Takayasu's arteritis is an inflammatory disease that causes stenosis of the aorta and its main branches. It most commonly affects young women in Asia. Symptoms vary depending on the arteries affected but may include headaches, fatigue, limb claudication, and hypertension. Diagnosis involves assessing symptoms, physical exam findings like blood pressure differences between limbs, and imaging tests like angiograms. Treatment consists of corticosteroids and immunosuppressive drugs to control inflammation, with surgery as needed for complications from narrowed arteries. Strict management of cardiovascular risk factors is also important.
takayasu arteritis is inflammatory disorder of medium sized arteries of unknown etiology, prevent in young female. lead to life threatening complication and long lasting morbidity. early diagnosis and treatment prevent complication and improve quality of life
Radiological evaluation of takayasu arteritis Dr. muhammad Bin Zulfiqar Servi...Dr. Muhammad Bin Zulfiqar
Radiological evaluation of takayasu arteritis Dr. muhammad Bin Zulfiqar Services Institute of Medical Sciences Services Hospital Lahore
In this presentation we will discuss the role of imaging in TA.
Takayasu arteritis (TA) is a rare nonspecific inflammatory disease of unknown cause, predominantly affecting
the aorta and its main branches, coronary arteries, and pulmonary arteries of young females. It induces a variety
of nonspecific inflammatory symptoms and ischemic symptoms due to stenotic lesions. Further progression
of TA causes destruction of the arterial wall media, leading to aortic regurgitation and aneurysms or
rupture of the involved arteries. Although serological tests specific for TA are not available, new better biomarkers
are emerging such as pentraxin3 and matrix metalloproteinases. Recent advances in imaging modalities
including magnetic resonance angiography, computed tomography (CT), sonography, and fluorodeoxy
glucose positron emission tomography/CT (FDG-PET/CT) allow earlier and accurate diagnosis of TA. Duration
between onset of the disease and diagnosis has become much shorter during the last decade. Medical treatment
for TA is also changing. In addition to the traditional glucocorticoids and immunosuppressants, many
new biological agents are being applied to patients with TA refractory to conventional treatment with favorable
results. As for treatment for vascular complications, efficacy of endovascular treatment is still a matter of
controversy because of the high rate of restenosis at an early stage after the procedure. Based on these advances,
the prognosis and quality of life of TA patients have improved to a great deal. However, there are
many issues that remain to be solved in the management of TA.
he diseased aorta in Takayasu’s arteritis features areas of ectasia and stenosis; the aorta is left with very little elastic tissue due to diffuse fibrosis of the intima, media, and externa. Stent-supported endovascular aortoplasty and surgical revascularization are associated with higher complication and recurrence rates, even with regular immunomodulation follow-up. Unlike atheromatous disease, the inflexible artery is vulnerable to dissection, and is as “brittle as glass” during balloon angioplasty. Therefore, some authors suggest self-expanding stent or stent-graft supported angioplasty for this condition, with high-pressure dilation,to overcome fibrosis caused by panarteritis. However, the incidence of dissection in this situation appears to be under-reported.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
SCAD is a rare, sometimes fatal, traumatic condition with approximately eighty percent of cases affecting women. The coronary artery can suddenly develop a tear, causing blood to flow between the layers which forces them apart, potentially causing a blockage of blood flow through the artery and a resulting heart attack. The condition may be related to female hormone levels, as it is often seen in post-partum women, or in women during or very near menstruation, but not always. It is not uncommon for SCAD to occur in people in good physical shape and with no known prior history of heart related illness. It is also not uncommon for SCAD to occur in people in their 20's, 30's, and 40's, as well as older.
PAD can be diagnosed in asymptomatic individuals by a combination of physical examination and simple, noninvasive Doppler ultrasonography to measure the ankle–brachial index
takayasu arteritis is inflammatory disorder of medium sized arteries of unknown etiology, prevent in young female. lead to life threatening complication and long lasting morbidity. early diagnosis and treatment prevent complication and improve quality of life
Radiological evaluation of takayasu arteritis Dr. muhammad Bin Zulfiqar Servi...Dr. Muhammad Bin Zulfiqar
Radiological evaluation of takayasu arteritis Dr. muhammad Bin Zulfiqar Services Institute of Medical Sciences Services Hospital Lahore
In this presentation we will discuss the role of imaging in TA.
Takayasu arteritis (TA) is a rare nonspecific inflammatory disease of unknown cause, predominantly affecting
the aorta and its main branches, coronary arteries, and pulmonary arteries of young females. It induces a variety
of nonspecific inflammatory symptoms and ischemic symptoms due to stenotic lesions. Further progression
of TA causes destruction of the arterial wall media, leading to aortic regurgitation and aneurysms or
rupture of the involved arteries. Although serological tests specific for TA are not available, new better biomarkers
are emerging such as pentraxin3 and matrix metalloproteinases. Recent advances in imaging modalities
including magnetic resonance angiography, computed tomography (CT), sonography, and fluorodeoxy
glucose positron emission tomography/CT (FDG-PET/CT) allow earlier and accurate diagnosis of TA. Duration
between onset of the disease and diagnosis has become much shorter during the last decade. Medical treatment
for TA is also changing. In addition to the traditional glucocorticoids and immunosuppressants, many
new biological agents are being applied to patients with TA refractory to conventional treatment with favorable
results. As for treatment for vascular complications, efficacy of endovascular treatment is still a matter of
controversy because of the high rate of restenosis at an early stage after the procedure. Based on these advances,
the prognosis and quality of life of TA patients have improved to a great deal. However, there are
many issues that remain to be solved in the management of TA.
he diseased aorta in Takayasu’s arteritis features areas of ectasia and stenosis; the aorta is left with very little elastic tissue due to diffuse fibrosis of the intima, media, and externa. Stent-supported endovascular aortoplasty and surgical revascularization are associated with higher complication and recurrence rates, even with regular immunomodulation follow-up. Unlike atheromatous disease, the inflexible artery is vulnerable to dissection, and is as “brittle as glass” during balloon angioplasty. Therefore, some authors suggest self-expanding stent or stent-graft supported angioplasty for this condition, with high-pressure dilation,to overcome fibrosis caused by panarteritis. However, the incidence of dissection in this situation appears to be under-reported.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
SCAD is a rare, sometimes fatal, traumatic condition with approximately eighty percent of cases affecting women. The coronary artery can suddenly develop a tear, causing blood to flow between the layers which forces them apart, potentially causing a blockage of blood flow through the artery and a resulting heart attack. The condition may be related to female hormone levels, as it is often seen in post-partum women, or in women during or very near menstruation, but not always. It is not uncommon for SCAD to occur in people in good physical shape and with no known prior history of heart related illness. It is also not uncommon for SCAD to occur in people in their 20's, 30's, and 40's, as well as older.
PAD can be diagnosed in asymptomatic individuals by a combination of physical examination and simple, noninvasive Doppler ultrasonography to measure the ankle–brachial index
Aortic Aneurysm: Diagnosis, Management, Exercise Testing, And TrainingJavidsultandar
An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso.
Aortic aneurysms can dissect or rupture:
The force of blood pumping can split the layers of the artery wall, allowing blood to leak in between them. This process is called a dissection.
The aneurysm can burst completely, causing bleeding inside the body. This is called a rupture.
Dissections and ruptures are the cause of most deaths from aortic aneurysms.
Study of 89 Cases of Peripheral Vascular Disease by CT AngiographyM A Hasnat
The purpose of this study was to observe the morphological pattern by CT angiography
and risk factors for development of peripheral vascular disease in Bangladeshi patient suffering
from peripheral vascular disease using a multidetector scanner in the evaluation of patients with
peripheral vascular disease.
presentation will give a idea about management of thoracoabdominal aortic aneurysm, including detail of investigation and treatment options available today.
VASCULITIS INTRODUCTION.
TYPES OF VASCULITIS
DIAGNOSING CRIERIA
TREATMENT AND GUIDELINES
DRUGS USED IN BURGER'S DISEASE
A CASE ON VASCULITIS
APPROACH OF TREATMENT
PATIENT COUNSELLING FOR THE PARTICULAR PATIENT
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. DEFINITION
TAKAYASU’S ARTERITIS is an inflammatory and
stenotic disease of medium and large sized
arteries characterised by a strong prediliction for
the aorta and its branches .
AORTIC ARCH SYNDROME
PULSELESS DISEASE.
3. HISTORY
Dr. Takayasu described the retinal changes of
the disease in 1905 at the Annual
Ophthalmology Society meeting in Japan, and
his abstract was subsequently published in
1908. The condition is now called Takayasu
arteritis in his honor.
4. INCIDENCE AND PREVALENCE
Uncommon disease.
Annual incidence rate 1.2-2.6 cases/million
Prevalent in adolescent and young women
M.C. in Asia
No racial/geographical distribution.
5. Race
Takayasu arteritis is observed more frequently in
patients of Asian or Indian descent. Japanese have a
higher incidence of aortic arch involvement. india report
higher incidences of abdominal involvement.
Sex
80% of patients - women; however, the high female-to-
male ratio seems to decrease west of Japan. In India, the
female-to-male ratio is as low as 1.6:1.
Age
Most patients are aged 4-63 years, mean age of onset -
30 years. <15% of cases present in individuals older than
40 years.
11. Cardiac and vascular features
Bruit, with the most common location being the carotid artery
(80%)
Blood pressure difference of extremities (45%-69%)
Claudication (38%-81%)
Carotodynia or vessel tenderness (13%-32%)
Hypertension (28%-53%; 58% with renal artery stenosis in one
series)
Aortic regurgitation (20%-24%)
Raynaud’s syndrome (15%) .Pericarditis (< 8%) ,Congestive
heart failure (< 7%) , Myocardial infarction (< 3%).
12. NEUROLOGICAL FEATURES
Headache (50%-70%)
Visual disturbance (16%-35%) - Strong
association with common carotid and
vertebral artery disease
Stroke (5%-9%)
Transient ischemic attacks (3%-7%)
Seizures (0%-20%)
14. Particular attention to peripheral pulses, blood pressure
in all 4 extremities, and an ophthalmologic examination.
The most discriminatory finding is a systolic blood
pressure difference (>10 mm Hg) between arms.
Hypertension due to renal artery involvement is found in
approximately 50% of patients.
Absent or diminished pulses are the clinical hallmark of
Takayasu arteritis, but pulses are normal in many patients
and upper limbs are affected more often Than lower
limbs.
15. Physical examination contd…
Carotidynia may be present.
Bruits are often noted.
Aortic regurgitation is a common finding.
Ophthalmologic examination may show retinal
hemorrhages, cotton-wool exudates, venous dilatation
and beading, microaneurysms of peripheral retina, optic
atrophy, vitreous hemorrhage, and classic wreathlike
peripapillary arteriovenous anastomoses (extremely rare).
Skin changes resembling erythema nodosum or ulcerating
nodular lesions may be seen.
19. AMERICAN COLLEGE OF
RHEUMATOLOGY – CLASSIFICATION
CRITERIA
3 OF 6 NECESSARY
1.Age < 40 yr onset
2.Claudication of extremities
3.Decreased pulsation in one/both brachial arteries
4.Diff of at least 10mm of hg SBP between arms
5.Bruit over one/both sub cl art /abd aorta
6.Arteriografic narrowing/occlusion of entire abd
aorta,its primary br. Or large arteries of both UL and LL
20. LABORATORY STUDIES
The acute-phase reactants and clinical
parameters generally used to define active inflammatory
disease do not universally reflect active blood vessel
inflammation in Takayasu arteritis.
The ESR is elevated in most but not all patients
during active inflammatory disease. Therefore, it is
not a consistently reliable marker of disease activity,
with both false-positive and false-negative
associations reported.]
21. Tests:
Arteriogram
Angiogram
Complete blood count (CBC)
C-reactive protein (CRP)
Electrocardiogram (ECG)
Erythrocyte sedimentation rate (ESR)
Magnetic resonance angiography (MRA)
Magnetic resonance imaging (MRI)
Ultrasound
X-ray of the chest
22. Imaging Studies
While imaging studies (CT scanning, MRI) show typical
patterns of stenosis or aneurysms of the arteries,
angiography remains the standard for diagnosis and
evaluation of the extent of disease. recent studies
suggest that noninvasive imaging modalities such as
MRI, ultrasonography,and 18F-fluorodeoxyglucose
positron emission tomography (18F-FDG-PET) allow
diagnosis of Takayasu arteritis earlier in the disease
course than standard angiography and provide a means
for monitoring disease activity.
Angiography is used to evaluate only the appearance of
the lumen and cannot be used to differentiate between
active and inactive lesions.
23. Takayasu arteritis can be divided into 6 types based on
angiographic involvement, as follows:
Type I - Branches of the aortic arch
Type IIa - Ascending aorta, aortic arch, and its branches
Type IIb - Type IIa region plus thoracic descending aorta
Type III - Thoracic descending aorta, abdominal aorta,
renal arteries, or a combination
Type IV - Abdominal aorta, renal arteries, or both
Type V - Entire aorta and its branches
24. Other tests
MRA is equally or more sensitive than angiography for revealing
lesions in the aorta .
CT helical scanning angiography is a sensitive and specific
diagnostic tool.
Color Doppler ultrasonography provides details of the vascular
wall, lumen, and flow and is a useful tool for screening and follow-
up, particularly forcarotid and subclavian arteries.
PET scanning with radioactive-labeled 18-fluorodeoxyglucose
(FDG) has been shown to be useful in monitoring disease activity
and response to treatment in preliminary studies. Presence or
absence of FDG uptake correlates well with clinical state and MRI
findings. Its use in patients with Takayasu arteritis requires further
investigation.
MRA or CT angiography and FDG-PET may be useful to monitor
vascular response to treatment.
26. MEDICAL CARE
Assessing disease activity in patients with Takayasu arteritis
is frequently challenging, since clinical, biologic, and
radiologic information do not always correlate.
Prospective study criteria established by Kerr et al (NIH) are
used to assess disease activity in patients with Takayasu
arteritis. New onset or worsening of two or more of the
following features indicates active disease:
1.systemic features, such as fever and arthralgias (no
identified cause)
2. erythrocyte sedimentation rate
3.Features of vascular ischemia or inflammation, such as
claudication, diminished or absent pulse, bruit, carotodynia,
or asymmetric blood pressure in either upper or lower
limbs (or both)
4.Typical angiographic features
27. Treatment
Treatment of Takayasu arteritis is difficult, but
patients who do have the right treatment can see
positive results. Early detection is important.
Most patients are treated with steroids and
immunosuppressive drugs. Surgery is reserved for
complications caused by narrowed arteries.
Surgery to bypass narrowed arteries --
angioplasty or stent placement -- may be needed to
supply blood or open up the constriction.
29. Corticosteroids are the mainstay of therapy for active
Takayasu arteritis, and some patients may require
additional cytotoxic agents to achieve remission and
taper of chronic corticosteroid treatment.
Oral corticosteroids are started at 1 mg/kg daily or
divided twice daily and tapered over weeks to
months as symptoms subside.
Long-term low-dose corticosteroid therapy may be
required.
Osteoporosis prevention when patients are started
on corticosteroids should be seriously considered
30. Cytotoxic agents are used for patients whose
disease is steroid-resistant or relapsing. These
agents are usually continued for at least one year
after remission and are then tapered to
discontinuation. The following agents with their
respective doses are as follows:
Methotrexate - 7.5-25 mg/wk oral
Azathioprine - 1-2 mg/kg/d oral
Cyclophosphamide - 2 mg/kg/d oral (should be
reserved for patients with the most severe and
refractory disease states)
31. Strict management of traditional
cardiovascular risk factors such as
dyslipidemia, hypertension, and lifestyle
factors is mandatory to minimize secondary
cardiovascular complications, which are the
major cause of death in this disease.
Additionally, low-dose aspirin may have a
therapeutic effect in large vessel vasculitis.
•Strict management of traditional cardiovascular risk factors such as dyslipidemia, hypertension, and lifestyle factors is mandatory to minimize secondary cardiovascular complications, which are the major cause of death in this disease. Additionally, low-dose aspirin ma
32. ANTI –TNF AGENTS
In an uncontrolled series of 15 patients, adjunctive treatment with
anti–tumor necrosis factor (TNF) agents was effective in patients with
active, relapsing Takayasu arteritis despite treatment with steroids and
multiple other immunosuppressive agents.
The initial dose of etanercept was 25 mg twice weekly (7 patients),
and infliximab (11 patients [3 were switched from etanercept to
infliximab]) was given at 3 mg/kg initially and at 2 weeks, 6 weeks, and
every 8 weeks thereafter. I
In 9 of the 14 responders, an increase in the anti-TNF dosage was
required to sustain remission.
The preliminary results suggest that anti-TNF therapy may be a require
further studies. A larger randomized controlled study of anti-TNF
therapy for Takayasu arteritis is puseful adjunct to corticosteroids in
the treatment of patients with Takayasu arteritis and Planned
33. SURGICAL CARE Critical stenotic lesions should be treated by angioplasty or surgical
revascularization during periods of remission.
Indications for surgical repair or angioplasty are as follows:
1.Renovascular stenosis causing hypertension
2.Coronary artery stenosis leading to myocardial ischemia
3.Extremity claudication induced by routine activity
4.Cerebral ischemia and/or critical stenosis of 3 or more cerebral
vessels
5.Aortic regurgitation
6.Thoracic or abdominal aneurysms larger than 5 cm in diameter
7.Severe coarctation of the aorta
8.Percutaneous transluminal coronary angioplasty is followed by
restenosis at the angioplasty site within 1-2 years in a substantial
number of patients.
9.Bypass graft procedures have the best long-term patency rates
35. MORTALITY/MORBIDITY
Takayasu arteritis is a chronic relapsing and remitting disorder.
10-year survival rate is approximately 90%; however, this rate is
reduced in the presence of major complications.[6]
Complications of Takayasu arteritis include valvular heart disease,
stroke, heart failure, retinopathy, and renovascular hypertension. The
5- and 10-year survival rates are approximately 69% and 36%,
respectively, in patients with two or more complications. The 5- and
10-year survival rates associated with one or fewer complications are
100% and 96%, respectively.
A 2008 study assessing quality of life with Takayasu arteritis shows
worse scores for physical and mental health compared with many
other chronic diseases associated with peripheral vascular disease.
Disease remission is the only factor that positively influences both
physical and mental quality of life.Patients with RHEUMATOID
ARTHRITIS or rate their quality of life as similar to those with
Takayasu arteritis.
36. In cortisone-resistant patients, stronger
medications which suppress the immune system
(immunosuppressive drugs), thereby further
decreasing active inflammation of the arteries,
have been used. Examples
include prednisone, prednisolone,methotrexate (R
heumatrex,
Trexall),cyclosporine, cyclophosphamide (Cytoxan)
, and azathioprine (Imuran). Strict control
ofelevated blood pressure (hypertension) is
important.
37. Pictured below is a close–up view of an
angiogram of the left vertebral and subclavian
arteries in a patient with Takayasu’s arteritis.
Note the narrowing and irregularities that
occur at several sites, and the “corkscrew”
configuration of one vessel segment near the
junction of the two arteries. These changes,
caused by inflammation in the blood vessel
wall, sometimes cause complete blockage of
the artery.
38.
39. Pictured below is a normal aortic arch on
the left, with narrow, smooth blood
vessels. On the right is an example of an
abnormal aortic arch in a patient with
Takayasu’s, with obvious dilation of the
ascending aorta on the left side of the
picture
40.
41. Although the lung involvement in
Takayasu’s is frequently overshadowed by
involvement of systemic large blood vessels,
the pulmonary arteries may also be affected
in this disorder. Pictured below is a
pulmonary angiogram demonstrating
beading and cut–off lesions of the right
pulmonary arteries, and a large aneurysm
of the left pulmonary artery.
42.
43. Indian journal of ophthalmology,vol
50,2002.
Bilateral anterior ischaemic optic neuropathy
in Takayasu arteritis Abstract This report
describes a case of a young male with
bilateral, asymmetrical AION. He was
subsequently diagnosed with Takayasu's
disease
44. Publication of neurology society of
India,vol 49,2001.
Single stage bilateral common carotid artery stenting in a patient
of Takayasu arteritis.
» Abstract
Carotid angioplasty and stenting is increasingly becoming a safe
and efficacious modality of treatment in the management of
carotid artery stenosis. Although atherosclerosis is the
predominant cause of this morbid disease, Takayasu arteritis
assumes special importance in south east Asia. The diffuse nature
of this disease with associated inflammation and scarring of the
vessel make revascularisation difficult. We report a case of
Takayasu arteritis tid stenting was done in a single sitting.
45. JAPI, feb 2006
Coexistence of Takayasu’s Arteritis with Ulcerative
Colitis
Abstract
The association of ulcerative colitis with Takayasu’s
arteritis is rarely reported. The occurrence of the
two together is possibly related to a common
pathophysiology involving alteration in immune
mechanisms.
Takayasu's arteritis is more prevalent in Japan and
South East Asia whereas Ulcerative Colitis is more
inWestern countries. The coexistence of these two
diseases is uncommon and hence this report.
46. Clinical journal of immunology,vol
2009
Research Article
Lack of Antilipoprotein Lipase Antibodies in Takayasu's
Arteritis
Abstract
Background. Antilipoprotein lipase (anti-LPL) antibodies were
described in rheumatic diseases. In systemic lupus
erythematosus they were highly associated with
inflammatory markers and dyslipidemia, and may ultimately
contribute to vascular damage. The relevance of this
association in Takayasu's arteritis, which is characterized by
major inflammatory process affecting vessels, has not been
determined.
47. Pub MED.gov ,jul 9,2001
[Takayasu's disease: interest in methotrexate treatment].
Abstract
We report a case in which methotrexate proved to be
effective. CASE REPORT: A 6-year-old girl presented with
Takayasu's disease with elevated blood pressure of
renovascular origin. Corticosteroids controlled the
inflammatory syndrome but not the renal involvement and
stopped the growth. Methotrexate (10 mg/m2/week)
resulted in the control of the disease, the reduction of
steroids and normal growth. CONCLUSION: In Takayasu's
disease, steroids should be given as first-line therapy. In
case of failure, side effects or steroid dependency, small
doses of methotrexate may facilitate the disease's control
and weaning from the steroids
48. Oxford journal of
Rheumatology,nov 8,2005.
Post-interventional immunosuppressive treatment and
vascular restenosis in Takayasu's arteritis
Abstract
Objective. To investigate the outcome of vascular interventions
and the effect of post-interventional immunosuppressive
treatment on the occurrence of vascular restenosis in patients
with Takayasu's arteritis (TA).
Conclusion. Restenosis occurred in 31.7% of TA patients after
intervention. A lower restenosis rate was observed when the
vascular interventions were performed at the stable stage and
when post-interventional immunosuppressive treatment was
implemented.
49. American journal of Rheumatology,April
2008
Successful treatment of a patient with takayasu arteritis
using a humanized anti–interleukin-6 receptor antibody
Abstract
Takayasu arteritis (TA) is a chronic inflammatory disease
that involves the aorta and its major branches. Since
overproduction of interleukin-6 (IL-6) seems to play a
pathogenic role in TA, we used the anti–IL-6 receptor (IL-
6R) antibody tocilizumab to treat a 20-year-old woman
with refractory active TA complicated by ulcerative colitis
(UC). Treatment with tocilizumab improved the clinical
manifestations of TA and the abnormal laboratory findings
in this patient and ameliorated the activity of UC. These
results indicate that IL-6R inhibition with tocilizumab might
be a future treatment option for .
50. JOURNAL OF PAEDIATRICS,Sept
2008
Treatment of Takayasu's Arteritis with Tumor Necrosis
Factor Antagonists
Four children with Takayasu's arteritis were treated with
tumor necrosis factor antagonists because of disease
relapse during conventional therapy or as a first-line
agent. Two patients went into remission; in the other 2,
the response was partial. Anti-tumor necrosis factor
agents can have a role in the treatment of Takayasu's
arteritis; further controlled studies are required.
51. Curr Opin
Rheumatology.2005;17(1) 2005
Advances in the medical and surgical treatment
of Takayasu arteritis.
SUMMARY: In the future, greater therapeutic
success may be achieved by addressing both the
inflammatory and the myointimal proliferative
components of Takayasu arteritis. New drugs
that target intimal hyperplasia, as well as drug-
eluting stents, deserve to be studied for possible
utility as adjuncts to present treatments.
52. Journal of invasive cardiology,Nov
2009
Covered Stent for the Treatment of Coronary
Aneurysm after Sirolimus-Eluting Stent
Implantation a Patient with Takayasu’s
Arteritis
ABSTRACT:
Drug-eluting stents (DES) have been used
successfully to treat both de-novo and
restenotic lesions in these patients.
53. Curr Opin Rheumatology,2009
Advances in the use of biologic agents for the
treatment of systemic vasculitis.
RECENT FINDINGS: The greatest amount of
experience with these agents for the treatment of
systemic vasculitis is with antitumor necrosis factor
agents, pooled intravenous immunoglobulin, and
anti-B-cell therapies such as rituximab. SUMMARY:
Biologic agents represent the next evolution in
treatment for the primary systemic vasculitides.
54. Clinical Rheumatology
journal.,2008
Mycophenolate mofetil in Takayasu’s arteritis
Abstract
Mycophenolate mofetil (MMf) has recently been
reported as a useful alternative immunosuppressive
drug in autoimmune diseases.This study is the
largest series till date establishing the use of
mycophenolate as a safe and effective steroid-
sparing immunosuppressant in Takayasu's arteritis
55. Indian jrnl of Paediatrics,july
2002.
Recent advances in the management of non-
specific aorto-arteritis.
Today, percutaneous transluminar balloon
angioplasty (PTBA) has emerged as a non-surgical,
safe, effective alternative therapeutic option and
endovascular stents have revolutionised the
management. The disease must be suspected and
diagnosed precisely with echocardiography and
angiography before it is too late to manage.