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- Drosos, GC, et al.
(författare)
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EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome
- 2022
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 81:6, s. 768-779
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Tidskriftsartikel (refereegranskat)abstract
- To develop recommendations for cardiovascular risk (CVR) management in gout, vasculitis, systemic sclerosis (SSc), myositis, mixed connective tissue disease (MCTD), Sjögren’s syndrome (SS), systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).MethodsFollowing European League against Rheumatism (EULAR) standardised procedures, a multidisciplinary task force formulated recommendations for CVR prediction and management based on systematic literature reviews and expert opinion.ResultsFour overarching principles emphasising the need of regular screening and management of modifiable CVR factors and patient education were endorsed. Nineteen recommendations (eleven for gout, vasculitis, SSc, MCTD, myositis, SS; eight for SLE, APS) were developed covering three topics: (1) CVR prediction tools; (2) interventions on traditional CVR factors and (3) interventions on disease-related CVR factors. Several statements relied on expert opinion because high-quality evidence was lacking. Use of generic CVR prediction tools is recommended due to lack of validated rheumatic diseases-specific tools. Diuretics should be avoided in gout and beta-blockers in SSc, and a blood pressure target <130/80 mm Hg should be considered in SLE. Lipid management should follow general population guidelines, and antiplatelet use in SLE, APS and large-vessel vasculitis should follow prior EULAR recommendations. A serum uric acid level <0.36 mmol/L (<6 mg/dL) in gout, and disease activity control and glucocorticoid dose minimisation in SLE and vasculitis, are recommended. Hydroxychloroquine is recommended in SLE because it may also reduce CVR, while no particular immunosuppressive treatment in SLE or urate-lowering therapy in gout has been associated with CVR lowering.ConclusionThese recommendations can guide clinical practice and future research for improving CVR management in rheumatic and musculoskeletal diseases.
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- Ćirović, N., et al.
(författare)
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Thought and mood/arousal disturbances as central broad dimensions in youth psychopathology : A network analysis
- 2024
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Ingår i: Neuroscience Applied. - 2772-4085. ; 3:Suppl 1, s. 103951-103951
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Tidskriftsartikel (refereegranskat)abstract
- Mounting evidence has implicated that the structure of psychopathology is better conceptualized as dimensional and not categorical as well as hierarchical [1-3]. A hierarchical structure includes a broad general dimension of psychopathology and more specific dimensions that capture distinct aspects of psychopathology [3]. Studies inquiring into the structure of psychopathology in youth are limited, but highly needed to provide the basis for aetiological research. A network paradigm could offer a novel way to study the structure of psychopathological dimensions revealing dynamics behind their interrelations.This study was based on the previous analysis that aimed to map various psychopathological symptoms and personality traits within the hierarchical structure based on the Hierarchical Taxonomy of Psychopathology (HiTOP) [2] in a multinational sample of 3923 community adolescents (34.7% males, aged 15 to 19 years) (https://osf.io/fujxa/).Twelve specific components were derived via sequential principal component analysis (PCA) and further analysed here: thought dysfunction, low mood, fearfulness, anxiety, physiological hyperarousal, attentional dysfunction, disruptive mood, antisocial behaviour, antagonistic behaviour, detachment, self-destructive behaviour, and substance use. These components were an input to a network analysis to study the grouping/node communities, interconnectedness, and centrality of them. The analyses include Exploratory Graph Analysis (EGA; model=glasso) for dimensionality/grouping analysis and network analysis (EBICglasso estimation performed on Spearman correlations) performed in EGAnet and bootnet packages in R. We used Strength and Expected Influence as centrality measures. Components are represented as nodes in the network.The EGA suggested four dimensions/node communities: the first consisting of substance use and antisocial behaviour, the second composed of self-destructive behaviour and disruptive mood, the third consisting of antagonism and detachment, and the fourth consisting of thought dysfunction, low mood, physiological arousal, anxiety, attentional dysfunction, and fearfulness.The network analysis revealed that thought dysfunction, physiological arousal, low mood, and disruptive mood were the most central nodes in the network suggesting their interconnectedness with all other nodes in the network.Our network analysis revealed that specific psychopathological subfactors in youth could be clustered into four broader separate dimensions. Specifically, thought and mood/arousal disturbances proved to be most interconnected with all other nodes/subfactors in the network suggesting that these subfactors could be central in youth psychopathology.This result reinforces earlier observations, indicating that thought dysfunction encompasses more than just disordered thought content and forms; it also represents a transdiagnostic phenomenon that spans various disorder dimensions [5]. Thought dysfunction is primarily associated with psychosis but it is also an indication of a broader inability to regulate thinking processes in general (i.e., dysfunctional processes) and extends to other cognitive-rational disturbances [1]. In addition, these findings also align with previous findings that negative affectivity (mostly related to individual differences in experiences of negative emotions), like low or disruptive mood and arousal difficulties highly likely underly general psychopathology [1].
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