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Stiles was never a fan of the games because he didn't think it was fair to watch men fight to the death just because he could. But it doesn't look too bad right? It's pronounced- well, I pronounce it- 'Caw-vay. If you speak Latin that is awesome, I'm thinking about learning, but I'm just going to keep everything now and in the future whatever I write the first time!
Cave Lupus Guild
Brain, ,. Multiple cranial nerve palsies: analysis of cases. Arch Neurol, 62 , pp. Petri, A. Orbai, G. Gordon, J. Merrill, P. Fortin, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum, 64 , pp.
Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum, 42 , pp. CO;2- Medline. Aslam, F. Bannout, E.
Cranial nerve palsies: sarcoidosis to systemic lupus erythematosus. Case Rep Rheumatol, , pp. Bertsias, D. Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations. Nat Rev Rheumatol, 6 , pp.
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Teoh, E. Yap, K. Au Eong. Neuro-ophthalmological manifestations of systemic lupus erythematosus in Asian patients. Clin Exp Ophthalmol, 29 , pp. Chan, E. Li, F. Lai, J.
- Mortality rate.
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An unusual case of systemic lupus erythematosus with isolated hypoglossal nerve palsy, fulminant acute pneumonitis, and pulmonary amyloidosis. Ann Rheum Dis, 48 , pp. These data support higher incidence rates of SLE in African American than white populations, with women of African descent experiencing roughly 3 times the rates of white women. Even higher rates have been reported from the UK, where multiple sources for case ascertainment were used, including multiple physicians, lupus advocacy groups, patient registers, hospital inpatient information, and laboratory data.
In , Hopkinson et al reported the crude incidence rate of In , Johnson et al 36 reported an incidence rate of Incidence data for SLE in the Caribbean are available from 2 population studies conducted on the French island of Martinique and the Dutch territory of Curacao. Deligny et al 17 reported a rate of 8.
Cave Lupus (ISBN: 1469150603)
The annual incidence rate of SLE among women in Barbados standardized to the US population was 12 per ,, which is considerably higher than those reported from other Caribbean territories. However, these prevalence data are not directly comparable. Similar to the challenges associated with incidence data, marked disparities in the worldwide burden of prevalent SLE is also a result of methodologic differences among the studies. Furthermore, it has been reported that some sources of data used for SLE case ascertainment, such as administrative files, may have a specificity of only In addition to variation in susceptibility to SLE, which has age, sex, ethnic, and geographic determinants, there is also heterogeneity of the disease in terms of clinical presentation and course, which likely reflects elements of genetic, environmental, psychosocial, and cultural factors.
The Barbadian cohort exhibits clinical features in keeping with other populations of African origin, notably the increased frequency of discoid lesions and nephritis and the low frequency of photosensitivity when compared to white populations 5 , 8 , 39 , It is interesting to note that, although pericarditis is a frequent clinical feature of SLE, pericardial tamponade is considered to be distinctly rare, occurring in only 1—2.
Our documented occurrence of pericardial tamponade of 2. Severe renal disease is the major cause of death in our population. We previously demonstrated that African Barbadians with SLE nephritis tended to present within 3 years of SLE diagnosis with features of poor prognosis such as a younger age, heavy proteinuria, renal impairment, and hypertension with a resultant inordinately high mortality rate of However, similar to our experience, there were few deaths in this study.
Specialist centers for the care of SLE patients in industrialized countries generally demonstrate improved survival rates for SLE over recent decades. SLE mortality from a multinational cohort of 9, patients from 23 referral centers yielded an overall SMR of 2. Few studies of SLE have been conducted at the population level, and there are potentially important lessons to be learned. However, ethnic disparities continue to exist in developed countries.
The disparity in clinical outcome observed between white subjects and populations of African descent within industrialized countries is also seen in less economically advanced countries. For example, in native South Africans, Wadee et al report of persistent early deaths from active disease and infection At the end of , there were 33 clinical cases of SLE receiving care in the rheumatology services that had not attained the 4 ACR criteria necessary for formal classification as definite cases of SLE.
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This likely reflects the inherent limitation of the ACR criteria that are not meant for diagnosis and will not capture every case of clinical disease. As with other classification criteria, the ACR criteria are apt to identify cases with more severe disease, with the most common clinical manifestations, and with a longer disease duration 51 , We believe that referral patterns for SLE in Barbados facilitate early close observation of patients by the local rheumatologist. Furthermore, our methods have allowed full ascertainment of all local cases of SLE, and persons who might have sought care abroad during the course of their illness will still have established medical care on the island, and therefore almost certainly come to the attention of the rheumatologist and other specialists.
The significant burden of SLE in Barbados and the establishment of a registry provide opportunities for future study into genetic, psychosocial, economic, environmental, diagnostic, and therapeutic factors that might influence disease outcomes. The Barbados Lupus Registry is therefore a unique resource that has the potential to allow greater understanding of disparities in SLE in populations of the West African diaspora, as well as of therapeutic strategies to reduce the high burden of complications and mortality currently observed.
All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be submitted for publication. Flower had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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Volume 64 , Issue 8. The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account. If the address matches an existing account you will receive an email with instructions to retrieve your username. Systemic Lupus Erythematosus Free Access. Cindy Flower Corresponding Author E-mail address: cindy.
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