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Mashup Score: 6Clinical assessment and management of lumbar spinal stenosis: clinical dilemmas and considerations for surgical referral - 1 day(s) ago
Lumbar spinal stenosis is the leading indication for spine surgery in older adults. Surgery is recommended in clinical guidelines if non-surgical treatments have been provided with insufficient benefit. The difficulty for clinicians is that the current number of randomised controlled trials is low, which creates uncertainty about which treatments to provide. For non-surgical clinicians this paucity of data leads to a clinical dilemma of whether to continue managing the patient or refer to a spine surgeon.
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Mashup Score: 5The Florida Scoring System for stratifying children with suspected Sjögren's disease: a cross-sectional machine learning study - 2 day(s) ago
The Florida Scoring System is a paediatrician-friendly tool that can be used to assist classification and long-term monitoring of suspected childhood Sjögren’s disease. The resulting stratification has important implications for clinical management, trial design, and pathobiological research. We found a highly symptomatic patient group with negative serology and diagnostic profiles, which warrants clinical attention. We further revealed that salivary gland ultrasonography can be a non-invasive alternative to minor salivary gland biopsy in children.
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Mashup Score: 1Blau syndrome presenting as lipoma arborescens - 3 day(s) ago
A 29-year-old woman presented with a 23-year history of multiple joint swelling and intermittent pain. Physical examination showed large, soft, and fluctuant soft tissue swelling of the hands, wrists, elbows, knees, and ankles, bilaterally (figure A; appendix p 2). Symmetric tense knee effusions restricted her range of motion. She had previously had multiple recurrences of panuveitis, cataract, and secondary glaucoma in both eyes for 7 years, with retinal detachment leading to blindness in her left eye.
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Mashup Score: 53
Two conventional synthetic DMARD tapering strategies were associated with significantly lower rates of flare-free survival compared with stable conventional synthetic DMARD treatment, and the data do not support non-inferiority. However, drug-free remission was achiveable for a significant subgroup of patients. This trial provides information on risk and benefits of different treatment strategies important for shared decision making.
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Mashup Score: 2
Giant cell arteritis is the most frequent systemic inflammatory vasculitis, mainly affecting large vessels.1 The cause of giant cell arteritis is complex; the fewer risk loci identified in giant cell arteritis compared with other immune-mediated diseases emphasises that an intricate relationship between genetic, environmental, and other factors is likely to be involved in the development of the disease. Therefore, making an effort to use genetic findings to predict the risk of giant cell arteritis is likely to be hampered by the fact that genetic factors contribute to disease susceptibility to an unknown extent.
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Mashup Score: 8Risk loci involved in giant cell arteritis susceptibility: a genome-wide association study - 7 day(s) ago
We have found several additional loci associated with giant cell arteritis, highlighting the crucial role of angiogenesis in disease susceptibility. Our study represents a step forward in the translation of genomic findings to clinical practice in giant cell arteritis, proposing new treatments and a method to measure genetic predisposition to this vasculitis.
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Mashup Score: 9The Lancet Respiratory Medicine, August 2023, Volume 11, Issue 8, Pages 663-754, e73-e77 - 8 day(s) ago
Explore the current issue of The Lancet Respiratory Medicine, a monthly journal covering content in respiratory medicine and critical care
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Mashup Score: 4
Vaccination remains the only strategy to generate durable protective immunity against any infectious disease, but data for SARS-CoV-2 vaccination continues to highlight those receiving B-cell depleting therapies, glucocorticoids, and antiproliferative medications such as mycophenolate mofetil as those with the greatest attenuation of immune responses, resulting in an increased risk of breakthrough infections.1 More worrisome is that additional vaccine doses might not seroconvert a large proportion of these patients, particularly those receiving B-cell depleting therapies,2 although many of these observations were done in a small observation study setting.
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Mashup Score: 5
A third vaccine dose improved the serological and T-cell response in the majority of patients who are immunocompromised. Individuals with chronic renal disease, lymphoid malignancy, on B-cell targeted therapies, or with no serological response after two vaccine doses are at higher risk of poor response to a third vaccine dose.
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Mashup Score: 0Protecting patients with SLE against herpes zoster: time for early proactive vaccine counselling - 10 day(s) ago
Vaccination is an effective strategy to mitigate the risk and disease burden of herpes zoster (shingles). With the arrival of a recombinant subunit vaccine (Shingrix), in addition to the longer lasting, live-attenuated vaccine (Zostavax), a window of opportunity exists to optimise protection against herpes zoster in patients with immune-mediated inflammatory diseases without risk of infection. However, since the recombinant zoster vaccine was introduced in 2018, data on the safety and effectiveness in patients with immune-mediated inflammatory diseases are scarce.
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