Tanya Martinson

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Description Years of carrying out death row executions have taken a toll on prison warden Bernadine Williams. As she prepares to execute another inmate, Bernadine must confront the psychological and emotional demons her job creates, ultimately connecting her to the man she is sanctioned to kill

Drama Alfre Woodard Country USA

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Release year 2019

This article is about a type of lupus. For the group of diseases known as "lupus" see Lupus erythematosus. Systemic lupus erythematosus Other names Lupus Young woman with the typical " butterfly rash " found in lupus Pronunciation sih- STEM -ik LOOP -?s ERR -i-thee-m?- TOH -s?s Specialty Rheumatology Symptoms Painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, red rash [1] Usual onset 15?45 years of age [1] 2] Duration Long term [1] Causes Unclear [1] Diagnostic method Based on symptoms and blood tests [1] Medication NSAIDs, corticosteroids, immunosuppressants, hydroxychloroquine, methotrexate [1] Prognosis 15 year survival ~80% 3] Frequency 2?7 per 10, 000 [2] Systemic lupus erythematosus ( SLE) also known simply as lupus, is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. [1] Symptoms vary between people and may be mild to severe. [1] Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. [1] Often there are periods of illness, called flares, and periods of remission during which there are few symptoms. [1] The cause of SLE is not clear. [1] It is thought to involve genetics together with environmental factors. [4] Among identical twins, if one is affected there is a 24% chance the other one will be as well. [1] Female sex hormones, sunlight, smoking, vitamin D deficiency, and certain infections, are also believed to increase the risk. [4] The mechanism involves an immune response by autoantibodies against a person's own tissues. [1] These are most commonly anti-nuclear antibodies and they result in inflammation. [1] Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests. [1] There are a number of other kinds of lupus erythematosus including discoid lupus erythematosus, neonatal lupus, and subacute cutaneous lupus erythematosus. [1] There is no cure for SLE. [1] Treatments may include NSAIDs, corticosteroids, immunosuppressants, hydroxychloroquine, and methotrexate. [1] Although corticosteroids are rapidly effective, long term use results in side effects. [5] Alternative medicine has not been shown to affect the disease. [1] Life expectancy is lower among people with SLE. [6] SLE significantly increases the risk of cardiovascular disease with this being the most common cause of death. [4] With modern treatment about 80% of those affected survive more than 15 years. [3] Women with lupus have pregnancies that are higher risk but are mostly successful. [1] Rate of SLE varies between countries from 20 to 70 per 100, 000. [2] Women of childbearing age are affected about nine times more often than men. [4] While it most commonly begins between the ages of 15 and 45, a wide range of ages can be affected. [1] 2] Those of African, Caribbean, and Chinese descent are at higher risk than white people. [4] 2] Rates of disease in the developing world are unclear. [7] Lupus is Latin for "wolf" the disease was so-named in the 13th century as the rash was thought to appear like a wolf's bite. [8] Signs and symptoms Common symptoms of SLE [9] SLE is one of several diseases known as " the great imitator " because it often mimics or is mistaken for other illnesses. [10] SLE is a classical item in differential diagnosis, 11] because SLE symptoms vary widely and come and go unpredictably. Diagnosis can thus be elusive, with some people having unexplained symptoms of SLE for years. Common initial and chronic complaints include fever, malaise, joint pains, muscle pains, and fatigue. Because these symptoms are so often seen in association with other diseases, these signs and symptoms are not part of the diagnostic criteria for SLE. When occurring in conjunction with other signs and symptoms, however, they are considered suggestive. [12] While SLE can occur in both males and females, it is found far more often in women, and the symptoms associated with each sex are different. [6] Females tend to have a greater number of relapses, a low white blood cell count, more arthritis, Raynaud's phenomenon, and psychiatric symptoms. Males tend to have more seizures, kidney disease, serositis (inflammation of tissues lining the lungs and heart) skin problems, and peripheral neuropathy. [13] Skin As many as 70% of people with lupus have some skin symptoms. The three main categories of lesions are chronic cutaneous (discoid) lupus, subacute cutaneous lupus, and acute cutaneous lupus. People with discoid lupus may exhibit thick, red scaly patches on the skin. Similarly, subacute cutaneous lupus manifests as red, scaly patches of skin but with distinct edges. Acute cutaneous lupus manifests as a rash. Some have the classic malar rash (or butterfly rash) associated with the disease. [14] This rash occurs in 30 to 60% of people with SLE. [15] Hair loss, mouth and nasal ulcers, and lesions on the skin are other possible manifestations. [16] Muscles and bones The most commonly sought medical attention is for joint pain, with the small joints of the hand and wrist usually affected, although all joints are at risk. More than 90 percent of those affected will experience joint or muscle pain at some time during the course of their illness. [17] Unlike rheumatoid arthritis, lupus arthritis is less disabling and usually does not cause severe destruction of the joints. Fewer than ten percent of people with lupus arthritis will develop deformities of the hands and feet. [17] People with SLE are at particular risk of developing osteoarticular tuberculosis. [18] A possible association between rheumatoid arthritis and SLE has been suggested, 19] and SLE may be associated with an increased risk of bone fractures in relatively young women. [20] Blood Anemia is common in children with SLE [21] and develops in about 50% of cases. [22] Low platelet count and white blood cell count may be due to the disease or a side effect of pharmacological treatment. People with SLE may have an association with antiphospholipid antibody syndrome [23] a thrombotic disorder) wherein autoantibodies to phospholipids are present in their serum. Abnormalities associated with antiphospholipid antibody syndrome include a paradoxical prolonged partial thromboplastin time (which usually occurs in hemorrhagic disorders) and a positive test for antiphospholipid antibodies; the combination of such findings have earned the term " lupus anticoagulant -positive. Another autoantibody finding in SLE is the anti-cardiolipin antibody, which can cause a false positive test for syphilis. citation needed] Heart SLE may cause pericarditis ?inflammation of the outer lining surrounding the heart, myocarditis ?inflammation of the heart muscle, or endocarditis ?inflammation of the inner lining of the heart. The endocarditis of SLE is non-infectious, and is also called ( Libman?Sacks endocarditis. It involves either the mitral valve or the tricuspid valve. Atherosclerosis also occurs more often and advances more rapidly than in the general population. [24] 25] Lungs SLE can cause pleuritic pain as well as inflammation of the pleurae known as pleurisy, which can rarely give rise to shrinking lung syndrome involving a reduced lung volume. [26] 27] Other associated lung conditions include pneumonitis, chronic diffuse interstitial lung disease, pulmonary hypertension, pulmonary emboli, and pulmonary hemorrhage. Kidneys Painless passage of blood or protein in the urine may often be the only presenting sign of kidney involvement. Acute or chronic renal impairment may develop with lupus nephritis, leading to acute or end-stage kidney failure. Because of early recognition and management of SLE, end-stage renal failure occurs in less than 5% 28] 29] of cases; except in the black population, where the risk is many times higher. The histological hallmark of SLE is membranous glomerulonephritis with "wire loop" abnormalities. [30] This finding is due to immune complex deposition along the glomerular basement membrane, leading to a typical granular appearance in immunofluorescence testing. Neuropsychiatric Neuropsychiatric syndromes can result when SLE affects the central or peripheral nervous system. The American College of Rheumatology defines 19 neuropsychiatric syndromes in systemic lupus erythematosus. [31] The diagnosis of neuropsychiatric syndromes concurrent with SLE (now termed as NPSLE. 32] is one of the most difficult challenges in medicine, because it can involve so many different patterns of symptoms, some of which may be mistaken for signs of infectious disease or stroke. [33] A common neurological disorder people with SLE have is headache, 34] although the existence of a specific lupus headache and the optimal approach to headache in SLE cases remains controversial. [35] Other common neuropsychiatric manifestations of SLE include cognitive dysfunction, mood disorder, cerebrovascular disease, 34] seizures, polyneuropathy, 34] anxiety disorder, psychosis, depression, and in some extreme cases, personality disorders. [36] Steroid psychosis can also occur as a result of treating the disease. [32] It can rarely present with intracranial hypertension syndrome, characterized by an elevated intracranial pressure, papilledema, and headache with occasional abducens nerve paresis, absence of a space-occupying lesion or ventricular enlargement, and normal cerebrospinal fluid chemical and hematological constituents. [37] More rare manifestations are acute confusional state, Guillain?Barré syndrome, aseptic meningitis, autonomic disorder, demyelinating syndrome, mononeuropathy (which might manifest as mononeuritis multiplex) movement disorder (more specifically, chorea) myasthenia gravis, myelopathy, cranial neuropathy and plexopathy. Neurological disorders contribute to a significant percentage of morbidity and mortality in people wit
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