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Your search keyword '"Sibbitt, Jr., Wilmer L."' showing total 5 results
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5 results on '"Sibbitt, Jr., Wilmer L."'

4. Biomarkers in the Pathogenesis, Diagnosis, and Treatment of Systemic Sclerosis

Author

Muruganandam,Maheswari, Ariza-Hutchinson,Angie, Patel,Rosemina A, Sibbitt Jr,Wilmer L, Muruganandam,Maheswari, Ariza-Hutchinson,Angie, Patel,Rosemina A, and Sibbitt Jr,Wilmer L

Abstract

Maheswari Muruganandam, Angie Ariza-Hutchinson, Rosemina A Patel, Wilmer L Sibbitt Jr Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USACorrespondence: Maheswari Muruganandam, Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, MSC 10 5550, 5th FL ACC, Albuquerque, NM, 87131, USA, Tel +1 (505) 272-4761, Fax +1 (505) 272-3624, Email mmuruganandam@salud.unm.eduAbstract: Systemic sclerosis (SSc) is a complex autoimmune disease characterized by vascular damage, vasoinstability, and decreased perfusion with ischemia, inflammation, and exuberant fibrosis of the skin and internal organs. Biomarkers are analytic indicators of the biological and disease processes within an individual that can be accurately and reproducibly measured. The field of biomarkers in SSc is complex as recent studies have implicated at least 240 pathways and dysregulated proteins in SSc pathogenesis. Anti-nuclear antibodies (ANA) are classical biomarkers with well-described clinical classifications and are present in more than 90% of SSc patients and include anti-centromere, anti-Th/To, anti-RNA polymerase III, and anti-topoisomerase I antibodies. Transforming growth factor-β (TGF-β) is central to the fibrotic process of SSc and is intimately intertwined with other biomarkers. Tyrosine kinases, interferon-1 signaling, IL-6 signaling, endogenous thrombin, peroxisome proliferator-activated receptors (PPARs), lysophosphatidic acid receptors, and amino acid metabolites are new biomarkers with the potential for developing new therapeutic agents. Other biomarkers implicated in SSc-ILD include signal transducer and activator of transcription 4 (STAT4), CD226 (DNAX accessory molecule 1), interferon regulatory factor 5 (IRF5), interleukin-1 receptor–associated kinase-1 (IRAK1), connective tissue growth factor (CTGF), pyrin domai

Published
2023

5. Outcomes and Complications of Corticosteroid Injection of Rheumatoid Nodules.

Author

ARIZA-HUTCHINSON, ANGIE, PATEL, ROSEMINA A., EMIL, N. SUZANNE, MURUGANANDAM, MAHESWARI, NUNEZ, SHARON E., MCELWEE, MATTHEW K., O'SULLIVAN, FRANK X., FIELDS, RODERICK A., HAYWARD, WILLIAM A., HASELER, LUKE J., SIBBITT JR., WILMER L., and Sibbitt, Wilmer L Jr

Subjects
*REPEATED measures design, *CORTICOSTEROIDS, *RHEUMATOID factor, *TRIAMCINOLONE acetonide, *SURGICAL excision, *RHEUMATOID arthritis
Abstract

Objective: Rheumatoid nodules (RN), a classic cutaneous extra-articular manifestation of rheumatoid arthritis, can often cause discomfort or cosmetic embarrassment. This research determined the effectiveness and complications of corticosteroid injection of the RN.Methods: Using a repeated measure design, 66 consecutive symptomatic RN were measured, underwent corticosteroid injection with 1 to 2mL of a 50:50 mixture of 1% lidocaine and triamcinolone acetonide (20-40mg), and then reassessed at four months for softening, reduction in size, and complications, including infection.Results: The mean age of our patient group was 53.3±10.6 years; 45 percent were Hispanic, 55 percent were non-Hispanic White, 100 percent were seropositive (rheumatoid factor and/or anti-CCP antibody), and 87.5 percent were female. Baseline mean RN diameter was 0.50±0.51cm and four months after injection was reduced to 0.29±0.33cm (decreased 42% or 0.21±0.57cm reduction, 95% CI: 0.46 <0.21< 0.37, p=0.013), 100 percent (66/66) were less painful, and 77 percent (51/66) were palpably softened. However, 70 percent (46/66) demonstrated cutaneous atrophy and/or hypopigmentation at four months, 53 percent (35/66) nodules recurred within 12 months, and 47 percent (31/66) nodules were eventually surgically removed.Limitations: Two (3%) of the larger RN (2.5cm on the olecranon and 2cm on the 2nd toe) became infected and failed antibiotic therapy, necessitating surgical excision for complete resolution.Conclusion: For short-term symptomatic relief, smaller RN can be safely injected with triamcinolone. Large symptomatic RN (≥2cm) are at greater risk of infection; thus, in these cases, lower corticosteroid doses or surgical excision may be preferred. In the long-term, effective systemic antirheumatic therapy with treat-to-target is the best approach. [ABSTRACT FROM AUTHOR]

Published
2022

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