Clayton Pappas (legalhat58)

There are only very few data on the prognostic value of stress cardiovascular magnetic resonance (CMR) in elderly people, while life expectancy of the general population is steadily increasing. Therefore, this study aims to assess the prognostic value of vasodilator stress perfusion CMR in elderly >75 years. Between 2008 and 2017, we included consecutive elderly >75 years without known coronary artery disease (CAD) referred for dipyridamole stress CMR. They were followed for the occurrence of major adverse cardiovascular events (MACE) including cardiac death or non-fatal myocardial infarction. Univariate and multivariate analyses were performed to determine the prognostic value of ischaemia or late gadolinium enhancement. Of 754 elderly individuals (82.0 ± 3.9 years, 48.4% men), 659 (87.4%) completed the follow-up with median follow-up of 4.7 years. Using Kaplan-Meier analysis, the presence of myocardial ischaemia was associated with the occurrence of MACE [hazard ratio (HR) 5.38, 95% confidence interval (CI) 3.56-9.56; P < 0.001]. In a multivariable Cox regression including clinical characteristics and CMR indexes, inducible ischaemia was an independent predictor of a higher incidence of MACE (HR 4.44, 95% CI 2.51-7.86; P < 0.001). In patients without ischaemia, the occurrence of MACE was lower in women when compared with men (P < 0.01). Stress CMR is safe and has discriminative prognostic value in elderly, with a significantly lower event rate of future cardiovascular event or death in subjects without ischaemia or infarction. Stress CMR is safe and has discriminative prognostic value in elderly, with a significantly lower event rate of future cardiovascular event or death in subjects without ischaemia or infarction. To determine the efficacy of biologics in preventing radiographic progression in peripheral joints of PsA patients. Studies were searched in MEDLINE, Web of Science, and abstracts from the last three EULAR and ACR meetings up to 31 December 2019. Primary and secondary endpoints were the proportion of patients without radiographic progression and the mean change in total radiographic score at week 24. Eleven studies, involving 5382 patients, 9 drugs and 18 treatments, were included. Patients receiving biologics were more likely to achieve radiographic non-progression compared with placebo [odds ratio pooled 2.40, 95% CI 2.00, 2.87; TNF inhibitors (TNFi) 2.94, 95% CI 2.38, 3.63; IL inhibitors (ILi) 2.15, 95% CI 1.69, 2.74; abatacept 1.54, 95% CI 1.03, 2.28] and have significantly lower radiographic progression [standardized mean difference (SMD) pooled -2.16, 95% CI -2.91, -1.41; TNFi -2.82, 95% CI -4.31, -1.33; ILi -1.60, 95% CI -2.49, -0.72; abatacept -0.40, 95% CI -0.59, -0.21]. Concomitant MTX therapy was not superior to monotherapy (SMD pooled 0.01, 95% CI -0.07, 0.08; biologics 0.01, 95% CI -0.09, 0.11; placebo -0.01, 95% CI -0.13, 0.12). The effect of ustekinumab and secukinumab on radiographic progression was not influenced by prior anti-TNF therapy (SMD -0.08, 95% CI -0.25, 0.10). Biologic agents may retard radiographic progression in PsA patients in terms of bone erosion and joint space narrowing compared with placebo. MTX seems to have no added effect. Prior anti-TNF therapy seems to not influence the radiographic efficacy of IL blockers. Biologic agents may retard radiographic progression in PsA patients in terms of bone erosion and joint space narrowing compared with placebo. MTX seems to have no added effect. Prior anti-TNF therapy seems to not influence the radiographic efficacy of IL blockers. To investigate whether the auto-inflammatory nature and the pathergic reaction in Behçet's disease (BD) are driven by a disturbed toll-like receptor (TLR) response. We compared both TLR expression by flow-cytometry and TLR response by stimulation assay in 18 BD patients (both pathergy positive and pa