Прегледај по Аутор "Zlatković-Švenda, Mirjana"
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- СтавкаAntiphospholipid Antibodies and Vascular Thrombosis in Patients with Severe Forms of COVID-19(MDPI, 2023) Zlatković-Švenda, Mirjana; Ovuka, Milica; Ogrič, Manca; Čučnik, Saša; Žigon, Polona; Radivčev, Aleksandar; Zdravković, Marija; Radunović, GoranAntiphospholipid antibodies (aPLA) are a laboratory criterion for the classification of antiphospholipid syndrome (APS) and are known to cause clinical symptoms such as vascular thrombosis or obstetric complications. It is suggested that aPLA may be associated with thromboembolism in severe COVID-19 cases. Therefore, we aimed to combine clinical data with laboratory findings of aPLA at four time points (admission, worsening, discharge, and 3-month follow-up) in patients hospitalized with COVID-19 pneumonia. In 111 patients with COVID-19 pneumonia, current and past history of thrombosis and pregnancy complications were recorded. Nine types of aPLA were determined at four time points: anticardiolipin (aCL), anti- 2-glycoprotein I (anti- 2GPI), and antiphosphatidylserine/ prothrombin (aPS/PT) of the IgM, IgG, or IgA isotypes. During hospitalization, seven patients died, three of them due to pulmonary artery thromboembolism (none were aPLA positive). Only one of the five who developed pulmonary artery thrombosis was aPLA positive. Out of 9/101 patients with a history of thrombosis, five had arterial thrombosis and none were aPLA positive at admission and follow-up; four had venous thrombosis, and one was aPLA positive at all time points (newly diagnosed APS). Of these 9/101 patients, 55.6% were transiently aPLA positive at discharge only, compared to 26.1% without a history of thrombosis (p = 0.041). Patients with severe forms of COVID-19 and positive aPLA should receive the same dose and anticoagulant medication regimen as those with negative aPLA because those antibodies are mostly transiently positive and not linked to thrombosis and fatal outcomes.
- СтавкаEffects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs(BMJ Publishing Group, 2022) Gwinnutt, James M; Wieczorek, Maud; Rodríguez-Carrio, Javier; Balanescu, Andra; Bischoff-Ferrari, Heike A; Boonen, Annelies; Cavalli, Giulio; de Souza, Savia; de Thurah, Annette; E Dorner, Thomas; Moe, Rikke Helene; Putrik, Polina; Silva-Fernández, Lucía; Stamm, Tanja; Walker-Bone, Karen; Welling, Joep; Zlatković-Švenda, Mirjana; Guillemin, Francis; Verstappen, Suzanne MBackground A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed. Methods Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage). Results In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression. Conclusion The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing. Rheumatic and musculoskeletal diseases (RMDs) are a diverse range of conditions that primarily affect people’s joints, causing pain, disability and reductions in health-related quality of life (HR-QoL). 1–3 According to the Global Burden of Disease study, RMDs are one of the leading causes of global disability.4 5 Some RMDs have effective pharmacological treatments that limit disease progression (eg, rheumatoid arthritis (RA)6), whereas others have no effective disease modifying treatment options (eg, osteoarthritis (OA)7). However, in all RMDs there is room for additional improvement in outcomes. In the general population, lifestyle modifications have been shown to improve non-RMD related outcomes. For instance, diet (ie, specific food stuffs ingested as part of daily living, and supplements or nutrients ingested to improve health) has a significant impact on the risk of chronic disease8 and benefits to mental health.9 However, it is unclear whether lifestyle modifications, such as changes to diet, have a beneficial impact on RMD related outcomes (including disease activity, pain, function, HR-QoL, radiographic damage, fatigue and depression). In 2018, a EULAR Taskforce was convened to develop recommendations for lifestyle improvements in people with RMDs with regards to RMD progression (including both modifiable (eg, pain, fatigue) and irreversible (eg, joint damage) outcomes).10 The taskforce decided to focus on six lifestyle factors: diet, exercise, weight, alcohol, smoking and paid work, and seven diseases: RA, OA, axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and gout (henceforth referred to collectively as RMDs). For each of these lifestyle factors, systematic reviews were performed, aiming to collate all relevant literature on each factor in order to formulate evidence based recommendations. This article reports the results of systematic reviews on the effect of diet on progression of RMDs.
- СтавкаLongitudinal Analysis of Antiphospholipid Antibody Dynamics after Infection with SARS-CoV-2 or Vaccination with BNT162b2(MDPI, 2023) Ogrič, Manca; Žigon, Polona; Sodin-Semrl, Snezna; Zlatković-Švenda, Mirjana; Zdravković, Marija; Ovuka, Milica; Švec, Tinka; Lakota, Katja; Radšel, Peter; Rotar, Žiga; Čučnik, SašaAntiphospholipid antibodies (aPL) comprise a group of autoantibodies that reflect prothrombotic risk in antiphospholipid syndrome (APS) but may also be present in a small proportion of healthy individuals. They are often transiently elevated in infections, including SARS-CoV-2, and may also be associated with vaccine-induced autoimmunity. Therefore, we aimed to investigate the dynamics of aPL in COVID-19 patients and in individuals (healthcare professionals—HCPs) after receiving BNT162b2 vaccine and to compare aPL levels and positivity with those found in APS patients. We measured solid-phase identifiable aPL, including anticardiolipin (aCL), anti- 2 glycoprotein I (anti- 2GPI), and anti-prothrombin/phosphatidylserine (aPS/PT) antibodies in 58 HCPs before and after vaccination (at 3 weeks, 3, 6, and 9 months after the second dose, and 3 weeks after the third booster dose), in 45 COVID-19 patients hospitalized in the ICU, in 89 COVID-19 patients hospitalized in the non-ICU (at admission, at hospital discharge, and at follow-up), and in 52 patients with APS. The most frequently induced aPL in COVID-19 patients (hospitalized in non-ICU) were aCL (50.6% of patients had positive levels at at least one time point), followed by anti- 2GPI (21.3% of patients had positive levels at at least one time point). In 9/89 COVID-19 patients, positive aPL levels persisted for three months. One HCP developed aCL IgG after vaccination but the persistence could not be confirmed, and two HCPs developed persistent anti- 2GPI IgG after vaccination with no increase during a 1-year follow-up period. Solid-phase aPL were detected in 84.6% of APS patients, in 49.4% of COVID-19 patients hospitalized in the non-ICU, in 33.3% of COVID-19 patients hospitalized in the ICU, and in only 17.2% of vaccinated HCPs. aPL levels and multiple positivity were significantly lower in both infected groups and in vaccinated individuals compared with APS patients. In conclusion, BNT162b2 mRNA vaccine may have induced aPL in a few individuals, whereas SARS-CoV-2 infection itself results in a higher percentage of aPL induction, but the levels, persistence, and multiple positivity of aPL do not follow the pattern observed in APS
- СтавкаRheumatoid arthritis and spondyloarthritis prevalence in four European countries – a comparative study(Serbian Medical Association, 2022) Zlatković-Švenda, Mirjana; Saraux, Alain; Tuncer, Tiraje; Dadoniene, Jolanta; Miltiniene, Dalia; Gilgil, Erdal; Stojanović, Roksanda; Guillemin, FrancisIntroduction/Objective The objective was to compare rheumatoid arthritis (RA), spondyloarthritis (SpA) and subtypes of SpA prevalence in four European countries. Methods A 33-items detection questionnaire, containing self-reported diagnosis, classification criteria for RA and SpA, personal and family history, was translated using cross-cultural adaptation and validated in France, Turkey, Lithuania and Serbia, where it was used on a population sample. Suspected cases were evaluated and confirmed by a rheumatologist. Prevalence estimates were age- and sex-standardized to European standard population. Results In total, 33,454 people older than 18 years were screened and 31,454 interviewed: France 14,671, Lithuania 6,558, Serbia 6,213, Turkey 4,012. Standardized RA prevalence varied from 0.29% (95% CI: 0.17–0.40) in France to 0.57% (0.31–0.84) in Turkey; this inequality was mostly caused by differences in women prevalence (from 0.42% in France to 1.02% in Turkey) SpA prevalence was similar in France (0.30%), Serbia (0.35%) and Turkey (0.37%), but in Lithuania it was 0.89%, which could be caused by geographic and genetic differences, as SpA prevalence was higher in North and East Europe, as well as the human leukocyte antigen B27 presence. SpA prevalence was equally presented by gender for France and Serbia. Regarding SpA subtypes, ankylosing spondylitis prevalence varied from 0.07–0.30% (Serbia–Lithuania), PsA 0.10–0.26% (France–Lithuania), reactive arthritis was 0.09–0.18% (Serbia–Lithuania). Previously nondiagnosed SpA cases were found in 6.9% in France, 25.9% in Lithuania and 31.2% in Serbia. Conclusion East–West decreasing tendency for the female RA prevalence was noted. SpA was higher in North-Eastern Europe than in its Western and Southern part. One quarter of the SpA patients in Lithuania and one third in Serbia were not previously diagnosed. The SpA population prevalence was higher than expected and similar to RA.