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Analysis of microvascular parameters in the retinal circulation-known to reflect those in the systemic circulation-allows us to differentiate between eutrophic and hypertrophic remodelling of small arteries. This study aimed to examine microvascular changes in patients with congestive heart failure (CHF) and reduced as well as mid-range ejection fraction.

Forty subjects with CHF underwent measurement of retinal capillary flow (RCF), wall-to-lumen ratio (WLR), vessel and lumen diameter, wall thickness, and wall cross-sectional area (WCSA) of retinal arterioles of the right eye by scanning laser Doppler flowmetry (SLDF). Applying a matched pair approach, we compared this group with reference values of age-matched controls from a random sample in the population of Pilsen, Czech Republic. There was no significant difference in RCF and WLR between the groups (RCF P=0.513; WLR P=0.106). In contrast, wall thickness and WCSA, indicators of hypertrophic remodelling, were higher in CHF subjects (WT 15.0±4.2 vs. 12.7±4.2μm, P=0.021; WCSA 4437.6±1314.5 vs. 3615.9±1567.8μm
, P=0.014). Similarly, vessel (109.4±11.1 vs. 100.5±14.4μm, P=0.002) and lumen diameter (79.0±7.9 vs. 75.2±8.5μm, P=0.009) were increased in CHF.

In CHF subjects, we observed hypertrophic remodelling of retinal arterioles indicative of similar changes of small resistance arteries in the systemic circulation. Microvascular structure and function assessed by SLDF may thereby represent a useful, non-invasive method for monitoring of microvascular damage in patients with CHF and may offer innovative treatment targets for new CHF therapies.
In CHF subjects, we observed hypertrophic remodelling of retinal arterioles indicative of similar changes of small resistance arteries in the systemic circulation. Microvascular structure and function assessed by SLDF may thereby represent a useful, non-invasive method for monitoring of microvascular damage in patients with CHF and may offer innovative treatment targets for new CHF therapies.
To compare the responsiveness of BILAG-2004 and SLEDAI-2000 disease activity indices and determine if there was any added value in combining BILAG-2004, BILAG System Tally (BST) or simplified BST (sBST) with SLEDAI-2000.

This was a multi-centre longitudinal study of SLE patients. Data were collected on BILAG-2004, SLEDAI-2000 and therapy on consecutive assessments in routine practice. The external responsiveness of the indices was assessed by determining the relationship between change in disease activity and change in therapy between two consecutive visits. Comparison of indices and their derivatives was performed by assessing the main effects of the indices using logistic regression. ROC curves analysis was used to describe the performance of these indices individually and in various combinations and comparisons of AUC were performed.

There were 1414 observations from 347 patients. Both BILAG-2004 and SLEDAI-2000 maintained an independent relationship with change in therapy when compared. There was songfulness.
Due to population ageing as well as the high prevalence of hypertension and age-related macular degeneration (AMD) in elderly individuals, and the relationship between hypertension and AMD is unclear. Our research aimed to investigate the association between hypertension, wet AMD (wAMD) and the treatment strategy of wAMD patients affected by hypertension.

Data of wAMD patients at Zhongshan Ophthalmic Center, Sun Yat-sen University, between 1 January 2002 and 30 June 2019, were extracted from the electronic healthcare information system. wAMD patients were divided into subgroups by hypertension status, age, sex, the need for vitrectomy surgery and the number of anti-VEGF drug intravitreal injections that these were divided in 1-3 vs. >3 (available time from 1 January 2012 to 30 June 2019).

A total of 3096 wAMD patients (41.7% female, 58.3% male) with an age range of 50-96years (68.7 (SD 9.42) years) were included. wAMD was significantly associated with hypertension (p<0.001). After adjustment for sex and age, Cox regression model showed a significant association between hypertension in wAMD patients and the number of injections (RR=1.31, 95% CI 1.13-1.50, p<0.001). There was no significant association between hypertension and the need for vitrectomy (p=0.82).

wet AMD was associated with hypertension status, and after the regular series of three injections, wAMD patients with hypertension were more likely to receive anti-VEGF drug intravitreal injections than those without hypertension. These results may facilitate prospective research on the prevention of wAMD and contribute to the management of wAMD patients.
wet AMD was associated with hypertension status, and after the regular series of three injections, wAMD patients with hypertension were more likely to receive anti-VEGF drug intravitreal injections than those without hypertension. These results may facilitate prospective research on the prevention of wAMD and contribute to the management of wAMD patients.
To understand medication, lifestyle, and clinical care changes by persons with RA during the first months (March through May 2020) of the COVID-19 pandemic in the US.

Data were provided by adults with RA participating in FORWARD, The National Databank for Rheumatic Diseases, observational registry who answered COVID-19 web-based surveys in May 2020 and previously provided baseline (pre-COVID) characteristics and medication use. We compared medication changes by DMARD exposure in logistic models adjusting for age, sex, comorbidities including pulmonary and cardiovascular diseases, education, health insurance, RA activity, fatigue, and polysymptomatic distress.

Of 734 respondents, 221 (30%) reported medication changes. Changers more commonly used glucocorticoids (GCs) (33% vs 18%) and less commonly used non-hydroxychloroquine conventional DMARDs (49% vs 62%) pre-COVID and reported more economic hardship during COVID (23% vs 15%). selleck chemicals llc While JAK inhibitor use was associated (OR 1.9 [95%CI 1.0, 3.4]) with change, only pre-COVID GCs remained a strong predictor (OR 3.0 [1.9, 4.9]) in multivariable models. Change in care was significantly associated with pulmonary disease (OR 2.9 [1.3, 6.5]), worse RA activity (OR 1.1 [1.0, 1.1]), and GC use (OR 1.6 [1.0, 2.5]). While the incidence of medication change before and after ACR guidelines were published was the same, self-imposed changes were approximately twice as likely before, and physician guided changes were more likely after.

Persons with RA in the US made substantial medication changes during the first three months of the COVID-19 pandemic. Changes after publication of ACR recommendations were made with increased physician guidance.
Persons with RA in the US made substantial medication changes during the first three months of the COVID-19 pandemic. Changes after publication of ACR recommendations were made with increased physician guidance.
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