a systemic vasculitis affecting aorta and its large branches which were firstly reported from Japan. TAK develops mainly in young females and the number of patients with TAK in Japan is estimated about 6,000 to 10,000. This low prevalence has made genetic studies of TAK difficult to elucidate its genetic background. The HLA region, especially HLA-B locus, is the strongest susceptibility locus to TAK. The association between TAK and HLA-B*52:01 has been established beyond ethnicity. Recently, two different Japanese research groups identified HLA-B67:01, a relatively rare allele in East Asian population, as a novel susceptibility allele. At the same time, two amino acid variations, namely, histidine at position 171 and phenylalanine at position 67 were reported as susceptibility and protective variations, respectively. Since these positions of amino acid are in the peptide binding grooves of HLA-B protein, changes of peptide-binding in MHC class I seem to play a critical role on susceptibility to TAK. Furthermore, the importance of these two amino acid variations would explain the lack of susceptibility effect of HLA-B*51:01 to TAK, which shares most of amino acid sequences with HLA-B*52:01 except for two amino acids including the position 67.

Relapse of Takayasu arteritis as a cause of suicidal poisoning and subsequent major ischemic stroke successfully treated with thrombolytic therapy.

PubMed

Komatina, Neneal; Lepić, Toplica; Labović, Boban; Stevović, Tatjana; Petronijević, Milan; Radovinović-Tasić, Sanja; Obradović, Dragana

2016-08-01

Takayasu arteritis (TA) is a rare large vessel arteritis, affecting primarily aorta and its major branches. Its clinical manifestations can vary significantly - from asymptomatic to serious vascular events. Acute neurological complications are frequent at the onset of the disease and in relapses. Anxiety and depression are more frequent in TA patients than in general population as well as during relapses. Prevalence of transient ischemic attack or ischemic stroke in TA patients is approximately 10-20%. We presented a patient with TA that began with a depressive episode resulting in attempted suicide by bromazepame poisoning. This was subsequently followed by major ischemic stroke caused by thrombosis of the left middle cerebral artery (probably due to aortic arch embolism) successfully treated with intravenous thrombolysis. Intravenous thrombolysis appears to be safe and effective in patients with TA and stroke.

Takayasu's arteritis: Anesthetic significance and management of a patient for cesarean section using the epidural volume extension technique

PubMed Central

Tiwari, Akhilesh Kumar; Tomar, Gaurav Singh; Chadha, Madhur; Kapoor, Mukul C.

2011-01-01

Takayasu's arteritis (TA) is a rare, chronic progressive pan-endarteritis involving the aorta and its main branches. Anesthesia for patients with TA is complicated by severe uncontrolled hypertension, end-organ dysfunction, stenosis of major blood vessels, and difficulties in monitoring arterial blood pressure. We present the successful anesthetic management of a 23-year-old woman having TA with bilateral subclavian and renal artery stenosis posted for emergency cesarean section by using the epidural volume extension technique, which offers the combined advantage of both spinal and epidural anesthesia and, at the same time, also avoids the need of sophisticated neurological monitors like EEG and transcranial Doppler. PMID:25885310

Takayasu's Disease in a Patient with Ulcerative Colitis.

PubMed

Chae, Myung Joon; Yu, Cheol Woong; Lee, Soo Yeon; Jang, Duck Hyun; Hyun, Joo Yong; Jeong, Su Jin; Kim, Myoung Hwan

2013-02-01

A 35-year-old Korean man with a 10-year history of ulcerative colitis (UC) presented with pain and swelling of the right neck. The patient was diagnosed with Takayasu's arteritis (TA) and had human leukocyte antigen (HLA) B-52, which is frequently found in patients having both UC and Takayasu's disease concurrently on HLA analysis. This case is the first report of a patient with both TA and UC in Korea, to the best of our knowledge.

Delayed Contrast-Enhanced MRI of the Coronary Artery Wall in Takayasu Arteritis

PubMed Central

Schneeweis, Christopher; Schnackenburg, Bernhard; Stuber, Matthias; Berger, Alexander; Schneider, Udo; Yu, Jing; Gebker, Rolf; Weiss, Robert G.; Fleck, Eckart; Kelle, Sebastian

2012-01-01

Background Takayasu arteritis (TA) is a rare form of chronic inflammatory granulomatous arteritis of the aorta and its major branches. Late gadolinium enhancement (LGE) with magnetic resonance imaging (MRI) has demonstrated its value for the detection of vessel wall alterations in TA. The aim of this study was to assess LGE of the coronary artery wall in patients with TA compared to patients with stable CAD. Methods We enrolled 9 patients (8 female, average age 46±13 years) with proven TA. In the CAD group 9 patients participated (8 male, average age 65±10 years). Studies were performed on a commercial 3T whole-body MR imaging system (Achieva; Philips, Best, The Netherlands) using a 3D inversion prepared navigator gated spoiled gradient-echo sequence, which was repeated 34–45 minutes after low-dose gadolinium administration. Results No coronary vessel wall enhancement was observed prior to contrast in either group. Post contrast, coronary LGE on IR scans was detected in 28 of 50 segments (56%) seen on T2-Prep scans in TA and in 25 of 57 segments (44%) in CAD patients. LGE quantitative assessment of coronary artery vessel wall CNR post contrast revealed no significant differences between the two groups (CNR in TA: 6.0±2.4 and 7.3±2.5 in CAD; p = 0.474). Conclusion Our findings suggest that LGE of the coronary artery wall seems to be common in patients with TA and similarly pronounced as in CAD patients. The observed coronary LGE seems to be rather unspecific, and differentiation between coronary vessel wall fibrosis and inflammation still remains unclear. PMID:23236382

Delayed contrast-enhanced MRI of the coronary artery wall in takayasu arteritis.

PubMed

Schneeweis, Christopher; Schnackenburg, Bernhard; Stuber, Matthias; Berger, Alexander; Schneider, Udo; Yu, Jing; Gebker, Rolf; Weiss, Robert G; Fleck, Eckart; Kelle, Sebastian

2012-01-01

Takayasu arteritis (TA) is a rare form of chronic inflammatory granulomatous arteritis of the aorta and its major branches. Late gadolinium enhancement (LGE) with magnetic resonance imaging (MRI) has demonstrated its value for the detection of vessel wall alterations in TA. The aim of this study was to assess LGE of the coronary artery wall in patients with TA compared to patients with stable CAD. We enrolled 9 patients (8 female, average age 46±13 years) with proven TA. In the CAD group 9 patients participated (8 male, average age 65±10 years). Studies were performed on a commercial 3T whole-body MR imaging system (Achieva; Philips, Best, The Netherlands) using a 3D inversion prepared navigator gated spoiled gradient-echo sequence, which was repeated 34-45 minutes after low-dose gadolinium administration. No coronary vessel wall enhancement was observed prior to contrast in either group. Post contrast, coronary LGE on IR scans was detected in 28 of 50 segments (56%) seen on T2-Prep scans in TA and in 25 of 57 segments (44%) in CAD patients. LGE quantitative assessment of coronary artery vessel wall CNR post contrast revealed no significant differences between the two groups (CNR in TA: 6.0±2.4 and 7.3±2.5 in CAD; p = 0.474). Our findings suggest that LGE of the coronary artery wall seems to be common in patients with TA and similarly pronounced as in CAD patients. The observed coronary LGE seems to be rather unspecific, and differentiation between coronary vessel wall fibrosis and inflammation still remains unclear.

Vascular lesions in patient with Takayasu arteritis and massive elevated lipoprotein(a) levels. Residual involvement or premature aterosclerosis?

PubMed

Alarcón García, José Carlos; Rodríguez Suárez, Santiago; Muñiz Grijalvo, Ovidio; García Morillo, Salvador

Lipoprotein (a) [Lp(a)] is a lipoprotein defined by presenting a specific apolipoprotein, ApoA, linked to the ApoB-100 by different types of chemical bonds, including a disulfide bridge. Despite their atherogenic mechanism is not fully understood, its importance has been demonstrated in the development of premature aterosclerosis. Multiple studies have shown its role as a cardiovascular risk factor associated with heart disease and stroke. We report the case of a patient with a diagnosis of Takayasu arteritis in which a massive elevation of Lp(a) was detected. We emphasize its diagnostic and therapeutic implications. Copyright © 2016 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

Treatment of Takayasu arteritis with the IL-6R antibody tocilizumab vs. cyclophosphamide.

PubMed

Kong, Xiufang; Zhang, Xiaojie; Lv, Peng; Cui, Xiaomeng; Ma, Lili; Chen, Huiyong; Liu, Hao; Lin, Jiang; Jiang, Lindi

2018-05-02

To evaluate the treatment effects of the IL-6R antibody tocilizumab and cyclophosphamide (CTX) in patients with Takayasu arteritis (TA) and explore the mechanism by analyzing their effects on various cytokines. This study included 9 TA patients treated with tocilizumab, 15 TA patients treated with CTX and 24 healthy controls. Treatment effects were evaluated based on: (1) Kerr score and Indian Takayasu Clinical Activity Score (ITAS2010), (2) improvement of previous lesions and occurrence of new vascular lesions on magnetic resonance angiography (MRA), (3) changes in various cytokine levels, (4) glucocorticoid sparing, and (5) adverse effects. ELISA was used to analyze the cytokine levels. Before treatment, all the patients had active disease accompanied with elevated C-reactive protein (CRP), serum amyloid A (SAA), interleukin (IL)-6 and pentraxin-3 (PTX3). Moreover, an imbalance in the MMP-TIMP system was also observed in these patients. Among them, IL-6 and MMP-9 levels were significantly associated with vascular enhancement scores and stenosis scores, respectively. At 6months after treatment, improved clinical manifestations and glucocorticoids sparing were observed in both groups without any severe side effects. Although no significant improvement occurred in the vascular stenosis, thickness and enhancement scores in both groups, a more degree of decrease of ESR, CRP level, significantly decreased MMP-9 level and increased MMP-2 level were found in the tocilizumab group than in the CTX group. The IL-6R antibody may be more effective in mitigating vascular inflammation and remodeling than CTX via inhibition of IL-6 and MMP-9. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Revisited HLA and non-HLA genetics of Takayasu arteritis--where are we?

PubMed

Terao, Chikashi

2016-01-01

Takayasu arteritis (TAK) is an immune-mediated vasculitis affecting large arteries first reported in 1908 from Japan. Case reports of familial onset of TAK from Japan and other countries indicated genetic contribution to TAK onset beyond ethnicity. Genetic studies of TAK have been performed mainly addressing the human leukocyte antigen (HLA) locus. HLA genetic studies of TAK that have previously been reported are reviewed in this manuscript. HLA-B*52:01 is associated with TAK beyond population. Many of the associations other than HLA-B*52:01 can be explained by a haplotype with HLA-B*52:01. HLA-B*67:01 is a novel susceptibility HLA-B allele to TAK confirmed in the Japanese population. Further independent associations are suggested in the HLA locus. Involvement of the 171st and 67th amino acid residues with TAK onset has been indicated. The 67th amino acid may explain the difference in susceptibility effects to TAK and Behçet's disease between HLA-B*52:01 and *51:01. HLA-B*52:01 is associated not only with TAK susceptibility but also with clinical phenotypes. Recent genome-wide association studies of TAK revealed multiple non-HLA susceptibility genes. In particular, the IL12B region seems to have a central role in TAK onset and its progression. Whether TAK and giant cell arteritis (GCA), the other vasculitis affecting large arteries, are the same disease is an interesting question to address in spite of different clinical manifestations between the two diseases. GCA is associated with HLA-DR4, which is not associated with TAK. GCA is not associated with HLA-Bw52. These two diseases seem not to share non-HLA susceptibility loci based on the recent genetic studies.

Takayasu Arteritis in Major Rheumatology Centers in Malaysia.

PubMed

Khor, Chiew Gek; Tan, Bee Eng; Kan, Sow Lai; Tsang, Esther Ee Ling; Lim, Ai Lee; Chong, Eleen Yun Yin; Rachel, Thundyil; Teh, Cheng Lay; Loh, Yet Lin; Chʼng, Shereen Suyin; dʼSouza, Beryl Agnes; Mohd Mokhtar, Ainon; Ong, Swee Gaik; Mohd Isa, Liza

2016-06-01

There is paucity of data for Takayasu arteritis (TAK) among South Asians. We aimed to evaluate the clinical features, angiographic findings, as well as treatment and outcome of TAK among Malaysian multiethnic groups. This is a retrospective review of 40 patients with TAK seen in major rheumatology centres in Malaysia between April 2006 and September 2013. Majority were female patients (92.5%), with a female-to-male ratio of 12:1. Median duration of disease from diagnosis was 66 months (interquartile range, 33-177 months). Fifteen (37.5%) were Malays, 9 (22.5%) each were Indians and indigenous from East Malaysia and 7 (17.5%) were Chinese. Indian and indigenous from East Malaysia were overrepresented in this disease. The mean (SD) age of symptom onset and diagnosis were 25.5 (8.1) and 27.4 (8.4), respectively. The 3 most common clinical presentations at diagnosis were diminished or absent pulse, which occurred in 80% of the patients, followed by blood pressure discrepancy (60%) and arterial bruit (52.5%). There was no difference in clinical presentation among ethnic groups. The subclavian artery was the commonest vessel involved (72.5%), followed by the carotid artery (65%) and renal artery (47.5%). Eight patients had coronary artery involvement, and 2 patients had pulmonary artery involvement. Type I arterial involvement was the commonest (80.0%), followed by type IV (35%), present in isolation or mixed type. Glucocorticoid was the main medical treatment (90.0%). Nineteen patients (47.5%) underwent revascularization procedures. Five patients died during the follow-up period. The Malaysian TAK cohort had similarities with and differences from other published TAK cohort. A nationwide TAK registry is needed to determine the prevalence of the disease among different ethnic groups.

Takayasu arteritis in childhood: misdiagnoses at disease onset and associated diseases.

PubMed

Clemente, Gleice; Silva, Clovis A; Sacchetti, Silvana B; Ferriani, Virginia P L; Oliveira, Sheila K; Sztajnbok, Flavio; Bica, Blanca E R G; Cavalcanti, André; Robazzi, Teresa; Bandeira, Marcia; Terreri, Maria Teresa

2018-06-01

Juvenile-Takayasu arteritis (j-TA) is a difficult diagnosis and some patients develop uncommon manifestations and associated diseases that may contribute to the delayed diagnosis. Our aim was to identify the misdiagnoses, the associated diseases and the atypical manifestations observed in a j-TA Brazilian multicentre study. 71 children and adolescents who met the classification criteria for j-TA were included. The misdiagnoses, the associated diseases and the atypical manifestations were evaluated. 19 (26.8%) patients had misdiagnoses. The most common of them was aortic coarctation in six (8.4%) patients, followed by rheumatic fever in five (7.0%) and one patient presented with both former diagnoses. Limb pain (two patients), spondyloarthropathy, juvenile idiopathic arthritis (JIA), spinal arteriovenous malformation, polyarteritis nodosa (PAN) and fever of unknown origin (FUO) were other misdiagnoses. Patients who had misdiagnoses previously to j-TA diagnosis presented a trend to have a longer diagnosis delay. 11 (15.5%) patients had 14 TA-associated diseases, such as pulmonary tuberculosis (5 patients), rheumatic fever (2 patients), spondyloarthropathy, polyarticular JIA, Crohn's disease, Prader-Willi disease, diabetes mellitus, Moyamoya and primary immunodeficiency. 7 (9.9%) patients presented 10 atypical manifestations, such as pyoderma gangrenosum, erythema nodosum, myositis, chorea, enthesitis, episcleritis, uveitis, hepatomegaly, splenomegaly and necrosis of extremities. Our study emphasizes the main misdiagnoses, associated diseases and atypical manifestations that occur in patients with j-TA and warns of the features that may alert paediatricians to this diagnosis, such as constitutional symptoms and elevated inflammatory markers.

A novel susceptibility locus for Takayasu arteritis in the IL12B region can be a genetic marker of disease severity.

PubMed

Matsumura, Takayoshi; Amiya, Eisuke; Tamura, Natsuko; Maejima, Yasuhiro; Komuro, Issei; Isobe, Mitsuaki

2016-06-01

Takayasu arteritis (TAK) is an acute and chronic vasculitis of unknown etiology. Recently, our group reported that SNP rs6871626 in the IL12B region had significant association with disease susceptibility to TAK. However, association of the SNP with clinical characteristics of TAK has yet to be determined. Therefore, we assessed whether this SNP was associated with TAK disease severity as represented by early onset and/or refractoriness to medical therapy. A total of 90 patients were genotyped for rs6871626 and their clinical charts were reviewed retrospectively. By examining the relationship between genotype and clinical profiles of patients, we found a strong association between the number of risk alleles and the frequency of severe cases as defined by (1) age at onset <20 years old, (2) steroid resistance, and/or (3) a relapse of disease [p = 0.03; odds ratio 3.75 (95 % confidence interval 1.13-13.5)]. Thus, our study points to potential diagnostic use of SNP rs6871626 for predicting disease severity of TAK, with the goal of genotyping-oriented therapy in the near future.

Association of Takayasu arteritis with HLA-B 67:01 and two amino acids in HLA-B protein.

PubMed

Terao, Chikashi; Yoshifuji, Hajime; Ohmura, Koichiro; Murakami, Kosaku; Kawabata, Daisuke; Yurugi, Kimiko; Tazaki, Junichi; Kinoshita, Hideyuki; Kimura, Akinori; Akizuki, Masashi; Kawaguchi, Yasushi; Yamanaka, Hisashi; Miura, Yasuo; Maekawa, Taira; Saji, Hiroo; Mimori, Tsuneyo; Matsuda, Fumihiko

2013-10-01

Takayasu arteritis (TAK) is a rare autoimmune arteritis that affects large arteries. Although the association between TAK and HLA-B 52:01 is established, the other susceptibility HLA-B alleles are not fully known. We performed genetic association studies to determine independent HLA-B susceptibility alleles other than HLA-B 52:01 and to identify important amino acids of HLA-B protein in TAK susceptibility. One hundred patients with TAK and 1000 unrelated healthy controls were genotyped for HLA-B alleles in the first set, followed by a replication set containing 73 patients with TAK and 1000 controls to compare the frequencies of HLA-B alleles. Step-up logistic regression analysis was performed to identify susceptibility amino acids of HLA-B protein. Strong associations of susceptibility to TAK with HLA-B 52:01 and HLA-B 67:01 were observed (P = 1.0 × 10(-16) and 9.5 × 10(-6), respectively). An independent susceptibility effect of HLA-B 67:01 from HLA-B 52:01 was also detected (P = 1.8 × 10(-7)). Amino acid residues of histidine at position 171 and phenylalanine at position 67, both of which are located in antigen binding grooves of the HLA-B protein, were associated with TAK susceptibility (P ≤ 3.8 × 10(-5)) with a significant difference from other amino acid variations (ΔAIC ≥ 9.65). HLA-B 67:01 is associated with TAK independently from HLA-B 52:01. Two amino acids in HLA-B protein are strongly associated with TAK susceptibility.

Coexistence of ulcerative colitis and Sjögren's syndrome in a patient with Takayasu's arteritis and Hashimoto's thyroiditis.

PubMed

Park, Hyun Woo; Lee, Hyun Seok; Hwang, Sejin; Lee, Han Sol; Bae, Han-Ik; Yoon, Ghilsuk

2017-04-01

A 31-year-old woman with a 15-year history of Takayasu's arteritis (TA) and a 13-year history of Hashimoto's thyroiditis presented with hematochezia. She received a diagnosis of Sjögren's syndrome at 1 month before her visit to Kyungpook National University Medical Center. Her colonoscopic findings were compatible with a diagnosis of ulcerative colitis (UC). She was treated with oral mesalazine, and her hematochezia symptoms subsequently disappeared. The coexistence of UC and TA has been reported; however, reports on the coexistence of UC and Sjögren's syndrome, or of UC and Hashimoto's thyroiditis are rare. Although the precise etiologies of these diseases are unknown, their presence together suggests that they may have a common pathophysiologic background. Furthermore, in patients with autoimmune or vascular diseases, including TA, systemic manifestations should be assessed with consideration of inflammatory bowel diseases including UC in the presence of gastrointestinal symptoms such as diarrhea and hematochezia.

NMR-Based Serum Metabolomics Discriminates Takayasu Arteritis from Healthy Individuals: A Proof-of-Principle Study.

PubMed

Guleria, Anupam; Misra, Durga Prasanna; Rawat, Atul; Dubey, Durgesh; Khetrapal, Chunni Lal; Bacon, Paul; Misra, Ramnath; Kumar, Dinesh

2015-08-07

Takayasu arteritis (TA) is a debilitating, systemic disease that involves the aorta and large arteries in a chronic inflammatory process that leads to vessel stenosis. Initially, the disease remains clinically silent (or remains undetected) until the patients present with vascular occlusion. Therefore, new methods for appropriate and timely diagnosis of TA cases are needed to start proper therapy on time and also to monitor the patient's response to the given treatment. In this context, NMR-based serum metabolomic profiling has been explored in this proof-of-principle study for the first time to determine characteristic metabolites that could be potentially helpful for diagnosis and prognosis of TA. Serum metabolic profiling of TA patients (n = 29) and healthy controls (n = 30) was performed using 1D (1)H NMR spectroscopy, and possible biomarker metabolites were identified. Using projection to least-squares discriminant analysis, we could distinguish TA patients from healthy controls. Compared to healthy controls, TA patients had (a) increased serum levels of choline metabolites, LDL cholesterol, N-acetyl glycoproteins (NAGs), and glucose and (b) decreased serum levels of lactate, lipids, HDL cholesterol, and glucogenic amino acids. The results of this study are preliminary and need to be confirmed in a prospective study.

Relationship of HLA-B*51 and HLA-B*52 alleles and TNF-α-308A/G polymorphism with susceptibility to Takayasu arteritis: a meta-analysis.

PubMed

Chen, Si; Luan, Haixia; Li, Liubing; Zeng, Xiaoli; Wang, Tian; Li, Yongzhe; Yuan, Hui

2017-01-01

We performed a meta-analysis to determine whether combined evidence shows an association between HLA-B*51 and HLA-B*52 alleles and TNF-α-308A/G polymorphism and the susceptibility to Takayasu arteritis (TA). Relevant articles dated November 2015 were acquired from the PubMed, Embase and Cochrane databases. The number of genotypes and/or alleles for HLA-B*51 and HLA-B*52 alleles and TNF-α-308 A/G polymorphism in cases and control subjects was extracted, and statistical analysis was conducted using STATA 11.2 software. We included 20 studies with 1864 TA patients and 6973 controls. The HLA-B*52 allele was found to be associated with TA (pooled OR 3.91, 95 % CI 3.22-4.74, P < 0.0001). The meta-analysis of TNF-α-308 A/G polymorphism for the A allele vs. G allele (P = 0.006) and AA + AG vs. GG (P = 0.023) revealed a significant association with TA. However, we did not find that the HLA-B*51 allele was associated with TA. This meta-analysis demonstrated that the HLA-B*52 allele and TNF-α-308 A/G polymorphism may contribute to TA susceptibility.

Effect of endovascular treatment on nitric oxide and renal function in Takayasu's arteritis with renovascular hypertension.

PubMed

Parildar, Zuhal; Gulter, Ceyda; Parildar, Mustafa; Oran, Ismail; Erdener, Dilek; Memis, Ahmet

2002-01-01

Renal involvement in Takayasu's arteritis (TA) effects the disease outcome and endovascular treatment is an effective treatment of choice. We investigated nitric oxide (NO) levels and the effect of endovascular treatment in renovascular hypertensive TA patients. In five hypertensive patients with renal artery stenosis due to TA, serum creatinine, nitrite, nitrate; urinary microalbumin, nitrite, nitrate measurements and blood pressures were recorded at entry and after 24 h and 6 weeks of endovascular treatment. Serum NO levels were higher in patients than controls (p = 0.008). Serum and urine NO levels increased 24 h after the treatment and decreased after 6 weeks (p = 0.015; p = 0.01, respectively). After the treatment blood pressures decreased. Urinary microalbumin excretions increased after the intervention (p = 0.02) and returned to normal in patients 1 and 4, and decreased in the others. There were no significant differences in estimated glomerular filtration rate (EGFR), serum creatinine, urinary sodium and potassium levels. Increased NO secretion in these patients may contribute to improve the prognosis of renal function through its vasodilator and antiproliferative activities possibly by counterbalancing the excessive vasoconstrictor actions. Endovascular treatment causes a dilatation-induced shear stress that may be responsible for the increased NO release, which in turn leads to the rapid hypotensive response. Copyright 2002 S. Karger AG, Basel

Surgical treatment of middle aortic syndrome with Takayasu arteritis or midaortic dysplastic syndrome.

PubMed

Kim, S M; Jung, I M; Han, A; Min, S-I; Lee, T; Ha, J; Kim, S J; Min, S-K

2015-08-01

Middle aortic syndrome (MAS) is a rare condition characterized by severe stenosis of the distal thoracic or abdominal aorta. The aims of this study are to define the anatomic characteristics of MAS and to review the various surgical methods and their outcomes in terms of long-term durability Ten adult patients were diagnosed with MAS caused by Takayasu arteritis (TA) or midaortic dysplastic syndrome and underwent surgical treatment between July 1992 and January 2013. The aortic lesions were mostly suprarenal (n = 7) and stenoses were commonly found in the celiac axis (n = 6), SMA (n = 7), and renal artery (n = 6). Indications for operation were uncontrolled hypertension in six patients and lower extremity claudication in four. Eight aortic bypasses, one supraceliac aortic interposition graft, and one bilateral aorto-renal bypass were performed. Adjunctive renal bypass with saphenous vein graft (n = 4) and IMA reimplantation (n = 2) were performed simultaneously. There was no post-operative mortality, and one complication of iliac dissection at the distal anastomosis site was detected and treated by stenting. Hypertension was cured or improved in five of the six patients, and lower extremity claudication improved in all of them. With a median follow up of 60 months (range, 12-263), all the aortic bypasses were patent and one adjunctive renal artery bypass graft with aortic bypass was occluded 29 months post-operatively. Aortic bypass for MAS is safe and shows excellent long-term durability. Considering the patients are relatively young with a long life expectancy, aggressive surgical treatment could be beneficial. Lifelong follow up to monitor complications and disease progression is necessary. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Endoscopic features and genetic background of inflammatory bowel disease complicated with Takayasu arteritis.

PubMed

Akiyama, Shintaro; Fujii, Toshimitsu; Matsuoka, Katsuyoshi; Yusuke, Ebana; Negi, Mariko; Takenaka, Kento; Nagahori, Masakazu; Ohtsuka, Kazuo; Isobe, Mitsuaki; Watanabe, Mamoru

2017-05-01

Takayasu arteritis (TA) is occasionally complicated with inflammatory bowel disease (IBD). This study assessed the endoscopic and genetic features of IBD complicated with TA (IBD-TA). This study retrospectively reviewed the clinical charts of 142 TA patients (14 men and 128 women; median age 48.5 years [range, 18-97 years]). Human lymphocyte antigen (HLA) types and a single-nucleotide polymorphism rs6871626 in the IL12B gene were assessed in 101 and 81 patients with TA, respectively. Inflammatory bowel disease was diagnosed in 13 (9.2%) of the 142 patients. The endoscopic features of IBD-TA at initial diagnosis (n = 8) showed discontinuous and focal mucosal inflammations (n = 7, 87.5%), and only one case was diagnosed as ulcerative colitis (UC) at the first colonoscopy. In the genetic comparison of HLA class I between TA patients with IBD and those without IBD, HLA-B*52:01 and C*12:02 were more frequent in the IBD-TA group (P = 0.001 and P = 0.009, respectively). Meanwhile, HLA-DRB-1*15:02, DQA-1*01:03, DQB-1*06:01, and DPB-1*09:01 as HLA class II were positively associated with IBD-TA (P = 0.004, P = 0.019, P = 0.019, and P = 0.002, respectively). IL12B rs6871626 did not show an association with IBD-TA compared with that with TA without IBD. The endoscopic findings of IBD-TA at initial diagnosis were atypical for UC or Crohn's disease. IBD-TA possessed the HLA haplotype, which had a susceptible effect on UC. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Hepatorenal bypass using autogenous, free internal iliac artery graft: An attractive alternative to revascularize the right kidney in Takayasu's disease.

PubMed

Khattar, Nikhil; Guleria, Sandeep; Sharma, Sanjeev

2012-04-01

Nonspecific aortoarteritis or Takayasu's disease (TD) is a chronic pan endarteritis of unknown origin involving the aorta and its major branches affecting young adults especially women. The disease is more common in eastern Asian countries. Hypertension in these patients generally reflects as renal artery stenosis, which is seen in 28-75% of patients. Surgical revascularization is occasionally needed in patients with failed medical management or endovascular interventions. We report two cases of Takayasu's arteritis in young women where renal revascularization was done using free internal iliac artery hepatorenal bypass graft with excellent control of hypertension in the postoperative period.

Vitamin D Levels in Takayasu's Arteritis and a Review of the Literature on Vasculitides.

PubMed

Alibaz-Oner, Fatma; Asmaz-Haliloglu, Özlem; Gogas-Yavuz, Dilek; Can, Meryem; Haklar, Goncagul; Direskeneli, Haner

2016-09-01

Takayasu's arteritis (TAK) is a chronic, large-vessel vasculitis. Vitamin D, as a steroidal hormone, has recently been shown to have immunoregulatory and immunosuppressive effects. Low vitamin D levels are demonstrated in various autoimmune disorders. The aim of this study is to investigate vitamin D levels in patients with TAK. A comprehensive review of vitamin D levels in systemic vasculitides (SVs) is also performed. The study included 36 patients with TAK, 28 patients with Behçet's disease (BD) as disease control and 30 sex-matched healthy controls. Plasma 25-hydroxy vitamin D (25(OH) vit D) levels were measured with high-performance liquid chromatography. "Deficiency" was defined as 25(OH) vit D levels below 25 nmol/l and "insufficiency" as below 50 nmol/l. Plasma 25(OH) vit D levels were significantly lower in TAK patients (16.93 ± 10.62 nmol/l) than healthy controls (64.63 ± 21.82 nmol/l). Vitamin D level in BD patients (38.8 ± 20.9 nmol/l) is lower than healthy controls but higher than TAK patients. The frequency of vitamin D deficiency was 83.3% in patients with TAK compared to 3.3% in healthy controls. Plasma 25(OH) vit D levels were same between clinically active and inactive patients. In literature review, very few studies were found to investigate vitamin D in SVs. We observed a high prevalence of vitamin D deficiency in patients with TAK. As various immune effects of vitamin D on mononuclear cells and arterial endothelium is shown, vitamin D deficiency can be a predisposing factor for immune activation in SV. We therefore suggest monitorization and replacement of vitamin D status in all TAK and other SV patients. © 2015 Wiley Periodicals, Inc.

Takayasu arteritis and ulcerative colitis: high rate of co-occurrence and genetic overlap.

PubMed

Terao, Chikashi; Matsumura, Takayoshi; Yoshifuji, Hajime; Kirino, Yohei; Maejima, Yasuhiro; Nakaoka, Yoshikazu; Takahashi, Meiko; Amiya, Eisuke; Tamura, Natsuko; Nakajima, Toshiki; Origuchi, Tomoki; Horita, Tetsuya; Matsukura, Mitsuru; Kochi, Yuta; Ogimoto, Akiyoshi; Yamamoto, Motohisa; Takahashi, Hiroki; Nakayamada, Shingo; Saito, Kazuyoshi; Wada, Yoko; Narita, Ichiei; Kawaguchi, Yasushi; Yamanaka, Hisashi; Ohmura, Koichiro; Atsumi, Tatsuya; Tanemoto, Kazuo; Miyata, Tetsuro; Kuwana, Masataka; Komuro, Issei; Tabara, Yasuharu; Ueda, Atsuhisa; Isobe, Mitsuaki; Mimori, Tsuneyo; Matsuda, Fumihiko

2015-05-01

Takayasu arteritis (TAK) is a systemic vasculitis affecting large arteries and large branches of the aorta. Ulcerative colitis (UC) is a prevalent autoimmune colitis. Since TAK and UC share HLA-B*52:01 and IL12B as genetic determinants, and since there are case reports of the co-occurrence of these diseases, we hypothesized that UC is a common complication of TAK. We undertook this study to perform a large-scale analysis of TAK, both to evaluate the prevalence of concurrent cases of TAK and UC and to identify and estimate susceptibility genes shared between the 2 diseases. We analyzed a total of 470 consecutive patients with TAK from 14 institutions. We characterized patients with TAK and UC by analyzing clinical manifestations and genetic components. Genetic overlapping of TAK and UC was evaluated with the use of UC susceptibility single-nucleotide polymorphisms by comparing risk directions and effect sizes between susceptibility to the 2 diseases. Thirty of 470 patients with TAK had UC (6.4% [95% confidence interval 4.3-9.0]). This percentage was strikingly higher than that expected from the prevalence of UC in Japan. Patients with TAK complicated with UC developed TAK at an earlier stage of life (P = 0.0070) and showed significant enrichment of HLA-B*52:01 compared to TAK patients without UC (P = 1.0 × 10(-5) ) (odds ratio 12.14 [95% confidence interval 2.96-107.23]). The 110 non-HLA markers of susceptibility to UC significantly displayed common risk directions with susceptibility to TAK (P = 0.0054) and showed significant departure of permutation P values from expected P values (P < 1.0 × 10(-10) ). UC is a major complication of TAK. These 2 diseases share a significant proportion of their genetic background, and HLA-B*52:01 may play a central role in their co-occurrence. © 2015, American College of Rheumatology.

Endovascular Versus Open Surgical Intervention in Patients with Takayasu's Arteritis: A Meta-analysis.

PubMed

Jung, Jae Hyun; Lee, Young Ho; Song, Gwan Gyu; Jeong, Han Saem; Kim, Jae-Hoon; Choi, Sung Jae

2018-06-01

Although medical treatment has advanced, surgical treatment is needed to control symptoms of Takayasu's arteritis (TA), such as angina, stroke, hypertension, or claudication. Endovascular or open surgical intervention is performed; however, there are few comparative studies on these methods. This meta-analysis and systematic review aimed to examine the outcome of surgical treatment of TA. A meta-analysis comparing outcomes of endovascular and open surgical intervention was performed using MEDLINE and Embase. This meta-analysis included only observational studies, and the evidence level was low to moderate. Data were pooled and analysed using a fixed or random effects model with the I 2 statistic. The included studies involved a total of 770 patients and 1363 lesions, with 389 patients treated endovascularly and 420 treated by surgical revascularization. Restenosis was more common with endovascular than open surgical intervention (odds ratio [OR] 5.18, 95% confidence interval [CI] 2.78-9.62; p < .001). In subgroup analysis according to the involved lesions, endovascular intervention patients showed more restenosis than open surgical intervention patients in the coronary artery, supra-aortic branches, and renal artery. In both the active and inactive stages, restenosis was more common in those treated endovascularly than in those treated by open surgery. However, stroke occurred less often with endovascular intervention than with open surgical intervention (OR 0.33, 95% CI 0.12-0.90; p = .003). Mortality and complications other than stroke and mortality did not differ between endovascular and open surgical intervention. This meta-analysis has shown a lower risk of restenosis with open surgical intervention than with endovascular intervention. Stroke was generally more common with open surgical intervention than with endovascular intervention. However, there were differences according to the location of the lesion, and the risk of stroke in open surgery is higher

Tumour necrosis factor (TNF)-α-308 gene polymorphism in Indian patients with Takayasu's arteritis - a pilot study.

PubMed

Sandhya, P; Danda, Sumita; Danda, Debashish; Lonarkar, Shraddha; Luke, Shana S; Sinha, Shanta; Joseph, George

2013-04-01

Tumour necrosis factor-alpha (TNF-α)- 308 promoter gene polymorphism has been shown to be associated with several autoimmune disorders and infections such as tuberculosis. There is no study on TNF-α gene polymorphism in Takayasu's arteritis (TA) till date. We aimed to study this polymorphism in TA, a granulomatous vasculitis, probably triggered by Mycobacterium tuberculosis. TNF-α - 308 gene polymorphism was studied in 34 patients with TA and 39 healthy controls recruited from Christian Medical College, India. PCR was done followed by enzyme digestion. G and A polymorphisms were analysed. Occurrence of alleles in the disease group was compared with controls as well as with historical controls. GG allele was most frequent in TA and in controls. GA allele was detected in four controls but only in one patient who was the oldest in the study group. AA polymorphism was detected in one control but not in TA. When compared with controls from other populations, it was found that our allelic frequency was similar to that in Japan as well as from USA with mixed population. However, predominantly Caucasian population studied from Netherlands, Germany and England, where TA is rare, had a higher frequency of A allele as compared to our controls. Our preliminary results indicated that G allele at TNF-α - 308 was more common in TA patients and controls similar to that in other Indian as well as Japanese population. Compared to the western population, A allele was relatively less common in our study subjects.

Evaluation of clinical measurements and development of new diagnostic criteria for Takayasu arteritis in a Chinese population.

PubMed

Kong, X; Ma, L; Wu, L; Chen, H; Ma, L; Sun, Y; Wu, W; Ji, Z; Zhang, Z; Yang, C; Ye, S; Chen, S; Dai, S; Xue, Y; Qin, G; Zou, Y; Yu, Q; Jiang, L

2015-01-01

Takayasu arteritis (TA) is a chronic granulomatous large-vessel vasculitis. When diagnosing TA, the criteria designed by the American College of Rheumatology (ACR) are used commonly but they were just classification criteria. There is an urgent need for a new set of diagnostic criteria. One hundred and thirty-one TA patients and 132 control patients with other types of vascular disease were enrolled and both groups were distributed into a "training set" and a "validation set". All general information as well as clinical, laboratory and imaging data were collected. After comparing all the medical records of two groups in the training set, logistic regression and clinical judgment were used to form the new criteria for TA. The new criteria were tested by the validation set. New TA diagnostic criteria within total score 26 include age (<40 years), female, chest pain/chest distress, amaurosis, vascular bruits, a decreased/absent pulse, involvement of the aortic arch or its major branches, and involvement of the abdominal aorta or its branches. Patients with a score ≥ 8 were diagnosed as TA. The sensitivity and specificity of our new criteria were 91.92% and 93.94%, respectively, higher than those of the ACR criteria (75.76%, 85.86%) and the Ishikawa criteria (56.57%, 94.95%). The areas under the ROC curves of the new criteria and ACR criteria were 0.981 and 0.868, respectively (p<0.001). Sensitivity and specificity tested in the validation set were 90.63% and 96.97%, respectively. The new diagnostic criteria exhibited high sensitivity and specificity and have demonstrated to be feasible in the diagnosis of TA.

Evaluation of takayasu arteritis with delayed contrast-enhanced MR imaging by a free-breathing 3D IR turbo FLASH.

PubMed

Liu, Min; Liu, Weifang; Li, Haoyuan; Shu, Xiaoming; Tao, Xincao; Zhai, Zhenguo

2017-12-01

The primary aim of our case-control study was to observe delayed contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with Takayasu arteritis (TA) in comparison with magnetic resonance angiography (MRA). Twenty-seven patients including 15 with active TA and 12 with stable TA who underwent both aortic MRA and DCE-MRI were included. A total of 27 sex- and age-matched healthy volunteers were enrolled as the control group. MRA were obtained with T1WI-volume-interpolated breath-hold examination sequence or fast low-angle shot (FLASH) sequence. DCE-MRI was acquired with a free-breathing three-dimensional inversion recovery Turbo fast low-angle shot (3D IR Turbo FLASH). Neither stenosis nor delayed enhancement of arterial wall was shown in the control group. In patients with stable TA, arterial stenosis was observed on MRA. On DCE-MR, delayed enhancement of arterial walls could be observed in the active TA group but not in the stable TA group or the control group. Stenotic arteries on MRA were comparable in the active TA and stable TA (χ = 2.70, P = .259); however, delayed enhancement of arterial walls in the active-TA group were more than those in the stable group (χ = 27.00, P < .001). Our results suggest that DCE-MRI with the free-breathing 3D IR Turbo FLASH sequence could assess TA and delayed enhancement on DCE-MRI is one characteristics of the active TA. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Takayasu's arteritis is associated with HLA-B*52, but not with HLA-B*51, in Turkey.

PubMed

Sahin, Ziver; Bıcakcıgil, Muge; Aksu, Kenan; Kamali, Sevil; Akar, Servet; Onen, Fatos; Karadag, Omer; Ozbalkan, Zeynep; Ates, Askin; Ozer, Huseyin Te; Yilmaz, Vuslat; Seyahi, Emire; Ozturk, Mehmet A; Cefle, Ayse; Cobankara, Veli; Onat, A Mesut; Tunc, Ercan; Düzgün, Nursen; Aydin, Sibel Z; Yilmaz, Neslihan; Fresko, İzzet; Karaaslan, Yasar; Kiraz, Sedat; Akkoc, Nurullah; Inanc, Murat; Keser, Gokhan; Uyar, F Aytul; Direskeneli, Haner; Saruhan-Direskeneli, Güher

2012-02-06

HLA-B*51 and HLA-B*52 are two close human leukocyte antigen (HLA) allele groups with minor amino acid differences. However, they are associated with two different vasculitides (HLA-B*51 in Behçet's disease and HLA-B*52 in Takayasu's arteritis (TAK)) and with major clinical and immunological differences. In this study, we aimed to screen a large cohort of TAK patients from Turkey for the presence of HLA-B*51 and HLA-B*52 as susceptibility and severity factors. TAK patients (n = 330) followed at a total of 15 centers were included in the study. The mean age of the patients was 37.8 years, and 86% were women. DNA samples from the patients and healthy controls (HC; n = 210) were isolated, and the presence of HLA-B*51 or HLA-B*52 was screened for by using PCR with sequence-specific primers. We found a significant association of HLA-B*52 with TAK (20.9% vs HC = 6.7%, P = 0.000, OR = 3.7, 95% CI = 2.02 to 6.77). The distribution of HLA-B*51 did not differ between TAK patients and HCs (22.7% vs 24.8%, OR = 0.9, 95% CI = 0.60 to 1.34). The presence of HLA-B*52 decreased in late-onset patients (> 40 years of age; 12.0%, P = 0.024, OR = 0.43, 95% CI = 0.20 to 0.91). Patients with angiographic type I disease with limited aortic involvement also had a lower presence of HLA-B*52 compared to those with all other disease subtypes (13.1% vs 26%, P = 0.005, OR = 0.43, 95% CI = 0.23 to 0.78). In this study, the previously reported association of TAK with HLA-B*52 in other populations was confirmed in patients from Turkey. The functional relevance of HLA-B*52 in TAK pathogenesis needs to be explored further.

mTOR pathway is activated in endothelial cells from patients with Takayasu arteritis and is modulated by serum immunoglobulin G.

PubMed

Hadjadj, Jérôme; Canaud, Guillaume; Mirault, Tristan; Samson, Maxime; Bruneval, Patrick; Régent, Alexis; Goulvestre, Claire; Witko-Sarsat, Véronique; Costedoat-Chalumeau, Nathalie; Guillevin, Loïc; Mouthon, Luc; Terrier, Benjamin

2018-06-01

Takayasu arteritis (TA) and GCA are large-vessel vasculitides characterized by vascular remodelling involving endothelial cells (ECs) and vascular smooth muscle cells. Mammalian target of rapamycin (mTOR) pathway has been involved in vascular remodelling. We hypothesized that the mTOR pathway was involved in the pathogenesis of large-vessel vasculitis. We used IF analysis on aortic and temporal artery biopsies from patients with TA and GCA to assess the involvement of the mTOR pathway and searched for antibodies targeting ECs in serum by IIF and cellular ELISA. We evaluated in vitro the effect of purified IgG from patients on mTOR pathway activation and cell proliferation. IF analyses on tissues revealed that both mTORC1 and mTORC2 are activated specifically in ECs from TA patients but not in ECs from GCA patients and healthy controls (HCs). Using IIF and ELISA, we observed higher levels of antibodies binding to ECs in TA patients compared with GCA patients and HCs. Using western blot, we demonstrated that purified IgG from TA patients caused mTORC1 activation in ECs, whereas this effect was not observed with purified IgG from GCA patients or HCs. Purified IgG from TA patients induced a significant EC proliferation compared with to GCA and HC IgG, and this effect was decreased after EC exposure with sirolimus, a specific mTOR inhibitor and PI3K inhibitor. Our results suggest that antibodies targeting ECs drive endothelial remodelling in TA through activation of the mTOR pathway, but not in GCA. Inhibition of the mTOR pathway could represent a therapeutic option in TA.

Low Dose Naltrexone to Improve Physical Health in Patients With Vasculitis

ClinicalTrials.gov

2018-06-08

Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Giant Cell Arteritis; Granulomatosis With Polyangiitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis

Takayasu's disease in Arabs.

PubMed Central

Sattar, M. A.; White, A. G.; Eklof, B.; Fenech, F. F.

1985-01-01

Four cases of Takayasu's disease in female Arabs are reported. All patients had classical features of the disease. Typing for HLA phenotype showed that all patients had HLA A2, A9, BW35 and DR7 antigens, suggesting an immunogenetic basis for the disease. As far as we know, this is the first report of Takayasu's disease in this ethnic group. Images Figure 1 PMID:2862623

Educational Needs of Patients With Systemic Vasculitis

ClinicalTrials.gov

2014-07-11

Behcet's Disease; Churg-Strauss Syndrome; Vasculitis, Central Nervous System; Giant Cell Arteritis; Wegener Granulomatosis; Henoch-Schoenlein Purpura; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu's Arteritis

Journey of Patients With Vasculitis From First Symptom to Diagnosis

ClinicalTrials.gov

2018-06-05

Vasculitis; Systemic Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatous Vasculitis; Temporal Arteritis; Giant Cell Arteritis; Granulomatosis With Polyangiitis; Wegener Granulomatosis; Henoch Schonlein Purpura; IgA Vasculitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis; Urticarial Vasculitis

Takayasu's Arteritis

MedlinePlus

... the largest blood vessel in the body (the aorta) and its branches. Thus, the complications of Takayasu’s ... with Takayasu’s, with obvious dilation of the ascending aorta on the left side of the picture. Clinicians ...

Impact of Vasculitis on Employment and Income

ClinicalTrials.gov

2016-01-26

Vasculitis; Systemic Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatosis; Temporal Arteritis; Wegener Granulomatosis; Henoch-Schoenlein Purpura; Microscopic Polyangiitis; Polyarteritis Nodosa (PAN); Takayasu's Arteritis; Urticarial Vasculitis

Reproductive Health in Men and Women With Vasculitis

ClinicalTrials.gov

2014-06-25

Giant Cell Arteritis; Takayasu's Arteritis; Polyarteritis Nodosa; Wegener's Granulomatosis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Behcet's Disease; Kawasaki Disease; Henoch-schoenlein Purpura; Vasculitis, Central Nervous System; Drug-induced Necrotizing Vasculitis

VCRC Tissue Repository

ClinicalTrials.gov

2018-04-23

Aortitis; Cutaneous Vasculitis; Eosinophilic Granulomatosis With Polyangiitis; Giant Cell Arteritis; Granulomatosis With Polyangiitis (Wegener's); Henoch-Schonlein Purpura; IgA Vasculitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis; Churg-Strauss Syndrome

[Large vessel vasculitides].

PubMed

Morović-Vergles, Jadranka; Puksić, Silva; Gracanin, Ana Gudelj

2013-01-01

Large vessel vasculitis includes Giant cell arteritis and Takayasu arteritis. Giant cell arteritis is the most common form of vasculitis affect patients aged 50 years or over. The diagnosis should be considered in older patients who present with new onset of headache, visual disturbance, polymyalgia rheumatica and/or fever unknown cause. Glucocorticoides remain the cornerstone of therapy. Takayasu arteritis is a chronic panarteritis of the aorta ant its major branches presenting commonly in young ages. Although all large arteries can be affected, the aorta, subclavian and carotid arteries are most commonly involved. The most common symptoms included upper extremity claudication, hypertension, pain over the carotid arteries (carotidynia), dizziness and visual disturbances. Early diagnosis and treatment has improved the outcome in patients with TA.

Two susceptibility loci to Takayasu arteritis reveal a synergistic role of the IL12B and HLA-B regions in a Japanese population.

PubMed

Terao, Chikashi; Yoshifuji, Hajime; Kimura, Akinori; Matsumura, Takayoshi; Ohmura, Koichiro; Takahashi, Meiko; Shimizu, Masakazu; Kawaguchi, Takahisa; Chen, Zhiyong; Naruse, Taeko K; Sato-Otsubo, Aiko; Ebana, Yusuke; Maejima, Yasuhiro; Kinoshita, Hideyuki; Murakami, Kosaku; Kawabata, Daisuke; Wada, Yoko; Narita, Ichiei; Tazaki, Junichi; Kawaguchi, Yasushi; Yamanaka, Hisashi; Yurugi, Kimiko; Miura, Yasuo; Maekawa, Taira; Ogawa, Seishi; Komuro, Issei; Nagai, Ryozo; Yamada, Ryo; Tabara, Yasuharu; Isobe, Mitsuaki; Mimori, Tsuneyo; Matsuda, Fumihiko

2013-08-08

Takayasu arteritis (TAK) is an autoimmune systemic vasculitis of unknown etiology. Although previous studies have revealed that HLA-B*52:01 has an effect on TAK susceptibility, no other genetic determinants have been established so far. Here, we performed genome scanning of 167 TAK cases and 663 healthy controls via Illumina Infinium Human Exome BeadChip arrays, followed by a replication study consisting of 212 TAK cases and 1,322 controls. As a result, we found that the IL12B region on chromosome 5 (rs6871626, overall p = 1.7 × 10(-13), OR = 1.75, 95% CI 1.42-2.16) and the MLX region on chromosome 17 (rs665268, overall p = 5.2 × 10(-7), OR = 1.50, 95% CI 1.28-1.76) as well as the HLA-B region (rs9263739, a proxy of HLA-B*52:01, overall p = 2.8 × 10(-21), OR = 2.44, 95% CI 2.03-2.93) exhibited significant associations. A significant synergistic effect of rs6871626 and rs9263739 was found with a relative excess risk of 3.45, attributable proportion of 0.58, and synergy index of 3.24 (p ≤ 0.00028) in addition to a suggestive synergistic effect between rs665268 and rs926379 (p ≤ 0.027). We also found that rs6871626 showed a significant association with clinical manifestations of TAK, including increased risk and severity of aortic regurgitation, a representative severe complication of TAK. Detection of these susceptibility loci will provide new insights to the basic mechanisms of TAK pathogenesis. Our findings indicate that IL12B plays a fundamental role on the pathophysiology of TAK in combination with HLA-B(∗)52:01 and that common autoimmune mechanisms underlie the pathology of TAK and other autoimmune disorders such as psoriasis and inflammatory bowel diseases in which IL12B is involved as a genetic predisposing factor. Copyright © 2013 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Autologous Peripheral Blood Stem Cell Transplantation in Patients With Life Threatening Autoimmune Diseases

ClinicalTrials.gov

2005-06-23

Purpura, Schoenlein-Henoch; Graft Versus Host Disease; Anemia, Hemolytic, Autoimmune; Rheumatoid Arthritis; Churg-Strauss Syndrome; Hypersensitivity Vasculitis; Wegener's Granulomatosis; Systemic Lupus Erythematosus; Giant Cell Arteritis; Pure Red Cell Aplasia; Juvenile Rheumatoid Arthritis; Polyarteritis Nodosa; Autoimmune Thrombocytopenic Purpura; Takayasu Arteritis

Giant Cell Arteritis

MedlinePlus

Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

Equine Arteritis Virus

USDA-ARS?s Scientific Manuscript database

03. Nidovirales : 03.004. Arteriviridae : 03.004.0. {03.004.0. unknown} : 03.004.0.01. Arterivirus : 03.004.0.01.001. Equine arteritis virus will be published online. The article details the phenotypic and genotypic makeup of equine arteritis virus (EAV), and summarizes its biological properties....

Addison's disease secondary to connective tissue diseases: a report of six cases.

PubMed

Zhang, Zhuo-li; Wang, Yu; Zhou, Wei; Hao, Yan-jie

2009-04-01

Addison's disease is an autoimmune process. However, Addison's disease associated with connective tissue diseases (CTD) is only occasionally reported. Here, we report six cases of Addison's disease secondary to a variety of CTD, which include systemic lupus erythematosus, Takayasu arteritis, systemic sclerosis, ankylosing spondylitis (AS) and antiphospholipid antibody syndrome. The association of Addison's disease with Takayasu arteritis and AS is reported for the first time. We also found high prevalence of hypothyroidism as concomitant autoimmune disorder. Our case series highlight the autoimmune features of Addison's disease. Therefore, we suggest considering adrenal dysfunction in patients with CTD.

Clinical and vascular features of Takayasu arteritis at the time of ischemic stroke.

PubMed

de Paula, Luiz Eduardo; Alverne, Andrea Rocha; Shinjo, Samuel K

2013-01-01

Takayasus arteritis (TA) is a systemic vasculitis whose clinical presentation varies from asymptomatic to serious neurovascular events, including stroke. However, few studies are currently available assessing stroke in TA. Thus, we described the clinical and laboratory characteristics and vascular imaging features in patients with TA at the time of stroke. This is a single center retrospective cohort study investigating the clinical and demographic data of 18 (15.0%) patients with a history of stroke confirmed by imaging methods, among 120 patients with TA, assessed in the 1985-2012 period. The mean age of the 18 patients at the time of stroke was 29.4+/-10.9 years, with 94.4% female and 88.9% Caucasian. Of these patients, 14 (77.8%) had previous stroke at diagnosis of TA, while in four cases the stroke occurred after confirmed TA diagnosis. Regarding the clinical course, 12 (66.7%) had peripheral neurological sequelae and one patient died as a result of cerebral hyperperfusion syndrome after carotid revascularization. Our results showed a high prevalence of stroke in TA and revealed most of these events occurred concomitantly with diagnosed TA. Moreover, although four patients had strokes after diagnosis of TA, these occurred at a young age, demonstrating they were most likely the result of vascular changes secondary to TA.

Cannabis arteritis: review of the literature.

PubMed

Cottencin, Olivier; Karila, Laurent; Lambert, Marc; Arveiller, Catherine; Benyamina, Amine; Boissonas, Alain; Goudemand, Michel; Reynaud, Michel

2010-12-01

Consumption of cannabis in young adults has continued to increase in recent years. Cannabis arteritis was first described in the 1960s, but the number of cases has continued to increase. We reviewed current knowledge of the different types of cannabis arteritis in young adults and found 70 cases of cannabis arteritis in the literature. We discuss physiopathological arguments in favor of cannabis vascular toxicity per se, although we did not find sufficient evidence to identify cannabis arteritis as a specific diagnostic entity. Many factors suggest a link between cannabis consumption and arteritis in young adults, but it is difficult to say whether this type of arteritis is similar to thromboangiitis obliterans. We were unable to demonstrate a formal association between cannabis smoking and the development of thromboangiitis obliterans, because most case reports showed associated tobacco smoking (97%) and the number of years cannabis had been smoked by the participants was mostly unknown. Cannabis consumption would however seems to be an aggravating factor, together with tobacco, in arteritis, which occurs in young adults.

Pediatric Vasculitis Initiative

ClinicalTrials.gov

2018-05-03

Wegeners Granulomatosis (Granulomatosis With Polyangiitis); Microscopic Polyangiitis; Churg Strauss Syndrome (Eosinophilic Granulomatosis With Polyangiitis); Polyarteritis Nodosa; Takayasu Arteritis; Primary CNS Vasculitis; Unclassified Vasculitis

Cannabis arteritis.

PubMed

El Omri, Naoual; Eljaoudi, Rachid; Mekouar, Fadwa; Jira, Mohammed; Sekkach, Youssef; Amezyane, Taoufik; Ghafir, Driss

2017-01-01

Cannabis is the most consumed psychoactive substance by young people. Chronic use of cannabis can lead to cannabis arteritis, which is a very rare peripheral vascular disease similar to Buerger's disease. It is affecting young adults, especially men, consuming cannabis. A 27-year old woman, with no particular past medical history except for long-term use of cannabis and tobacco developed a digital necrosis in the left hand. She denied using other illicit drugs. Doppler ultrasound examination of the upper limbs was unremarkable. Toxicological analysis revealed the presence of cannabis in both biological fluid and hair strand. Despite medical treatment, cessation of the cannabis and tobacco consumption and hyperbaric oxygen therapy, an amputation of necrotic parts was then required. This case shows the prolonged use of cannabis could be a risk factor for young adult arteritis. Faced with a rapidly progressive arteritis occurring in young adult, the physician should consider the history of use of cannabis. Hair analysis can be useful for confirmation of the chronic consumption of drugs.

Yellow Fever Vaccine in Patients With Rheumatic Diseases

ClinicalTrials.gov

2018-04-05

Systemic Lupus; Rheumatoid Arthritis; Spondyloarthritis; Inflammatory Myopathy; Systemic Sclerosis; Mixed Connective Tissue Disease; Takayasu Arteritis; Granulomatosis With Polyangiitis; Sjogren's Syndrome; Juvenile Idiopathic Arthritis; Juvenile Dermatomyositis

Giant cell arteritis of fallopian tube.

PubMed

Azzena, A; Altavilla, G; Salmaso, R; Vasoin, F; Pellizzari, P; Doria, A

1994-01-01

One case of giant cells arteritis involving tubaric arteries in a postmenopausal woman is described. The patient was 59 years old and presented with asthenia, anemia, fever, weight loss, an abdominal palpable mass and elevated erythrocyte sedimentation rate. Exploratory laparotomy revealed a large ovarian cyst of 14 cm in diameter. Extensive giant cell arteritis, Horton's type, of the small-sizes arteries was found unexpectedly in the fallopian tube of the patient who had had a prior ovariectomy. Giant cell arteritis of the female genital tract is a rare finding in elderly women and may occur as an isolated finding or as part of generalised arteritis.

Giant cell arteritis mimicking a testicular tumour.

PubMed

Sundaram, S; Smith, D H

2001-07-01

Giant cell arteritis involving the testis was identified incidentally upon orchidectomy of a right testicular mass. The mass looked like a malignant process on ultrasound. The patient also had generalised disease and was treated appropriately. Giant cell arteritis involving the bladder, prostate, uterus, and adnexa have been described before. To our knowledge, this is the first described case of giant cell arteritis affecting the testis.

Polymyalgia Rheumatica

MedlinePlus

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HIV and Rheumatic Disease

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Neck Pain

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Psoriatic Arthritis

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What Is a Rheumatologist?

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Genetics and Rheumatic Disease

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Pregnancy and Rheumatic Disease

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Find a Rheumatologist

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Juvenile Arthritis

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Gout

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Dermatomyositis (Juvenile)

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Immune System and Its Link to Rheumatic Diseases

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HCV and Rheumatic Disease

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Osteonecrosis

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Antinuclear Antibodies (ANA)

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NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

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Sex and Arthritis

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Osteonecrosis of the Jaw (ONJ)

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Joint Injection/Aspiration

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American College of Rheumatology

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Carpal Tunnel Syndrome

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Metabolic Myopathies

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Spinal Stenosis

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Sjögren's Syndrome

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Granulomatosis with Polyangiitis (Wegener's)

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Calcium Pyrophosphate Deposition (CPPD)

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Cryopyrin-Associated Autoinflammatory Syndromes (CAPS) - Juvenile

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Tendinitis and Bursitis

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Vasculitis

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Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis Syndrome (PFAPA)

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Giant Cell Arteritis Presenting as Scalp Necrosis

PubMed Central

Maidana, Daniel E.; Muñoz, Silvia; Acebes, Xènia; Llatjós, Roger; Jucglà, Anna; Álvarez, Alba

2011-01-01

The differential of scalp ulceration in older patients should include several causes, such as herpes zoster, irritant contact dermatitis, ulcerated skin tumors, postirradiation ulcers, microbial infections, pyoderma gangrenosum, and giant cell arteritis. Scalp necrosis associated with giant cell arteritis was first described in the 1940s. The presence of this dermatological sign within giant cell arteritis represents a severity marker of this disease, with a higher mean age at diagnosis, an elevated risk of vision loss and tongue gangrene, as well as overall higher mortality rates, in comparison to patients not presenting this manifestation. Even though scalp necrosis due to giant cell arteritis is exceptional, a high level of suspicion must be held for this clinical finding, in order to initiate prompt and proper treatment and avoid blindness. PMID:21789466

Giant cell arteritis: a review.

PubMed

Patil, Pravin; Karia, Niral; Jain, Shaifali; Dasgupta, Bhaskar

2013-01-01

Giant cell arteritis is the most common vasculitis in Caucasians. Acute visual loss in one or both eyes is by far the most feared and irreversible complication of giant cell arteritis. This article reviews recent guidelines on early recognition of systemic, cranial, and ophthalmic manifestations, and current management and diagnostic strategies and advances in imaging. We share our experience of the fast track pathway and imaging in associated disorders, such as large-vessel vasculitis.

Giant cell arteritis: a review

PubMed Central

Patil, Pravin; Karia, Niral; Jain, Shaifali; Dasgupta, Bhaskar

2013-01-01

Giant cell arteritis is the most common vasculitis in Caucasians. Acute visual loss in one or both eyes is by far the most feared and irreversible complication of giant cell arteritis. This article reviews recent guidelines on early recognition of systemic, cranial, and ophthalmic manifestations, and current management and diagnostic strategies and advances in imaging. We share our experience of the fast track pathway and imaging in associated disorders, such as large-vessel vasculitis. PMID:28539785

Takayasu's disease in a young black boy.

PubMed

Oguntona, S A

2010-12-01

Takayusu's disease is a rare disease affecting women predominantly during the child- bearing age. It is a primary vasculitis condition of large-vessels that responds well to steroid therapy. Immunosuppressives and vascular reconstruction may be needed as necessary. Reference was made to the case note of this young boy who was being co-managed by cardiology and vascular clinics. The diagnosis of Takayasu's disease was confirmed by the rheumatology unit and appropriate literature search was done. Takayusu's disease responds well to steroid therapy as exemplified by this patient. There was no relapse of the active inflammation after six months of steroid therapy. A high index of suspicion must be exercise in diagnosing Takayasu's disease. It could be difficult to have a clue early in the disease process because of non-specific presentations. Appropriate referral should however be made to Rheumatologist when the diagnosis is suspected. This will go a long way in delaying the morbidity that is associated with this rare disease.

Clinical correlation of biopsy results in patients with temporal arteritis.

PubMed

Yuksel, Volkan; Guclu, Orkut; Tastekin, Ebru; Halici, Umit; Huseyin, Serhat; Inal, Volkan; Canbaz, Suat

2017-11-01

Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. The results of our study are noteworthy, since there is limited data on pathologic diagnosis of temporal arteritis in Turkey. We studied the medical records, laboratory findings such as erythrocyte sedimentation rate and C-reactive protein levels, biopsy results, and postoperative complications of all the patients operated for temporal artery biopsy at our clinic. We used the computerized laboratory registry that keeps all records of 42 consecutive temporal artery biopsy results from January 2011 to December 2016. The mean age was 66±12.5 years. The most common manifestations on admission were temporal headache, optic neuritis and jaw claudication, respectively. Temporal artery biopsy  results confirmed tempoal arteritis in eight out of 42 (19%) patients. There was no statistically significant difference between biopsy-positive and biopsy-negative groups in terms of sex, age, erythrocyte sedimentation rate, C-reactive protein and biopsy length. We were not able to find a correlation between the analysis of biopsy results and clinical evaluation of patients with temporal arteritis. We suggest that diagnosis of temporal arteritis  depends on clinical suspicion. Laboratory examination results may not be helpful in accurate diagnosis of tempoal arteritis.

Vasculitis Pregnancy Registry

ClinicalTrials.gov

2018-04-30

Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Granulomatosis With Polyangiitis (GPA); Wegener's Granulomatosis; IgA Vasculitis; Henoch-Schoenlein Purpura (HSP); Microscopic Polyangiitis (MPA); Polyarteritis Nodosa (PAN); Takayasu Arteritis (TAK); Urticarial Vasculitis; Systemic Vasculitis

Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?

PubMed Central

Gupta, Prabha Nini; Salam Basheer, Abdul; Sukumaran, Gireesh Gomaty; Padmajan, Sabin; Praveen, Satheesan; Velappan, Praveen; Nair, Bigesh Unnikrishnan; Nair, Sandeep Govindan; Kunjuraman, Usha Kumari; Madthipat, Unnikrishnan; R, Jayadevan

2013-01-01

Femoral pseudoaneurysm is a common complication of repeated femoral puncture during cardiac catheterisation. We describe here the development of femoral pseudoaneurysms in a patient with Takayasu's arteritis, which healed in response to conservative treatment, and review the literature on the prevention and treatment of femoral pseudoaneurysm. PMID:27326111

Ophthalmic presentation of giant cell arteritis in African-Americans

PubMed Central

Garrity, S T; Pistilli, M; Vaphiades, M S; Richards, N Q; Subramanian, P S; Rosa, P R; Lam, B L; Osborne, B J; Liu, G T; Duncan, K E; Shin, R K; Volpe, N J; Shindler, K S; Lee, M S; Moster, M L; Tracey, E H; Cuprill-Nilson, S E; Tamhankar, M A

2017-01-01

Purpose To determine the differences in the presentation of ophthalmic giant cell arteritis between African-Americans and Caucasians. Methods This was a multicenter retrospective case series comparing African-American patients with ophthalmic GCA to a previously published Caucasian cohort. Neuro-ophthalmic centers across the United States were contacted to provide data on African-American patients with biopsy-proven ophthalmic giant cell arteritis. The differences between African-American and Caucasian patients with respect to multiple variables, including age, sex, systemic and ophthalmic signs and symptoms, ocular ischemic lesions, and laboratory results were studied. Results The Caucasian cohort was slightly older (mean=76.1 years) than the African-American cohort (mean=72.6 years, P=0.03), and there was no difference in sex distribution between the two cohorts. Headache, neck pain, and anemia were more frequent, while jaw claudication was less frequent in African-Americans (P<0.01, <0.001, 0.02, and 0.03 respectively). Acute vision loss was the most common presentation of giant cell arteritis in both groups, though it was less common in African-Americans (78 vs 98% of Caucasians, P<0.001). Eye pain was more common in African-Americans (28 vs 8% of Caucasians, P<0.01). Conclusions The presenting features of ophthalmic giant cell arteritis in African-Americans and Caucasians are not markedly different, although a few significant differences exist, including higher rates of headache, neck pain, anemia, and eye pain, and lower rates of jaw claudication and acute vision loss in African-Americans. Persons presenting with suspicious signs and symptoms should undergo evaluation for giant cell arteritis regardless of race. PMID:27636230

The Relationship of the Severity and Category of Acute Rejection With Intimal Arteritis Defined in Banff Classification to Clinical Outcomes.

PubMed

Wu, Kaiyin; Budde, Klemens; Schmidt, Danilo; Neumayer, Hans-Helmut; Rudolph, Birgit

2015-08-01

It is unclear if the category of acute rejection with intimal arteritis (ARV) is relevant to short- and long-term clinical outcomes and if the graft outcomes are affected by the severity of intimal arteritis. One hundred forty-eight ARV episodes were reviewed and categorized according to the 2013 Banff criteria of AMR: T cell-mediated rejection with intimal arteritis (v) lesion (TCMRV; n = 78), total antibody-mediated rejection with v lesion (AMRV), which were further divided into suspicious AMRV (n = 37) and AMRV (n = 33). The Banff scores of intimal arteritis (v1, v2 and v3) represented low, moderate, and high ARV severity. The grafts with TCMRV, suspicious AMRV (sAMRV), and AMRV showed similar responses to antirejection therapy, whereas the grafts with v2- or v3-ARV responded significantly poorer compared to those with v1-ARV. The 8-year death-censored graft survival (DCGS) rate was 56.8% of TCMRV versus 34.1% of total AMRV (Log rank, P = 0.03), but the 1- and 5-year DCGS rates were comparable between the 2 groups; moreover, the 1-, 5-, and 8-year DCGS rates of v1-ARV were evidently higher than v2- and v3-ARV (each pairwise comparison to v1-AVR yields P < 0.01); in contrast, the DCGS rates were similar between sAMRV and AMRV. The existing donor-specific antibodies or moderate microvascular inflammation or C4d-positive staining or intensive tubulointerstitial inflammation played a less significant role on the long-term graft survival. Compared to the category, the ARV severity is more closely associated with the initial response to antirejection therapy and long-term graft failure. The sAMRV and AMRV might represent a spectrum of the same disorder.

Management of giant cell arteritis and polymyalgia rheumatica.

PubMed

Meskimen, S; Cook, T D; Blake, R L

2000-04-01

Giant cell arteritis and polymyalgia rheumatica are closely related disorders that affect persons more than 50 years of age and cause substantial morbidity. Patients with giant cell arteritis typically have a localized headache, nonspecific systemic symptoms, temporal artery tenderness and a high erythrocyte sedimentation rate (ESR). The diagnosis is confirmed by characteristic pathologic findings on temporal artery biopsy. Patients with polymyalgia rheumatica usually have similar nonspecific systemic symptoms, proximal muscle pain and stiffness, and an elevated ESR. The diagnosis is based on the clinical findings. Both disorders are treated with corticosteroids: high dosages for giant cell arteritis (prednisone in a dosage of 40 to 60 mg per day) and lower dosages for polymyalgia rheumatica (prednisone in a dosage of 10 to 20 mg per day). Symptom relief in response to treatment is rapid and reinforces the diagnosis. After normalization of the ESR, the corticosteroid is tapered, with the patient monitored closely for symptom recurrence. Most patients require corticosteroid therapy for two to three years and experience one or more treatment complications.

Bilateral Posterior Scleritis Associated with Giant Cell Arteritis: A Case Report.

PubMed

Erdogan, Mehmet; Sayin, Nihat; Yıldız Ekinci, Dilbade; Bayramoglu, Sadik

2017-09-15

To report a case of bilateral posterior scleritis associated with giant cell arteritis Case Report: A 62-year-old female patient presented with bilateral progressive vision loss was diagnosed with bilateral posterior scleritis. According to clinical signs and symptoms and laboratory testing, Giant cell arteritis was also diagnosed. Within 8 weeks of the corticosteroid treatment, the serous retinal detachments completely resolved and choroidal thickness decreased in both eyes. Visual acuity increased, and the symtoms related to Giant cell arteritis improved. Posterior scleritis is an inflammatory disease that may be associated with many autoimmune systemic diseases. GCA should be thought of particularly in patients over the age of 50 with bilateral involvement, and a relevant detailed history should be obtained for early and correct diagnosis and treatment.

[Medicinal laws and application examples of traditional Chinese medicine prescriptions for multiple aorto-arteritis].

PubMed

Zhang, Xin-Gen; Cai, Hai-Ying

2016-05-01

To collect the literature on traditional Chinese medicine treatment for multiple aorto-arteritis from China National Knowledge Infrastructure(CNKI), establish prescriptions database after screening and normalizing the prescriptions reported in these literature, and analyze their medicinal rules by using traditional Chinese medicine inheritance support system. A total of 126 prescriptions for multiple aorto-arteritis were screened, containing 212 kinds of Chinese herbs. 26 core herb combinations were obtained by analysis of the commonly used herbs and their use frequencies. The treatment for multiple aorto-arteritis was manly of tonifying qi to nourish blood, promoting blood circulation to remove blood stasis, warming yang to dredge collaterals, and four new prescriptions were obtained. On this basis, two clinical cases were taken as the examples by analyzing the medicinal rules and the features of multiple aorto-arteritis. The first case showed that the herb combination of this study conformed to the basic core drug application mode and the core pathogenesis of multiple aorto-arteritis. The second case reflected the characteristics of the new prescriptions' herb combinations based on entropy hierarchical clustering. The practical analysis of the two clinical cases further indicated the reliability of the results. This study has certain guiding significance and reference value on new medicine research and development as well as clinical traditional Chinese medicine treatment for multiple aorto-arteritis. Copyright© by the Chinese Pharmaceutical Association.

Diffuse corpus callosum infarction - Rare vascular entity with differing etiology.

PubMed

Mahale, Rohan; Mehta, Anish; Buddaraju, Kiran; John, Aju Abraham; Javali, Mahendra; Srinivasa, Rangasetty

2016-01-15

Infarctions of the corpus callosum are rare vascular events. It is relatively immune to vascular insult because of its rich vascular supply from anterior and posterior circulations of brain. Report of 3 patients with largely diffuse acute corpus callosum infarction. 3 patients with largely diffuse acute corpus callosum infarction were studied and each of these 3 patients had 3 different aetiologies. The 3 different aetiologies of largely diffuse acute corpus callosum infarction were cardioembolism, tuberculous arteritis and takayasu arteritis. Diffuse corpus callosum infarcts are rare events. This case series narrates the three different aetiologies of diffuse acute corpus callosum infarction which is a rare vascular event. Copyright © 2015 Elsevier B.V. All rights reserved.

Infectious arteritis of the internal carotid artery complicating retropharyngeal abscess.

PubMed

Lisan, Q; Tran, H; Verillaud, B; Herman, P

2016-02-01

Retropharyngeal abscess is a well-known entity in children, but can also occur in adults. The two main vascular complications are vascular compression and pseudoaneurysm, while infectious arteritis of the internal carotid artery is exceptional. The authors describe a case of a retropharyngeal abscess in an adult woman complicated by infectious arteritis of the internal carotid artery. This rare complication was treated by endovascular occlusion of the internal carotid artery and incision and drainage of the abscess in combination with antibiotic and anticoagulant therapy. The patient did not present any neurological sequelae and follow-up MRI did not reveal any signs of vascular or neurological complications. This case highlights the importance of thorough examination of imaging performed in the context of deep neck space abscess to detect signs of vascular involvement. Treatment must be aggressive in view of the life-threatening risk of arterial rupture or septic embolism. This is the first reported case of infectious arteritis involving the internal carotid artery complicating retropharyngeal abscess. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The early history of giant cell arteritis and polymyalgia rheumatica: first descriptions to 1970.

PubMed

Hunder, Gene G

2006-08-01

Giant cell arteritis and polymyalgia rheumatica were described separately more than 100 years ago. However, the original reports of both conditions were neglected for many years. After the article by Horton et al on giant cell arteritis in the 1930s and studies published by others in the 1940s, giant cell arteritis began to be recognized as a specific disease. In the 1950s and 1960s, many of the numerous presentations and complications of giant cell arteritis were recorded. In a somewhat similar fashion, physicians became cognizant of polymyalgia rheumatica only after several independent descriptions in the 1940s and 1950s. The rapid response of both syndromes to glucocorticoid therapy was discovered shortly after cortisone's effect on rheumatoid arthritis was described. The origin of the proximal aching and stiffness in polymyalgia rheumatica was more difficult to understand. The relatively minor findings in the joints on physical examination seemed insufficient to account for the severe discomfort. As the link between polymyalgia rheumatica and giant cell arteritis became apparent, some thought the aching in polymyalgia rheumatica was related to vasculitis. The debate about whether proximal synovitis or vasculitis was the cause of the symptoms continued after 1970. Although the reason these 2 conditions were associated was not considered by 1970, the establishment of the syndromes as clinically linked entities provided the groundwork for further progress in the next decades.

[«Man-in-the-barrel» syndrome: atypical manifestation of giant cell arteritis].

PubMed

Calle-Lopez, Y; Fernandez-Ramirez, A F; Franco-Dager, E; Gomez-Lopera, J G; Vanegas-Garcia, A L

2018-06-01

«Man-in-the-barrel» syndrome refers to diplegia of the upper extremities in which mobility of the head and lower limbs is preserved. Brachial plexitis that presents as «man-in-the-barrel» syndrome is an unusual manifestation of giant cell arteritis. We report a case of C5-C6 plexitis as part of the clinical features of a patient with giant cell arteritis. A 70-year-old male with a two-month history of weight loss, headache, facial pain and jaw claudication, associated with a persistent elevation of acute phase reactants and bilateral brachial plexopathy, with no evidence of neck or brain injuries or occult neoplasm and with negative autoimmunity tests. Results of the biopsy study of the temporal artery were compatible with giant cell arteritis, and the positron emission tomography scan revealed extensive vascular involvement of the aorta and its branches. Although the typical clinical manifestations of giant cell arteritis are headache, jaw claudication, loss of sight, constitutional symptoms and polymyalgia rheumatica, its presence must be suspected in patients over the age of 50 who manifest alterations affecting the peripheral nerve, including brachial diplegia with no other demonstrable cause.

The activation pattern of macrophages in giant cell (temporal) arteritis and primary angiitis of the central nervous system.

PubMed

Mihm, Bernhard; Bergmann, Markus; Brück, Wolfgang; Probst-Cousin, Stefan

2014-06-01

To determine if the pattern of macrophage activation reflects differences in the pathogenesis and clinical presentation of giant cell arteritis and primary angiitis of the central nervous system, specimens of 10 patients with giant cell arteritis and five with primary angiitis of the central nervous system were immunohistochemically studied and the expression of the macrophage activation markers 27E10, MRP14, MRP8 and 25F9 was determined in the vasculitic infiltrates. Thus, a partly different expression pattern of macrophage activation markers in giant cell arteritis and primary angiitis of the central nervous system was observed. The group comparison revealed that giant cell arteritis cases had significantly higher numbers of acute activated MRP14-positive macrophages, whereas primary angiitis of the central nervous system is characterized by a tendency toward more MRP8-positive intermediate/late activated macrophages. Furthermore, in giant cell arteritis comparably fewer CD8-positive lymphocytes were observed. These observations suggest, that despite their histopathological similarities, giant cell arteritis and primary angiitis of the central nervous system appear to represent either distinct entities within the spectrum of granulomatous vasculitides or different stages of similar disease processes. Their discrete clinical presentation is reflected by different activation patterns of macrophages, which may characterize giant cell arteritis as a more acute process and primary angiitis of the central nervous system as a more advanced inflammatory process. © 2013 Japanese Society of Neuropathology.

Characteristics of cerebrovascular accidents at time of diagnosis in a series of 98 patients with giant cell arteritis.

PubMed

Zenone, Thierry; Puget, Marie

2013-12-01

The objective of this study was to determine the characteristics of cerebrovascular accidents at time of diagnosis in patients with giant cell arteritis. Retrospective data were collected from 98 patients at a single hospital with giant cell arteritis (according to the American College of Rheumatology classification criteria) diagnosed between October 1999 and January 2012. Cerebrovascular accident was found at initial presentation in 6 patients (6.1 %, 95 % CIs 2.3-12.9). Most of them had other symptoms of giant cell arteritis when the disease began. Signs reflecting the involvement of vertebro-basilar territory were present in 3 cases. No other case of cerebrovascular accident was described during the follow-up of patient; particularly no case of cerebrovascular accident occurred once corticosteroid therapy for the treatment of giant cell arteritis had been initiated. No differences in the epidemiologic, clinical and laboratory features at the time of diagnosis between patients who had cerebrovascular accidents and the rest of the giant cell arteritis patients were observed. Prognosis was good in our survey. However, there was no case of bilateral vertebral artery occlusion, a condition associated with poor prognosis. The present study confirms that cerebrovascular accidents may be the initial manifestation of giant cell arteritis, an argument in favor of a direct effect of the vasculitis in the development of cerebrovascular accidents rather than a complication of the corticosteroid therapy. The diagnosis of giant cell arteritis should always be considered in an elderly patient with stroke and an unexplained elevation of inflammatory biomarkers.

Maladie de Takayasu et polyarthrite rhumatoïde: une association rare - à propos d'une observation

PubMed Central

Frikha, Faten; Maazoun, Fatma; Snoussi, Mouna; Abid, Leila; Abid, Hanen; Bouassida, Walid; Kaddour, Neila; Bahloul, Zouhir

2012-01-01

L'artérite de Takayasu ou maladie de Takayasu (MT) et la polyarthrite rhumatoïde (PR) et sont deux maladies inflammatoires chroniques et leur association a été rapportée dans la littérature à travers quelques observations de cas sporadiques. Nous rapportons une nouvelle observation d'une telle association. Une patiente âgée de 44 ans, diagnostiquée avec une polyarthrite rhumatoïde à facteur rhumatoïde positif, qui a développé des céphalées avec des vertiges de caractère permanent. L'examen révélait un pouls radial et huméral abolis à droite, un souffle carotidien bilatéral et une tension artérielle imprenable à droite. L'artériographie a confirmé la présence d'une atteinte de l'arc aortique type MT. Le diagnostic d'une maladie de Takayasu associée à une polyarthrite rhumatoïde était retenu. La patiente était traitée par une corticothérapie (prednisone à la dose de 0,5 mg/kg par jour) et un traitement de fond par Méthotrexate avec une bonne réponse initiale. A travers notre observation et une revue de la littérature, les caractéristiques épidémiologiques, étiopathogéniques, cliniques, thérapeutiques et évolutives de cette association seront discutées. PMID:22937201

[Medial longitudinal fasciculus (MLF) syndrome in a patient with giant cell arteritis].

PubMed

Uenaka, Takeshi; Hamaguchi, Hirotoshi; Sekiguchi, Kenji; Kowa, Hisatomo; Kanda, Fumio; Toda, Tatsushi

2015-01-01

A 76-year-old female was referred to our department because of diplopia for two months and intermittent claudication for five months. She showed medial longitudinal fasciculus (MLF) syndrome. Brain MRI (T2WI) showed multiple infarctions in the right pontine tegmentum and left paramedian midbrain. A biopsy of superficial temporal artery showed the characteristic findings of glanulomatous inflammation indicative of giant cell arteritis. We thought the mechanism of this cerebral infarction as artery to artery embolization or intracranial arteritis. Treatment with oral prednisolone (1 mg/kg/day) improved her limb claudication and normalized serum C-reactive protein level.

The Central Bright Spot Sign: A Potential New MR Imaging Sign for the Early Diagnosis of Anterior Ischemic Optic Neuropathy due to Giant Cell Arteritis.

PubMed

Remond, P; Attyé, A; Lecler, A; Lamalle, L; Boudiaf, N; Aptel, F; Krainik, A; Chiquet, C

2017-07-01

A rapid identification of the etiology of anterior ischemic optic neuropathy is crucial because it determines therapeutic management. Our aim was to assess MR imaging to study the optic nerve head in patients referred with anterior ischemic optic neuropathy, due to either giant cell arteritis or the nonarteritic form of the disease, compared with healthy subjects. Fifteen patients with giant cell arteritis-related anterior ischemic optic neuropathy and 15 patients with nonarteritic anterior ischemic optic neuropathy from 2 medical centers were prospectively included in our study between August 2015 and May 2016. Fifteen healthy subjects and patients had undergone contrast-enhanced, flow-compensated, 3D T1-weighted MR imaging. The bright spot sign was defined as optic nerve head enhancement with a 3-grade ranking system. Two radiologists and 1 ophthalmologist independently performed blinded evaluations of MR imaging sequences with this scale. Statistical analysis included interobserver agreement. MR imaging scores were significantly higher in patients with giant cell arteritis-related anterior ischemic optic neuropathy than in patients with nonarteritic anterior ischemic optic neuropathy ( P ≤ .05). All patients with giant cell arteritis-related anterior ischemic optic neuropathy (15/15) and 7/15 patients with nonarteritic anterior ischemic optic neuropathy presented with the bright spot sign. No healthy subjects exhibited enhancement of the anterior part of the optic nerve. There was a significant relationship between the side of the bright spot and the side of the anterior ischemic optic neuropathy ( P ≤ .001). Interreader agreement was good for observers (κ = 0.815). Here, we provide evidence of a new MR imaging sign that identifies the acute stage of giant cell arteritis-related anterior ischemic optic neuropathy; patients without this central bright spot sign always had a nonarteritic pathophysiology and therefore did not require emergency corticosteroid

Telethermography with thermostimulus in the study of temporal arteritis

NASA Astrophysics Data System (ADS)

Di Carlo, Aldo

2004-12-01

Giant-cell arteritis or Horton's arteritis (HA) is an immunomediated disease of large vessels. In particular it affects temporal arteries; its outcome is generally benign, but in some cases brain strokes or blindness are possible. Paraclinical diagnostic tools and, in particular, imaging techniques are very useful for diagnosing and monitoring the evolution. The method of thermostimulus applied to traditional telethermography (Ts-TTG) is particularly useful in the study of HA. While direct thermography (TTG) is limited in the evaluating fluximetric data because of its reduced sensitivity (no more than 0.1 °C), the thermostimulus technique allows us to know exactly the minimal variations in blood flow of these arteries. This method uses a thermogenerator connected with a thermal probe, a latex balloon containing a mixture of alcohol-water. Once this liquid reaches the temperature of the thermal stress (5 °C × 20 s), the probe is applied by contact on the cutaneous area of interest. Thermal insulation enables us to see, immediately after the thermal stimulus, a time-lag in the thermal recovery of these two components, respectively that of the artery (mean time of thermal recovery ⩽20 s) and that of the surrounding healthy skin (mean time of thermal recovery ⩾60 s). Moreover, applying the thermal stimulus successively on the two temporal areas, there will be a temporal difference in their respective thermal recoveries, also in cases of very low thermal differences (<0.01 °C). A group of 10 subjects affected by monolateral temporal arteritis was examined in a retrospective study. The results demonstrate the usefulness of this innovative method that, among other advantages, excludes the possibility of false negatives.

Arteriography in ponies with Strongylus vulgaris arteritis.

PubMed

Slocombe, J O; Rendano, V T; Owen, R R; Pennock, P W; McCraw, B M

1977-04-01

Radiographs of the aorta and abdominal arteries were obtained from a normal anesthetized pony following catheterization of a femoral artery for nonselective, semiselective or selective arteriography. The arteries had smooth borders and regular diameters and the branches of the cranial mesenteric artery could be followed distally on the angiogram through to the smaller branches proximal to the bowel wall. Following arteriography, the pony walked normally and there were minimal alterations of the levels of serum muscle enzymes and blood lactate. The procedures for arteriography were repeated in three days. At that time the femoral artery was patent and satisfactory angiograms were obtained. Similiarly, radiographs were obtained from two ponies artificially infected with Strongylus vulgaris. The cranial msenteric artery and some of its branches, the right renal artery and segments of the aorta had irregular borders and were enlarged. Branches of the cranial mesenteric artery could not be followed distally because the flow of the contrast material was blocked. Following the above procedures, euthanasia of all ponies was expedited and the findings of arteritis, thrombosis and dilatation of arteries at necropsy compared favorably with interpretations from the radiographs. At least in the pony, arteriography can be a valuable research and diagnostic tool for the demonstration of lesions associated with verminous arteritis.

Multiple Cranial Nerve Palsies in Giant Cell Arteritis.

PubMed

Ross, Michael; Bursztyn, Lulu; Superstein, Rosanne; Gans, Mark

2017-12-01

Giant cell arteritis (GCA) is a systemic vasculitis of medium and large arteries often with ophthalmic involvement, including ischemic optic neuropathy, retinal artery occlusion, and ocular motor cranial nerve palsies. This last complication occurs in 2%-15% of patients, but typically involves only 1 cranial nerve. We present 2 patients with biopsy-proven GCA associated with multiple cranial nerve palsies.

Spontaneous and Drug-induced Arteritis/Polyarteritis in the Göttingen Minipig-Review.

PubMed

Dincer, Zuhal; Piccicuto, Virginie; Walker, Ursula Junker; Mahl, Andreas; McKeag, Sean

2018-02-01

Arteritis/polyarteritis occurs spontaneously in many species used in preclinical toxicology studies. In Göttingen minipigs, arteritis/polyarteritis is an occasionally observed background change. In the minipig, this finding differs in frequency and nature from age-related polyarteritis nodosa in rats or monkeys, and Beagle pain syndrome in dogs. In minipigs, it can be present in a single small- or medium-sized artery of an organ or a few organs and is most commonly recorded in the cardiac and extracardiac blood vessels, vagina, oviduct, rectum, epididymis, spinal cord, pancreas, urinary bladder, kidneys, and stomach. The etiology is unknown although it has been considered in minipigs as well as in rats, dogs, and monkeys to be possibly immune mediated. This background change is important with respect to its nature and distribution in the minipig in order to distinguish it from drug-induced vascular changes, which might occur in similar locations and have similar morphologic features. This review summarizes the morphology, incidence, and predilection sites of arteritis as a spontaneously occurring background change and as a drug-induced vasculopathy in the minipig, and also describes the main aspects to consider when evaluating vascular changes in Göttingen minipig toxicity studies and their human relevance.

Arteriography in ponies with Strongylus vulgaris arteritis.

PubMed Central

Slocombe, J O; Rendano, V T; Owen, R R; Pennock, P W; McCraw, B M

1977-01-01

Radiographs of the aorta and abdominal arteries were obtained from a normal anesthetized pony following catheterization of a femoral artery for nonselective, semiselective or selective arteriography. The arteries had smooth borders and regular diameters and the branches of the cranial mesenteric artery could be followed distally on the angiogram through to the smaller branches proximal to the bowel wall. Following arteriography, the pony walked normally and there were minimal alterations of the levels of serum muscle enzymes and blood lactate. The procedures for arteriography were repeated in three days. At that time the femoral artery was patent and satisfactory angiograms were obtained. Similiarly, radiographs were obtained from two ponies artificially infected with Strongylus vulgaris. The cranial msenteric artery and some of its branches, the right renal artery and segments of the aorta had irregular borders and were enlarged. Branches of the cranial mesenteric artery could not be followed distally because the flow of the contrast material was blocked. Following the above procedures, euthanasia of all ponies was expedited and the findings of arteritis, thrombosis and dilatation of arteries at necropsy compared favorably with interpretations from the radiographs. At least in the pony, arteriography can be a valuable research and diagnostic tool for the demonstration of lesions associated with verminous arteritis. Images Fig. 1. Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 8. Fig. 9. Fig. 10. Fig. 12. PMID:861832

Recent advances in Takayasu’s arteritis

PubMed Central

Alibaz-Öner, Fatma; Aydın, Sibel Zehra; Direskeneli, Haner

2015-01-01

Takayasu’s arteritis (TAK) is a rare, chronic large-vessel vasculitis (LVV) that predominantly affects the aorta, its major branches, and the pulmonary arteries. Recent advances in the diagnosis, clinical course, disease assessment with biomarkers/imaging and new clinical tools, patient-reported outcomes, and new treatment options of TAK are discussed in this review. Conventional angiography, the gold standard method for initial diagnosis, appears to have been replaced with new imaging modalities such as magnetic resonance angiography (MRA) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in recent years. MRA and FDG-PET are also promising for the assessment of disease activity. New tools for disease assessment such as Indian Takayasu’s Arteritis Score 2010 (ITAS2010) and color Doppler ultrasound (CDUS) aim to better characterize and quantify disease activity; however, different imaging modalities in routine follow-up are not incorporated sufficiently in these approaches. Prognosis is possibly getting better, with lower mortality in recent years; however, it is difficult to assess the widely different vascular intervention rates among the clinical series. Leflunomide, tumor necrosis factor (TNF)-α antagonists, and tocilizumab are new options for patients resistant to conventional therapies. There is a clear need to develop a validated set of outcome measures for use in clinical trials of TAK. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group has taken on this task, finished a Delphi exercise with experts, and aims to develop a core set of outcomes for LVV in accordance with OMERACT Filter 2.0. PMID:27708916

Anterior spinal artery aneurysm in aortic stenosis of different etiology: Report of three cases.

PubMed

Singh, Vivek; Naik, Suprava; Bhoi, Sanjeev K; Phadke, R V

2017-04-01

Isolated aneurysms of spinal arteries are rare. Spinal artery aneurysms are commonly found in association with spinal cord arteriovenous malformation and coarctation of aorta and rarely with aortic arch interruption and Klippel-Trenaunay syndrome. Spinal angiograms are the gold standard for diagnosing these spinal artery aneurysms but with the advances in computed tomography technology these aneurysms can also be very well demonstrated in computed tomography angiograms. We describe three cases of anterior spinal artery aneurysm, those are flow related aneurysms, associated with coarctation of aorta and with Takayasu arteritis.

Isolated aortitis versus giant cell arteritis: are they really two sides of the same coin?

PubMed

Talarico, Rosaria; Boiardi, Luigi; Pipitone, Nicolo'; d'Ascanio, Anna; Stagnaro, Chiara; Ferrari, Claudia; Elefante, Elena; Salvarani, Carlo; Bombardieri, Stefano

2014-01-01

The aim of the study was to compare epidemiological data, clinical findings and results of investigations in patients with isolated aortitis and those with giant cell arteritis (GCA) to establish whether patients with isolated aortitis differ from those with GCA. We reviewed the medical notes of all patients consecutively seen in two Rheumatology centres in the last two decades with a suspicion of GCA, searching for cases characterised by abnormal [18F] fluorodeoxyglucose (FDG) PET uptake of the aorta. 'Isolated aortitis' was defined as increased FDG uptake in the aorta not explained by atherosclerosis in the absence of FDG uptake in other large vessels. Comparing the epidemiological and clinical data of patients with isolated arteritis with those with GCA, we observed many statistical significant differences. First of all, the male/female ratio was reversed, with a predominant male involvement in isolated arteritis. Moreover, the mean age of patients with isolated arteritis was significantly lower than that of GCA patients (62 vs. 78.4 yrs; p<0.0001). None of the patients with isolated aortitis presented at any time of the disease course the typical symptoms of GCA, while in a low percentage of cases constitutional symptoms represented the only clinical features. Beside the aortic arch, the sites more frequent involved were the thoracic and abdominal tracts, in all cases without an uptake of the aortic branches. It is not known whether our patients with isolated aortitis represent variants of GCA or TA, nor is it known how they will evolve, but we can certainly conclude that these patients have a different epidemiologic and clinical profile, and do not necessarily represent two sides of the same coin.

Giant cell arteritis: diagnostic accuracy of MR imaging of superficial cranial arteries in initial diagnosis-results from a multicenter trial.

PubMed

Klink, Thorsten; Geiger, Julia; Both, Marcus; Ness, Thomas; Heinzelmann, Sonja; Reinhard, Matthias; Holl-Ulrich, Konstanze; Duwendag, Dirk; Vaith, Peter; Bley, Thorsten Alexander

2014-12-01

To assess the diagnostic accuracy of contrast material-enhanced magnetic resonance (MR) imaging of superficial cranial arteries in the initial diagnosis of giant cell arteritis ( GCA giant cell arteritis ). Following institutional review board approval and informed consent, 185 patients suspected of having GCA giant cell arteritis were included in a prospective three-university medical center trial. GCA giant cell arteritis was diagnosed or excluded clinically in all patients (reference standard [final clinical diagnosis]). In 53.0% of patients (98 of 185), temporal artery biopsy ( TAB temporal artery biopsy ) was performed (diagnostic standard [ TAB temporal artery biopsy ]). Two observers independently evaluated contrast-enhanced T1-weighted MR images of superficial cranial arteries by using a four-point scale. Diagnostic accuracy, involvement pattern, and systemic corticosteroid ( sCS systemic corticosteroid ) therapy effects were assessed in comparison with the reference standard (total study cohort) and separately in comparison with the diagnostic standard TAB temporal artery biopsy ( TAB temporal artery biopsy subcohort). Statistical analysis included diagnostic accuracy parameters, interobserver agreement, and receiver operating characteristic analysis. Sensitivity of MR imaging was 78.4% and specificity was 90.4% for the total study cohort, and sensitivity was 88.7% and specificity was 75.0% for the TAB temporal artery biopsy subcohort (first observer). Diagnostic accuracy was comparable for both observers, with good interobserver agreement ( TAB temporal artery biopsy subcohort, κ = 0.718; total study cohort, κ = 0.676). MR imaging scores were significantly higher in patients with GCA giant cell arteritis -positive results than in patients with GCA giant cell arteritis -negative results ( TAB temporal artery biopsy subcohort and total study cohort, P < .001). Diagnostic accuracy of MR imaging was high in patients without and with sCS systemic

Trial of Tocilizumab in Giant-Cell Arteritis.

PubMed

Stone, John H; Tuckwell, Katie; Dimonaco, Sophie; Klearman, Micki; Aringer, Martin; Blockmans, Daniel; Brouwer, Elisabeth; Cid, Maria C; Dasgupta, Bhaskar; Rech, Juergen; Salvarani, Carlo; Schett, Georg; Schulze-Koops, Hendrik; Spiera, Robert; Unizony, Sebastian H; Collinson, Neil

2017-07-27

Giant-cell arteritis commonly relapses when glucocorticoids are tapered, and the prolonged use of glucocorticoids is associated with side effects. The effect of the interleukin-6 receptor alpha inhibitor tocilizumab on the rates of relapse during glucocorticoid tapering was studied in patients with giant-cell arteritis. In this 1-year trial, we randomly assigned 251 patients, in a 2:1:1:1 ratio, to receive subcutaneous tocilizumab (at a dose of 162 mg) weekly or every other week, combined with a 26-week prednisone taper, or placebo combined with a prednisone taper over a period of either 26 weeks or 52 weeks. The primary outcome was the rate of sustained glucocorticoid-free remission at week 52 in each tocilizumab group as compared with the rate in the placebo group that underwent the 26-week prednisone taper. The key secondary outcome was the rate of remission in each tocilizumab group as compared with the placebo group that underwent the 52-week prednisone taper. Dosing of prednisone and safety were also assessed. Sustained remission at week 52 occurred in 56% of the patients treated with tocilizumab weekly and in 53% of those treated with tocilizumab every other week, as compared with 14% of those in the placebo group that underwent the 26-week prednisone taper and 18% of those in the placebo group that underwent the 52-week prednisone taper (P<0.001 for the comparisons of either active treatment with placebo). The cumulative median prednisone dose over the 52-week period was 1862 mg in each tocilizumab group, as compared with 3296 mg in the placebo group that underwent the 26-week taper (P<0.001 for both comparisons) and 3818 mg in the placebo group that underwent the 52-week taper (P<0.001 for both comparisons). Serious adverse events occurred in 15% of the patients in the group that received tocilizumab weekly, 14% of those in the group that received tocilizumab every other week, 22% of those in the placebo group that underwent the 26-week taper, and 25% of

Tocilizumab for giant cell arteritis with corticosteroid-resistant progressive anterior ischemic optic neuropathy.

PubMed

Vionnet, Julien; Buss, Guillaume; Mayer, Cédric; Sokolov, Arseny A; Borruat, François-Xavier; Spertini, François

2017-10-01

Giant cell arteritis is an inflammatory disorder of the medium- and large-size arteries. Permanent visual loss related to arteritic anterior ischemic optic neuropathy is among the most serious complications of this disease and initial treatment usually consists of high dose corticosteroids. There is no consensus in the literature concerning the optimal therapeutic approach in giant cell arteritis patients with corticosteroid-resistant arteritic anterior ischemic optic neuropathy. A 73-year-old Caucasian female with biopsy-proven giant cell arteritis developed an acute visual loss of the right eye due to arteritic anterior ischemic optic neuropathy. Despite 5 daily methylprednisolone pulses, systemic symptoms persisted and rapid involvement of the controlateral eye was documented. Therefore, tocilizumab (humanised monoclonal antibody binding the human interleukin-6 receptor) was introduced as a potential salvage therapy with a swift consecutive resolution of the systemic symptoms and stabilization of the ophthalmic lesions. Although a late effect of steroids pulses cannot be formally ruled out in this dramatic situation, tocilizumab likely offered a decisive effect in preventing bilateral blindness and may have contributed to steroid tapering. Tocilizumab may represent a new early effective second-line treatment option in corticosteroid-resistant anterior ischemic optic neuropathy. More data are needed to confirm this observation and to evaluate the safety profile of this treatment. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Association of aortic and main left coronary aneurysms with severe aortic insufficiency in Takayasu’s arteritis

PubMed Central

Schafranski, Marcelo Derbli; Ferraz de Freitas, Marcelo; Valladão de Carvalho, Marcelo

2011-01-01

Takayasu’s arteritis is a granulomatous vasculitis of unknown etiology that affects mainly the aorta and its branches. As a result of intimal fibroproliferation, segmental stenosis, occlusion, dilatation, and aneurysmal formation of the involved vessels may develop. It is an uncommon disease and usually affects young Asian female patients during the second and third decades of life. Coronary arteries are exceptionally affected and coronary aneurysm formation is a very rare finding. We describe a case of a previously healthy 26-year-old Caucasian female whose Takayasu’s arteritis presented as a previously undescribed association of aortic and main left coronary aneurysms with severe aortic insufficiency. PMID:24765288

Identification of a divergent genotype of equine arteritis virus from South American donkeys.

PubMed

Rivas, J; Neira, V; Mena, J; Brito, B; Garcia, A; Gutierrez, C; Sandoval, D; Ortega, R

2017-12-01

A novel equine arteritis virus (EAV) was isolated and sequenced from feral donkeys in Chile. Phylogenetic analysis indicates that the new virus and South African asinine strains diverged at least 100 years from equine EAV strains. The results indicate that asinine strains belonged to a different EAV genotype. © 2017 Blackwell Verlag GmbH.

Endovascular treatment of complicated aortic aneurysms in patients with underlying arteriopathies.

PubMed

Baril, Donald T; Carroccio, Alfio; Palchik, Eugene; Ellozy, Sharif H; Jacobs, Tikva S; Teodorescu, Victoria; Marin, Michael L

2006-07-01

Patients with arteriopathies including giant cell arteritis, Marfan syndrome, and Takayasu's disease are at risk for aneurysmal degeneration of the aorta. Aortic repair has been recommended for these patients to prevent rupture. The purpose of this study was to examine outcomes following endovascular stent graft (EVSG) repair of aortic aneurysms in this patient population. Over an 8-year period, 11 patients (six men, five women) with arteriopathies underwent endovascular aortic repair. The mean age was 50 (range 15-81). Diseases included Marfan syndrome (n = 6), Takayasu's disease (n = 3), and giant cell arteritis (n = 2). Success of EVSG repair was evaluated per the reporting standards of the Society for Vascular Surgery/American Association for Vascular Surgery. Follow-up was a mean of 28.9 months (range 3-68). Six patients underwent EVSG repair of the thoracic aorta, four underwent EVSG repair of the abdominal aorta, and one underwent a staged repair of the thoracic and subsequently the abdominal aorta. Six true aneurysms and six pseudoaneurysms were repaired. Eight patients had previous aortic surgery, including four with multiple aortic operations. For the 12 aneurysms treated, technical success was achieved in 11 (91.7%). One technical failure occurred due to a small iliac access vessel, requiring an eventual iliac conduit for insertion. Early complications (<30 days) occurred in three patients. Type I or III endoleak developed following two repairs (16.7%). Aneurysm expansion occurred following one repair (8.3%). No aneurysm-related deaths occurred during follow-up. EVSG repair of aortic aneurysms is feasible and can be safely performed in patients with arteriopathies. Long-term durability in this younger group of patients who carry an ongoing risk of arterial degeneration remains to be determined.

Medullary ischemia due to vertebral arteritis associated with Behçet syndrome: a case report.

PubMed

Kaido, Takanobu; Otsuki, Taisuke; Ogawa, Masafumi; Takahashi, Akio; Kaneko, Yuu; Yamamoto, Toshiyuki; Nakata, Yasuhiro

2012-09-01

Here we report an extremely rare case of Behçet syndrome (BS) that showed acute onset of Wallenberg syndrome and was treated successfully by corticosteroids. A 51-year-old woman with BS had a sudden onset of Wallenberg syndrome. Three days after the onset, she was transferred to our institute. In the magnetic resonance imaging (MRI) study on admission, T2-weighted and fluid-attenuated inversion recovery images showed a high intensity area in the left paramedian region of the medulla oblongata. Contrast-enhanced T1-weighted images showed enhancement in the vessel wall of the left vertebral artery. We diagnosed her as having Wallenberg syndrome due to the acute vertebral arteritis associated with BS. After initiation of high-dose steroid therapy, her symptoms gradually improved. Two months after admission, she was discharged from our institute with mild hemihypesthesia. We hypothesized that vertebral arteritis due to BS had caused hypoperfusion of the medullary perforators causing Wallenberg syndrome in our patient.

An ultrasound-based comparative study on carotid plaques in HIV-positive patients vs. atherosclerotic and arteritis patients: atherosclerotic or inflammatory lesions?

PubMed

Maggi, Paolo; Perilli, Francesco; Lillo, Antonio; Carito, Valentina; Epifani, Giuseppe; Bellacosa, Chiara; Pastore, Giuseppe; Regina, Guido

2007-02-01

We have previously described two cases of HIV-1-positive patients undergoing surgery for stenosis of the internal carotid arteries. Histology revealed an extensive inflammatory infiltration of the vascular wall and no evidence of atheromasic plaque. This unexpected pattern of carotid damage prompted us to perform a more accurate investigation of the characteristics of carotid plaques in a group of HIV-positive patients. The results were compared with those obtained from young patients affected by atherosclerosis of the epi-aortic vessels and patients with arteritis. The patients underwent ultrasonography of the epi-aortic vessels using one of the latest generation power color-Doppler with 7.5 MHz probes. The study population included 61 HIV-positive patients and 47 HIV-negative patients (37 atherosclerotic and 10 with arteritis). Compared with HIV-negative atherosclerotic patients, there were significantly higher proportions of HIV-positive patients with iso-hypoechogenic lesions (81.8 vs. 29%) that were homogeneous both in their parietal and endoluminal portions (96.7 vs. 21.6% and 88.5 vs. 54.0%, respectively), with a smooth or slightly irregular surface (99.0 vs. 56.7%) (P=0.001 for all differences). No statistically significant differences were seen between HIV-positive and arteritis patients. Our study evidenced that the ultrasonographic structure of the epi-aortic lesions in HIV-positive patients substantially differ from those of the plaques in atherosclerotic patients, although they share similar characteristics with patients affected by arteritis. Further investigations are warranted to better define the structure and the mechanism of onset of these lesions.

Augmented TLR2 expression on monocytes in both human Kawasaki disease and a mouse model of coronary arteritis.

PubMed

Lin, I-Chun; Kuo, Ho-Chang; Lin, Ying-Jui; Wang, Feng-Shen; Wang, Lin; Huang, Shun-Chen; Chien, Shao-Ju; Huang, Chien-Fu; Wang, Chih-Lu; Yu, Hong-Ren; Chen, Rong-Fu; Yang, Kuender D

2012-01-01

Kawasaki disease (KD) of unknown immunopathogenesis is an acute febrile systemic vasculitis and the leading cause of acquired heart diseases in childhood. To search for a better strategy for the prevention and treatment of KD, this study compared and validated human KD immunopathogenesis in a mouse model of Lactobacillus casei cell wall extract (LCWE)-induced coronary arteritis. Recruited subjects fulfilled the criteria of KD and were admitted for intravenous gamma globulin (IVIG) treatment at the Kaohsiung Chang Gung Memorial Hospital from 2001 to 2009. Blood samples from KD patients were collected before and after IVIG treatment, and cardiovascular abnormalities were examined by transthoracic echocardiography. Wild-type male BALB/c mice (4-week-old) were intraperitoneally injected with LCWE (1 mg/mL) to induce coronary arteritis. The induced immune response in mice was examined on days 1, 3, 7, and 14 post injections, and histopathology studies were performed on days 7 and 14. Both human KD patients and LCWE-treated mice developed coronary arteritis, myocarditis, valvulitis, and pericarditis, as well as elevated plasma levels of interleukin (IL)-2, IL-6, IL-10, monocyte chemoattractant protein (MCP)-1, and tumor necrosis factor (TNF)-α in acute phase. Most of these proinflammatory cytokines declined to normal levels in mice, whereas normal levels were achieved in patients only after IVIG treatment, with a few exceptions. Toll-like receptor (TLR)-2, but not TLR4 surface enhancement on circulating CD14+ monocytes, was augmented in KD patients before IVIG treatment and in LCWE-treated mice, which declined in patients after IVIG treatment. This result suggests that that not only TLR2 augmentation on CD14+ monocytes might be an inflammatory marker for both human KD patients and LCWE-induced CAL mouse model but also this model is feasible for studying therapeutic strategies of coronary arteritis in human KD by modulating TLR2-mediated immune activation on CD14

Augmented TLR2 Expression on Monocytes in both Human Kawasaki Disease and a Mouse Model of Coronary Arteritis

PubMed Central

Lin, I-Chun; Kuo, Ho-Chang; Lin, Ying-Jui; Wang, Feng-Shen; Wang, Lin; Huang, Shun-Chen; Chien, Shao-Ju; Huang, Chien-Fu; Wang, Chih-Lu; Yu, Hong-Ren; Chen, Rong-Fu; Yang, Kuender D.

2012-01-01

Background Kawasaki disease (KD) of unknown immunopathogenesis is an acute febrile systemic vasculitis and the leading cause of acquired heart diseases in childhood. To search for a better strategy for the prevention and treatment of KD, this study compared and validated human KD immunopathogenesis in a mouse model of Lactobacillus casei cell wall extract (LCWE)-induced coronary arteritis. Methods Recruited subjects fulfilled the criteria of KD and were admitted for intravenous gamma globulin (IVIG) treatment at the Kaohsiung Chang Gung Memorial Hospital from 2001 to 2009. Blood samples from KD patients were collected before and after IVIG treatment, and cardiovascular abnormalities were examined by transthoracic echocardiography. Wild-type male BALB/c mice (4-week-old) were intraperitoneally injected with LCWE (1 mg/mL) to induce coronary arteritis. The induced immune response in mice was examined on days 1, 3, 7, and 14 post injections, and histopathology studies were performed on days 7 and 14. Results Both human KD patients and LCWE-treated mice developed coronary arteritis, myocarditis, valvulitis, and pericarditis, as well as elevated plasma levels of interleukin (IL)-2, IL-6, IL-10, monocyte chemoattractant protein (MCP)-1, and tumor necrosis factor (TNF)-α in acute phase. Most of these proinflammatory cytokines declined to normal levels in mice, whereas normal levels were achieved in patients only after IVIG treatment, with a few exceptions. Toll-like receptor (TLR)-2, but not TLR4 surface enhancement on circulating CD14+ monocytes, was augmented in KD patients before IVIG treatment and in LCWE-treated mice, which declined in patients after IVIG treatment. Conclusion This result suggests that that not only TLR2 augmentation on CD14+ monocytes might be an inflammatory marker for both human KD patients and LCWE-induced CAL mouse model but also this model is feasible for studying therapeutic strategies of coronary arteritis in human KD by modulating TLR2

Equine viral arteritis in breeding and sport horses in central Spain.

PubMed

Cruz-Lopez, Fatima; Newton, Richard; Sanchez-Rodriguez, Ana; Ireland, Joanne; Mughini-Gras, Lapo; Moreno, Miguel A; Fores, Paloma

2017-12-01

Equine viral arteritis (EVA) may have a high economic impact on breeding stud farms due to the occurrence of EVA-associated abortion outbreaks and the ability of the virus to persist in carrier stallions. While the consequences of EVA in premises with sport horses are usually less severe, the first confirmed outbreak of EVA in Spain occurred in a riding club in Barcelona, but no data on the seroprevalence of EVA in sport horses have been reported in Spain. Given the importance of both Spanish Purebred (SP) breeding horses and sport horses for Spain's equine industry, the aim of this study was to determine and compare the seroprevalence of EVA in these two horse populations in central Spain. Serum samples from 155 SP breeding horses residing in 16 stud farms and 105 sport horses of different breeds housed in 12 riding clubs, collected between September 2011 and November 2013, were tested using a commercial EVA antibody ELISA test with a 100% sensitivity, and confirmed by seroneutralisation (SN) test. EVA seroprevalence in SP breeding horses was higher 21.1% (95% CI 15.3-26.8%) than that in sport horses (6.7%, 95% CI 1.89-11.45%). However, the primary use (breeding vs. sport) was not significantly associated with seropositivity to Equine Arteritis Virus (EAV), suggesting that different management factors do not affect EVA circulation in these two horse populations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis.

PubMed

Matteson, Eric L; Buttgereit, Frank; Dejaco, Christian; Dasgupta, Bhaskar

2016-02-01

Diagnosis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) is based on typical clinical, histologic, and laboratory features. Ultrasonographic imaging in PMR with assessment especially of subdeltoid bursitis can aid in diagnosis and in following response to treatment. In GCA, diagnosis and disease activity are supported with ultrasonographic, MRI, or [(18)F]fluorodeoxyglucose PET evaluation of large vessels. Glucocorticoids are the primary therapy for PMR and GCA. Methotrexate may be used in patients at high risk for glucocorticoid adverse effects and patients with frequent relapse or needing protracted therapy. Other therapeutic approaches including interleukin 6 antagonists are under evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

Cannabis arteritis: ever more important to consider.

PubMed

Santos, Rui Pedro; Resende, Cristina Isabel Pinho; Vieira, Ana Paula; Brito, Celeste

2017-03-13

Cannabis arteritis (CA) is a major and underdiagnosed cause of peripheral arterial disease in young patients. A 34-year-old man, daily smoker of 20 cigarettes and two cannabis cigarettes for 14 years, presented with a necrotic plaque of left hallux for 3 weeks. The Doppler ultrasound and angiography were compatible with severe Buerger's disease. Submitted to a revascularisation procedure and hypocoagulation with rivaroxaban. He had ceased smoking but maintained consumption of cannabis. Owing to the persistence of distal necrosis, amputation of the hallux was performed with good evolution. CA is a subtype of Buerger's disease. It is poorly known but increasingly prevalent and manifests in cannabis users regardless of tobacco use. The drug is considered at least a cofactor of the arteriopathy. The most effective treatment is cessation of consumption. Being cannabis one of the most consumed drugs, its mandatory to ask about its use in all young patients with arteriopathy. 2017 BMJ Publishing Group Ltd.

Saddle-nose and bilateral cauliflower ear deformities with pyoderma gangrenosum-like ulcers, cavitary pulmonary lesions, digital gangrene and pulselessness in a young female.

PubMed

Subhadarshani, Sweta; Gupta, Vishal; Chahal, Anurag; Verma, Kaushal K

2017-06-15

We report a young female who presented with saddle-nose and bilateral cauliflower ear deformities along with pyoderma gangrenosum-like ulcers, digital gangrene and pulselessness. Subsequently, she was found to have bilateral conductive hearing loss, a corneal opacity, mild aortic regurgitation and radiological evidence of cavitary changes in lungs and aortoarteritis. Our patient had a constellation of symptoms which posed a diagnostic challenge. Finally, a diagnosis of relapsing polychondritis with several unusual features was made. Overlap with Takayasu's arteritis and granulomatosis with polyangitis, which has been reported rarely in the literature, cannot be excluded. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Seroprevalence and factors associated with seropositivity to equine arteritis virus in Spanish Purebred horses in Spain.

PubMed

Cruz, F; Fores, P; Mughini-Gras, L; Ireland, J; Moreno, M A; Newton, R

2016-09-01

Equine viral arteritis (EVA), a disease caused by infection with the equine arteritis virus (EAV), is present in many European countries. In Spain, the last confirmed outbreak was reported in 1992 and there is a paucity of seroprevalence studies. The disease has a major impact on the equine breeding industry, which is mainly represented by Spanish Purebred (SP) horses in Spain. To estimate the seroprevalence of EAV in the breeding SP horse population in central Spain and identify potential horse and studfarm level factors associated with seropositivity to EAV. Cross-sectional study. Individual serum samples from 555 SP horses, collected between September 2011 and November 2013 at 35 studfarms, were tested using a commercially available EAV antibody ELISA and seroneutralisation as the World Organisation for Animal Health reference confirmation test for samples with positive and equivocal results. Data on factors putatively associated with seropositivity to EAV were collected via a questionnaire and examined using random effects logistic regression for analysis of clustered data. Equine arteritis virus seroprevalence in the SP breeding population in central Spain standardised for the sex distribution of the reference horse population, was estimated to be 16.8% (95% confidence interval 5.2-28.5%). Increasing numbers of breeding mares on the studfarm and increasing percentage of mares with reproductive problems during the last 12 months were identified as being positively associated with EAV seropositivity. Mares vaccinated against Equine herpesvirus-1 (EHV-1) and/or -4 (EHV-4) were also positively associated with EAV seropositivity. These findings are of importance to ensure appropriate biosecurity measures for studfarms are carried out and may help facilitate the development of an EVA surveillance programme in the SP breeding horse population. © 2015 EVJ Ltd.

PET/CT in giant cell arteritis: High 18F-FDG uptake in the temporal, occipital and vertebral arteries.

PubMed

Rehak, Z; Vasina, J; Ptacek, J; Kazda, T; Fojtik, Z; Nemec, P

18 F-FDG PET/CT imaging is useful in patients with fever of unknown origin and can detect giant cell arteritis in extracranial large arteries. However, it is usually assumed that temporal arteries cannot be visualized with a PET/CT scanner due to their small diameter. Three patients with clinical symptoms of temporal arteritis were examined using a standard whole body PET/CT protocol (skull base - mid thighs) followed by a head PET/CT scan using the brain protocol. High 18 F-FDG uptake in the aorta and some arterial branches were detected in all 3 patients with the whole body protocol. Using the brain protocol, head imaging led to detection of high 18 F-FDG uptake in temporal arteries as well as in their branches (3 patients), in occipital arteries (2 patients) and also in vertebral arteries (3 patients). Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

What is the impact of giant cell arteritis on patients’ lives? A UK qualitative study

PubMed Central

Liddle, Jennifer; Bartlam, Roisin; Mallen, Christian D; Mackie, Sarah L; Prior, James A; Helliwell, Toby; Richardson, Jane C

2017-01-01

Objectives Clinical management of giant cell arteritis (GCA) involves balancing the risks and burdens arising from the disease with those arising from treatment, but there is little research on the nature of those burdens. We aimed to explore the impact of giant cell arteritis (GCA) and its treatment on patients’ lives. Methods UK patients with GCA participated in semi-structured telephone interviews. Inductive thematic analysis was employed. Results 24 participants were recruited (age: 65–92 years, time since diagnosis: 2 months to >6 years). The overarching themes from analysis were: ongoing symptoms of the disease and its treatment; and ‘life-changing’ impacts. The overall impact of GCA on patients’ lives arose from a changing combination of symptoms, side effects, adaptations to everyday life and impacts on sense of normality. Important factors contributing to loss of normality were glucocorticoid-related treatment burdens and fear about possible future loss of vision. Conclusions The impact of GCA in patients’ everyday lives can be substantial, multifaceted and ongoing despite apparent control of disease activity. The findings of this study will help doctors better understand patient priorities, legitimise patients’ experiences of GCA and work with patients to set realistic treatment goals and plan adaptations to their everyday lives. PMID:28838902

Does herpes zoster predispose to giant cell arteritis: a geo-epidemiologic study.

PubMed

Ing, Edsel B; Ing, Royce; Liu, Xinyang; Zhang, Angela; Torun, Nurhan; Sey, Michael; Pagnoux, Christian

2018-01-01

Giant cell arteritis (GCA) is the most common systemic vasculitis in the elderly and can cause irreversible blindness and aortitis. Varicella zoster (VZ), which is potentially preventable by vaccination, has been proposed as a possible immune trigger for GCA, but this is controversial. The incidence of GCA varies widely by country. If VZ virus contributes to the immunopathogenesis of GCA we hypothesized that nations with increased incidence of GCA would also have increased incidence of herpes zoster (HZ). We conducted an ecologic analysis to determine the relationship between the incidence of HZ and GCA in different countries. A literature search for the incidence rates (IRs) of GCA and HZ from different countries was conducted. Correlation and linear regression was performed comparing the disease IR of each country for subjects 50 years of age or older. We found the IR for GCA and HZ from 14 countries. Comparing the IRs for GCA and HZ in 50-year-olds, the Pearson product-moment correlation ( r ) was -0.51, with linear regression coefficient (β) -2.92 (95% CI -5.41, -0.43; p =0.025) using robust standard errors. Comparing the IRs for GCA and HZ in 70-year-olds, r was -0.40, with β -1.78, which was not statistically significant (95% CI -4.10, 0.53; p =0.12). Although this geo-epidemiologic study has potential for aggregation and selection biases, there was no positive biologic gradient between the incidence of clinically evident HZ and GCA.

Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association.

PubMed

Procop, Gary W; Eng, Charis; Clifford, Alison; Villa-Forte, Alexandra; Calabrese, Leonard H; Roselli, Eric; Svensson, Lars; Johnston, Douglas; Pettersson, Gosta; Soltesz, Edward; Lystad, Lisa; Perry, Julian D; Blandford, Alexander; Wilson, Deborah A; Hoffman, Gary S

2017-01-01

It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen. DNA samples extracted from 11 surgically sterile temporal arteries and 31 surgically sterile thoracic aortas were used in an attempt to identify the vessel-associated VZV genome. Two different validated PCR methods were used. Thirty-one thoracic aorta aneurysm specimens included biopsies from 8 patients with GCA, 2 from patients with TAK, 6 from patients with FIA, and 15 from patients without vasculitis, who had non-inflammatory aneurysms. Eleven temporal artery biopsies were collected from 5 patients with GCA and 6 controls. The presence of VZV was not identified in either the specimens from patients with large vessel vasculitis or from the controls. Using surgically sterile snap-frozen specimens, we were unable to confirm recent reports of the presence of VZV in either aortas or temporal arteries from patients with large vessel vasculitis or controls.

Is intimal hyperplasia a marker of neuro-ophthalmic complications of giant cell arteritis?

PubMed

Makkuni, D; Bharadwaj, A; Wolfe, K; Payne, S; Hutchings, A; Dasgupta, B

2008-04-01

The ischaemic complications of giant cell arteritis (GCA) such as blindness and stroke may result from luminal narrowing of the affected arteries. This study focuses on the association between the severity of intimal proliferation on temporal artery biopsy (TAB) histology and neuro-ophthalmic complications (NOCs) of GCA. We identified 30 cases of biopsy-proven temporal arteritis. One histopathologist (blinded to the clinical details) evaluated the TAB specimens and categorized the degree of maximum stenosis due to intimal hyperplasia into four grades: grade 1 is <50% luminal occlusion due to intimal hyperplasia, grade 2 is 50-75%, grade 3 is >75% and grade 4 is complete luminal occlusion. A second histopathologist (also blinded to the clinical details) independently evaluated the TAB specimens using the same grading system. The NOCs in these patients were noted after a case record review. Of the 30 patients, 12 had NOC-10 with eye complications (complete visual loss, anterior ischaemic neuropathy, visual field defects), one patient had cerebral infarcts and one had both cerebral infarcts and vision loss. There was evidence for a statistically significant trend of NOC associated with higher intimal hyperplasia scores (P = 0.001). The scores of the histopathologists agreed for 23 (77%) patients and differed by 1 category for the remaining 7 (kappa-statistic 0.88). Our study suggests that the degree of intimal hyperplasia on TAB histology (routinely available to all hospital units) seems to be closely associated with NOCs of GCA. The study highlights the possible prognostic as well as diagnostic role of the biopsy. We feel that intimal hyperplasia noted in biopsy specimens may help us in the risk stratification of GCA patients and targeting of appropriate and novel therapies.

Does herpes zoster predispose to giant cell arteritis: a geo-epidemiologic study

PubMed Central

Ing, Edsel B; Ing, Royce; Liu, Xinyang; Zhang, Angela; Torun, Nurhan; Sey, Michael; Pagnoux, Christian

2018-01-01

Purpose Giant cell arteritis (GCA) is the most common systemic vasculitis in the elderly and can cause irreversible blindness and aortitis. Varicella zoster (VZ), which is potentially preventable by vaccination, has been proposed as a possible immune trigger for GCA, but this is controversial. The incidence of GCA varies widely by country. If VZ virus contributes to the immunopathogenesis of GCA we hypothesized that nations with increased incidence of GCA would also have increased incidence of herpes zoster (HZ). We conducted an ecologic analysis to determine the relationship between the incidence of HZ and GCA in different countries. Methods A literature search for the incidence rates (IRs) of GCA and HZ from different countries was conducted. Correlation and linear regression was performed comparing the disease IR of each country for subjects 50 years of age or older. Results We found the IR for GCA and HZ from 14 countries. Comparing the IRs for GCA and HZ in 50-year-olds, the Pearson product-moment correlation (r) was −0.51, with linear regression coefficient (β) −2.92 (95% CI −5.41, −0.43; p=0.025) using robust standard errors. Comparing the IRs for GCA and HZ in 70-year-olds, r was −0.40, with β −1.78, which was not statistically significant (95% CI −4.10, 0.53; p=0.12). Conclusion Although this geo-epidemiologic study has potential for aggregation and selection biases, there was no positive biologic gradient between the incidence of clinically evident HZ and GCA. PMID:29391771

Simultaneous Presentation of Giant Cell Arteritis and Myelodysplastic Syndrome in an Elderly Japanese Man.

PubMed

Senjo, Hajime; Higuchi, Takakazu; Morimoto, Masaya; Koyamada, Ryosuke; Yanaoka, Chisun; Okada, Sadamu

2018-05-18

An 81-year-old Japanese man presented with constitutional symptoms and anemia and was diagnosed with giant cell arteritis (GCA) and myelodysplastic syndrome (MDS) simultaneously. His symptoms and anemia improved promptly with steroids; however, the MDS rapidly progressed to overt leukemia. While MDS patients are at an increased risk of autoimmune diseases, an association with GCA has rarely been reported. This case illustrates the importance of considering GCA as a cause of anemia in elderly patients if MDS is already diagnosed, even in countries where the prevalence of GCA is very low. The simultaneous development of GCA and MDS suggests a common pathogenetic link between these two diseases.

CD8+ T Cells Contribute to the Development of Coronary Arteritis in the Lactobacillus casei Cell Wall Extract-Induced Murine Model of Kawasaki Disease.

PubMed

Noval Rivas, Magali; Lee, Youngho; Wakita, Daiko; Chiba, Norika; Dagvadorj, Jargalsaikhan; Shimada, Kenichi; Chen, Shuang; Fishbein, Michael C; Lehman, Thomas J A; Crother, Timothy R; Arditi, Moshe

2017-02-01

Kawasaki disease (KD) is the leading cause of acquired heart disease among children in developed countries. Coronary lesions in KD in humans are characterized by an increased presence of infiltrating CD3+ T cells; however, the specific contributions of the different T cell subpopulations in coronary arteritis development remain unknown. Therefore, we sought to investigate the function of CD4+ and CD8+ T cells, Treg cells, and natural killer (NK) T cells in the pathogenesis of KD. We addressed the function of T cell subsets in KD development by using a well-established murine model of Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis. We determined which T cell subsets were required for development of KD vasculitis by using several knockout murine strains and depleting monoclonal antibodies. LCWE-injected mice developed coronary lesions characterized by the presence of inflammatory cell infiltrates. Frequently, this chronic inflammation resulted in complete occlusion of the coronary arteries due to luminal myofibroblast proliferation (LMP) as well as the development of coronary arteritis and aortitis. We found that CD8+ T cells, but not CD4+ T cells, NK T cells, or Treg cells, were required for development of KD vasculitis. The LCWE-induced murine model of KD vasculitis mimics many histologic features of the disease in humans, such as the presence of CD8+ T cells and LMP in coronary artery lesions as well as epicardial coronary arteritis. Moreover, CD8+ T cells functionally contribute to the development of KD vasculitis in this murine model. Therapeutic strategies targeting infiltrating CD8+ T cells might be useful in the management of KD in humans. © 2016, American College of Rheumatology.

Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities.

PubMed

Dejaco, Christian; Brouwer, Elisabeth; Mason, Justin C; Buttgereit, Frank; Matteson, Eric L; Dasgupta, Bhaskar

2017-10-01

The fields of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) have advanced rapidly, resulting in a new understanding of these diseases. Fast-track strategies and improved awareness programmes that prevent irreversible sight loss through early diagnosis and treatment are a notable advance. Ultrasonography and other imaging techniques have been introduced into routine clinical practice and there have been promising reports on the efficacy of biologic agents, particularly IL-6 antagonists such as tocilizumab, in treating these conditions. Along with these developments, which should improve outcomes in patients with GCA and PMR, new questions and unmet needs have emerged; future research should address which pathogenetic mechanisms contribute to the different phases and clinical phenotypes of GCA, what role imaging has in the early diagnosis and monitoring of GCA and PMR, and in which patients and phases of these diseases novel biologic drugs should be used. This article discusses the implications of recent developments in our understanding of GCA and PMR, as well as the unmet needs concerning epidemiology, pathogenesis, imaging and treatment of these diseases.

Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association

PubMed Central

Procop, Gary W.; Eng, Charis; Clifford, Alison; Villa-Forte, Alexandra; Calabrese, Leonard H.; Roselli, Eric; Svensson, Lars; Johnston, Douglas; Pettersson, Gosta; Soltesz, Edward; Lystad, Lisa; Perry, Julian D.; Blandford, Alexander; Wilson, Deborah A.; Hoffman, Gary S.

2017-01-01

Objective It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen. Methods and Results DNA samples extracted from 11 surgically sterile temporal arteries and 31 surgically sterile thoracic aortas were used in an attempt to identify the vessel-associated VZV genome. Two different validated PCR methods were used. Thirty-one thoracic aorta aneurysm specimens included biopsies from 8 patients with GCA, 2 from patients with TAK, 6 from patients with FIA, and 15 from patients without vasculitis, who had non-inflammatory aneurysms. Eleven temporal artery biopsies were collected from 5 patients with GCA and 6 controls. The presence of VZV was not identified in either the specimens from patients with large vessel vasculitis or from the controls. Conclusions Using surgically sterile snap-frozen specimens, we were unable to confirm recent reports of the presence of VZV in either aortas or temporal arteries from patients with large vessel vasculitis or controls. PMID:28758156

Behçet's disease.

PubMed

Saadoun, David; Wechsler, Bertrand

2012-04-12

DEFINITION OF THE DISEASE: Behçet disease (BD) is a chronic, relapsing, multisystemic disorder characterized by mucocutaneous, ocular, vascular and central nervous system manifestations. BD seems to cluster along the ancient Silk Road, which extends from eastern Asia to the Mediterranean basin. European cases are often described, not exclusively in the migrant population. The clinical spectrum includes oral and genital ulcerations, uveitis, vascular, neurological, articular, renal and gastrointestinal manifestations. The etiopathogenesis of the disease remains unknown, although genetic predisposition, environmental factors and immunological abnormalities have been implicated. Diagnosis is only based on clinical criteria. DIFFERRENTIAL DIAGNOSIS: It depends on the clinical presentation of BD, but sarcoidosis, multiple sclerosis, Crohn's disease, Takayasu's arteritis, polychondritis or antiphospholipid syndrome need to be considered. Treatment is symptomatic using steroids and immunomodulatory therapy. It is efficient depending on the rapidity of initiation, the compliance, and the duration of therapy. The prognosis is severe due to the ocular, neurological and arterial involvement.

Effective removal of equine arteritis virus from stallion semen.

PubMed

Morrell, J M; Geraghty, R M

2006-05-01

A method of removing equine arteritis virus (EAV) from equine semen used for artificial insemination is urgently needed. Recent medical studies suggest that a double semen processing technique of density gradient centrifugation followed by a 'swim-up' can provide virus-free sperm preparations for assisted reproduction. To investigate the use of the double semen processing technique to obtain virus-free sperm preparations from stallion semen containing EAV. Aliquots of an ejaculate from an uninfected stallion were spiked with virus and processed by the double processing technique. The sperm preparations were tested by PCR for the presence of EAV. The procedure was repeated using an ejaculate from a known shedding stallion, testing processed and unprocessed aliquots by PCR and virus isolation. Virus-free sperm preparations were obtained using the double sperm processing technique. The 'swim-up' step is apparently required to ensure complete virus removal. The double semen processing technique is potentially a useful and simple tool for the removal of EAV from the semen of shedding stallions. The inclusion of density gradient centrifugation and 'swim-up' in protocols for the processing of semen for artificial insemination could help prevent the transmission of viral diseases carried in semen, such as EAV.

The use of the color Doppler ultrasonography in the diagnosis and monitoring of an atypical case of giant-cell arteritis.

PubMed

Martins, N; Polido-Pereira, J; Rodrigues, A M; Soares, F; Batista, P; Pereira da Silva, J A

2016-01-01

Giant Cell Arteritis (GCA) is a large vessels vasculitis that is typically characterised by headache, scalp tenderness, jaw claudication and visual disturbances. Temporal arteries color Doppler ultrasonography (CDUS) is a sensitive and non-invasive image technique used in the diagnosis of this disease. This work highlights the importance of CDUS in the diagnostic workup of GCA and also demonstrates it´s usefullness in the evaluation and documentation of the response to corticosteroids therapy in an atypical case of ACG.

Chimeric viruses containing the N-terminal ectodomains of GP5 and M proteins of porcine reproductive and respiratory syndrome do not change the cellular tropism of equine arteritis virus

USDA-ARS?s Scientific Manuscript database

Equine arteritis virus (EAV) and porcine reproductive and respiratory syndrome virus (PRRSV) are members of family Arteriviridae; they share many biological properties but differ significantly in cellular tropism. Using an infectious cDNA clone of EAV, we engineered a panel of six chimeric viruses b...

Ulcerative colitis associated with Takayasu's disease in two patients who received proctocolectomy.

PubMed

Masuda, Hideki; Ishii, Ukimoto; Aoki, Nobuhiko; Nakayama, Hisashi; Sato, Fumii; Karube, Hideaki; Suzuki, Shigeru; Kondo, Toshihiko

2002-01-01

Ulcerative colitis (UC) associated with Takayasu's disease (TD) is not common in Japan. Here, we report two patients with both diseases who received a total proctocolectomy. Patient 1, a 41-year-old woman with chronic continuous type UC, was first diagnosed with TD at the age of 10 years. Subsequently, she was diagnosed with UC and rectal cancer. HLA typing showed A2, A31(19), B52(5), and DR2(DRB1*1502). Coronary angiography showed 90% narrowing of the right coronary artery (RCA). After alleviating the RCA narrowing by percutaneous transluminal coronary angioplasty (PTCA), we performed a total proctocolectomy and ileostomy. Patient 2, a 20-year-old woman, was first diagnosed with TD at the age of 13 years. Severe symptoms, indicating fulminant UC, started 1 month prior to hospitalization. She was judged as needing surgery because the symptoms were not alleviated even with high doses of prednisolone. HLA typing showed A2, A31(19), B52, B61(40), DR2(DRB1*1502), and DR4 (DRB1*0405). Aortography showed a narrowing of the right renal artery; however, her renal function was normal. Based on these findings, we performed a three-stage operation for total proctocolectomy. Previously, we have reported that the DRB1*1502 and DRw11 genes were closely related to the intractability of UC. To date, we have not determined whether or how the DRB1*1502 gene might be related to TD. As the number of cases of UC associated with TD increases, it will be necessary to examine their DR2 subtypes.

Correlation between ocular pulse amplitude measured by dynamic contour tonometer and colour Doppler flow imaging of the arteric retrobulbar vessels.

PubMed

Marjanović, Ivan; Mijajlović, Milija; Covicković-Sternić, Nadezda; Kontić, Djordje; Hentova-Senćanić, Paraskeva; Marković, Vujica; Bozić, Marija

2011-01-01

An altered perfusion of the optic nerve head has been proposed as a pathogenic factor in glaucoma. The aim of this study was to evaluate the correlation between ocular pulse amplitude (OPA), measured by Dynamic contour tonometer (DCT) and colour Doppler imaging (CDI) of the arteric retrobulbar vessels. Twenty patients older than 50 years were examined, and divided into two equal groups. The first group comprised of patients with normal tension glaucoma treated with topical antiglaucomatous therapy, and the second group included patients with ocular hypertension and glaucoma suspicious without any antiglaucomatous therapy. Ocular pulse amplitude (OPA) was measured with DCT. CDI was also performed. We measured haemodynamic parameters of the internal carotid artery (ICA), ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCA). Peak systolic (PSV), end-diastolic (EDV) velocities were measured, and resistance index (RI) and pulsatility index (PI) were calculated. Correlation with OPA showed indirect servitude in the RI of the ICA, RI and PI of the CRA, in the first group; and in the PSV and EDV of the ICA, in the RI and PI of the OA, EDV and RI of the CRA, and RI of the PCA, in the second group Increase of OPA was mostly followed by the increase of the parameters (PSV, EDV, RI, and PI) of the arteric retrobulbar vessels in the first group; in the second group, increase of OPA was in almost 50% of parameters followed by their decrease.

ELA-DRA polymorphisms are not associated with Equine Arteritis Virus infection in horses from Argentina.

PubMed

Kalemkerian, P B; Metz, G E; Peral-Garcia, P; Echeverria, M G; Giovambattista, G; Díaz, S

2012-12-01

Polymorphisms at Major Histocompatibility Complex (MHC) genes have been associated with resistance/susceptibility to infectious diseases in domestic animals. The aim of this investigation was to evaluate whether polymorphisms of the DRA gene the Equine Lymphocyte Antigen is associated with susceptibility to Equine Arteritis Virus (EAV) infection in horses in Argentina. The equine DRA gene was screened for polymorphisms using Pyrosequencing® Technology which allowed the detection of three ELA-DRA exon 2 alleles. Neither allele frequencies nor genotypic differentiation exhibited any statistically significant (P-values=0.788 and 0.745) differences between the EAV-infected and no-infected horses. Fisher's exact test and OR calculations did not show any significant association. As a consequence, no association could be established between the serological condition and ELA-DRA. Copyright © 2012 Elsevier Ltd. All rights reserved.

Association of vascular physical examination findings and arteriographic lesions in large vessel vasculitis.

PubMed

Grayson, Peter C; Tomasson, Gunnar; Cuthbertson, David; Carette, Simon; Hoffman, Gary S; Khalidi, Nader A; Langford, Carol A; McAlear, Carol A; Monach, Paul A; Seo, Philip; Warrington, Kenneth J; Ytterberg, Steven R; Merkel, Peter A

2012-02-01

To assess the utility of the vascular physical examination to detect arteriographic lesions in patients with established large vessel vasculitis (LVV), including Takayasu's arteritis (TAK) and giant cell arteritis (GCA). In total, 100 patients (TAK = 68, GCA = 32) underwent standardized physical examination and angiography of the carotid, subclavian, and axillary arteries. Sensitivity and specificity were calculated for the association between findings on physical examination focusing on the vascular system (absent pulse, bruit, and blood pressure difference) and arteriographic lesions defined as stenosis, occlusion, or aneurysm. We found 67% of patients had at least 1 abnormality on physical examination (74% TAK, 53% GCA). Arteriographic lesions were seen in 76% of patients (82% TAK, 63% GCA). Individual physical examination findings had poor sensitivity (range 14%-50%) and good-excellent specificity (range 71%-98%) to detect arteriographic lesions. Even when considering physical examination findings in combination, at least 30% of arteriographic lesions were missed. Specificity improved (range 88%-100%) if individual physical examination findings were compared to a broader region of vessels rather than specific anatomically correlated vessels and if ≥ 1 physical examination findings were combined. In patients with established LVV, physical examination alone is worthwhile to detect arterial disease but does not always localize or reveal the full extent of arteriographic lesions. Abnormal vascular system findings on physical examination are highly associated with the presence of arterial lesions, but normal findings on physical examination do not exclude the possibility of arterial disease. Serial angiographic assessment is advisable to monitor arterial disease in patients with established LVV.

Development of a Core Set of Outcome Measures for Large-vessel Vasculitis: Report from OMERACT 2016.

PubMed

Sreih, Antoine G; Alibaz-Oner, Fatma; Kermani, Tanaz A; Aydin, Sibel Z; Cronholm, Peter F; Davis, Trocon; Easley, Ebony; Gul, Ahmet; Mahr, Alfred; McAlear, Carol A; Milman, Nataliya; Robson, Joanna C; Tomasson, Gunnar; Direskeneli, Haner; Merkel, Peter A

2017-12-01

Among the challenges in conducting clinical trials in large-vessel vasculitis (LVV), including both giant cell arteritis (GCA) and Takayasu arteritis (TA), is the lack of standardized and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group initiated an international effort to develop and validate data-driven outcome tools for clinical investigation in LVV. An international Delphi exercise was completed to gather opinions from clinical experts on LVV-related domains considered important to measure in trials. Patient interviews and focus groups were completed to identify outcomes of importance to patients. The results of these activities were presented and discussed in a "Virtual Special Interest Group" using telephone- and Internet-based conferences, discussions through electronic mail, and an in-person session at the 2016 OMERACT meeting. A preliminary core set of domains common for all forms of LVV with disease-specific elements was proposed. The majority of experts agree with using common outcome measures for GCA and TA, with the option of supplementation with disease-specific items. Following interviews and focus groups, pain, fatigue, and emotional effect emerged as health-related quality of life domains important to patients. Current disease assessment tools, including the Birmingham Vasculitis Activity Score, were found to be inadequate to assess disease activity in GCA and standardized assessment of imaging tests were felt crucial to study LVV, especially TA. Initial data from a clinician Delphi exercise and structured patient interviews have provided themes toward an OMERACT-endorsed core set of domains and outcome measures.

Lymphocytic Arteritis in Epstein-Barr Virus Vulvar Ulceration (Lipschütz Disease): A Report of 7 Cases.

PubMed

Barrett, Mary M; Sangüeza, Martin; Werner, Betina; Kutzner, Heinz; Carlson, John A

2015-09-01

Epstein-Barr virus (EBV) infection can rarely present as painful genital ulcers, mostly in young female adolescents. Typically diagnosed by clinical findings, EBV vulvar ulceration (EBVVU) is rarely biopsied. Herein, the authors report the histopathology in 8 biopsies from 7 EBVVU patients, all serologically confirmed for acute (4/7) or reactivated-chronic (3/7) EBV infection. The 7 women all presented with 1 or more painful, punched-out vulvar ulcers. Only patients with acute EBV infection showed other clinical findings: fever and/or atypical lymphocytosis affected 75% (3/4); lymphadenopathy in 50%; and malaise/fatigue, dysuria and/or hepatomegaly in 25%. All reactivated-chronic EBVVU had a solitary ulcer, and 2 had history of a similar episode of vulvar ulceration (aphthosis). Histopathologically, lymphocytic arteritis was identified in 88% (7/8); a submucosal scar was found in the eighth specimen. Other histopathologies included venulitis (62%), endarteritis obliterans (38%), thrombosis (25%), neutrophilic sebaceous adenitis (25%), and mucosal lymphoid hyperplasia (12%). Dense angiocentric CD3 CD4 T-cell lymphocyte-predominant infiltrates were found, regionally or diffusely. In 2 specimens, neutrophils compromised half of the infiltrate. Minor components of CD8, CD20, and CD30 lymphocytes, CD123 plasmacytoid monocytes, CD68 macrophages, and plasma cells were present. Small-vessel endothelium and smooth muscle adjacent to the ulcers faintly expressed cytoplasmic EBV latent membrane protein-1 (LMP1). In situ hybridization for early EBV mRNA (EBER) identified rare solitary or scattered clustered positive lymphocytes in 38%. Polymerase chain reaction for EBV DNA was positive in one EBER positive biopsy. EBV infection has been documented in muscular vessel vasculitis. Based on the aforementioned, EBVVU appears to be the consequence of localized lymphocytic arteritis.

Equine arteritis virus is delivered to an acidic compartment of host cells via clathrin-dependent endocytosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nitschke, Matthias; Korte, Thomas; Tielesch, Claudia

Equine arteritis virus (EAV) is an enveloped, positive-stranded RNA virus belonging to the family Arteriviridae. Infection by EAV requires the release of the viral genome by fusion with the respective target membrane of the host cell. We have investigated the entry pathway of EAV into Baby Hamster Kindey cells (BHK). Infection of cells assessed by the plaque reduction assay was strongly inhibited by substances which interfere with clathrin-dependent endocytosis and by lysosomotropic compounds. Furthermore, infection of BHK cells was suppressed when clathrin-dependent endocytosis was inhibited by expression of antisense RNA of the clathrin-heavy chain before infection. These results strongly suggestmore » that EAV is taken up via clathrin-dependent endocytosis and is delivered to acidic endosomal compartments.« less

Giant Cell Arteritis of the Female Genital Tract With Occult Temporal Arteritis and Marginal Zone Lymphoma Harboring Novel 20q Deletion: A Case Report and Literature Review.

PubMed

Pradhan, Dinesh; Amin, Rajnikant M; Jones, Miroslawa W; Surti, Urvashi; Parwani, Anil V

2016-02-01

Giant cell arteritis (GCA) is an immunologically mediated vasculitis of large and medium-sized vessels, typically affecting the cranial arteries and usually occurring in the elderly. GCA of the female genital tract is extremely rare with only 31 cases reported in the English literature. An 83-year-old white female with postmenopausal vaginal bleeding revealed an endometrial polyp on pelvic ultrasonography following which polypectomy and subsequently hysterectomy with bilateral salpingo-oophorectomy was done. Microscopy revealed a well-differentiated endometrioid adenocarcinoma. Interestingly, classic GCA involving numerous small to medium-sized arteries of the cervix, myometrium, bilateral fallopian tubes, and ovaries was also identified. Hematologic evaluation revealed marginal zone lymphoma with an exceptionally rare 20q deletion. Bilateral temporal artery biopsy was done subsequently, which exhibited GCA on microscopy. Corticosteroid was started that improved her polymyalgia rheumatica symptoms. The patient is on follow-up for 3 years and is doing well. To our knowledge, this is the first case of GCA of the female genital tract associated with a lymphoma and the second case of marginal zone lymphoma with the novel 20q deletion. © The Author(s) 2015.

Varicella zoster virus in the temporal artery of a patient with giant cell arteritis.

PubMed

Nagel, Maria A; Khmeleva, Nelly; Boyer, Philip J; Choe, Alexander; Bert, Robert; Gilden, Don

2013-12-15

We recently detected varicella zoster virus (VZV) in the temporal arteries (TA) of 5/24 patients with clinically suspect giant cell arteritis (GCA) whose TAs were GCA-negative pathologically; in those GCA-negative, VZV+TAs, virus antigen predominated in the arterial adventitia, but without medial necrosis and multinucleated giant cells. During our continuing search for VZV antigen in GCA-negative TAs, in the TA of one subject, we found abundant VZV antigen, as well as VZV DNA, in multiple regions (skip areas) of the TA spanning 350 μm, as well as in skeletal muscle adjacent to the infected TA. Additional pathological analysis of sections adjacent to those containing viral antigen revealed inflammation involving the arterial media and abundant multinucleated giant cells characteristic of GCA. Detection of VZV in areas of the TA with pathological features of GCA warrants further correlative pathological-virological analysis of VZV in GCA. © 2013.

Unlikely culprit: congenital middle aortic syndrome diagnosed in the sixth decade of life.

PubMed

Ali, Muhammad Sajawal; Tchernodrinski, Stefan; Mohananey, Divyanshu; Ali, Ahya Sajawal

2016-08-16

A 58-year-old woman was admitted with acute heart failure. She had a long history of resistant hypertension, with an unremarkable work up for secondary causes in the past. Her brachial blood pressure was 210/70 mm Hg, with ankle blood pressure of 100/70 mm Hg. CT angiogram revealed marked narrowing of the descending thoracic aorta between the left subclavian artery and the diaphragm, consistent with middle aortic syndrome (MAS). She was initially managed with diuretics and antihypertensives. Subsequently thoracotomy revealed a severely hypoplastic segment of the descending aorta. The diseased segment was resected and aortic reconstruction performed. Histopathology showed fragmentation of the medial elastic fibres and fibrosis of the medial and intimal layers. These findings along with gross aortic hypoplasia and absence of features of Takayasu's arteritis, suggest that our patient had congenital MAS. The patient has done well since her surgery. We believe this is the first case of congenital MAS reported in the sixth decade of life. 2016 BMJ Publishing Group Ltd.

Coagulation and fibrinolysis in inflammatory bowel disease and in giant cell arteritis.

PubMed

Vrij, Anton A; Rijken, Joop; van Wersch, Jan W J; Stockbrügger, Reinhold W

2003-01-01

In inflammatory bowel disease (IBD), gut microvascular thrombosis as well as thromboembolic complications have repeatedly been observed. We examined the long-term course of markers of coagulation and fibrinolysis in relation to clinical disease activity. In a prospective study, prothrombin fragment 1 and 2 (F1.2), thrombin-antithrombin complex (TAT), antithrombin, D-dimer, plasmin-alpha(2)-antiplasmin complex (PAP) and plasminogen activator inhibitor-1 (PAI-1) were measured in 20 patients with Crohn's disease (CD), 18 with ulcerative colitis (UC), and 19 with giant cell arteritis during active and inactive disease, as well as in 51 controls without inflammation. Levels of F1.2, TAT, D-dimer, PAP and PAI-1 were significantly higher in active versus inactive CD and UC. However, even after 12 months of follow-up, in CD and UC the mean levels of F1.2, D-dimer and PAP were significantly higher than the levels of the controls. Levels of F1.2, D-dimer and PAP were markedly raised for a long time in clinically inactive IBD, underlining a chronic state of hypercoagulation and enhanced fibrinolysis. Copyright 2003 S. Karger AG, Basel

Cross-phenotype analysis of Immunochip data identifies KDM4C as a relevant locus for the development of systemic vasculitis.

PubMed

Ortiz-Fernández, Lourdes; Carmona, Francisco David; López-Mejías, Raquel; González-Escribano, Maria Francisca; Lyons, Paul A; Morgan, Ann W; Sawalha, Amr H; Smith, Kenneth G C; González-Gay, Miguel A; Martín, Javier

2018-04-01

Systemic vasculitides represent a heterogeneous group of rare complex diseases of the blood vessels with a poorly understood aetiology. To investigate the shared genetic component underlying their predisposition, we performed the first cross-phenotype meta-analysis of genetic data from different clinically distinct patterns of vasculitis. Immunochip genotyping data from 2465 patients diagnosed with giant cell arteritis, Takayasu's arteritis, antineutrophil cytoplasmic antibody-associated vasculitis or IgA vasculitis as well as 4632 unaffected controls were analysed to identify common susceptibility loci for vasculitis development. The possible functional consequences of the associated variants were interrogated using publicly available annotation data. The strongest association signal corresponded with an intergenic polymorphism located between HLA-DQB1 and HLA-DQA2 (rs6932517, P=4.16E-14, OR=0.74). This single nucleotide polymorphism is in moderate linkage disequilibrium with the disease-specific human leucocyte antigen (HLA) class II associations of each type of vasculitis and could mark them. Outside the HLA region, we identified the KDM4C gene as a common risk locus for vasculitides (highest peak rs16925200, P=6.23E-07, OR=1.75). This gene encodes a histone demethylase involved in the epigenetic control of gene expression. Through a combined analysis of Immunochip data, we have identified KDM4C as a new risk gene shared between systemic vasculitides, consistent with the increasing evidences of the crucial role that the epigenetic mechanisms have in the development of complex immune-mediated conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC.

PubMed

Slart, Riemer H J A

2018-07-01

Large vessel vasculitis (LVV) is defined as a disease mainly affecting the large arteries, with two major variants, Takayasu arteritis (TA) and giant cell arteritis (GCA). GCA often coexists with polymyalgia rheumatica (PMR) in the same patient, since both belong to the same disease spectrum. FDG-PET/CT is a functional imaging technique which is an established tool in oncology, and has also demonstrated a role in the field of inflammatory diseases. Functional FDG-PET combined with anatomical CT angiography, FDG-PET/CT(A), may be of synergistic value for optimal diagnosis, monitoring of disease activity, and evaluating damage progression in LVV. There are currently no guidelines regarding PET imaging acquisition for LVV and PMR, even though standardization is of the utmost importance in order to facilitate clinical studies and for daily clinical practice. This work constitutes a joint procedural recommendation on FDG-PET/CT(A) imaging in large vessel vasculitis (LVV) and PMR from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine (EANM), the Cardiovascular Council of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), and the PET Interest Group (PIG), and endorsed by the American Society of Nuclear Cardiology (ASNC). The aim of this joint paper is to provide recommendations and statements, based on the available evidence in the literature and consensus of experts in the field, for patient preparation, and FDG-PET/CT(A) acquisition and interpretation for the diagnosis and follow-up of patients with suspected or diagnosed LVV and/or PMR. This position paper aims to set an internationally accepted standard for FDG-PET/CT(A) imaging and reporting of LVV and PMR.

Progranulin antibodies in autoimmune diseases.

PubMed

Thurner, Lorenz; Preuss, Klaus-Dieter; Fadle, Natalie; Regitz, Evi; Klemm, Philipp; Zaks, Marina; Kemele, Maria; Hasenfus, Andrea; Csernok, Elena; Gross, Wolfgang L; Pasquali, Jean-Louis; Martin, Thierry; Bohle, Rainer Maria; Pfreundschuh, Michael

2013-05-01

Systemic vasculitides constitute a heterogeneous group of diseases. Autoimmunity mediated by B lymphocytes and their humoral effector mechanisms play a major role in ANCA-associated vasculitis (AAV) as well as in non-ANCA associated primary systemic vasculitides and in the different types of autoimmune connective tissue disorders and rheumatoid arthritis. In order to detect autoantibodies in systemic vasculitides, we screened protein macroarrays of human cDNA expression libraries with sera from patients with ANCA-associated and ANCA-negative primary systemic vasculitides. This approach led to the identification of antibodies against progranulin, a 88 kDA secreted glycoprotein with strong anti-inflammatory activity in the course of disease of giant-cell arteritis/polymyalgia rheumatica (14/65), Takayasu's arteritis (4/13), classical panarteritis nodosa (4/10), Behcet's disease (2/6) and in the course of disease in granulomatosis with polyangiitis (31/75), Churg-Strauss syndrome (7/23) and in microscopic polyangiitis (7/19). In extended screenings the progranulin antibodies were also detected in other autoimmune diseases such as systemic lupus erythematosus (39/91) and rheumatoid arthritis (16/44). Progranulin antibodies were detected only in 1 of 97 healthy controls. Anti-progranulin positive patients with systemic vasculitides, systemic lupus erythematosus or rheumatoid arthritis had significant lower progranulin plasma levels, indicating a neutralizing effect. In light of the anti-inflammatory effects of progranulin, progranulin antibodies might exert pro-inflammatory effects thus contributing to the pathogenesis of the respective autoimmune diseases and might serve as a marker for disease activity. This hypothesis is supported by the fact that a positive progranulin antibody status was associated with active disease in granulomatosis with polyangiitis. Copyright © 2012 Elsevier Ltd. All rights reserved.

Infections and the risk of incident giant cell arteritis: a population-based, case-control study.

PubMed

Rhee, Rennie L; Grayson, Peter C; Merkel, Peter A; Tomasson, Gunnar

2017-06-01

Alterations in the immune system and infections are suspected to increase susceptibility to giant cell arteritis (GCA). Recently herpes zoster has been directly implicated in the pathogenesis of GCA. We examined the association between prior infections, in particular herpes zoster, and incident GCA in a population-based cohort. A nested case-control study was performed using an electronic database from the UK. Cases with newly diagnosed GCA were identified using a validated algorithm and compared with age-matched, sex-matched and practice-matched controls. Conditional logistic regression was used to examine the relationship between any infection or herpes zoster infection on the development of GCA after adjusting for potential confounders; results were expressed as incidence rate ratios (IRRs). There were 4559 cases of GCA and 22 795 controls. Any prior infection and herpes zoster were associated with incident GCA (IRR 1.26 (95% CI 1.16 to 1.36), p<0.01; and 1.17 (95% CI 1.04 to 1.32), p<0.01, respectively). A greater number of infections was associated with a higher risk of developing GCA (IRR for 1, 2-4 and ≥5 infections was 1.28, 1.60 and 2.18, respectively). Antecedent infections and, to a lesser extent, herpes zoster infections are modestly associated with incident GCA. These data provide population-level support for the hypothesis that long-standing alterations of the immune system are associated with susceptibility to GCA and suggest that herpes zoster is unlikely to play a major causal role in the pathogenesis of GCA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases.

PubMed

Pujades-Rodriguez, Mar; Duyx, Bram; Thomas, Sara L; Stogiannis, Dimitris; Smeeth, Liam; Hemingway, Harry

2016-03-01

Evidence of the association of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) with the full range of cardiovascular diseases (CVDs) is limited. We examined their relationship with the first clinical presentation of the 12 most common CVDs in an unselected population-based cohort of men and women. We analysed CArdiovascular disease research using LInked Bespoke studies and Electronic health Records (CALIBER) data, which links primary care and hospital and mortality data in England, from 1997 to 2010. We assembled a cohort of men and women initially free from CVD at baseline and included all patients with PMR and/or GCA (PMR/GCA) diagnosis, matched by age, sex and general practice with up to 10 individuals without PMR/GCA. Random effects Poisson regression analysis was used to study the association between PMR/GCA and the initial presentation of 12 types of CVDs. The analysis included 9776 patients with PMR only, 1164 with GCA only, 627 with PMR and GCA and 105 504 without either condition. During a median of 3.14 years of follow-up 2787 (24.1%) individuals with PMR/GCA and 21 559 (20.4%) without PMR/GCA developed CVDs. Patients with PMR/GCA had lower rates of unheralded coronary death (3.18 vs 3.61/1000 person-years; adjusted incidence ratio 0.79, 95% CI 0.66 to 0.95), transient ischaemic attack (5.11 vs 5.61/1000 person-years; 0.67, 95% CI 0.54 to 0.84) and coronary and death composite (24.17 vs 25.80/1000 person-years; 0.90, 95% CI 0.82 to 0.98). No associations were observed for other CVDs or cerebrovascular diseases, and in patients with only PMR or GCA. No evidence of interaction by age or sex was found. Estimates decreased with longer PMR/GCA duration and findings were robust to multiple sensitivity analyses. In this large contemporary population-based cohort the presence of PMR and/or GCA was not associated with an increased risk of CVDs or cerebrovascular diseases regardless of PMR/GCA duration. Published by the BMJ Publishing Group

Giant-cell arteritis without cranial manifestations

PubMed Central

de Boysson, Hubert; Lambert, Marc; Liozon, Eric; Boutemy, Jonathan; Maigné, Gwénola; Ollivier, Yann; Ly, Kim; Manrique, Alain; Bienvenu, Boris; Aouba, Achille

2016-01-01

Abstract Diagnosis of giant-cell arteritis (GCA) is challenging in the absence of cardinal cranial symptoms/signs. We aimed to describe the clinical presentation, diagnostic process, and disease course of GCA patients without cranial symptoms, and to compare them to those of patients with typical cranial presentation. In this retrospective multicenter study, we enrolled patients with GCA who satisfied at least 3 of the 5 American College of Rheumatology criteria for GCA, or 2 criteria associated with contributory vascular biopsy other than temporal artery biopsy or with demonstration of large-vessel involvement; underwent iconographic evaluation of large arterial vessels (aortic CT scan or a positron emission tomography with 18F-fluorodeoxyglucose combined with computed tomography (FDG-PET/CT) scan or cardiac echography combined with a large-vessel Doppler) at diagnosis. We divided the cohort into 2 groups, distinguishing between patients without cranial symptoms/signs (i.e., headaches, clinical temporal artery anomaly, jaw claudication, ophthalmologic symptoms) and those with cranial symptoms/signs. In the entire cohort of 143 patients, all of whom underwent vascular biopsy and vascular imaging, we detected 31 (22%) patients with no cranial symptoms/signs. In the latter, diagnosis was biopsy proven in an arterial sample in 23 cases (74% of patients, on a temporal site in 20 cases and on an extratemporal site in 3). One-third of these 31 patients displayed extracranial symptoms/signs whereas the remaining two-thirds presented only with constitutional symptoms and/or inflammatory laboratory test results. Compared to the 112 patients with cardinal cranial clinical symptoms/signs, patients without cranial manifestations displayed lower levels of inflammatory laboratory parameters (C-reactive level: 68 [9–250] mg/L vs 120 [3–120] mg/L; P < 0.01), highest rate of aorta and aortic branch involvement identified (19/31 (61%) vs 42/112 (38%); P = 0.02) and also

[Aortic inflammatory lesions in Behçet's disease].

PubMed

Desbois, A-C; Wechsler, B; Cacoub, P; Saadoun, D

2016-04-01

The arterial lesions affect about 10% of patients with Behçet's disease (BD). Aortic inflammatory involvement includes predominantly aortic aneurysmal lesions affecting most often the abdominal aorta. They account for the severity of the disease and are a leading cause of death when they hit the aorta or pulmonary arteries. Within the arterial lesions of BD, aortic involvement is, with femoral lesions, the most common site involved (18-28% of patients with vascular disease). Unlike other large vessels vasculitis (i.e. giant cell arteritis and Takayasu's arteritis) diffuse aortitis is observed in less than 5% of patients with BD. Aortic lesions of BD may be asymptomatic (systematic imaging or occasionally associated with other vascular event) or be revealed by the occurrence of abdominal, thoracic or lumbar pain, or an aortic valve insufficiency. Fever is frequently associated. Increase in acute phase reactants is common in these patients. Histological analysis may show infiltration by lymphocytes, neutrophils and plasma cells in the media and adventitia and a proliferation of the vasa vasorum in the media as well as a fibroblastic proliferation. In the later phase, a fibrous thickening of the media and adventitia is observed as well as a proliferation and thickening of the vasa vasorum. The therapeutic management should always include a medical treatment for the control of inflammation (corticosteroids, immunosuppressive drugs and/or biotherapy) and often an endovascular or surgical treatment if the aneurysm is threatening. The choice between endovascular or surgical treatment is considered case by case, depending on the experience of the team, anatomical conditions and of the clinical presentation. In this review, we provide a detailed and updated review of the literature to describe the aortic inflammatory damage associated with Behçet's disease. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights

The Incidence of Primary Systemic Vasculitis in Jerusalem: A 20-year Hospital-based Retrospective Study.

PubMed

Nesher, Gideon; Ben-Chetrit, Eli; Mazal, Bracha; Breuer, Gabriel S

2016-06-01

The incidence of primary systemic vasculitides varies among different geographic regions and ethnic origins. The aim of this study was to examine the incidence rates of vasculitides in the Jerusalem Jewish population, and to examine possible trends in incidence rates over a 20-year period. The clinical databases of inpatients at the 2 medical centers in Jerusalem were searched for patients with vasculitis diagnosed between 1990-2009. Individual records were then reviewed by one of the authors. The significance of trends in incidence rates throughout the study period was evaluated by Pearson correlation coefficient. The average annual incidence rate of polyarteritis nodosa was 3.6/million adults (95% CI 1.6-4.7). Incidence rates did not change significantly during this period (r = 0.39, p = 0.088). The incidence of granulomatosis with polyangiitis (GPA) was 4.1 (2.2-5.9) for the whole period, during which it increased significantly (r = 0.53, p < 0.05). The incidence of microscopic polyangiitis (MPA) was lower: 2.3 (1.2-3.5)/million. It also increased significantly (r = 0.55, p < 0.05). The incidence of eosinophilic granulomatosis with polyangiitis was 1.2 (0.4-1.9), which remained stable throughout the study period. The incidence of Takayasu arteritis was 2.1/million (95% CI 1.2-2.9), and it also remained stable. Giant cell arteritis (GCA) incidence was 8.1 (5.7-10.6)/100,000 population aged 50 years or older. In sharp contrast with other vasculitides, its incidence decreased significantly throughout the study period (r = -0.61, p < 0.01). The incidence rates of vasculitides in the Jewish population of Jerusalem are in the lower range of global incidence rates. While GPA and MPA incidence are increasing, GCA incidence is decreasing.

18 F-Fluorodeoxyglucose-Positron Emission Tomography As an Imaging Biomarker in a Prospective, Longitudinal Cohort of Patients With Large Vessel Vasculitis.

PubMed

Grayson, Peter C; Alehashemi, Sara; Bagheri, Armin A; Civelek, Ali Cahid; Cupps, Thomas R; Kaplan, Mariana J; Malayeri, Ashkan A; Merkel, Peter A; Novakovich, Elaine; Bluemke, David A; Ahlman, Mark A

2018-03-01

To assess the clinical value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in a prospective cohort of patients with large vessel vasculitis (LVV) and comparator subjects. Patients with Takayasu arteritis and giant cell arteritis were studied, along with a comparator group consisting of patients with hyperlipidemia, patients with diseases that mimic LVV, and healthy controls. Participants underwent clinical evaluation and FDG-PET imaging, and patients with LVV underwent serial imaging at 6-month intervals. We calculated sensitivity and specificity of FDG-PET interpretation for distinguishing patients with clinically active LVV from comparator subjects and from patients with disease in clinical remission. A qualitative summary score based on global arterial FDG uptake, the PET Vascular Activity Score (PETVAS), was used to study associations between activity on PET scan and clinical characteristics and to predict relapse. A total of 170 FDG-PET scans were performed in 115 participants (56 patients with LVV and 59 comparator subjects). FDG-PET distinguished patients with clinically active LVV from comparator subjects with a sensitivity of 85% (95% confidence interval [95% CI] 69, 94) and a specificity of 83% (95% CI 71, 91). FDG-PET scans were interpreted as active vasculitis in most patients with LVV in clinical remission (41 of 71 [58%]). Clinical disease activity status, disease duration, body mass index, and glucocorticoid use were independently associated with activity on PET scan. Among patients who underwent PET during clinical remission, future clinical relapse was more common in patients with a high PETVAS than in those with a low PETVAS (55% versus 11%; P = 0.03) over a median follow-up period of 15 months. FDG-PET provides information about vascular inflammation that is complementary to, and distinct from, clinical assessment in LVV. FDG-PET scan activity during clinical remission was associated with future clinical relapse. © 2017

History of primary vasculitis in Latin America.

PubMed

Iglesias Gammara, Antonio; Coral, Paola; Quintana, Gerardo; Toro, Carlos E; Flores, Luis Felipe; Matteson, Eric L; Restrepo, José Félix

2010-03-01

A literature review utilizing Fepafem, Bireme, LiLacs, Scielo Colombia, Scielo Internacional, former MedLine, Pubmed, and BVS Colombia as well as manual searches in the libraries of major Latin American universities was performed to study vasculitis in Latin America. Since 1945, a total of 752 articles have been published by Latin American authors. However, only a minority are devoted to primary vasculitides, and even fewer have been published in indexed journals. Approximately 126 are in OLD, Medline, Pubmed, Bireme, and Scielo. Most publications are from Mexico, followed by Brazil and Colombia. Systematic studies of the epidemiology of primary idiopathic vasculitis are available for a few countries, i.e. Brazil, Mexico, Colombia, Chile, and Peru. Takayasu arteritis and ANCA-associated vasculitis are the best studied forms of vasculitis in Latin America. Interest and expertise in vasculitis is growing in Latin America, as reflected in the increased number of published articles from this region of the world in the last decade. Racial and environmental factors are possibly responsible for the differential expression of various types of primary vasculitis observed in Latin America. With time, the unique features, epidemiology, and better treatment strategies for idiopathic vasculitides in Latin America will emerge.

[Investigation on a group of autistic children: risk factors and medical social considerations].

PubMed

Troili, G M; Businaro, R; Massoni, F; Ricci, L; Petrone, L; Ricci, P; Ricci, S

2013-01-01

The aim of this work is to study the association between autism in a group of autistic children and risk factors for specific familiar diseases and developmental disease in the early years of life, through a medical social investigation. For this study, we have submitted an anamnestic questionnaire to 29 autistic children and their families in a South Italy region (Basilicata), collecting data about children and their parents. The results show that many children have a family history of autoimmune diseases (psoriasis, rheumatoid arthritis, celiac disease, Takayasu's arteritis), allergies and food intolerances, suggesting a putative involvement of the immune system in autism etiopathogenesis. Analyzing residences areas of patients, Potenza and Matera, with their environmental factors (radioactive waste repositories, incinerators, intensive farming), we demonstrate that the particular territorial characteristics don't affect autism. Autistic disorder is a spectrum of neurologic disorders complex both in etiopathogenesis and healthcare. So we aim to continue the study already undertaken on cytokines of autistic subjects serum and to extend it through biomolecular approaches assessing the presence of specific genetic polymorphisms in order to identify the physiopathogenetic mechanisms underlying the disease and to evaluate the predictive risk with the aim to improve care interventions.

Recent advances in our understanding of giant cell arteritis pathogenesis.

PubMed

Samson, Maxime; Corbera-Bellalta, Marc; Audia, Sylvain; Planas-Rigol, Ester; Martin, Laurent; Cid, Maria Cinta; Bonnotte, Bernard

2017-08-01

Giant cell arteritis (GCA) is a granulomatous vasculitis affecting large arteries, especially the aorta and the extracranial branches of the external carotid artery. Its exact pathogenesis is not fully understood but major progress has been made in recent years, leading to new therapeutic targets like inhibition of the interleukin-6 pathway or the modulation of immune checkpoints. The cause of GCA has not been clearly identified but it is thought that GCA occurs on a genetic background and is triggered by unknown environmental factors that could activate and lead to the maturation of dendritic cells localized in the adventitia of normal arteries. These activated dendritic cells then produce chemokines which trigger the recruitment of CD4 + T cells, which in turn become activated, proliferate and polarize into Th1 and Th17 cells, which produce IFN-γ and IL-17, respectively. Exposed to IFN-γ, endothelial cells and vascular smooth muscle cells produce chemokines leading to the recruitment of further Th1 cells, CD8 + T cells and monocytes. The latter differentiate into macrophages, which, when persistently exposed to IFN-γ, form giant cells, the histological hallmark of GCA. With the contribution of vascular smooth muscle cells, immune cells then trigger the destruction and remodeling of the arterial wall, thus leading to the formation of a neo-intima resulting in progressive occlusion of the arterial lumen, which is responsible for the ischemic symptoms of GCA. In this paper, we review recent progress in our understanding of GCA pathogenesis in the fields of genetics, epigenetics, infections, immunology and vascular remodeling. Copyright © 2017 Elsevier B.V. All rights reserved.

Ustekinumab for refractory giant cell arteritis: A prospective 52-week trial.

PubMed

Conway, Richard; O'Neill, Lorraine; Gallagher, Phil; McCarthy, Geraldine M; Murphy, Conor C; Veale, Douglas J; Fearon, Ursula; Molloy, Eamonn S

2018-04-22

Giant cell arteritis (GCA) is the most common form of systemic vasculitis. Glucocorticoids are an effective treatment but have significant adverse events and relapses are common. Interleukins 12 (IL-12) and 23 (IL-23) stimulate T H 1 and T H 17 responses and are implicated in the pathogenesis of GCA. The aim of this study was to evaluate the efficacy and safety of IL-12/23 blockade with ustekinumab in GCA. We performed a prospective open label study of ustekinumab in patients with refractory GCA. Ustekinumab 90mg was administered subcutaneously every 12 weeks. The primary outcome was the comparison of the median glucocorticoid dose prior to commencement of ustekinumab and at 52 weeks. Secondary outcomes included physician assessed relapse, acute phase reactants, and imaging assessment of large vessel vasculitis (LVV). Twenty-five GCA patients received ustekinumab. All patients had failed to taper glucocorticoids despite addition of a median of 1 other immunosuppressive agent. At week 52, median (IQR) daily prednisolone dose decreased from 20 (15, 25)mg to 5 (2.5, 5)mg (p < 0.001). Six patients (24%) stopped prednisolone completely. No patient experienced a relapse of GCA while receiving ustekinumab. Median (IQR) CRP decreased significantly from 12.9 (5.3, 42) to 6 (2.6, 12.5)mg/L (p = 0.006). CT angiography demonstrated improvement of LVV in all patients studied. No unexpected adverse events were observed with ustekinumab. Ustekinumab may be effective for the treatment of GCA and warrants further assessment in a randomized controlled trial. Copyright © 2018 Elsevier Inc. All rights reserved.

Detection of IS6110 and HupB gene sequences of Mycobacterium tuberculosis and bovis in the aortic tissue of patients with Takayasu’s arteritis

PubMed Central

2012-01-01

Background Takayasu’s arteritis (TA) is a chronic inflammatory disease affecting the large arteries and their branches; its etiology is still unknown. In individuals suffering from TA, arterial inflammation progresses to stenosis and/or occlusion, leading to organ damage and affecting survival. Relation of TA with Mycobacterium tuberculosis has been known, but there have been only a few systematic studies focusing on this association. The IS6110 sequence identifies the Mycobacterium tuberculosis complex and the HupB establishes the differences between M. tuberculosis and M. bovis. Our objective was to search the presence of IS6110 and HupB genes in aorta of patients with TA. Methods We analyzed aorta tissues embedded in paraffin from 5760 autopsies obtained from our institution, we divided the selected samples as cases and controls; Cases: aortic tissues of individuals with Takayasu’s arteritis. Control positive: aortic tissues (with tuberculosis disease confirmed) and control negative with other disease aortic (atherosclerosis). Results Of 181 selected aorta tissues, 119 fulfilled the corresponding criteria for TA, TB or atherosclerosis. Thus 33 corresponded to TA, 33 to tuberculosis (TB) and 53 to atherosclerosis. The mean age was 22 ± 13, 41 ± 19, and 57 ± 10, respectively. IS6110 and HupB sequences were detected in 70% of TA tissues, 82% in tuberculosis, and in 32% with atherosclerosis. Important statistical differences between groups with TA, tuberculosis versus atherosclerosis (p = 0.004 and 0.0001, respectively) were found. Conclusion We identified a higher frequency of IS6110 and HupB genes in aortic tissues of TA patients. This data suggests that arterial damage could occur due to previous infection with M. tuberculosis. PMID:22905864

Polymyalgia rheumatica and giant cell arteritis: a 5-year epidemiologic and clinical study in Reggio Emilia, Italy.

PubMed

Salvarani, C; Macchioni, P L; Tartoni, P L; Rossi, F; Baricchi, R; Castri, C; Chiaravalloti, F; Portioli, I

1987-01-01

Among the population of Reggio Emilia, Italy, 56 patients with polymyalgia rheumatica (PR) and giant cell arteritis (GCA) were identified during the 5-year period 1981-85. The average annual incidence rates of PR and GCA were 12.8 and 8.8 respectively per 100,000 population aged 50 years or older. Forty-nine patients were followed up and the mean duration of follow-up was 32 months. All the patients received steroid therapy. We have evaluated the cumulative probability of requiring continued steroid therapy between patients with PR only, GCA only, and PR associated with GCA using life-table methods with permanent discontinuation of therapy as an end point. The different duration of steroid therapy between these 3 groups did not achieve statistical significance by the method of Lee and Desu. We identified a 5 variable discriminant function that correctly predicted whether the duration of therapy would be longer or shorter than 16 months (median duration of therapy) in 80% of our patients followed up for at least 24 months. The presence of synovitis in PR is also discussed.

Dermal arteritis of the nasal philtrum in a Giant Schnauzer and three Saint Bernard dogs.

PubMed

Torres, Sheila M F; Brien, Timothy O; Scott, Danny W

2002-10-01

Arteritis of the nasal philtrum is described in four dogs. Two of the Saint Bernards were related. The lesions were solitary, well-circumscribed, linear ulcers that were neither pruritic nor painful. The age of the dogs at the time the owners first noticed the lesion ranged from 3 to 6 years. The ulcers had been present for 0.5-5 years before diagnosis was pursued. Three of the dogs experienced repeated, mild episodes of arterial bleeding from the ulcers. Two dogs also experienced a severe episode of bleeding that required surgical intervention. Histopathological findings included a V-shaped ulcer, neutrophilic dermal inflammation subjacent to the ulcer and lymphoplasmacytic dermatitis bordering the ulcer. The most remarkable pathological findings were present in the deep dermal arteries and arterioles subjacent to the ulcer. The changes were characterized by subendothelial spindle cell proliferation with marked extracellular matrix deposition that stained blue with Alcian Blue (mucin) and Masson's trichrome (collagen) and resulted in intimal thickening, and stenosis of dermal arteries and arterioles. Immunohistochemical studies suggested that the proliferating spindle cells were of either myofibroblast or smooth muscle origin (actin and vimentin positive). Anti-inflammatory therapy (glucocorticoids; tetracycline and niacinamide; fish oil) may be beneficial for long-term control of this condition, however, long-term maintenance treatment appears to be necessary.

Genome-Wide Association Study among Four Horse Breeds Identifies a Common Haplotype Associated with In Vitro CD3+ T Cell Susceptibility/Resistance to Equine Arteritis Virus Infection ▿

PubMed Central

Go, Yun Young; Bailey, Ernest; Cook, Deborah G.; Coleman, Stephen J.; MacLeod, James N.; Chen, Kuey-Chu; Timoney, Peter J.; Balasuriya, Udeni B. R.

2011-01-01

Previously, we have shown that horses could be divided into susceptible and resistant groups based on an in vitro assay using dual-color flow cytometric analysis of CD3+ T cells infected with equine arteritis virus (EAV). Here, we demonstrate that the differences in in vitro susceptibility of equine CD3+ T lymphocytes to EAV infection have a genetic basis. To investigate the possible hereditary basis for this trait, we conducted a genome-wide association study (GWAS) to compare susceptible and resistant phenotypes. Testing of 267 DNA samples from four horse breeds that had a susceptible or a resistant CD3+ T lymphocyte phenotype using both Illumina Equine SNP50 BeadChip and Sequenom's MassARRAY system identified a common, genetically dominant haplotype associated with the susceptible phenotype in a region of equine chromosome 11 (ECA11), positions 49572804 to 49643932. The presence of a common haplotype indicates that the trait occurred in a common ancestor of all four breeds, suggesting that it may be segregated among other modern horse breeds. Biological pathway analysis revealed several cellular genes within this region of ECA11 encoding proteins associated with virus attachment and entry, cytoskeletal organization, and NF-κB pathways that may be associated with the trait responsible for the in vitro susceptibility/resistance of CD3+ T lymphocytes to EAV infection. The data presented in this study demonstrated a strong association of genetic markers with the trait, representing de facto proof that the trait is under genetic control. To our knowledge, this is the first GWAS of an equine infectious disease and the first GWAS of equine viral arteritis. PMID:21994447

Circulating soluble adhesion molecules in patients with giant cell arteritis. Correlation between soluble intercellular adhesion molecule-1 (sICAM-1) concentrations and disease activity

PubMed Central

Coll-Vinent, B.; Vilardell, C.; Font, C.; Oristrell, J.; Hernandez-Rodrigu..., J.; Yague, J.; Urbano-Marquez, A.; Grau, J.; Cid, M.

1999-01-01

OBJECTIVE—To evaluate whether changes in concentrations of circulating adhesion molecules are related to disease activity in patients with giant cell arteritis (GCA).
METHODS—A sandwich ELISA was used to measure soluble intercellular adhesion molecule-1 (sICAM-1), sICAM-3, vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin), and L-selectin (sL-selectin) in serum and plasma samples from patients with GCA. A cross sectional study was performed on 64 GCA patients at different activity stages and on 35 age and sex matched healthy donors. Thirteen of these patients were evaluated at the time of diagnosis and serially during follow up.
RESULTS—At the time of diagnosis, sICAM-1 concentrations were significantly higher in active GCA patients than in controls (mean (SD) 360.55 (129.78) ng/ml versus 243.25 (47.43) ng/ml, p<0.001). In contrast, sICAM-3, sVCAM-1, sE-selectin, and sL-selectin values did not differ from those obtained in normal donors. With corticosteroid administration, a decrease in sICAM-1 concentrations was observed, reaching normal values when clinical remission was achieved (263.18 (92.7) ng/ml globally, 293.59 (108.39) ng/ml in the group of patients in recent remission, and 236.83 (70.02) ng/ml in those in long term remission). In the 13 patients followed up longitudinally, sICAM-1 values also normalised with clinical remission (225.87 (64.25) ng/ml in patients in recent remission, and 256.29 (75.15) ng/ml in those in long term remission).
CONCLUSIONS—Circulating sICAM-1 concentrations clearly correlate with clinically apparent disease activity in GCA patients. Differences with results previously found in patients with other vasculitides may indicate that different pathogenic mechanisms contribute to vascular inflammation in different disorders.

 Keywords: adhesion molecules; giant cell arteritis; inflammation PMID:10364919

Functional mechanism of lung mosaic CT attenuation: assessment with deep-inspiration breath-hold perfusion SPECT-CT fusion imaging and non-breath-hold Technegas SPECT.

PubMed

Suga, K; Yasuhiko, K; Iwanaga, H; Tokuda, O; Matsunaga, N

2009-01-01

The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Although further validation is required, our results indicate that heterogeneous pulmonary arterial

Do solar cycles influence giant cell arteritis and rheumatoid arthritis incidence?

DOE PAGES

Wing, Simon; Rider, Lisa G.; Johnson, Jay R.; ...

2015-05-15

Our objective was to examine the influence of solar cycle and geomagnetic effects on the incidence of giant cell arteritis (GCA) and rheumatoid arthritis (RA). Methods: We used data from patients with GCA (1950-2004) and RA (1955-2007) obtained from population-based cohorts. Yearly trends in age-adjusted and sex-adjusted incidence were correlated with the F10.7 index (solar radiation at 10.7 cm wavelength, a proxy for the solar extreme ultraviolet radiation) and AL index (a proxy for the westward auroral electrojet and a measure of geomagnetic activity). Fourier analysis was performed on AL, F10.7, and GCA and RA incidence rates. Results: The correlationmore » of GCA incidence with AL is highly significant: GCA incidence peaks 0-1 year after the AL reaches its minimum (ie, auroral electrojet reaches a maximum). The correlation of RA incidence with AL is also highly significant. RA incidence rates are lowest 5-7 years after AL reaches maximum. AL, GCA and RA incidence power spectra are similar: they have a main peak (periodicity) at about 10 years and a minor peak at 4-5 years. However, the RA incidence power spectrum main peak is broader (8-11 years), which partly explains the lower correlation between RA onset and AL. The auroral electrojets may be linked to the decline of RA incidence more strongly than the onset of RA. The incidences of RA and GCA are aligned in geomagnetic latitude. Conclusions: AL and the incidences of GCA and RA all have a major periodicity of about 10 years and a secondary periodicity at 4-5 years. Geomagnetic activity may explain the temporal and spatial variations, including east-west skewness in geographic coordinates, in GCA and RA incidence, although the mechanism is unknown. Lastly, the link with solar, geospace and atmospheric parameters need to be investigated. These novel findings warrant examination in other populations and with other autoimmune diseases.« less

Do solar cycles influence giant cell arteritis and rheumatoid arthritis incidence?

PubMed Central

Wing, Simon; Rider, Lisa G; Johnson, Jay R; Miller, Federick W; Matteson, Eric L; Gabriel, Sherine E

2015-01-01

Objective To examine the influence of solar cycle and geomagnetic effects on the incidence of giant cell arteritis (GCA) and rheumatoid arthritis (RA). Methods We used data from patients with GCA (1950–2004) and RA (1955–2007) obtained from population-based cohorts. Yearly trends in age-adjusted and sex-adjusted incidence were correlated with the F10.7 index (solar radiation at 10.7 cm wavelength, a proxy for the solar extreme ultraviolet radiation) and AL index (a proxy for the westward auroral electrojet and a measure of geomagnetic activity). Fourier analysis was performed on AL, F10.7, and GCA and RA incidence rates. Results The correlation of GCA incidence with AL is highly significant: GCA incidence peaks 0–1 year after the AL reaches its minimum (ie, auroral electrojet reaches a maximum). The correlation of RA incidence with AL is also highly significant. RA incidence rates are lowest 5–7 years after AL reaches maximum. AL, GCA and RA incidence power spectra are similar: they have a main peak (periodicity) at about 10 years and a minor peak at 4–5 years. However, the RA incidence power spectrum main peak is broader (8–11 years), which partly explains the lower correlation between RA onset and AL. The auroral electrojets may be linked to the decline of RA incidence more strongly than the onset of RA. The incidences of RA and GCA are aligned in geomagnetic latitude. Conclusions AL and the incidences of GCA and RA all have a major periodicity of about 10 years and a secondary periodicity at 4–5 years. Geomagnetic activity may explain the temporal and spatial variations, including east-west skewness in geographic coordinates, in GCA and RA incidence, although the mechanism is unknown. The link with solar, geospace and atmospheric parameters need to be investigated. These novel findings warrant examination in other populations and with other autoimmune diseases. PMID:25979866

Do solar cycles influence giant cell arteritis and rheumatoid arthritis incidence?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wing, Simon; Rider, Lisa G.; Johnson, Jay R.

Our objective was to examine the influence of solar cycle and geomagnetic effects on the incidence of giant cell arteritis (GCA) and rheumatoid arthritis (RA). Methods: We used data from patients with GCA (1950-2004) and RA (1955-2007) obtained from population-based cohorts. Yearly trends in age-adjusted and sex-adjusted incidence were correlated with the F10.7 index (solar radiation at 10.7 cm wavelength, a proxy for the solar extreme ultraviolet radiation) and AL index (a proxy for the westward auroral electrojet and a measure of geomagnetic activity). Fourier analysis was performed on AL, F10.7, and GCA and RA incidence rates. Results: The correlationmore » of GCA incidence with AL is highly significant: GCA incidence peaks 0-1 year after the AL reaches its minimum (ie, auroral electrojet reaches a maximum). The correlation of RA incidence with AL is also highly significant. RA incidence rates are lowest 5-7 years after AL reaches maximum. AL, GCA and RA incidence power spectra are similar: they have a main peak (periodicity) at about 10 years and a minor peak at 4-5 years. However, the RA incidence power spectrum main peak is broader (8-11 years), which partly explains the lower correlation between RA onset and AL. The auroral electrojets may be linked to the decline of RA incidence more strongly than the onset of RA. The incidences of RA and GCA are aligned in geomagnetic latitude. Conclusions: AL and the incidences of GCA and RA all have a major periodicity of about 10 years and a secondary periodicity at 4-5 years. Geomagnetic activity may explain the temporal and spatial variations, including east-west skewness in geographic coordinates, in GCA and RA incidence, although the mechanism is unknown. Lastly, the link with solar, geospace and atmospheric parameters need to be investigated. These novel findings warrant examination in other populations and with other autoimmune diseases.« less

Involvement and prognosis value of CD8(+) T cells in giant cell arteritis.

PubMed

Samson, Maxime; Ly, Kim Heang; Tournier, Benjamin; Janikashvili, Nona; Trad, Malika; Ciudad, Marion; Gautheron, Alexandrine; Devilliers, Hervé; Quipourt, Valérie; Maurier, François; Meaux-Ruault, Nadine; Magy-Bertrand, Nadine; Manckoundia, Patrick; Ornetti, Paul; Maillefert, Jean-Francis; Besancenot, Jean-François; Ferrand, Christophe; Mesturoux, Laura; Labrousse, François; Fauchais, Anne-Laure; Saas, Philippe; Martin, Laurent; Audia, Sylvain; Bonnotte, Bernard

2016-08-01

CD8(+) T cells participate in the pathogenesis of some vasculitides. However, little is known about their role in Giant Cell Arteritis (GCA). This study was conducted to investigate CD8(+) T cell involvement in the pathogenesis of GCA. Analyses were performed at diagnosis and after 3 months of glucocorticoid treatment in 34 GCA patients and 26 age-matched healthy volunteers. Percentages of CD8(+) T-cell subsets, spectratype analysis of the TCR Vβ families of CD8(+) T cells, levels of cytokines and chemokines and immunohistochemistry of temporal artery biopsies (TAB) were assessed. Among total CD8(+) T cells, percentages of circulating cytotoxic CD8 T lymphocytes (CTL, CD3(+)CD8(+)perforin(+)granzymeB(+)), Tc17 (CD3(+)CD8(+)IL-17(+)), CD63(+)CD8(+) T cells and levels of soluble granzymes A and B were higher in patients than in controls, whereas the percentage of Tc1 cells (CD3(+)CD8(+)IFN-γ(+)) was similar. Moreover, CD8(+) T cells displayed a restricted TCR repertoire in GCA patients. Percentages of circulating CTL, Tc17 and soluble levels of granzymes A and B decreased after treatment. CXCR3 expression on CD8(+) T cells and its serum ligands (CXCL9, -10, -11) were higher in patients. Analyses of TAB revealed high expression of CXCL9 and -10 associated with infiltration by CXCR3(+)CD8(+) T cells expressing granzyme B and TiA1. The intensity of the CD8 T-cell infiltrate in TAB was predictive of the severity of the disease. This study demonstrates the implication and the prognostic value of CD8(+) T-cells in GCA and suggests that CD8(+) T-cells are recruited within the vascular wall through an interaction between CXCR3 and its ligands. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pathologic Markers Determining Prognosis in Patients with Treated or Healing Giant Cell Arteritis.

PubMed

Sultan, Harris; Smith, Stacy V; Lee, Andrew G; Chévez-Barrios, Patricia

2018-06-08

To provide quantitative evidence linking the Cluster of Differentiation-68 (CD68)+ macrophage-marker found on temporal artery biopsies (TABs) with disease prognosis. Retrospective, cross-sectional study METHODS: We examined 42 consecutive patients who had undergone unilateral TABs at a single hospital in 2015. Clinical data, laboratory data, and histopathologic features of TABs were recorded. clinical diagnosis of giant cell arteritis (GCA) with TAB performed at the same center. CD68 immunohistochemistry was used to label macrophages in the TABs. multiple logistic regression and bivariate comparisons to measure the association between CD68+ cells per histologic section with placement on immunomodulatory therapy (IMT). Twenty seven patients were females (64%), with a mean age of 72 (standard deviation [S.D.] ±7.7). Eleven patients (26%) were placed on IMT, 17 (40%) had disease recurrence during steroid taper, and 25 (60%) were referred to rheumatology. Of 42 biopsies, 35 underwent staining with CD68 to confirm active inflammation in suspicious, but not diagnostic, specimens. Patients eventually placed on IMT had increased CD68+ cells/slice compared to those not on IMT (median 5.00 [25-75 th quartile 2.00-7.15] vs 1.21 [0.38-2.57], p=0.031, respectively). A receiver operating characteristics (ROC) curve demonstrates that 2.17 CD68+ cells/slice predicts placement on IMT with an odds ratio of 1.54 (95% C.I. 1.02-2.33, p=0.038). Patients refractory to initial steroid tapers and those eventually placed on IMT had increased CD68 cells/section. CD68+ macrophages and their location on the internal elastic lamina may predict disease severity in patients with presumed GCA. Our results suggest that this marker may expedite patient triaging to alternate treatment to the usual steroid therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

An infectious recombinant equine arteritis virus expressing green fluorescent protein from its replicase gene.

PubMed

van den Born, Erwin; Posthuma, Clara C; Knoops, Kèvin; Snijder, Eric J

2007-04-01

Thus far, systems developed for heterologous gene expression from the genomes of nidoviruses (arteriviruses and coronaviruses) have relied mainly on the translation of foreign genes from subgenomic mRNAs, whose synthesis is a key feature of the nidovirus life cycle. In general, such expression vectors often suffered from relatively low and unpredictable expression levels, as well as genome instability. In an attempt to circumvent these disadvantages, the possibility to express a foreign gene [encoding enhanced green fluorescent protein (eGFP)] from within the nidovirus replicase gene, which encodes two large polyproteins that are processed proteolytically into the non-structural proteins (nsps) required for viral RNA synthesis, has now been explored. A viable recombinant of the arterivirus Equine arteritis virus, EAV-GFP2, was obtained, which contained the eGFP insert at the site specifying the junction between the two most N-proximal replicase-cleavage products, nsp1 and nsp2. EAV-GFP2 replication could be launched by transfection of cells with either in vitro-generated RNA transcripts or a DNA launch plasmid. EAV-GFP2 displayed growth characteristics similar to those of the wild-type virus and was found to maintain the insert stably for at least eight passages. It is proposed that EAV-GFP2 has potential for arterivirus vector development and as a tool in inhibitor screening. It can also be used for fundamental studies into EAV replication, which was illustrated by the fact that the eGFP signal of EAV-GFP2, which largely originated from an eGFP-nsp2 fusion protein, could be used to monitor the formation of the membrane-bound EAV replication complex in real time.

Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study

PubMed Central

Crowson, Cynthia S.; Makol, Ashima; Ytterberg, Steven R.; Saitta, Antonino; Salvarani, Carlo; Matteson, Eric L.; Warrington, Kenneth J.

2016-01-01

Objective To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population. Methods A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review. Results The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events. Conclusion In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects. PMID:26901431

Marked Acceleration of Atherosclerosis following Lactobacillus casei induced Coronary Arteritis in a Mouse Model of Kawasaki Disease

PubMed Central

Chen, Shuang; Lee, Young Ho; Crother, Timothy R.; Fishbein, Michael; Zhang, Wenxuan; Yilmaz, Atilla; Shimada, Kenichi; Schulte, Danica J; Lehman, Thomas J.A.; Shah, Prediman K.; Arditi, Moshe

2012-01-01

Objective To investigate if Lactobacillus casei cell wall extract (LCWE)-induced Kawasaki Disease (KD) accelerates atherosclerosis in hypercholesterolemic mice. Method and Resuslts Apoe−/− or Ldlr−/− mice were injected with LCWE (KD mice) or PBS, fed high fat diet for 8 weeks, and atherosclerotic lesions in aortic sinuses (AS), arch (AC) and whole aorta were assessed. KD mice had larger, more complex aortic lesions with abundant collagen, and both extracellular and intracellular lipid and foam cells, compared to lesions in control mice despite similar cholesterol levels. Both Apoe−/− KD and Ldlr−/− KD mice showed dramatic acceleration in atherosclerosis vs. controls, with increases in en face aortic atherosclerosis and plaque size in both the AS and AC plaques. Accelerated atherosclerosis was associated with increased circulating IL-12p40, IFN-γ, TNF-α, and increased macrophage, DC, and T cell recruitment in lesions. Furthermore, daily injections of the IL-1Ra, which inhibits LCWE induced KD vasculitis, prevented the acceleration of atherosclerosis. Conclusions Our results suggest an important pathophysiologic link between coronary arteritis/vasculitis in the KD mouse model and subsequent atherosclerotic acceleration, supporting the concept that a similar relation may also be present in KD patients. These results also suggest that KD in childhood may predispose to accelerated and early atherosclerosis as adults. PMID:22628430

Fast track pathway reduces sight loss in giant cell arteritis: results of a longitudinal observational cohort study.

PubMed

Patil, P; Williams, M; Maw, W W; Achilleos, K; Elsideeg, S; Dejaco, C; Borg, F; Gupta, S; Dasgupta, B

2015-01-01

To investigate the effectiveness of a fast track pathway (FTP) on sight loss in patients with suspected giant cell arteritis (GCA). A longitudinal observational cohort study was conducted in the secondary care rheumatology department. One hundred and thirty-five newly referred suspected GCA patients seen via the FTP (Jan. 2012-Dec. 2013) were compared to 81 patients seen through the conventional referral and review system (Jan. 2009-Dec. 2011). The FTP resulted in significant reduction in irreversible sight loss from 37.0% (as seen in the historical cohort 2009-2011) to 9.0 % (2012-2013, OR 0.17, p=0.001). Adjustment for clinical and demographic parameters including known risk factors for GCA associated blindness did not significantly change the primary result (OR 0.08, p=0.001). FTP resulted in a reduction of time from symptom onset to diagnosis, particularly by reduction of time from general practitioner's (GP) referral to the rheumatology review (79% of FTP patients were seen within one working day compared to 64.6 % in the conventional pathway, p=0.023). The FTP has seen a reduction in number of GP appointments. There was a significant reduction of permanent sight loss with a fast track GCA pathway. The effect may be due to multiple factors including better GP education and reduction in delayed diagnosis. These results need verification at other sites.

Aortitis in giant cell arteritis: diagnosis with FDG PET/CT and agreement with CT angiography.

PubMed

Hommada, Mona; Mekinian, Arsène; Brillet, Pierre-Yves; Abad, Sébastien; Larroche, Claire; Dhôte, Robin; Fain, Olivier; Soussan, Michael

2017-11-01

To assess the detection rate of aortitis in giant cell arteritis (GCA) with fluorodeoxyglucose positron emission tomography/computed tomography (PET) and to compare the findings with CT angiography (CTA). Fifty-two GCA patients and 27 controls were included. GCA patients had a PET scan at diagnosis (35/52) or during relapse (17/52). Concomitant CTA was performed in 35/52 patients. Aortitis was defined as FDG uptake higher than the liver for PET and wall thickness≥3mm for CTA. Agreement between PET and CTA was evaluated by the kappa coefficient and Spearman correlation coefficient. Aortitis was diagnosed using PET in 40% (14/35) of patients at diagnosis and in 0% of controls (0/27). Agreement was perfect between PET and CT at a patient-based level, and very good at a vascular segment-based level (kappa: 0.72 to 1). PET was positive in 35% (6/17) of patients scanned during GCA relapse, showing aortitis (n=4) and/or articular uptake (n=4). Discrepancies between PET and CT were observed only in relapsing GCA (n=3). Correlation between the maximum standardized uptake value and wall thickness was moderate at diagnosis (r: 0.57 to 0.7) and not statistically significant during relapse. The detection rate of aortitis in GCA patients using PET is 40%, approximately in the range of CTA rates, suggesting that the two techniques have similar sensitivity. PET seems valuable in relapsing GCA, allowing the detection of vascular and articular activities. Copyright © 2017 Elsevier B.V. All rights reserved.

What is Vasculitis?

MedlinePlus

... sudden deafness. Giant Cell Arteritis Giant cell arteritis (ar-ter-I-tis) usually affects the temporal artery, ... heart problems. Polyarteritis Nodosa Polyarteritis nodosa (POL-e-ar-ter-I-tis no-DO-suh) can affect ...

Flares in Biopsy-Proven Giant Cell Arteritis in Northern Italy

PubMed Central

Restuccia, Giovanna; Boiardi, Luigi; Cavazza, Alberto; Catanoso, Mariagrazia; Macchioni, Pierluigi; Muratore, Francesco; Cimino, Luca; Aldigeri, Raffaella; Crescentini, Filippo; Pipitone, Nicolò; Salvarani, Carlo

2016-01-01

Abstract This study evaluated the frequency, timing, and characteristics of flares in a large cohort of Italian patients with biopsy-proven giant cell arteritis (GCA) and to identify factors at diagnosis able to predict the occurrence of flares. We evaluated 157 patients with biopsy-proven transmural GCA diagnosed and followed at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 4 years of follow-up. Fifty-seven patients (36.5%) experienced ≥1 flares. Fifty-one (46.4%) of the 110 total flares (88 relapses and 22 recurrences) were experienced during the first 2 years after diagnosis. The majority of relapses occurred with doses of prednisone ≤ 10 mg/day (82.9%), whereas only 3.4% of relapses occurred for doses ≥ 25 mg/day. Polymyalgia rheumatica (46.5%) and cranial symptoms (41.9%) were the most frequent manifestations at the time of the first relapse. Cumulative prednisone dose during the first year and total cumulative prednisone dose were significantly higher in flaring patients compared with those without flares (7.8 ± 2.4 vs 6.7 ± 2.4 g, P = 0.02; 15.5 ± 8.9 vs 10.0 ± 9.2 g, P = 0.0001, respectively). The total duration of prednisone treatment was longer in flaring patients (58 ± 44 vs 30 ± 30 months, P = 0.0001). Patients with disease flares had at diagnosis more frequently systemic manifestations (P = 0.02) and fever ≥ 38°C (P = 0.02), significantly lower hemoglobin levels (P = 0.05), more frequent presence at temporal artery biopsy (TAB) specimens of giant cells (P = 0.04) and intraluminal acute thrombosis (P = 0.007), and more moderate/severe arterial inflammation (P = 0.009) compared with those without flares. In the multivariate model fever ≥ 38 °C (hazard ratio 2.14; 95% confidence interval, 1.06–4.32, P = 0.03) and the severity of inflammatory infiltrate

Control of HIV-1 by an HLA-B*52:01-C*12:02 Protective Haplotype.

PubMed

Chikata, Takayuki; Murakoshi, Hayato; Koyanagi, Madoka; Honda, Kazutaka; Gatanaga, Hiroyuki; Oka, Shinichi; Takiguchi, Masafumi

2017-12-12

HLA-B*52:01-C*12:02, which is found in approximately 20% of all Japanese persons, is well known to be associated with ulcerative colitis and Takayasu arteritis. This haplotype is also known to be protective in individuals infected with human immunodeficiency virus (HIV) type 1. Recent studies showed that HLA-B*52:01-restricted HIV-1-specific T cells suppress HIV-1 and that HLA-C*12:02 together with KIR2DL2 play an important role in natural killer cell-mediated control of HIV-1. However, the role of HLA-C*12:02-restricted cytotoxic T lymphocytes (CTLs) in suppressing HIV-1 replication remains unknown. In the present study, we demonstrated that HLA-C*12:02-restricted CTLs specific for 2 immunodominant epitopes, Pol IY11 and Nef MY9, contributed to the suppression of HIV-1 replication in HIV-1-infected individuals. Further analysis demonstrated that these 2 HLA-C*12:02-restricted CTLs together with 4 HLA-B*52:01-restricted ones effectively suppressed HIV-1 in individuals with the HLA-B*52:01-C*12:02 haplotype. Thus, both HLA-C*12:02 and HLA-B*52:01 alleles contribute to HIV-1 suppression via both HIV-1-specific CTLs and natural killer cells in individuals with this haplotype. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Development of outcome measures for large-vessel vasculitis for use in clinical trials: opportunities, challenges, and research agenda.

PubMed

Direskeneli, Haner; Aydin, Sibel Z; Kermani, Tanaz A; Matteson, Eric L; Boers, Maarten; Herlyn, Karen; Luqmani, Raashid A; Neogi, Tuhina; Seo, Philip; Suppiah, Ravi; Tomasson, Gunnar; Merkel, Peter A

2011-07-01

Giant cell (GCA) and Takayasu's arteritis (TAK) are 2 forms of large-vessel vasculitis (LVV) that involve the aorta and its major branches. GCA has a predilection for the cranial branches, while TAK tends to affect the extracranial branches. Both disorders may also cause nonspecific constitutional symptoms. Although some clinical features are more common in one or the other disorder and the ages of initial presentation differ substantially, there is enough clinical and histopathologic overlap between these disorders that some investigators suggest GCA and TAK may be 2 processes within the spectrum of a single disease. There have been few randomized therapeutic trials completed in GCA, and none in TAK. The lack of therapeutic trials in LVV is only partially explained by the rarity of these diseases. It is likely that the lack of well validated outcome measures for LVV and uncertainties regarding trial design contribute to the paucity of trials for these diseases. An initiative to develop a core set of outcome measures for use in clinical trials of LVV was launched by the international OMERACT Vasculitis Working Group in 2009 and subsequently endorsed by the OMERACT community at the OMERACT 10 meeting. Aims of this initiative include: (1) to review the literature and existing data related to outcome assessments in LVV; (2) to obtain the opinion of experts and patients on disease content; and (3) to formulate a research agenda to facilitate a more data-based approach to outcomes development.

Identification of streptococcal proteins reacting with sera from Behçet's disease and rheumatic disorders.

PubMed

Cho, Sung Bin; Lee, Ju Hee; Ahn, Keun Jae; Cho, Suhyun; Park, Yong-Beom; Lee, Soo-Kon; Bang, Dongsik; Lee, Kwang Hoon

2010-01-01

We evaluated the reactivity of sera from Behçet's disease (BD), systemic lupus erythematosus (SLE), dermatomyositis (DM), rheumatoid arthritis (RA), and Takayasu's arteritis (TA) patients against human α-enolase and streptococcal α-enolase, and identified additional streptococcal antigens. Enzyme-linked immunosorbent assay (ELISA) and immunoblotting were performed using sera from patients with BD, SLE, DM, RA, and TA and healthy volunteers (control) against human α-enolase and streptococcal α-enolase. Immunoblot analysis and matrix-assisted laser desorption ionisation-time-of-flight mass spectrometry were used to identify and recombine other streptococcal antigens. Specific positive signals against recombinant human α-enolase were detected by IgM ELISA of serum samples from 50% of BD, 14.3% of SLE, 57.1% of DM, 42.9% of RA, and 57.1% of TA patients. Specific positive signals against streptococcal α-enolase were detected from 42.9% of BD, 14.3% of DM, and 14.3% of TA patients. No SLE and RA sera reacted against streptococcal α-enolase antigen. Streptococcal proteins reacting with sera were identified as hypothetical protein (HP) for SLE and DM patients, acid phosphatase (AP) for RA patients, and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) for TA patients. We observed that RA patients did not present serum reactivity against either HP or GAPDH though BD, SLE, DM, and TA patients did. Also, AP reacted with sera from BD, SLE, DM, RA, and TA patients.

Renal autotransplantation--a possibility in the treatment of complex renal vascular diseases and ureteric injuries.

PubMed

Hau, Hans Michael; Bartels, Michael; Tautenhahn, Hans-Michael; Morgul, Mehmet Haluk; Fellmer, Peter; Ho-Thi, Phuc; Benckert, Christoph; Uhlmann, Dirk; Moche, Michael; Thelen, Armin; Schmelzle, Moritz; Jonas, Sven

2012-12-31

We report our contemporary experiences with renal autotransplantation in patients with complicated renal vascular diseases and/or complex ureteral injuries. Since its first performance, renal autotransplantation has been steadily improved and become a safe and effective procedure. Between 1998 and 2006, 6 renal autotransplantations in 6 patients were performed at the University Medical Center of Leipzig. After nephrectomy and renal perfusion ex vivo, the kidney was implanted standardized in the fossa iliaca. The vessels were anastomized to the iliac vessels, the ureter was reimplanted in an extravesical tunneled ureteroneocystostomy technique according to Lich-Gregoir. Demographic, clinical, and laboratory data of the patients were collected and analyzed for pre-, intra-, and postoperative period. Indications for renal autotransplantation were complex renovascular diseases in 2 patients (1 with fibromuscular dysplasia and 1 with Takayasu's arteritis) and in 4 patients with complex ureteral injuries. The median duration of follow-up was 9.7 years (range: 5.6-13.3). The laboratory values of our 6 patients showed improvements of creatinine, urea and blood pressure levels in comparison to the preoperative status at the end of follow-up period. The present study reports excellent results of renal autotransplantation in patients with renovascular disease or complex ureteric injuries. After a median follow-up of 9.7 years all 6 patients present with stable renal function as well as normal blood pressure values. Postoperative complications were observed with a rate comparable to other studies.

Allelic Variation in CXCL16 Determines CD3+ T Lymphocyte Susceptibility to Equine Arteritis Virus Infection and Establishment of Long-Term Carrier State in the Stallion.

PubMed

Sarkar, Sanjay; Bailey, Ernest; Go, Yun Young; Cook, R Frank; Kalbfleisch, Ted; Eberth, John; Chelvarajan, R Lakshman; Shuck, Kathleen M; Artiushin, Sergey; Timoney, Peter J; Balasuriya, Udeni B R

2016-12-01

Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of horses and other equid species. Following natural infection, 10-70% of the infected stallions can become persistently infected and continue to shed EAV in their semen for periods ranging from several months to life. Recently, we reported that some stallions possess a subpopulation(s) of CD3+ T lymphocytes that are susceptible to in vitro EAV infection and that this phenotypic trait is associated with long-term carrier status following exposure to the virus. In contrast, stallions not possessing the CD3+ T lymphocyte susceptible phenotype are at less risk of becoming long-term virus carriers. A genome wide association study (GWAS) using the Illumina Equine SNP50 chip revealed that the ability of EAV to infect CD3+ T lymphocytes and establish long-term carrier status in stallions correlated with a region within equine chromosome 11. Here we identified the gene and mutations responsible for these phenotypes. Specifically, the work implicated three allelic variants of the equine orthologue of CXCL16 (EqCXCL16) that differ by four non-synonymous nucleotide substitutions (XM_00154756; c.715 A → T, c.801 G → C, c.804 T → A/G, c.810 G → A) within exon 1. This resulted in four amino acid changes with EqCXCL16S (XP_001504806.1) having Phe, His, Ile and Lys as compared to EqCXL16R having Tyr, Asp, Phe, and Glu at 40, 49, 50, and 52, respectively. Two alleles (EqCXCL16Sa, EqCXCL16Sb) encoded identical protein products that correlated strongly with long-term EAV persistence in stallions (P<0.000001) and are required for in vitro CD3+ T lymphocyte susceptibility to EAV infection. The third (EqCXCL16R) was associated with in vitro CD3+ T lymphocyte resistance to EAV infection and a significantly lower probability for establishment of the long-term carrier state (viral persistence) in the male reproductive tract. EqCXCL16Sa and EqCXCL16

Allelic Variation in CXCL16 Determines CD3+ T Lymphocyte Susceptibility to Equine Arteritis Virus Infection and Establishment of Long-Term Carrier State in the Stallion

PubMed Central

Cook, R. Frank; Eberth, John; Chelvarajan, R. Lakshman; Artiushin, Sergey; Timoney, Peter J.

2016-01-01

Equine arteritis virus (EAV) is the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of horses and other equid species. Following natural infection, 10–70% of the infected stallions can become persistently infected and continue to shed EAV in their semen for periods ranging from several months to life. Recently, we reported that some stallions possess a subpopulation(s) of CD3+ T lymphocytes that are susceptible to in vitro EAV infection and that this phenotypic trait is associated with long-term carrier status following exposure to the virus. In contrast, stallions not possessing the CD3+ T lymphocyte susceptible phenotype are at less risk of becoming long-term virus carriers. A genome wide association study (GWAS) using the Illumina Equine SNP50 chip revealed that the ability of EAV to infect CD3+ T lymphocytes and establish long-term carrier status in stallions correlated with a region within equine chromosome 11. Here we identified the gene and mutations responsible for these phenotypes. Specifically, the work implicated three allelic variants of the equine orthologue of CXCL16 (EqCXCL16) that differ by four non-synonymous nucleotide substitutions (XM_00154756; c.715 A → T, c.801 G → C, c.804 T → A/G, c.810 G → A) within exon 1. This resulted in four amino acid changes with EqCXCL16S (XP_001504806.1) having Phe, His, Ile and Lys as compared to EqCXL16R having Tyr, Asp, Phe, and Glu at 40, 49, 50, and 52, respectively. Two alleles (EqCXCL16Sa, EqCXCL16Sb) encoded identical protein products that correlated strongly with long-term EAV persistence in stallions (P<0.000001) and are required for in vitro CD3+ T lymphocyte susceptibility to EAV infection. The third (EqCXCL16R) was associated with in vitro CD3+ T lymphocyte resistance to EAV infection and a significantly lower probability for establishment of the long-term carrier state (viral persistence) in the male reproductive tract. EqCXCL16Sa and Eq

Effect of the South African asinine-94 strain of equine arteritis virus (EAV) in pregnant donkey mares and duration of maternal immunity in foals.

PubMed

Paweska, J T

1997-06-01

Clinical, virological and serological responses were investigated in five pregnant donkey mares after experimental exposure to the South African asinine-94 strain of equine arteritis virus (EAV), and the duration of maternal immunity to EAV was studied in their foals. In four intranasally inoculated mares, fever with maximum rectal temperatures of 39.1-40.7 degrees C was recorded 2-11 d after challenge. All the inoculated mares developed mild depression, and a serous ocular and nasal discharge; in three mares mild conjuctivitis was observed. The virus was recovered from the nasopharynx and from buffy-coat samples of all the mares 3-10 d, and 2-18 d post inoculation (p.i.), respectively. Seroconversion to EAV was detected on days 8-10 p.i. Peak serum-virus-neutralizing antibody titres of log10 1.8-2.4, and IgG ELISA OD values of 0.85-2.15 were recorded 2-3 weeks p.i. The in-contact (p.c.) control mare developed fever on days 15-19 post exposure, and showed mild clinical signs of equine viral arteritis similar to those observed in the inoculated mares. Seroconversion to EAV was detected in the p.c. mare on day 20 post exposure, and virus was isolated from nasal swabs and blood samples collected at the time of the febrile response and 1-3 d afterwards. None of the mares aborted. After they had given normal birth 45-128 d p.i. or after p.c. exposure, no virus could be isolated from their placentas. The concentration of EAV-neutralizing antibody in colostrum was two to eight times higher than in serum samples collected at the time of parturition. All the foals born to infected mares were clinically normal at the time of birth and throughout the subsequent 1-2 months of observation. No EAV was recovered from the buffy-coat fraction of blood samples collected at birth nor from those collected on days 1, 2 and 7 after birth. Also, no virus-serum-neutralizing or IgG ELISA antibody to EAV was detected in sera collected immediately after birth before the foals started nursing

A Genome-wide Association Study Identifies Risk Alleles in Plasminogen and P4HA2 Associated with Giant Cell Arteritis.

PubMed

Carmona, F David; Vaglio, Augusto; Mackie, Sarah L; Hernández-Rodríguez, José; Monach, Paul A; Castañeda, Santos; Solans, Roser; Morado, Inmaculada C; Narváez, Javier; Ramentol-Sintas, Marc; Pease, Colin T; Dasgupta, Bhaskar; Watts, Richard; Khalidi, Nader; Langford, Carol A; Ytterberg, Steven; Boiardi, Luigi; Beretta, Lorenzo; Govoni, Marcello; Emmi, Giacomo; Bonatti, Francesco; Cimmino, Marco A; Witte, Torsten; Neumann, Thomas; Holle, Julia; Schönau, Verena; Sailler, Laurent; Papo, Thomas; Haroche, Julien; Mahr, Alfred; Mouthon, Luc; Molberg, Øyvind; Diamantopoulos, Andreas P; Voskuyl, Alexandre; Brouwer, Elisabeth; Daikeler, Thomas; Berger, Christoph T; Molloy, Eamonn S; O'Neill, Lorraine; Blockmans, Daniel; Lie, Benedicte A; Mclaren, Paul; Vyse, Timothy J; Wijmenga, Cisca; Allanore, Yannick; Koeleman, Bobby P C; Barrett, Jennifer H; Cid, María C; Salvarani, Carlo; Merkel, Peter A; Morgan, Ann W; González-Gay, Miguel A; Martín, Javier

2017-01-05

Giant cell arteritis (GCA) is the most common form of vasculitis in individuals older than 50 years in Western countries. To shed light onto the genetic background influencing susceptibility for GCA, we performed a genome-wide association screening in a well-powered study cohort. After imputation, 1,844,133 genetic variants were analyzed in 2,134 case subjects and 9,125 unaffected individuals from ten independent populations of European ancestry. Our data confirmed HLA class II as the strongest associated region (independent signals: rs9268905, p = 1.94 × 10 -54 , per-allele OR = 1.79; and rs9275592, p = 1.14 × 10 -40 , OR = 2.08). Additionally, PLG and P4HA2 were identified as GCA risk genes at the genome-wide level of significance (rs4252134, p = 1.23 × 10 -10 , OR = 1.28; and rs128738, p = 4.60 × 10 -9 , OR = 1.32, respectively). Interestingly, we observed that the association peaks overlapped with different regulatory elements related to cell types and tissues involved in the pathophysiology of GCA. PLG and P4HA2 are involved in vascular remodelling and angiogenesis, suggesting a high relevance of these processes for the pathogenic mechanisms underlying this type of vasculitis. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Geographical and genetic factors do not account for significant differences in the clinical spectrum of giant cell arteritis in southern europe.

PubMed

Gonzalez-Gay, Miguel A; Boiardi, Luigi; Garcia-Porrua, Carlos; Macchioni, Pierluigi; Amor-Dorado, Juan C; Salvarani, Carlo

2004-03-01

To investigate whether genetic and geographical differences may influence the clinical spectrum of giant cell arteritis (GCA), we compared the demographic and clinical features of patients with biopsy-proven GCA from Reggio Emilia (Northern Italy) and Lugo (Northwest Spain) during a 15-year period. We performed a retrospective review of the case records of all patients diagnosed with biopsy-proven GCA at Hospital Xeral-Calde (Lugo, Spain) and Hospital Santa Maria Nuova (Reggio Emilia, Italy) between 1 January 1986 and 31 December 2001. Both hospitals are the only referral centers for populations living in central Galicia and central Emilia Romagna, respectively. During the period of study, 194 Lugo residents and 126 Reggio Emilia residents were diagnosed with biopsy proven GCA. Reggio Emilia patients were more likely to be female (74% vs 54%; p = 0.0001). Although Lugo patients complained of headache (86%) more commonly than did those from Reggio Emilia (77%), the difference was only marginally significant (p = 0.05). The proportion of patients with visual manifestations or visual loss was remarkably similar (22% for visual manifestations and 17% for visual loss in Lugo and 29% and 21% for Reggio Emilia residents). The mean erythrocyte sedimentation rate prior to the onset of therapy was also similar. Apart from differences in sex, the clinical spectrum of GCA in these 2 Southern European regions was similar.

Development and Characterization of an Infectious cDNA Clone of the Modified Live Virus Vaccine Strain of Equine Arteritis Virus

PubMed Central

Zhang, Jianqiang; Go, Yun Young; Huang, Chengjin M.; Meade, Barry J.; Lu, Zhengchun; Snijder, Eric J.; Timoney, Peter J.

2012-01-01

A stable full-length cDNA clone of the modified live virus (MLV) vaccine strain of equine arteritis virus (EAV) was developed. RNA transcripts generated from this plasmid (pEAVrMLV) were infectious upon transfection into mammalian cells, and the resultant recombinant virus (rMLV) had 100% nucleotide identity to the parental MLV vaccine strain of EAV. A single silent nucleotide substitution was introduced into the nucleocapsid gene (pEAVrMLVB), enabling the cloned vaccine virus (rMLVB) to be distinguished from parental MLV vaccine as well as other field and laboratory strains of EAV by using an allelic discrimination real-time reverse transcription (RT)-PCR assay. In vitro studies revealed that the cloned vaccine virus rMLVB and the parental MLV vaccine virus had identical growth kinetics and plaque morphologies in equine endothelial cells. In vivo studies confirmed that the cloned vaccine virus was very safe and induced high titers of neutralizing antibodies against EAV in experimentally immunized horses. When challenged with the heterologous EAV KY84 strain, the rMLVB vaccine virus protected immunized horses in regard to reducing the magnitude and duration of viremia and virus shedding but did not suppress the development of signs of EVA, although these were reduced in clinical severity. The vaccine clone pEAVrMLVB could be further manipulated to improve the vaccine efficacy as well as to develop a marker vaccine for serological differentiation of EAV naturally infected from vaccinated animals. PMID:22739697

Downregulation of MicroRNA eca-mir-128 in Seminal Exosomes and Enhanced Expression of CXCL16 in the Stallion Reproductive Tract Are Associated with Long-Term Persistence of Equine Arteritis Virus.

PubMed

Carossino, Mariano; Dini, Pouya; Kalbfleisch, Theodore S; Loynachan, Alan T; Canisso, Igor F; Shuck, Kathleen M; Timoney, Peter J; Cook, R Frank; Balasuriya, Udeni B R

2018-05-01

Equine arteritis virus (EAV) can establish long-term persistent infection in the reproductive tract of stallions and is shed in the semen. Previous studies showed that long-term persistence is associated with a specific allele of the CXCL16 gene ( CXCL16S ) and that persistent infection is maintained despite the presence of a local inflammatory and humoral and mucosal antibody responses. In this study, we demonstrated that equine seminal exosomes (SEs) are enriched in a small subset of microRNAs (miRNAs). Most importantly, we demonstrated that long-term EAV persistence is associated with the downregulation of an SE-associated miRNA (eca-mir-128) and with an enhanced expression of CXCL16 in the reproductive tract, a putative target of eca-mir-128. The findings presented here suggest that SE eca-mir-128 is implicated in the regulation of the CXCL16/CXCR6 axis in the reproductive tract of persistently infected stallions, a chemokine axis strongly implicated in EAV persistence. This is a novel finding and warrants further investigation to identify its specific mechanism in modulating the CXCL16/CXCR6 axis in the reproductive tract of the EAV long-term carrier stallion. IMPORTANCE Equine arteritis virus (EAV) has the ability to establish long-term persistent infection in the stallion reproductive tract and to be shed in semen, which jeopardizes its worldwide control. Currently, the molecular mechanisms of viral persistence are being unraveled, and these are essential for the development of effective therapeutics to eliminate persistent infection. Recently, it has been determined that long-term persistence is associated with a specific allele of the CXCL16 gene ( CXCL16S ) and is maintained despite induction of local inflammatory, humoral, and mucosal antibody responses. This study demonstrated that long-term persistence is associated with the downregulation of seminal exosome miRNA eca-mir-128 and enhanced expression of its putative target, CXCL16, in the reproductive

Which Patients with Giant Cell Arteritis Will Develop Cardiovascular or Cerebrovascular Disease? A Clinical Practice Research Datalink Study.

PubMed

Robson, Joanna C; Kiran, Amit; Maskell, Joe; Hutchings, Andrew; Arden, Nigel; Dasgupta, Bhaskar; Hamilton, William; Emin, Akan; Culliford, David; Luqmani, Raashid

2016-06-01

To evaluate the risk of cerebrovascular disease and cardiovascular disease (CVD) in patients with giant cell arteritis (GCA), and to identify predictors. The UK Clinical Practice Research Datalink 1991-2010 was used for a parallel cohort study of 5827 patients with GCA and 37,090 age-, sex-, and location-matched controls. A multivariable competing risk model (non-cerebrovascular/CV-related death as the competing risk) determined the relative risk [subhazard ratio (SHR)] between patients with GCA compared with background controls for cerebrovascular disease, CVD, or either. Each cohort (GCA and controls) was then analyzed individually using the same multivariable model, with age and sex now present, to identify predictors of CVD or cerebrovascular disease. Patients with GCA, compared with controls, had an increased risk SHR (95% CI) of cerebrovascular disease (1.45, 1.31-1.60), CVD (1.49, 1.37-1.62), or either (1.47, 1.37-1.57). In the GCA cohort, predictors of "cerebrovascular disease or CVD" included increasing age, > 80 years versus < 65 years (1.98, 1.62-2.42), male sex (1.20, 1.05-1.38), and socioeconomic status, most deprived quintile versus least deprived (1.34, 1.01-1.78). These predictors were also present within the non-GCA cohort. Patients with GCA are more likely to develop cerebrovascular disease or CVD than age-, sex-, and location-matched controls. In common with the non-GCA cohort, patients who are older, male, and from the most deprived compared with least deprived areas have a higher risk of cerebrovascular disease or CVD. Further work is needed to understand how this risk may be mediated by specific behavioral, social, and economic factors.

Management of Large-Vessel Vasculitis With FDG-PET

PubMed Central

Soussan, Michael; Nicolas, Patrick; Schramm, Catherine; Katsahian, Sandrine; Pop, Gabriel; Fain, Olivier; Mekinian, Arsene

2015-01-01

Abstract We aimed to clarify the role of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the management of large-vessel vasculitis (LVV), focusing on 3 issues which are as follows: describe and determine the different FDG-PET criteria for the diagnosis of vascular inflammation, the performance of FDG-PET for the diagnosis of large-vessel inflammation in giant cell arteritis (GCA) patients, and the performance of FDG-PET to evaluate the disease inflammatory activity in Takayasu arteritis (TA) patients. MEDLINE, Cochrane Library, and EMBASE database were searched for articles that evaluated the value of FDG-PET in LVV, from January 2000 to December 2013. Inclusion criteria were American College of Rheumatology criteria for GCA or TA, definition PET positivity threshold, and >4 cases included. Sensitivity (Se) and specificity (Sp) of FDG-PET for the diagnosis of large-vessel inflammation were calculated from each included individual study, and then pooled for meta-analysis with a random-effects model. Twenty-one studies (413 patients, 299 controls) were included in the systematic review. FDG-PET showed FDG vascular uptake in 70% (288/413) of patients and 7% (22/299) of controls. Only vascular uptake equal to or higher than the liver uptake was significantly different between GCA/TA patients and controls (P < 0.001). The meta-analysis of GCA patients (4 studies, 57 patients) shows that FDG-PET has high Se and Sp for the diagnosis of large-vessel inflammation in GCA patients in comparison to controls, with a pooled Se at 90% (95% confidence interval [CI], 79%–93%) and a pooled Sp at 98% (95% CI, 94%–99%). The meta-analysis of TA patients (7 studies, 191 patients) shows that FDG-PET has a pooled Se at 87% (95% CI, 78%–93%) and Sp at 73% (95% CI, 63%–81%) for the assessment of disease activity in TA, with up to 84% Sp, with studies using National Institutes of Health criteria as the disease activity assessment scale. FDG-PET showed good

Fever of unknown origin as initial manifestation of large vessel giant cell arteritis: diagnosis by colour-coded sonography and 18-FDG-PET.

PubMed

Czihal, M; Tatò, F; Förster, S; Rademacher, A; Schulze-Koops, H; Hoffmann, U

2010-01-01

To evaluate the clinical characteristics and imaging results (CDS, 18-FDG-PET) of patients with large vessel giant cell arteritis (LV-GCA) presenting as fever of unknown origin (FUO). From a series of 82 patients with GCA we identified 8 patients with FUO as initial disease manifestation. Clinical characteristics and results of CDS and 18-FDG-PET were analysed. Patients with FUO and those with other clinical manifestations of GCA were compared. 18-FDG-PET-scans were available for 6/8 patients, revealing enhanced tracer uptake of the thoracic aorta and the aortic branches in all patients. CDS was performed in 8/8 patients, with detection of hypoechogenic wall thickening related to LV-GCA in 7/8 patients. Subjects with FUO were significantly younger (60.9 vs. 69.3 years, p<0.01) and had a stronger humoral inflammatory response (CRP 12.6 vs. 7.1 mg/dl, p<0.01; ESR 110 vs. 71 mm/hour, p<0.01), when compared to the other GCA-patients. LV-GCA should be considered as important differential diagnosis in patients with FUO. In addition to 18-FDG-PET, which is known to be a valuable method in the diagnostic work-up of FUO, we recommend CDS of the supraaortal and femoropopliteal arteries for the initial diagnostic work-up.

Comparison of idiopathic (isolated) aortitis and giant cell arteritis-related aortitis. A French retrospective multicenter study of 117 patients.

PubMed

Espitia, Olivier; Samson, Maxime; Le Gallou, Thomas; Connault, Jérôme; Landron, Cedric; Lavigne, Christian; Belizna, Cristina; Magnant, Julie; de Moreuil, Claire; Roblot, Pascal; Maillot, François; Diot, Elisabeth; Jégo, Patrick; Durant, Cécile; Masseau, A; Brisseau, Jean-Marie; Pottier, Pierre; Espitia-Thibault, Alexandra; Santos, Anabele Dos; Perrin, François; Artifoni, Mathieu; Néel, Antoine; Graveleau, Julie; Moreau, Philippe; Maisonneuve, Hervé; Fau, Georges; Serfaty, Jean-Michel; Hamidou, Mohamed; Agard, Christian

2016-06-01

The aim of the study was to compare clinical/imaging findings and outcome in patients with idiopathic (isolated aortitis, IA) and with giant cell arteritis (GCA)-related aortitis. Patients from 11 French internal medicine departments were retrospectively included. Aortitis was defined by aortic wall thickening >2mm and/or an aortic aneurysm on CT-scan, associated to inflammatory syndrome. Patients with GCA had at least 3 ACR criteria. Aortic events (aneurysm, dissection, aortic surgeries) were reported, and free of aortic events-survival were compared. Among 191 patients with non-infectious aortitis, 73 with GCA and 44 with IA were included. Patients with IA were younger (65 vs 70 years, p=0.003) and comprised more past/current smokers (43 vs 15%, p=0.0007). Aortic aneurisms were more frequent (38% vs 20%, p=0.03), and aortic wall thickening was more pronounced in IA. During follow-up (median=34 months), subsequent development of aortic aneurysm was significantly lower in GCA when compared to IA (p=0.009). GCA patients required significantly less aortic surgery during follow-up than IA patients (p=0.02). Mean age, sex ratio, inflammatory parameters, and free of aortic aneurism survival were equivalent in patients with IA ≥ 60 years when compared to patients with GCA-related aortitis. IA is more severe than aortitis related to GCA, with higher proportions of aortic aneurism at diagnosis and during follow-up. IA is a heterogeneous disease and its prognosis is worse in younger patients <60 years. Most patients with IA ≥ 60 years share many features with GCA-related aortitis. Copyright © 2016 Elsevier B.V. All rights reserved.

Vasculitis

MedlinePlus

... rash, joint pain, weakness, and numbness or tingling. Giant cell arteritis. This condition is an inflammation of ... arteries in your head, especially at the temples. Giant cell arteritis can cause headaches, scalp tenderness, jaw ...

Central nervous system involvement in pediatric rheumatic diseases: current concepts in treatment.

PubMed

Duzova, Ali; Bakkaloglu, Aysin

2008-01-01

Central nervous system (CNS) manifestations are not rare in pediatric rheumatic diseases. They may be a relatively common feature of the disease, as in systemic lupus erythematosus (SLE) and Behçet's disease. Direct CNS involvement of a systemic rheumatic disease, primary CNS vasculitis, indirect involvement secondary to hypertension, hypoxia and metabolic changes, and drug associated adverse events may all result in CNS involvement. We have reviewed the CNS manifestations of SLE, Behçet's disease, Henoch-Schönlein purpura, polyarteritis nodosa, juvenile idiopathic arthritis, juvenile ankylosing spondylitis, familial Mediterranean fever, scleroderma, sarcoidosis, Wegener's granulomatosis, Takayasu's arteritis, CINCA syndrome, Kawasaki disease, and primary CNS vasculitis; and adverse CNS effects of anti-rheumatic drugs in pediatric patients. The manifestations are diverse; ranging from headache, seizures, chorea, changes in personality, depression, memory and concentration problems, cognitive impairment, cerebrovascular accidents to coma, and death. The value of cerebrospinal fluid (CSF) examination (pleocytosis, high level of protein), auto-antibodies in serum and CSF, electroencephalography, neuroimaging with computerized tomography, magnetic resonance imaging, SPECT, PET, and angiography depends on the disease. Brain biopsy is gold standard for the diagnosis of CNS vasculitis, however it may be inconclusive in 25% of cases. A thorough knowledge of the rheumatic diseases and therapy-related adverse events is mandatory for the management of a patient with rheumatic disease and CNS involvement. Severe CNS involvement is associated with poor prognosis, and high mortality rate. High dose steroid and cyclophosphamide (oral or intravenous) are first choice drugs in the treatment; plasmapheresis, IVIG, thalidomide, and intratechal treatment may be valuable in treatment-resistant, and serious cases.

[Prokaryotic expression of the major antigenic domain of equine arteritis virus GL protein and the establishment of putative indirect ELISA assay].

PubMed

Liang, Cheng-Zhu; Cao, Rui-Bing; Wei, Jian-Chao; Zhu, Lai-Hua; Chen, Pu-Yan

2006-06-01

According to the antigenic analysis of equine arteritis virus (EAV) GL protein, one pair of primers were designed, with which the gene fragment coding the high antigenic domain of EAV GL protein was amplified from the EAV genome. The cloned gene was digested with BamH I and Xho I and then inserted into pET-32a and resulted pET-GL1. The pET-GL1 was transformed into the host cell BL21(DE3) and the expression was optimized including cultivation temperature and concentration of IPTG. The aim protein was highly expressed and the obtained recombinant protein manifested well reactiongenicity as was confirmed by Western blot. The recombinant GL1 protein was purified by the means of His * Bind resin protein purification procedure. Then an indirect ELISA was established to detect antibody against EAV with the purified GL1 protein as the coating antigen. The result showed that the optimal concentration of coated antigen was 9.65 microg/mL and the optimal dilution of serum was 1:80. The positive criterion of this ELISA assay is OD (the tested serum) > 0.4 and OD (the tested serum) /OD (the negative serum) > 2.0. The iGL-ELISA was evaluated versus micro-virus neutralization test. The ELISA was performed on 900 sera from which were preserved by this lab during horse entry/exit inspection, the agreement (94.1%) of these test were considered suitable for individual serological detection. In another test which 180 sera samples were detected by iGL-ELISA and INGEZIM ELISA kit respectively. The agreement ratio between the two methods is 95.6%.

A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility

PubMed Central

Carmona, F. David; Mackie, Sarah L.; Martín, Jose-Ezequiel; Taylor, John C.; Vaglio, Augusto; Eyre, Stephen; Bossini-Castillo, Lara; Castañeda, Santos; Cid, Maria C.; Hernández-Rodríguez, José; Prieto-González, Sergio; Solans, Roser; Ramentol-Sintas, Marc; González-Escribano, M. Francisca; Ortiz-Fernández, Lourdes; Morado, Inmaculada C.; Narváez, Javier; Miranda-Filloy, José A.; Martínez-Berriochoa, Agustín; Unzurrunzaga, Ainhoa; Hidalgo-Conde, Ana; Madroñero-Vuelta, Ana B.; Fernández-Nebro, Antonio; Ordóñez-Cañizares, M. Carmen; Escalante, Begoña; Marí-Alfonso, Begoña; Sopeña, Bernardo; Magro, César; Raya, Enrique; Grau, Elena; Román, José A.; de Miguel, Eugenio; López-Longo, F. Javier; Martínez, Lina; Gómez-Vaquero, Carmen; Fernández-Gutiérrez, Benjamín; Rodríguez-Rodríguez, Luis; Díaz-López, J. Bernardino; Caminal-Montero, Luis; Martínez-Zapico, Aleida; Monfort, Jordi; Tío, Laura; Sánchez-Martín, Julio; Alegre-Sancho, Juan J.; Sáez-Comet, Luis; Pérez-Conesa, Mercedes; Corbera-Bellalta, Marc; García-Villanueva, M. Jesús; Fernández-Contreras, M. Encarnación; Sanchez-Pernaute, Olga; Blanco, Ricardo; Ortego-Centeno, Norberto; Ríos-Fernández, Raquel; Callejas, José L.; Fanlo-Mateo, Patricia; Martínez-Taboada, Víctor M.; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A.; Gianfreda, Davide; Santilli, Daniele; Ramirez, Giuseppe A.; Soriano, Alessandra; Muratore, Francesco; Pazzola, Giulia; Addimanda, Olga; Wijmenga, Cisca; Witte, Torsten; Schirmer, Jan H.; Moosig, Frank; Schönau, Verena; Franke, Andre; Palm, Øyvind; Molberg, Øyvind; Diamantopoulos, Andreas P.; Carette, Simon; Cuthbertson, David; Forbess, Lindsy J.; Hoffman, Gary S.; Khalidi, Nader A.; Koening, Curry L.; Langford, Carol A.; McAlear, Carol A.; Moreland, Larry; Monach, Paul A.; Pagnoux, Christian; Seo, Philip; Spiera, Robert; Sreih, Antoine G.; Warrington, Kenneth J.; Ytterberg, Steven R.; Gregersen, Peter K.; Pease, Colin T.; Gough, Andrew; Green, Michael; Hordon, Lesley; Jarrett, Stephen; Watts, Richard; Levy, Sarah; Patel, Yusuf; Kamath, Sanjeet; Dasgupta, Bhaskar; Worthington, Jane; Koeleman, Bobby P.C.; de Bakker, Paul I.W.; Barrett, Jennifer H.; Salvarani, Carlo; Merkel, Peter A.; González-Gay, Miguel A.; Morgan, Ann W.; Martín, Javier

2015-01-01

We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10−40, OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1∗04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10−43) and HLA-DQα1 47 (p = 4.02 × 10−46), 56, and 76 (both p = 1.84 × 10−45) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10−6, OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10−6, OR = 1.20), and REL (rs115674477, p = 1.10 × 10−5, OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function. PMID:25817017

Random walker in temporally deforming higher-order potential forces observed in a financial crisis.

PubMed

Watanabe, Kota; Takayasu, Hideki; Takayasu, Misako

2009-11-01

Basic peculiarities of market price fluctuations are known to be well described by a recently developed random-walk model in a temporally deforming quadratic potential force whose center is given by a moving average of past price traces [M. Takayasu, T. Mizuno, and H. Takayasu, Physica A 370, 91 (2006)]. By analyzing high-frequency financial time series of exceptional events, such as bubbles and crashes, we confirm the appearance of higher-order potential force in the markets. We show statistical significance of its existence by applying the information criterion. This time series analysis is expected to be applied widely for detecting a nonstationary symptom in random phenomena.

An immunohistochemical analysis of folate receptor beta expression and distribution in giant cell arteritis - a pilot study

PubMed Central

Albano-Aluquin, Shirley; Malysz, Jozef; Aluquin, Vincent R; Ratnam, Manohar; Olsen, Nancy

2017-01-01

Background: Giant cell arteritis (GCA) is a chronic vasculitis of large and medium vessels in which no targetable biomarkers exist to allow selective treatment, predict disease activity and monitor therapeutic responses. The accessibility of the temporal artery (TA) for biopsy allows morphologic studies to characterize macrophages and T cells in the microenvironment of the arterial wall. We evaluated the expression of folate receptor beta (FRB), a candidate diagnostic/therapeutic biomarker, compared its expression with key macrophage markers and correlated it with GCA severity. Methods: Formalin-fixed paraffin-embedded tissue sections were examined from 6 patients with GCA and 2 controls. Immunohistochemistry was performed using FRB, ETB, CD68 and CD3 antibodies to evaluate for activated macrophages and T cells, assess FRB distribution along the intima, media and adventitial layers and composition of inflammatory infiltrates. We compared the expression of FRB, ETB and CD68 in GCA versus negative controls and in severe (with visual loss) versus mild (without visual loss) disease. Results: In GCA, moderate to severe inflammation was accompanied by >90% destruction of the internal elastic lamina. Macrophages comprised 36.3 ± 4.1% while CD3+ lymphocytes accounted for 61.7 ± 4.1% of total leukocytes. FRB was selectively expressed in macrophages and localized to the adventitia. GCA patients had marginally increased median FRB (9.8 cells/hpf vs. 0; p=0.095), ETB (20.5 vs. 0; p=0.095) and CD68 (38.8 vs. 5; p=0.071) expression versus controls. ETB was found in endothelial cells, smooth muscle cells and macrophages in intima/media. FRB positively correlated with ETB (r=0.90; p-0.037) and CD68 levels (r=0.90; p=0.037). ETB expression positively correlated with CD68 (r=1.0; p<0.0001). There was no difference in FRB between severe and mild GCA. Conclusion: FRB is a potential diagnostic and therapeutic biomarker with restricted expression in GCA macrophages. FRB+ macrophages

Retrospective, Multicenter Comparison of the Clinical Presentation of Patients Presenting With Diplopia From Giant Cell Arteritis vs Other Causes.

PubMed

Ross, Ahmara G; Jivraj, Imran; Rodriguez, Geoffrey; Pistilli, Maxwell; Chen, John J; Sergott, Robert C; Moster, Mark; Sheldon, Claire A; Liu, Grant T; Foroozan, Rod; Ko, Melissa W; Francis, Courtney E; Williams, Zoë R; Lee, Andrew G; McClelland, Collin M; Shindler, Kenneth S; Yalamanchili, Sushma; Osborne, Benjamin; Hedges, Thomas R; Van Stavern, Gregory P; Puckett, Ernest; Rigi, Mohammed; García-Basterra, Ignacia; Tamhankar, Madhura A

2018-04-24

Although giant cell arteritis (GCA) is a well-known cause of transient and permanent vision loss, diplopia as a presenting symptom of this condition is uncommon. We compared symptoms and signs of patients presenting with diplopia from GCA to those from other causes. This was a multicenter, retrospective study comparing the clinical characteristics of patients presenting with diplopia from GCA with age-matched controls. Demographic information, review of symptoms, ophthalmic examination, and laboratory data of biopsy-proven patients with GCA were compared with those of age-matched controls presenting with diplopia. A total of 27 patients presented with diplopia from GCA, 19 with constant diplopia, and 8 with transient diplopia. All patients with constant diplopia from GCA were matched with 67 control subjects who had diplopia from other etiologies. Patients with GCA were more likely to describe other accompanying visual symptoms (58% vs 25%, P = 0.008), a greater number of systemic GCA symptoms (3.5, GCA vs 0.6, controls, P < 0.001) such as headache (94% [17/18] vs 39% [23/67]; P < 0.001), jaw claudication (80% [12/15] vs 0% [0/36]; P < 0.001), and scalp tenderness (44% [7/16] vs 7% [3/43]; P < 0.001). Ocular ischemic lesions (26% vs 1%, P < 0.001) were also common in patients with diplopia from GCA. Inflammatory markers were elevated significantly in patients with GCA vs controls (erythrocyte sedimentation rate: 91% [10/11] vs 12% [3/25], P < 0.001; C-reactive protein: 89% [8/9] vs 11% [2/19], P < 0.001). GCA is a rare but serious cause of diplopia among older adults and must be differentiated from other more common benign etiologies. Our study suggests that most patients with diplopia from GCA have concerning systemic symptoms and/or elevated inflammatory markers that should trigger further work-up. Moreover, careful ophthalmoscopic examination should be performed to look for presence of ocular ischemic lesions in older patients presenting with acute diplopia.

[Changes in prescription patterns for peripheral and cerebral vasoactive drugs before and after establishing prescription standards in France].

PubMed

Vuittenez, F; Guignard, E; Comte, S

1999-01-23

Assess changes in the number of prescriptions for peripheral and cerebral vasoactive drugs for the treatment of lower limb arteritis and cerebrovascular disease since the promulgation in 1995 of prescription standards for the treatment of lower limb arteritis. Assess compliance to prescription standards with a detailed analysis of patient features, prescriptions written for lower limb arteritis, cerebrovascular disease and concomitant diseases and evaluate changes in treatment costs for lower limb arteritis and cerebrovascular disease as well as cost of the full prescription, including treatments for associated diseases. This study was based on data recorded during the Permanent Study of Medical Prescriptions conducted from March 1994 to February 1995 and from March 1995 to February 1996 by the IMS. Prescription costs were established from the National Description Files of the IMS. Treatment costs were expressed as public price (FF) tax included. Prescriptions meeting the following criteria were selected for each period: prescriptions written by general practitioners for drugs with peripheral and cerebral vasoactivity (excepting calcium antagonists with a cerebral target) belonging to the Anatomic Therapeutic Classes C4A1 of the European Pharmaceutical Marketing Research Association, Bromly 1996; prescriptions for diagnoses 447.6 (arteritis) and 437.9 (cerebrovascular disease) according to the 9th WHO classification. A random sample of 500 prescriptions was selected to calculate costs. Since the advent of the prescription standards in 1995, prescriptions have dropped off by 6.3% for lower limb arteritis and by 14.8% for cerebrovascular disease. There was a 3.7 point decline in the percentage of multiple prescriptions of vasoactive drugs for lower limb arteritis (21.7% prior to March 1995 versus 18% after promulgation of the prescription standards, p > 0.1) and a 1.8 increase in the percentage of multiple prescriptions for cerebrovascular disease (14% prior to March

A large-scale genetic analysis reveals a strong contribution of the HLA class II region to giant cell arteritis susceptibility.

PubMed

Carmona, F David; Mackie, Sarah L; Martín, Jose-Ezequiel; Taylor, John C; Vaglio, Augusto; Eyre, Stephen; Bossini-Castillo, Lara; Castañeda, Santos; Cid, Maria C; Hernández-Rodríguez, José; Prieto-González, Sergio; Solans, Roser; Ramentol-Sintas, Marc; González-Escribano, M Francisca; Ortiz-Fernández, Lourdes; Morado, Inmaculada C; Narváez, Javier; Miranda-Filloy, José A; Beretta, Lorenzo; Lunardi, Claudio; Cimmino, Marco A; Gianfreda, Davide; Santilli, Daniele; Ramirez, Giuseppe A; Soriano, Alessandra; Muratore, Francesco; Pazzola, Giulia; Addimanda, Olga; Wijmenga, Cisca; Witte, Torsten; Schirmer, Jan H; Moosig, Frank; Schönau, Verena; Franke, Andre; Palm, Øyvind; Molberg, Øyvind; Diamantopoulos, Andreas P; Carette, Simon; Cuthbertson, David; Forbess, Lindsy J; Hoffman, Gary S; Khalidi, Nader A; Koening, Curry L; Langford, Carol A; McAlear, Carol A; Moreland, Larry; Monach, Paul A; Pagnoux, Christian; Seo, Philip; Spiera, Robert; Sreih, Antoine G; Warrington, Kenneth J; Ytterberg, Steven R; Gregersen, Peter K; Pease, Colin T; Gough, Andrew; Green, Michael; Hordon, Lesley; Jarrett, Stephen; Watts, Richard; Levy, Sarah; Patel, Yusuf; Kamath, Sanjeet; Dasgupta, Bhaskar; Worthington, Jane; Koeleman, Bobby P C; de Bakker, Paul I W; Barrett, Jennifer H; Salvarani, Carlo; Merkel, Peter A; González-Gay, Miguel A; Morgan, Ann W; Martín, Javier

2015-04-02

We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10(-40), OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1(∗)04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10(-43)) and HLA-DQα1 47 (p = 4.02 × 10(-46)), 56, and 76 (both p = 1.84 × 10(-45)) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10(-6), OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10(-6), OR = 1.20), and REL (rs115674477, p = 1.10 × 10(-5), OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK.

PubMed

Robson, Joanna C; Kiran, Amit; Maskell, Joe; Hutchings, Andrew; Arden, Nigel; Dasgupta, Bhaskar; Hamilton, William; Emin, Akan; Culliford, David; Luqmani, Raashid A

2015-01-01

To evaluate the risk of aortic aneurysm in patients with giant cell arteritis (GCA) compared with age-, gender- and location-matched controls. A UK General Practice Research Database (GPRD) parallel cohort study of 6999 patients with GCA and 41 994 controls, matched on location, age and gender, was carried out. A competing risk model using aortic aneurysm as the primary outcome and non-aortic-aneurysm-related death as the competing risk was used to determine the relative risk (subhazard ratio) between non-GCA and GCA subjects, after adjustment for cardiovascular risk factors. Comparing the GCA cohort with the non-GCA cohort, the adjusted subhazard ratio (95% CI) for aortic aneurysm was 1.92 (1.52 to 2.41). Significant predictors of aortic aneurysm were being an ex-smoker (2.64 (2.03 to 3.43)) or a current smoker (3.37 (2.61 to 4.37)), previously taking antihypertensive drugs (1.57 (1.23 to 2.01)) and a history of diabetes (0.32 (0.19 to 0.56)) or cardiovascular disease (1.98 (1.50 to 2.63)). In a multivariate model of the GCA cohort, male gender (2.10 (1.38 to 3.19)), ex-smoker (2.20 (1.22 to 3.98)), current smoker (3.79 (2.20 to 6.53)), previous antihypertensive drugs (1.62 (1.00 to 2.61)) and diabetes (0.19 (0.05 to 0.77)) were significant predictors of aortic aneurysm. Patients with GCA have a twofold increased risk of aortic aneurysm, and this should be considered within the range of other risk factors including male gender, age and smoking. A separate screening programme is not indicated. The protective effect of diabetes in the development of aortic aneurysms in patients with GCA is also demonstrated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Equine Arteritis Virus Has Specific Tropism for Stromal Cells and CD8+ T and CD21+ B Lymphocytes but Not for Glandular Epithelium at the Primary Site of Persistent Infection in the Stallion Reproductive Tract

PubMed Central

Carossino, Mariano; Loynachan, Alan T.; Canisso, Igor F.; Cook, R. Frank; Campos, Juliana R.; Nam, Bora; Go, Yun Young; Squires, Edward L.; Troedsson, Mats H. T.; Swerczek, Thomas; Del Piero, Fabio; Bailey, Ernest; Timoney, Peter J.

2017-01-01

ABSTRACT Equine arteritis virus (EAV) has a global impact on the equine industry as the causative agent of equine viral arteritis (EVA), a respiratory, systemic, and reproductive disease of equids. A distinctive feature of EAV infection is that it establishes long-term persistent infection in 10 to 70% of infected stallions (carriers). In these stallions, EAV is detectable only in the reproductive tract, and viral persistence occurs despite the presence of high serum neutralizing antibody titers. Carrier stallions constitute the natural reservoir of the virus as they continuously shed EAV in their semen. Although the accessory sex glands have been implicated as the primary sites of EAV persistence, the viral host cell tropism and whether viral replication in carrier stallions occurs in the presence or absence of host inflammatory responses remain unknown. In this study, dual immunohistochemical and immunofluorescence techniques were employed to unequivocally demonstrate that the ampulla is the main EAV tissue reservoir rather than immunologically privileged tissues (i.e., testes). Furthermore, we demonstrate that EAV has specific tropism for stromal cells (fibrocytes and possibly tissue macrophages) and CD8+ T and CD21+ B lymphocytes but not glandular epithelium. Persistent EAV infection is associated with moderate, multifocal lymphoplasmacytic ampullitis comprising clusters of B (CD21+) lymphocytes and significant infiltration of T (CD3+, CD4+, CD8+, and CD25+) lymphocytes, tissue macrophages, and dendritic cells (Iba-1+ and CD83+), with a small number of tissue macrophages expressing CD163 and CD204 scavenger receptors. This study suggests that EAV employs complex immune evasion mechanisms that warrant further investigation. IMPORTANCE The major challenge for the worldwide control of EAV is that this virus has the distinctive ability to establish persistent infection in the stallion's reproductive tract as a mechanism to ensure its maintenance in equid

Temporal arteritis

MedlinePlus

... the blood vessels that supply blood to the head, neck, upper body and arms. It is also called ... the blood vessels that supply blood to the head, neck, upper body, and arms. It most commonly occurs ...

Induction of Regulatory t Cells by Low Dose il2 in Autoimmune and Inflammatory Diseases

ClinicalTrials.gov

2018-01-10

Rheumatoid Arthritis; Ankylosing Spondylitis; Systemic Lupus Erythematosus; Psoriasis; Behcet's Disease; Wegener's Granulomatosis; Takayasu's Disease; Crohn's Disease; Ulcerative Colitis; Autoimmune Hepatitis; Sclerosing Cholangitis; Gougerot-sjögren; Idiopathic Thrombocytopenic Purpura; Systemic Sclerosis

Risk Associated with Cumulative Oral Glucocorticoid Use in Patients with Giant Cell Arteritis in Real-World Databases from the USA and UK.

PubMed

Gale, Sara; Wilson, Jessica C; Chia, Jenny; Trinh, Huong; Tuckwell, Katie; Collinson, Neil; Dimonaco, Sophie; Jick, Susan; Meier, Christoph; Mohan, Shalini V; Sarsour, Khaled

2018-05-11

Treatment of giant cell arteritis (GCA) involves immediate initiation of high-dose glucocorticoid therapy with slow tapering of the dose over many months. Chronic exposure to glucocorticoids is associated with serious comorbidities. The objective of this analysis was to determine the glucocorticoid exposure and risk of glucocorticoid-related adverse events (AEs) in real-world patients with GCA. Data from the Truven Healthcare MarketScan ® database (from January 1, 2000, to June 30, 2015) and the Clinical Practice Research Datalink (CPRD; from January 1, 1995, to August 31, 2013) were used to retrospectively analyze patients aged ≥ 50 years with GCA in the USA and UK, respectively. Outcomes included oral glucocorticoid use (cumulative prednisone-equivalent exposure), glucocorticoid-related AEs and the association of AE risk with glucocorticoid exposure over 52 weeks. Of the 4804 patients in the US MarketScan database and 3973 patients in the UK CPRD database included, 71.3 and 74.6% were women and mean age was 73.4 and 73.0 years, respectively. Median starting glucocorticoid dose and cumulative glucocorticoid dose at 52 weeks were 20-50 mg/day and 4000-4800 mg, respectively. The most frequent glucocorticoid-related AEs were hypertension and eye, bone health, and glucose tolerance conditions. In the first year after diagnosis, the likelihood of any glucocorticoid-related AE was significantly increased for each 1 g increase in cumulative glucocorticoid dose in the US and UK cohorts (odds ratio [95% CI], 1.170 [1.063, 1.287] and 1.06 [1.03, 1.09], respectively; P < 0.05 for both). Similar trends were observed for the risk of glucocorticoid-related AEs over full follow-up (mean, USA: 3.9 years, UK: 6.3 years). In real-world patients with GCA, increased cumulative glucocorticoid exposure was associated with an increased risk of glucocorticoid-related AEs. F. Hoffmann-La Roche Ltd. Plain language summary available for this article.

Effectiveness of ivermectin against later 4th-stage Strongylus vulgaris in ponies.

PubMed

Slocombe, J O; McCraw, B M; Pennock, P W; Vasey, J

1982-09-01

Twelve pony foals were reared worm-free and inoculated with Strongylus vulgaris. Approximately 8 weeks after they were inoculated, 6 foals were given ivermectin IM at a dosage rate of 200 micrograms/kg of body weight and 6 were given a placebo. All foals were necropsied 35 days after treatment. Ivermectin was 98.9% effective in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries and in reducing clinical signs and permitting resolution of lesions associated with verminous arteritis. One pony foal reared on pasture and with evidence of arteritis of the cranial mesenteric and ileocolic arteries on arteriography was treated with ivermectin at a dosage rate of 200 micrograms/kg of body weight. On arteriographs taken subsequently, there was evidence of regression of the lesion, and at necropsy 9 weeks after treatment, there was no arteritis or larvae in those arteries.

The tropics and the crime they did not commit.

PubMed

Goorhuis, A; van Thiel, P P A M; Middeldorp, S; van Eck, B L F; Grobusch, M P

2013-02-01

Travellers to tropical destinations who seek medical attention after returning to their home country often present with fever, frequently as a result of an imported infectious disease. For this reason, clinicians initially focus on an infectious cause when a clear relationship in time exists between travel and disease onset. We present a case of a patient, who developed fever 2 weeks after his return from Ghana and who was finally diagnosed with an auto-immune disease: arteritis of the large arteries. This case illustrates that broad differential diagnostic thinking is paramount in the assessment of returned travellers.

[VASCULITIDES IN CHILDHOOD: A RETROSPECTIVE STUDY IN A PERIOD FROM 2002 TO 2012 AT THE DEPARTMENT OF PAEDIATRICS, UNIVERSITY HOSPITAL CENTRE ZAGREB].

PubMed

Jelusić, Marija; Kostić, Lucija; Frković, Marijan; Davidović, Masa; Malcić, Ivan

2015-01-01

The aim of our study was to analyze clinical features, laboratory findings, treatment, course and outcome of different types of vasculitis in children. All children aged up to 18 years that have been diagnosed with a vasculitis disorder from 2002. to 2012. at the Department of Paediatric, University Hospital Centre Zagreb according to EULAR/PRES/PRINTO criteria were included in the study. Vasculitis was diagnosed in 180 children, 101 girls and 79 boys, mean age 7.19 ± 3.7 years, with an average follow-up of 5.58 ± 3.28 years. Most of the children (155 or 86%) were diagnosed with Henoch-Shönlein purpura (HSP), polyarteritis nodosa (PAN) was diagnosed in 6 children (3.3%), isolated cutaneous leukocytoclastic vasculitis in 5 (2.8%), Takayasu arteritis (TA) and Kawasaki disease in 2 (1.1%) respectively, hypocomplementemic urticarial vasculitis in one patient (0.5%) and other types of vasculitis in 10 (5.5%) patients (vasculitides in systemic connective tissue disorders in 7 and unclassified vasculitides in 3 patients). All patients had elevated inflammatory markers (C-reactive protein and erythrocyte sedimentation rate). Anti-neutrophil cytoplasmatic antibodies (ANCA) were positive only in one patient, suffering from microscopic polyangiitis. Treatment modality in most patients were NSAIDs, while children with kidney or gastrointestinal system affection were treated with glucocorticoids and/or immunosuppresive drugs. Biological therapy (anti-CD20, rituximab) was used in patients with most severe symptoms. One child (0.56%), suffering from microscopic polyangiitis, died due to kidney failure during the follow-up. Forty patients (22.6%) had one disease relapse, while 6 (3.4%) had two relapses. In conclusion, we found some differences in laboratory parameters (e.g. lower incidence of elevated antistreptolysin O titer in HSP) and epidemiological data (e.g. higher prevalence of PAN in female children) in comparison to data from available studies, while other clinical

[Results of a regional survey on the treatment of rhizomelic pseudopolyarthritis and temporal arteritis. Apropos of 242 cases treated by various modalities with synthetic antimalarials, corticoids and non-steroidal anti-inflammatory agents].

PubMed

David-Chaussé, J; Dehais, J; Leman, A

1983-01-01

The authors report the results of a retrospective therapeutic survey concerning 176 cases of rhizomelic pseudopolyarthritis (RPP) and 66 cases of temporal arteritis (TA). Of 128 cases of RPP treated initially by synthetic anti-malarials (SAM) and non-steroidal anti-inflammatory agents (NSAI), 66 were followed up until cure which was obtained after a mean of 23 months and 3 subsequently received brief steroid therapy. 45 cases of RPP were treated initially with corticosteroids. They were generally associated with SAM which enabled early weaning of the steroids, towards the 8 th month, or at least reducing the dose. Cure was obtained within 24 months. Three patients were treated by NSAI and gold therapy. After cure, 5 cases of recurrence and 1 case of TA were observed. 40 cases of TA were initially treated with SAM and NSAI. Twenty cures were obtained within a mean of 28 months. 4 patients later received brief corticosteroid therapy because of an extension of the signs, including two cases of ocular manifestations with a resolving course. Of 25 cases of TA initially treated with steroids, 20 received SAM in combination, or in relay which enabled either steroids, weaning towards the 14th month or a reduction in the dose of steroids. Cure was obtained in an average of 35 months. One case of impaired visual acuity occurred during corticosteroid treatment. Immunosuppressants were used in one patient. No cases of recurrence were observed. Iatrogenic complications with SAM were rare, generally benign and reversible, in contrast to those associated with corticosteroid therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma thromboxane B2 levels in horses experimentally infected with Strongylus vulgaris.

PubMed

Cambridge, H; Reynoldson, J A; Dunsmore, J D

1989-06-01

Plasma thromboxane B2 (TXB2) the stable inactive metabolite of thromboxane A2 (TXA2), was measured daily by specific radioimmunoassay in three groups of animals before and after experimental infection with Strongylus vulgaris. Infection of four 'parasite naive' foals produced a typical acute syndrome with intermittent but statistically insignificant rises in TXB2 levels. Interpretation of results was complicated by the presence of a non-septic peritonitis associated with implantation of the foals with electrodes for recording myoelectrical activity. In two foals of similar age, with some natural exposure to S. vulgaris, there was little or no clinical response to infection and increases in TXB2 were absent. Baseline levels were also much lower, indicating that the peritonitis may have affected the results obtained in the first group of foals. Severe mesenteric arteritis was confirmed at necropsy in all six foals. A third group of yearling horses, all with natural exposure to the parasite, were generally resistant to infection. One animal developed arteritis with clinical signs of diarrhoea and mild colic, and also showed intermittent increases in TXB2. The mean plasma TXB2 level after infection was significantly higher than in the control period, although absolute levels were lower than those recorded in the 'parasite naive' foals. Other animals in this group had low TXB2 levels and minimal arteritis was found at necropsy. These results indicate that although infection appears to have an effect on plasma TXB2, the changes are inconsistent and not reliable indicators of the presence of verminous arteritis. The results also confirm the difficulty in establishing infection and the variability of the response in animals with previous exposure.

Cannabis-associated arterial disease.

PubMed

Desbois, Anne Claire; Cacoub, Patrice

2013-10-01

The aim of this study was to describe the different arterial complications reported in cannabis smokers. This study was a literature review. Cannabis use was found to be associated with stroke, myocardial infarction, and lower limb arteritis. Arterial disease involved especially young men. There was a very strong temporal link between arterial complications and cannabis use for stroke and myocardial infarction episodes. Patient outcome was closely correlated with cannabis withdrawal and relapses associated with cannabis rechallenge. Cannabis use was associated with particular characteristics of arterial disease. The increased risk of myocardial infarction onset occurred within 1 hour of smoking marijuana compared with periods of non-use. Strokes occurred mainly in the posterior cerebral circulation. Compared with cohorts of thromboangiitis obliterans patients, those with cannabis-associated limb arteritis were younger, more often male, and had more frequent unilateral involvement of the lower limbs at clinical presentation. Cannabis use is associated with arterial disease such as stroke, myocardial infarction, and limbs arteritis. It appears essential to investigate cannabis use in young patients presenting with such arterial manifestations, as outcome is closely correlated with cannabis withdrawal. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluation and management of "sinus headache" in the otolaryngology practice.

PubMed

Patel, Zara M; Setzen, Michael; Poetker, David M; DelGaudio, John M

2014-04-01

Patients, primary care doctors, neurologists and otolaryngologists often have differing views on what is truly causing headache in the sinonasal region. This review discusses common primary headache diagnoses that can masquerade as "sinus headache" or "rhinogenic headache," such as migraine, trigeminal neuralgia, tension-type headache, temporomandibular joint dysfunction, giant cell arteritis (also known as temporal arteritis) and medication overuse headache, as well as the trigeminal autonomic cephalalgias, including cluster headache, paroxysmal hemicrania, and hemicrania continua. Diagnostic criteria are discussed and evidence outlined that allows physicians to make better clinical diagnoses and point patients toward better treatment options. Copyright © 2014 Elsevier Inc. All rights reserved.

Management of outpatients in France with stable coronary artery disease. Findings from the prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease (CLARIFY) registry.

PubMed

Danchin, Nicolas; Ferrieres, Jean; Guenoun, Maxime; Cattan, Simon; Rushton-Smith, Sophie K; Greenlaw, Nicola; Ferrari, Roberto; Steg, Philippe Gabriel

2014-01-01

Improvements in the treatment of coronary artery disease mean that an increasing number of patients survive acute cardiovascular events and live as outpatients with or without anginal symptoms. To determine the characteristics and management of contemporary outpatients with stable coronary artery disease in Western Europe, and to compare France with the other Western European countries. CLARIFY (prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an international, prospective, observational, longitudinal study. Between November 2009 and July 2010, 32,954 adult outpatients with stable coronary artery disease (defined as a history of documented myocardial infarction [of >3 months], prior coronary revascularization, chest pain with myocardial ischaemia, or coronary stenosis of>50% proven by angiography) were enrolled in 45 countries. The demographics and management of CLARIFY patients enrolled in France were compared with those enrolled in other Western European countries (Austria, Belgium, Denmark, Germany, Greece, Ireland, Italy, Netherlands, Portugal, Spain, Switzerland and the UK). Of the 14,726 patients enrolled in Western Europe (mean age 66.2 [10.2] years; 79.6% male), 2432 (16.5%) were from France. The use of aspirin was lower in France than in other Western European countries (74.5% vs. 86.9%, respectively), whereas use of thienopyridines (48.5% vs. 21.7%), oral anticoagulants (12.3% vs. 9.0%) and lipid-lowering drugs (95.8% vs. 92.5%) was higher. Beta-blockers were used in 73% of both groups. Angina was less prevalent in France (6.3% vs. 15.5%) and French patients showed higher levels of physical activity than their counterparts in Western Europe. The management of patients with stable CAD in France appears favourable, with good adherence to guideline-based therapies, but there remains room for improvement in terms of symptom and risk factor control. Copyright © 2014. Published by Elsevier Masson SAS.

Bilateral Non-arteritic Anterior Ischaemic Optic Neuropathy as the Presentation of Systemic Amyloidosis.

PubMed

Kanaan, M Z; Lorenzi, A R; Thampy, N; Pandit, R; Dayan, Margaret

2017-12-01

A 75-year-old hypertensive female with stable idiopathic intermediate uveitis presented with bilateral sequential optic neuropathy with optic disc swelling. The optic neuropathy in the first affected eye (right) was thought to be due to non-arteritic anterior ischaemic optic neuropathy (NAION). Asymptomatic left optic disc swelling was found at routine review 2 months later, and a diagnosis of giant cell arteritis (GCA) was sought. Temporal artery duplex ultrasound showed the "halo sign," but a subsequent temporal artery biopsy showed light-chain (AL) amyloidosis with no signs of giant cell arteritis. In this case, bilateral sequential ischaemic optic neuropathy mimicking non-arteritic anterior ischaemic optic neuropathy was the presenting sign of systemic amyloidosis involving the temporal arteries.

Autoimmune phenomena following prostatectomy.

PubMed

Tweezer-Zaks, Nurit; Marai, Ibrahim; Livneh, Avi; Bank, Ilan; Langevitz, Pnina

2005-09-01

Benign prostatic hypertrophy is the most common benign tumor in males, resulting in prostatectomy in 20-30% of men who live to the age of 80. There are no data on the association of prostatectomy with autoimmune phenomena in the English-language medical literature. To report our experience with three patients who developed autoimmune disease following prostatectomy. Three patients presented awith autoimmune phenomenon soon after a prostectomy for BPH or prostatic carcinoma: one had clinically diagnosed temporal arteritis, one had leukocytoclastic vasculitis, and the third patient developed sensory Guillian-Barré syndrome following prostatectomy. In view of the temporal association between the removal of the prostate gland andthe autoimmune process, combined with previously known immunohistologic features of BPH, a cause-effect relationship probably exists.

Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

PubMed

Borji, Hassan; Moosavi, Zahra; Ahmadi, Fatemeh

2014-09-01

Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

What Is Giant Cell Arteritis?

MedlinePlus

Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

Thyroid diseases and cerebrovascular disease.

PubMed

Squizzato, A; Gerdes, V E A; Brandjes, D P M; Büller, H R; Stam, J

2005-10-01

Acute cerebral ischemia has been described in different diseases of the thyroid gland, and not only as a result of thyrotoxic atrial fibrillation and cardioembolic stroke. The purpose of this review is to summarize the studies on the relationship between thyroid diseases and cerebrovascular diseases, discussing the main findings for overt hyperthyroidism and hypothyroidism, as well as for subclinical thyroid dysfunction. In overt hyperthyroidism, cardioembolic stroke is clearly associated to thyrotoxic atrial fibrillation, and in subclinical hyperthyroidism with serum thyroid-stimulating hormone levels <0.1 mU/L, the incidence of atrial fibrillation is increased. Although in vitro and in vivo studies indicate a hypercoagulability state in hyperthyroidism, there is insufficient evidence to prove that this state leads to an increased risk of cardiac emboli. However, the hypothesis that overt hyperthyroidism may cause acute cerebral venous thrombosis is intriguing. Possible associations between hyperthyroidism and Moyamoya or Giant cell arteritis have only been described in case reports. There is enough evidence that overt hypothyroidism is associated with several traditional and newer atherosclerotic risk factors, especially hypertension, hyperlipidemia, and hyperhomocysteinemia. For subclinical hypothyroidism, these associations are less certain. Hypothyroidism has been associated with signs of aortic or coronary atherosclerosis, but no case-control or cohort studies have ever investigated hypothyroidism as a possible risk factor for atherothrombotic stroke. Hyperthyroidism is associated with atrial fibrillation and cardioembolic stroke. Hypothyroidism is associated with a worse cardiovascular risk factor profile and leads to progression of atherosclerosis. Associations between hyperthyroidism and acute cerebral venous thrombosis, Moyamoya, and Giant cell arteritis have been suggested, but sound evidence is lacking. Additional studies are needed to clarify these

Relative Frequencies of Arteritic and Nonarteritic Anterior Ischemic Optic Neuropathy in an Arab Population.

PubMed

Gruener, Anna M; Chang, Jessica R; Bosley, Thomas M; Al-Sadah, Zakeya M; Kum, Clarissa; McCulley, Timothy J

2017-12-01

To evaluate the relative frequencies of arteritic and nonarteritic anterior ischemic optic neuropathy (AION) in an Arab population and to compare and contrast these findings with known epidemiological data from Caucasian populations. A retrospective review of the medical records of all patients diagnosed with AION at the King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia, between 1997 and 2012. Of 171 patients with AION, 4 had biopsy-proven giant-cell arteritis (GCA). The relative frequencies of arteritic anterior ischemic optic neuropathy (AAION) and nonarteritic anterior ischemic optic neuropathy (NAION) in this Arab cohort were 2.3% and 97.7%, respectively. The relative frequencies of arteritic anterior ischemic optic neuropathy and nonarteritic anterior ischemic optic neuropathy differ between Arab and North American clinic-based populations, with giant-cell arteritis-related ischemia being much less frequent in Saudi Arabia.

Stable Causal Relationships Are Better Causal Relationships.

PubMed

Vasilyeva, Nadya; Blanchard, Thomas; Lombrozo, Tania

2018-05-01

We report three experiments investigating whether people's judgments about causal relationships are sensitive to the robustness or stability of such relationships across a range of background circumstances. In Experiment 1, we demonstrate that people are more willing to endorse causal and explanatory claims based on stable (as opposed to unstable) relationships, even when the overall causal strength of the relationship is held constant. In Experiment 2, we show that this effect is not driven by a causal generalization's actual scope of application. In Experiment 3, we offer evidence that stable causal relationships may be seen as better guides to action. Collectively, these experiments document a previously underappreciated factor that shapes people's causal reasoning: the stability of the causal relationship. Copyright © 2018 Cognitive Science Society, Inc.

Machiavellianism, Relationship Satisfaction, and Romantic Relationship Quality.

PubMed

Brewer, Gayle; Abell, Loren

2017-08-01

Machiavellianism is characterised by a manipulative interpersonal style, willingness to exploit others, and a preference for emotionally detached relationships. The present studies investigate the extent to which Machiavellianism influences relationship satisfaction and romantic relationship quality. In Study 1, 194 heterosexual partnered women completed Machiavellianism and Relationship Satisfaction measures. Women with higher levels of Machiavellianism reported lower levels of relationship satisfaction. In Study 2, 132 heterosexual partnered women completed Machiavellianism, Trust, Commitment, Control, and Emotional Abuse scales. Women with higher levels of Machiavellianism perceived their partners to be less dependable, reported less faith in their partners, and were less willing to persist with the relationship than those with low levels of Machiavellianism. With regards to negative behavior, Machiavellianism predicted each form of control and emotional abuse investigated, such that those with high levels of Machiavellianism were more likely to engage in controlling behavior and emotional abuse. Findings have important implications for the prediction of romantic relationship quality and in particular for negative behavior such as control and abuse.

Machiavellianism, Relationship Satisfaction, and Romantic Relationship Quality

PubMed Central

Brewer, Gayle; Abell, Loren

2017-01-01

Machiavellianism is characterised by a manipulative interpersonal style, willingness to exploit others, and a preference for emotionally detached relationships. The present studies investigate the extent to which Machiavellianism influences relationship satisfaction and romantic relationship quality. In Study 1, 194 heterosexual partnered women completed Machiavellianism and Relationship Satisfaction measures. Women with higher levels of Machiavellianism reported lower levels of relationship satisfaction. In Study 2, 132 heterosexual partnered women completed Machiavellianism, Trust, Commitment, Control, and Emotional Abuse scales. Women with higher levels of Machiavellianism perceived their partners to be less dependable, reported less faith in their partners, and were less willing to persist with the relationship than those with low levels of Machiavellianism. With regards to negative behavior, Machiavellianism predicted each form of control and emotional abuse investigated, such that those with high levels of Machiavellianism were more likely to engage in controlling behavior and emotional abuse. Findings have important implications for the prediction of romantic relationship quality and in particular for negative behavior such as control and abuse. PMID:28904597

Relationships.

ERIC Educational Resources Information Center

Safilios-Rothschild, Constantina, Ed.

1981-01-01

Examined in 10 articles aspects of relationships including: (1) factors leading to new relationship types; (2) sex differences in relationships; (3) perception differences in dating couples; (4) typologies of intimacy; (5) sex roles and intimacy; (6) friendships; and (7) sex-role identity and behavior in heterosexual and gay couples. (RC)

Relationship stigma and relationship outcomes in interracial and same-sex relationships: Examination of sources and buffers.

PubMed

Rosenthal, Lisa; Starks, Tyrel J

2015-12-01

Interracial and same-sex romantic relationships are more common and socially accepted in the United States than ever before; yet, stigmatization of these relationships persists, with consequences for relationship dynamics. We conducted an online survey study with adults living in the United States in interracial and same-sex relationships to examine associations of relationship stigma from family, friends, and public with several relationship outcomes (i.e., investment, satisfaction, intimate partner aggression victimization and perpetration, commitment, intimacy, trust, passion, love, sexual communication, and sexual satisfaction), as well as the potential buffering roles of egalitarianism and dyadic coping. Regression analyses with 480 participants support that above and beyond individually experienced discrimination and other well-known predictors of relationship outcomes, relationship stigma from friends in particular was associated with lower relationship commitment, trust, love, and sexual communication, as well as greater odds of intimate partner aggression victimization. Egalitarianism and dyadic coping moderated some of the associations of relationship stigma from family, friends, and public with relationship outcomes, supporting their potential roles as buffers. These findings suggest many avenues for future research and implications for clinicians working with interracial and same-sex couples, individuals in those couples, and their families. Given increasing prevalence of interracial and same-sex relationships and marriages, more work should continue to explore these couples' experiences and how best to support them. (c) 2015 APA, all rights reserved).

Haematological and biochemical values in horses naturally infected with Strongylus vulgaris.

PubMed

Bailey, M; Kent, J; Martin, S C; Lloyd, S; Soulsby, E J

1984-08-18

The concentrations of serum proteins (beta 1, beta 2, gamma, alpha 1, alpha 2 globulins and albumin) and absolute numbers of eosinophils, neutrophils and lymphocytes were examined in 64 naturally infected horses and ponies in which the number of larvae of Strongylus vulgaris in the cranial mesenteric artery and the severity of the lesion of verminous arteritis could be determined. The horses were grouped according to the number of larvae found and the severity of the arteritis. The results demonstrated that, although some significant deviation from a random distribution occurred in certain of the values (chi 2 test), there was considerable individual variation in the values obtained for individual animals within groups and overlap of the range of values between groups. Also the number of larvae present in the artery did not necessarily accurately reflect the severity of the arterial lesion. Thus, the parameters examined could not be used reliably to estimate the intensity of infection with S vulgaris in an individual animal.

Kawasaki disease: State of the art.

PubMed

Newburger, Jane W

2017-09-01

Kawasaki disease is an acute febrile arteritis of childhood that can result in coronary artery aneurysms if untreated in the first 10 and ideally 7 days of illness. Kawasaki disease begins as a necrotizing arteritis with neutrophilic infiltrate, followed by subacute/chronic changes and luminal myofibroblastic proliferation that can cause coronary artery stenosis. Manifestations include the presence of ≥5 days of fever, together with clinical criteria of extremity changes, rash, conjunctivitis, oral changes, and unilateral cervical lymphadenopathy. Echocardiography should be performed at the time of diagnosis, then 1-2 weeks and 4-6 weeks later, with more frequent studies in individuals with coronary artery dilation or persistent fever. Coronary artery dimensions are characterized both as z-scores and absolute measurements, and coronary architecture evolves over time in children who have aneurysms in the first weeks of illness. Systematic follow-up and therapies are tailored to the degree of coronary disease and to coronary ischemia. © 2017 Wiley Periodicals, Inc.

Giant Cell Arteritis and Polymyalgia Rheumatica

MedlinePlus

... Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids ... Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids ...

Polymyalgia Rheumatica and Giant Cell Arteritis

MedlinePlus

... information on research progress in these diseases. Contact Us NIAMS Archive Viewers and Players Social Media Moderation Policy FOIA Privacy Statement Accessibility Disclaimer Digital Strategy Open Source Data Public Data Listing NIH... ...

Relationship Dissolution and Psychologically Aggressive Dating Relationships: Preliminary Findings From a College-Based Relationship Education Course.

PubMed

Negash, Sesen; Cravens, Jaclyn D; Brown, Preston C; Fincham, Frank D

This study evaluated the impact of a relationship education program, delivered as part of a college course, among students (N = 152) who reported experiencing psychological aggression in their exclusive dating relationship. Preliminary results showed that compared to those in the control group, participants receiving relationship education were significantly more likely to end their romantic relationship, even after controlling for relationship satisfaction. Furthermore, when relationship termination occurred, those in the intervention group were significantly more likely to attribute the breakup to their participation in the class as compared to those in the control group. The tentative findings are an important preliminary step in assessing the benefits of relationship education in reducing the risk of psychological aggression among college students.

GIANT CELL AORTITIS DIAGNOSED WITH PET/CT - PARANEOPLASTIC SYNDROME?

PubMed

Bakula, Marija; Cerovec, Mislav; Mayer, Miroslav; Huić, Dražen; Anić, Branimir

2016-05-01

Vasculitides are heterogenic group of autoimmune connective tissue diseases which often present difficulties in early diagnosing. Giant cell arteritis is vasculitis of large and medium arteries. It predominantly presents with symptoms of affection of the external carotid artery branches. Furthermore, the only symptoms can be constitutional. In clinical practice, vasculitides are sometimes considered as paraneoplastic, but no definite association with malignancies has been established and the mechanisms are still debated. The gold standard for diagnosing giant cell arteritis is a positive temporal artery biopsy, but the results can often be false negative. Additionally, more than half of the patients have aorta and its main branches affected. Considering aforementioned, imaging studies are essential in confirming large-vessel vasculitis, amongst which is highly sensitive PET/CT. We present the case of a 70-year-old female patient with constitutional symptoms and elevated sedimentation rate. After extensive diagnostic tests, she was admitted to our Rheumatology unit. Aortitis of the abdominal aorta has been confirmed by PET/CT and after the introduction of glucocorticoids the disease soon went into clinical and laboratory remission. Shortly after aortitis has been diagnosed, lung carcinoma was revealed of which the patient died. At the time of the comprehensive diagnostics, there was no reasonable doubt for underlying malignoma. To the best of our knowledge, there are no recent publications concerning giant cell arteritis and neoplastic processes in the context of up-to-date non-invasive diagnostic methods (i.e. PET/CT). In the light of previous research results, we underline that the sensitivity of PET/CT is not satisfactory when estimating cancer dissemination in non-enlarged lymph nodes and that its value can at times be overestimated.

The Role of Ultrasound Compared to Biopsy of Temporal Arteries in the Diagnosis and Treatment of Giant Cell Arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study.

PubMed

Luqmani, Raashid; Lee, Ellen; Singh, Surjeet; Gillett, Mike; Schmidt, Wolfgang A; Bradburn, Mike; Dasgupta, Bhaskar; Diamantopoulos, Andreas P; Forrester-Barker, Wulf; Hamilton, William; Masters, Shauna; McDonald, Brendan; McNally, Eugene; Pease, Colin; Piper, Jennifer; Salmon, John; Wailoo, Allan; Wolfe, Konrad; Hutchings, Andrew

2016-11-01

Giant cell arteritis (GCA) is a relatively common form of primary systemic vasculitis, which, if left untreated, can lead to permanent sight loss. We compared ultrasound as an alternative diagnostic test with temporal artery biopsy, which may be negative in 9-61% of true cases. To compare the clinical effectiveness and cost-effectiveness of ultrasound with biopsy in diagnosing patients with suspected GCA. Prospective multicentre cohort study. Secondary care. A total of 381 patients referred with newly suspected GCA. Sensitivity, specificity and cost-effectiveness of ultrasound compared with biopsy or ultrasound combined with biopsy for diagnosing GCA and interobserver reliability in interpreting scan or biopsy findings. We developed and implemented an ultrasound training programme for diagnosing suspected GCA. We recruited 430 patients with suspected GCA. We analysed 381 patients who underwent both ultrasound and biopsy within 10 days of starting treatment for suspected GCA and who attended a follow-up assessment (median age 71.1 years; 72% female). The sensitivity of biopsy was 39% [95% confidence interval (CI) 33% to 46%], which was significantly lower than previously reported and inferior to ultrasound (54%, 95% CI 48% to 60%); the specificity of biopsy (100%, 95% CI 97% to 100%) was superior to ultrasound (81%, 95% CI 73% to 88%). If we scanned all suspected patients and performed biopsies only on negative cases, sensitivity increased to 65% and specificity was maintained at 81%, reducing the need for biopsies by 43%. Strategies combining clinical judgement (clinician's assessment at 2 weeks) with the tests showed sensitivity and specificity of 91% and 81%, respectively, for biopsy and 93% and 77%, respectively, for ultrasound; cost-effectiveness (incremental net monetary benefit) was £485 per patient in favour of ultrasound with both cost savings and a small health gain. Inter-rater analysis revealed moderate agreement among sonographers (intraclass

An Endangered Relationship

ERIC Educational Resources Information Center

Trousdale, Ann M.

2008-01-01

There exist three essential relationships in the human experience: relationship with oneself, relationship with others, and relationship with the natural world. This article focuses on one of these relationships and how children's literature may be used to support and enhance it: relationship with the natural world. The author chose this…

Relationship authenticity partially mediates the effects of attachment on relationship satisfaction.

PubMed

Rasco, Danney; Warner, Rebecca M

2017-01-01

Individuals with anxious and avoidant attachment tend to experience less satisfaction in their relationships. Past research suggests the negative effects of attachment on relationship satisfaction may be partially mediated by self-disclosure and self-concealment; the present study evaluated relationship authenticity as a potential additional mediator. Confirmatory factor analysis indicated that relationship authenticity is distinct from self-disclosure and self-concealment. Relationship authenticity predicted additional variance in relationship satisfaction controlling for attachment, self-disclosure, and self-concealment. The results were consistent with relationship authenticity, along with self-disclosure and self-concealment, partially mediating the effects of attachment on relationship satisfaction. These findings suggest that relationship authenticity may play a unique role in understanding how attachment influences relationship satisfaction. Theoretical and clinical implications are discussed.

Romantic relationship development: The interplay between age and relationship length.

PubMed

Lantagne, Ann; Furman, Wyndol

2017-09-01

The present study explored how romantic relationship qualities develop with age and relationship length. Eight waves of data on romantic relationships were collected over 10.5 years during adolescence and early adulthood from a community-based sample in a Western U.S. city (100 males, 100 females; M age Wave 1 = 15.83). Measures of support, negative interactions, control, and jealousy were derived from interviews and questionnaire measures. Using multilevel modeling, main effects of age were found for jealousy, and main effects of relationship length were found for each quality. However, main effects were qualified by significant age by length interactions for each and every relationship quality. Short relationships increased in support with age. In comparison, long-term adolescent relationships were notable in that they were both supportive and turbulent, with elevated levels of support, negative interactions, control, and jealousy. With age, long-term relationships continued to have high levels of support, but decreased in negative interactions, control, and jealousy. Present findings highlight how the interplay between age and relationship length is key for understanding the development of romantic relationships. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impact of an Intimate Relationships Class on Unrealistic Relationship Beliefs

ERIC Educational Resources Information Center

Bass, Brenda L.; Drake, Teske R.; Linney, Kirsten D.

2007-01-01

Unrealistic relationship beliefs have been shown to be related to lower levels of relationship satisfaction. Yet, young adults often hold unrealistic or irrational beliefs about intimate relationships. The purpose of this study was to assess the effectiveness of an intimate relationships course in reducing young adults' irrational relationship…

Relationship challenges and relationship maintenance activities following disclosure of transsexualism.

PubMed

Alegría, C Aramburu

2010-12-01

• Transsexual persons are increasing their visibility in society, and health care providers and others (such as social workers) will be called upon to help with issues that transsexual persons face. Challenges that face transsexual persons often include issues involving relationships. Psychiatric and mental health nurses and other caregivers can increase their therapeutic skills in working with couples that include transsexual persons by becoming aware of these challenges and subsequent activities that can help with them. • This research study looks at couple relationships in which one partner reveals male-to-female transsexual identity. These are relationships that were established as man-woman and now will transition into relationships that include a male-to-female person and a female partner. • Common challenges for these couples include issues related to: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) presenting in public. • Relationship maintenance activities that helped the couples in the study maintain and strengthen their relationships through these challenges include: (1) communication; (2) self-talk (for example, putting the situation in perspective); (3) social networks; (4) positive interactions; (5) impression management (for example, managing displays of affection in public); and (6) social activism. This qualitative study describes the relational dynamics that help sustain relationships of couples that include male-to-female transsexual persons (MTF) and their natal female partners (NF) following disclosure of transsexualism. Relationship challenges and relationship maintenance activities are identified. Each partner in 17 MTF-NF couples participated in individual surveys and interviews. The data were coded for themes related to relationship challenges and activities. MTF-NF couples experience challenges within the contexts of their relationships and of society. These challenges

[Streptococcus milleri: An unusual cause of skull extensive osteomyelitis in an immunocompetent patient].

PubMed

Duquenne, C; Dernis, E; Zehrouni, A; Bizon, A; Duquenne, M

2017-09-01

Streptococcus milleri (Streptococcus anginosus, intermedius and constellatus) are commensal organisms, which can become pathogenic and cause infection with frequent abscess formation, local or metastatic extension. Osteomyelitis of the skull has been rarely reported in this type of infection. Skull osteomyelitis due to Streptococcus milleri is reported in a 61-year-old immunocompetent man without any medical history, occurring 10 months after a head injury without any wound or complication at initial presentation. A progressive right parieto-occipital headache with worsening and increased acute phase reactants evoked a giant cell arteritis. After few days of corticosteroid therapy (0.5 mg/kg/day), diagnosis of subcutaneous abscess associated to an extensive osteomyelitis of the skull due to Streptococcus milleri was diagnosed. The outcome was favorable after drainage of one liter of pus, irrigation, debridement and antibiotherapy by amoxicillin for 8 weeks. It is necessary to discuss the differential diagnosis of giant cell arteritis particularly when symptoms are unusual. Even a short-term corticosteroid therapy may dramatically exacerbate an undetected infection. Copyright © 2017. Published by Elsevier SAS.

Ancestral Relationships Using Metafounders: Finite Ancestral Populations and Across Population Relationships.

PubMed

Legarra, Andres; Christensen, Ole F; Vitezica, Zulma G; Aguilar, Ignacio; Misztal, Ignacy

2015-06-01

Recent use of genomic (marker-based) relationships shows that relationships exist within and across base population (breeds or lines). However, current treatment of pedigree relationships is unable to consider relationships within or across base populations, although such relationships must exist due to finite size of the ancestral population and connections between populations. This complicates the conciliation of both approaches and, in particular, combining pedigree with genomic relationships. We present a coherent theoretical framework to consider base population in pedigree relationships. We suggest a conceptual framework that considers each ancestral population as a finite-sized pool of gametes. This generates across-individual relationships and contrasts with the classical view which each population is considered as an infinite, unrelated pool. Several ancestral populations may be connected and therefore related. Each ancestral population can be represented as a "metafounder," a pseudo-individual included as founder of the pedigree and similar to an "unknown parent group." Metafounders have self- and across relationships according to a set of parameters, which measure ancestral relationships, i.e., homozygozities within populations and relationships across populations. These parameters can be estimated from existing pedigree and marker genotypes using maximum likelihood or a method based on summary statistics, for arbitrarily complex pedigrees. Equivalences of genetic variance and variance components between the classical and this new parameterization are shown. Segregation variance on crosses of populations is modeled. Efficient algorithms for computation of relationship matrices, their inverses, and inbreeding coefficients are presented. Use of metafounders leads to compatibility of genomic and pedigree relationship matrices and to simple computing algorithms. Examples and code are given. Copyright © 2015 by the Genetics Society of America.

Ancestral Relationships Using Metafounders: Finite Ancestral Populations and Across Population Relationships

PubMed Central

Legarra, Andres; Christensen, Ole F.; Vitezica, Zulma G.; Aguilar, Ignacio; Misztal, Ignacy

2015-01-01

Recent use of genomic (marker-based) relationships shows that relationships exist within and across base population (breeds or lines). However, current treatment of pedigree relationships is unable to consider relationships within or across base populations, although such relationships must exist due to finite size of the ancestral population and connections between populations. This complicates the conciliation of both approaches and, in particular, combining pedigree with genomic relationships. We present a coherent theoretical framework to consider base population in pedigree relationships. We suggest a conceptual framework that considers each ancestral population as a finite-sized pool of gametes. This generates across-individual relationships and contrasts with the classical view which each population is considered as an infinite, unrelated pool. Several ancestral populations may be connected and therefore related. Each ancestral population can be represented as a “metafounder,” a pseudo-individual included as founder of the pedigree and similar to an “unknown parent group.” Metafounders have self- and across relationships according to a set of parameters, which measure ancestral relationships, i.e., homozygozities within populations and relationships across populations. These parameters can be estimated from existing pedigree and marker genotypes using maximum likelihood or a method based on summary statistics, for arbitrarily complex pedigrees. Equivalences of genetic variance and variance components between the classical and this new parameterization are shown. Segregation variance on crosses of populations is modeled. Efficient algorithms for computation of relationship matrices, their inverses, and inbreeding coefficients are presented. Use of metafounders leads to compatibility of genomic and pedigree relationship matrices and to simple computing algorithms. Examples and code are given. PMID:25873631

Let it go: Relationship autonomy predicts pro-relationship responses to partner transgressions.

PubMed

Hadden, Benjamin W; Baker, Zachary G; Knee, C Raymond

2017-11-24

The purpose of the present research is to better understand how relationship autonomy-having more self-determined reasons for being committed to a relationship-contributes to pro-relationship responses to transgressions in romantic relationships (e.g., forgiveness and accommodation). Study 1 employed a cross-sectional design (N = 350) and Study 2 used a weekly diary (N = 121) to test associations between relationship autonomy and pro-relationship responses to transgressions. Studies 3 and 4 utilized dyadic designs (Study 3: N = 200 couples, 400 individuals; Study 4: N = 275 couples, 550 individuals) to determine how both partners' relationship autonomy is associated with pro-relationship responses. Results revealed that relationship autonomy is robustly associated with pro-relationship responses to transgressions, both as general tendencies and as responses to idiosyncratic transgressions. Results of actor-partner interdependence model (APIM) analyses in Studies 3 and 4 provide evidence that one's partner's relationship autonomy is important for promoting pro-relationship responses as well. Study 4 also found that people perceive that partners respond better to transgressions if their partner is high in relationship autonomy. This research provides consistent and compelling evidence that the degree of self-determination underlying commitment is important for understanding how people respond to transgressions in their relationships, beyond their current levels of commitment. © 2017 Wiley Periodicals, Inc.

Ambulatory Care Data Base (ACDB) Data Dictionary Sequential Files of Phase 2.

DTIC Science & Technology

1992-04-01

CEREBRAL ARTERIES 4340 CEREBRAL THROMBOSIS 43491 STROKE , ISCHEMIC 435 TRANSIENT CEREBRAL ISCHEMIA 4359 TRANSIENT ISCHEMIC ATTACK (TIA) 43591 TRANS...HYPERTENSIVE CRISIS 4373 ANEURYSM, CEREBRAL , NONRUPTURED 4374 ARTERITIS, CEREBRAL 4378 CEREBROVASCULAR DISEASE, OTHER ILL-DEFINED 43781 STROKE , LACUNAR...95950 MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOC 95999 OTHER NEUROLOGICAL DIAGNOSTIC PROCEDURES 96500 CHEMO INJ, SINGLE, PRE-MIX, PUSH 96501

Angioplasty for Non-arteriosclerotic Renal Artery Stenosis: The Efficacy of Cutting Balloon Angioplasty Versus Conventional Angioplasty

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanaka, Ryoichi; Higashi, Masahiro; Naito, Hiroaki

2007-07-15

Purpose. We examined the efficacy of conventional balloon angioplasty and cutting balloon angioplasty (CBA) for the treatment of non-arteriosclerotic renal artery stenosis (RAS). Materials and Methods. From 1993 to 2005, 20 patients underwent 27 percutaneous transluminal renalangioplasty (PTRA) for non-arteriosclerotic RAS (men: 8, women: 12, 25.5 +/- 2 years old; 16 fibromuscular dysplasia (FMD), 4 Takayasu disease). We evaluated the efficacy of CBA by comparing the rate of initial technical success and surgical conversion. Results. Before the clinical authorization of CBA, three of twelve patients (25 %) underwent surgical bypass due to the failure of PTRA due to the hardnessmore » of the lesion. After the approval of cutting balloon, we performed CBA in four cases (2 FMD,2 Takayasu disease) to dilate hard lesions, within which a properly sized balloon could not dilate due to their hardness, or to reduce the risk of local dissection. Initial successes were obtained in all patients (8/8, 100%) and none of the patients underwent surgical conversion. Despite of the good initial result, restenosis was observed in three cases within 6 month (3/4, 75 %). Additional interventions were performed in all patients, then, the severity of the restenotic lesion was found not to be exceeded comparing with the initial lesion. Conclusion. The cutting balloon angioplasty may be safe and useful procedure for hard lesions of RAS caused by non-arteriosclerotic disease? especially fibromuscular dysplasia. The cutting balloon may provide the initial success, but the effect on long-term patency is still controversial.« less

Doctor-patient relationship

PubMed Central

Chamsi-Pasha, Hassan; Albar, Mohammed A.

2016-01-01

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor’s instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients. PMID:26837392

Romantic Relationship Development: The Interplay between Age and Relationship Length

ERIC Educational Resources Information Center

Lantagne, Ann; Furman, Wyndol

2017-01-01

The present study explored how romantic relationship qualities develop with age and relationship length. Eight waves of data on romantic relationships were collected over 10.5 years during adolescence and early adulthood from a community-based sample in a Western U.S. city (100 males, 100 females; M age Wave 1 = 15.83). Measures of support,…

Parenting in On/Off Relationships: The Link Between Relationship Churning and Father Involvement.

PubMed

Turney, Kristin; Halpern-Meekin, Sarah

2017-06-01

Family systems theory points to the interconnected nature of dyadic relationships within the family unit, arguing for attention to how the parental relationship shapes their ties to and interactions with their children. Grounded in family systems theory, we consider how relationship churning-defined as being in an on-again/off-again relationship with the same partner-is associated with father involvement. We use data from the Fragile Families and Child Wellbeing Study to examine how father involvement among relationship churners compares with father involvement among those in three other relationship types (measured during the first five years of the focal child's life): stably together relationships, stably broken-up relationships, and repartnered relationships. First, we find that churning fathers remain more involved with their 9-year-old children than do parents who stably break up or repartner, but they are less involved than those who are stably together. Second, lower relationship quality among churners-and, to a lesser extent, repartnering and childbearing with a new partner-explains some of the differences in father involvement between churners and the stably together. Third, these differences are most apparent among parents not living together when father involvement is measured. Taken together, the focus on relationship churning extends prior research on the association between relationship transitions and father involvement by separating relationship instability from partner change.

Relationship Churning, Physical Violence, and Verbal Abuse in Young Adult Relationships

ERIC Educational Resources Information Center

Halpern-Meekin, Sarah; Manning, Wendy D.; Giordano, Peggy C.; Longmore, Monica A.

2013-01-01

Young adults' romantic relationships are often unstable, commonly including breakup--reconcile patterns. From the developmental perspective of emerging adulthood exploration, such relationship "churning" is expected; however, minor conflicts are more common in churning relationships. Using data from the Toledo Adolescent Relationships…

Quantifying Emotional Intelligence in Relationships: The Validation of the Relationship Skills Map

ERIC Educational Resources Information Center

Cox, Judith Ellen

2010-01-01

Emotional intelligence in relationships can be developed and enhanced through the use of an assessment instrument within a mentoring or counseling relationship. The Relationship Skills Map (RSM) has been created for this purpose. This study concerns the validation of the Relationship Skills Map. Participants in this study included members of a…

Retinal vasculitis associated with Crohn's disease.

PubMed Central

Garcia-Diaz, M.; Mira, M.; Nevado, L.; Galván, A.; Berenguer, A.; Bureo, J. C.

1995-01-01

Although systemic vasculitis can be a complication of inflammatory bowel disease at several locations (skin, eyes, brain, mesentery, and lung) the association of retinal vasculitis with Crohn's disease is rare. We studied a 26-year-old woman with biopsy-demonstrated Crohn's disease who developed a severe bilateral retinal arteritis and phlebitis, with acute loss of vision. Images Figure 1 Figure 2 PMID:7746779

Ambulatory Care Data Base (ACDB) Data Dictionary Sequential Files of Phase 2.

DTIC Science & Technology

1992-04-01

ARTERIES 4340 CEREBRAL THROMBOSIS 43491 STROKE , ISCHEMIC 435 TRANSIENT CEREBRAL ISCHEMIA 4359 TRANSIENT ISCHEMIC ATTACK (TIA) 43591 TRANS ISCHEMIC ATTACK W...CRISIS 4373 ANEURYSM, CEREBRAL , NONRUPTURED 4374 ARTERITIS, CEREBRAL 4378 CEREBROVASCULAR DISEASE, OTHER ILL-DEFINED 43781 STROKE , LACUNAR 438 LATE...FOR LOCALIZATION OF CEREBRAL SEIZURE FOC 95999 OTHER NEUROLOGICAL DIAGNOSTIC PROCEDURES 96500 CHEMO INJ, SINGLE, PRE-MIX, PUSH 96501 CHEMO INJ, SINGLE

Better Classroom Relationships

ERIC Educational Resources Information Center

Kecskemeti, Maria; Winslade, John

2016-01-01

The usual approaches to classroom relationships are either teacher-centred or student-centred. This book breaks new ground in its exploration of relationship-centred classrooms. In relationship-centred classrooms, the teacher and the student are equally important. That shifts the focus to the quality of their interaction and whether it is…

Personality and Sibling Relationships.

ERIC Educational Resources Information Center

Furman, Wyndol; Lanthier, Richard P.

1996-01-01

This study examined the role personality variables play in sibling relationships. It proposed that the characteristics of sibling relationships are influenced by: family constellation variables such as birth order, gender, and age spacing; parent-child relationships including quality of relationship and parent management of siblings; and the…

Gender role attitudes, relationship efficacy, and self-disclosure in intimate relationships.

PubMed

Horne, Rebecca M; Johnson, Matthew D

2018-01-01

Drawing from the intimacy process model and data from 5,042 individuals who remained partnered across Waves 1 and 2 of the German Panel Analysis of Intimate Relationships and Family Dynamics (pairfam), this study examined the contributions of traditional gender role attitudes and relationship efficacy in predicting levels of self-disclosure within an intimate relationship. Independent samples t-tests demonstrated females scored higher than males on self-disclosure and relationship efficacy measures but lower on traditional gender role attitudes. An ordinary least squares regression analysis revealed relationship efficacy was a stronger predictor of self-disclosure compared to traditional gender role attitudes, which were not associated with self-disclosure. The findings suggest attitudes with an interpersonal motivational system may be especially important for setting the intimacy process into motion within an intimate union.

Relationship status and relationship instability, but not dominance, predict individual differences in baseline cortisol levels.

PubMed

Maestripieri, Dario; Klimczuk, Amanda C E; Seneczko, Marianne; Traficonte, Daniel M; Wilson, M Claire

2013-01-01

We investigated variation in baseline cortisol levels in relation to relationship status (single or in a relationship), relationship characteristics (length, stability, presence or absence of clear dominance), or individual attributes (dominant or subordinate status, relative physical attractiveness, relationship worries). Study participants were 77 men and 75 women aged between 18 and 38 years. Individuals in romantic relationships had lower cortisol levels than singles. Individuals of African ethnicity, however, showed the opposite pattern. Individuals who perceived their relationship to be highly unstable had higher cortisol levels. Aside from African-Americans, married individuals reported the lowest relationship instability and the lowest cortisol levels, followed by individuals in long-term relationships, and by individuals in short-term relationships. The presence or absence of clear dominance in the relationship, dominance status, or relationship worries did not affect cortisol levels. Therefore relationship status and relationship instability were better predictors of variation in cortisol (presumably through stress-related mechanisms) than individual attributes.

Adolescents' Perceptions of Relationships with Older Sibling in the Context of Other Close Relationships.

ERIC Educational Resources Information Center

Seginer, Rachel

1998-01-01

Examined 11th graders' perceived relationships with older sibling in the context of adolescent-parent and adolescent-peer relationships. Found that relationships with older siblings were similar to relationships with parents and peers. Positive sibling relationships contributed to emotional and school-related support beyond the contribution of…

Assessing Relationship and Sexual Satisfaction in Adolescent Relationships Formed Online and Offline.

PubMed

Blunt-Vinti, Heather D; Wheldon, Christopher; McFarlane, Mary; Brogan, Natalie; Walsh-Buhi, Eric R

2016-01-01

Using the Internet to meet new people is becoming more common; however, such behavior is often considered risky, particularly for adolescents. Nevertheless, adolescents are meeting people through online venues and some are forming romantic/sexual relationships. The purpose of this study was to examine the relationship and sexual satisfaction reported by teens in online- and offline-initiated relationships. Data were collected from 273 13-19 year olds visiting a publicly funded clinic through 2010 and 2011. Questions included where respondents met the partner (online vs. offline), time between meeting and first sex, how well they knew the partner, and relationship and sexual (R&S) satisfaction. Analyses consisted of descriptive statistics, t tests, and path analysis, exploring R&S satisfaction in online- and offline-initiated relationships. R&S satisfaction scores were moderate for adolescents who reported meeting partners online and in person but were statistically higher in offline-initiated relationships. There was an inverse relationship between having an online partner and both relationship and sexual satisfaction. Additionally, knowing partners for a longer period of time and feeling more knowledgeable about partners before having sex were statistically significantly related to higher R&S satisfaction. Teens in this study reported more satisfying relationships with partners met offline compared with online. Results suggest that encouraging teens to wait longer and to get to know their partner(s) better before engaging in sex may improve satisfaction with, and quality of, those relationships. These findings provide an important contribution to sexual health promotion among young people, with whom technology use is ubiquitous. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

Romantic relationships and mental health.

PubMed

Braithwaite, Scott; Holt-Lunstad, Julianne

2017-02-01

This paper reviews the research on relationships and mental health. Individuals who are more mentally healthy are more likely to select into relationships, but relationships are also demonstrably associated with mental health. The type of relationship matters - evidence suggests that more established, committed relationships, such as marriage, are associated with greater benefits than less committed unions such as cohabitation. The association between relationships and mental health is clearly bidirectional, however, stronger effects are observed when mental health is the outcome and relationships are the predictor, suggesting that the causal arrow flows more strongly from relationships to mental health than vice versa. Moreover, improving relationships improves mental health, but improving mental health does not reliably improve relationships. Our review of research corroborates the view that relationships are a keystone component of human functioning that have the potential to influence a broad array of mental health outcomes. Copyright © 2016. Published by Elsevier Ltd.

Relationships among Internet attitudes, Internet use, romantic beliefs, and perceptions of online romantic relationships.

PubMed

Anderson, Traci L

2005-12-01

The purpose of this study was to investigate factors relating to perceptions of online romantic relationships. One hundred seventy-seven people who had never been involved in an online romantic relationship completed a survey to assess relationships among perceptions of online romantic relationships and (a) amount of Internet use, (b) Internet affinity, (c) perceived realism of the Internet, and (d) romantic beliefs. Results reveal that amount of time spent online and affinity for the Internet are positively related to more favorable perceptions of online romantic relationships, whereas perceived realism and romantic beliefs were not related to perceptions of online romantic relationships. Romantic beliefs, therefore, may lend themselves to more conventional notions of relationships. Implications for and development and maintenance of online relationships, as impacted by social support networks, are discussed.

Investigation of Consensually Nonmonogamous Relationships.

PubMed

Conley, Terri; Matsick, Jessica; Moors, Amy Catherine; Ziegler, Ali

2017-03-01

We proposed that the premise that monogamy is the exemplary form of romantic partnership underlies much theory and research on relationship quality, and we addressed how this bias has prompted methodological issues that make it difficult to effectively address the quality of nonmonogamous relationships. Because the idea that consensually nonmonogamous (CNM) relationships are functional (i.e., satisfying and of high quality) is controversial, we included a basic study to assess, in a variety of ways, the quality of these relationships. In that study, we found few differences in relationship functioning between individuals engaged in monogamy and those in CNM relationships. We then considered how existing theories could help researchers to understand CNM relationships and how CNM relationships could shed light on relationship processes, and we proposed a model of how CNM and monogamous relationships differ. Finally, in a second study, we determined that even researchers who present data about CNM are affected by the stigma surrounding such relationships. That is, researchers presenting findings favoring polyamory were perceived as more biased than researchers presenting findings favoring monogamy.

Relationship Risks in Context: A Cumulative Risk Approach to Understanding Relationship Satisfaction

PubMed Central

Rauer, Amy J.; Karney, Benjamin R.; Garvan, Cynthia W.; Hou, Wei

2009-01-01

Risks associated with less satisfying intimate relationships often co-occur within individuals, raising questions about approaches that consider only their independent impact. Utilizing the cumulative risk model, which acknowledges the natural covariation of risk factors, this study examined individuals in intimate relationships using the Florida Family Formation Survey (n = 2,876) and a replication sample (n = 1,048). Analyses confirmed that not only was relationship satisfaction lower among those with more risks, but the cumulative risk score was predictive above and beyond the individual risk factors. Furthermore, experiencing multiple risks exacerbated the negative associations between individual risks and relationship satisfaction, suggesting that the operation of a risk factor in a relationship is moderated by the presence or absence of other risks. PMID:19587840

Preadolescents’ Relationships with Pet Dogs: Relationship Continuity and Associations with Adjustment

PubMed Central

Kerns, Kathryn A.; Koehn, Amanda J.; van Dulmen, Manfred H. M.; Stuart-Parrigon, Kaela L.; Coifman, Karin G.

2017-01-01

Research on human-animal interaction in children has been studied in isolation rather than integrated with core theories of children’s relationships. This study is one of the first to examine how children’s relationships with pet dogs are related to their human relationships (parent-child attachments, friendships) and to child adjustment, and to include observational assessment of children’s interactions with their pet dog. Children (9 to 11 years old, n = 99) completed questionnaires regarding relationships with pet dogs, parents, and friends. Half the children were observed interacting with their pet dog. Children and teachers reported children’s adjustment. Children who felt closer to their dogs were more securely attached to mothers and fathers, and reported more positive qualities and less conflict with friends. Children with more secure attachments to mothers, and greater companionship with dogs, interacted more with their dogs. Parental attachment and friendship quality, but not the pet dog relationship, were related to child adjustment. PMID:29422765

The Relationship Between the Customer Relationship Management and Patients' Loyalty to Hospitals.

PubMed

Hajikhani, Shadi; Tabibi, Seyed Jamaledin; Riahi, Leila

2015-06-25

Customer Relationship Management (CRM) with its various components has been considered as a tool causing customers' loyalty. The present study aims to investigate the relationship between the various components of customer relationship management and patients' loyalty to the place of their treatment. This cross sectional and descriptive-analytical study was conducted among nurses and hospitalized patients in inpatient wards in selected hospitals in 2014. Using the stratified random sampling method, 224 valid and reliable researcher-drafted questionnaires were completed for CRM by nurses and 359 questionnaires were completed by patients for patients' loyalty in the studied wards. Data were analyzed using the SPSS(20) software. There was no statistically significant relationship between the level of patients' loyalty and organizational indicators, information technology and knowledge management (P Value>0.05). However, there was a statistically significant relationship between loyalty and the dimensions of the service process (P Value=0.04), human resources (P Value=0.002) and CRM (P Value=0.038). The strength of these relationships were 34, 40 and 36 percent, respectively all of which were positive. Customer Relationship Management is a tool for improving influencing factors on patients' satisfaction and loyalty. Therefore, attempts to implement customer relationship management as a process for improving hospitals performance and improving communication between service providers in hospitals and customers leading to enhance patients' loyalty should be taken into account by managers and policy makers in the health sectors.

The Relationship Between the Customer Relationship Management and Patients’ Loyalty to Hospitals

PubMed Central

Hajikhani, Shadi; Tabibi, Seyed Jamaledin; Riahi, Leila

2016-01-01

Background and Aim: Customer Relationship Management (CRM) with its various components has been considered as a tool causing customers’ loyalty. The present study aims to investigate the relationship between the various components of customer relationship management and patients’ loyalty to the place of their treatment. Methods: This cross sectional and descriptive-analytical study was conducted among nurses and hospitalized patients in inpatient wards in selected hospitals in 2014. Using the stratified random sampling method, 224 valid and reliable researcher-drafted questionnaires were completed for CRM by nurses and 359 questionnaires were completed by patients for patients’ loyalty in the studied wards. Data were analyzed using the SPSS20 software. Results: There was no statistically significant relationship between the level of patients’ loyalty and organizational indicators, information technology and knowledge management (P Value>0.05). However, there was a statistically significant relationship between loyalty and the dimensions of the service process (P Value=0.04), human resources (P Value=0.002) and CRM (P Value=0.038). The strength of these relationships were 34, 40 and 36 percent, respectively all of which were positive. Conclusion: Customer Relationship Management is a tool for improving influencing factors on patients’ satisfaction and loyalty. Therefore, attempts to implement customer relationship management as a process for improving hospitals performance and improving communication between service providers in hospitals and customers leading to enhance patients’ loyalty should be taken into account by managers and policy makers in the health sectors. PMID:26493416

Parent-child relationships, partner relationships, and emotional adjustment: a birth-to-maturity prospective study.

PubMed

Overbeek, Geertjan; Stattin, Håkan; Vermulst, Ad; Ha, Thao; Engels, Rutger C M E

2007-03-01

This study examined whether detrimental childhood relationships with parents were related to partner relationship quality and emotional adjustment in adulthood. The authors tested a theoretical model in which (a) low-quality parent-child relationships were related to conflict and low-quality communication with parents in adolescence, (b) parent-adolescent conflict and low-quality communication were linked to low-quality partner relationships in young adulthood, and (c) low-quality partner relationships in young adulthood were predictive of low-quality partner relationships as well as depression, anxiety, and dissatisfaction with life at midlife. Multi-informant data were used from 212 Swedish individuals who were followed from birth into adulthood. Results demonstrated that, as hypothesized, negative parent-child bonds were indirectly related to low-quality partner relationships and dissatisfaction with life in adulthood (but not anxiety and depression) through conflictual parent-adolescent communication and low-quality partner relationships in young adulthood.

Relationships between body image, sexual satisfaction, and relationship quality in romantic couples.

PubMed

van den Brink, Femke; Vollmann, Manja; Smeets, Monique A M; Hessen, David J; Woertman, Liesbeth

2018-03-08

Previous studies found important associations between body image, sexual satisfaction, and perceived romantic relationship quality, but mainly focused on one individual's perceptions rather than both partners. To take the interdependency of romantic partners into account, the present study examined these associations in romantic couples with a dyadic approach. In a cross-sectional design, 151 Dutch heterosexual couples completed an online survey measuring body image, sexual satisfaction, and perceived relationship quality. Hypotheses were tested using the actor-partner interdependence model (APIM) and an APIM extended with a mediator (APIMeM), with couple members' body image as predictors, couple members' sexual satisfaction as mediators, and couple members' relationship quality as outcomes. Results indicated that within individuals, a more positive body image was linked to higher perceived romantic relationship quality through greater sexual satisfaction. No gender differences were found, implying that body image and sexual satisfaction are equally strongly associated with perceived relationship quality in women and men. Results revealed no associations of an individual's body image and sexual satisfaction with the partner's perceived relationship quality. These findings implicate that interventions focusing on developing and maintaining a positive body image may be helpful in building on a more satisfying sex life and higher perceived relationship quality. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sliding versus Deciding in Relationships: Associations with Relationship Quality, Commitment, and Infidelity

PubMed Central

Owen, Jesse; Rhoades, Galena K.; Stanley, Scott M.

2013-01-01

From choosing a partner to date to deciding to cohabit or marry, individuals are faced with many relationship choices. Given the costs of failed relationships (e.g., personal distress, problems with work, lower well-being for children, lost opportunities to meet other partners), it is important consider how individuals are approaching these decisions. The current study tested if more thoughtful and clear relationship decision-making processes would relate to individuals’ levels of satisfaction with and dedication to their partners as well as their extra-dyadic involvements. In a sample of 252 men and women, the results showed that regardless of relationship status (i.e., dating, cohabiting, or married), those who reported more thoughtful decision-making processes also reported more dedication to their partners, higher satisfaction with the relationship, and fewer extra-dyadic involvements. PMID:23690736

The relationship between egalitarianism, dominance, and violence in intimate relationships

PubMed Central

Karakurt, Gunnur; Cumbie, Tamra

2012-01-01

The aim of this study was to understand the relationship between egalitarianism, dominance, and intimate partner violence within the context of couples’ dynamics. In particular, it was hypothesized that dominance and sexist attitudes would have both self and partner effects on relationship aggression. To test this hypothesis, gender role egalitarianism, dominance/control, sexism, power dynamics, and aggression were assessed using several measures. Questionnaires for these measures were completed by 87 heterosexual dyads. The relationship between female and male scores on the dominance, egalitarianism, sexism, and intimate partner violence scales were examined using Actor-Partner Interdependence Model (APIM). Findings indicated that the APIM model provided a satisfactory fit to the data*. For both sexes, dominance had more explanatory power than sexism and egalitarianism when all else was controlled in the model. Furthermore, contrary to our expectation, male egalitarian attitude had no significant actor or partner effect on relationship aggression, while female egalitarian attitude had significant actor and partner effects on relationship aggression. Dyadic analysis indicated that cultural pointers of patriarchy, such as egalitarianism among young college students, were not associated with male-to-female violence. The sample size might also have an effect on this result in that a larger sample with older participants might yield different results. PMID:23123589

Balance Theory Revisited: Relationship Issue Relevance Affects Imbalance-Induced Tension in Workplace Relationships.

PubMed

Reid, Chelsea A; Davis, Jody L; Pollack, Jeffrey M; Coughlan, Richard S

2017-08-18

The present work applies and extends balance theory by examining the role of relevance of issue to the relationship in balance theory processes within the context of workplace relationships. In Experiment 1, a sample of working adults (N = 81) reported greater job tension when self-supervisor dissimilarity involved a relationship-relevant (vs. non-relationship) ethical dilemma. In Experiment 2, a sample of working students (N = 185) who perceived greater self-supervisor dissimilarity about workplace (vs. family) ethics reported greater job tension, and in turn, less job satisfaction and organizational commitment. Perceiving dissimilarity with a work supervisor in attitudes about relationship-relevant issues may negatively affect outcomes at work. Importantly, these experiments demonstrated that not all dissimilarity is likely to yield negative outcomes; only relationship-relevant (vs. non-relevant) dissimilarity was a catalyst for imbalance-induced tension.

Cancer-specific Relationship Awareness, Relationship Communication, and Intimacy Among Couples Coping with Early Stage Breast Cancer

PubMed Central

Manne, Sharon L.; Siegel, Scott; Kashy, Deborah; Heckman, Carolyn J.

2013-01-01

If couples can maintain normalcy and quality in their relationship during the cancer experience, they may experience greater relational intimacy. Cancer-specific relationship awareness, which is an attitude defined as partners focusing on the relationship and thinking about how they might maintain normalcy and cope with cancer as a couple or “team”, is one factor that may help couples achieve this goal. The main aim of this study was to evaluate the associations between cancer-specific relationship awareness, cancer-specific communication (i.e., talking about cancer’s impact on the relationship, disclosure, and responsiveness to partner disclosure), and relationship intimacy and evaluate whether relationship communication mediated the association between relationship awareness and intimacy. Two hundred fifty four women diagnosed with early stage breast cancer and their partners completed measures of cancer-specific relationship awareness, relationship talk, self-and perceived partner disclosure, perceived partner responsiveness, and relationship intimacy. Results indicated that patients and spouses who were higher in cancer-specific relationship awareness engaged in more relationship talk, reported higher levels of self-disclosure, and perceived that their partner disclosed more. Their partners reported that they were more responsive to disclosures. Relationship talk and perceived partner responsiveness mediated the association between cancer–specific relationship awareness and intimacy. Helping couples consider ways they can maintain normalcy and quality during the cancer experience and framing coping with cancer as a “team” effort may facilitate better communication and ultimately enhance relationship intimacy. PMID:25242854

Intimate Relationships and Psychopathology

ERIC Educational Resources Information Center

Whisman, Mark A.; Baucom, Donald H.

2012-01-01

Relationship functioning and individual mental health and well-being are strongly associated with one another. In this article, we first review the cross-sectional and longitudinal associations between relationship discord and various types of psychopathology, We then review findings suggesting that relationship discord is associated with poorer…

Can you tell that I'm in a relationship? Attachment and relationship visibility on Facebook.

PubMed

Emery, Lydia F; Muise, Amy; Dix, Emily L; Le, Benjamin

2014-11-01

People often attempt to shape others' perceptions of them, but the role of romantic relationships in this process is unknown. The present set of studies investigates relationship visibility, the centrality of relationships in the self-images that people convey to others. We propose that attachment underlies relationship visibility and test this hypothesis across three studies in the context of Facebook. Avoidant individuals showed low desire for relationship visibility, whereas anxious individuals reported high desired visibility (Studies 1 and 2); however, similar motives drove both groups' actual relationship visibility (Study 1). Moreover, both avoidant individuals and their partners were less likely to make their relationships visible (Studies 1 and 3). On a daily basis, when people felt more insecure about their partner's feelings, they tended to make their relationships visible (Study 3). These studies highlight the role of relationships in how people portray themselves to others. © 2014 by the Society for Personality and Social Psychology, Inc.

Dual Relationships in Counseling.

ERIC Educational Resources Information Center

Herlihy, Barbara; Corey, Gerald

Issues involving dual relationships in counseling are discussed in this monograph. Dual relationships occur when counselors have another, significantly different, relationship with one of their clients, students, or supervisees. This monograph is intended to be a resource that reflects the current thinking of the counseling profession and that…

Relationship management strategies for daughters in conflicted relationships with their ageing mothers.

PubMed

Pickering, Carolyn E Z; Moon, Ailee; Pieters, Huibrie C; Mentes, Janet C; Phillips, Linda R

2015-03-01

To study relationship management strategies of daughters in conflicted relationships with their mothers and how they promoted or prevented elder abuse. Daughters have enduring, unique relationships with their mothers that often carry over into caregiving. Pre-caregiving relationship quality is related to many caregiving outcomes, although it is unclear how. Qualitative study. Grounded theory design, informed by feminism, with telephone interviews conducted between January 2013-July 2013. The sample (N = 13) was recruited through an online recruitment strategy, with advertisements posted on relevant websites asking 'Are you in an abusive relationship with your ageing mother?' Daughters used coping strategies and self-protective strategies aimed at decreasing their exposure to aggression and emotional distress when interacting with their ageing mothers. Daughters also used spiteful aggression out of the desire for revenge. Although the daughters' strategies served their personal needs, they jeopardized the mothers' needs by creating an environment where neglect could occur. Daughters also readily and intentionally used aggression against their mothers. These were strategies daughters have found useful. These strategies may be potential areas for designing interventions to promote healthy family relationships and decrease the occurrence of elder abuse and neglect. © 2014 John Wiley & Sons Ltd.

The operation was a success, but the patient cannot see.

PubMed

Semmer, Anne E; Lee, Michael S; Taban, Mehran; Smith, Scott; Kosmorsky, Gregory

2009-01-01

A 71-year-old African American woman presented with severe vision loss in her left eye one day following trabeculectomy with mitomycin C and retrobulbar anesthesia. She had a new left relative afferent pupillary defect and macular whitening. The optic disc appeared normal. Intraocular pressure and fluorescein angiography were normal. Westergren erythrocyte sedimentation rate and C-reactive protein were elevated. Temporal artery biopsy was positive for giant cell arteritis.

Relationship Power in the Context of Heterosexual Intimate Relationships: A Conceptual Development.

PubMed

Halstead, Valerie; De Santis, Joseph; Williams, Jessica

2016-01-01

Various theoretical frameworks have been utilized while examining the concept of relationship power. In addition, the conceptual definition and operational use are inconsistent throughout literature. A concept analysis was conducted on the basis of the guidelines provided by Walker and Avant. The proposed definition of relationship power is the relative, perceived, and actual ability to influence a relationship partner. Antecedents, attributes, and consequences are presented. Because of the various adverse outcomes related to relationship power (eg, intimate partner violence, depression), an understanding of this concept is essential. Furthermore, a clear understanding is needed to advance nursing knowledge, leading to future research and theory development.

Relationships among Young Adults' Marital Messages Received, Marital Attitudes, and Relationship Self-Efficacy

ERIC Educational Resources Information Center

Shurts, W. Matthew; Myers, Jane E.

2012-01-01

The authors examined relationships among university students' marital messages received (MMR), marital attitudes, and romantic relationship self-efficacy (RSE). Results indicated that students' marital attitudes and romantic relationship status predicted their level of RSE. The authors found differences in MMR, marital attitudes, and RSE on the…

Control pole placement relationships

NASA Technical Reports Server (NTRS)

Ainsworth, O. R.

1982-01-01

Using a simplified Large Space Structure (LSS) model, a technique was developed which gives algebraic relationships for the unconstrained poles. The relationships, which were obtained by this technique, are functions of the structural characteristics and the control gains. Extremely interesting relationships evolve for the case when the structural damping is zero. If the damping is zero, the constrained poles are uncoupled from the structural mode shapes. These relationships, which are derived for structural damping and without structural damping, provide new insight into the migration of the unconstrained poles for the CFPPS.

Are narcissists more attracted to people in relationships than to people not in relationships?

PubMed Central

Okdie, Bradley M.

2018-01-01

Does grandiose narcissism predict greater attraction for others in relationships? We examined this question by replicating previous work implicating grandiose narcissists as mate poachers (Studies 1 and 2). We then used an experimental paradigm (Studies 3 and 4) to assess the extent to which grandiose narcissists indicate a greater interest in someone who is already in a relationship compared to someone who is single. Results suggest that although grandiose narcissism related to reports of more frequent mate poaching attempts, grandiose narcissists did not appear to be more interested in taking someone away from an existing relationship. Instead, participants took their own relationship status into consideration (rather than the relationship status of a target) when evaluating their interest in a target for a short-term fling or a long-term relationship. Thus, although grandiose narcissists report more frequent mate poaching attempts, they do not appear to be more interested in people in relationships compared to those who are single. PMID:29584747

Are narcissists more attracted to people in relationships than to people not in relationships?

PubMed

Brunell, Amy B; Robison, Joshua; Deems, Nicholas P; Okdie, Bradley M

2018-01-01

Does grandiose narcissism predict greater attraction for others in relationships? We examined this question by replicating previous work implicating grandiose narcissists as mate poachers (Studies 1 and 2). We then used an experimental paradigm (Studies 3 and 4) to assess the extent to which grandiose narcissists indicate a greater interest in someone who is already in a relationship compared to someone who is single. Results suggest that although grandiose narcissism related to reports of more frequent mate poaching attempts, grandiose narcissists did not appear to be more interested in taking someone away from an existing relationship. Instead, participants took their own relationship status into consideration (rather than the relationship status of a target) when evaluating their interest in a target for a short-term fling or a long-term relationship. Thus, although grandiose narcissists report more frequent mate poaching attempts, they do not appear to be more interested in people in relationships compared to those who are single.

Romantic Relationships and Relationship Satisfaction Among Adults With Asperger Syndrome and High-Functioning Autism.

PubMed

Strunz, Sandra; Schermuck, Constanze; Ballerstein, Sarah; Ahlers, Christoph J; Dziobek, Isabel; Roepke, Stefan

2017-01-01

Individuals with autism spectrum disorder (ASD) often experience difficulties in maintaining romantic relationships. In this study high-functioning adults with ASD were examined concerning their romantic relationship interest and experience. Participants, 31 recruited via an outpatient clinic and 198 via an online survey, were asked to answer a number of self-report questionnaires. The total sample comprised 229 high-functioning adults with ASD (40% males, average age: 35 years). Of the total sample, 73% indicated romantic relationship experience and only 7% had no desire to be in a romantic relationship. ASD individuals whose partner was also on the autism spectrum were significantly more satisfied with their relationship than those with neurotypical partners. Severity of autism, schizoid symptoms, empathy skills, and need for social support were not correlated with relationship status. Our findings indicate that the vast majority of high-functioning adults with ASD are interested in romantic relationships. © 2016 Wiley Periodicals, Inc.

Relationship Quality Time: The Validation of a Relationship Quality Scale in Higher Education

ERIC Educational Resources Information Center

Snijders, Ingrid; Rikers, Remy M. J. P.; Wijnia, Lisette; Loyens, Sofie M. M.

2018-01-01

This study investigated the overall "quality" of the interpersonal relationship students have with faculty and staff, that is, relationship quality (RQ). In relationship management research, RQ is paramount for the creation of bonds with customers, which in turn is necessary for the sustainability of organizations, that is, continuity…

Synergistic relationships among stress, depression, and troubled relationships: insights from psychoneuroimmunology.

PubMed

Jaremka, Lisa M; Lindgren, Monica E; Kiecolt-Glaser, Janice K

2013-04-01

Stress and depression consistently elevate inflammation and are often experienced simultaneously, which is exemplified by people in troubled relationships. Troubled relationships also elevate inflammation, which may be partially explained by their ability to engender high levels of stress and depression. People who are stressed, depressed, or in troubled relationships are also at greater risk for health problems than their less distressed counterparts. Inflammation, a risk factor for a variety of age-related diseases including cardiovascular disease, Type II diabetes, metabolic syndrome, and frailty, may be one key mechanistic pathway linking distress to poor health. Obesity may further broaden the health implications of stress and depression; people who are stressed or depressed are often overweight, and adipose tissue is a major source of proinflammatory cytokines. Stress, depression, and troubled relationships may have synergistic inflammatory effects: loneliness, subclinical depression, and major depression enhance inflammatory responses to an acute stressful event. The relationship between distress and inflammation is bidirectional; depression enhances inflammation and inflammation promotes depression. Interesting questions emerge from this literature. For instance, some stressors may be more potent than others and thus may be more strongly linked to inflammation. In addition, it is possible that psychological and interpersonal resources may buffer the negative inflammatory effects of stress. Understanding the links among stress, depression, troubled relationships, and inflammation is an exciting area of research that may provide mechanistic insight into the links between distress and poor health. © 2013 Wiley Periodicals, Inc.

Building Relationships through Exchange

ERIC Educational Resources Information Center

Primavera, Angi; Hall, Ellen

2011-01-01

From the moment of birth, children form and develop relationships with others in their world based on exchange. Children recognize that engaging in such encounters offers them the opportunity to enter into a relationship with another individual and to nurture that relationship through the exchange of messages and gifts, items and ideas. At Boulder…

Relationship history and relationship attitudes in gay males and lesbians: attachment style and gender differences.

PubMed

Ridge, S R; Feeney, J A

1998-12-01

The objective of the present study was to assess the applicability of attachment theory to the relationships of gay males and lesbians, with particular emphasis on parental relationships, relationship satisfaction, sexual attitudes and 'coming out' as being homosexual. Gay males (n = 77) and lesbians (n = 100) completed questionnaires assessing attachment style, working models of attachment, early relationships with parents and relationship history, status and functioning. A comparison sample of heterosexual participants completed measures of attachment style and relationship history. Relative frequencies of attachment styles were similar for homosexual and heterosexual samples. Contrary to previous research using largely heterosexual respondents, no link between early parenting and attachment style was found. However, homosexual males reported more positive early relationships with mothers than did females. Associations of attachment style with working models, relationship variables and sexual attitudes largely supported those based on heterosexual samples. Gender and attachment style differences were found in reported effects of 'coming out' on relationships with parents. Overall, the results suggest that insecure attachment may not be over-represented in gay and lesbian samples, but that insecurity is associated with less relationship satisfaction and with problems related to the disclosure of sexual orientation. The implications of these findings for research and clinical practice are addressed.

Two personalities, one relationship: both partners' personality traits shape the quality of their relationship.

PubMed

Robins, R W; Caspi, A; Moffitt, T E

2000-08-01

This research tested 6 models of the independent and interactive effects of stable personality traits on each partner's reports of relationship satisfaction and quality. Both members of 360 couples (N = 720) completed the Multidimensional Personality Questionnaire and were interviewed about their relationship. Findings show that a woman's relationship happiness is predicted by her partner's low Negative Emotionality, high Positive Emotionality, and high Constraint, whereas a man's relationship happiness is predicted only by his partner's low Negative Emotionality. Findings also show evidence of additive but not interactive effects: Each partner's personality contributed independently to relationship outcomes but not in a synergistic way. These results are discussed in relation to models that seek to integrate research on individual differences in personality traits with research on interpersonal processes in intimate relationships.

Family Relationships and Well-Being

PubMed Central

Thomas, Patricia A; Liu, Hui; Umberson, Debra

2017-01-01

Abstract Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses. PMID:29795792

Reciprocal Relationships: Something for Everyone.

PubMed

Tumosa, Nina

2017-01-01

Reciprocal relationships based on mutual goals, respect and trust are key to maintaining working relationships and getting reliable research results. Yet relationship building is not a concept taught in academia. These skills are often learned the hard way, with singular solutions found for case-by-case scenarios. Several journeys to identify the components, barriers and rewards of reciprocal relationships are discussed.

Theoretical Perspectives on Sibling Relationships

PubMed Central

Whiteman, Shawn D.; McHale, Susan M.; Soli, Anna

2011-01-01

Although siblings are a fixture of family life, research on sibling relationships lags behind that on other family relationships. To stimulate interest in sibling research and to serve as a guide for future investigations by family scholars, we review four theoretical psychologically oriented perspectives—(a) psychoanalytic-evolutionary, (b) social psychological, (c) social learning, and (d) family-ecological systems—that can inform research on sibling relationships, including perspectives on the nature and influences on developmental, individual, and group differences in sibling relationships. Given that most research on siblings has focused on childhood and adolescence, our review highlights these developmental periods, but we also incorporate the limited research on adult sibling relationships, including in formulating suggestions for future research on this fundamental family relationship. PMID:21731581

Coworkers' Perspectives on Mentoring Relationships.

PubMed

Janssen, Suzanne; Tahitu, Joël; van Vuuren, Mark; de Jong, Menno D T

2018-04-01

Research into workplace mentoring is primarily focused on the experiences and perceptions of individuals involved in the relationship, while there is scarcely any research focusing on the impact of mentoring relationships on their social environment. This exploratory research aims to give insight into how coworkers' perceptions and experiences of informal mentoring relationships in their workgroup are related to their perceptions of workgroup functioning. The results of 21 semistructured interviews show that coworkers believe that mentoring relationships affect their workgroup's functioning by influencing both their workgroup's performance and climate . Coworkers applied an instrumental perspective and described how they think that mentoring relationships both improve and hinder their workgroup's performance as they influence the individual functioning of mentor and protégé, the workgroup's efficiency, and organizational outcomes. Furthermore, coworkers applied a relational perspective and described how mentoring relationships may influence their workgroup's climate in primarily negative ways as they may be perceived as a subgroup, cause feelings of distrust and envy, and are associated with power issues. The results of this study emphasize the importance of studying mentoring relationships in their broader organizational context and set the groundwork for future research on mentoring relationships in workgroups.

Posttraumatic Stress Disorder Symptoms, Relationship Adjustment, and Relationship Aggression in a Sample of Female Flood Victims

PubMed Central

Monson, Candice M.; Schumm, Jeremiah A.; Watkins, Laura E.; Panuzio, Jillian; Resick, Patricia A.

2010-01-01

This study tested a model examining the interrelationships among posttraumatic stress disorder (PTSD) symptoms, intimate relationship adjustment, and intimate relationship aggression in a sample of 205 adult female flood victims. At the bivariate level, higher PTSD symptoms were associated with higher physical and psychological aggression victimization, poorer relationship adjustment, and higher physical and psychological aggression perpetration. Results from structural equation modeling (SEM) analyses indicated that relationship aggression victimization influenced aggression perpetration directly, and in the case of physical aggression, indirectly through its relationship with PTSD symptoms and relationship adjustment. The influence of PTSD symptoms on physical aggression perpetration was fully explained by poorer relationship adjustment. These findings extend prior work from other traumatized populations documenting associations between variables reflecting PTSD symptomatology and indices of relationship functioning, and indicate a need for further investigation in this area of inquiry. PMID:21057584

Sanctification and spiritual disclosure in parent-child relationships: implications for family relationship quality.

PubMed

Brelsford, Gina M

2013-08-01

Social scientific research on family life, religion, and spirituality tends to focus on global religiousness and spirituality with few studies seeking to understand interpersonal religious and spiritual contributors, namely sanctification and spiritual disclosure, from multiple family members' perspectives. This study explored 91 mother-college student and 64 father-college student dyads who rated their use of spiritual disclosure and theistic and nontheistic sanctification of the parent-child dyad in relation to parent-child relationship quality (e.g., parent-child relationship satisfaction and open communication). Results indicate significant positive links between higher levels of spiritual disclosure and greater theistic and nontheistic sanctification, for mothers, fathers, and their children. However, only greater nontheistic sanctification and higher levels spiritual disclosure were significantly related to increased parent-child relationship quality. Through use of Actor-Partner Interdependence Models (APIMs) results indicated unique contributions of spiritual disclosure to parent-child relationship quality above nontheistic sanctification for open communication in the family. However, full models, which included nontheistic sanctification and spiritual disclosure, predict college students' relationship satisfaction with their mothers and fathers. Implications for interpersonal religiousness and spirituality as contributors to familial relationship quality in research and practice are discussed. © 2013 American Psychological Association

Parental relationships in fragile families.

PubMed

McLanahan, Sara; Beck, Audrey N

2010-01-01

As nonmarital childbearing escalated in the United States over the past half century, fragile families--defined as unmarried couples with children--drew increased interest from researchers and policy makers. Sara McLanahan and Audrey Beck discuss four aspects of parental relationships in these families: the quality of parents' intimate relationship, the stability of that relationship, the quality of the co-parenting relationship among parents who live apart, and nonresident fathers' involvement with their child. At the time of their child's birth, half of the parents in fragile families are living together and another third are living apart but romantically involved. Despite high hopes at birth, five years later only a third of parents are still together, and new partners and new children are common, leading to high levels of instability and complexity in these families. Drawing on findings from the Fragile Families and Child Wellbeing Study, McLanahan and Beck highlight a number of predictors of low relationship quality and stability in these families, including low economic resources, government policies that discourage marriage, gender distrust and acceptance of single motherhood, sex ratios that favor men, children from previous unions, and psychological factors that make it difficult for parents to maintain healthy relationships. No single factor appears to have a dominant effect. The authors next discuss two types of experiments that attempt to establish causal effects on parental relationships: those aimed at altering economic resources and those aimed at improving relationships. What can be done to strengthen parental relationships in fragile families? The authors note that although economic resources are a consistent predictor of stable relationships, researchers and policy makers lack good causal information on whether increasing fathers' employment and earnings will increase relationship quality and union stability. They also note that analysts need to

Parental Relationships in Fragile Families

PubMed Central

McLanahan, Sara; Beck, Audrey N.

2011-01-01

Summary As nonmarital childbearing escalated in the United States over the past half century, fragile families—defined as unmarried couples with children—drew increased interest from researchers and policy makers. Sara McLanahan and Audrey Beck discuss four aspects of parental relationships in these families: the quality of parents’ intimate relationship, the stability of that relationship, the quality of the co-parenting relationship among parents who live apart, and nonresident fathers’ involvement with their child. At the time of their child’s birth, half of the parents in fragile families are living together and another third are living apart but romantically involved. Despite high hopes at birth, five years later only a third of parents are still together, and new partners and new children are common, leading to high levels of instability and complexity in these families. Drawing on findings from the Fragile Families and Child Wellbeing Study, McLanahan and Beck highlight a number of predictors of low relationship quality and stability in these families, including low economic resources, government policies that discourage marriage, gender distrust and acceptance of single motherhood, sex ratios that favor men, children from previous unions, and psychological factors that make it difficult for parents to maintain healthy relationships. No single factor appears to have a dominant effect. The authors next discuss two types of experiments that attempt to establish causal effects on parental relationships: those aimed at altering economic resources and those aimed at improving relationships. What can be done to strengthen parental relationships in fragile families? The authors note that although economic resources are a consistent predictor of stable relationships, researchers and policy makers lack good causal information on whether increasing fathers’ employment and earnings will increase relationship quality and union stability. They also note that

When the Relationship becomes Her: Revisiting Women's Body Concerns from a Relationship Contingency Perspective

ERIC Educational Resources Information Center

Sanchez, Diana T.; Kwang, Tracy

2007-01-01

Given women's communally oriented socialization and social pressures to find romantic partners, many heterosexual women may derive self-worth from having romantic relationships (relationship contingency). Across two studies, we explored whether relationship contingency heightens women's body shame. Studies 1A and 1B found that relationship…

University Students Leaving Relationships (USLR): Scale Development and Gender Differences in Decisions to Leave Romantic Relationships

ERIC Educational Resources Information Center

Hendy, Helen M.; Can, S. Hakan; Joseph, Lauren J.; Scherer, Cory R.

2013-01-01

The University Students Leaving Relationships scale was developed to identify student concerns when contemplating dissolution of romantic relationships. Participants included 1,106 students who rated the importance of issues when deciding to leave relationships. Factor analysis produced three dimensions: Missing the Relationship, Social…

Leveraging a Relationship with Biology to Expand a Relationship with Physics

ERIC Educational Resources Information Center

Sawtelle, Vashti; Turpen, Chandra

2016-01-01

This work examines how experiences in one disciplinary domain (biology) can impact the relationship a student builds with another domain (physics). We present a model for disciplinary relationships using the constructs of identity, affect, and epistemology. With these constructs we examine an ethnographic case study of a student who experienced a…

Relationships between Organizations and Publics: Development of a Multi-Dimensional Organization-Public Relationship Scale.

ERIC Educational Resources Information Center

Bruning, Stephen D.; Ledingham, John A.

1999-01-01

Attempts to design a multiple-item, multiple-dimension organization/public relationship scale. Finds that organizations and key publics have three types of relationships: professional, personal, and community. Provides an instrument that can be used to measure the influence that perceptions of the organization/public relationship have on consumer…

Relationships of Self-Regard and Affective Self-Disclosure to Relationship Satisfaction in College Students.

ERIC Educational Resources Information Center

Vera, Elizabeth M.; Betz, Nancy E.

The development and maintenance of romantic relationships in college students has been an increasingly frequent focus of attention among researchers interested in college student development. This study examined the role of gender in the relationships of emotional self-disclosure, self-esteem, and relationship satisfaction. Using a sample of…

Minding the close relationship.

PubMed

Harvey, J H; Omarzu, J

1997-01-01

In this theoretical analysis, we argue that a process referred to as minding is essential for a couple to feel mutually close and satisfied in a close relationship over a long period Minding represents a package of mutual self-disclosure, other forms of goal-oriented behavior aimed at facilitating the relationship, and attributions about self's and other's motivations, intentions, and Mort in the relationship. Self-disclosure and attribution activities in minding are aimed at getting to know the other, trying to understand the other's motivations and deeper disposition as they pertain to the relationship, and showing respect and acceptance for knowledge gained about other. We link the concept of minding to other major ideas and literatures about how couples achieve closeness: self-disclosure and social penetration, intimacy, empathy and empathic accuracy, and love and self-expansion. We argue that the minding process articulated here has not previously been delineated and that it is a useful composite notion about essential steps in bonding among humans. We also argue that the minding concept stretches our understanding of the interface of attribution and close relationships. We present research possibilities and implications and consider possible alternative positions and counter arguments about the merits of the minding idea for close relationship satisfaction.

Computer-Mediated Communication in Intimate Relationships: Associations of Boundary Crossing, Intrusion, Relationship Satisfaction, and Partner Responsiveness.

PubMed

Norton, Aaron M; Baptist, Joyce; Hogan, Bernie

2018-01-01

This study examined the impact of technology on couples in committed relationships through the lens of the couple and technology framework. Specifically, we used data from 6,756 European couples to examine associations between online boundary crossing, online intrusion, relationship satisfaction, and partner responsiveness. The results suggest that participants' reports of online boundary crossing were linked with lower relationship satisfaction and partner responsiveness. Also, lower relationship satisfaction and partner responsiveness were associated with increased online boundary crossing. The results suggest that men, but not women, who reported greater acceptability for online boundary crossing were more likely to have partners who reported lower relationship satisfaction in their relationships. Implications for clinicians, relationship educators, and researchers are discussed. © 2017 American Association for Marriage and Family Therapy.

Relationship Building Blocks

ERIC Educational Resources Information Center

Santabarbara, Todd; Erbe, Ryan; Cooper, Scott

2009-01-01

Intimate or romantic relationships for young people today play an integral role in their health and quality of life. Between the ages of 11 and 13 students become more interested in the opposite sex and as a result they begin to develop more intimate relationships. Around this age students are learning to deal with these feelings of attraction and…

Coworkers’ Perspectives on Mentoring Relationships

PubMed Central

Janssen, Suzanne; Tahitu, Joël; van Vuuren, Mark; de Jong, Menno D. T.

2016-01-01

Research into workplace mentoring is primarily focused on the experiences and perceptions of individuals involved in the relationship, while there is scarcely any research focusing on the impact of mentoring relationships on their social environment. This exploratory research aims to give insight into how coworkers’ perceptions and experiences of informal mentoring relationships in their workgroup are related to their perceptions of workgroup functioning. The results of 21 semistructured interviews show that coworkers believe that mentoring relationships affect their workgroup’s functioning by influencing both their workgroup’s performance and climate. Coworkers applied an instrumental perspective and described how they think that mentoring relationships both improve and hinder their workgroup’s performance as they influence the individual functioning of mentor and protégé, the workgroup’s efficiency, and organizational outcomes. Furthermore, coworkers applied a relational perspective and described how mentoring relationships may influence their workgroup’s climate in primarily negative ways as they may be perceived as a subgroup, cause feelings of distrust and envy, and are associated with power issues. The results of this study emphasize the importance of studying mentoring relationships in their broader organizational context and set the groundwork for future research on mentoring relationships in workgroups. PMID:29568215

Doctor-patient relationship. Islamic perspective.

PubMed

Chamsi-Pasha, Hassan; Albar, Mohammed A

2016-02-01

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor's instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.

Development of Humane Interpersonal Relationships

ERIC Educational Resources Information Center

Kleptsova, Elena Yuryevna; Balabanov, Anton Anatolyevich

2016-01-01

The article reflects some theoretical aspects of humanization of interpersonal relationships in the sphere of education. The notion "humanization of interpersonal relationships" is being analyzed. The authors offer a characterization of some parameters of relationships: orientation, modality, valence, intensity, awareness,…

The Effects of a Premarital Relationship Enrichment Program on Relationship Satisfaction

ERIC Educational Resources Information Center

Yilmaz, Tugba; Kalkan, Melek

2010-01-01

The aim of this study is to investigate the effects of a premarital relationship enrichment program on relationship satisfaction among couples. The experimental and control groups were totally composed of 20 individuals. In order to test whether there are any significant differences between the scores of pre-test and post-test within the control…

Organizational Dimensions of Relationship-centered Care

PubMed Central

Safran, Dana Gelb; Miller, William; Beckman, Howard

2006-01-01

Four domains of relationship have been highlighted as the cornerstones of relationship-centered health care. Of these, clinician-patient relationships have been most thoroughly studied, with a rich empirical literature illuminating significant linkages between clinician-patient relationship quality and a wide range of outcomes. This paper explores the realm of clinician-colleague relationships, which we define to include the full array of relationships among clinicians, staff, and administrators in health care organizations. Building on a stream of relevant theories and empirical literature that have emerged over the past decade, we synthesize available evidence on the role of organizational culture and relationships in shaping outcomes, and posit a model of relationship-centered organizations. We conclude that turning attention to relationship-centered theory and practice in health care holds promise for advancing care to a new level, with breakthroughs in quality of care, quality of life for those who provide it, and organizational performance. PMID:16405711

The Physician-Patient Relationship

PubMed Central

Ennis, Jeffrey H.

1990-01-01

The physician-patient relationship, like any human relationship, blends two types of interactions described by philosopher Martin Buber. In an “I-It” interaction, the physician objectifies the patient and his or her problem; in an “I-Thou” interaction, the physician perceives the patient as an emotional being. My encounters with medical practitioners as a patient with brachial neuritis and Guillain-Barré syndrome illustrate these forms of the physician-patient relationship. Imagesp2216-a PMID:11651130

Relationship quality and relationship context as antecedents of person- and task-focused interpersonal citizenship behavior.

PubMed

Settoon, Randall P; Mossholder, Kevin W

2002-04-01

A model hypothesizing relationship quality and relationship context as antecedents of two complementary forms of interpersonal citizenship behavior (ICB) was tested. Measures with coworkers as the frame of reference were used to collect data from 273 individuals working in 2 service-oriented organizations. As hypothesized, variables reflecting relationship quality were associated with person-focused ICB, as mediated by empathic concern. Also as hypothesized, a relationship context variable, network centrality, exhibited a direct relationship with task-focused ICB. Unexpectedly, network centrality was directly associated with person-focused ICB. and empathic concern was associated with task-focused ICB. The results are discussed, and implications for research and practice are offered.

Positioning the booty-call relationship on the spectrum of relationships: sexual but more emotional than one-night stands.

PubMed

Jonason, Peter K; Li, Norman P; Richardson, Jessica

2011-09-01

Most research on human sexuality has focused on long-term pairbonds and one-night stands. However, growing evidence suggests there are relationships that do not fit cleanly into either of those categories. One of these relationships is a "booty-call relationship." The purpose of this study was to describe the sexual and emotional nature of booty-call relationships by (a) examining the types of emotional and sexual acts involved in booty-call relationships and (b) comparing the frequency of those acts in booty-call relationships to one-night stands and serious long-term relationships. In addition, the manner in which sociosexuality is associated with the commission of these acts was also examined. Demonstrative of booty-call relationships' sexual nature was individuals' tendency to leave after sex and infrequent handholding. In contrast, the romantic nature of booty-call relationships was demonstrated through the frequency of acts like kissing. The results suggest the booty-call relationship is a distinct type of relationship situated between one-night stands and serious romantic relationships.

Concept relationship editor: a visual interface to support the assertion of synonymy relationships between taxonomic classifications

NASA Astrophysics Data System (ADS)

Craig, Paul; Kennedy, Jessie

2008-01-01

An increasingly common approach being taken by taxonomists to define the relationships between taxa in alternative hierarchical classifications is to use a set-based notation which states relationship between two taxa from alternative classifications. Textual recording of these relationships is cumbersome and difficult for taxonomists to manage. While text based GUI tools are beginning to appear which ease the process, these have several limitations. Interactive visual tools offer greater potential to allow taxonomists to explore the taxa in these hierarchies and specify such relationships. This paper describes the Concept Relationship Editor, an interactive visualisation tool designed to support the assertion of relationships between taxonomic classifications. The tool operates using an interactive space-filling adjacency layout which allows users to expand multiple lists of taxa with common parents so they can explore and assert relationships between two classifications.

Longitudinal transmission of conflict resolution styles from marital relationships to adolescent-parent relationships.

PubMed

Van Doorn, Muriel D; Branje, Susan J T; Meeus, Wim H J

2007-09-01

This study longitudinally investigated transmission: Can the way adolescents resolve conflicts with their parents be explained by the way parents resolve conflicts with each other? Questionnaires about conflict resolution styles were completed by 282 young adolescents (mean age = 13.2) and their parents. Path analyses with cross-lagged effects indicated that transmission of conflict resolution styles from marital relationships to adolescent-parent relationships occurs: Conflict engagement and positive problem solving in marital relationships were significantly related to, respectively, conflict engagement and positive problem solving in adolescent-parent relationships 2 years later. No significant longitudinal effects emerged with regard to withdrawal. Thus, the study shows that the way marital conflicts are handled affects how adolescents deal with conflicts. PsycINFO Database Record (c) 2007 APA, all rights reserved

Emotional Dependency and Dysfunctional Relationship Beliefs as Predictors of Married Turkish Individuals' Relationship Satisfaction.

PubMed

Kemer, Gülşah; Çetinkaya Yıldız, Evrim; Bulgan, Gökçe

2016-11-02

In this study, we examined married individuals' relationship satisfaction in relation to their emotional dependency and dysfunctional relationship beliefs. Our participants consisted of 203 female and 181 male, a total of 384 married individuals from urban cities of Turkey. Controlling the effects of gender and length of marriage, we performed a hierarchical regression analysis. Results revealed that married Turkish individuals' relationship satisfaction was significantly explained by their emotional dependency (sr 2 = .300, p < .001), and perceptions of interpersonal rejection (sr 2 = .075, p < .001) and unrealistic relationship expectations (sr 2 = .028, p .05). When compared to perceptions of interpersonal rejection and unrealistic relationship expectations, emotional dependency had the largest role in explaining participants' satisfaction with their marriages. We discuss the results in light of current literature as well as cultural relevance. We also provide implications for future research and mental health practices.

Conflict management in online relationships.

PubMed

Ishii, Kumi

2010-08-01

With the diffusion of networked technology, personal relationships can be easily formed and maintained online today. Similar to a face-to-face situation, conflict is also seen in these online relationships. Early theories suggested that computer-mediated communication (CMC) tends to increase conflicts because of the lack of social-context cues, and CMC is not rich enough to manage conflict. As CMC has become part of our daily life, we often face conflict online, and thus we need to understand how people manage conflict online. This study explored how online users manage interpersonal conflict. Self-report survey data from 159 university students were analyzed to examine their conflict-management styles in association with the perceived closeness of the online relationship and a future intention toward the relationship. The results indicated that online users select cooperative management styles to handle conflict in their close relationships. In addition, online users avoid less cooperative styles when they want to continue the relationship.

SOCIAL RELATIONSHIPS AND SLEEP QUALITY

PubMed Central

Kent, Robert G.; Uchino, Bert N.; Cribbet, Matthew R.; Bowen, Kimberly; Smith, Timothy W.

2015-01-01

Background The quality of social relationships and social support appears to be associated with physical health outcomes and sleep quality. Almost all previous research in this area focuses on positive aspects of relationships. Purpose The present study thus intended to examine the links between supportive, aversive, ambivalent, and indifferent network ties and sleep quality. Methods Relationship data, PSQI-assessed sleep quality, and depression were examined in 175 middle-aged and older adults. Results Consistent with hypotheses, supportive ties were positively related to sleep quality, while aversive ties predicted worse sleep quality; associations that were primarily seen for close relationships. Ambivalent and indifferent ties were not significant predictors of sleep quality. Importantly, depression was found to mediate the link between relationship quality and sleep quality. Conclusions These data suggest the more specific types of social relationships that may be linked to poor sleep quality, and that depression appears to underlie these associations. PMID:25976874

Changes in Teacher-Student Relationships

ERIC Educational Resources Information Center

Gehlbach, Hunter; Brinkworth, Maureen E.; Harris, Anna D.

2012-01-01

Background: Although teacher-student relationships lie at the heart of students' schooling experience, fundamental questions regarding these relationships remain unanswered. Aims: This study investigates three related questions about these relationships: To what extent do they change from the beginning to the end of a school year? Are any emergent…

Peer Relationships in Child Development.

ERIC Educational Resources Information Center

Berndt, Thomas J., Ed.; Ladd, Gary W., Ed.

Although hypotheses about the consequences of peer relationships for children's development have served as the foundation for much of the research into children and adolescent peer relationships, direct assessment of the impact of such relationships on children's personality, social behavior, or cognition has rarely been done. This book discusses…

Relationship Satisfaction and Risk Factors for Suicide.

PubMed

Till, Benedikt; Tran, Ulrich S; Niederkrotenthaler, Thomas

2017-01-01

Previous studies suggest that troubled romantic relationships are associated with higher risk factors for mental health. However, studies examining the role of relationship satisfaction in suicide risk factors are scarce. We investigated differences in risk factors for suicide between individuals with high relationship satisfaction, individuals with low relationship satisfaction, and singles. Furthermore, we explored patterns of experiencing, and dealing with, conflicts in the relationship and examined associations with suicide risk factors. In this cross-sectional study, we assessed relationship status, relationship satisfaction, specific types of relationship conflicts, and suicide risk factors (i.e., suicidal ideation, hopelessness, depression) with questionnaires among 382 individuals in Austria. Risk factors for suicide were higher among singles than among individuals in happy relationships, but highest among those with low relationship satisfaction [corrected]. Participants reporting a high number of unsolved conflicts in their relationship had higher levels of suicidal ideation, hopelessness, and depression than individuals who tend to solve issues with their partner amicably or report no conflicts. Relationship satisfaction and relationship conflicts reflect risk factors for suicide, with higher levels of suicidal ideation, hopelessness, and depression reported by individuals who mentioned unsolved conflicts with their partner and experienced low satisfaction with their relationship.

The Relationships between Child Temperament, Teacher-Child Relationships, and Teacher-Child Interactions

ERIC Educational Resources Information Center

Oren, Meral; Jones, Ithel

2009-01-01

The purpose of the study was to examine the relationships between child temperament, teacher-child relationships, and teacher-child interactions in four preschool classrooms. The preliminary analyses revealed classroom differences for all variables. In all the classrooms except one, the temperament factor Reactivity had positive and high…

Interpersonal Relationships: Exploring Race and Relationship Decisions among African American College Men

ERIC Educational Resources Information Center

McGowan, Brian L.

2016-01-01

This study explores how race influenced African American men's interpersonal relationships with other men at a predominantly White institution. The use of both semi-structured and photo-elicitation interview formats provided participants an opportunity to reflect on their precollege experiences, identity, and relationships. Two categories emerged…

Relationship-contingent self-esteem and the ups and downs of romantic relationships.

PubMed

Knee, C Raymond; Canevello, Amy; Bush, Amber L; Cook, Astrid

2008-09-01

Relationship-contingent self-esteem (RCSE) emerges from perspectives on authenticity, need fulfillment, and relationship functioning and is an unhealthy form of self-esteem that depends on one's relationship. Four studies provided evidence of convergent, discriminant, incremental, and predictive validity for RCSE. Study 1 tested associations between RCSE and several conceptually related and unrelated constructs in multiple samples. In Study 2, the authors employed an event-contingent diary procedure to examine reports of self-esteem as a function of everyday relationship events. The association between event valence and changes in self-esteem became stronger with RCSE, and this interaction remained controlling for several parallel interactions by other constructs. Study 3 employed an interval-contingent diary procedure and found support for a mediation model in which the moderating role of RCSE largely occurred through momentary emotions, which in turn predicted momentary self-esteem. Study 4 sampled couples and found that partners who were both higher in RCSE felt more committed but not more satisfied or close.

Forming the Mentor-Mentee Relationship

ERIC Educational Resources Information Center

Hudson, Peter

2016-01-01

A positive mentor-mentee relationship is essential for the mentee's development of teaching practices. As mentors can hold the balance of power in the relationship with preservice teachers, how do mentors develop positive mentor-mentee relationships? This multi-case study involved: (a) written responses from over 200 teachers involved in a…

Text-Frame Relationships and ESL.

ERIC Educational Resources Information Center

Burquest, Donald A.; Henry, Floreen Barger

The relationship of contextual background to comprehension of written texts is discussed with reference to instruction in English as a second language (ESL). A theory advanced by Kerry Stewart Robichaux proposes six possible relationships between a text and its cultural "frame." Applications of the six text-frame relationships to foreign…

Functional Relationships for Investigating Cognitive Processes

PubMed Central

Wright, Anthony A.

2013-01-01

Functional relationships (from systematic manipulation of critical variables) are advocated for revealing fundamental processes of (comparative) cognition—through examples from my work in psychophysics, learning, and memory. Functional relationships for pigeon wavelength (hue) discrimination revealed best discrimination at the spectral points of hue transition for pigeons—a correspondence (i.e., functional relationship) similar to that for humans. Functional relationships for learning revealed: Item-specific or relational learning in matching to sample as a function of the pigeons’ sample-response requirement, and same/different abstract-concept learning as a function of the training set size for rhesus monkeys, capuchin monkeys, and pigeons. Functional relationships for visual memory revealed serial position functions (a 1st order functional relationship) that changed systematically with retention delay (a 2nd order relationship) for pigeons, capuchin monkeys, rhesus monkeys, and humans. Functional relationships for rhesus-monkey auditory memory also revealed systematic changes in serial position functions with delay, but these changes were opposite to those for visual memory. Functional relationships for proactive interference revealed interference that varied as a function of a ratio of delay times. Functional relationships for change detection memory revealed (qualitative) similarities and (quantitative) differences in human and monkey visual short term memory as a function of the number of memory items. It is concluded that these findings were made possible by varying critical variables over a substantial portion of the manipulable range to generate functions and derive relationships. PMID:23174335

Perceptions of close and group relationships mediate the relationship between anxiety and depression over a decade later

PubMed Central

Jacobson, Nicholas C.; Newman, Michelle G.

2016-01-01

Background Previous research has demonstrated that anxiety reliably predicts later depression, but little has been uncovered about the mechanism underlying this connection. Interpersonal relationships appear to be a viable mechanism of the association as anxiety has been shown to predict later deficits in both close (e.g., “best friendships”) and group relationships (e.g., classroom peer groups), and deficits in both close and group relationships have been linked to later depressive symptoms. The current study examined close and group relationships as potential mediators between anxiety and depression 12–14 years later. Methods In a nationally representative sample of adolescents (N = 6,504), anxiety was measured at baseline, perceptions of close relationships (i.e., feeling loved) and perceptions of group relationships (i.e., feeling part of a group) were measured 6 months later, and depression levels and diagnosis were measured 12–14 years later. Results Using structural equation models, the results showed that adolescent perceptions of both close and group relationships significantly mediated the relationship between adolescent anxiety and adult levels of depression. Furthermore, perceptions of not being accepted/loved in close relationships significantly mediated the relationship between adolescent anxiety and clinical depression in adulthood. Conclusions These results suggest that a perception of not being accepted in group relationships may be a mechanism by which heightened anxiety in adolescents leads to heightened nonclinical depression in adulthood. On the other hand, adolescent perceptions of not feeling loved or accepted in close relationships may be a mechanism by which heightened anxiety in adolescence leads to clinical depression—in adulthood. PMID:26290461

PERCEPTIONS OF CLOSE AND GROUP RELATIONSHIPS MEDIATE THE RELATIONSHIP BETWEEN ANXIETY AND DEPRESSION OVER A DECADE LATER.

PubMed

Jacobson, Nicholas C; Newman, Michelle G

2016-01-01

Previous research has demonstrated that anxiety reliably predicts later depression, but little has been uncovered about the mechanism underlying this connection. Interpersonal relationships appear to be a viable mechanism of the association as anxiety has been shown to predict later deficits in both close (e.g., "best friendships") and group relationships (e.g., classroom peer groups), and deficits in both close and group relationships have been linked to later depressive symptoms. The current study examined close and group relationships as potential mediators between anxiety and depression 12-14 years later. In a nationally representative sample of adolescents (N = 6,504), anxiety was measured at baseline, perceptions of close relationships (i.e., feeling loved) and perceptions of group relationships (i.e., feeling part of a group) were measured 6 months later, and depression levels and diagnosis were measured 12-14 years later. Using structural equation models, the results showed that adolescent perceptions of both close and group relationships significantly mediated the relationship between adolescent anxiety and adult levels of depression. Furthermore, perceptions of not being accepted/loved in close relationships significantly mediated the relationship between adolescent anxiety and clinical depression in adulthood. These results suggest that a perception of not being accepted in group relationships may be a mechanism by which heightened anxiety in adolescents leads to heightened nonclinical depression in adulthood. On the other hand, adolescent perceptions of not feeling loved or accepted in close relationships may be a mechanism by which heightened anxiety in adolescence leads to clinical depression--in adulthood. © 2015 Wiley Periodicals, Inc.

Relationship Governance and Learning in Partnerships

ERIC Educational Resources Information Center

Kohtamaki, Marko

2010-01-01

Purpose: Relationship learning is a topic of considerable importance for industrial networks, yet a lack of empirical research on the impact of relationship governance structures on relationship learning remains. The purpose of this paper is to analyze the impact of relationship governance structures on learning in partnerships.…

Family caregivers' attributions about care-recipient behaviour: does caregiver relationship satisfaction mediate the attribution-distress relationship?

PubMed

Hui, Siu-Kuen Azor; Elliott, Timothy R; Martin, Roy; Uswatte, Gitendra

2011-09-01

The relations of caregiver attributions about care-recipient's problem behaviour to caregiving relationship satisfaction and caregiver distress were examined. This is a cross sectional study. Seventy-five family caregivers of individuals diagnosed with various disabling health conditions were recruited and interviewed. Caregiver attributions (internality, intentionality, responsibility, and controllability), caregiving relationship satisfaction, and caregiver distress variables were measured. Structural equation techniques tested an a priori model of the latent constructs of caregiver attributions and caregiver relationship satisfaction to caregiver distress. Maladaptive caregiver attributions (i.e., more trait, higher intentionality, higher responsibility, and higher controllability) about care-recipients' problem behaviours predicted lower caregiving relationship satisfaction, which in turn was predictive of higher caregiver distress. Unexpectedly, caregiver attributions were not directly related to caregiver distress. However, attributions had an indirect effect on distress through relationship satisfaction. Younger caregivers experienced higher caregiver distress. Caregivers' explanations about care-recipient's problem behaviour are indicative of their satisfaction in the relationship with the care recipient, and poor caregiving relationship satisfaction is predictive of caregiver distress. Caregiver attributions and relationship quality may be considered in interventions with family caregivers. ©2010 The British Psychological Society.

Relationship Quality and Domestic Violence in Women's Same-Sex Relationships: The Role of Minority Stress

ERIC Educational Resources Information Center

Balsam, Kimberly F.; Szymanski, Dawn M.

2005-01-01

Despite a large body of literature addressing relationship quality and domestic violence in women's same-sex relationships, few studies have empirically examined how stress specific to living as a lesbian or bisexual woman might correlate with these relationship variables. Degree of outness, internalized homophobia, lifetime and recent experiences…

Testosterone levels in women and men who are single, in long-distance relationships, or same-city relationships.

PubMed

van Anders, Sari M; Watson, Neil V

2007-02-01

Research points to an association between testosterone (T) and partnering in some women and men, and this association has been interpreted as an effect of either relationship status (i.e. differences in relationship status lead to differences in T) or relationship orientation (i.e. T is associated with the likelihood of entering relationships). To address whether physical partner presence was associated with decreased T, we examined T levels in people (72 women; 49 men) who were single, in long-distance relationships, or in same-city relationships. No participants were using exogenous hormones, including hormonal contraceptives. Participants provided a saliva sample and responded to questions about their relationship status. Single men had higher T than long-distance and same-city partnered men, which supports the relationship orientation interpretation. In contrast, same-city partnered women had lower T than single women and women in long-distance relationships, which supports the relationship status interpretation. We conclude that physical partner presence is not necessary to see an association between partnering and hormones in men (since same-city and long-distance partnered men had similar T levels), but may be necessary in women (since same-city partnered women had lower T than long-distance partnered women).

Extravasal occlusion of large vessels with titanic clips: efficiency, indications, and contraindications.

PubMed

Vasilenko, Yu V; Kim, A I; Kotov, S A

2002-11-01

The mechanism of extravasal occlusion of blood vessels with titanic clips "Atrauclip" and "Ligaclip extra" was studied in order to reveal indications and contraindications to their use. Occlusion with the clips of both types was ineffective in vessels with a diameter of >7.0 mm. Arteritis or the presence of an intravascular occlusion facility in the vessel were also the contraindications for clip occlusion. In overcases the procedure of occlusion with titanic clips was efficient and atraumatic.

Headache of a diagnosis: frontotemporal pain and inflammation associated with osteolysis.

PubMed

Tacon, Lyndal J; Parkinson, Jonathon F; Hudson, Bernard J; Brewer, Janice M; Little, Nicholas S; Clifton-Bligh, Roderick J

2008-11-17

A 62-year-old woman presented with left frontotemporal pain, scalp tenderness and raised levels of inflammatory markers. Temporal arteritis was considered likely, and symptoms resolved with prednisone therapy. This delayed diagnostic bone biopsy until a soft tissue abscess formed, and Pott's puffy tumour associated with Prevotella osteomyelitis of the frontal bone was diagnosed. This case highlights the value of early histopathological examination, and is a reminder of a condition seen frequently in the pre-antibiotic era.

Isolated benign cerebral vasculitis or migrainous vasospasm?

PubMed Central

Serdaru, M; Chiras, J; Cujas, M; Lhermitte, F

1984-01-01

A 39-year-old woman experienced severe headache, epilepsy and rapidly progressive aphasia and hemianopia. Carotid angiograms displayed segmentary narrowing of intracranial arteries as previously described in benign cerebral vasculitis. Her superficial temporal artery was also involved, allowing a biopsy of the abnormal part of the vessel. Microscopical study of this artery was normal. A second carotid angiogram, 14 days later, showed normal intracranial arteries. These findings suggest arterial spasm rather than distal arteritis. Images PMID:6693916

Dysfunctional Relationship Beliefs in Parent-Late Adolescent Relationship and Conflict Resolution Behaviors

ERIC Educational Resources Information Center

Hamamci, Zeynep

2007-01-01

The purpose of this study is to investigate the role of dysfunctional relationships beliefs on both the perceptions of their relationships with the parents and conflict resolution behaviors of late adolescence. The sample was consisted of 372 Turkish university students (248 women and 124 men). Interpersonal Cognitive Distortions Scale,…

Building Relationships with Parents

ERIC Educational Resources Information Center

Cullaj, Stephanie

2015-01-01

Communicating with parents may seem like one more task on top of an overwhelming workload, but creating a positive relationship with parents has many benefits for all involved. The author discusses the steps to creating these relationships and communicating with families.

Ecological Structure Activity Relationships

EPA Science Inventory

Ecological Structure Activity Relationships, v1.00a, February 2009
ECOSAR (Ecological Structure Activity Relationships) is a personal computer software program that is used to estimate the toxicity of chemicals used in industry and discharged into water. The program predicts...

Family Relationships and Adolescents’ Health Attitudes and Weight: The Understudied Role of Sibling Relationships

PubMed Central

Senguttuvan, Umadevi; Whiteman, Shawn D.; Jensen, Alexander C.

2014-01-01

Family relationships are important predictors of adolescents’ diet, physical activity, and health issues including obesity. Despite their prominence in the family, siblings have received little attention on how they may influence these health-related behaviors. Addressing this gap, the present study examined associations between sibling relationship qualities and adolescents’ health attitudes, exercise behaviors, and weight controlling for other family relationship qualities. Participants included one parent and two adolescent siblings (ages 12 to 19) from 326 families. Multilevel models indicated that net of parent-adolescent relationship qualities and adolescents’ personal characteristics, sibling intimacy was related to healthy attitudes and greater exercise behaviors, whereas sibling conflict was associated with increased risk of being overweight. Links between sibling conflict and weight status, however, were further qualified by gender composition of the sibling dyad. Results highlight the significance of sibling relationships in adolescents’ everyday health attitudes and behaviors and implications for intervention efforts are discussed. PMID:24954967

Shared Relationship Efficacy of Dyad Can Increase Life Satisfaction in Close Relationships: Multilevel Study

PubMed Central

Ito, Kenichi; Yoshida, Toshikazu

2016-01-01

Characteristics of relationship itself play an important role in determining well-being of individuals who participate in the relationship. We used efficacy expectations mutually shared between close friends or romantic partners as a characteristic of relationship and investigated its impact on their life satisfaction. In Study 1, we conducted a cross-sectional study among 137 pairs of close same-sex friends to test whether the efficacy expectations shared between friends are associated with levels of life satisfaction. In Study 2, we conducted a longitudinal study among 114 heterosexual romantic couples to test predictive validity of the efficacy expectations shared between couples predict levels of life satisfaction 2 month later. In both studies we found a consistent result that as degrees of the efficacy expectations shared between individuals in a relationship increased, the degree of their life satisfaction also increased. Underlying mechanisms that explain how characteristics of relationship itself increase life satisfaction are discussed. PMID:27437946

Sailor Relationship Management: The Use of Customer Relationship Management in Sailor Morale and Retention

DTIC Science & Technology

2002-08-16

advances in information technology. Customer Relationship Management ( CRM ) is a concept that has personalized the marketing process over the Internet. An...even newer concept, Employee Relationship Management (ERM), seeks to turn the lessons learned from CRM inwards to a company’s own employees, not to...within the Navy, resulting in Sailor Relationship Management (SRM.) The work included focus group interviews that led to the development of a survey

Drinking and Dating: Examining the Link between Relationship Satisfaction, Hazardous Drinking, and Readiness-to-Change in College Dating Relationships

PubMed Central

Khaddouma, Alexander; Shorey, Ryan C.; Brasfield, Hope; Febres, Jeniimarie; Zapor, Heather; Elmquist, Joanna; Stuart, Gregory L.

2015-01-01

The present study examined the influence of relationship satisfaction on readiness-to-change alcohol use and the influence of hazardous drinking on readiness-to-change relationship issues in college student dating relationships. A sample of 219 college students in a current dating relationship (aged 18–25) completed self-report measures of dating relationship satisfaction, alcohol use, readiness-to-change alcohol use, and readiness-to-change relationship issues via an online survey from August to December 2011. Participants were grouped on the basis of their scores on measures of alcohol use (hazardous drinkers vs. nonhazardous drinkers) and relationship satisfaction (high vs. low). Results indicated that alcohol use was negatively correlated with relationship satisfaction. Furthermore, hazardous drinkers with high relationship satisfaction indicated more readiness-to-change alcohol use than hazardous drinkers with low relationship satisfaction. Alcohol problems were not related to readiness-to-change relationship issues. These findings indicate that highly satisfied dating relationships during college may positively influence readiness-to-change heavy drinking habits among college students. PMID:26997754

Customer Loyalty and Customer Relationship Management

NASA Astrophysics Data System (ADS)

Zhang, Pengwei; Li, Min; Jiao, Xiaojing; Zhou, Ruijin

The contemporary company attaches great importance to marketing relationship and customer relations is the core of this relationship. Further, customer satisfaction and loyalty is the core of the customer relationship management. Sometimes, high customer satisfaction causes low profit because enterprises do not realize that strengthening the loyalty of the aimed customer is the key of customer relationship management.

Ideals as Anchors for Relationship Experiences

PubMed Central

Frye, Margaret; Trinitapoli, Jenny

2016-01-01

Research on young-adult sexuality in sub-Saharan Africa typically conceptualizes sex as an individual-level risk behavior. We introduce a new approach that connects the conditions surrounding the initiation of sex with subsequent relationship well-being, examines relationships as sequences of interdependent events, and indexes relationship experiences to individually held ideals. New card-sort data from southern Malawi capture young women’s relationship experiences and their ideals in a sequential framework. Using optimal matching, we measure the distance between ideal and experienced relationship sequences to (1) assess the associations between ideological congruence and perceived relationship well-being, (2) compare this ideal-based approach to other experience-based alternatives, and (3) identify individual- and couple-level correlates of congruence between ideals and experiences in the romantic realm. We show that congruence between ideals and experiences conveys relationship well-being along four dimensions: expressions of love and support, robust communication habits, perceived biological safety, and perceived relationship stability. We further show that congruence is patterned by socioeconomic status and supported by shared ideals within romantic dyads. We argue that conceiving of ideals as anchors for how sexual experiences are manifest advances current understandings of romantic relationships, and we suggest that this approach has applications for other domains of life. PMID:27110031

What do short-term and long-term relationships look like? Building the relationship coordination and strategic timing (ReCAST) model.

PubMed

Eastwick, Paul W; Keneski, Elizabeth; Morgan, Taylor A; McDonald, Meagan A; Huang, Sabrina A

2018-05-01

Close relationships research has examined committed couples (e.g., dating relationships, marriages) using intensive methods that plot relationship development over time. But a substantial proportion of people's real-life sexual experiences take place (a) before committed relationships become "official" and (b) in short-term relationships; methods that document the time course of relationships have rarely been applied to these contexts. We adapted a classic relationship trajectory-plotting technique to generate the first empirical comparisons between the features of people's real-life short-term and long-term relationships across their entire timespan. Five studies compared long-term and short-term relationships in terms of the timing of relationship milestones (e.g., flirting, first sexual intercourse) and the occurrence/intensity of important relationship experiences (e.g., romantic interest, strong sexual desire, attachment). As romantic interest was rising and partners were becoming acquainted, long-term and short-term relationships were indistinguishable. Eventually, romantic interest in short-term relationships plateaued and declined while romantic interest in long-term relationships continued to rise, ultimately reaching a higher peak. As relationships progressed, participants evidenced more features characteristic of the attachment-behavioral system (e.g., attachment, caregiving) in long-term than short-term relationships but similar levels of other features (e.g., sexual desire, self-promotion, intrasexual competition). These data inform a new synthesis of close relationships and evolutionary psychological perspectives called the Relationship Coordination and Strategic Timing (ReCAST) model. ReCAST depicts short-term and long-term relationships as partially overlapping trajectories (rather than relationships initiated with distinct strategies) that differ in their progression along a normative relationship development sequence. (PsycINFO Database Record (c

"If you don't have honesty in a relationship, then there is no relationship": African American girls' characterization of healthy dating relationships, a qualitative study.

PubMed

Debnam, Katrina J; Howard, Donna E; Garza, Mary A

2014-12-01

The quality of dating relationships in adolescence can have long lasting effects on identity development, self-esteem, and interpersonal skills, and can shape values and behaviors related to future intimate relationships. The aims of this study were to: (1) investigate how African American adolescent girls characterize healthy relationships; and (2) describe the meanings of these characteristics in the context of the Centers for Disease Control and Prevention's (CDC) 12 healthy dating relationship qualities. We conducted semi-structured one-on-one in-depth interviews with 33 African American high school girls in the mid-Atlantic region. Trained staff transcribed interviews verbatim and entered the data into ATLAS.ti for coding and analysis. Participants' specified and vividly described eight healthy relationship characteristics: good communication, honesty, trust, respect, compromise, understanding, individuality, and self-confidence. Of these characteristics, three (good communication, compromise, and respect) were described in ways discordant with CDC's definitions. Findings highlight a need to better understand how girls develop values and ascribe characteristics of healthy relationships in order to reduce their risk for teen dating violence.

Exploring the impact of marital relationship on the mental health of children: Does parent-child relationship matter?

PubMed

Li, Chunkai; Jiang, Shan; Fan, Xiaoyan; Zhang, Qiunv

2018-04-01

This study aimed to examine the associations between marital relationships and parent-child relationships on children's mental health. Participants included 19,487 students from the 2013-2014 baseline China Education Panel Survey. Structural equation modeling was applied to analyze the data and results revealed that marital and parent-child relationships positively affected children's mental health. Parent-child relationship also played a mediating role between marital relationship and children's mental health. The unique contributions of this study and its theoretical and practical implications were discussed.

Relationship quality and student engagement

NASA Astrophysics Data System (ADS)

Culver, Jennifer

The purpose of this study was to examine the qualities of support, relatedness, and negative interaction within parent-child and teacher-student relationships and their association with cognitive, psychological, and behavioral engagement. Additionally, this study explored the contributions of cognitive and psychological engagement on behavioral engagement. The role of gender, grade, and ethnicity on relationship quality and engagement was also considered. Participants (n=311) were students in grades three through five from a suburban school district in southeastern Michigan. Perceptions of teacher-student relationship quality varied by grade level. In general, younger students reported greater teacher support and relatedness in comparison to older students. Conversely, older students perceived greater conflict within the teacher-student relationship. Student engagement also varied by grade level, with younger students reporting greater engagement than older students. Ethnicity also contributed to variance in student engagement, with African American students reporting significantly more engagement than Caucasian or Multiracial students. Teacher-student relationship quality was a significant predictor of student engagement, even after controlling for student characteristics and parent-child relationship variables. Results of path analysis revealed that cognitive and psychological engagement contributed significantly to behavioral engagement.

20 CFR 222.14 - Deemed marriage relationship.

Code of Federal Regulations, 2013 CFR

2013-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.14 Deemed marriage relationship. If a ceremonial or common-law marriage relationship cannot be established under State law, a claimant... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Deemed marriage relationship. 222.14 Section...

20 CFR 222.14 - Deemed marriage relationship.

Code of Federal Regulations, 2014 CFR

2014-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.14 Deemed marriage relationship. If a ceremonial or common-law marriage relationship cannot be established under State law, a claimant... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Deemed marriage relationship. 222.14 Section...

20 CFR 222.14 - Deemed marriage relationship.

Code of Federal Regulations, 2012 CFR

2012-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.14 Deemed marriage relationship. If a ceremonial or common-law marriage relationship cannot be established under State law, a claimant... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Deemed marriage relationship. 222.14 Section...

Assessment of Relationship-Specific Incentive and Threat Sensitivities: Predicting Satisfaction and Affect in Adult Intimate Relationships

ERIC Educational Resources Information Center

Laurenceau, Jean-Philippe; Kleinman, Brighid M.; Kaczynski, Karen J.; Carver, Charles S.

2010-01-01

Self-report scales assessing relationship-specific incentive and threat sensitivity were created. Initial tests of factor structure and associations with relationship quality were conducted in a sample of persons in intimate relationships (Study 1). Associations with conceptually related measures were examined to determine convergent and…

Effectiveness of fenbendazole against later 4th-stage Strongylus vulgaris in ponies.

PubMed

Slocombe, J O; McCraw, B M; Pennock, P W; Baird, J D

1983-12-01

Twelve pony foals (reared worm-free) were inoculated with Strongylus vulgaris. Approximately 8 weeks later, 4 of the foals were given fenbendazole (10% suspension) at a dosage rate of 10 mg/kg of body weight daily for 5 days and 4 foals were given the suspension at a dosage rate of 50 mg/kg daily for 3 days; the remaining foals were given a placebo. All treatments were administered by stomach tube. Fenbendazole was 99.6 and 97.9% effective in the 2 treatment groups, respectively, in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries. On microscopic examination of the ileocolic artery from fenbendazole-treated foals, a few larval remnants were found beneath the tunica intima in small organized mural thrombi overgrown with endothelium. It would appear that larvae are rapidly destroyed after administration of fenbendazole. A pony foal reared on pasture and with arteriographic evidence of arteritis of the cranial mesenteric and ileocolic arteries was treated with fenbendazole (10% suspension) by stomach tube at a dosage rate of 50 mg/kg of body weight daily for 3 days. By arteriographic examination made 4 weeks later, there was evidence of regression of the lesion, and at necropsy done a week later, there was no arteritis or larvae in the lumen of those arteries.

Assessment of cardiovascular disease in the donkey: clinical, echocardiographic and pathological observations.

PubMed

Roberts, S L; Dukes-McEwan, J

2016-10-15

The Donkey Sanctuary (DS) owns 3500-4000 donkeys, estimated to be about 35 per cent of the UK population. Although postmortem surveys suggest a high prevalence of cardiovascular disease in donkeys, there is sparse clinical information about cardiovascular examination findings and echocardiographic findings in health and disease. In this cross-sectional study, auscultation findings were recorded, and in a subset of donkeys, echocardiography was used to screen for structural and functional cardiac disease. 202 donkeys were examined; 117 geldings and 85 females. Heart sounds S1 and S2 were detected in all donkeys, but none had audible S3. S4 was detected in nine (4.5 per cent; significantly older than those without S4; P<0.001). A heart murmur was detected in four donkeys. Echocardiography identified these to be due to a ventricular septal defect in one, and aortic regurgitation in three. An additional 43 donkeys had echocardiography. A further 10 donkeys were identified to have aortic insufficiency, but no other valvular regurgitation. 76/202 donkeys subsequently underwent postmortem examination. Three showed degenerative aortic valve changes. One donkey had nodular lesions in the intima of proximal aorta and sinus of Valsalva. Histopathology showed multifocal chronic nodular eosinophilic arteritis, consistent with verminous arteritis. The DS pathology database identified other similar cases. British Veterinary Association.

HDD proves effective in crossing French river

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-06-01

Gas de France is the primary transporter and distributor of natural gas in France, operating some 28,000 kilometers of gas pipelines. In 1996, Gas de France and Gas du Sud Ouest moved forward with the Artere du Midi consisting of a 375-kilometer gas pipeline, respectively in charge of 200-kilometer and a 175-kilometer sections linking the east and west grids in the southeast of France. A significant part of the Artere du Midi included a crossing of the Rhone River near Aries. The Rhone flows from north to south between the volcanic massif central and the Alps into the Mediterranean Sea.more » The crossing site is just at the entry of the Rhone delta, where the flow decelerates and erosion deposits of large granular size have occurred for millennia. Geotechnical investigations indicated that the crossing has difficult soil conditions, mostly made of coarse sand with numerous lenses of gravel and cobble. The Rhone delta, once occupied by the Romans is scenic and historic, so the construction method was very sensitive to the local public and tourist. Despite the geotechnical conditions, Gaz de France chose the horizontal directional drilling method for construction because it offers minimal environmental impact and a relatively short construction schedule. The paper discusses the horizontal directional drilling process.« less

NADPH oxidase deficiency underlies dysfunction of aged CD8+ Tregs

PubMed Central

Wen, Zhenke; Shimojima, Yasuhiro; Shirai, Tsuyoshi; Li, Yinyin; Ju, Jihang; Yang, Zhen; Tian, Lu; Goronzy, Jörg J.

2016-01-01

Immune aging results in progressive loss of both protective immunity and T cell–mediated suppression, thereby conferring susceptibility to a combination of immunodeficiency and chronic inflammatory disease. Here, we determined that older individuals fail to generate immunosuppressive CD8+CCR7+ Tregs, a defect that is even more pronounced in the age-related vasculitic syndrome giant cell arteritis. In young, healthy individuals, CD8+CCR7+ Tregs are localized in T cell zones of secondary lymphoid organs, suppress activation and expansion of CD4 T cells by inhibiting the phosphorylation of membrane-proximal signaling molecules, and effectively inhibit proliferative expansion of CD4 T cells in vitro and in vivo. We identified deficiency of NADPH oxidase 2 (NOX2) as the molecular underpinning of CD8 Treg failure in the older individuals and in patients with giant cell arteritis. CD8 Tregs suppress by releasing exosomes that carry preassembled NOX2 membrane clusters and are taken up by CD4 T cells. Overexpression of NOX2 in aged CD8 Tregs promptly restored suppressive function. Together, our data support NOX2 as a critical component of the suppressive machinery of CD8 Tregs and suggest that repairing NOX2 deficiency in these cells may protect older individuals from tissue-destructive inflammatory disease, such as large-vessel vasculitis. PMID:27088800

Effectiveness of an interpersonal relationship program on interpersonal relationships, self-esteem, and depression in nursing students.

PubMed

Yoon, Hee Sang; Kim, Gyung Hee; Kim, Jiyoung

2011-12-01

The purpose of this study was to examine the effectiveness of an interpersonal relationship program on interpersonal relationships, self-esteem, and depression in nursing students. This was a quasi-experiment with a nonequivalent control group pre-posttest design. Sixty-four nursing students participated in the study with 31 in the experimental group and 33 in the control group. They were from 3 different colleges of nursing located in Seoul. The interpersonal relationship program was held 10 times over 10 weeks, taking 90 minutes per session. The interpersonal relationship change scale developed by Schlein and Guemey, Rosenberg's self-esteem scale, and CED-S for depression were the instruments used in the study. The data collection period was from January 4 to March 8, 2011, and the collected data were analyzed with SPSS 14.0 using the Χ(2)-test, t-test, and paired t-test. The results showed a significant difference between the experimental group and the control group in terms of the degree of interpersonal relationships, self-esteem, and depression. The results indicate that interpersonal relationship programs have positive effects for improving interpersonal relationships and self-esteem, and decreasing depression in nursing students.

20 CFR 222.35 - Relationship as stepchild.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Relationship as stepchild. 222.35 Section 222... RELATIONSHIPS Relationship as Child § 222.35 Relationship as stepchild. A claimant will be considered to have the relationship of stepchild of an employee, and will be considered a child for annuity but not for...

Alliance and group cohesion in relationship education.

PubMed

Owen, Jesse; Antle, Becky; Barbee, Anita

2013-09-01

Relationship education programs have been shown as an effective way to increase relationship functioning. There is less known about how process factors, such as alliance with the leader or group dynamics, affect outcomes in these interventions. We examined group cohesion and alliance with the leader in a relationship education program tailored for individuals. Specifically, we examined whether participants' ratings (n = 126) of the group cohesion and alliance with the leader were associated with changes in relationship adjustment, relationship confidence, and communication quality from pre- to postintervention. The results demonstrated that participants' perceptions of the cohesion among the members in their relationship education group, but not the leader-participant alliance, made a significant contribution to the changes in participants' relationship functioning. These results suggest that the group dynamics among the members in the group are important ingredients in relationship education. Implications for relationship programs are provided. © FPI, Inc.

The Romantic Relationships of Adolescents With ADHD.

PubMed

Rokeach, Alan; Wiener, Judith

2018-01-01

This study compared the romantic relationships of adolescents with and without ADHD with regard to romantic involvement, relationship content, and relationship quality. A community sample of 58 participants (30 ADHD, 28 Comparison), ages 13 to 18, completed questionnaires assessing various features of romantic relationships. Adolescents with ADHD reported having more romantic partners than their typically developing (TD) peers. Females with ADHD were found to have shorter romantic relationships than TD adolescents while males with ADHD reported their age of first intercourse to be nearly 2 years sooner than TD peers. Irrespective of gender, adolescents with ADHD had nearly double the number of lifetime sexual partners. However, the romantic relationships of adolescents with and without ADHD did not differ on levels of aggression or relationship quality. Given the outcomes associated with poor-quality romantic relationships, comprehensive assessments of adolescents with ADHD should include queries into their romantic relationships.

The Profile-Query Relationship.

ERIC Educational Resources Information Center

Shepherd, Michael A.; Phillips, W. J.

1986-01-01

Defines relationship between user profile and user query in terms of relationship between clusters of documents retrieved by each, and explores the expression of cluster similarity and cluster overlap as linear functions of similarity existing between original pairs of profiles and queries, given the desired retrieval threshold. (23 references)…

The Therapeutic Relationship: Enhancing Referrals.

PubMed

Coyle, Mary Kathleen

2018-05-19

This article focuses on the ways rehabilitation nurses use the therapeutic relationship to lessen barriers some veterans experience when a referral to mental health treatment is recommended. Veterans presenting with posttraumatic stress symptoms are discussed, and possible interventions within the therapeutic relationship are proposed. Veterans' perception of mental health stigma, building a collaborative therapeutic relationship, recommending a referral and assessments of stress responses, posttraumatic stress symptoms, suicide risk, and intervention strategies are proposed. When changes in functioning and suicidality occur in veterans with posttraumatic stress disorder symptoms, it is important to screen and engage veterans at risk. When veterans in the rehabilitation process present with a need for mental health referral, barriers to treatment may include the stigma of mental health treatment. Rehabilitation nurses using the therapeutic relationship act as change agents to assist veterans in overcoming these barriers to treatment. The therapeutic relationship provides nurses with a foundation to provide opportunities for veterans to be supported and to seek treatment.

Social and parasocial relationships on social network sites and their differential relationships with users' psychological well-being.

PubMed

Baek, Young Min; Bae, Young; Jang, Hyunmi

2013-07-01

With the advent of social network sites (SNSs), people can efficiently maintain preexisting social relationships and make online friendships without offline encounters. While such technological features of SNSs hold a variety of potential for individual and collective benefits, some scholars warn that use of SNSs might lead to socially negative consequences, such as social isolation, erosion of social cohesion, or SNS addiction. This study distinguishes types of SNS relationships, and investigates their relationships with social isolation, interpersonal trust, and SNS addiction. We classify SNS relationships into two types: (a) social relationships based on reciprocity between a user and his/her friends, and (b) parasocial relationships in which an ordinary user is aware of activities of a celebrity (e.g., famous actors, athletes, and others) but not vice versa. Based on achievements in studies of media effect and social psychology, we constructed a set of hypotheses, and tested them using a subsample of SNS users drawn from representative survey data in South Korea. We found that dependency on parasocial relationships is positively related with loneliness but negatively correlated with interpersonal distrust, while dependency on social relationship is negatively correlated with loneliness but positively related with trust. However, more dependency on both social and parasocial relationships are positively related with SNS addiction. Implications based on findings are also discussed.

The Loss and Recovery of Erotic Intimacy in Primary Relationships: Narrative Therapy and Relationship Enhancement Therapy.

ERIC Educational Resources Information Center

Snyder, Maryhelen

2000-01-01

Therapists working with intimate relationships are frequently confronted with issues regarding the loss of erotic intimacy, differences in levels of sexual desire, and the existence of intimate relationships outside the primary. Proposes that an approach derived from an integration of narrative therapy and relationship enhancement therapy can be…

Top, Bottom, and Versatile Anal Sex Roles in Same-Sex Male Relationships: Implications for Relationship and Sexual Satisfaction.

PubMed

Moskowitz, David A; Garcia, Christopher P

2018-06-01

Across much of the gay and bisexual male research on sexual position self-label (i.e., calling oneself a top, bottom, or versatile), there exist two commonalities: (1) studies tend to focus almost entirely on individual, relationally single androphilic men; (2) studies rarely account for relationships and relationship dynamics. In response, we explored the role of self-label over sexual and relationship satisfaction among gay and bisexual partnered men. Specifically, we looked at whether adopted sexual position identities were consonant or dissonant (i.e., matching or mismatching) with enacted behavior in relationships and how that impacted men's attitudes toward different relational attributes. Through an online survey, we sampled 169 men in same-sex relationships, asking them questions about their ideal penetrative role identities and their reality penetrative roles with their partner. We then asked them to rate their relationship on 10 sexual and interpersonal attributes. Multiple regression modeling suggested ideal-reality penetrative role dissonance was predictive of sexual dissatisfaction among tops who bottomed in their relationships and, to a lesser extent, bottoms who topped. In contrast, penetrative role dissonance was predictive of relationship satisfaction among tops who bottomed in their relationship, but not bottoms who topped. We conclude that a potential reason for this paradox among tops who bottom may be sexual altruism. That is, men may be satisfied with other aspects within their relationships, understand their partner's anal sex preferences, and accommodate that position in response to their initial relationship satisfaction.

Would You Do It Again? Relationship Skills Gained in a Long-Distance Relationship

ERIC Educational Resources Information Center

Mietzner, Sara; Lin Li-Wen

2005-01-01

This study examined if experienced long-distance relationship (LDR) participants would be willing to be involved in a LDR again. In addition, although positive and negative outcomes have been reported in LDRs research, very little research investigated relationship skills gained during a LDR. Students in a Midwestern university completed…

The Crucial Coaching Relationship

ERIC Educational Resources Information Center

Scales, Peter C.

2016-01-01

One of the most powerful ways to boost the payoff from school sports lays in helping coaches build developmental relationships with student-athletes. Developmental relationships are close connections through which young people develop character skills to discover who they are, gain the ability to shape their own lives, and learn how to interact…

Weight stigma in existing romantic relationships.

PubMed

Boyes, Alice D; Latner, Janet D

2009-01-01

Associations between body mass index (BMI; kg/m2) and relationship quality and other partner/relationship perceptions were investigated in 57 dating or married couples. Heavier women had lower quality relationships, which they predicted were more likely to end. They partnered with less desirable men and thought their partners would rate them as less warm/trustworthy. Heavier women were judged by their male partners as lower in attractiveness/vitality and as poorer matches to their partners' attractiveness ideals. In contrast, men's BMI was generally not associated with relationship functioning. These findings point to the potential mechanisms that may contribute to heavier women's relationship difficulties.

Relationship marketing in a hospital library.

PubMed

Enyeart, Amanda L; Weaver, Debbie

2005-01-01

This article explores relationship marketing as adopted by staff of the Forbes Medical Library at The Children's Hospital in Denver. It provides a broad overview of relationship marketing along with its applications in libraries, and a description of how the library staff has used specific relationships with different hospital groups to enhance library service. The examples illustrate the importance of persistence, patience, and flexibility when consciously developing relationships between a library and individuals or groups.

The effect of relationship status on health with dynamic health and persistent relationships.

PubMed

Kohn, Jennifer L; Averett, Susan L

2014-07-01

The dynamic evolution of health and persistent relationship status pose econometric challenges to disentangling the causal effect of relationships on health from the selection effect of health on relationship choice. Using a new econometric strategy we find that marriage is not universally better for health. Rather, cohabitation benefits the health of men and women over 45, being never married is no worse for health, and only divorce marginally harms the health of younger men. We find strong evidence that unobservable health-related factors can confound estimates. Our method can be applied to other research questions with dynamic dependent and multivariate endogenous variables. Copyright © 2014 Elsevier B.V. All rights reserved.

Emotions & Relationships: Dealing with the Tough Stuff

Cancer.gov

Emotions & Relationships: Dealing with the Tough Stuff; emotional health; emotional health; emotional health article; emotional health articles; best way to deal with emotions; best ways to deal with relationships; how to build relationships; how to strengthen relationships

The brief family relationship scale: a brief measure of the relationship dimension in family functioning.

PubMed

Fok, Carlotta Ching Ting; Allen, James; Henry, David

2014-02-01

The Relationship dimension of the Family Environment Scale, which consists of the Cohesion, Expressiveness, and Conflict subscales, measures a person's perception of the quality of his or her family relationship functioning. This study investigates an adaptation of the Relationship dimension of the Family Environment Scale for Alaska Native youth. The authors tested the adapted measure, the Brief Family Relationship Scale, for psychometric properties and internal structure with 284 12- to 18-year-old predominately Yup'ik Eskimo Alaska Native adolescents from rural, remote communities. This non-Western cultural group is hypothesized to display higher levels of collectivism traditionally organized around an extended kinship family structure. Results demonstrate a subset of the adapted items function satisfactorily, a three-response alternative format provided meaningful information, and the subscale's underlying structure is best described through three distinct first-order factors, organized under one higher order factor. Convergent and discriminant validity of the Brief Family Relationship Scale was assessed through correlational analysis.

Explosion Source Modeling, Seismic Waveform Prediction and Yield Verification Research

DTIC Science & Technology

1976-05-01

TITLE (and S..bsdtl.) S. TYPE Of REPORT & PERIOD COVERED- r~r.s~oNscu ~ ~ ~ Q arterly Technical1 Report nicri~ ~ ~n v c~’i ~ ESE ~ ~ Feb. 1, 1976 -i...Description of the techni- que and the constitutive models may be found in Cherry, et al. (1975). KASSERI was detonated in ash flow tuff at Area 20...With these theoretical records we can reduce the measurement errors to nearly vanishing. Rather ’ than measuring by eye, a parabola is fit to the

Unusual headaches in the elderly.

PubMed

Bamford, Cynthia C; Mays, MaryAnn; Tepper, Stewart J

2011-08-01

Prevalence of headache lowers with age, and headaches of elderly adults tend to be different than those of the younger population. Secondary headaches, such as headaches associated with vascular disease, head trauma, and neoplasm, are more common. Also, certain headache types tend to be geriatric disorders, such as primary cough headache, hypnic headache, typical aura without headache, exploding head syndrome, and giant cell arteritis. This review provides an overview of some of the major and unusual geriatric headaches, both primary and secondary.

The influence of attraction to partner on heterosexual women's sexual and relationship satisfaction in long-term relationships.

PubMed

Mark, Kristen P; Herbenick, Debby

2014-04-01

Previous research has consistently found that attraction is important in the formation of relationships though research on attraction in long-term relationships is less well understood. This article examined the predictive value of self-reported attraction to partner and change in attraction to partner on sexual and relationship satisfaction in 176 women in committed heterosexual relationships using online survey methodology. Participants' age ranged from 21 to 56 (M = 34.5) years and their relationship length ranged from 5 to 35 (M = 11.75) years. Hierarchical multiple regression results indicated that change in attraction to partner was the most salient predictor of sexual satisfaction, with current attraction to partner also related to women's sexual satisfaction, accounting for 20 % of the variance. Current attraction to partner was the only significant predictor of women's relationship satisfaction, accounting for 22 % of the variance. Additionally, attraction variables accounted for variance above and beyond the impact of relationship and sexual satisfaction. These findings suggest that self-reported attraction to partner is an important contributor to women's satisfaction outcomes in long-term relationships. Further studies in the area of attraction to partner that include couple dynamics and longitudinal data are encouraged and implications for therapists, clinicians, and educators are discussed.

24 CFR 891.685 - Prohibited relationships.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Prohibited relationships. 891.685... and Individuals-Section 162 Assistance § 891.685 Prohibited relationships. The requirements for prohibited relationships for 202/162 projects are provided in § 891.130. ...

24 CFR 891.685 - Prohibited relationships.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Prohibited relationships. 891.685... and Individuals-Section 162 Assistance § 891.685 Prohibited relationships. The requirements for prohibited relationships for 202/162 projects are provided in § 891.130. ...

Accentuating the Positive, Eliminating the Negative? Relationship Maintenance as a Predictor of Two-Dimensional Relationship Quality

ERIC Educational Resources Information Center

Malinen, Kaisa; Tolvanen, Asko; Ronka, Anna

2012-01-01

In this study, relationship maintenance and its connections with positive and negative relationship quality were examined among Finnish parents (N = 177 women and 153 men; i.e., partners from 150 couples and 27 women and 3 men whose partner did not participate in the study). Relationship maintenance was measured using Stafford, Dainton, and Haas's…

In-law Relationships Before and After Marriage

PubMed Central

Fingerman, Karen L.; Gilligan, Megan; VanderDrift, Laura; Pitzer, Lindsay

2013-01-01

Relationships with in-laws play an important role in individuals’ lives, but we do not know how these ties are formed. We considered two pathways through which early relationships with mothers-in-laws may affect subsequent in-law relationship qualities: a) dimensions of the early relationship and, b) beliefs and expectations of the future relationship. Sixty men and women engaged to be married and their mothers (N = 240) completed interviews prior to, and 6 to 8 months following the wedding. Measures at Time 1 assessed three dimensions of the in-law relationship: a) behavioral (contact by phone, in person), b) emotional (positive and negative relationship qualities), and c) cognitive (knowledge about the other person). Participants also described positive and negative expectations of their future tie. Multilevel models revealed that dimensions of the tie prior to the marriage were associated with post-wedding in-law relationship qualities. When the parties had individual contact with one another and positive feelings before the wedding, ties were stronger following the wedding. Data from open-ended descriptions of negative expectations obtained before the wedding predicted negative relationship qualities after the wedding. Husbands, wives, and mothers-in-law showed similar patterns with regard to relationship qualities. Discussion focuses on the role of early emotional qualities of the in-law tie for subsequent in-law relationships. PMID:23794954

Moments of real relationship in psychoanalytic supervision.

PubMed

Watkins, C Edward

2012-09-01

What role does the real relationship play in psychoanalytic supervision? While the real relationship's role has long been and continues to be considered with regard to psychoanalysis, it has received virtually no attention in the supervision literature. In this paper, using Horney's construct of the real self as conceptual anchor, I attempt to: (1) situate the real relationship squarely within the borders of the psychoanalytic supervision relationship; (2) examine the relevance of real relationship phenomena for the supervision experience; (3) provide some simple, ordinary yet meaningful examples of case dialogue that illustrate moments of real relationship in supervision; and (4) introduce the concept of real relationship rupture and consider its potential ramifications for and impact upon the supervisor-supervisee relationship. Just as ruptures can occur in the supervisory alliance, I propose that ruptures can also transpire in the supervisory real relationship, have the potential to reverberate throughout the entirety of the supervision experience, and depending upon how they are handled, can prove either constructive and relationally energizing and enlivening or enervating and eviscerating to supervision process and outcome.

Relationship Churning in Emerging Adulthood: On/Off Relationships and Sex with an Ex

ERIC Educational Resources Information Center

Halpern-Meekin, Sarah; Manning, Wendy D.; Giordano, Peggy C.; Longmore, Monica A.

2013-01-01

We build on the emerging adulthood literature to examine two forms of relationship instability, reconciliations and sex with an ex; we term these forms of relationship churning. Analyzing recent data on emerging adult daters and cohabitors (n = 792), we find that nearly half report a reconciliation (a breakup followed by reunion) and over half of…

Multicultural Issues in Graduate Advising Relationships

ERIC Educational Resources Information Center

Schlosser, Lewis Z.; Talleyrand, Regine M.; Lyons, Heather Z.; Kim, Bryan S. K.; Johnson, W. Brad

2011-01-01

Although advisor-advisee relationships are ubiquitous to graduate training, there is relatively little scholarship bearing on advising relationships. Not surprisingly, the intersection between multiculturalism and advising relationships is also sparse. Given the potential increase in the numbers of People of Color entering graduate training due to…

Ambivalent Sexism in Close Relationships: (Hostile) Power and (Benevolent) Romance Shape Relationship Ideals

PubMed Central

Lee, Tiane L.; Fiske, Susan T.; Glick, Peter; Chen, Zhixia

2013-01-01

Gender-based structural power and heterosexual dependency produce ambivalent gender ideologies, with hostility and benevolence separately shaping close-relationship ideals. The relative importance of romanticized benevolent versus more overtly power-based hostile sexism, however, may be culturally dependent. Testing this, northeast US (N=311) and central Chinese (N=290) undergraduates rated prescriptions and proscriptions (ideals) for partners and completed Ambivalent Sexism and Ambivalence toward Men Inventories (ideologies). Multiple regressions analyses conducted on group-specific relationship ideals revealed that benevolent ideologies predicted partner ideals, in both countries, especially for US culture’s romance-oriented relationships. Hostile attitudes predicted men’s ideals, both American and Chinese, suggesting both societies’ dominant-partner advantage. PMID:23914004

Verminous arteritis in a 3-month-old thoroughbred foal.

PubMed

DeLay, J; Peregrine, A S; Parsons, D A

2001-04-01

Strongylus vulgaris migration and cranial mesenteric arterial thrombus formation resulted in fatal colic in a 3-month-old Thoroughbred foal. Vascular damage associated with S. vulgaris occurs early in the course of infection and, despite widespread use of broad-spectrum anthelmintics, appropriate management is still essential to minimize exposure of young animals to this parasite.

Verminous arteritis in a 3-month-old thoroughbred foal.

PubMed Central

DeLay, J; Peregrine, A S; Parsons, D A

2001-01-01

Strongylus vulgaris migration and cranial mesenteric arterial thrombus formation resulted in fatal colic in a 3-month-old Thoroughbred foal. Vascular damage associated with S. vulgaris occurs early in the course of infection and, despite widespread use of broad-spectrum anthelmintics, appropriate management is still essential to minimize exposure of young animals to this parasite. PMID:11326632

39 CFR 601.105 - Business relationships.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Business relationships. 601.105 Section 601.105... PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.105 Business relationships. (a) General. A person or organization wishing to have a continuing business relationship with the Postal...

39 CFR 601.105 - Business relationships.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Business relationships. 601.105 Section 601.105... PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.105 Business relationships. (a) General. A person or organization wishing to have a continuing business relationship with the Postal...

39 CFR 601.105 - Business relationships.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Business relationships. 601.105 Section 601.105... PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.105 Business relationships. (a) General. A person or organization wishing to have a continuing business relationship with the Postal...

39 CFR 601.105 - Business relationships.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Business relationships. 601.105 Section 601.105... PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.105 Business relationships. (a) General. A person or organization wishing to have a continuing business relationship with the Postal...

Improve Relationships to Improve Student Performance

ERIC Educational Resources Information Center

Arum, Richard

2011-01-01

Attempts to raise student performance have focused primarily on either relationships between adults in the system or formal curriculum. Relatively ignored has been a focus on what sociologists believe is the primary relationship of consequence for student outcomes--authority relationships between students and educators. Successful school reform is…

Personality-Relationship transaction in young adulthood.

PubMed

Neyer, F J; Asendorpf, J B

2001-12-01

Personality and social relationships were assessed twice across a 4-year period in a general population sample of 489 German young adults. Two kinds of personality-relationship transaction were observed. First, mean-level change in personality toward maturity (e.g., increase in Conscientiousness and decrease in Neuroticism) was moderated by the transition to partnership but was independent of other developmental transitions. Second, individual differences in personality traits predicted social relationships much better than vice versa. Specifically, once initial correlations were controlled for, Extraversion, Shyness, Neuroticism, self-esteem, and Agreeableness predicted change in various qualities of relationships (especially with friends and colleagues), whereas only quality of relationships with preschool children predicted later Extraversion and Neuroticism. Consequences for the transactional view of personality in young adulthood are discussed.

Perceptions of Parent-Child Attachment Relationships and Friendship Qualities: Predictors of Romantic Relationship Involvement and Quality in Adolescence.

PubMed

Kochendorfer, Logan B; Kerns, Kathryn A

2017-05-01

Relationships with parents and friends are important contexts for developing romantic relationship skills. Parents and friends may influence both the timing of involvement and the quality of romantic relationships. Three models of the joint influence of parents and friends (direct effects model, mediation model, and moderator model) have been proposed. The present study uses data from a longitudinal study (n = 1012; 49.8% female; 81.1% Caucasian) to examine how attachment and friendship quality at age 10 years predict romantic relationship involvement and quality at ages 12 and 15 years. The results supported the direct effects model, with attachment and friendship quality uniquely predicting different romantic relationship outcomes. The findings provide further support for the important influence of family and friends on early romantic relationships.

20 CFR 222.12 - Ceremonial marriage relationship.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.12 Ceremonial marriage relationship. A valid ceremonial marriage is one which would be recognized as valid by the courts of the State... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Ceremonial marriage relationship. 222.12...

20 CFR 222.12 - Ceremonial marriage relationship.

Code of Federal Regulations, 2012 CFR

2012-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.12 Ceremonial marriage relationship. A valid ceremonial marriage is one which would be recognized as valid by the courts of the State... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Ceremonial marriage relationship. 222.12...

20 CFR 222.12 - Ceremonial marriage relationship.

Code of Federal Regulations, 2014 CFR

2014-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.12 Ceremonial marriage relationship. A valid ceremonial marriage is one which would be recognized as valid by the courts of the State... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Ceremonial marriage relationship. 222.12...

20 CFR 222.12 - Ceremonial marriage relationship.

Code of Federal Regulations, 2013 CFR

2013-04-01

... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.12 Ceremonial marriage relationship. A valid ceremonial marriage is one which would be recognized as valid by the courts of the State... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Ceremonial marriage relationship. 222.12...

20 CFR 222.12 - Ceremonial marriage relationship.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Ceremonial marriage relationship. 222.12... FAMILY RELATIONSHIPS Relationship as Wife, Husband, or Widow(er) § 222.12 Ceremonial marriage relationship. A valid ceremonial marriage is one which would be recognized as valid by the courts of the State...

Assisting couples to develop healthy relationships: effects of couples relationship education on cortisol.

PubMed

Ditzen, Beate; Hahlweg, Kurt; Fehm-Wolfsdorf, Gabriele; Baucom, Don

2011-06-01

Couple conflict in unhappy marriages is suggested to impair individual health via chronic psychophysiological stress reactions in couples' everyday lives. As a consequence, we hypothesized that standard couples relationship education (CRE) would decrease psychophysiological stress, namely salivary cortisol levels, during couple conflict in the laboratory as compared to a standard psychological stress paradigm. We considered cortisol to be of particular interest in this context, as it mediates endocrine and immune responses to stress, and thus might influence couples' health. Salivary cortisol was repeatedly investigated in 61 couples during (a) a standard psychological stress test with no relevance for the couples, and (b) a standard couple conflict discussion in the laboratory before and after CRE. In addition, increases in self-evaluated relationship quality were analyzed with regard to their influence on salivary cortisol. Data were analyzed using multilevel modeling. Cortisol responses to the couple-external psychological stress test were unaffected by CRE, but specifically cortisol responses during the couple conflict discussion were significantly reduced following CRE compared to pre-intervention levels. Moreover, cortisol decreases during conflict were partially mediated by increases in self-reported relationship quality following CRE. These data suggest that CRE might buffer the harmful effects of repeated conflict in close relationships. Rather than ameliorating overall stress resilience, CRE might thus specifically improve individual health through increased relationship quality and reduced HPA axis activity during couple conflict. Copyright © 2010 Elsevier Ltd. All rights reserved.

Impact of pediatric cancer on family relationships.

PubMed

Erker, Craig; Yan, Ke; Zhang, Liyun; Bingen, Kristin; Flynn, Kathryn E; Panepinto, Julie

2018-05-01

Little is known about the impact of cancer on family relationships from the perspective of the pediatric cancer patient and their sibling(s). This study assessed and compared children's experiences of family relationships in patients receiving active cancer therapy, those who have completed therapy, and siblings. A cross-sectional study of children with cancer and their siblings aged 8-17 years old was conducted. Children completed the PROMIS Pediatric Family Relationships short form and the Depressive Symptoms, Anxiety, and Peer Relationships short forms. The Mann-Whitney test assessed differences in Family Relationships scores between therapy groups, while the Wilcoxon signed-rank test assessed differences between patients and siblings. An actor-partner interdependence model (APIM) was used to assess how patient and sibling variables were associated with their own and each others' family relationships. Two hundred and sixty-five children completed the assessments. Siblings of patients on-therapy had worse family relationships than patients on-therapy (P = 0.015). Family relationships of patients off-therapy did not differ from their siblings or the patients on-therapy. Family relationships scores did not differ between the sibling cohorts. The APIM found patient family relationships were impaired when their own peer relationships decreased and when either their own or their siblings had increased depressive symptoms. Sibling family relationships were impaired when their own depression increased, and when the patient counterpart was female, younger age, had less depressive symptoms, more anxiety or a diagnosis of leukemia/lymphoma (compared to solid tumor). Based on these findings, increased psychosocial resources for patients and siblings of children undergoing cancer therapy may be warranted. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

The quality of social relationships in ravens

PubMed Central

Fraser, Orlaith N.; Bugnyar, Thomas

2015-01-01

The quality of a social relationship represents the history of past social interactions between two individuals, from which the nature and outcome of future interactions can be predicted. Current theory predicts that relationship quality comprises three separate components, its value, compatibility and security. This study is the first to investigate the components of relationship quality in a large-brained bird. Following methods recently used to obtain quantitative measures of each relationship quality component in chimpanzees, Pan troglodytes, we entered data on seven behavioural variables from a group of 11 ravens, Corvus corax, into a principal components analysis. The characteristics of the extracted components matched those predicted for value, compatibility and security, and were labelled as such. When the effects of kinship and sex combination on each relationship quality component were analysed, we found that kin had more valuable relationships, whereas females had less secure and compatible relationships, although the effect of sex combination on compatibility only applied to nonkin. These patterns are consistent with what little knowledge we have of raven relationships from aviary studies and show that the components of relationship quality in ravens may indeed be analogous to those in chimpanzees. PMID:25821236

29 CFR 801.8 - Employment relationship.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Employment relationship. 801.8 Section 801.8 Labor... OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 General § 801.8 Employment relationship. (a) EPPA... employer in relationship to an employee or prospective employee” (EPPA section 2(2)). (b) EPPA restrictions...

29 CFR 788.16 - Employment relationship.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Employment relationship. 788.16 Section 788.16 Labor... MORE THAN EIGHT EMPLOYEES ARE EMPLOYED § 788.16 Employment relationship. (a) The Supreme Court has made..., the permanency of the relationship, the opportunities for profit or loss, the initiative judgment or...

The Multidimensional Nature of Relationships: The Perceptions of Iranian Nursing Students and Educators of the Student-Educator Relationship.

PubMed

Heydari, Abbas; Yaghoubinia, Fariba; Roudsari, Robab Latifnejad

2016-03-01

The student-educator relationship in nursing is very important to the success of teaching and learning. The perceptions of students and educators of this relationship affect its success. Therefore, it is necessary to better understand this relationship. The purpose of the current study was to explore Iranian nursing students' and educators' perceptions of student-educator relationship in clinical nursing education. In this conventional content analysis study, eight Bachelor of Nursing students and 10 clinical nursing educators from nursing and midwifery school in Mashhad (Iran) participated. Purposive sampling was used to select participants. Data were gathered using semistructured interviews. To analyze data, a conventional content analysis approach was used to identify meaning units and their condensation and to make codes and create categories : Results showed that the multidimensional nature of the student-educator relationship in clinical nursing education consists of (a) dimensions related to the educator, (b) dimensions related to the student, and (c) dimensions of relationship quality. Each of these categories is composed of codes that showed the perception of participants about the nature of relationship. On the basis of the unique features and attributes regarding relationship perceptions in clinical nursing education identified among the participants of this study, students and educators in Iran should pay greater attention to establishing the relationship as it relates to these attributes.

Abusive Relationships

MedlinePlus

... advice. loveisrespect.org : 1-866-331-9474 National Domestic Violence Hotline : 1-800-799-SAFE (7233) National Sexual ... Rape National Latino Alliance for the Elimination of Domestic Violence If you’re concerned about abusive relationships, here’s ...

Symmetries and Asymmetries in Children's Relationships.

ERIC Educational Resources Information Center

Hartup, Willard W.

It has long been recognized that childhood socialization occurs mainly through relationships with others, but only within the last decade or so can it be said that the study of relationships has become central to developmental psychology. As young children grow older, their sphere of relationships extends beyond the primary caretakers, and perhaps…

A Randomized Controlled Trial of the Web-Based OurRelationship Program: Effects on Relationship and Individual Functioning

PubMed Central

Doss, Brian D.; Cicila, Larisa N.; Georgia, Emily J.; Roddy, McKenzie K.; Nowlan, Kathryn M.; Benson, Lisa A.; Christensen, Andrew

2016-01-01

Objective Within the United States, one-third of married couples are distressed and almost half of first marriages (and more than half of unmarried cohabiting relationships) end in divorce/separation. Additionally, relationship distress has been linked to mental and physical health problems in partners and their children. Although couple therapy is effective in reducing relationship distress, it is utilized by less than one third of divorcing couples. Therefore, more accessible interventions for relationship distress are needed. Method This study tests the efficacy of the OurRelationship (OR) program, an eight-hour online program adapted from an empirically-based, in-person couple therapy. In the program, couples complete online activities and have four, 15-minute calls with project staff. Nationwide, 300 heterosexual couples (N = 600 participants) participated; couples were generally representative of the US in terms of race, ethnicity, and education. Couples were randomly assigned to begin the program immediately or to a two month waitlist control group. Results Compared to the waitlist group, intervention couples reported significant improvements in relationship satisfaction (Cohen’s d=0.69), relationship confidence (d=0.47), and negative relationship quality (d=0.57). Additionally, couples reported significant improvements in multiple domains of individual functioning, especially when individuals began the program with difficulties in that domain: depressive (d=0.71) and anxious symptoms (d=0.94), perceived health (d=0.51), work functioning (d=0.57), and quality of life (d=0.44). Conclusions In a nationally-representative sample of couples, the OR program was effective in significantly improving both relationship and individual functioning, suggesting it can substantially increase the reach of current interventions through its low-cost, web-based format. PMID:26999504

The relationship between playing computer or video games with mental health and social relationships among students in guidance schools, Kermanshah.

PubMed

Reshadat, S; Ghasemi, S R; Ahmadian, M; RajabiGilan, N

2014-01-09

Computer or video games are a popular recreational activity and playing them may constitute a large part of leisure time. This cross-sectional study aimed to evaluate the relationship between playing computer or video games with mental health and social relationships among students in guidance schools in Kermanshah, Islamic Republic of Iran, in 2012. Our total sample was 573 students and our tool was the General Health Questionnaire (GHQ-28) and social relationships questionnaires. Survey respondents reported spending an average of 71.07 (SD 72.1) min/day on computer or video games. There was a significant relationship between time spent playing games and general mental health (P < 0.04) and depression (P < 0.03). There was also a significant difference between playing and not playing computer or video games with social relationships and their subscales, including trans-local relationships (P < 0.0001) and association relationships (P < 0.01) among all participants. There was also a significant relationship between social relationships and time spent playing games (P < 0.02) and its dimensions, except for family relationships.

Terminating the Doctor-Patient Relationship

ERIC Educational Resources Information Center

Kay, Jarald

1978-01-01

Emotional aspects of ending the physician-patient relationship should be illustrated in clinical teaching courses. Teaching opportunities include examination of this relationship and professional development, unresolved doctor-patient conflicts, role underevaluation, patient gifts, and referral procedures. (Author/LBH)

Enhancing the Principal-School Counselor Relationship: Toolkit

ERIC Educational Resources Information Center

College Board Advocacy & Policy Center, 2011

2011-01-01

The College Board, NASSP and ASCA believe that the principal-counselor relationship is a dynamic and organic relationship that evolves over time in response to the ever-changing needs of a school. The goal of an effective principal-counselor relationship is to use the strength of the relationship to collaboratively lead school reform efforts to…

The Unidimensional Relationship Closeness Scale (URCS): Reliability and Validity Evidence for a New Measure of Relationship Closeness

ERIC Educational Resources Information Center

Dibble, Jayson L.; Levine, Timothy R.; Park, Hee Sun

2012-01-01

A fundamental dimension along which all social and personal relationships vary is closeness. The Unidimensional Relationship Closeness Scale (URCS) is a 12-item self-report scale measuring the closeness of social and personal relationships. The reliability and validity of the URCS were assessed with college dating couples (N = 192), female friends…

Drinking and Dating: Examining the Link among Relationship Satisfaction, Hazardous Drinking, and Readiness-to-Change in College Dating Relationships

ERIC Educational Resources Information Center

Khaddouma, Alexander; Shorey, Ryan C.; Brasfield, Hope; Febres, Jeniimarie; Zapor, Heather; Elmquist, Joanna; Stuart, Gregory L.

2016-01-01

For this study we examined the association between relationship satisfaction and readiness-to-change alcohol use, as well as the associations between hazardous drinking and readiness-to-change relationship issues in college dating relationships. A sample of 219 college students in a current dating relationship (aged 18-25) completed self-report…

The neuropeptide oxytocin modulates consumer brand relationships

PubMed Central

Fürst, Andreas; Thron, Jesko; Scheele, Dirk; Marsh, Nina; Hurlemann, René

2015-01-01

Each year, companies invest billions of dollars into marketing activities to embellish brands as valuable relationship partners assuming that consumer brand relationships (CBRs) and interpersonal relationships rest upon the same neurobiological underpinnings. Given the crucial role of the neuropeptide oxytocin (OXT) in social bonding, this study tests whether OXT-based mechanisms also determine the bond between consumers and brands. We conducted a randomized, placebo-controlled study involving 101 subjects and analyzed the effect of intranasal OXT on consumers’ attribution of relationship qualities to brands, brands paired with human celebrity endorsers, and familiar persons. OXT indeed promoted the attribution of relationship qualities not only in the case of social and semi-social stimuli, but also brands. Intriguingly, for subjects scoring high on autistic-like traits, the effect of OXT was completely reversed, evident in even lower relationship qualities across all stimulus categories. The importance of OXT in a CBR context is further corroborated by a three-fold increase in endogenous release of OXT following exposure to one’s favorite brand and positive associations between baseline peripheral OXT concentrations and brand relationship qualities. Collectively, our findings indicate that OXT not only plays a fundamental role in developing interpersonal relationships, but also enables relationship formation with objects such as brands. PMID:26449882

The neuropeptide oxytocin modulates consumer brand relationships.

PubMed

Fürst, Andreas; Thron, Jesko; Scheele, Dirk; Marsh, Nina; Hurlemann, René

2015-10-09

Each year, companies invest billions of dollars into marketing activities to embellish brands as valuable relationship partners assuming that consumer brand relationships (CBRs) and interpersonal relationships rest upon the same neurobiological underpinnings. Given the crucial role of the neuropeptide oxytocin (OXT) in social bonding, this study tests whether OXT-based mechanisms also determine the bond between consumers and brands. We conducted a randomized, placebo-controlled study involving 101 subjects and analyzed the effect of intranasal OXT on consumers' attribution of relationship qualities to brands, brands paired with human celebrity endorsers, and familiar persons. OXT indeed promoted the attribution of relationship qualities not only in the case of social and semi-social stimuli, but also brands. Intriguingly, for subjects scoring high on autistic-like traits, the effect of OXT was completely reversed, evident in even lower relationship qualities across all stimulus categories. The importance of OXT in a CBR context is further corroborated by a three-fold increase in endogenous release of OXT following exposure to one's favorite brand and positive associations between baseline peripheral OXT concentrations and brand relationship qualities. Collectively, our findings indicate that OXT not only plays a fundamental role in developing interpersonal relationships, but also enables relationship formation with objects such as brands.

Infant-Mother Relationship and Object Concept.

ERIC Educational Resources Information Center

Serafica, Felicisima C.; Uzgiris, Ina C.

The aims of this study were: (1) to specify who the infant-mother relationship evolves, and (2) to demonstrate how the development of object concept affects the evolution of that relationship. Subjects were 19 male and 17 female Caucasian infants from 4 to 12 months of age. The development of an interpersonal relationship was assessed through the…

Negative density-distribution relationship in butterflies.

PubMed

Päivinen, Jussi; Grapputo, Alessandro; Kaitala, Veijo; Komonen, Atte; Kotiaho, Janne S; Saarinen, Kimmo; Wahlberg, Niklas

2005-03-01

Because "laws of nature" do not exist in ecology, much of the foundations of community ecology rely on broad statistical generalisations. One of the strongest generalisations is the positive relationship between density and distribution within a given taxonomic assemblage; that is, locally abundant species are more widespread than locally sparse species. Several mechanisms have been proposed to create this positive relationship, and the testing of these mechanisms is attracting increasing attention. We report a strong, but counterintuitive, negative relationship between density and distribution in the butterfly fauna of Finland. With an exceptionally comprehensive data set (data includes all 95 resident species in Finland and over 1.5 million individuals), we have been able to submit several of the mechanisms to powerful direct empirical testing. Without exception, we failed to find evidence for the proposed mechanisms creating a positive density-distribution relationship. On the contrary, we found that many of the mechanisms are equally able to generate a negative relationship. We suggest that one important determinant of density-distribution relationships is the geographical location of the study: on the edge of a distribution range, suitable habitat patches are likely to be more isolated than in the core of the range. In such a situation, only the largest and best quality patches are likely to be occupied, and these by definition can support a relatively dense population leading to a negative density-distribution relationship. Finally, we conclude that generalizations about the positive density-distribution relationship should be made more cautiously.

Negative density-distribution relationship in butterflies

PubMed Central

Päivinen, Jussi; Grapputo, Alessandro; Kaitala, Veijo; Komonen, Atte; Kotiaho, Janne S; Saarinen, Kimmo; Wahlberg, Niklas

2005-01-01

Background Because "laws of nature" do not exist in ecology, much of the foundations of community ecology rely on broad statistical generalisations. One of the strongest generalisations is the positive relationship between density and distribution within a given taxonomic assemblage; that is, locally abundant species are more widespread than locally sparse species. Several mechanisms have been proposed to create this positive relationship, and the testing of these mechanisms is attracting increasing attention. Results We report a strong, but counterintuitive, negative relationship between density and distribution in the butterfly fauna of Finland. With an exceptionally comprehensive data set (data includes all 95 resident species in Finland and over 1.5 million individuals), we have been able to submit several of the mechanisms to powerful direct empirical testing. Without exception, we failed to find evidence for the proposed mechanisms creating a positive density-distribution relationship. On the contrary, we found that many of the mechanisms are equally able to generate a negative relationship. Conclusion We suggest that one important determinant of density-distribution relationships is the geographical location of the study: on the edge of a distribution range, suitable habitat patches are likely to be more isolated than in the core of the range. In such a situation, only the largest and best quality patches are likely to be occupied, and these by definition can support a relatively dense population leading to a negative density-distribution relationship. Finally, we conclude that generalizations about the positive density-distribution relationship should be made more cautiously. PMID:15737240

The Relationship between Impulsivity and Internet Gaming Disorder in Young Adults: Mediating Effects of Interpersonal Relationships and Depression.

PubMed

Ryu, Hyera; Lee, Ji-Yoon; Choi, Aruem; Park, Sunyoung; Kim, Dai-Jin; Choi, Jung-Seok

2018-03-06

Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young's Internet Addiction Test; Y-IAT), impulsivity (Barratt Impulsiveness Scale; BIS-11), interpersonal relationship (Relationship Change Scale; RCS), and depression (Beck Depression Inventory; BDI). We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults' IGD, we should consider not only individual factors (e.g., depression) but also socioenvironmental factors (e.g., interpersonal relationships).

The Relationship between Impulsivity and Internet Gaming Disorder in Young Adults: Mediating Effects of Interpersonal Relationships and Depression

PubMed Central

Ryu, Hyera; Lee, Ji-Yoon; Choi, Aruem; Park, Sunyoung; Kim, Dai-Jin

2018-01-01

Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young’s Internet Addiction Test; Y-IAT), impulsivity (Barratt Impulsiveness Scale; BIS-11), interpersonal relationship (Relationship Change Scale; RCS), and depression (Beck Depression Inventory; BDI). We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults’ IGD, we should consider not only individual factors (e.g., depression) but also socioenvironmental factors (e.g., interpersonal relationships). PMID:29509708

Relationships with former stepgrandparents after remarriage dissolution.

PubMed

Sanner, Caroline; Coleman, Marilyn; Ganong, Lawrence

2018-03-01

Increases in stepfamily formation and longevity suggest that more children have stepgrandparent relationships than ever before. Because remarriages end in divorce more often than first marriages, many children experience the involuntary dissolution of stepgrandparent ties. Little is known about stepgrandparent relationships in general, and even less is known about how these relationships are affected by remarriage dissolution. Guided by symbolic interaction theory, the purpose of this study was to understand how stepgrandchildren make sense of their relationships with former stepgrandparents. We explored their perceptions of why relationships were or were not maintained and the impact of continued or dissolved ties on their personal well-being. Former stepgrandchildren (N = 29) aged 18 to 37 were interviewed about their former stepgrandparents. The quality and continuity of these relationships were contingent on stepgrandchildren's relationships with former stepparents, biological parents' relationships with former stepgrandparents, and efforts by former stepgrandparents to remain involved. Losing ties with former stepgrandparents was upsetting, especially when relationships with biological grandparents were not close. Individuals who maintained relationships with former stepgrandparents benefitted from continued access to valuable resources (e.g., positive role models, additional sources of love and support). Our findings have important implications for clinicians' and researchers' understanding of the effects of remarriage dissolution on children as well as the intergenerational efforts that may be critical for preserving meaningful stepfamily ties. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

[Emotion and the nurse-patient relationship].

PubMed

Chiang, Hsien-Hsien

2008-02-01

The purpose of this study was to examine how emotion affects the nurse-patient relationship. The discussion is derived from a qualitative research study that examined the nurse-patient relationship in humanistic care by observing courses of introduction to nursing and nursing ethics. First, the meaning of the caring relationship is addressed. Secondly, the relationship between empathy and self transcendence is examined. Finally, the nurse's emotion as a tool for healing the other is illustrated. Thoughtful work discussions also seem to identify nurses' awareness of their own emotion as not only promoting self transcendence, but also promoting the healing process.

Gratitude: prompting behaviours that build relationships.

PubMed

Bartlett, Monica Y; Condon, Paul; Cruz, Jourdan; Baumann, Jolie; Desteno, David

2012-01-01

The emotion gratitude is argued to play a pivotal role in building and maintaining social relationships. Evidence is accumulating that links gratitude to increases in relationship satisfaction. Yet, there is currently little evidence for how gratitude does this. The present paper provides experimental evidence of gratitude facilitating relationship-building behaviours. Study 1 provides evidence that gratitude promotes social affiliation, leading one to choose to spend time with a benefactor. Study 2 offers further evidence of gratitude's ability to strengthen relationships by showing that gratitude facilitates socially inclusive behaviours, preferentially towards one's benefactor, even when those actions come at a cost to oneself.

Brief Report: Activities in Heterosexual Romantic Relationships--Grade Differences and Associations with Relationship Satisfaction

ERIC Educational Resources Information Center

Carlson, Wendy; Rose, Amanda J.

2012-01-01

Whereas much research addresses relations of youths' heterosexual romantic relationships with sexual and/or delinquent activities, less attention has been paid to youths' more normative, day-to-day activities with romantic partners. This gap in the literature is problematic given that these activities define the substance of the relationships and…

Science and Technology in the Latvian SSR on its Twentieth Anniversary

DTIC Science & Technology

1961-10-18

the normal state and neutra- tization of the human suparenals have been studied. The features of development of the lymph nodes in foetuses and newborn...cerebral ha~emorrhages off the foetus and n~exib.orn. Work is are Out on the -rophylaxis of birth i~njuriesa nd pre’ventioin off Ico mpiicstione arter...Vitaml-a Research lr~tatAut~e are studying the role of the "nost I~ortarit vitEaxn2.ns in *he PhYsiology and pathology of the femaile body, foetus and

Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator.

PubMed

Chen, Shih-Chih; Jong, Din; Lai, Min-Tsai

2014-09-01

Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

32 CFR 395.5 - Relationships.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Relationships. 395.5 Section 395.5 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) ORGANIZATIONAL CHARTERS DEFENSE LEGAL SERVICES AGENCY § 395.5 Relationships. (a) In performance of assigned...

Adolescents’ Emotional Reactivity across Relationship Contexts

PubMed Central

Cook, Emily C.; Buehler, Cheryl; Blair, Bethany L.

2012-01-01

Adolescents’ emotional reactivity in family, close friendships, and romantic relationships was examined in a community-based sample of 416 two-parent families. Six waves of annual data were analyzed using structural equation modeling. Emotional reactivity to interparental conflict during early adolescence was associated prospectively with adolescents’ reactivity to conflict in friendships and romantic relationships during middle adolescence. Close friendship reactivity partially explained the prospective association between reactivity to interparental conflict and romantic relationship reactivity. The association between perceived emotional reactivity and relationship conflict was stronger for girls than boys. Results have important developmental implications regarding adolescents’ emotional reactivity across salient interpersonal contexts during adolescence. PMID:22545839

32 CFR 18.5 - Relationships.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Relationships. 18.5 Section 18.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE MILITARY COMMISSIONS APPOINTING AUTHORITY FOR MILITARY COMMISSIONS § 18.5 Relationships. (a) In the performance of assigned functions and...

32 CFR 18.5 - Relationships.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Relationships. 18.5 Section 18.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE MILITARY COMMISSIONS APPOINTING AUTHORITY FOR MILITARY COMMISSIONS § 18.5 Relationships. (a) In the performance of assigned functions and...

The Psychology of Close Relationships: Fourteen Core Principles.

PubMed

Finkel, Eli J; Simpson, Jeffry A; Eastwick, Paul W

2017-01-03

Relationship science is a theory-rich discipline, but there have been no attempts to articulate the broader themes or principles that cut across the theories themselves. We have sought to fill that void by reviewing the psychological literature on close relationships, particularly romantic relationships, to extract its core principles. This review reveals 14 principles, which collectively address four central questions: (a) What is a relationship? (b) How do relationships operate? (c) What tendencies do people bring to their relationships? (d) How does the context affect relationships? The 14 principles paint a cohesive and unified picture of romantic relationships that reflects a strong and maturing discipline. However, the principles afford few of the sorts of conflicting predictions that can be especially helpful in fostering novel theory development. We conclude that relationship science is likely to benefit from simultaneous pushes toward both greater integration across theories (to reduce redundancy) and greater emphasis on the circumstances under which existing (or not-yet-developed) principles conflict with one another.

Assessing Client-Caregiver Relationships and the Applicability of the "Student-Teacher Relationship Scale" for People with Intellectual Disabilities

ERIC Educational Resources Information Center

Roeden, John M.; Maaskant, Marian A.; Koomen, Helma M. Y.; Candel, Math J. J. M.; Curfs, Leopold M. G.

2012-01-01

Improvements in client-caregiver relationships may lead to improvements in the quality of life of clients with intellectual disabilities (ID). For this reason, interventions aimed at influencing these relationships are important. To gain insight into the nature and intention of these relationships in the ID population, suitable measurement…

The Baby Boomers' Intergenerational Relationships

ERIC Educational Resources Information Center

Fingerman, Karen L.; Pillemer, Karl A.; Silverstein, Merril; Suitor, J. Jill

2012-01-01

Purpose: As Baby Boomers enter late life, relationships with family members gain importance. This review article highlights two aspects of their intergenerational relationships: (a) caregiving for aging parents and (b) interactions with adult children in the context of changing marital dynamics. Design and Methods: The researchers describe three…

Semantic Relationships between Contextual Synonyms

ERIC Educational Resources Information Center

Zeng, Xian-mo

2007-01-01

Contextual synonym is a linguistic phenomenon often applied but rarely discussed. This paper is to discuss the semantic relationships between contextual synonyms and the requirements under which words can be used as contextual synonyms between each other. The three basic relationships are embedment, intersection and non-coherence. The requirements…

Relationships in the Flipped Classroom

ERIC Educational Resources Information Center

McCollum, Brett M.; Fleming, Cassidy L.; Plotnikoff, Kara M.; Skagen, Darlene N.

2017-01-01

This study examines the effectiveness of flipped classrooms in chemistry, and identifies relationships as a major factor impacting the success of flipped instruction methods. Examination of student interview data reveals factors that affect the development of peer-peer, peer-peer leader, and peer-expert relationships in firstyear general chemistry…

Taking Chances in Romantic Relationships

ERIC Educational Resources Information Center

Elliott, Lindsey; Knox, David

2016-01-01

A 64 item Internet questionnaire was completed by 381 undergraduates at a large southeastern university to assess taking chances in romantic relationships. Almost three fourths (72%) self-identified as being a "person willing to take chances in my love relationship." Engaging in unprotected sex, involvement in a "friends with…

49 CFR 1.25 - Relationships.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Relationships. 1.25 Section 1.25 Transportation Office of the Secretary of Transportation ORGANIZATION AND DELEGATION OF POWERS AND DUTIES Office of the Secretary § 1.25 Relationships. (a) Normal staff role. Normally, the functions of the Assistant Secretaries...

Seven Habits of Reclaiming Relationships.

ERIC Educational Resources Information Center

Laursen, Erik K.

2002-01-01

Describes an ethnographic study undertaken with 23 youth, in residential treatment centers, to explore the effect of caring relationships on their lives. Seven elements of caring relationships were identified: trust; attention; empathy; availability; affirmation; respect; and virtue. Describes how the components of successful caring can be used to…

Brokenhearts: Dissolution of Romantic Relationships.

ERIC Educational Resources Information Center

Meeker, F. B.; La Fong, Carl

Results of an investigation examining the dissolution of romantic relationships are analyzed. Men and women (N=105) who had ended romantic relationships were surveyed in structured individual interviews. Commonalities and differences in respondents' perceptions of the experience were examined. Specific tests were made of a corollary to Waller's…

Relative Power in Sibling Relationships Across Adolescence.

PubMed

Lindell, Anna K; Campione-Barr, Nicole

2017-06-01

During childhood, older siblings typically hold a more powerful position in their relationship with their younger siblings, but these relationships are thought to become more egalitarian during adolescence as siblings begin to prepare for their relationships as adults and as younger siblings become more socially and cognitively competent. Little is known about relationship factors that may explain this shift in power dynamics, however. The present study therefore examined longitudinal changes in adolescents' and their siblings' perceptions of sibling relative power from age 12 to 18 (n = 145 dyads), and examined whether different levels of sibling relationship positivity and negativity, as well as sibling structural variables, indicated different over-time changes in relative power. Multilevel models indicated that adolescents reported significant declines in their siblings' relative power across adolescence, with older siblings relinquishing the most power over time. However, only siblings with less positively involved relationships reported declines in relative power, suggesting that siblings who maintain highly involved relationships may not become more egalitarian during adolescence. © 2017 Wiley Periodicals, Inc.

Client's view of a successful helping relationship.

PubMed

Ribner, David S; Knei-Paz, Cigal

2002-10-01

This study asked clients from multiproblem families to describe a successful helping relationship. The replies were analyzed using narrative research techniques and results are presented in conceptual categories with illustrative quotations from the interviews. The article offers conclusions about client preferences in the areas of working relationship, work styles, and worker characteristics. The results revealed two general domains of the client-worker relationship: factors that provided a sense of equality in the relationship, for example, love, friendship, and a nonjudgmental stance; and the notion that the helping relationship should parallel more normative contacts and include components such as flexibility, chemistry, luck, and going the extra distance.

Predicting Relationship Stability Among Midlife African American Couples

PubMed Central

Cutrona, Carolyn E.; Russell, Daniel W.; Burzette, Rebecca G.; Wesner, Kristin A.; Bryant, Chalandra M.

2012-01-01

Objective This study examined predictors of relationship stability over 5 years among heterosexual cohabiting and married African American couples raising an elementary-school-age child. The vulnerability–stress–adaptation model of relationships (Karney & Bradbury, 1995) guided the investigation. Contextual variables were conceptualized as important determinants of education and income, which in turn influence family structure, stress, and relationship quality and stability. Religiosity was tested as a resource variable that enhances relationship stability. Method Couples (N = 207) were drawn from the Family and Community Health Study. Variables assessed at Wave 1 (education, income, religiosity, biological vs. stepfamily status, marital status, financial strain, and relationship quality) were used to predict relationship stability 5 years later. Results Higher levels of education were associated with higher income, lower financial strain, and family structures that research has shown to be more stable (marriage rather than cohabitation and biological-family rather than stepfamily status; Bumpass & Lu, 2000). These variables, in turn, influenced relationship quality and stability. Religiosity, an important resource in the lives of African Americans, promoted relationship stability through its association with marriage, biological-family status, and women’s relationship quality. Conclusions Enhancing the stability of African American couples’ relationships will require changes in societal conditions that limit opportunities for education and income and weaken relationship bonds. Programs to assist couples with blended families are needed, and incorporation of spirituality into culturally sensitive relationship interventions for African American couples may also prove beneficial. PMID:22004304

Perceptions of primary and secondary relationships in polyamory

PubMed Central

Campbell, Lorne; Kohut, Taylor; Holmes, Bjarne M.; Lehmiller, Justin J.; Harman, Jennifer J.; Atkins, Nicole

2017-01-01

In consensually non-monogamous relationships there is an open agreement that one, both, or all individuals involved in a romantic relationship may also have other sexual and/or romantic partners. Research concerning consensual non-monogamy has grown recently but has just begun to determine how relationships amongst partners in consensually non-monogamous arrangements may vary. The current research examines this issue within one type of consensual non-monogamy, specifically polyamory, using a convenience sample of 1,308 self-identified polyamorous individuals who provided responses to various indices of relationship evaluation (e.g. acceptance, secrecy, investment size, satisfaction level, commitment level, relationship communication, and sexual frequency). Measures were compared between perceptions of two concurrent partners within each polyamorous relationship (i.e., primary and secondary partners). Participants reported less stigma as well as more investment, satisfaction, commitment and greater communication about the relationship with primary compared to secondary relationships, but a greater proportion of time on sexual activity with secondary compared to primary relationships. We discuss how these results inform our understanding of the unique costs and rewards of primary-secondary relationships in polyamory and suggest future directions based on these findings. PMID:28542619

PHARMACOKINETIC STUDY OF ORAL ε-AMINOCAPROIC ACID IN THE NORTHERN ELEPHANT SEAL (MIROUNGA ANGUSTIROSTRIS).

PubMed

Kaye, Sarrah; Johnson, Shawn; Arnold, Robert D; Nie, Ben; Davis, Joshua T; Gulland, Frances; Abou-Madi, Noha; Fletcher, Daniel J

2016-06-01

ε-Aminocaproic acid (EACA) is a lysine analogue antifibrinolytic drug used to treat bleeding disorders in humans and domestic animals. Its use in zoological medicine is rare, and dosage is anecdotal. One possible application of EACA is to treat bleeding associated with prepatent Otostrongylus arteritis in Northern elephant seals ( Mirounga angustirostris ) presenting to wildlife rehabilitation centers. This study used an in vitro model of hyperfibrinolysis and a thromboelastograph-based assay to estimate the therapeutic plasma concentration of EACA in elephant seals (85 μg/ml, 95% confidence interval = 73.8-96.8 μg/ml). A concurrent pharmacokinetic study of orally administered, single-dose EACA found that doses of 75 and 100 mg/kg achieved therapeutic plasma concentrations (>85 μg/ml), but the drug was rapidly eliminated and remained in the therapeutic range for only 0.4 and 1.5 hr, respectively. Models of repeated oral dosing at 100 mg/kg every 6 hr predict that therapeutic plasma concentration will be maintained for 31.7% (7.6 hr) of a 24-hr period. More frequent dosing would be required to maintain continuous therapeutic concentrations but would be impractical in a wildlife rehabilitation setting. Further pharmacodynamic studies to evaluate the duration of action of EACA in elephant seals and a prospective, placebo-controlled study are needed to determine if EACA is effective in decreasing bleeding associated with prepatent Otostrongylus arteritis and other bleeding disorders in this species.

What's a Good Job? The Importance of Employment Relationships. CPRN Study. Changing Employment Relationships Series.

ERIC Educational Resources Information Center

Lowe, Graham S.; Schellenberg, Grant

The Changing Employment Relationships Project examined the importance of good employment relationships for workers, employers, and public policy. A nationally representative sample of 2,500 employed Canadians was surveyed, and 8 focus groups were conducted. The research findings were analyzed to explain the multidimensional nature of the…

Relationship Building as a Retention Strategy: Linking Relationship Attitudes and Satisfaction Evaluations to Behavioral Outcomes.

ERIC Educational Resources Information Center

Bruning, Stephen D.

2002-01-01

Determines whether student-university relationship attitudes and satisfaction evaluations distinguished those who returned to a university from those who did not. Shows that respondent relationship attitudes differentiate those who returned to the university from those who did not, which provides a quantitative illustration of the benefits of…

Assessing how much couples work at their relationship: the behavioral self-regulation for effective relationships scale.

PubMed

Wilson, Keithia L; Charker, Jill; Lizzio, Alf; Halford, Kim; Kimlin, Siobhan

2005-09-01

It is widely believed that satisfying couple relationships require work by the partners. The authors equated the concept of work to relationship self-regulation and developed a scale to assess this construct. A factor analysis of the scale in a sample of 187 newlywed couples showed it comprised 2 factors of relationship strategies and effort. The factor structure was replicated in an independent sample of 97 newlywed couples. In both samples the scale had good internal consistency and high convergent validity between self- and partner-report forms. Self-regulation accounted for substantial variance in relationship satisfaction in both newlywed samples and in a 3rd sample of 61 long-married couples. The self-regulation and satisfaction association was independent of mood or self-report common method variance. (c) 2005 APA, all rights reserved

Solar wind proton temperature-velocity relationship

NASA Technical Reports Server (NTRS)

Lopez, R. E.; Freeman, J. W.

1986-01-01

Helios 1 data are analyzed to find an experimental fit for the temperature-velocity relationship at 1 AU. It is shown that the proton temperature-velocity changes at a velocity of approximately 500 km/s. Interplanetary dynamic processes, i.e., stream interactions, are shown to affect the temperature-velocity relationships less than 22 percent; the functional form of these relationships appears to be preserved throughout the solar cycle. It is pointed out that any comprehensive model of the solar wind will have to address the difference in the temperature-velocity relationship between the low- and high-speed wind, since this is a product of the acceleration and subsequent heating process generating the solar wind.

Adolescents' Parent and Peer Relationships.

ERIC Educational Resources Information Center

Field, Tiffany; Diego, Miguel; Sanders, Christopher

2002-01-01

The differences between how suburban high school students (N=89) rated the quality of their parent and peer relationships were assessed. Adolescents with high parent and high peer relationship scores had more friends, greater family togetherness, lower levels of depression and drug use, and higher grade point averages. Results highlight the…

Counseling for Work and Relationship

ERIC Educational Resources Information Center

Richardson, Mary Sue

2012-01-01

Counseling for work and relationship is a social constructionist perspective, informed by feminist and social justice values, and responsive to radical changes in contemporary lives, that fosters a shift in vocational psychology from helping people develop careers to helping people construct lives through work and relationship. The first and major…

Implicit Theories of Peer Relationships

ERIC Educational Resources Information Center

Rudolph, Karen D.

2010-01-01

This research investigated the role of children's implicit theories of peer relationships in their psychological, emotional, and behavioral adjustment. Participants included 206 children (110 girls; 96 boys; M age = 10.13 years, SD = 1.16) who reported on their implicit theories of peer relationships, social goal orientation, need for approval,…

Intergenerational Relationship Quality Across Three Generations

PubMed Central

Tighe, Lauren A.; Fingerman, Karen L.; Zarit, Steven H.

2012-01-01

Objectives. Studies of intergenerational relationship quality often include one or two generations. This study examined within-family differences and similarities or transmission of positive and negative relationship quality across three generations. Method. Participants included 633 middle-aged individuals (G2; 52% women, ages 40–60 years), 592 of their offspring (G3; 53% daughters; ages 18–41 years), and 337 of their parents (i.e., grandparents; G1; 69% women; ages 59–96 years). Results. Multilevel models revealed differences and similarities in relationship quality across generations. The oldest generation (G1) reported greater positive and less negative quality relationships than the middle (G2) and the younger (G3) generations. There was limited evidence of transmission. Middle-aged respondents who reported more positive and less negative ties with their parents (G1) reported more positive and less negative ties with their own children (G3). Grandmother (G1) reports of more positive relationship quality were associated with G3 reports of more positive relationship quality with G2. Discussion. Findings are consistent with the intergenerational stake hypothesis and only partially consistent with the theory of intergenerational transmission. Overall, this study suggests that there is greater within-family variability than similarities in how family members feel about one another. PMID:22628478

Development of intimate relationships in adolescence.

PubMed

Raymond, Marissa; Catallozzi, Marina; Lin, Alison J; Ryan, Owen; Rickert, Vaughn I

2007-12-01

This article examines adolescent intimacy through a developmental lens. As they age, adolescents develop the relational skills necessary to gain independence from their parents and form intimate relationships with friends and romantic partners. This article details how adolescents' intimate relationships expand from parental connections to encompass friendships, dating, and sexual activity during progressing stages of development. Finally, clinical implications for adolescent health care practitioners for promoting intimacy and healthy relationships are suggested.

Safety management in a relationship-oriented culture.

PubMed

Hsu, Shang Hwa; Lee, Chun-Chia

2012-01-01

A relationship-oriented culture predominates in the Greater China region, where it is more important than in Western countries. Some characteristics of this culture influence strongly the organizational structure and interactions among members in an organization. This study aimed to explore the possible influence of relationships on safety management in relationship-oriented cultures. We hypothesized that organizational factors (management involvement and harmonious relationships) within a relationship-oriented culture would influence supervisory work (ongoing monitoring and task instructions), the reporting system (selective reporting), and teamwork (team communication and co-ordination) in safety management at a group level, which would in turn influence individual reliance complacency, risk awareness, and practices. We distributed a safety climate questionnaire to the employees of Taiwanese high-risk industries. The results of structural equation modeling supported the hypothesis. This article also discusses the findings and implications for safety improvement in countries with a relationship-oriented culture.

Pathological love: impulsivity, personality, and romantic relationship.

PubMed

Sophia, Eglacy C; Tavares, Hermano; Berti, Marina P; Pereira, Ana P; Lorena, Andrea; Mello, Cidália; Gorenstein, Clarice; Zilberman, Monica L

2009-05-01

Pathological love (PL)--behavior characterized by providing repetitive and uncontrolled care and attention to the partner in a romantic relationship--is a rarely studied condition, despite not being rare and causing suffering. This study aims at investigating impulsivity, personality, and characteristics related to the romantic relationship in this population. Eighty-nine individuals (50 with PL; 39 individuals with no psychiatric disorder) were compared regarding impulsivity, personality, type of attachment, satisfaction with romantic relationship, and love style. Individuals with PL have higher levels of impulsivity (P<.001; Barratt Impulsiveness Scale), higher self-transcendence, that is, are more unconventional and hold sense of communion with a wider reality (P<.001; Temperament and Character Inventory) and keep dissatisfactory romantic relationships (P<.001; Adapted Relationship Assessment Scale). Individuals with PL present personality traits and relationship aspects that must be taken into account in devising assessment and therapeutic strategies for this population.

Taking the pulse of strategic outsourcing relationships.

PubMed

Getz, Kenneth A; Lamberti, Mary Jo; Kaitin, Kenneth I

2014-10-01

Articles in peer-reviewed journals and the trade press presuppose that strategic outsourcing relationships have been formed to replace preexisting collaborative approaches with contract research organizations. They do not consider that large, fragmented pharmaceutical and biotechnology companies may be supporting competing and conflicting relationship models simultaneously. A recent Tufts Center for the Study of Drug Development study quantifies actual strategic outsourcing practices among drug development companies and sheds new light on why these relationships may be failing. Tufts Center for the Study of Drug Development conducted an in-depth assessment of 43 Phase II and III clinical studies completed since 2012 to examine the outsourcing relationships used by 9 major pharmaceutical and biotechnology companies to support key functional areas. Descriptive statistics were assessed and t tests were performed to characterize outsourcing practices by function and to determine differences in study performance between transactional and strategic outsourcing relationships. The results indicate that sponsor companies are using a variety of outsourcing relationship models to support their studies, mixing and matching the use of internal staff, and using traditional transactional and strategic outsourcing relationships simultaneously. Specifically, despite the fact that each sponsor company had entered into several strategic outsourcing relationships, in no instance did a single contract research organization manage all functional areas supporting an individual Phase II or III study. In addition, sponsor companies vary the types of outsourcing relationship models that they use on a study-by-study basis. The inability of pharmaceutical and biotechnology companies to consistently embrace and coordinate sourcing strategies is creating internal friction and inefficiency. As a result, the expected impact of strategic outsourcing relationships on drug development performance

The impact of the within my reach relationship training on relationship skills and outcomes for low-income individuals.

PubMed

Antle, Becky; Sar, Bibhuti; Christensen, Dana; Karam, Eli; Ellers, Fran; Barbee, Anita; van Zyl, Michel

2013-07-01

A federal grant was awarded to provide the Within My Reach healthy relationships curriculum to low-income, at-risk individuals involved with various social service agencies. The effectiveness of this curriculum was evaluated for 202 participants through measures of training and relationship outcomes pre-, immediately post- and 6 months posttraining. Participants experienced high levels of training satisfaction; significant increases in knowledge, communication/conflict resolution skills, and relationship quality; as well as a trend in the reduction of relationship violence. An important implication of this research is that MFTs may broaden their service delivery to at-risk individuals by collaborating with community agencies to adapt established relationship enhancement programs, evidence-based tools, and principles that complement traditional couples therapy. © 2012 American Association for Marriage and Family Therapy.

Relationship Needs of College Students.

ERIC Educational Resources Information Center

Martin, Debra Faye

The purpose of this study was to investigate the attributes which college students use to describe a desired mate or relationship needs. The sample consisted of 108 students, of which 58 were females and 50 were males. The following independent variables were investigated: gender, age, relationship status, and family structure. The dependent…

The interpersonal relationship in clinical practice. The Barrett-Lennard Relationship Inventory as an assessment instrument.

PubMed

Simmons, J; Roberge, L; Kendrick, S B; Richards, B

1995-03-01

The biomedical model that has long been central to medical practice is gradually being expanded to a broader biopsychosocial model. Relationship-building skills commensurate with the new paradigm need to be understood by educators and taught to medical practitioners. The person-centered, or humanistic, model of psychologist Carl Rogers provides a theoretical approach for the development of effective biopsychosocial relationships. The Barrett-Lennard Relationship Inventory (BLRI) was developed in 1962 as an assessment instrument for the person-centered model. In this article, the person-centered model and the use of the BLRI as an assessment instrument of this model are discussed. Current and potential uses of the BLRI are explored.

Supportive relationship: Experiences of Iranian students and teachers concerning student-teacher relationship in clinical nursing education

PubMed Central

Heydari, Abbas; Yaghoubinia, Fariba; Roudsari, Robab Latifnejad

2013-01-01

Background: Student-teacher relationship is a salient issue in nursing education and has long-lasting implication in professional development of nursing students. Nowadays, this relationship in clinical settings is different from the past due to changing in nursing education paradigm. The purpose of this qualitative study was to explore the experiences of students and teachers about student-teacher relationship in the context of clinical nursing education in Iran. Materials and Methods: In this qualitative study that has been carried out adopting conventional qualitative content analysis approach, six bachelor nursing students and six clinical teachers in school of Nursing and Midwifery, were selected through purposive sampling. Semi-structured interview and participant observation were used for data collection. Interviews transcribed verbatim and analyzed using conventional content analysis through the process of data reduction and condensation, coding and also generating the categories and themes. Results: Results of the study showed the existence of a type of relationship in clinical education in which supportive actions of clinical teachers were prominent. These supportive actions appeared as three major categories including educational support, emotional support and social support which emerged from data. Conclusion: The results of this study explicit the ways that support could be provided for students in their relationship with clinical teachers. It also determines the teachers’ need to know more about the influence of their supportive relationship on students’ learning and the best possible outcomes of their education in clinical settings. PMID:24554945

Supportive relationship: Experiences of Iranian students and teachers concerning student-teacher relationship in clinical nursing education.

PubMed

Heydari, Abbas; Yaghoubinia, Fariba; Roudsari, Robab Latifnejad

2013-11-01

Student-teacher relationship is a salient issue in nursing education and has long-lasting implication in professional development of nursing students. Nowadays, this relationship in clinical settings is different from the past due to changing in nursing education paradigm. The purpose of this qualitative study was to explore the experiences of students and teachers about student-teacher relationship in the context of clinical nursing education in Iran. In this qualitative study that has been carried out adopting conventional qualitative content analysis approach, six bachelor nursing students and six clinical teachers in school of Nursing and Midwifery, were selected through purposive sampling. Semi-structured interview and participant observation were used for data collection. Interviews transcribed verbatim and analyzed using conventional content analysis through the process of data reduction and condensation, coding and also generating the categories and themes. Results of the study showed the existence of a type of relationship in clinical education in which supportive actions of clinical teachers were prominent. These supportive actions appeared as three major categories including educational support, emotional support and social support which emerged from data. The results of this study explicit the ways that support could be provided for students in their relationship with clinical teachers. It also determines the teachers' need to know more about the influence of their supportive relationship on students' learning and the best possible outcomes of their education in clinical settings.

Relationship self-efficacy protects against mental health problems among women in bidirectionally aggressive intimate relationships with men.

PubMed

Sullivan, Tami P; McPartland, Tara; Price, Carolina; Cruza-Guet, Maria Cristina; Swan, Suzanne C

2013-10-01

Research examining predictors or correlates of mental health problems among women who experience or use aggression in intimate relationships typically assesses factors that confer risk. Such research has primarily examined intimate partner violence (IPV) victimization or aggression frequency or severity as central risk factors for mental health problems. In the general population, one factor demonstrating a protective effect on mental health problems is self-efficacy. Research on self-efficacy among women who experience or use aggression in intimate relationships is nearly absent. The purpose of this study was to determine if self-efficacy specific to a woman's ability to manage various relationship problems (i.e., relationship self-efficacy [RSE]) played a protective role against the severity of posttraumatic stress, depression, and anxiety symptoms among 354 community-residing women who were victimized and used aggression (bidirectional IPV). Regression analyses found that RSE uniquely predicted each mental health outcome above and beyond what was accounted for by the frequency of physical, sexual, and psychological victimization and aggression. Further, RSE fully mediated the relationships between psychological victimization and each mental health outcome. If replicated, and in circumstances where it is determined safe to do so, findings suggest RSE as a promising avenue for future research to improve the health and well-being of women in bidirectionally aggressive relationships.

The Mentoring Relationship in Action.

ERIC Educational Resources Information Center

IUME Briefs, 1992

1992-01-01

Mentoring is now a very popular, but loosely defined, feature of many programs for youth. The heart of mentoring is the relationship between the youth and the mentor, but little is actually known about this relationship. Mentoring should not be limited to at-risk youth, since many average students or underachievers from stable backgrounds may…

Pharmacists' and patients' roles in the pharmacist-patient relationship: are pharmacists and patients reading from the same relationship script?

PubMed

Worley, Marcia M; Schommer, Jon C; Brown, Lawrence M; Hadsall, Ronald S; Ranelli, Paul L; Stratton, Timothy P; Uden, Donald L

2007-03-01

Pharmacists' professional roles have maturated to include provision of information, education, and pharmaceutical care services. These changes have resulted in a focus on collaborative pharmacist-patient professional relationships, in which pharmacists and patients both have roles and responsibilities. The study purpose was to investigate pharmacists' and patients' views of selected pharmacist and patient roles in the pharmacist-patient professional relationship, using principles of role theory. Pharmacist and patient role dimensions studied included (1) "information sharing,"(2) "responsible behavior," and (3) "interpersonal communication." "Creating a patient-centered relationship" and "active communication related to health care" were additional pharmacist and patient role dimensions studied, respectively. Data were collected via mailed questionnaires from national random samples of 500 patients aged 18 years and older and 500 pharmacists. Internal consistency reliability was estimated for pharmacist and patient role dimensions using Cronbach's coefficient alpha and bivariate correlation analysis. Student's t test was used to compare pharmacists' and patients' views of role dimensions (alpha level of significance=.05). Descriptive statistics were used to characterize the pharmacist and patient samples. The adjusted response rates for the pharmacist and patient groups were 34.9% (173/496) and 40.8% (196/480), respectively. Pharmacist and patient role dimensions exhibited adequate reliability coefficients. Results showed that pharmacists and patients have similar views regarding pharmacists' "information sharing" roles in the relationship, but for the most part, patients agree less about pharmacists' "responsible behavior," "creating a patient-centered relationship," and "interpersonal communication" roles. Regarding patient roles in the relationship, pharmacists and patients have different views about patients' "information sharing," "responsible behavior

Information sharing and relationships on social networking sites.

PubMed

Steijn, Wouter M P; Schouten, Alexander P

2013-08-01

This article investigates the relationship between sharing personal information and relationship development in the context of social networking sites (SNSs). Information disclosed on these sites could affect relationships in a different manner compared to more traditional interactions, such as instant messaging or face-to-face interaction. Respondents in the age range of 12 to 83 were surveyed about experiences of relationship development as a consequence of contact through Facebook or Hyves-the most popular Dutch SNSs. Results showed a primarily positive effect of information sharing on SNSs on our relationships. Furthermore, relationship development mainly occurs among acquaintances and friends, and public posts are most strongly related to relationship development. These findings suggest that SNSs might affect relationships in a distinct fashion as acquaintances and friends gain access to public self-disclosures that might normally only be reserved for close friends and family. Overall, this study provides an insight into some of the positive aspects of the public nature of SNSs in contrast with the general negative associations.

Social Relationships and Children's Subjective Well-Being

ERIC Educational Resources Information Center

Goswami, Haridhan

2012-01-01

The quality of relationships is now recognised as an important aspect of children's subjective well-being. This article focuses on both positive and negative quality of relationships. It includes six areas of children's relationships--family, neighbourhood adults, positive affect friendship, negative affect friendship, experiences of being bullied…

Relationship Quality in Interethnic Marriages and Cohabitations

ERIC Educational Resources Information Center

Hohmann-Marriott, Bryndl E.; Amato, Paul

2008-01-01

This study focuses on the factors underlying differences in relationship quality between interethnic and same-ethnic couples. Using the National Survey of Families and Households and the Fragile Families and Child Wellbeing Study, we examine relationship satisfaction, interpartner conflict and subjective assessments of relationship instability in…

Influence of Roads on the Surrounding Natural Environment - Vegetation, Soil, and Ground Water

DTIC Science & Technology

1980-02-01

0 __________ _______ ___ _ ii _ _ _ _ en 12bm ~11 I.IO .Figuz 9. Observationsomr~ de Gundlatorp (nr 15). 1W 15, - 1~Karlsharnn - Ronrioby, (Study site...0s . . number of’ srscie s - -- ANTAL ATf 1EJPER RUTA 9 10 13 3 Per souare TOTALI AITAL LATER 13 total n- -her of srnecies Table 2. Analyses of...50. It .5 POA ANNUA 2 1 3 5 100. 3. 2.7 POA NERORALIS 2 0 0 1 50. . 8 No.of species per square ANJTAL ARTER PE.R RUTA 7 6 S 6 Total no. Of S ~eciesE

Crowned dens syndrome diagnosed on ¹⁸F-FDG PET/CT.

PubMed

Monet, Antoine; Massonnat, Richard; Merino, Bertrand; Riviere, Annalisa; Richez, Christophe

2014-12-01

An 87-year-old woman with corticosteroid-resistant polymyalgia rheumatica underwent ¹⁸F-FDG PET/CT for suspected giant cell arteritis or neoplastic disease. FDG uptake in the immediate vicinity of the odontoid process, with a crownlike calcification, was identified on the CT scan on the posterior side of the dens, thus confirming the diagnosis of crowned dens syndrome. Because this rare syndrome is frequently misdiagnosed, nuclear physicians should be aware of the signs and symptoms of this condition, which may call for the use of PET/CT imagery.

Ion Channels in Leukocytes

DTIC Science & Technology

1991-07-01

muscle k142), heart muscle (80), bo- are released. In recent years much has been learned vine pulmonar arter endothelial cells (251), and rat about the...b3 Zn or cytes from cystic fibrosis patients lack a Cl current that Ni (1 mM)-added to the cytoplasmic side of the mem- can be acti% ated b3 the...that at37’C hu- to be defectiv.- in cystic fibrosis (55, 277), and Chen et al. man T-cell CiL channels are active at rest, implies that (25) have shown

Ophthalmologic complications of systemic disease.

PubMed

Klig, Jean E

2008-02-01

The human eye, as an organ, can offer critical clues to the presence of systemic disease. This article discusses the various ophthalmologic manifestations of systemic disease that can be evident on examination by an emergency department provider, as well as some findings that can be discerned with specialty consultation. The following topics are reviewed with respect to potential ocular signs and complications: syphilis, herpes zoster, Lyme disease, acquired immunodeficiency syndrome, Reiter's syndrome, Kawasaki's disease, temporal arteritis, endocarditis, hypertension, and diabetes mellitus. Indications for emergent ophthalmologic consultation are also emphasized.

Negotiating commitment and involvement in the nurse-patient relationship.

PubMed

Morse, J M

1991-04-01

The relationship that is established between the nurse and the patient is the result of interplay or covert negotiations until a mutually satisfying relationship is reached. Depending on the duration of the contact between the nurse and the patient, the needs of the patient, the commitment of the nurse and the patient's willingness to trust the nurse, one of four types of mutual relationship will emerge: a clinical relationship, a therapeutic relationship, a connected relationship or an over-involved relationship. If the nurse is unwilling or unable to be committed to the patient, a unilateral relationship will develop, with the patient continuing to use manipulative or coercive behaviours, attempting to increase the nursing involvement in the relationship. If the patient is unwilling to trust the nurse and accept his or her illness situation, she or he will manifest 'difficult' behaviours, be withdrawn or elope. The changing nature of the relationship, and the conditions and consequences of each type of relationship are discussed.