Showing papers by "London Bridge Hospital published in 2009"

The Euro-Phospholipid project: epidemiology of the antiphospholipid syndrome in Europe.

Abstract: The Euro-Phospholipid project started in 1999 with a multicentre, consecutive and prospective design. A total cohort of 1000 patients with antiphospholipid syndrome (APS), derived from 13 countries (Belgium, Bulgaria, Denmark, France, Germany, Greece, Hungary, Israel, Italy, the Netherlands, Portugal, Spain and United Kingdom), has been followed since then. This project allowed the identification of the prevalence and characteristics of the main clinical and immunological manifestations at the onset and during the evolution of APS and demonstrated that it is possible to recognize more homogeneous subsets of clinical significance. Patients with APS associated with systemic lupus erythematosus (SLE) had more episodes of arthritis, livedo reticularis and more frequently exhibited thrombocytopenia and leucopenia. Female patients had more episodes of arthritis and livedo reticularis - both connected with the higher prevalence of migraine and SLE-related APS in women, while male patients had more myocardial infarction, epilepsy and lower limb arterial thrombosis. Childhood onset patients presented more episodes of chorea and jugular vein thrombosis, whereas older onset patients were more frequently male and had more strokes and angina pectoris, but less frequently livedo reticularis.

The Euro-lupus project: epidemiology of systemic lupus erythematosus in Europe.

Abstract: The Euro-lupus project provides updated information on the epidemiologic characteristics of systemic lupus erythematosus (SLE) at the change of the millennium and defines several clinical and immunological prognostic factors. The Euro-lupus cohort is composed of 1000 patients with SLE who have been followed prospectively since 1991. Among other findings, this project has shown that a) the age at onset of the disease, the gender and the autoantibody pattern, among other factors, modify the disease expression and define some specific SLE subsets; b) most of the SLE inflammatory manifestations are less common after long-term evolution of the disease, thus probably reflecting the effect of therapy as well as the progressive remission of the disease in many patients and c) a more prominent role of thrombotic events is becoming evident affecting both morbidity and mortality in SLE.

European consensus statement on the terminology used in the management of lupus glomerulonephritis

Abstract: Systemic lupus erythematosus (SLE) is a complex, multisystem autoimmune disorder, which often involves referral to multiple medical specialists. Lupus nephritis (LN) occurs in ~35% of adults with SLE and predicts poor survival. There is currently no consensus on how to manage patients with SLE or LN across specialties and across different European countries. The Lupus Nephritis Terminology Advisory Group was formed to address this issue as it impacts upon LN treatment. It has developed consensus statements based on opinions from expert panel meetings with nephrologists, nephropathologists, rheumatologists, clinical immunologists and internal medicine specialists from many European countries, after reviewing current guidelines from the European League Against Rheumatism, the American College of Rheumatology and the participants' experience. In this article, we report consensus statements that were developed in six important areas: classification of patients with LN, how classification affects the selection of treatment options and definitions of induction, response, flare and maintenance. We have also proposed a consensus for the terminology involved in the management of LN that is consistent with clinical opinion gathered from multidisciplinary expert meetings and with existing guidelines. We believe this consensus approach provides agreed expert opinion to clinicians and will form the basis for optimising LN treatment.

Sexual Response in Cardiovascular Disease

Abstract: The cardiovascular response to sexual activity in men and women is similar to other daily activities and not excessive between couples in a long-standing relationship. The risk of an ischemic event...

Rituximab in lupus and beyond: the state of the art

Abstract: On 17th December 2008, nephrologists and rheumatologists gathered at the London Lupus Centre, London Bridge Hospital, to review anecdotal experience and published data concerning rituximab (RTX) in SLE. The meeting, which followed a similar conference held in 2006,1 also examined RTX use in treatment of rheumatoid arthritis (RA), anti-phospholipid syndrome (APS), Sjögren’s syndrome and vasculitis. The presentations underscored the considerable recent progress made in characterising the efficacy and tolerability of B cell depletion therapy (BCDT) in these settings and highlighted some key areas for future research. A consensus emerged that BCDT potentially offers an effective, relatively well tolerated, treatment for SLE and that a need for innovations in management remains.

Where can I find out more

Abstract: What is in store for the guppy? Variation is essential to understanding the genetics underlying biological processes. The guppy provides a huge amount of natural variation that can be studied genetically. This variation has not been produced by mutagenesis screens, but instead has been shaped by natural selection. Thus, combined with emerging genomic resources, the guppy is an ideal organism for understanding the evolutionary genetics and molecular basis of adaptation.

Heart and lungs

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Hughes syndrome: a disease of our time

Abstract: It is a double honour for me to be invited to give this lecture. Firstly, because I regard Professor Feng not only as one of the true giants of world rheumatology, but also as a very good friend. He has been the catalyst and leader in the development of rheumatology both in Singapore, as well as in Asia in general. He has trained countless fellows, one of whom Mee Ling Boey, was a fellow in my unit at the time of the description of the antiphospholipid syndrome 25 yeas ago in 1983. Secondly, again through Professor Feng’s leadership, this is the first ‘Ten Topics’ Asia meeting. ‘Ten Topics’ was started in 1985 as a concentrated two-day update in rheumatology, especially in lupus and connective tissue diseases. The St Thomas’ meeting, held each July, has proved popular to saturation point. Ten years ago, ‘Ten Topics’ was launched in Barcelona. We now have ‘Ten Topics’ in Rome, Buenos Aires and Nice, all keeping to the tight format of short clinical and ‘basic’ updates, aimed as ‘high’ as possible. I hope that this, the 2008 Singapore meeting will be the first of many annual Asian ‘Ten Topics’.