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Sample records for activity score das28

  1. The Reliability of Disease Activity Score in 28 Joints-C-Reactive Protein Might Be Overestimated in a Subgroup of Rheumatoid Arthritis Patients, When the Score Is Solely Based on Subjective Parameters

    DEFF Research Database (Denmark)

    Jensen Hansen, Inger Marie; Asmussen Andreasen, Rikke; Van Bui Hansen, Mark Nam

    2017-01-01

    BACKGROUND: Disease Activity Score in 28 Joints (DAS28) is a scoring system to evaluate disease activity and treatment response in rheumatoid arthritis (RA). A DAS28 score of greater than 3.2 is a well-described limit for treatment intensification; however, the reliability of DAS28 might be overe......BACKGROUND: Disease Activity Score in 28 Joints (DAS28) is a scoring system to evaluate disease activity and treatment response in rheumatoid arthritis (RA). A DAS28 score of greater than 3.2 is a well-described limit for treatment intensification; however, the reliability of DAS28 might...... be overestimated. OBJECTIVE: The aim of this study was to evaluate the reliability of DAS28 in RA, especially focusing on a subgroup of patients with a DAS28 score of greater than 3.2. METHODS: Data from RA patients registered in the local part of Danish DANBIO Registry were collected in May 2015. Patients were....... Patients with central sensitization and psychological problems and those with false-positive diagnosis of RA are at high risk of overtreatment.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where...

  2. Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation.

    Science.gov (United States)

    Kumar, B Siddhartha; Suneetha, P; Mohan, Alladi; Kumar, D Prabath; Sarma, K V S

    2017-11-01

    In patients with rheumatoid arthritis (RA), disease severity assessment is done using Disease Activity Score in 28 joints with ESR (DAS28). Computing DAS28 is time-consuming, requires laboratory testing and an online calculator. There is a need to validate rapid methods of disease severity assessment for routine daily use. This study was conducted to compare DAS28, Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) and Routine Assessment of Patient Index Data with 3 measures (RAPID3) to assess the disease activity in patients with RA. We prospectively studied the utility of CDAI, HAQ-DI and RAPID3 scoring in 100 consecutive newly diagnosed, disease modifying antirheumatic drugs (DMARDs) naïve adult patients with RA seen during January 2013 and June 2014 at a tertiary care teaching hospital in south India. The mean age of the patients was 42.1±11.6 yr, there were 82 females. The median [interquartile range (IQR)] symptom duration was 6 (range 4-12) months. The median (IQR) DAS28, CDAI, HAQ-DI and RAPID3 scores at presentation were 7 (6-7), 36 (28-43), 2 (1-2) and 17 (13-19), respectively. A significant positive correlation was observed between DAS28 and CDAI (r=0.568; Pfair' agreement was observed in between DAS28 and CDAI (kappa-statistic=0.296). The agreement between DAS28 and HAQ-DI (kappa-statistic=0.007) and RAPID3 (kappa-statistic=0.072) was less robust. In adult patients with RA, in the setting where illiteracy is high, CDAI emerged as the preferred choice for rapid assessment of severity of disease at the time of initial presentation.

  3. Effects of timing of prednisolone on the duration of early morning stiffness, pain and disease activity score (das-28) in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Gul, H.; Nasim, A.; Salim, B.

    2017-01-01

    To determine the effects of timing of prednisolone on duration of early morning stiffness, pain score, number of swollen and tender joints, erythrocyte sedimentation rate (ESR) and disease activity score 28 (DAS-28) in joints in patients with rheumatoid arthritis. Study Design: It was quasi experimental study. Place and Duration of Study: This study was conducted in the department of rheumatology Fauji Foundation Hospital Rawalpindi over a period of 3 months, from Dec 2015 to Feb 2016. Material and Methods: Total sample size of 85 was calculated by using non probability consecutive sampling technique. Patients with established rheumatoid arthritis diagnosed on the basis of ACR 1987 criteria were included in the study. All these patients had a disease duration of minimum 6 months and were on disease modifying anti rheumatic drugs and were taking =7.5mg of prednisolone and these patients were treated with the same dose of prednisolone given in morning at 8:00 A.M. for the first 15 days followed by treatment with same single daily dose of prednisolone given at the night 10:00 P.M. for next 15 days. This study compared duration of early morning stiffness, pain scores, number of swollen and tender joints, DAS-28 and ESR on day 15th and day 30th. Results: A total of 85 patients of established rheumatoid arthritis were included in the study. All patients were female with a mean duration of disease of 7.87 +- 6.41 years. The mean age of patients was 49.39 +- 10.24 years. Mean of pain score, duration of morning stiffness, DAS-28, number of tender and swollen joint count, and ESR was decreased in patients who took prednisolone at 10:00 pm and had significant statistical difference (p-value<0.001). Conclusions: Administration of low dose of prednisolone at night has good effects on duration of early morning stiffness, pain scores, number of swollen and tender joints, ESR and DAS-28. (author)

  4. Test–retest reliability of the Disease Activity Score 28 CRP (DAS28-CRP), the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) in rheumatoid arthritis when based on patient self-assessment of tender and swollen joints

    DEFF Research Database (Denmark)

    Heegaard, Cecilie; Dreyer, Lene; Egsmose, Charlotte

    2013-01-01

    and physician-derived scores. Thirty out-clinic RA patients with stable disease were included. A joint count was performed two times 1 week apart by the patient and by an experienced physician. Test-retest reliability was expressed as the least significant difference (LSD), as the LSD in percent of the mean...... score (%LSD) and as intra-individual coefficients of variation (CVi). Mean scores based on physician vs. patient joint counts (visit 1) were: DAS28-CRP(4v) 3.5 ± 1.0 vs. 3.6 ± 1.1 (not significant (NS)), DAS28-CRP(3v) 3.4 ± 0.9 vs. 3.5 ± 0.9 (NS), SDAI 14.2 ± 9.4 vs.14.1 ± 9.4 (NS) and CDAI 13.4 ± 9.......3 vs. 13.3 ± 9.4 (NS). The LSDs (%LSD) for duplicate assessments of patient-derived scores (visit 2 vs. 1) were: DAS28-CRP(4v) 0.8 (23.2), DAS28-CRP(3v) 0.9 (25.2), SDAI 8.3 (59.9) and CDAI 8.4 (63.8). Similar LSDs were found for differences between duplicate assessments of physician-derived scores...

  5. Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

    Science.gov (United States)

    Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

    2016-04-01

    The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

  6. Is DAS28-CRP with three and four variables interchangeable in individual patients selected for biological treatment in daily clinical practice?

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek

    2011-01-01

    DAS28 is a widely used composite score for the assessment of disease activity in patients with rheumatoid arthritis (RA) and is often used as a treatment decision tool in the daily clinic. Different versions of DAS28 are available. DAS28-CRP(3) is calculated based on three variables: swollen...... and tender joint counts and CRP. DAS28-CRP(4) also includes patient global assessment. Thresholds for low and high disease activity are the same for the two scores. Based on the Bland-Altman method, the interchangeability between DAS28-CRP with three and four variables was examined in 319 RA patients...... selected for initiating biological treatment. Data were extracted from the Danish registry for biological treatment in rheumatology (DANBIO). Multiple regression analysis was used to assess the predictability of the DAS28 scores by several measures of disease activity. The overall mean DAS28-CRP was 4...

  7. Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Nielung, Louise; Christensen, Robin; Danneskiold-Samsøe, Bente

    2015-01-01

    Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109...... Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit...... are interchangeable when assessing RA patients and the two versions of DAS28 are comparable between studies....

  8. Optimal responses in disease activity scores to treatment in rheumatoid arthritis: Is a DAS28 reduction of >1.2 sufficient?

    Science.gov (United States)

    Mian, Aneela N; Ibrahim, Fowzia; Scott, David L; Galloway, James

    2016-06-16

    The overall benefit of intensive treatment strategies in rheumatoid arthritis (RA) remains uncertain. We explored how reductions in disability and improvements in quality of life scores are affected by alternative assessments of reductions in disease activity scores for 28 joints (DAS28) in two trials of intensive treatment strategies in active RA. One trial (CARDERA) studied 467 patients with early active RA receiving 24 months of methotrexate monotherapy or steroid and disease-modifying anti-rheumatic drug (DMARD) combinations. The other trial (TACIT) studied 205 patients with established active RA; they received 12 months of treatment with DMARD combinations or biologic agents. We compared changes in the health assessment questionnaire (HAQ) and Euroqol-5D (EQ5D) at trial endpoints in European League Against Rheumatism (EULAR) good and moderate EULAR responders in patients in whom complete endpoint data were available. In the CARDERA trial 98 patients (26 %) were good EULAR responders and 160 (32 %) were EULAR moderate responders; comparable data in TACIT were 66 (35 %) and 86 (46 %) patients. The magnitude of change in the HAQ and EQ5D was greater in both trials in EULAR good responders than in EULAR moderate responders. HAQ scores had a difference in of -0.49 (95 % CI -0.66, -0.32) in the CARDERA and -0.31 (95 % CI -0.47, -0.13) in the TACIT trial. With the EQ5D comparable differences were 0.12 (95 % CI 0.04, 0.19) and 0.15 (95 % CI 0.05, 0.25). Both exceeded minimum clinically important differences in HAQ and EQ5D scores. We conclude that achieving a good EULAR response with DMARDs and biologic agents in active RA results in substantially improved mean HAQ and EQ5D scores. Patients who achieve such responses should continue on treatment. However, continuing such treatment strategies is more challenging when only a moderate EULAR response is achieved. In these patients evidence of additional clinically important benefits in measures such as the HAQ

  9. ACR/EULAR Definitions of Remission Are Associated with Lower Residual Inflammatory Activity Compared with DAS28 Remission on Hand MRI in Rheumatoid Arthritis.

    Science.gov (United States)

    Lisbona, Maria Pilar; Solano, Albert; Ares, Jesús; Almirall, Miriam; Salman-Monte, Tarek Carlos; Maymó, Joan

    2016-09-01

    To determine the level of residual inflammation [synovitis, bone marrow edema (BME), tenosynovitis, and total inflammation] quantified by hand magnetic resonance imaging (h-MRI) in patients with rheumatoid arthritis (RA) in remission according to 3 different definitions of clinical remission, and to compare these remission definitions. A cross-sectional study. To assess the level of residual MRI inflammation in remission, cutoff levels associated to remission and median scores of MRI residual inflammatory lesions were calculated. Data from an MRI register of patients with RA who have various levels of disease activity were used. These were used for the analyses: synovitis, BME according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system, tenosynovitis, total inflammation, and disease activity composite measures recorded at the time of MRI. Receiver-operating characteristic analysis was used to identify the best cutoffs associated with remission for each inflammatory lesion on h-MRI. Median values of each inflammatory lesion for each definition of remission were also calculated. A total of 388 h-MRI sets of patients with RA with different levels of disease activity, 130 in remission, were included. Cutoff values associated with remission according to the Simplified Disease Activity Index (SDAI) ≤ 3.3 and the Boolean American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definitions for BME and tenosynovitis (1 and 3, respectively) were lower than BME and tenosynovitis (2 and 5, respectively) for the Disease Activity Score on 28 joints (DAS28) ≤ 2.6. Median scores for synovitis, BME, and total inflammation were also lower for the SDAI and Boolean ACR/EULAR remission criteria compared with DAS28. Patients with RA in remission according to the SDAI and Boolean ACR/EULAR definitions showed lower levels of MRI-detected residual inflammation compared with DAS28.

  10. Subclinical synovitis and tenosynovitis by ultrasonography (US) 7 score in patients with rheumatoid arthritis treated with synthetic drugs, in clinical remission by DAS28.

    Science.gov (United States)

    Ventura-Ríos, Lucio; Sánchez Bringas, Guadalupe; Hernández-Díaz, Cristina; Cruz-Arenas, Esteban; Burgos-Vargas, Rubén

    2017-11-29

    To identify synovitis and tenosynovitis active by using the Ultrasound 7 (US 7) scoring system in patients with rheumatoid arthritis (RA) in clinical remission induced by synthetic disease-modifying antirheumatic drugs (DMARDs). This is a multicentric, cross-sectional, observational study including 94 RA patients >18 years old who were in remission as defined by the 28-joints disease activity score (DAS28) <2.6 induced by synthetic DMARD during at least 6 months. Patients with a previous or current history of biologic DMARD treatment were not included in the study. Demographic and clinical data were collected by the local rheumatologist; the US evaluation was performed by a calibrated rheumatologist, who intended to detect grayscale synovitis and power Doppler (PD) using the 7-joint scale. Intra and inter-reader exercises of images between 2 ultrasonographers were realized. Patients' mean age was 49.1±13.7 years; 83% were women. The mean disease duration was 8±7 years and remission lasted for 27.5±31.8 months. The mean DAS28 score was 1.9±0.66. Grayscale synovitis was present in 94% of cases; it was mild in 87.5% and moderate in 12.5%. Only 12.8% of the patients had PD. The metatarsophalangeal, metacarpophalangeal, and carpal joints of the dominant hand were the joints more frequently affected by synovitis. Tenosynovitis by grayscale was observed in 9 patients (9.6%). The intra and inter-reading kappa value were 0.77, p<0.003 (CI 95%, 0.34-0.81) and 0.81, p<0.0001 (CI 95%, 0.27-0.83) respectively. Low percentage of synovitis and tenosynovitis active were founded according to PD US by 7 score in RA patients under synthetic DMARDs during long remission. This score has benefit because evaluate tenosynovitis, another element of subclinical disease activity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  11. Timing and Magnitude of Initial Change in Disease Activity Score 28 Predicts the Likelihood of Achieving Low Disease Activity at 1 Year in Rheumatoid Arthritis Patients Treated with Certolizumab Pegol: A Post-hoc Analysis of the RAPID 1 Trial

    NARCIS (Netherlands)

    van der Heijde, Désirée; Keystone, Edward C.; Curtis, Jeffrey R.; Landewé, Robert B.; Schiff, Michael H.; Khanna, Dinesh; Kvien, Tore K.; Ionescu, Lucian; Gervitz, Leon M.; Davies, Owen R.; Luijtens, Kristel; Furst, Daniel E.

    2012-01-01

    Objective. To determine the relationship between timing and magnitude of Disease Activity Score [DAS28(ESR)] nonresponse (DAS28 improvement thresholds not reached) during the first 12 weeks of treatment with certolizumab pegol (CZP) plus methotrexate, and the likelihood of achieving low disease

  12. Agreement between the DAS28-CRP assessed with 3 and 4 variables in patients with rheumatoid arthritis treated with biological agents in the daily clinic

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek

    2013-01-01

    The Disease Activity Score-28-C-reactive Protein 4 [DAS28-CRP(4)] composite measure for rheumatoid arthritis (RA) is based on 4 variables: tender and swollen joint counts, CRP, and patient global assessment. DAS28-CRP(3) includes only 3 variables, because patient global assessment has been omitted...

  13. There Is No Further Gain from Calculating Disease Activity Score in 28 Joints with High Sensitivity Assays of C-Reactive Protein Because of High Intraindividual Variability of CRP

    DEFF Research Database (Denmark)

    Jensen Hansen, Inger Marie; Asmussen Andreasen, Rikke; Antonsen, Steen

    2016-01-01

    Background/Purpose: The threshold for reporting of C-reactive protein (CRP) differs from laboratory to laboratory. Moreover, CRP values are affected by the intra individual biological variability.[1] With respect to disease activity score in 28 joints (DAS28) and Rheumatoid Arthritis (RA), precise...... threshold for reporting CRP is important due to the direct effects of CRP on calculating DAS28, patient classification and subsequent treatment decisions[2] Methods: This study consists of two sections: a theoretical consideration discussing the performance of CRP in calculating DAS28 with regard...... to the biological variation and reporting limit for CRP and a cross sectional study of all RA patients from our department (n=876) applying our theoretical results. In the second section, we calculate DAS28 twice with actual CRP and CRP=9, the latter to elucidate the positive consequences of changing the lower...

  14. The Relationship Between Function and Disease Activity as Measured by the HAQ and DAS28 Varies Over Time and by Rheumatoid Factor Status in Early Inflammatory Arthritis (EIA). Results from the CATCH Cohort.

    Science.gov (United States)

    Boyd, Tristan A; Bonner, A; Thorne, C; Boire, G; Hitchon, C; Haraoui, B P; Keystone, E C; Bykerk, V P; Pope, J E

    2013-01-01

    To investigate the relationship between function and disease activity in early inflammatory arthritis (EIA). Canadian Early Arthritis Cohort (CATCH) (n=1143) is a multi-site EIA cohort. Correlations between the Health Assessment Questionnaire Disability Index (HAQ) and DAS28 were done at every 3 months for the first year and then at 18 and 24 months. We also investigated the relationship between HAQ and DAS28 by age (<65 versus ≥65) and RF (positive vs negative). Mean HAQ and DAS28 scores were highest at the initial visit with HAQ decreasing over 24 months from a baseline of 0.94 to 0.40 and DAS28 scores decreasing from 4.54 to 2.29. All correlations between HAQ and DAS28 were significant at all time points (p<0.01). The correlations between HAQ and DAS28 were variable over time. The strongest correlation between HAQ and DAS28 occurred at initial visit (most DMARD naive) (n=1,143) and 18 months (r=0.57, n=321) and 24 months (r=0.59, n=214). The baseline correlation between HAQ and DAS28 was significantly different than correlations obtained at 3, 6, and 12 months (p=0.02, 0.01, and 0.01, respectively). Age did not change the association between HAQ and DAS28 {<65 years old (r=0.50, n=868) versus ≥65 (r=0.48, n=254), p=0.49}. The correlation between HAQ and DAS28 was stronger with RF+ patients (r=0.63, n=636) vs RF negative (r=0.47, n=477), p=0.0043. Over 2 years in EIA, HAQ and DAS both improved; correlations at time points were different over 2 years and RF status affected the correlations.

  15. Change in CD3 positive T-cell expression in psoriatic arthritis synovium correlates with change in DAS28 and magnetic resonance imaging synovitis scores following initiation of biologic therapy - a single centre, open-label study

    LENUS (Irish Health Repository)

    Pontifex, Eliza K

    2011-01-27

    Abstract Introduction With the development of increasing numbers of potential therapeutic agents in inflammatory disease comes the need for effective biomarkers to help screen for drug efficacy and optimal dosing regimens early in the clinical trial process. This need has been recognized by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group, which has established guidelines for biomarker validation. To seek a candidate synovial biomarker of treatment response in psoriatic arthritis (PsA), we determined whether changes in immunohistochemical markers of synovial inflammation correlate with changes in disease activity scores assessing 28 joints (ΔDAS28) or magnetic resonance imaging synovitis scores (ΔMRI) in patients with PsA treated with a biologic agent. Methods Twenty-five consecutive patients with PsA underwent arthroscopic synovial biopsies and MRI scans of an inflamed knee joint at baseline and 12 weeks after starting treatment with either anakinra (first 10 patients) or etanercept (subsequent 15 patients) in two sequential studies of identical design. DAS28 scores were measured at both time points. Immunohistochemical staining for CD3, CD68 and Factor VIII (FVIII) was performed on synovial samples and scored by digital image analysis (DIA). MRI scans performed at baseline and at 12 weeks were scored for synovitis semi-quantitatively. The ΔDAS28 of the European League Against Rheumatism good response definition (>1.2) was chosen to divide patients into responder and non-responder groups. Differences between groups (Mann Whitney U test) and correlations between ΔDAS28 with change in immunohistochemical and MRI synovitis scores (Spearman\\'s rho test) were calculated. Results Paired synovial samples and MRI scans were available for 21 patients (8 anakinra, 13 etanercept) and 23 patients (8 anakinra, 15 etanercept) respectively. Change in CD3 (ΔCD3) and CD68 expression in the synovial sublining layer (ΔCD68sl) was significantly greater in

  16. Development and validation of modified disease activity scores in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G; Smolen, Josef S

    2014-01-01

    -CDAI) were generated for each subject in the validation cohort. The M-DAS28, M-SDAI, and M-CDAI scores were compared to conventional scores of disease activity with regard to associations with MRI measures of synovitis and radiographic progression, assessed using Pearson's and Spearman's correlations, linear......OBJECTIVE: To develop and validate composite disease activity scores, based on widely available clinical measures, that would demonstrate improved correlation with detection of synovitis on magnetic resonance imaging (MRI) and radiographic progression, in comparison with conventional measures.......15 × SJC28 + 0.22 × EvGA + 1 and M-SDAI = CRP + SJC28 + EvGA. Both modified and conventional disease activity scores correlated significantly with MRI measures of synovitis. Modified scores showed superior correlation with synovitis, as compared to conventional scores, at all time points (P

  17. Comparação entre o Disease Activity Score-28 e o Juvenile Arthritis Disease Activity Score na artrite idiopática juvenil

    Directory of Open Access Journals (Sweden)

    Renata Campos Capela

    2015-02-01

    Full Text Available Introdução A avaliação de atividade da artrite reumatoide e da artrite idiopática juvenil é feita por meio de instrumentos distintos, respectivamente pelo DAS-28 e pelo JADAS. Objetivo Comparar o DAS-28 e o JADAS com a pontuação de 71, 27 e 10 articulações, na artrite idiopática juvenil. Método Foram avaliadas 178 visitas em oito pacientes com artrite idiopática juvenil, participantes de um ensaio clínico controlado de fase III, testando eficácia e segurança do abatacepte. Pontuaram-se as articulações ativas e limitadas, a avaliação global pelo médico e pelos pais em escala analógica visual de 0-10 cm e a velocidade de hemossedimentação convertida em escala de 0-10, em todas as visitas. A comparação entre os índices de atividade entre diferentes observações foi por Anova ou modelo ajustado Gama. As observações pareadas entre o DAS-28 e o JADAS 71, 27 e 10, respectivamente, foram analisadas por meio de regressão linear. Resultados Houve diferença significativa entre as medidas individuais, exceto a VHS, nos primeiros quatro meses de tratamento com biológico, quando cinco entre os oito pacientes atingiram a resposta ACR-Pedi 30, com melhora. Os índices DAS-28, JADAS 71, 27 e 10 também apresentaram diferença relevante durante o período de observação. O ajustamento por meio de regressão linear entre o DAS-28 e o JADAS resultou em fórmulas matemáticas para conversão: [DAS-28 = 0,0709 (JADAS 71 + 1,267] (R2 = 0,49; [DAS-28 = 0,084 (JADAS 27 + 1,7404] (R2 = 0,47 e [DAS-28 = 0,1129 (JADAS-10 + 1,5748] (R2 = 0,50. Conclusão A conversão da pontuação do DAS-28 e do JADAS 71, 27 e 10 por esse modelo matemático permitiria a aplicação equivalente de ambos em adolescentes com artrite.

  18. Disease activity score in rheumatoid arthritis with or without secondary fibromyalgia

    International Nuclear Information System (INIS)

    Zammurrad, S.; Munir, W.; Farooqi, A.

    2013-01-01

    Objective: To correlate disease activity score (DAS-28) in the patients with rheumatoid arthritis (RA) with and without secondary fibromyalgia. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, from November 2011 to April 2012. Methodology: Patients aged above 16 years diagnosed to have rheumatoid arthritis according to ACR/EULAR criteria 2010 were included in the study. Fibromyalgia (FM) was diagnosed by ACR 1990 criteria. Patients of other autoimmune diseases or psychiatric illnesses were excluded. DAS was determined and compared using t-test with significance at p < 0.05. Results: The mean age of study subjects was 42.9 years. Thirty one out of total 138 patients had fibromyalgia (22.4%). Female gender was predominant (92.0%); being 96.8% in patients with and in 88.2% without fibromyalgia. The average DAS score was high (5.3 + 1.5) in fibromyalgia patients compared to those without fibromyalgia (3.9 + 1.2); this difference in mean value was statistically significant (p = < 0.001). Conclusion: DAS-28 is a useful tool for assessing rheumatoid arthritis disease status in outpatient setting, however, increased disease activity must be assessed for possible co-existence of fibromyalgia which can spuriously give high DAS value and adversely affect treatment decision. (author)

  19. There Is No Further Gain from Calculating Disease Activity Score in 28 Joints with High Sensitivity Assays of C-Reactive Protein Because of High Intraindividual Variability of CRP: A Cross Sectional Study and Theoretical Consideration

    DEFF Research Database (Denmark)

    Jensen Hansen, Inger Marie; Asmussen Andreasen, Rikke; Antonsen, Steen

    Background/Purpose: The threshold for reporting of C-reactive protein (CRP) differs from laboratory to laboratory. Moreover, CRP values are affected by the intra individual biological variability.[1] With respect to disease activity score in 28 joints (DAS28) and Rheumatoid Arthritis (RA), precise...... threshold for reporting CRP is important due to the direct effects of CRP on calculating DAS28, patient classification and subsequent treatment decisions[2] Methods: This study consists of two sections: a theoretical consideration discussing the performance of CRP in calculating DAS28 with regard...... to the biological variation and reporting limit for CRP and a cross sectional study of all RA patients from our department (n=876) applying our theoretical results. In the second section, we calculate DAS28 twice with actual CRP and CRP=9, the latter to elucidate the positive consequences of changing the lower...

  20. No further gain can be achieved by calculating Disease Activity Score in 28 joints with high-sensitivity assay of C-reactive protein because of high intraindividual variability of C-reactive protein: A cross-sectional study and theoretical consideration.

    Science.gov (United States)

    Hansen, Inger M J; Emamifar, Amir; Andreasen, Rikke A; Antonsen, Steen

    2017-01-01

    Disease Activity Score in 28 joints (DAS28) is commonly used to evaluate disease activity of rheumatoid arthritis (RA) and is a guide to treatment decision.The aim of this study was to evaluate the impact of lower reporting limit for C-reactive protein (CRP), with respect to intraindividual biological variability, on the calculation of DAS28 and subsequent patient classification.This study consists of 2 sections: a theoretical consideration discussing the performance of CRP in calculating DAS28 taking intraindividual biological variation and lower reporting limit for CRP into account and a cross-sectional study of RA patients applying our theoretical results. Therefore, we calculated DAS28 twice, with the actual CRP values and CRP = 9 mg/L, the latter to elucidate the positive effects of reducing the lower reporting limit of CRP from <10 to <3 mg/L.Lower-reporting limit of <10 mg/L leads to overestimate DAS28. However, reducing lower reporting limit for CRP to <3 mg/L results in optimizing DAS28 calculation. Further lowering of reporting limit for CRP to <3 mg/L does not increase the precision of DAS28 owing to the relatively large intraindividual biological variation.Five hundred twelve patients were included. There was a significant difference between recalculated and patients DAS28 (P < 0.001). One hundred nine patients had DAS28 deviation (compatible to remission to low: 66, low to moderate: 39. and moderate to high: 4).Owing to significant impact of intraindividual biologic variation on DAS28 and patient classification, special attention should be paid to calculate DAS28 when CRP values are within normal range. Furthermore, we conclude that results of different studies evaluating DAS28 and treatment response are not comparable if the reporting limits of CRP are unknown.

  1. Change in CD3 positive T-cell expression in psoriatic arthritis synovium correlates with change in DAS28 and magnetic resonance imaging synovitis scores following initiation of biologic therapy--a single centre, open-label study.

    LENUS (Irish Health Repository)

    Pontifex, Eliza K

    2011-01-01

    With the development of increasing numbers of potential therapeutic agents in inflammatory disease comes the need for effective biomarkers to help screen for drug efficacy and optimal dosing regimens early in the clinical trial process. This need has been recognized by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group, which has established guidelines for biomarker validation. To seek a candidate synovial biomarker of treatment response in psoriatic arthritis (PsA), we determined whether changes in immunohistochemical markers of synovial inflammation correlate with changes in disease activity scores assessing 28 joints (ΔDAS28) or magnetic resonance imaging synovitis scores (ΔMRI) in patients with PsA treated with a biologic agent.

  2. Can baseline ultrasound results help to predict failure to achieve DAS28 remission after 1 year of tight control treatment in early RA patients?

    Science.gov (United States)

    Ten Cate, D F; Jacobs, J W G; Swen, W A A; Hazes, J M W; de Jager, M H; Basoski, N M; Haagsma, C J; Luime, J J; Gerards, A H

    2018-01-30

    At present, there are no prognostic parameters unequivocally predicting treatment failure in early rheumatoid arthritis (RA) patients. We investigated whether baseline ultrasonography (US) findings of joints, when added to baseline clinical, laboratory, and radiographical data, could improve prediction of failure to achieve Disease Activity Score assessing 28 joints (DAS28) remission (baseline. Clinical, laboratory, and radiographical parameters were recorded. Primary analysis was the prediction by logistic regression of the absence of DAS28 remission 12 months after diagnosis and start of therapy. Of 194 patients included, 174 were used for the analysis, with complete data available for 159. In a multivariate model with baseline DAS28 (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2-2.2), the presence of rheumatoid factor (OR 2.3, 95% CI 1.1-5.1), and type of monitoring strategy (OR 0.2, 95% CI 0.05-0.85), the addition of baseline US results for joints (OR 0.96, 95% CI 0.89-1.04) did not significantly improve the prediction of failure to achieve DAS28 remission (likelihood ratio test, 1.04; p = 0.31). In an early RA population, adding baseline ultrasonography of the hands, wrists, and feet to commonly available baseline characteristics did not improve prediction of failure to achieve DAS28 remission at 12 months. Clinicaltrials.gov, NCT01752309 . Registered on 19 December 2012.

  3. Therapeutic intervention scoring system-28 (TISS-28: diretrizes para aplicação Therapeutic intervention scoring system-28 (tiss-28: directrices para su aplicación Therapeutic intervention scoring system-28 (tiss-28: directions for application

    Directory of Open Access Journals (Sweden)

    Katia Grillo Padilha

    2005-06-01

    Full Text Available O Therapeutic Intervention Scoring System-28 (TISS-28 é um instrumento que permite dimensionar carga de trabalho de enfermagem em Unidade de Terapia Intensiva e estimar gravidade da doença. Apresenta-se nesta publicação as definições operacionais para sua aplicação, proposta por um grupo de especialistas na área, com vistas a uniformizar o significado de cada um dos itens e evitar vieses de interpretação.El Therapeutic Intervention Scoring System-28 (TISS-28 es un instrumento que permite dimensionar carga de trabajo de enfermería en una Unidad de Terapia Intensiva y estimar la gravedad de la enfermedad. Se presenta en esta publicación las definiciones operacionales para su aplicación, propuesta por un grupo de especialistas en el área, con vistas a uniformizar el significado de cada uno de los items y evitar sesgos de interpretación.Therapeutic Intervention Scoring System-28 (TISS-28 is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

  4. Evaluation of the activity of rheumatoid arthritis in clinical practice. Agreement between self-rated clinimetric evaluation and clinical evaluation with activity indexes: DAS28, CDAI and SDAI.

    Science.gov (United States)

    Horta-Baas, Gabriel; Pérez Bolde-Hernández, Arturo; Hernández-Cabrera, María Fernanda; Vergara-Sánchez, Imelda; Romero-Figueroa, María Del Socorro

    2017-10-11

    To achieve control of rheumatoid arthritis (RA) it is necessary to be able to evaluate its activity. The American College of Rheumatology (ACR) recommends for this purpose indexes of activity that can be performed by the patient (PAS-II and RAPID-3) and IA including medical evaluation with laboratory studies (DAS28 and SDAI) or without them (CDAI). The objective was to analyze the concordance between self-rated clinimetric evaluation and clinimetric evaluation performed by the physician. Analytical cross-sectional study in 126 patients with RA. The agreement was evaluated through the weighted κ coefficient and the Krippendorff's α coefficient. The PAS-II and RAPID-3 significantly correlated with all variables included in the core set of measures recommended by the ACR/EULAR. The agreement between PAS-II and CDAI-SDAI was good (κ: 0.6, α: 0.61-0.62), and moderate with DAS28-ESR (κ: 0.53, α: 0.56). The concordance between RAPID-3 and CDAI-SDAI was moderate (κ: 0.55-0.57, α: 0.50-0.51), and moderate with DAS28-ESR (κ: 0.55, α: 0.53). When categorizing the activity in remission/low activity vs. moderate/severe activity, the agreement was greater with the PAS-II (0.59 vs. 0.34; P=.012). The good concordance between PAS-II and SDAI supports their use in clinical practice, especially if biomarkers of inflammation or the possibility of joint count are not available. However, in order to recommend its routine application in clinical practice, it is necessary to perform longitudinal studies that assess its responsiveness. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Simplified Therapeutic Intervention Scoring System : The TISS-28 items - Results from a multicenter study

    NARCIS (Netherlands)

    Miranda, DR; deRijk, A; Schaufeli, W

    Objectives: To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. Design: Prospective, multicenter study. Setting: Twenty-two adult medical, surgical,

  6. Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

    DEFF Research Database (Denmark)

    Emamifar, Amir; Hangaard, Jørgen; Jensen Hansen, Inger Marie

    2017-01-01

    peptide antibody (anti-CCP), and antinuclear antibody (ANA), and also disease activity score in 28 joints-C-reactive protein at the time of diagnosis and after 4 months (±1–2 months) of treatment initiation were extracted from Danish Danbio Registry. Patients’ electronic hospital records for the past 10...... years were reviewed to reveal if they had been diagnosed with thyroid disorders or they had abnormal thyroid test.In all, 439 patients were included, female 60.1%, mean age 64.6 ± 15.0 years and disease duration 2.6 ± 1.7 years. Prevalence of thyroid disorders was 69/439 (15.7%) and hypothyroidism...... treatment compared with patients with isolated RA after 4 months of treatment (P = .02). There were no associations between thyroid disorders and age, disease duration, and also IgM RF positivity.Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease and poor outcome...

  7. RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.

    Science.gov (United States)

    Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon

    2017-06-01

    The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.

  8. Impact of hepatitis C virus infection on disease activity, functional status and ultrasonography findings in Egyptian rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Nabila Abd EI-Hamid Gohar

    2018-04-01

    Full Text Available Background: Hepatitis C virus (HCV infection is one of the most frequently encountered public health problems in Egypt. It is associated with many autoimmune diseases such as rheumatoid arthritis. Aim of the work: To assess the impact of HCV infection in rheumatoid arthritis (RA Egyptian patients; its relation to disease activity, functional status and ultrasonography findings. Patients and methods: The study included 155 RA patients further classified according to the presence of concomitant HCV infection into 2 groups; rheumatoid arthritis (RA and rheumatoid arthritis/hepatitis C virus (RA/HCV groups. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations, assessment of disease activity using the disease activity score 28 (DAS28 and assessment of functional status using the modified health assessment questionnaire (MHAQ. Ultrasonography (US assessment was done using the German US7 score. Results: Both DAS28 and MHAQ scores showed significant differences between both the RA and the RA/HCV groups (p < 0.001, with higher mean values observed in the RA/HCV group (5.4 ± 1.1 and 1.05 ± 0.79 respectively. Significantly higher US7 synovitis scores were found in the RA/HCV group compared to the RA group (p = 0.03. US7 synovitis tenosynovitis scores revealed significant correlations with DAS28 and US7 synovitis scores correlated with MHAQ in both groups. Conclusion: Concomitant HCV infection in RA patients had an impact on disease activity. RA patients with concomitant HCV infection (RA/HCV had higher DAS28 and MHAQ scores, with higher US7 synovitis scores compared to RA patients. US7 score is a valuable objective tool for the assessment of RA disease activity. Keywords: Rheumatoid arthritis, HCV infection, Ultrasonography, DAS28, MHAQ

  9. The correlation of serum bilirubin levels with disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Peng, You-Fan; Wang, Jun-Li; Pan, Guo-Gang

    2017-06-01

    We investigated the relationship between serum bilirubin and disease activity in patients with rheumatoid arthritis (RA). We included a total of 173 consecutive RA patients without steroid treatment and 346 healthy subjects; the disease activity score in 28 joints (DAS28) was used to assess disease activity in patients with RA. Serum bilirubin concentrations were significantly lower in RA patients than in controls. Serum bilirubin was found to be negatively correlated with C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) (r=-0.165, P=0.030; r=-192, P=0.012) in patients with RA. There was a negative correlation between the serum bilirubin and DAS28 score (r=-0.331, Pbilirubin was independently associated with the DAS28 score (b=-0.225, P=0.001) in the multiple linear regression analysis. Serum bilirubin concentrations are lower in patients with RA compared to controls and correlate with disease activity in patients with RA. Copyright © 2017. Published by Elsevier B.V.

  10. Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project.

    Science.gov (United States)

    Backhaus, M; Ohrndorf, S; Kellner, H; Strunk, J; Backhaus, T M; Hartung, W; Sattler, H; Albrecht, K; Kaufmann, J; Becker, K; Sörensen, H; Meier, L; Burmester, G R; Schmidt, W A

    2009-09-15

    To introduce a new standardized ultrasound score based on 7 joints of the clinically dominant hand and foot (German US7 score) implemented in daily rheumatologic practice. The ultrasound score included the following joints of the clinically dominant hand and foot: wrist, second and third metacarpophalangeal and proximal interphalangeal, and second and fifth metatarsophalangeal joints. Synovitis and synovial/tenosynovial vascularity were scored semiquantitatively (grade 0-3) by gray-scale (GS) and power Doppler (PD) ultrasound. Tenosynovitis and erosions were scored for presence. The scoring range was 0-27 for GS synovitis, 0-39 for PD synovitis, 0-7 for GS tenosynovitis, 0-21 for PD tenosynovitis, and 0-14 for erosions. Patients with arthritis were examined at baseline and after the start or change of disease-modifying antirheumatic drug (DMARD) and/or tumor necrosis factor alpha (TNFalpha) inhibitor therapy 3 and 6 months later. C-reactive protein level, erythrocyte sedimentation rate, rheumatoid factor, anti-cyclic citrullinated peptide, Disease Activity Score in 28 joints (DAS28), and radiographs of the hands and feet were performed. One hundred twenty patients (76% women) with rheumatoid arthritis (91%) and psoriatic arthritis (9%) were enrolled. In 52 cases (43%), erosions were seen in radiography at baseline. Patients received DMARDs (41%), DMARDs plus TNFalpha inhibitors (41%), or TNFalpha inhibitor monotherapy (18%). At baseline, the mean DAS28 was 5.0 and the synovitis scores were 8.1 in GS ultrasound and 3.3 in PD ultrasound. After 6 months of therapy, the DAS28 significantly decreased to 3.6 (Delta = 1.4), and the GS and PD ultrasound scores significantly decreased to 5.5 (-32%) and 2.0 (-39%), respectively. The German US7 score is a viable tool for examining patients with arthritis in daily rheumatologic practice because it significantly reflects therapeutic response.

  11. Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study.

    Science.gov (United States)

    Jawaheer, D; Olsen, J; Lahiff, M; Forsberg, S; Lähteenmäki, J; da Silveira, I G; Rocha, F A; Magalhães Laurindo, I M; Henrique da Mota, L M; Drosos, A A; Murphy, E; Sheehy, C; Quirke, E; Cutolo, M; Rexhepi, S; Dadoniene, J; Verstappen, S M M; Sokka, T

    2010-01-01

    To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner. Consecutive patients with RA were enrolled from 25 countries into the QUEST-RA program between 2005 and 2008. Clinical and demographic data were collected by treating rheumatologists and by patient self-report. Distributions of Disease Activity Scores (DAS28), BMI, age, and disease duration were assessed for each country and for the entire dataset; mean values between genders were compared using Student's t-tests. An association between BMI and DAS28 was investigated using linear regression, adjusting for age, disease duration and country. A total of 5,161 RA patients (4,082 women and 1,079 men) were included in the analyses. Overall, women were younger, had longer disease duration, and higher DAS28 scores than men, but BMI was similar between genders. The mean DAS28 scores increased with increasing BMI from normal to overweight and obese, among women, whereas the opposite trend was observed among men. Regression results showed BMI (continuous or categorical) to be associated with DAS28. Compared to the normal BMI range, being obese was associated with a larger difference in mean DAS28 (0.23, 95% CI: 0.11, 0.34) than being overweight (0.12, 95% CI: 0.03, 0.21); being underweight was not associated with disease activity. These associations were more pronounced among women, and were not explained by any single component of the DAS28. BMI appears to be associated with RA disease activity in women, but not in men.

  12. Reevaluation of the role of duration of morning stiffness in the assessment of rheumatoid arthritis activity.

    Science.gov (United States)

    Khan, Nasim A; Yazici, Yusuf; Calvo-Alen, Jaime; Dadoniene, Jolanta; Gossec, Laure; Hansen, Troels M; Huisman, Margriet; Kallikorm, Riina; Muller, Raili; Liveborn, Margareth; Oding, Rolf; Luchikhina, Elena; Naranjo, Antonio; Rexhepi, Sylejman; Taylor, Peter; Tlustochowich, Witold; Tsirogianni, Afrodite; Sokka, Tuulikki

    2009-11-01

    To evaluate the utility of the duration of morning stiffness (MS), as a patient-reported outcome (PRO), in assessing rheumatoid arthritis (RA) disease activity. We acquired information on 5439 patients in QUEST-RA, an international database of patients with RA evaluated by a standard protocol. MS duration was assessed from time of waking to time of maximal improvement. Ability of MS duration to differentiate RA activity states, based on Disease Activity Score (DAS)28, was assessed by analysis of variance; and a receiver-operating characteristic (ROC) curve was plotted for discriminating clinically active (DAS28 > 3.2) from less active (DAS28 3.2). MS duration has a moderate correlation with RA disease activity. Assessment of MS duration may be clinically helpful in patients with low RAPID3 scores.

  13. The value of power Doppler ultrasound in patients with rheumatoid arthritis in clinical remission: Reclassifying disease activity?

    Science.gov (United States)

    Vergara, Facundo; Ruta, Santiago; Rosa, Javier; Marín, Josefina; García-Mónaco, Ricardo; Soriano, Enrique R

    2017-03-18

    The aim of the present study was to describe the ultrasound (US) findings in patients with rheumatoid arthritis (RA) in clinical remission, and to evaluate the ability of power Doppler (PD) US to reclassify disease activity in these patients. We included consecutive patients with RA according to 2010 American College of Rheumatology/European League Against Rheumatism criteria, who were in clinical remission by the Disease Activity Score (DAS28<2.6). Twenty joints of both hands were assessed by US. PD signal was evaluated on a semi-quantitative scale from 0 to 3. Three different US-modified DAS28 (US-DAS28) were constructed, replacing the clinical swollen joint count by the PD US joint count using PD score ≥1, ≥2 or ≥3, respectively. Eighty-six patients were included. Twenty-three (26.7%) patients had at least one joint with abnormal US-positive PD signal. Thirteen percent of patients were reclassified to low disease activity by applying the US-DAS28 when joints were considered active with a PD signal ≥1; 12%, when a PD signal ≥2 was considered, and 2% of the patients were reclassified when a PD score of 3 was considered. No patients were reclassified to a level of moderate or high activity applying US-DAS28. Although around a quarter of patients with RA in clinical remission showed PD US features indicating residual activity, only a small percentage were reclassified to a state of low activity and none to a level of moderate or high activity, applying the proposed US-DAS28. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  14. Dereplication, Aggregation and Scoring Tool (DAS Tool) v1.0

    Energy Technology Data Exchange (ETDEWEB)

    2017-03-01

    Communities of uncultivated microbes are critical to ecosystem function and microorganism health, and a key objective of metagenomic studies is to analyze organism-specific metabolic pathways and reconstruct community interaction networks. This requires accurate assignment of genes to genomes, yet existing binning methods often fail to predict a reasonable number of genomes and report many bins of low quality and completeness. Furthermore, the performance of existing algorithms varies between samples and biotypes. Here, we present a dereplication, aggregation and scoring strategy, DAS Tool, that combines the strengths of a flexible set of established binning algorithms. DAS Tools applied to a constructed community generated more accurate bins than any automated method. Further, when applied to samples of different complexity, including soil, natural oil seeps, and the human gut, DAS Tool recovered substantially more near-complete genomes than any single binning method alone. Included were three genomes from a novel lineage . The ability to reconstruct many near-complete genomes from metagenomics data will greatly advance genome-centric analyses of ecosystems.

  15. A cross-sectional study of pain sensitivity, disease-activity assessment, mental health, and fibromyalgia status in rheumatoid arthritis.

    Science.gov (United States)

    Joharatnam, Nalinie; McWilliams, Daniel F; Wilson, Deborah; Wheeler, Maggie; Pande, Ira; Walsh, David A

    2015-01-20

    Pain remains the most important problem for people with rheumatoid arthritis (RA). Active inflammatory disease contributes to pain, but pain due to non-inflammatory mechanisms can confound the assessment of disease activity. We hypothesize that augmented pain processing, fibromyalgic features, poorer mental health, and patient-reported 28-joint disease activity score (DAS28) components are associated in RA. In total, 50 people with stable, long-standing RA recruited from a rheumatology outpatient clinic were assessed for pain-pressure thresholds (PPTs) at three separate sites (knee, tibia, and sternum), DAS28, fibromyalgia, and mental health status. Multivariable analysis was performed to assess the association between PPT and DAS28 components, DAS28-P (the proportion of DAS28 derived from the patient-reported components of visual analogue score and tender joint count), or fibromyalgia status. More-sensitive PPTs at sites over or distant from joints were each associated with greater reported pain, higher patient-reported DAS28 components, and poorer mental health. A high proportion of participants (48%) satisfied classification criteria for fibromyalgia, and fibromyalgia classification or characteristics were each associated with more sensitive PPTs, higher patient-reported DAS28 components, and poorer mental health. Widespread sensitivity to pressure-induced pain, a high prevalence of fibromyalgic features, higher patient-reported DAS28 components, and poorer mental health are all linked in established RA. The increased sensitivity at nonjoint sites (sternum and anterior tibia), as well as over joints, indicates that central mechanisms may contribute to pain sensitivity in RA. The contribution of patient-reported components to high DAS28 should inform decisions on disease-modifying or pain-management approaches in the treatment of RA when inflammation may be well controlled.

  16. Temporal summation of pain and ultrasound Doppler activity as predictors of treatment response in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Christensen, Anton Wulf; Rifbjerg-Madsen, Signe; Christensen, Robin

    2014-01-01

    activity score DAS28 can classify some patients with active RA solely based on a high tender joint count and poor patient global health score. In such cases, intensified treatment with anti-inflammatory drugs would be expected to yield poorer results than in cases with DAS28 elevation due to a high score...... (ie, degree of central sensitisation). The main objective of this study was to examine the prognostic values of pressure pain-induced temporal summation, ultrasound Doppler activity and the interaction between them in relation to treatment response (DAS28-CRP change) in patients with RA initiating any...... anti-inflammatory therapy. METHOD AND ANALYSIS: 120 participants ≥18 years of age will be recruited. Furthermore, they must be either (1) diagnosed with RA, untreated with disease-modifying antirheumatic drugs for at least 6 months and about to initiate disease-modifying antirheumatic drug treatment...

  17. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

    Science.gov (United States)

    Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

    2017-05-24

    To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; Pdisease was very good with an area under the curve (AUC) of 0.847 (95% confidence interval [CI]: 0.816 to 0.878; Pdisease activity groups, we propose the following cut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  18. Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Wallman, Johan K; Eriksson, Jonas K; Nilsson, Jan-Åke

    2016-01-01

    between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs. RESULTS: Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work......OBJECTIVE: To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA). METHODS: Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005-2010. Health Assessment...... Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare...

  19. Rheumatoid arthritis disease activity and vitamin D deficiency in an Asian resident population.

    Science.gov (United States)

    Quraishi, Mohammed K; Badsha, Humeira

    2016-04-01

    We aimed to assess the prevalence of vitamin D deficiency and its association with rheumatoid arthritis (RA) disease activity in a UAE population. Forty-five consecutive subjects were prospectively recruited during the early summer with their clinical examination and Health Assessment Questionnaire (HAQ) being recorded at a clinic appointment, along with their blood sample being taken for the 25-hydroxyvitamin D (25(OH)D) total test. Thirty-five (76%) patients claimed to be exposed to sunlight for Disease Activity Score (DAS28) or HAQ scores. A direct relationship was observed between HAQ scores and DAS28 scores (P culture. No association was observed between vitamin D and disease activity. However, the high prevalence of vitamin D deficiency may negatively impact on bone health of these patients in the future. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  20. M-ficolin levels reflect disease activity and predict remission in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll, Christian Gytz; Thiel, Steffen; Jensenius, Jens Christian

    2013-01-01

    To assess plasma M-ficolin concentrations in disease-modifying antirheumatic drug (DMARD)-naive patients with early rheumatoid arthritis (RA), to investigate the correlation of M-ficolin concentrations with disease activity markers, and to determine the predictive value of M-ficolin with respect...... to the Disease Activity Score in 28 joints (DAS28)....

  1. Reliability And Validity Of Turkish Version Of Motor Activity Log-28

    Directory of Open Access Journals (Sweden)

    Burcu Ersöz Hüseyinsinoğlu

    2011-06-01

    Full Text Available OBJECTIVE: The aim of this study was to adapt the Motor Activity Log-28 (MAL-28 into Turkish and probe the reliability and validity of this questionnaire in stroke patients. METHODS: Following the translation of the MAL-28 into Turkish, its reliability and construct validity was examined in 30 stroke patients. For the reliability study, patients were interviewed twice within a three day period, during which no rehabilitative activities were undertaken. The test-retest reliability was determined by using intra-class correlation coefficient (ICC and Spearman correlation coefficient (r; internal consistency was determined by Cronbach's alpha (α. The construct validity was examined by comparing MAL-28 Quality Of Movement (QOM scale and Amount Of Use (AOU scale with Wolf Motor Function Test (WMFT-Performance Time (PT and Functional Ability (FA scores. Furthermore, item-to-scale correlations of AOU and QOM scales were determined and correlation between totol scores of two scales was examined. RESULTS: Turkish version of MAL-28 AOU and QOM scales were reliable (ICC scores were 0.97 and 0.96, respectively and internally consistent (Cronbach’s α value was 0.96 for both scales. Test-retest reliability was supported (AOU, r=0.94; QOM, r=0.93. WMFT FA scores was correlated with both scales (r=0.63. Correlation between WMFT PT and AOU and QOM scales were -0.56 and -0.55. AOU and QOM scales were highly correlated (r=0.95. CONCLUSION: The findings indicate that Turkish version of MAL-28 is reliable and valid in individuals with stroke. Further investigation about its responsiveness is needed before using that version as a primary measurement in clinical trials

  2. Corelations between radiological score with clinical and laboratory parameters in rheumatoid arthritis

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    Mihaela Chicu

    2016-12-01

    Full Text Available Staging in rheumatoid arthritis (RA and evaluating the effectiveness of drug treatment involves the determination of radiological scores (for narrowing and erosions, this being the most specific changes and most commonly found in RA.Matherials and methods: Our study was condacted over a period of 12 months in Medical Rehabilitation Clinic of „Sf. Spiridon” Iasi Hospital, on a group of 40 women patients with RA in various stages of evolution. X-ray examination was done on hands and feet at the beginning and the end of the study period. There were computed radiographic Sharp scores for narrowing and erosions and the total score. Erosions were examined for 16 joints in each hand. For narrowing five joints were evaluated. For accuracy, radiological examination was done on mammography film. Rezults:After calculating Sharp scores - Van der Heide version - I compared them with the levels of clinical (HAQ, NAT, NAD, DAS28, bone densitometry and laboratory (ESR, CRP, rheumatoid factor, IL-1β parameters.Conclusions: The values of radiological scores for narrowing and erosions are directly correlate with DAS28, HAQ, rheumatoid factors levels and IgG values, and indirectly correlated with IL-1β levels.

  3. Dynamic contrast-enhanced 3-T magnetic resonance imaging: a method for quantifying disease activity in early polyarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Navalho, Marcio [Faculdade de Medicina da Universidade de Lisboa, Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon (Portugal); Hospital da Luz, Radiology Department, Lisbon (Portugal); Hospital da Luz, Centro de Imagiologia, Lisbon (Portugal); Resende, Catarina [Hospital da Luz, Rheumatology Department, Lisbon (Portugal); Hospital de Santa Maria, Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Lisbon (Portugal); Rodrigues, Ana Maria; Fonseca, Joao Eurico; Canhao, Helena [Faculdade de Medicina da Universidade de Lisboa, Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon (Portugal); Hospital de Santa Maria, Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Lisbon (Portugal); Gaspar, Augusto [Hospital da Luz, Radiology Department, Lisbon (Portugal); Campos, Jorge [Hospital de Santa Maria, Radiology Department, Centro Hospitalar de Lisboa Norte, EPE, Lisbon (Portugal)

    2012-01-15

    To determine whether measurement of synovial enhancement and thickness quantification parameters with 3.0-Tesla magnetic resonance imaging (3-T MRI) can reliably quantify disease activity in patients with early polyarthritis. Eighteen patients (16 women, 2 men; mean age 46 years) with early polyarthritis with less than 12 months of symptoms were included. MRI examination using 3-T device was performed by a new approach including both wrists and hands simultaneously in the examination field-of-view. MRI scoring of disease activity included quantification of synovial enhancement with simple measurements such as rate of early enhancement (REE; REE{sub 57} = S{sub 57}/S{sub 200}, where S{sub 57} and S{sub 200} are the signal intensities 57 s and 200 s after gadolinium injection) and rate of relative enhancement (RE; RE = S{sub 200} - S{sub 0}). Both wrists and hands were scored according to the Rheumatoid Arthritis MRI Scoring System (RAMRIS) for synovitis. Disease activity was clinically assessed by the 28-joint Disease Activity Score (DAS28). DAS28 score was strongly correlated with RE (r = 0.8331, p < 0.0001), REE (r = 0.8112, p < 0.0001), and RAMRIS score for synovitis (r = 0.7659, p < 0.0002). An REE score above 0.778 accurately identified patients with clinically active disease (sensitivity 92%; specificity 67%; p < 0.05). A statistically significant difference was observed in the RE, REE, and RAMRIS scores for synovitis between patients with active and inactive disease (p < 0.05). Our findings support the use of 3-T dynamic contrast-enhanced MRI for precise quantification of disease activity and for discriminating active disease from inactive disease in early polyarthritis. (orig.)

  4. Use of exploratory factor analysis to ascertain the correlation between the activities of rheumatoid arthritis and infection by human parvovirus B19.

    Science.gov (United States)

    Kakurina, Natalja; Kadisa, Anda; Lejnieks, Aivars; Mikazane, Helena; Kozireva, Svetlana; Murovska, Modra

    2015-01-01

    We evaluated a possible correlation between the clinical activities of rheumatoid arthritis (RA) and human parvovirus B19 (B19) infection using exploratory factor analysis (EFA). RA patients were organized into two groups: 100 patients in the main group and 97 in the RA(DAS28) group. Four subgroups were defined from the main group according to the presence or absence of certain infection-specific markers: group I comprised 43 patients who had IgG antibodies against B19; group II, 25 patients with active B19 infection (B19-specific IgM antibodies and/or plasma viremia); group III, 19 patients with latent/persistent B19 infection (virus-specific sequences in peripheral blood leukocytes' DNA with or without B19-specific IgG antibodies), and group IV, 13 patients without infection markers. The RA(DAS28) group was divided into four subgroups similarly to the main group: group I, 35; group II, 31; group III, 19; and group IV, 12 patients. Disease-specific clinical values in both groups were analyzed employing EFA, and the RA(DAS28) group was additionally assessed using Disease Activity Score (DAS)28. RA activity was higher in patients who had markers of B19 infection. The highest activity of RA in both study groups was in patients with latent/persistent infection. In the RA(DAS28) group, according to DAS28, the highest activity of RA was in patients with active B19 infection. Using EFA and DAS28, a correlation between the clinical activity of RA and B19 infection was confirmed. These data suggest that EFA is applicable for medico-biological studies. Copyright © 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  5. Association of modified NUTRIC score with 28-day mortality in critically ill patients.

    Science.gov (United States)

    Mukhopadhyay, Amartya; Henry, Jeyakumar; Ong, Venetia; Leong, Claudia Shu-Fen; Teh, Ai Ling; van Dam, Rob M; Kowitlawakul, Yanika

    2017-08-01

    For patients in the intensive care unit (ICU), nutritional risk assessment is often difficult. Traditional scoring systems cannot be used for patients who are sedated or unconscious since they are unable to provide information on their history of food intake and weight loss. We aim to validate the NUTRIC (NUTrition RIsk in Critically ill) score, an ICU-specific nutrition risk assessment tool in Asian patients. This was an observational study in the medical ICU of a university-affiliated tertiary hospital. We included all adult patients (≥18years) admitted between October 2013 and September 2014 who stayed for more than 24 hours in the ICU. Components of the modified NUTRIC (mNUTRIC) score, demographic details, body mass index (BMI), use of mechanical ventilation (MV), vasopressor drugs, and renal replacement therapy (RRT) were obtained from the ICU database. For patients on MV (maximum 12 days), we calculated the energy intake and nutritional adequacy (energy received ÷ energy recommended) from enteral or parenteral feeding data. Multivariable logistic regression analysis was used with 28-day mortality as the outcome of interest. 401 patients (62% male, mean age 60.0 ± 16.3 years, mean BMI 23.9 ± 6.2 kg/m 2 ) were included. In the univariate analysis, BMI, mNUTRIC score, MV, vasopressor drug, and RRT were associated with 28-day mortality. In the multivariable logistic regression analysis, mNUTRIC score (Odds ratio, OR 1.48, Confidence Interval, CI 1.25-1.74, p Nutritional adequacy was assessed in a subgroup of 273 (68%) patients who received MV for at least 48 hours. Median (IQR) nutritional adequacy was 0.44 (0.15-0.70). In patients with high mNUTRIC score (5-9), higher nutritional adequacy was associated with a lower predicted 28-day mortality; this was not observed in patients with low mNUTRIC (0-4) score (effect modification, p interaction nutritional adequacy may reduce the 28-day mortality in patients with a high mNUTRIC score. Copyright © 2016

  6. Multibiomarker disease activity score and C-reactive protein in a cross-sectional observational study of patients with rheumatoid arthritis with and without concomitant fibromyalgia.

    Science.gov (United States)

    Lee, Yvonne C; Hackett, James; Frits, Michelle; Iannaccone, Christine K; Shadick, Nancy A; Weinblatt, Michael E; Segurado, Oscar G; Sasso, Eric H

    2016-04-01

    To examine the association between a multibiomarker disease activity (MBDA) score, CRP and clinical disease activity measures among RA patients with and without concomitant FM. In an observational cohort of patients with established RA, we performed a cross-sectional analysis comparing MBDA scores with CRP by rank correlation and cross-classification. MBDA scores, CRP and clinical measures of disease activity were compared between patients with RA alone and RA with concomitant FM (RA and FM) by univariate and multivariate analyses. CRP was ⩽1.0 mg/dl for 184 of 198 patients (93%). MBDA scores correlated with CRP (r = 0.755, P < 0.001), but were often discordant, being moderate or high for 19%, 55% and 87% of patients with CRP ⩽0.1, 0.1 to ⩽0.3, or 0.3 to ⩽1.0 mg/dl, respectively. Among patients with CRP ⩽1.0 mg/dl, swollen joint count (SJC) increased linearly across levels of MBDA score, both with (P = 0.021) and without (P = 0.004) adjustment for CRP, whereas CRP was not associated with SJC. The 28-joint-DAS-CRP, other composite measures, and their non-joint-count component measures were significantly greater for patients with RA and FM (n = 25) versus RA alone (n = 173) (all P ⩽ 0.005). MBDA scores and CRP were similar between groups. MBDA scores frequently indicated RA disease activity when CRP did not. Neither one was significantly greater among patients with RA and FM versus RA alone. Thus, MBDA score may be a useful objective measure for identifying RA patients with active inflammation when CRP is low (⩽1.0 mg/dl), including RA patients with concomitant FM. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  7. The association of immunoglobulin A, immunoglobulin G and anti-cyclic citrullinated peptide antibodies with disease activity in seronegative rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Mansoor Karimifar

    2014-01-01

    Full Text Available Background: Rheumatoid arthritis (RA is a common autoimmune disease that is associated with progressive disability, systemic complications, and early death. The present study was aimed to investigate the level of immunoglobulin G (IgG and IgA isotypes and anti-cyclic citrullinated peptide (CCP antibody and to assess their association with disease severity based on disease activity score (DAS-28 in patients with IgM rheumatoid factor (IgM-RF negative RA. Materials and Methods: In this cross-sectional study, 62 RA patients with IgM-RF negative were assessed. Radiographs were obtained for all RA patients. The RF (IgG, and IgA and anti-CCP were measured by using the enzyme-linked immunosorbent assay. Values of cut-off points over 15 UI/mL for IgA IgA-RF, 20 UI/mL for IgG-RF and over 20 units for anti-CCP were considered positive. DAS-28 score was compared in regard to the IgA-RF and IgG-RF and anti-CCP positivity using Mann-Whitney test. Results: DAS-28 score in IgA-RF positive was significantly higher than IgA-RF negative (mean score, 6.03 ± 0.33 vs. 5.44 ± 0.76 respectively, P = 0.035. In IgG-RF positive patients, DAS-28 score was similar to patients with IgG-RF negative (5.64 ± 0.59 vs. 5.46 ± 0.78 respectively, P = 0.396. Furthermore, in patients with anti-CCP positive DAS-28 score was significantly higher than patients with anti-CCP negative (5.72 ± 0.61 vs. 5.38 ± 0.79 respectively, P = 0.049. Conclusion: Findings indicated that there was a significant association between the amounts of IgA and anti-CCP with severity of disease in RF negative RA patients while there was no significant association between the amounts of IgG and severity of RA disease.

  8. The association of body mass index with disease activity and clinical response to combination therapy in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Maryam Mirpourian

    2014-01-01

    Full Text Available Background: The role of obesity in clinical curse of rheumatoid arthritis (RA is not clear. We investigated the association of obesity and adiposity with disease activity and clinical response to combination therapy in RA patients. Materials and Methods: Active RA patients with the disease activity score using 28 joint counts (DAS28 > 2.6 were studied. Height, weight, and waist and hip circumferences were measured and body mass index (BMI and waist to hip ratio were calculated. Patients were treated with methotrexate (7.5 to 10 mg/week plus hydroxychloroquine (200 to 400 mg/day and prednisolone (2.5 to 10 mg/day and were followed by DAS28 for up to 24 weeks. Results: One hundred and six patients were studied; age = 48.5 ± 13.8 years, 87.7% female, disease duration = 4.4 years [SE = 0.48]. DAS28 was decreased from 4.5 ± 1.6 to 2.9 ± 1.4 (P < 0.001 after 24 weeks of treatment. Only in patients with disease duration of ≤2 years, BMI (r = -0.415, P = 0.005 and waist circumference (r = -0.296, P = 0.05 were correlated with baseline DAS28. Although BMI (r = -0.337, P = 0.025 and waist circumference (r = -0.315, P = 0.038 were correlated with change in DAS28 after therapy, these correlations were disappeared after controlling for baseline DAS28. Conclusion: Obesity and adiposity are associated with less severe disease activity in early stage of RA, but are not associated with response to combination therapy with methotrexate plus hydroxychloroquine in RA patients.

  9. Cartilage oligomeric matrix protein (COMP) in rheumatoid arthritis and its correlation with sonographic knee cartilage thickness and disease activity.

    Science.gov (United States)

    Sakthiswary, Rajalingham; Rajalingam, Shamala; Hussein, Heselynn; Sridharan, Radhika; Asrul, Abdul Wahab

    2017-12-01

    The aim of the study is to investigate the correlation of serum cartilage oligomeric matrix protein (COMP) levels with articular cartilage damage based on sonographic knee cartilage thickness (KCT) and disease activity in rheumatoid arthritis (RA). A total of 61 RA patients and 27 healthy controls were recruited in this study. Serum samples were obtained from all subjects to determine the serum COMP levels. All subjects had bilateral ultrasound scan of their knees. The KCT was based on the mean of measurements at three sites: the medial condyle, lateral condyle and intercondylar notch. Besides, the RA patients were assessed for their disease activity based on 28-joint-based Disease Activity Score (DAS 28). Serum COMP concentrations were significantly elevated in the RA patients compared to the controls (p = 0.001). The serum COMP levels had an inverse relationship with bilateral KCT in RA subjects and the healthy controls. COMP correlated significantly with disease activity based on DAS 28 (r = 0.299, p = 0.010), disease duration (r = 0.439, p = correlation between serum COMP and DAS 28 scores was comparable to the traditional markers of inflammation: erythrocyte sedimentation rate (ESR) (r = 0.372, p = 0.003) and C-reactive protein (CRP) (r = 0.305, p = 0.017). The serum COMP is a promising biomarker in RA which reflects disease activity and damage to the articular cartilage.

  10. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis

    Science.gov (United States)

    Kermani, TA; Cuthbertson, D; Carette, S; Hoffman, GS; Khalidi, NA; Koening, CL; Langford, CA; McKinnon-Maksimowicz, K; McAlear, CA; Monach, PA; Seo, P; Warrington, KJ; Ytterberg, SR; Merkel, PA; Matteson, EL

    2016-01-01

    Objective To evaluate the performance of the Birmingham Vasculitis Activity Score (BVAS) in the assessment of disease activity in giant cell arteritis (GCA). Methods Patients with GCA enrolled in a prospective, multicenter, longitudinal study with symptoms of active vasculitis during any visit were included. Spearman’s rank correlation was used to explore the association of the BVAS with other measures of disease activity. Results During a mean (SD) follow-up of 2.3 (1.6) years, symptoms of active GCA were present in 236 visits in 136 subjects (100 female, 74%). Median (range) BVAS1 (new/worse symptoms) was 1 (0–10) and median (range) BVAS2 (persistent symptoms) was 0 (0–5). Median (range) physician global assessment (PGA) was 4 (0–9) for disease activity in the past 28 days and 2 (0–9) for activity on the day of the visit. Important ischemic manifestations of active vasculitis not captured by the BVAS included tongue/jaw claudication (27%), upper extremity claudication (15%), lower extremity claudication (5%), carotidynia (7%), ischemic retinopathy (5%). During 25 visits (11%) with active disease, all symptoms of active vasculitis were captured in the “Other” category yet still resulted in a BVAS 1 and BVAS 2 of 0. BVAS1 moderately correlated with PGA for the past 28 days (Spearman’s correlation 0.50) and physician-rated disease activity for the past 28 days (Spearman’s correlation 0.46). Conclusions The BVAS has limited utility in GCA. Patients with active GCA can have a BVAS of 0. Many important ischemic symptoms attributable to active vasculitis are not captured in the composite score. PMID:27036388

  11. Changing clinical patterns in rheumatoid arthritis management over two decades: sequential observational studies.

    Science.gov (United States)

    Mian, Aneela N; Ibrahim, Fowzia; Scott, Ian C; Bahadur, Sardar; Filkova, Maria; Pollard, Louise; Steer, Sophia; Kingsley, Gabrielle H; Scott, David L; Galloway, James

    2016-01-27

    Rheumatoid arthritis (RA) treatment paradigms have shifted over the last two decades. There has been increasing emphasis on combination disease modifying anti-rheumatic drug (DMARD) therapy, newer biologic therapies have become available and there is a greater focus on achieving remission. We have evaluated the impact of treatment changes on disease activity scores for 28 joints (DAS28) and disability measured by the health assessment questionnaire scores (HAQ). Four cross-sectional surveys between 1996 and 2014 in two adjacent secondary care rheumatology departments in London evaluated changes in drug therapy, DAS28 and its component parts and HAQ scores (in three surveys). Descriptive statistics used means and standard deviations (SD) or medians and interquartile ranges (IQR) to summarise changes. Spearman's correlations assessed relationships between assessments. 1324 patients were studied. Gender ratios, age and mean disease duration were similar across all cohorts. There were temporal increases in the use of any DMARDs (rising from 61% to 87% of patients from 1996-2014), combination DMARDs (1% to 41%) and biologic (0 to 32%). Mean DAS28 fell (5.2 to 3.7), active disease (DAS28 > 5.1) declined (50% to 18%) and DAS28 remission (DAS28 disability measured by HAQ. As a consequence the relationship between DAS28 and HAQ has become weaker over time. Although the reasons for this divergence between disease activity and disability are uncertain, focussing treatment entirely in suppressing synovitis may be insufficient.

  12. Two-year efficacy of tocilizumab in patients with active rheumatoid arthritis in clinical practice.

    Science.gov (United States)

    Notario Ferreira, Irene; Ferrer González, Miguel Angel; Morales Garrido, Pilar; González Utrilla, Alfonso; García Sanchez, Antonio; Soto Pino, María José; Suero Rosario, Evelyn; Caro Hernández, Cristina; Añón Oñate, Isabel; Pérez Albaladejo, Lorena; Cáliz Cáliz, Rafael

    To evaluate the efficacy of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) in clinical practice, retention rates of the drug and predictors of response. We performed a descriptive, prospective, longitudinal, open-label study in patients receiving TCZ (8mg/kg/4 weeks) in a clinical practice setting. The clinical responses were evaluated using the European League Against Rheumatism (EULAR) response criteria, and the low activity and remission rates according to the Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) and the Clinical Disease Activity Index (CDAI). The EULAR response rate was 86.63% and the DAS28 remission rate was 53.7% after 6 months of treatment; rates of low disease activity were 52.9% on CDAI and 47.1% on DAS28 at month 24. There were no statistically significant differences in EULAR response, rates of low activity and remission on DAS28 between patients receiving TCZ alone and those receiving TCZ in combination therapy, or between patients positive or negative for rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide (anti-CCP) antibodies. The naïve biological therapy patients showed better remission and low activity rates after 6 months of treatment. The retention rate was 61% at month 24. Adverse events were among the most frequent causes of discontinuation. Tocilizumab is effective in RA, has a similar efficacy when used alone or in combination with synthetic disease-modifying antirheumatic drugs (DMARDs) and shows high retention rates. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  13. A K Das

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. A K Das. Articles written in Bulletin of Materials Science. Volume 28 Issue 2 April 2005 pp 131-136 Fly Ash. Some studies on the reaction between fly ash and lime · A Basumajumdar A K Das N Bandyopadhyay S Maitra · More Details Abstract Fulltext PDF. The reaction between ...

  14. Predictive Factors Related to the Efficacy of Golimumab in Patients with Rheumatoid Arthritis

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    Katsuaki Kanbe

    2015-01-01

    Full Text Available In order to investigate the predictive factors related to clinical efficacy and radiographic progression at 24 weeks by looking at the serum levels of tumor necrosis factor (TNF-α and interleukin (IL-6 including baseline characteristics in patients with rheumatoid arthritis (RA treated with golimumab, serum concentrations of TNF-α and IL-6 were analyzed every 4 weeks up to 24 weeks in 47 patients treated with golimumab. Baseline levels of the Disease Activity Score 28 C-reactive protein (DAS28-CRP and Simplified Disease Activity Index (SDAI scores were also assessed. Radiographic progression using the van der Heijde-modified Sharp (vdH-S score was assessed in 29 patients. Multiple regression analyses related to the DAS28-CRP score and delta total sharp score at 24 weeks was undertaken using the baseline characteristics of patients and serum concentrations of matrix metalloproteinase (MMP-3, TNF-α, and IL–6. The DAS28-CRP score and SDAI decreased significantly at 4 weeks up to 24 weeks compared with baseline. Serum levels of TNF-α were not changed significantly up to 24 weeks compared with baseline, but those of IL-6 decreased significantly at 4 weeks up to 8 weeks. Multiple regression analyses showed that disease duration and serum levels of MMP-3 were related significantly to the DAS28-CRP score at 24 weeks. Radiographic progression was related significantly to disease duration with regard to joint space narrowing and bone erosion. However, serum levels of TNF-α and IL-6 were not correlated significantly with the DAS28-CRP score and radiographic progression. These data suggest that decreasing serum levels of IL-6 significantly, MMP-3, and disease duration are predictive factors for RA activity in patients taking golimumab.

  15. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis.

    Science.gov (United States)

    Chandran, Binu; Goel, Ajay

    2012-11-01

    Curcumin is known to possess potent antiinflammatory and antiarthritic properties. This pilot clinical study evaluated the safety and effectiveness of curcumin alone, and in combination with diclofenac sodium in patients with active rheumatoid arthritis (RA). Forty-five patients diagnosed with RA were randomized into three groups with patients receiving curcumin (500 mg) and diclofenac sodium (50 mg) alone or their combination. The primary endpoints were reduction in Disease Activity Score (DAS) 28. The secondary endpoints included American College of Rheumatology (ACR) criteria for reduction in tenderness and swelling of joint scores. Patients in all three treatment groups showed statistically significant changes in their DAS scores. Interestingly, the curcumin group showed the highest percentage of improvement in overall DAS and ACR scores (ACR 20, 50 and 70) and these scores were significantly better than the patients in the diclofenac sodium group. More importantly, curcumin treatment was found to be safe and did not relate with any adverse events. Our study provides the first evidence for the safety and superiority of curcumin treatment in patients with active RA, and highlights the need for future large-scale trials to validate these findings in patients with RA and other arthritic conditions. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study.

    Science.gov (United States)

    Sokka, Tuulikki; Toloza, Sergio; Cutolo, Maurizio; Kautiainen, Hannu; Makinen, Heidi; Gogus, Feride; Skakic, Vlado; Badsha, Humeira; Peets, Tõnu; Baranauskaite, Asta; Géher, Pál; Ujfalussy, Ilona; Skopouli, Fotini N; Mavrommati, Maria; Alten, Rieke; Pohl, Christof; Sibilia, Jean; Stancati, Andrea; Salaffi, Fausto; Romanowski, Wojciech; Zarowny-Wierzbinska, Danuta; Henrohn, Dan; Bresnihan, Barry; Minnock, Patricia; Knudsen, Lene Surland; Jacobs, Johannes Wg; Calvo-Alen, Jaime; Lazovskis, Juris; Pinheiro, Geraldo da Rocha Castelar; Karateev, Dmitry; Andersone, Daina; Rexhepi, Sylejman; Yazici, Yusuf; Pincus, Theodore

    2009-01-01

    Gender as a predictor of outcomes of rheumatoid arthritis (RA) has evoked considerable interest over the decades. Historically, there is no consensus whether RA is worse in females or males. Recent reports suggest that females are less likely than males to achieve remission. Therefore, we aimed to study possible associations of gender and disease activity, disease characteristics, and treatments of RA in a large multinational cross-sectional cohort of patients with RA called Quantitative Standard Monitoring of Patients with RA (QUEST-RA). The cohort includes clinical and questionnaire data from patients who were seen in usual care, including 6,004 patients at 70 sites in 25 countries as of April 2008. Gender differences were analyzed for American College of Rheumatology Core Data Set measures of disease activity, DAS28 (disease activity score using 28 joint counts), fatigue, the presence of rheumatoid factor, nodules and erosions, and the current use of prednisone, methotrexate, and biologic agents. Women had poorer scores than men in all Core Data Set measures. The mean values for females and males were swollen joint count-28 (SJC28) of 4.5 versus 3.8, tender joint count-28 of 6.9 versus 5.4, erythrocyte sedimentation rate of 30 versus 26, Health Assessment Questionnaire of 1.1 versus 0.8, visual analog scales for physician global estimate of 3.0 versus 2.5, pain of 4.3 versus 3.6, patient global status of 4.2 versus 3.7, DAS28 of 4.3 versus 3.8, and fatigue of 4.6 versus 3.7 (P < 0.001). However, effect sizes were small-medium and smallest (0.13) for SJC28. Among patients who had no or minimal disease activity (0 to 1) on SJC28, women had statistically significantly higher mean values compared with men in all other disease activity measures (P < 0.001) and met DAS28 remission less often than men. Rheumatoid factor was equally prevalent among genders. Men had nodules more often than women. Women had erosions more often than men, but the statistical significance

  17. MiDAS: the field guide to the microbes of activated sludge.

    Science.gov (United States)

    McIlroy, Simon Jon; Saunders, Aaron Marc; Albertsen, Mads; Nierychlo, Marta; McIlroy, Bianca; Hansen, Aviaja Anna; Karst, Søren Michael; Nielsen, Jeppe Lund; Nielsen, Per Halkjær

    2015-01-01

    The Microbial Database for Activated Sludge (MiDAS) field guide is a freely available online resource linking the identity of abundant and process critical microorganisms in activated sludge wastewater treatment systems to available data related to their functional importance. Phenotypic properties of some of these genera are described, but most are known only from sequence data. The MiDAS taxonomy is a manual curation of the SILVA taxonomy that proposes a name for all genus-level taxa observed to be abundant by large-scale 16 S rRNA gene amplicon sequencing of full-scale activated sludge communities. The taxonomy can be used to classify unknown sequences, and the online MiDAS field guide links the identity to the available information about their morphology, diversity, physiology and distribution. The use of a common taxonomy across the field will provide a solid foundation for the study of microbial ecology of the activated sludge process and related treatment processes. The online MiDAS field guide is a collaborative workspace intended to facilitate a better understanding of the ecology of activated sludge and related treatment processes--knowledge that will be an invaluable resource for the optimal design and operation of these systems. © The Author(s) 2015. Published by Oxford University Press.

  18. Mannose-binding lectin gene polymorphisms are associated with disease activity and physical disability in untreated, anti-cyclic citrullinated peptide-positive patients with early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Garred, Peter; Madsen, Hans Ole

    2009-01-01

    OBJECTIVE: To study the association between polymorphisms in the mannose-binding lectin gene (MBL2) and disease activity, physical disability, and joint erosions in patients with newly diagnosed rheumatoid arthritis (RA). METHODS: Patients with early RA (n=158) not previously treated with disease...... modifying antirheumatic drugs, participating in a treatment trial (CIMESTRA study) were examined at inclusion for MBL2 pooled structural genotypes (O/O, A/O, A/A), regulatory MBL2 promoter polymorphism in position -221 (XX, XY, YY), anti-cyclic citrullinated peptide 2 antibodies (anti-CCP2), disease...... activity by Disease Activity Score-28 (DAS28 score), physical disability by Health Assessment Questionnaire (HAQ) score, and erosive changes in hands and feet (Sharp-van der Heijde score). RESULTS: Eight patients were homozygous MBL2 defective (O/O), 101 belonged to an intermediate group, and 49 were MBL2...

  19. Serum Epstein-Barr virus DNA, detected by droplet digital PCR, correlates with disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Kuusela, Elina; Kouri, Vesa-Petteri; Olkkonen, Juri; Koivuniemi, Riitta; Äyräväinen, Leena; Rajamäki, Kristiina; Valleala, Heikki; Nordström, Dan; Leirisalo-Repo, Marjatta; Ainola, Mari; Eklund, Kari K

    2018-03-20

    To study the prevalence of asymptomatic activation of Epstein-Barr virus (EBV) in patients with rheumatoid arthritis (RA) and to analyse the correlation of serum EBV DNA with the disease activity. The level of EBV DNA was determined by droplet digital PCR assay from the serum of 46 DMARD naive early RA (ERA) and 22 chronic RA (CRA)-patients at study onset. Follow-up samples from 31 ERA and 16 CRA patients were obtained after starting or modifying the anti-rheumatic treatment. EBV DNA was also measured from 33 healthy controls and 9 patients with adult onset Still's disease (AOSD). Disease activity was assessed by the disease activity score (DAS28). At baseline, EBV DNA was detected in the serum of 7 of the 46 ERA patients all of whom had moderate or high disease activity. In the follow-up samples, 11 of 31 patients were EBV DNA positive. At baseline EBV positive patients had significantly higher disease activity (p=0.036) and the concentration of EBV DNA correlated significantly with DAS28 (rs=0.333, p=0.024). EBV DNA was detected in 3 of 22 CRA patients at study onset and in 8 of 16 in the follow-up samples. At follow-up EBV positive patients had significantly higher DAS28 (p=0.027) and the concentration of EBV DNA correlated significantly with DAS28 (rs=0.724, p=0.002). Only one of the healthy controls and none of the AOSD patients were positive for EBV DNA. Active RA is associated with a lytic EBV infection which may have a role in the pathogenesis of RA.

  20. Induction therapy with adalimumab plus methotrexate for 24 weeks followed by methotrexate monotherapy up to week 48 versus methotrexate therapy alone for DMARD-naive patients with early rheumatoid arthritis: HIT HARD, an investigator-initiated study.

    Science.gov (United States)

    Detert, Jacqueline; Bastian, Hans; Listing, Joachim; Weiß, Anja; Wassenberg, Siegfried; Liebhaber, Anke; Rockwitz, Karin; Alten, Rieke; Krüger, Klaus; Rau, Rolf; Simon, Christina; Gremmelsbacher, Eva; Braun, Tanja; Marsmann, Bettina; Höhne-Zimmer, Vera; Egerer, Karl; Buttgereit, Frank; Burmester, Gerd-R

    2013-06-01

    To investigate the long-term effects of induction therapy with adalimumab (ADA) plus methotrexate (MTX) in comparison with placebo (PBO) plus MTX in DMARD-naïve patients with active early rheumatoid arthritis (RA). Patients with active early RA (disease duration of ≤12 months) were randomly assigned to receive 40 mg ADA subcutaneously every other week (eow) plus MTX 15 mg/week subcutaneously or PBO plus MTX subcutaneously at 15 mg/week over 24 weeks. Thereafter, all patients received MTX monotherapy up to week 48. The primary outcome was the Disease Activity Score 28 (DAS28) at week 48. Secondary outcomes included proportions of patients in remission (DAS28Health Assessment Questionnaire (HAQ) score and radiographic progression. 87 patients were assigned to ADA/MTX and 85 patients to PBO/MTX. At baseline, DAS28 was 6.2±0.8 in the ADA/MTX and 6.3±0.9 in the PBO/MTX groups. At week 24, treatment with ADA/MTX compared with PBO/MTX resulted in a greater reduction in DAS28 (3.0±1.2 vs 3.6±1.4; p=0.009) and other secondary outcomes such as DAS28 remission rate (47.9% vs 29.5%; p=0.021) and HAQ (0.49±0.6 vs 0.72±0.6; p=0.0014). At week 48, the difference in clinical outcomes between groups was not statistically significant (DAS28: 3.2±1.4 vs 3.4±1.6; p=0.41). Radiographic progression at week 48 was significantly greater in patients administered PBO/MTX (Sharp/van der Heijde score: ADA/MTX 2.6 vs PBO/MTX 6.4; p=0.03, Ratingen score: 1.7 vs 4.2; p=0.01). A greater reduction in radiographic progression after initial combination therapy with ADA and MTX was seen at week 48, even after discontinuation of ADA treatment at week 24. This sustained effect was not found at the primary endpoint (DAS28 reduction).

  1. Fibromyalgia Complicating Disease Management in Rheumatoid Arthritis

    International Nuclear Information System (INIS)

    Abbasi, L.; Haidri, F. R.

    2014-01-01

    Objective: To evaluate frequency of fibromyalgia in rheumatoid arthritis and its effect on disease activity score. Study Design: Cross-sectional study. Place and Duration of Study: The Indus Hospital, Karachi, from December 2010 to May 2011. Methodology: All adult patients of either gender diagnosed as rheumatoid arthritis on the basis of clinical, laboratory and X-ray criteria were included in the study. The sample data was separated into two groups depending on presence or absence of fibromyalgia and 28 joint disease activity score (DAS-28) value was evaluated. Results: There were 31 (25.83%) patients with rheumatoid arthritis and fibromyalgia (RAFM) out of the total 120. The median (IQR) age of patients was 40 (32 - 51) years. All were females. The overall female frequency was 79 (88.8%). The median (IQR) DAS-28 score in RA group was 4.9 (3.66 - 5.71), while the median (IQR) DAS-28 score in RAFM was 7.04 (6.62 - 7.64) [p < 0.0001]. The number of patient getting combination therapy of DMARD in RAFM group was 61.3% while in RA group was 42.7%. Conclusion: DAS-28 was found to be significantly higher in RAFM patients probably because of higher perception of pain. (author)

  2. Portuguese guidelines for the use of biological agents in rheumatoid arthritis - March 2010 update.

    Science.gov (United States)

    Fonseca, João Eurico; Canhão, Helena; Reis, Paulo; Santos, Maria José; Branco, Jaime; Quintal, Alberto; Malcata, Armando; Araújo, Domingos; Ventura, Francisco; Figueiredo, Guilherme; da Silva, José Canas; Patto, José Vaz; de Queiroz, Mário Viana; Santos, Rui André; Neto, Adriano José; de Matos, Alves de; Rodrigues, Ana; Mourão, Ana Filipa; Ribeiro, Ana Sofia; Cravo, Ana Rita; Barcelos, Anabela; Cardoso, Anabela; Vilar, António; Braña, Arecili; Faustino, Augusto; Silva, Candida; Godinho, Fátima; Cunha, Inês; Costa, José António; Gomes, José António Melo; Pinto, José António Araújo; da Silva, J A Pereira; Miranda, Luís Cunha; Inês, Luís; Santos, Luís Maurício; Cruz, Margarida; Salvador, Maria João; Ferreira, Maria Júlia; Rial, Maria; Bernardes, Miguel; Bogas, Mónica; Araújo, Paula; Machado, Pedro; Pinto, Patrícia; de Melo, Rui Gomes; Cortes, Sara; Alcino, Sérgio; Capela, Susana

    2010-01-01

    The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of rheumatoid arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of non-responders. Biological treatment should be considered in RA patients with a disease activity score 28 (DAS 28) superior to 3.2 despite treatment with 20mg/week of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 6 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, characterized by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of 0.6 in the DAS28 score. After 6 months of treatment response criteria is defined as a decrease of more than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist's clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).

  3. Mental health status can reflect disease activity in rheumatoid arthritis.

    Science.gov (United States)

    Sokolovic, Sekib; Dervisevic, Vedina; Fisekovic, Saida

    2014-06-01

    A significant number of patients with rheumatoid arthritis (RA) link the start of illness with psychological trauma or severe stress. Impaired mental health (IMH), defined as depression and anxiety with psychoneuroimmunological factors, can play a significant role in RA. The main objective of this research was to investigate the mutual correlation of IMH and RA activity, estimated by the laboratory and clinical parameters in RA patients. An open clinical prospective study that lasted for 6 months was designed. There were 72 patients included, 58 women and 14 men, aged 34 to 80 years and screened for mental health status. The study population was randomized following the Brief Symptoms Inventory (BSI) scale, comprised of 53 questions with a range from 0 (no symptoms) to 4 (severe). This mental test was done only once during the study. Following the results from the BSI scale, RA patients were divided into mentally stable and mentally unstable patients to investigate the influence of RA activity on mental health. The following laboratory and clinical parameters were analyzed: sex, age, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibody, and disease activity score (DAS28). All RA patients did not express extra-articular manifestations or Sjögren's syndrome. The chi-square test, ANOVA, Pearson's coefficient, and IBM Statistics - SPSS v19 were used. From a total of 72 RA patients, there were 44 mentally stable and 28 mentally unstable patients. All patients had either moderate or severe active disease. The only significant correlation of IMH and activity of RA was found in CRP and DAS28, but no significance was observed in ESR, RF, and anti-CCP. The DAS28 showed high disease activity with an average of 5.3 and CRP of 20.9 mg/L in patients with unstable mental health compared to stable mental health patients, where RA was associated with a moderate DAS average value of 4.35 and

  4. CD4+ CD25+ CD127low Regulatory T Cells as Indicator of Rheumatoid Arthritis Disease Activity.

    Science.gov (United States)

    Khattab, Sahar S; El-Saied, Amany M; Mohammed, Rehab A; Mohamed, Eman E

    2016-06-01

    Rheumatoid arthritis (RA) is an autoimmune disease characterized by disturbed immune regulation, inducing a progressive cartilage and bone destruction. Despite enrichment of T regulatory cell (T-regs) in synovial fluid, conflicting results are reported concerning T-regs in peripheral blood (PB) of RA patients. To determine possible correlation between the frequency of PB CD4+ CD25+CD127low (T-regs) with RA disease activity. Forty females with RA, classified according to the Disease Activity Score 28 (DAS-28), as highly active, mild-moderate or low disease activity; and 20 age and sex matched healthy controls, were enrolled to study CD4+ CD25+ CD127low T- regs in PB by flow cytometry. Active RA patients had lower frequency of the CD4+ CD25+ CD127low T- regs compared to those with mild-moderate or low disease activity (P <0.001). The frequencies of the T- regs showed negative correlation with the DAS-28 (P<0.01). In conclusion, CD4+ CD25+ CD127low T-regs is significantly lower in highly active RA patients compared to patients with lower activity or controls. Copyright© by the Egyptian Association of Immunologists.

  5. SAT0125 The impact of selected comorbidities on treatment outcome in patients with rheumatoid arthritis: an exploratory cohort study

    DEFF Research Database (Denmark)

    Emamifar, Amir; Jensen Hansen, Inger Marie

    2018-01-01

    diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28- CRP): An observational cohort study. Medicine (Baltimore) 2017;96:e8357. [2] Emamifar A, et al. Patients with newly diagnosed Rheumatoid Arthritis......Background: Patients with Rheumatoid Arthritis (RA) may present with various comorbidities resulting in worse treatment response.[1-2] Objectives: To investigate the impact of selected comorbid diseases on RA outcome with the aim of Disease Activity Score in 28 joints-C-Reactive Protein (DAS28-CRP......). Methods: All our RA patients were included in this study. Patients’ demographics, serology results and DAS28-CRP at the time of diagnosis and after 4 months of treatment initiation were collected. Patients’ electronic hospital records were evaluated for a positive history of thyroid diseases, Diabetes...

  6. Influence of balneophysical therapy on activity, functional capacity, and quality of life in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Stojanović Sonja

    2009-01-01

    Full Text Available Introduction It has been well known that balneophysical therapy has a therapeutic effect on clinical and biological parameters of disease activity in the patients with rheumatoid arthritis (RA. Objective. To determine the influence of balneophysical therapy on functional capacity, activity and quality of life of the patients with RA primarily treated with some of disease modifying antirheumatic drugs. Methods. The study enrolled 73 patients with RA treated with some of disease modifying antirheumatic drugs (Methotrexate in 85% of patients. During hospitalization at the Clinical Rheumatologic Department of the Institute 'Niska Banja', the patients were treated, beside the medicamentous therapy, by hydrotherapy (oligomineral, homeothermic, low radioactive water, mineral peloid therapy, electrotherapy and kinesiotherapy. Before and after balneotherapy, the patients filled in the Health Assessment Questionnaire (HAQ and the Quality of Life Rheumatoid Arthritis (QOL-RA scale. The Disease Activity Score (DAS 28 was used to measure the disease activity before and after balneotherapy. A possible value of HAQ was from 0 to 3, and QOL-RA from 0 to 10. Results. The mean value of the duration of balneophysical therapy was 14.7±4.8 days. We found significant improvement of functional capacity in the patients with RA. The average HAQ score before balneotherapy was 1.07±0.61, and 0.86±0.55 after balneotherapy, which was statistically significantly lower (p<0.05. DAS 28 after balneotherapy was also statistically significantly lower than DAS 28 before balneotherapy: the mean value of DAS 28 before therapy was 6.30±0.81 and after therapy 5.48±0.75 (p<0.001. The quality of life significantly improved after balneophysical therapy: the mean value of QOL-RA scale before therapy was 5.38±1.62 and after therapy 7.35±1.81 (p<0.05. Conclusion. Balneophysical therapy, when properly dosed, is an effective, adjuvant therapy in the patients with RA of mild disease

  7. CXCL13 predicts disease activity in early rheumatoid arthritis and could be an indicator of the therapeutic 'window of opportunity'

    DEFF Research Database (Denmark)

    Greisen, Stinne Ravn; Schelde, Karen Kræmmer; Rasmussen, Tue Kruse

    2014-01-01

    placebo (DMARD) (n¿=¿37) or methotrexate plus adalimumab (DMARD¿+¿ADA) (n¿=¿39). Treatment outcome was evaluated after 1 and 2 years. CXCL13 plasma levels in healthy volunteers (n¿=¿38) were also examined.ResultsBaseline CXCL13 plasma levels were increased in early rheumatoid arthritis patients...... in comparison with healthy volunteers. Also, plasma CXCL13 correlated positively with disease activity parameters; swollen joint count 28 (rho¿=¿0.34) and 40 (rho¿=¿0.39), visual analogue score (rho¿=¿0.38) and simplified disease activity index (rho¿=¿0.25) (all P¿... a significantly 2-fold more in the DMARD¿+¿ADA group than in the DMARD group. Baseline CXCL13 plasma levels in the DMARD group correlated inversely with disease activity parameters; disease activity score in 28 joints, four variables, C-reactive protein based (DAS28CRP) (rho¿=¿0.58, p¿

  8. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life.

    Science.gov (United States)

    El-Rabbat M, Sarah; Mahmoud, Nermeen K; Gheita, Tamer A

    2017-04-11

    To describe the frequencies of fibromyalgia syndrome (FMS) in various rheumatic diseases; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and Behçets disease (BD) patients and to study the relation to clinical manifestations and quality of life (QoL). 160 patients (50 RA, 50 SLE, 30 SSc and 30 BD) and matched corresponding healthy controls were included. Disease activity was assessed using disease activity score in 28 joints (DAS28) for RA, SLE Disease Activity index (SLEDAI), modified Rodnan skin score for SSc and BD Current Activity Form (BDCAF). The QoL was also recorded. Severity in FMS cases was estimated using the revised Fibromyalgia Impact Questionnaire score. In the RA, SLE, SSc and BD patients, FMS was found in 14%, 18%, 6.67% and 3.33% respectively compared to 2.1%, 3%, 3.3% and 0% in their corresponding controls. In RA patients, DAS28 was significantly higher in those with FMS (p=0.009) and significantly correlated with both Widespread Pain Index (WPI) (p=0.011) and Symptom Severity (SS) scale (p=0.012). The QoL scale in those with FMS was significantly worse (62.3±7.9) compared to those without (71.7±14.4) (p=0.023). In SLE patients, The WPI and SS both significantly correlated with the presence of thrombosis (r=0.28, p=0.049 and r=0.43, p=0.002 respectively). The SS scale tended to correlate with the SLEDAI (r=0.28, p=0.05). In BD patients, BDCAF and WPI significantly correlated (p=0.03). Fibromyalgia syndrome is more frequent in rheumatic diseases, could be related to the disease activity in RA and BD patients and to thrombosis in SLE and affected the QoL in RA. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  9. Portuguese guidelines for the use of biological agents in rheumatoid arthritis - October 2011 update.

    Science.gov (United States)

    Fonseca, João Eurico; Bernardes, Miguel; Canhão, Helena; Santos, Maria José; Quintal, Alberto; Malcata, Armando; Neto, Adriano; Cordeiro, Ana; Rodrigues, Ana; Mourão, Ana Filipa; Ribeiro, Ana Sofia; Cravo, Ana Rita; Barcelos, Anabela; Cardoso, Anabela; Vilar, António; Braña, Arecili; Faustino, Augusto; Silva, Candida; Duarte, Cátia; Araújo, Domingos; Nour, Dolores; Sousa, Elsa; Simões, Eugénia; Godinho, Fátima; Brandão, Filipe; Ventura, Francisco; Sequeira, Graça; Figueiredo, Guilherme; Cunha, Inês; Matos, J Alves; Branco, Jaime; Ramos, João; Costa, José António; Gomes, José António; Pinto, José; Silva, José Canas; Silva, J A; Patto, José Vaz; Costa, Lúcia; Miranda, Luís Cunha; Inês, Luís; Santos, Luís Maurício; Cruz, Margarida; Salvador, Maria João; Ferreira, Maria Júlia; Rial, Maria; Queiroz, Mário Viana; Bogas, Mónica; Araújo, Paula; Reis, Paulo; Abreu, Pedro; Machado, Pedro; Pinto, Patrícia; André, Rui; Melo, Rui; Garcês, Sandra; Cortes, Sara; Alcino, Sérgio; Ramiro, Sofia; Capela, Susana

    2011-01-01

    The authors present the revised version of the Portuguese Society of Rheumatology (SPR) guidelines for the treatment of Rheumatoid Arthritis (RA) with biological therapies. In these guidelines the criteria for introduction and maintenance of biological agents are discussed as well as the contraindications and procedures in the case of nonresponders. Biological treatment (with a tumour necrosis factor antagonist, abatacept or tocilizumab) should be considered in RA patients with a disease activity score 28 (DAS 28) equal to or greater than 3.2 despite treatment with at least 20mg-weekly-dose of methotrexate (MTX) for at least 3 months or, if such treatment is not possible, after 3 months of other conventional disease modifying drug or combination therapy. A DAS 28 score between 2.6 and 3.2 with a significant functional or radiological deterioration under treatment with conventional regimens could also constitute an indication for biological treatment. The treatment goal should be remission or, if that is not achievable, at least a low disease activity, defined by a DAS28 lower than 3.2, without significative functional or radiological worsening. The response criteria, at the end of the first 3 months of treatment, are a decrease of at least 0.6 in the DAS28 score. After 6 months of treatment res­ponse criteria is defined as a decrease greater than 1.2 in the DAS28 score. Non-responders, in accordance to the Rheumatologist’s clinical opinion, should try a switch to another biological agent (tumour necrosis factor antagonist, abatacept, rituximab or tocilizumab).

  10. Brief Report: Remission Rates With Tofacitinib Treatment in Rheumatoid Arthritis: A Comparison of Various Remission Criteria.

    Science.gov (United States)

    Smolen, Josef S; Aletaha, Daniel; Gruben, David; Zwillich, Samuel H; Krishnaswami, Sriram; Mebus, Charles

    2017-04-01

    Tofacitinib is an oral JAK inhibitor that is used for the treatment of rheumatoid arthritis (RA). In previous clinical trials of tofacitinib, a Disease Activity Score in 28 joints (DAS28)-based analysis was used to assess outcomes. In this study, remission rates according to various remission criteria were evaluated across 5 phase III randomized controlled studies. In all 5 studies, tofacitinib was administered at a dosage of 5 mg twice daily or 10 mg twice daily, either as monotherapy or with background methotrexate or other conventional synthetic disease-modifying antirheumatic drugs. One of the studies included adalimumab 40 mg once every 2 weeks. In addition to the 4-variable DAS28 using the erythrocyte sedimentation rate (DAS28-4[ESR]), a primary efficacy variable used in the phase III studies, disease activity was assessed post hoc by the 4-variable DAS28 using the C-reactive protein level (DAS28-4[CRP]), the Clinical Disease Activity Index (CDAI), the Simplified Disease Activity Index (SDAI), and Boolean-based assessment. A total of 3,306 patients were analyzed (1,213 of these patients received tofacitinib 5 mg twice daily, 1,212 received tofacitinib 10 mg twice daily, 679 received placebo, and 202 received adalimumab 40 mg every 2 weeks). Remission rates varied according to the criteria used, with higher rates in the active-treatment groups for the DAS28-4(CRP) than for other scores. At month 3, remission rates with tofacitinib 5 mg twice daily were 18-22% using the DAS28-4(CRP), 5-10% using the DAS28-4(ESR), 4-7% using the SDAI, 5-6% using the CDAI, and 2-7% using the Boolean-based method. In contrast, the remission rates with placebo varied from 0% to 7%, with small differences between the DAS28-4(ESR) and the DAS28-4(CRP). Although tofacitinib at dosages of 5 mg twice daily and 10 mg twice daily was effective compared with placebo in achieving disease remission, regardless of the disease activity measure, remission rates were substantially higher when

  11. Trends towards an improved disease state in rheumatoid arthritis over time: influence of new therapies and changes in management approach: analysis of the EMECAR cohort.

    Science.gov (United States)

    González-Alvaro, Isidoro; Descalzo, Miguel Angel; Carmona, Loreto

    2008-01-01

    The disease activity in patients with rheumatoid arthritis has improved during the past decade. The availability of new drugs and also a better assessment of the disease have been proposed to be responsible for this improvement. In the present work we estimate the effect of these factors on disease activity and function in patients with rheumatoid arthritis at the beginning of the new century. The Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide (EMECAR) cohort was assembled in 2000 from the random sampling of rheumatoid arthritis patients registered in 34 centers. The cohort was composed of 789 patients who underwent a baseline assessment plus four annual follow-up visits in which functional ability (Health Assessment Questionnaire score), the disease activity score obtained from 28-joint count with three parameters (DAS28-3) and radiological progression (Larsen score) were recorded. The effect of the calendar year on the DAS28-3, the Health Assessment Questionnaire score, and the Larsen score was obtained from adjusted models in which all treatments were included as dummy variables. The effect of time as the beta coefficient (95% confidence interval) for 2004, taking 2000 as a reference year, was -0.43 (-0.58 to -0.28) for the DAS28-3, 0.15 (0.07 to 0.22) for the Health Assessment Questionnaire score, and 4.4 (2.68 to 6.12) for the Larsen score. Treatment with new therapies, either leflunomide or TNF antagonists, increased in frequency from 1.1% (n = 8) in 2000 to 30.9% (n = 144) in 2004. Treatment with TNF antagonists (-0.28 (-0.5 to -0.05)) and with gold salts (-0.21 (-0.38 to -0.04)) was independently associated with a decrease in the DAS28-3 over time, whereas cyclosporin A treatment (0.45 (0.13 to 0.76)) was associated with an increase in disease activity. The mean disease activity of rheumatoid arthritis has improved from 2000 to 2004. An explanation is the introduction of new therapies, but not solely. Other factors related to the

  12. Comorbidities in Turkish patients with rheumatoid arthritis: association with the health-related quality of life in terms of disease activity, functional and radiological status, severity of pain, and social and emotional functioning

    Directory of Open Access Journals (Sweden)

    Yesim Garip

    2016-10-01

    Full Text Available Aims: The aim of our study was to investigate the comorbidities in Turkish RA patients and evaluate the impact of comorbidities on health-related quality of life (HRQoL in terms of disease activity, functional and radiological status, severity of pain, and social and emotional functioning. Methods: In a cross-sectional setting, a total of 160 RA patients who were admitted to our outpatient clinic between December 2013 and February 2014 were consecutively enrolled in the study. Comorbidities were recorded. Disease activity was measured by using Disease Activity Score-28 (DAS28. Stanford Health Assessment Questionnaire (HAQ was used for determining functional status, Nottingham Health Profile (NHP for HRQoL, and modified Sharp Score for radiological damage. Major results: Comorbidities were reported in 107 patients (66.88 %. The most common was peptic ulcer (31.25%. This was followed by osteoporosis (21.25%, dyslipidemia (15.63%, depression (15%, hypertension (13.75%, diabetes mellitus (13.13%, thyroid disorders (%8.13, lung diseases (%6.88, cardiovascular diseases (6.25%, and cancers [(1 breast cancer, 1 malign melanoma, 3 lung carcinoma, 3.13%], respectively. Patients with comorbidities scored significantly higher in DAS28, HAQ, pain, energy and physical mobility subgroups of NHP (p0.05. Conclusions: Comorbid conditions of RA are common and associated with more active and severe disease and functional impairment. Comorbidities should be detected and treated earlier to reduce its negative impact on outcome in RA.

  13. Progranulin Is Associated with Disease Activity in Patients with Rheumatoid Arthritis

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    Lucie Andrés Cerezo

    2015-01-01

    Full Text Available Objective. Progranulin (PGRN is implicated in the pathogenesis of rheumatoid arthritis (RA. The aim of this study was to assess the relationship between PGRN and disease activity in RA. Methods. PGRN levels were evaluated in patients with RA (n=47 and OA (n=42 and healthy controls (n=41. Immunohistochemical analysis of PGRN in synovial tissues was performed. The association between PGRN and C-reactive protein (CRP, disease activity score (DAS28-CRP, and health assessment questionnaire (HAQ was studied. Results. Circulating PGRN was elevated in patients with RA and OA compared to healthy controls (227.1±100.2 and 221.5±102.5 versus 128.1±34.7 ng/mL; P<0.001. Synovial fluid levels of PGRN were higher in patients with RA compared to OA (384.5±275.3 versus 241.4±165.2 ng/mL; P=0.002. PGRN expression was significantly upregulated in the synovial tissue of RA patients particularly in the inflammatory infiltrates. Serum PGRN levels correlated with DAS28 (r=0.327, P=0.049 and HAQ score (r=0.323, P=0.032, while synovial fluid PGRN correlated only with HAQ (r=0.310, P=0.043 in patients with RA. PGRN levels were not associated with CRP or autoantibodies. Conclusions. This study demonstrates increased PGRN expression at local sites of inflammation and association between PGRN levels, disease activity, and functional impairment in patients with RA.

  14. Changes in Ultrasonographic Vascularity Upon Initiation of Adalimumab Combination Therapy in Rheumatoid Arthritis Patients With an Inadequate Response to Methotrexate.

    Science.gov (United States)

    Kaeley, Gurjit S; Nishio, Midori J; Goyal, Janak R; MacCarter, Daryl K; Wells, Alvin F; Chen, Su; Kupper, Hartmut; Kalabic, Jasmina

    2016-11-01

    To assess joint disease activity by ultrasound (US) in patients with rheumatoid arthritis (RA) initiating treatment with adalimumab (ADA) plus methotrexate (MTX). Data for this post hoc analysis originated from the MUSICA trial (ClinicalTrials.gov identifier: NCT01185288), which evaluated the efficacy of initiating ADA (40 mg every other week) plus 7.5 or 20 mg/week MTX in 309 patients with RA with an inadequate response to MTX. Synovial vascularization over 24 weeks was assessed bilaterally at metacarpophalangeal joint 2 (MCP2), MCP3, MCP5, metatarsophalangeal joint 5, and the wrists by power Doppler US (PDUS). A semiquantitative 4-grade scale was used. Disease activity was assessed using the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) and Simplified Disease Activity Index (SDAI). The correlation between continuous variables was assessed using Pearson's correlation coefficient. After 24 weeks of treatment with ADA plus MTX, rapid improvements in the mean synovial vascularity score were observed; the greatest improvements were in MCP2 (-0.5), MCP3 (-0.4), and the wrist (-0.4). At week 24, patients with the lowest DAS28-CRP ( 0.9). Synovial vascularity scores correlated poorly with DAS28, swollen joint count in 66 joints (SJC66), SJC28, tender joint count in 68 joints (TJC68), TJC28, Clinical Disease Activity Index (CDAI), SDAI, physician's global assessment, patient's global assessment of pain, and disease duration (ρ < 0.2). Thirty-two (70%) of 46 patients with a DAS28-CRP of <2.6, and 11 (58%) of 19 patients with an SDAI indicating remission had at least 1 joint with a synovial vascularity score of ≥1. PDUS detects changes in synovial vascularity in RA patients treated with ADA plus MTX, and residual synovial vascularity in patients in whom clinical disease control has been achieved. © 2016 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

  15. Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: Results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Christensen, Ib Jarle; Tarp, Ulrik

    2010-01-01

    response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number...... versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1...

  16. MiDAS Field Guide – a Comprehensive Online Source of Information About the Microbes of Activated Sludge

    DEFF Research Database (Denmark)

    Nierychlo, Marta; McIlroy, Simon Jon; Saunders, Aaron Marc

    this information in MiDAS field guide (www.midasfieldguide.org). MiDAS taxonomy gives a solid foundation for the study of microbial ecology of the wastewater treatment processes. The online MiDAS field guide links the identity of genera that are important for the wastewater treatment process to details about...... guide to the microbes of activated sludge by comparing microbial community composition in 32 WWTPs located worldwide. This will facilitate a better understanding of the ecology of the ecosystem of activated sludge. Reference: McIlroy et al. MiDAS: the field guide to the microbes of activated sludge...... on a survey of 25 full-scale Danish wastewater treatment plants over 6 years and using MiDAS taxonomy, we have collected more than 150 key organisms in activated sludge wastewater treatment systems, linked their identity with available information on their function and distribution and included...

  17. Serum Leptin levels do not correlate with disease activity in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Sibel Yilmaz Oner

    2015-01-01

    Full Text Available Objectives Leptin, is a fat tissue hormone which effects energy expenditure , food intake , hematopoiesis, osteogenesis, angiogenesis, reproductive and immune systems. We aimed to determine serum leptin levels and investigate the association between disease activity and other parameters in RA patients. Methods Patients with RA (n=106 as the study group, healthy controls (n=52 and osteoarthritis (OA patients (n=37 as a control group were enrolled to the study. RA patients were categorized in four different groups according to DAS28 scores: remission ,low (LDA, moderate (MDA or high (HDA disease activity . Results No differences were present between the body mass indices of the three groups. Mean leptin levels in RA patients, OA group and healthy individuals were 25,60±13,41, 23,03±11,51 and 23,81±12,85 ng/ml, respectively and no significant difference was present between the groups. Nine of (8,5% RA patients were in remission, 16 (15,1% were in LDA, 40 (37,7% in MDA and 41 (38,7% were in HDA. Leptin levels did not correlate with DAS28 scores of RA patients (r=-0,12, p=0,11. Mean leptin levels in RA patients with remission was 32,65±7, 28 in LDA 23,94±10,94 in MDA 26,73±14,92 and in HDA 23,59±13,50 ng/ml (p=NS. No associations were observed between leptin levels and CRP, ESR, RF positivity and disease duration. Conclusions Our study revealed no correlation of disease activity and serum leptin levels. Therefore leptin does not seem to be an appropriate biomarker to monitorize inflammation in RA.

  18. Nursing Activities Score e demanda de trabalho de enfermagem em terapia intensiva Nursing Activities Score y demanda de trabajo de enfermería em cuidados intensivos Nursing Activities Score and demand of nursing work in intensive care

    Directory of Open Access Journals (Sweden)

    Illoma Rossany Lima Leite

    2012-01-01

    Full Text Available OBJETIVO: Medir e caracterizar a carga de trabalho de enfermagem em Unidade de Terapia Intensiva (UTI por meio da aplicação do Nursing Activities Score (NAS. MÉTODOS: Estudo descritivo quantitativo, retrospectivo, realizado em uma das UTIs de um Hospital Filantrópico de Teresina- PI, de setembro a outubro de 2010, com amostra de 66 pacientes. Foram realizadas 285 medidas do escore NAS. RESULTADOS: Quanto à carga de trabalho de enfermagem, foi verificada uma média do escore total do NAS de 68,1% (51,5% e 108,3%, correspondendo à porcentagem de tempo gasto pelo profissional de enfermagem na assistência direta ao paciente nas 24 horas. Houve correlação estatística entre NAS e desfecho clínico (p= 0,001. Já entre NAS e tempo de internação (p= 0,073 e NAS e idade (p=0,952, não houve significância estatística. CONCLUSÃO: Os resultados mostraram que os pacientes apresentaram elevada necessidade de cuidados, refletida pela média elevada do NAS.OBJETIVO: Medir y caracterizar la carga de trabajo de enfermería en una Unidad de Cuidados Intensivos (UCI por medio de la aplicación del Nursing Activities Score (NAS. MÉTODOS: Estudio descriptivo cuantitativo, retrospectivo, realizado en una de las UCIs de un Hospital Filantrópico de Teresina-PI, de setiembre a octubre del 2010, con una muestra de 66 pacientes. Se realizaron 285 medidas del score NAS. RESULTADOS: En cuanto a la carga de trabajo de enfermería, se verificó una media del score total del NAS del 68,1% (51,5% e 108,3%, correspondiendo al porcentaje de tiempo gastado por el profesional de enfermería en la asistencia directa al paciente en las 24 horas. Hubo correlación estadística entre NAS y deshecho clínico (p= 0,001. Ya entre NAS y tiempo de internamiento (p= 0,073 y NAS y edad (p=0,952, no hubo significancia estadística. CONCLUSIÓN: Los resultados mostraron que los pacientes presentaron elevada necesidad de cuidados, reflejada por la elevada media del NAS

  19. CRP genotype and haplotype associations with serum C-reactive protein level and DAS28 in untreated early rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Ammitzbøll, Christian Gytz; Steffensen, Rudi; Bøgsted, Martin

    2014-01-01

    investigated: rs11265257, rs1130864, rs1205, rs1800947, rs2808632, rs3093077 and rs876538. The genotype and haplotype associations with CRP and DAS28 levels were evaluated using linear regression analysis adjusted for age, sex and treatment. RESULTS: The minor allele of rs1205 C > T was associated......INTRODUCTION: Single-nucleotide polymorphisms (SNPs) in the CRP gene are implicated in the regulation of the constitutional C-reactive protein (CRP) expression and its response to proinflammatory stimuli. Previous reports suggest that these effects may have an impact on clinical decision...

  20. The efficacy of the traditional Chinese medicine Juanbi pill combined with methotrexate in active rheumatoid arthritis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Wang, Qiong; Wang, Yi-Ru; Jia, Qing-Yun; Liu, Li; Xu, Chong-Qing; Wang, Xiao-Yun; Yao, Min; Cui, Xue-Jun; Shi, Qi; Wang, Yong-Jun; Liang, Qian-Qian

    2018-03-20

    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by swelling and painful joints, eventually leading to joint destruction. There is still a lack of effective therapy to treat RA. The Juanbi pill is a Chinese medicine that has been widely used to treat active RA in China for hundreds of years, relieving pain and protecting the affected joints from malformation. However, there is no solid evidence to show the effect of the Juanbi pill on the management of active RA. We will conduct a multicenter, randomized, double-blind, placebo-controlled clinical trial to determine whether the traditional Chinese medicine Juanbi pill could relieve joint pain in RA and protect the joints. A total of 120 patients with active RA will be enrolled and treated with the Juanbi pill or a placebo for 3 months. The primary outcome measures are as follows: rate of in the American College of Rheumatology (ACR)50, change in the 28-joint Disease Activity Score (DAS28) from baseline at beginning of therapy to 3 months, and a change in the van der Heijde modified Sharp score measured from baseline to 12 months. The secondary outcome measures are as follows: rate of change in ACR20, ACR70, Health Assessment Questionnaire-Disability Index (HAQ-DI), and change in score in the Patient Assessment of Arthritis Pain, Patient Global Assessment of Arthritis, and the Athens Insomnia Scale (AIS) from baseline to 2-week, 1-month, 2-month, 3-month, 6-month, and 12-month follow up. In addition, the rate of change (score) in the ACR50 and DAS28 from the baseline to 2-week, 1-month, 2-month, 6-month, and 12-month follow up are also the secondary outcome measures. Although the Juanbi pill has been used in China for many years to treat RA, there is a lack of consensus about its effectiveness. This trial will provide convincing evidence about the effect of Juanbi pill on active RA. ClinicalTrials.gov, NCT02885597 . Registered on 30 August 2016.

  1. MiDAS

    DEFF Research Database (Denmark)

    McIlroy, Simon Jon; Saunders, Aaron Marc; Albertsen, Mads

    2015-01-01

    The Microbial Database for Activated Sludge (MiDAS) field guide is a freely available online resource linking the identity of abundant and process critical microorganisms in activated sludge wastewater treatment systems to available data related to their functional importance. Phenotypic properties...... of some of these genera are described, but most are known only from sequence data. The MiDAS taxonomy is a manual curation of the SILVA taxonomy that proposes a name for all genus-level taxa observed to be abundant by large-scale 16 S rRNA gene amplicon sequencing of full-scale activated sludge...... communities. The taxonomy can be used to classify unknown sequences, and the online MiDAS field guide links the identity to the available information about their morphology, diversity, physiology and distribution. The use of a common taxonomy across the field will provide a solid foundation for the study...

  2. Effect of Treat-to-target Strategies Aiming at Remission of Arterial Stiffness in Early Rheumatoid Arthritis: A Randomized Controlled Study.

    Science.gov (United States)

    Tam, Lydia Ho-Pui; Shang, Qing; Li, Edmund Kwok-Ming; Wong, Priscilla Ching-Han; Kwok, Kitty Yan; Kun, Emily Wai-Lin; Yim, Isaac Cheuk-Wan; Lee, Violet Ka-Lai; Yip, Ronald Man-Lung; Pang, Steve Hin-Ting; Lao, Virginia Weng-Nga; Mak, Queenie Wah-Yan; Cheng, Isaac Tsz-Ho; Lau, Xerox Sze-Lok; Li, Tena Ka-Yan; Zhu, Tracy Yaner; Lee, Alex Pui-Wai; Tam, Lai-Shan

    2018-05-15

    To determine the efficacy of 2 tight control treatment strategies aiming at Simplified Disease Activity Score (SDAI) remission (SDAI ≤ 3.3) compared to 28-joint count Disease Activity Score (DAS28) remission (DAS28 < 2.6) in the prevention of arterial stiffness in patients with early rheumatoid arthritis (RA). This was an open-label study in which 120 patients with early RA were randomized to receive 1 year of tight control treatment. Group 1 (n = 60) aimed to achieve SDAI ≤ 3.3 and Group 2 (n = 60), DAS28 < 2.6. Pulse wave velocity (PWV) and augmentation index (AIx) were measured at baseline and 12 months. A posthoc analysis was also performed to ascertain whether achieving sustained remission could prevent progression in arterial stiffness. The proportions of patients receiving methotrexate monotherapy were significantly lower in Group 1 throughout the study period. At 12 months, the proportions of patients achieving DAS28 and SDAI remission, and the change in PWV and AIx, were comparable between the 2 groups. In view of the lack of differences between the 2 groups, a posthoc analysis was performed at Month 12, including all 110 patients with PWV, to elucidate the independent predictors associated with the change in PWV. Multivariate analysis revealed that achieving sustained DAS28 remission at months 6, 9, and 12 and a shorter disease duration were independent explanatory variables associated with less progression of PWV. With limited access to biologic disease-modifying antirheumatic drugs, treatment efforts toward DAS28 and SDAI remission had similar effects in preventing the progression of arterial stiffness at 1 year. However, achieving sustained DAS28 remission was associated with a significantly greater improvement in PWV. [Clinical Trial registration: Clinicaltrial.gov NCT01768923.].

  3. easyDAS: Automatic creation of DAS servers

    Directory of Open Access Journals (Sweden)

    Jimenez Rafael C

    2011-01-01

    Full Text Available Abstract Background The Distributed Annotation System (DAS has proven to be a successful way to publish and share biological data. Although there are more than 750 active registered servers from around 50 organizations, setting up a DAS server comprises a fair amount of work, making it difficult for many research groups to share their biological annotations. Given the clear advantage that the generalized sharing of relevant biological data is for the research community it would be desirable to facilitate the sharing process. Results Here we present easyDAS, a web-based system enabling anyone to publish biological annotations with just some clicks. The system, available at http://www.ebi.ac.uk/panda-srv/easydas is capable of reading different standard data file formats, process the data and create a new publicly available DAS source in a completely automated way. The created sources are hosted on the EBI systems and can take advantage of its high storage capacity and network connection, freeing the data provider from any network management work. easyDAS is an open source project under the GNU LGPL license. Conclusions easyDAS is an automated DAS source creation system which can help many researchers in sharing their biological data, potentially increasing the amount of relevant biological data available to the scientific community.

  4. Severe deficiency of 25-hydroxyvitamin D3 (25-OH-D3) is associated with high disease activity of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Haga, Hans-Jacob; Schmedes, Anne; Naderi, Yusuf

    2013-01-01

    This study aims to measure the serum level of 25-hydroxyvitamin D₃ (25-OH-D₃) in 302 patients with rheumatoid arthritis (RA), studying the association to disease activity. Three hundred two RA patients underwent clinical examination and serological analysis. 25-Hydroxyvitamin D₃ was determined...... by high-performance liquid chromatography-tandem mass spectrometry. Vitamin D₃ deficiency defined as serum levels of 25-hydroxyvitamin D₃ below 50 nmol/l was detected in 101 RA patients (33.4 %). There was no significant correlation between the serum level of 25-hydroxyvitamin D₃ and Disease Activity...... Score 28 (DAS28) (3w) score. In a subpopulation of RA patients with very low serum level of 25-OH-D₃ (≤15 nmol/l) (n = 15), there were significant differences compared to patients with normal 25-OH-D3 (n = 200): higher percentage of patients with positive rheumatoid factor (100.0 versus 77.5 %; p = 0...

  5. Zymographic analysis using gelatin-coated film of the effect of etanercept on the extracellular matrix-degrading activity in synovial fluids of rheumatoid arthritis patients.

    Science.gov (United States)

    Kamataki, Akihisa; Ishida, Mutsuko; Komagamine, Masataka; Yoshida, Masaaki; Ando, Takanobu; Sawai, Takashi

    2016-04-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease. Most RA patients develop cartilage and bone destruction, and various proteinases are involved in the destruction of extracellular matrix of cartilage and bone. The aim of this study is to evaluate the utility of our newly developed method to measure total gelatinolytic activity. We adopted this method for measurement in synovial fluid from RA patients treated by the anti-rheumatic drug etanercept (ETN), a recombinant human soluble tumor necrosis factor receptor fusion protein, and compared the findings with clinical and laboratory data. Enzymatic activity of synovial fluid was analyzed by zymography using gelatin-coated film, and compared with the index of Disease Activity Score of 28 joints - C-reactive protein (DAS28-CRP), CRP and matrix metalloproteinase (MMP)-3 level before and after ETN therapy. Synovial fluids of 19 patients were collected before and after administration of ETN therapy. In nine of 19 patients, who showed a decrease in gelatin-degrading activity in synovial fluid, the index of DAS28-CRP (4.85-2.85, ΔDAS = -2.00) and CRP (3.30-0.94 mg/dL, ΔCRP = -2.36) was alleviated after ETN therapy, while cases with no change or an increase in gelatin-degrading activity showed a modest improvement in clinical data: DAS28-CRP (4.23-3.38, ΔDAS = -0.85) and CRP (1.70-0.74 mg/dL, ΔCRP = -0.96). Our newly developed method for measurement of gelatin-degrading activity in synovial fluid from RA patients is highly practicable and useful for predicting the effect of ETN therapy. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  6. Characteristics of patients with rheumatoid arthritis in Qatar: a cross-sectional study.

    Science.gov (United States)

    Lutf, Abdo; Poil, Abdul R; Hammoudeh, Mohammed

    2014-01-01

    To describe the clinical characteristics, serologic, radiological and clinical disease activity, and modality of therapy in patients with rheumatoid arthritis (RA) at tertiary outpatient care in Qatar. The study design was cross-sectional where 100 consecutive cases who met 1987 American College of Rheumatology criteria for diagnosis of RA were enrolled in this study. Demographic data (sex, nationality and age) numbers of swollen and tender joints, X-rays and current medications were collected during outpatients visits to Hamad General Hospital. Disease Activity Score of 28 joints (DAS28) and Health Assessment Questionnaires (HAQ) scores were calculated. All patients with RA who were seen as rheumatology outpatients were invited to participate in the study. One hundred patients were seen and examined during their follow-up at the outpatient clinic; data were collected and analyzed. Females represented 67% of all patients, 6% had more than six swollen joints, 9% had more than six tender joints. DAS28 and erythrocyte sedimentation rate (DAS28) calculation revealed 49% of patients were in remission (DAS28  3.2.Mean HAQ score was 1.02. Rheumatoid factor (RF) was positive in 63%, while anti-cyclic citrullinated protein antibody (anti-CCP) was positive in 71%, and 49% were positive for both. Radiography of hands and feet during the previous year was done in 65% of patients: 11% of them had erosions. Sixty-six percent were on one synthetic disease-modifying anti-rheumatic drug (DMARD) and 27% where on more than one synthetic DMARD and 7% where on no DMRD. Glucocorticoids were used in 51% and 29% were on biologics. Sixty-four percent of rheumatoid arthritis patients in Qatar were in remission or had low disease activity while the remaining 36% had active disease and among these patients 29% were on biologics. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  7. Obesity and rates of clinical remission and low MRI inflammation in rheumatoid arthritis.

    Science.gov (United States)

    George, Michael D; Østergaard, Mikkel; Conaghan, Philip G; Emery, Paul; Baker, Daniel G; Baker, Joshua F

    2017-10-01

    Obesity has been proposed as a risk factor for refractory rheumatoid arthritis (RA). We evaluated the impact of obesity on achieving clinical and imaging definitions of low disease activity. This study evaluated 470 patients with RA from GO-BEFORE and GO-FORWARD randomised clinical trials. Included patients had blinded clinical disease activity measures and MRI at baseline, 24 and 52 weeks. Synovitis, osteitis and total inflammation scores were determined using the RA MRI scoring system. Multivariable logistic regression analyses compared odds of achieving Disease Activity Score using 28 joints and C-reactive protein (DAS28-CRP) remission, low component measures, or low MRI inflammation measures at 24 weeks in patients with obesity versus no obesity. At 24 weeks, patients with obesity were significantly less likely to achieve DAS28(CRP) remission (OR 0.47; 95% CI 0.24 to 0.92, p=0.03). In contrast, patients with obesity had similar odds of achieving low synovitis (OR 0.94; 95% CI 0.51 to 1.72, p=0.84) and inflammation scores (OR 1.16; 95% CI 0.61 to 2.22, p=0.64) and greater odds of achieving low osteitis scores (OR 2.06; 95% CI 1.10 to 3.84, p=0.02) versus normal weight patients. Patients with RA and obesity have lower rates of DAS28 remission but similar rates of low MRI activity compared with patients without obesity, suggesting that obesity and its associated comorbidities can bias clinical disease activity measures. NCT00361335 and NCT00264550; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Imad Ghozlani

    2018-04-01

    Full Text Available Aim of the work: The aim of this study was to assess the influence of anti-cyclic citrullinated peptide (anti-CCP on disease activity, radiological severity, functional disability and bone loss in Moroccan women with rheumatoid arthritis (RA. Patients and methods: One hundred and thirty-six women with RA were recruited. Age, weight, height, disease duration and steroids cumulative dose were identified. Anti-CCP and Rheumatoid factor (RF were determined. Disease activity score (DAS28 was assessed and functional repercussion measured by the Health Assessment Questionnaire-disability index (HAQ-DI. Radiological status was assessed by the Sharp/van der Heijde (SvH erosion and narrowing score. Bone mineral density was determined by a Lunar Prodigy Vision Dual-energy X-ray absorptiometry and vertebral fracture assessment was classified using a combination of Genant semi-quantitative approach and morphometry. Results: Patients mean age was 49.6 ± 7.4 years and disease duration 7.7 ± 5 years. 109 (80.1% patients were anti-CCP positive. There was no significant difference in DAS28 between patients with and without anti-CCP. Nevertheless, weight, erythrocyte sedimentation rate (ESR, rheumatoid factor titer and positivity, SvH narrowing and erosion score and osteoporosis were significantly higher in patients with positive anti-CCP. Stepwise regression analysis showed that the presence of anti-CCP was independently associated with osteoporosis and SvH erosion score. Conclusions: Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients. They not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. The presence of these antibodies warrants special attention. Keywords: Rheumatoid arthritis, Anti-cyclic citrullinated peptide, Disease activity, Joint damage, Bone loss

  9. Reactor neutron activation analysis for aluminium in the presence of phosphorus and silicon. Contributions of /sup 28/Al activities from /sup 31/P (n,. cap alpha. ) /sup 28/Al and /sup 28/Si (n,p) /sup 28/Al reactions

    Energy Technology Data Exchange (ETDEWEB)

    Mizumoto, Yoshihiko (Kinki Univ., Higashi-Osaka, Osaka (Japan). Faculty of Science and Technology); Iwata, Shiro; Sasajima, Kazuhisa; Yoshimasu, Fumio; Yase, Yoshiro

    1984-01-01

    Reactor neutron activation analysis for aluminium in samples containing phosphorus and silicon was studied. The experiments were performed by using pneumatic tube of the Kyoto University Reactor (KUR). At first, the ratios of the /sup 28/Al activity produced from /sup 27/Al(n, ..gamma..) /sup 28/Al reaction by thermal neutrons to that from /sup 31/P(n, ..cap alpha..)/sup 28/Al reaction by fast neutrons, and to that from /sup 28/Si(n, p)/sup 28/Al reaction were measured by ..gamma..-ray spectrometry. With a ratio of about 5 for the thermal to fast neutron flux of KUR, the ratio of the /sup 28/Al activity from aluminium to that from phosphorus was to be 812 +- 7, and to that from silicon 282 +- 3. Secondly, the contributions of /sup 28/Al activities from phosphorus and silicon and the determination limit of aluminium were calculated for various parameters, such as fast neutron flux, thermal to fast neutron flux ratio, amounts of phosphorus and silicon, etc. Thirdly, on the basis of these results, aluminium contents in spinal cords and brains of amyotrophic lateral sclerosis, Parkinsonism-dementia complex and control cases were determined.

  10. Expression of K2P5.1 potassium channels on CD4+ T lymphocytes correlates with disease activity in rheumatoid arthritis patients.

    Science.gov (United States)

    Bittner, Stefan; Bobak, Nicole; Feuchtenberger, Martin; Herrmann, Alexander M; Göbel, Kerstin; Kinne, Raimund W; Hansen, Anker J; Budde, Thomas; Kleinschnitz, Christoph; Frey, Oliver; Tony, Hans-Peter; Wiendl, Heinz; Meuth, Sven G

    2011-02-11

    CD4+ T cells express K(2P)5.1 (TWIK-related acid-sensitive potassium channel 2 (TASK2); KCNK5), a member of the two-pore domain potassium channel family, which has been shown to influence T cell effector functions. Recently, it was shown that K(2P)5.1 is upregulated upon (autoimmune) T cell stimulation. The aim of this study was to correlate expression levels of K(2P)5.1 on T cells from patients with rheumatoid arthritis (RA) to disease activity in these patients. Expression levels of K(2P)5.1 were measured by RT-PCR in the peripheral blood of 58 patients with RA and correlated with disease activity parameters (C-reactive protein levels, erythrocyte sedimentation rates, disease activity score (DAS28) scores). Twenty patients undergoing therapy change were followed-up for six months. Additionally, synovial fluid and synovial biopsies were investigated for T lymphocytes expressing K(2P)5.1. K(2P)5.1 expression levels in CD4+ T cells show a strong correlation to DAS28 scores in RA patients. Similar correlations were found for serological inflammatory parameters (erythrocyte sedimentation rate, C-reactive protein). In addition, K(2P)5.1 expression levels of synovial fluid-derived T cells are higher compared to peripheral blood T cells. Prospective data in individual patients show a parallel behaviour of K(2P)5.1 expression to disease activity parameters during a longitudinal follow-up for six months. Disease activity in RA patients correlates strongly with K(2P)5.1 expression levels in CD4+ T lymphocytes in the peripheral blood in cross-sectional as well as in longitudinal observations. Further studies are needed to investigate the exact pathophysiological mechanisms and to evaluate the possible use of K(2P)5.1 as a potential biomarker for disease activity and differential diagnosis.

  11. Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA

    DEFF Research Database (Denmark)

    Sørensen, Jan; Primdahl, J; Horn, Hc

    2014-01-01

    per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Conclusions: Shared care and nurse care seem to cost less but provide broadly similar......Objectives: To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). Method: In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse...... consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient...

  12. Vitamin D is not useful as a biomarker for disease activity in rheumatoid arthritis.

    Science.gov (United States)

    de la Torre Lossa, Paola; Moreno Álvarez, Mario; González Guzmán, María Del Carmen; López Martínez, Rafael; Ríos Acosta, Carlos

    2018-05-17

    To determine whether there is an association between serum vitamin D levels and the Disease Activity Index in patients with rheumatoid arthritis (RA). An analytical, retrospective, cross-sectional study was performed at the Hospital Luis Vernaza and Center for Rheumatology and Rehabilitation. We included 18 to 75-year-old patients with a diagnosis of RA according to the 2010 classification criteria, and with a 25-hydroxyvitamin D (25 [OH] D) test within the last 3 months. The activity of the disease was assessed with the 28-joint Disease Activity Score (DAS28) and C-reactive protein (CRP) as an acute-phase reactant. Spearman's rank correlation coefficient was used to establish association between the variables. A total of 100 RA patients were studied. The mean vitamin D levels were 32.9 ± 11.5 ng/mL. In all, 45% showed insufficient 25 (OH) D and 55% had normal levels; no deficient vitamin D values were found. According to the DAS28-CRP, patients with low, moderate and high activity had an average vitamin D level of 30.4 ± 10.7, 31.9 ± 10.7, and 31.8 ± 12.1 ng/mL, respectively. There were no significant correlations between the disease activity and the serum vitamin D level (P=.60). In our group of RA patients, there was no statistically significant correlation between the levels of vitamin D and the activity of the disease, nor were other determining variables associated with vitamin D levels. Copyright © 2018 Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Urological comorbidities in Egyptian rheumatoid arthritis patients: Risk factors and relation to disease activity and functional status

    Directory of Open Access Journals (Sweden)

    Marwa Niazy

    2017-10-01

    Full Text Available Aim of the work: To assess the urological disorders in rheumatoid arthritis (RA patients, analyse the risk factors and to find their relation to disease activity and functional status. Patients and methods: 291 RA patients (253 females and 38 males; F:M 6.7:1 and 242 matched controls were included. Urological disorders in the form of urinary tract infections (UTI, urolithiasis and acute urine retention (AUR were assessed, risk factors were analysed. Disease activity score (DAS-28 and modified health assessment questionnaire (mHAQ were calculated. Results: RA patients had more frequent urological disorders (38.14% than controls (20.66%, more UTI (p < 0.001 and this difference persisted in females (p < 0.001. Urolithiasis tended to be more frequent in RA patients (p = 0.3; the difference was significant between the female patients and controls (p = 0.04. Urinary stones were comparable between the male patients and controls (p = 0.2. RA patients had more AUR (4.8% than the controls (2.1% (p = 0.07. Asthmatic patients particularly the females had more UTI (p = 0.001 and p < 0.001 respectively. UTIs were observed with higher steroid doses (p = 0.04 and urolithiasis were noticed more in hypertensive female patients (p = 0.03. Patients with higher DAS-28 and mHAQ developed more urological comorbidities (p0.49 and p = 0.82 respectively. UTI and urolithiasis were detected in patients with higher DAS 28 (p = 0.1 and p = 0.4 respectively. Conclusion: RA patients were found to have more urological disorders. Bronchial asthma, hypertension and higher steroid doses may increase risk for urinary comorbidities in RA. Patients with higher DAS28 and mHAQ had more urological comorbidities, however without statistically significant difference.

  14. Das Alter ist der wichtigste Risikofaktor der postoperativen erektilen Dysfunktion nach radikaler nerverhaltender Prostatektomie

    Directory of Open Access Journals (Sweden)

    Gruschka M

    2009-01-01

    Full Text Available Die radikale Prostatektomie ohne Nerverhalt geht mit Impotenz einher. Bei nerverhaltendem Vorgehen kann das Risiko der erektilen Dysfunktion gesenkt, aber nicht ausgeschlossen werden. Die präoperative Beratung der Patienten erfordert bei nerverhaltender Prostatektomie die Kenntnis der Faktoren, die Einfluss auf die postoperative Potenz haben. Patienten & Methoden: 110 Patienten antworteten 24 Monate nach radikaler perinealer nerverhaltender Prostatektomie auf einen per Post übermittelten Fragebogen. Die Patienten wurden, entsprechend dem Erection Hardness Score, nach der Rigidität ihrer Erektionen befragt. Überwiegend erfolgte der Nerverhalt unilateral (104/110. Verschiedene potenzielle Risikofaktoren (Alter, Qualität der präoperativen Erektion, Serum-PSA, Gleason-Score, Tumorvolumen, Prostatavolumen, adjuvante Strahlentherapie, ASA-Score, Chronic Disease Score [CDS], arterielle Hypertonie, Hypercholesterinämie, Diabetes mellitus, KHK, Nikotinkonsum wurden univariat mit der postoperativ erzielten Potenz korreliert. Multivariat wurden dann jene Parameter untersucht, die in der univariaten Analyse einen signifikanten (p ≤ 0,05 oder einen tendenziellen Zusammenhang (p ≤ 0,2 mit der postoperativen erektilen Funktion aufwiesen. Ergebnisse:Das Alter (p 0,001 und der ASAScore (p = 0,018 waren in der univariaten Analyse negative Prädiktoren der postoperativen Potenz. In der multivariaten Analyse war lediglich das Alter (p = 0,028 von signifikanter Bedeutung. Mit jedem Lebensjahr der Männer steigt das Risiko einer um eine Stufe im EHS schlechteren Erektion um das 1,128-Fache an. Bei einem Altersunterschied von 10 Jahren ist das Risiko eines postoperativ schlechteren Erektionsvermögens um den Faktor 3,334 erhöht, bei einem um 20 Jahre höheren Alter beträgt dieser Faktor 11,121. Diskussion & Praxisrelevanz: Das Lebensalter der Patienten wurde im Einklang mit der Literatur als signifikanter Faktor für die postoperative Potenz identifiziert

  15. Comparison of Photo Optical Imaging with Musculoskeletal Ultrasound and Clinical Examination in the Assessment of Inflammatory Activity in Proximal Interphalangeal Joints in Rheumatoid Arthritis and Osteoarthritis.

    Science.gov (United States)

    Amitai, Isabella; Werner, Stephanie; Schicke, Bernd; Burmester, Gerd-Rüdiger; Minet, Olaf; Zabaryło, Urszula; Backhaus, Marina; Ohrndorf, Sarah

    2015-09-01

    Lightscan is a novel, rapid, low-cost, easily operated and noninvasive imaging technology used to assess inflammatory activity in proximal interphalangeal (PIP) joints. The results are calculated automatically. To our knowledge, this is the first comparative study of photo optical imaging (POI), with clinical examination (CE), disease activity score at 28 joints (DAS28)-erythrocyte sedimentation rate (ESR), and musculoskeletal ultrasonography (US) in healthy subjects and patients with rheumatoid arthritis (RA) or osteoarthritis (OA). There were 688 PIP joints of both hands examined in 87 subjects (38 RA, 21 OA, 28 healthy) by Lightscan and compared with CE for clinically swollen and tender joints, DAS28-ESR (only RA), and US. With US as reference, POI had a sensitivity of 74% and a specificity of 93%. In the receiver-operating curve (ROC) analysis, the Lightscan showed a higher sensitivity and specificity [area under the curve (AUC) 0.879] for the distinction of healthy subjects versus patients (OA, RA) than US in greyscale (GSUS; AUC 0.797) and power Doppler (PDUS; AUC 0.67). POI correlated significantly with GSUS (r 0.473, p POI and GSUS were up to 79%, between POI and PDUS up to 92%, and between POI and CE up to 66%. POI did not correlate with DAS28-ESR. The Lightscan is a new technology offering sensitive imaging detection of inflammatory changes in subjects with RA and OA with PIP arthritis. POI was more sensitive than CE and correlated significantly to GSUS and PDUS, while presenting a higher sensitivity and specificity for the detection of healthy subjects versus patients (RA, OA) based on the ROC analysis.

  16. Dynamic Measurement of Disease Activity in Acute Pancreatitis: The Pancreatitis Activity Scoring System.

    Science.gov (United States)

    Wu, Bechien U; Batech, Michael; Quezada, Michael; Lew, Daniel; Fujikawa, Kelly; Kung, Jonathan; Jamil, Laith H; Chen, Wansu; Afghani, Elham; Reicher, Sonya; Buxbaum, James; Pandol, Stephen J

    2017-07-01

    Acute pancreatitis has a highly variable course. Currently there is no widely accepted method to measure disease activity in patients hospitalized for acute pancreatitis. We aimed to develop a clinical activity index that incorporates routine clinical parameters to assist in the measurement, study, and management of acute pancreatitis. We used the UCLA/RAND appropriateness method to identify items for inclusion in the disease activity instrument. We conducted a systematic literature review followed by two sets of iterative modified Delphi meetings including a panel of international experts between November 2014 and November 2015. The final instrument was then applied to patient data obtained from five separate study cohorts across Southern California to assess profiles of disease activity. From a list of 35 items comprising 6 domains, we identified 5 parameters for inclusion in the final weighted clinical activity scoring system: organ failure, systemic inflammatory response syndrome, abdominal pain, requirement for opiates and ability to tolerate oral intake. We applied the weighted scoring system across the 5 study cohorts comprising 3,123 patients. We identified several distinct patterns of disease activity: (i) overall there was an elevated score at baseline relative to discharge across all study cohorts, (ii) there were distinct patterns of disease activity related to duration of illness as well as (iii) early and persistent elevation of disease activity among patients with severe acute pancreatitis defined as persistent organ failure. We present the development and initial validation of a clinical activity score for real-time assessment of disease activity in patients with acute pancreatitis.

  17. Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis

    Science.gov (United States)

    Campanilho‐Marques, Raquel; Almeida, Beverley; Deakin, Claire; Arnold, Katie; Gallot, Natacha; de Iorio, Maria; Nistala, Kiran; Pilkington, Clarissa A.; Armon, Kate; Ellis‐Gage, Joe; Roper, Holly; Briggs, Vanja; Watts, Joanna; McCann, Liza; Roberts, Ian; Baildam, Eileen; Hanna, Louise; Lloyd, Olivia; Riley, Phil; McGovern, Ann; Ryder, Clive; Scott, Janis; Thomas, Beverley; Southwood, Taunton; Al‐Abadi, Eslam; Wyatt, Sue; Jackson, Gillian; Amin, Tania; Wood, Mark; VanRooyen, Vanessa; Burton, Deborah; Davidson, Joyce; Gardner‐Medwin, Janet; Martin, Neil; Ferguson, Sue; Waxman, Liz; Browne, Michael; Friswell, Mark; Foster, Helen; Swift, Alison; Jandial, Sharmila; Stevenson, Vicky; Wade, Debbie; Sen, Ethan; Smith, Eve; Qiao, Lisa; Watson, Stuart; Venning, Helen; Satyapal, Rangaraj; Stretton, Elizabeth; Jordan, Mary; Mosley, Ellen; Frost, Anna; Crate, Lindsay; Warrier, Kishore; Wedderburn, Lucy; Pilkington, Clarissa; Hasson, Nathan; Nistala, Kiran; Maillard, Sue; Halkon, Elizabeth; Brown, Virginia; Juggins, Audrey; Smith, Sally; Lunt, Sian; Enayat, Elli; Varsani, Hemlata; Kassoumeri, Laura; Beard, Laura; Arnold, Katie; Glackin, Yvonne; Simou, Stephanie; Campanilho‐Marques, Raquel; Almeida, Beverley; Murray, Kevin; Ioannou, John; Suffield, Linda; Al‐Obaidi, Muthana; Lee, Helen; Leach, Sam; Smith, Helen; Wilkinson, Nick; Inness, Emma; Kendall, Eunice; Mayers, David; Clinch, Jacqui; Pluess‐Hall, Helen

    2016-01-01

    Objective To compare the abbreviated Cutaneous Assessment Tool (CAT), Disease Activity Score (DAS), and Myositis Intention to Treat Activity Index (MITAX) and correlate them with the physician's 10‐cm skin visual analog scale (VAS) in order to define which tool best assesses skin disease in patients with juvenile dermatomyositis. Methods A total of 71 patients recruited to the UK Juvenile Dermatomyositis Cohort and Biomarker Study were included and assessed for skin disease using the CAT, DAS, MITAX, and skin VAS. The Childhood Myositis Assessment Scale (CMAS), manual muscle testing of 8 groups (MMT8), muscle enzymes, inflammatory markers, and physician's global VAS were recorded. Relationships were evaluated using Spearman's correlations and predictors with linear regression. Interrater reliability was assessed using intraclass correlation coefficients. Results All 3 tools showed correlation with the physician's global VAS and skin VAS, with DAS skin showing the strongest correlation with skin VAS. DAS skin and CAT activity were inversely correlated with CMAS and MMT8, but these correlations were moderate. No correlations were found between the skin tools and inflammatory markers or muscle enzymes. DAS skin and CAT were the quickest to complete (mean ± SD 0.68 ± 0.1 minutes and 0.63 ± 0.1 minutes, respectively). Conclusion The 3 skin tools were quick and easy to use. The DAS skin correlated best with the skin VAS. The addition of CAT in a bivariate model containing the physician's global VAS was a statistically significant estimator of skin VAS score. We propose that there is scope for a new skin tool to be devised and tested, which takes into account the strengths of the 3 existing tools. PMID:26881696

  18. Changing clinical patterns in rheumatoid arthritis management over two decades:Sequential observational studies

    OpenAIRE

    Mian, Aneela N; Ibrahim, Fowzia; Scott, Ian C; Bahadur, Sardar; Filkova, Maria; Pollard, Louise; Steer, Sophia; Kingsley, Gabrielle H; Scott, David L; Galloway, James

    2016-01-01

    BACKGROUND: Rheumatoid arthritis (RA) treatment paradigms have shifted over the last two decades. There has been increasing emphasis on combination disease modifying anti-rheumatic drug (DMARD) therapy, newer biologic therapies have become available and there is a greater focus on achieving remission. We have evaluated the impact of treatment changes on disease activity scores for 28 joints (DAS28) and disability measured by the health assessment questionnaire scores (HAQ).METHODS: Four cross...

  19. Estimativa do vigor das sementes e das plântulas de Bixa orellana L.

    Directory of Open Access Journals (Sweden)

    Roberta Leopoldo Ferreira

    Full Text Available RESUMO A multiplicação de espécies como as da planta de urucum tem limitações em função do conhecimento limitado das características morfológicas e fisiológicas das sementes e das plântulas e da restrição de métodos para determinar a qualidade dessas sementes. Nessa pesquisa, o objetivo foi estudar a adequação do teste de envelhecimento acelerado para estimar o vigor das sementes de urucum (Bixa orellana L., relacionando os resultados desse teste com a formação das plântulas e as diferenças de genótipo dos acessos genéticos. As sementes de urucum, representadas por quatro acessos genéticos, e por três lotes, foram avaliadas pelos testes de germinação, primeira contagem da germinação, classificação do vigor das plântulas e emergência das plântulas (total e índice de velocidade. No teste de envelhecimento acelerado foram avaliados a temperatura, de 41 ºC, e os períodos, de 48; 72 e 96 horas, de exposição das sementes às umidades relativas de 100% (água e de 76% (solução saturada de NaCl. A solução saturada reduz a quantidade de água absorvida pelas sementes de urucum, expostas às condições do teste de envelhecimento acelerado, reduzindo a deterioração das sementes, favorecendo a uniformidade dos resultados e a redução da proliferação de fungos, comuns na germinação das sementes de urucum. O teste de envelhecimento acelerado, com água ou solução salina, por 72 horas ou 96 horas, é eficiente para classificar as sementes de urucum quanto à qualidade. Assim, as variações dos teores de água das sementes de urucum devem ser entre 23;6 e 28;9% (72 horas e 29;7 e 32;9% (96 horas para a utilização da água e entre 7,3 e 9,5% para a utilização da solução salina de NaCl.

  20. Advanced glycation end-products inhibition improves endothelial dysfunction in rheumatoid arthritis.

    Science.gov (United States)

    Syngle, Ashit; Vohra, Kanchan; Garg, Nidhi; Kaur, Ladbans; Chand, Prem

    2012-02-01

    Chronic inflammation in rheumatoid arthritis is associated with vascular endothelial dysfunction. The objective was to study the efficacy and safety of advanced glycation end products (AGEs) inhibitor (benfotiamine 50 mg + pyridoxamine 50 mg + methylcobalamin 500 μg, Vonder(®) (ACME Lifescience, Baddi, Himachal Pradesh, India)) on endothelial function in rheumatoid arthritis (RA). Twenty-four patients with established active RA with high disease activity (Disease Activity Score of 28 joints [DAS28 score] > 5.1) despite treatment with stable doses of conventional disease-modifying antirheumatic drugs were investigated. Inflammatory disease activity (DAS28 and Health Assessment Questionnaire-Disability Index [HAQ-DI] scores, erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]), markers of endothelial dysfunction, serum nitrite concentration and endothelium-dependent and -independent vasodilation of the brachial artery were measured before and after 12 weeks therapy with twice a day oral AGEs inhibitor. After treatment, flow-mediated vasodilation improved from 9.64 ± 0.65% to 15.82 ± 1.02% (P < 0.01), whereas there was no significant change in endothelium-independent vasodilation with nitroglycerin and baseline diameter; serum nitrite concentration significantly reduced from 5.6 ± 0.13 to 5.1 ± 0.14 μmol/L (P = 0.004), ESR from 63.00 ± 3.5 to 28.08 ± 1.5 mm in the first h (P < 0.01) and CRP levels from 16.7 ± 4.1 to 10.74 ± 2.9 mg/dL (P < 0.01). DAS28 and HAQ-DI scores were significantly reduced, from 5.9 ± 0.17 to 3.9 ± 0.17 (P < 0.01) and 4.6 ± 0.17 to 1.7 ± 0.22 (P < 0.01), respectively. Advanced glycation end products inhibitor improves endothelial dysfunction and inflammatory disease activity in RA. In RA, endothelial dysfunction is part of the disease process and is mediated by AGEs-induced inflammation. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and

  1. Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST-RA database.

    Science.gov (United States)

    Sokka, T; Kautiainen, H; Pincus, T; Toloza, S; da Rocha Castelar Pinheiro, G; Lazovskis, J; Hetland, M L; Peets, T; Immonen, K; Maillefert, J F; Drosos, A A; Alten, R; Pohl, C; Rojkovich, B; Bresnihan, B; Minnock, P; Cazzato, M; Bombardieri, S; Rexhepi, S; Rexhepi, M; Andersone, D; Stropuviene, S; Huisman, M; Sierakowski, S; Karateev, D; Skakic, V; Naranjo, A; Baecklund, E; Henrohn, D; Gogus, F; Badsha, H; Mofti, A; Taylor, P; McClinton, C; Yazici, Y

    2009-11-01

    To analyse associations between the clinical status of patients with rheumatoid arthritis (RA) and the gross domestic product (GDP) of their resident country. The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) cohort includes clinical and questionnaire data from 6004 patients who were seen in usual care at 70 rheumatology clinics in 25 countries as of April 2008, including 18 European countries. Demographic variables, clinical characteristics, RA disease activity measures, including the disease activity score in 28 joints (DAS28), and treatment-related variables were analysed according to GDP per capita, including 14 "high GDP" countries with GDP per capita greater than US$24,000 and 11 "low GDP" countries with GDP per capita less than US$11,000. Disease activity DAS28 ranged between 3.1 and 6.0 among the 25 countries and was significantly associated with GDP (r = -0.78, 95% CI -0.56 to -0.90, r(2) = 61%). Disease activity levels differed substantially between "high GDP" and "low GDP" countries at much greater levels than according to whether patients were currently taking or not taking methotrexate, prednisone and/or biological agents. The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in "low GDP" than in "high GDP" countries. These findings may alert healthcare professionals and designers of health policy towards improving the clinical status of patients with RA in all countries.

  2. Ultrasound resistive index, power Doppler, and clinical parameters in established rheumatoid arthritis.

    Science.gov (United States)

    Bisi, Melissa Cláudia; do Prado, Aline Defaveri; Piovesan, Deise Marcela; Bredemeier, Markus; da Silveira, Inês Guimarães; Mendonça, José Alexandre; Staub, Henrique Luiz

    2017-04-01

    Ultrasonography (US) is a useful tool for the evaluation of sinovial vascularization and proliferation in rheumatoid arthritis (RA). Accordingly, resistive index (RI) on spectral Doppler (sD) US provides a quantitative analysis of vascular inflammation, but its utility in the evaluation of RA activity has not been established. Our objective was to determine the association of RI with other US parameters of synovitis and with clinical disease activity in established RA. Patients with positive power Doppler (pD) were included in a prospective cross-sectional study. Disease activity and disability were evaluated using the Disease Activity Score in 28-joints (DAS28) and Health Assessment Questionnaire (HAQ), respectively. Gray scale (GS) synovitis, pD, and sD analyses were performed by one of two examiners in wrists and the second and third metacarpophalangeal and proximal interphalangeal joints. The 10-joint GS and 10-joint pD scores and mean RI were then calculated. Weighted kappa (WK) values were employed to assess interobserver reability, and correlations were tested using the Spearman coefficient. Ninety-five RA patients (median duration of disease of 7 years and mean DAS28 of 4.32 ± 1.66) were included. WK values in real-time US were 0.77 for synovitis, 0.87 for pD, and 0.68 for RI. There were no significant correlations of RI with 10-joint GS, 10-joint pD, DAS28, joint counts, or HAQ (P > 0.10 for all tests). Patients in remission had a mean RI similar to those with high disease activity (0.62 ± 0.10, n = 15 versus 0.63 ± 0.13, n = 34, respectively). The addition of the RI score did not seem to improve US performance in patients with established RA.

  3. Concomitant fibromyalgia in rheumatoid arthritis is associated with the more frequent use of biological therapy

    DEFF Research Database (Denmark)

    Rask Lage-Hansen, Philip; Chrysidis, S; Lage-Hansen, M

    2016-01-01

    identified. No group differences were found regarding disease duration, age, gender, and serological status. Of the RA patients with concomitant FM, 64% were treated with biological therapy vs. 32% of RA patients without concomitant FM (p = 0.002). The mean DAS28 in the FM group was 4.4 compared to 2......OBJECTIVES: To compare the 28-joint Disease Activity Score (DAS28) and its components in patients with rheumatoid arthritis (RA) with and without concomitant fibromyalgia (FM), and to investigate the use of biological treatment in the two groups. METHOD: Questionnaires developed to diagnose FM were...... applied to investigate group differences in the use of biological therapy, baseline characteristics, patient-reported outcomes, and DAS28 between groups when appropriate. RESULTS: Questionnaires were completed by 162 out of 264 (61%) patients. Twenty-five patients (15.4%) with concomitant FM were...

  4. Sustained Remission Improves Physical Function in Patients with Established Rheumatoid Arthritis, and Should Be a Treatment Goal

    DEFF Research Database (Denmark)

    Einarsson, Jon Thorkell; Geborek, Pierre; Saxne, Tore

    2016-01-01

    of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. METHODS: Patients with RA...... treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) achieved...... SR, i.e., remission during consecutive visits for at least 6 months. The course of functional status was assessed using the HAQ at each visit. RESULTS: Of the 2416 patients, 1177 (48.7%) reached DAS28 remission at some point. SR was achieved by 382 (15.8%) for the DAS28 and 186 (7.7%) for the SDAI...

  5. Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Dirven Linda

    2012-07-01

    Full Text Available Abstract Objective To determine the prevalence of vertebral fractures (VFs after 5 years of disease activity score (DAS-steered treatment in patients with early rheumatoid arthritis (RA and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD over time. Methods Five-year radiographs of the spine of 275 patients in the BeSt study, a randomized trial comparing four treatment strategies, were used. Treatment was DAS-steered (DAS ≤ 2.4. A height reduction >20% in one vertebra was defined a vertebral fracture. With linear mixed models, DAS and Health Assessment Questionnaire (HAQ scores over 5 years were compared for patients with and without VFs. With generalized estimating equations the association between BMD and VFs was determined. Results VFs were observed in 41/275 patients (15%. No difference in prevalence was found when stratified for gender, prednisone use and menopausal status. Disease activity over time was higher in patients with VFs, mean difference 0.20 (95% CI: 0.05-0.36, and also HAQ scores were higher, independent of disease activity, with a mean difference of 0.12 (95% CI: 0.02-0.2. Age was associated with VFs (OR 1.06, 95% CI: 1.02-1.09, mean BMD in spine and hip over time were not (OR 95% CI, 0.99: 0.78-1.25 and 0.94: 0.65-1.36, respectively. Conclusion After 5 years of DAS-steered treatment, 15% of these RA patients had VFs. Higher age was associated with the presence of VFs, mean BMD in hip and spine were not. Patients with VFs have greater functional disability over time and a higher disease activity, suggesting that VFs may be prevented by optimal disease activity suppression.

  6. Identification of citrullination sites specific for peptidylarginine deiminase 2 (PAD2) and PAD4 in fibrinogen from synovial fluid of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Sharma, Mandvi; Damgaard, Dan; Senolt, L.

    2017-01-01

    /4 and citrullination sites were identified by LC-MS/MS on a Q-exactive orbitrap following proteolytic digestion with Lys-C. These in vitro citrullination profiles were compared to those observed in SF fibrinogen of four RA patients with varying DAS28 scores, CRP levels and leukocyte counts. DAS28 scores >5.1 and ≤2...

  7. Determinação das curvas de secagem das sementes de andiroba em secador solar

    Directory of Open Access Journals (Sweden)

    Andreza P. Mendonça

    2015-04-01

    Full Text Available Comumente, o óleo de andiroba é extraído na Amazônia pelo método tradicional ou ainda por prensa. A eficiência na extração está relacionada ao aquecimento e ao teor de água das sementes. Desta forma, a determinação de um modelo de secagem que represente satisfatoriamente os dados experimentais é de suma importância para minimizar as alterações promovidas pelo processo obtendo-se, consequentemente, produto de qualidade. O objetivo do trabalho foi descrever a cinética de secagem das sementes de andiroba, tal como ajustar os modelos matemáticos aos dados experimentais usando-se secador solar. Foi utilizado, como critério do ajuste dos modelos matemáticos, o coeficiente de determinação, a magnitude do erro médio relativo e o desvio-padrão da estimativa. A secagem em menor tempo (14 dias da Carapa surinamensis para atingir o teor de água de equilíbrio (12,28% se deve, possivelmente, ao menor tamanho das sementes e à maior quantidade de óleo em relação à Carapa guianensis. O modelo Logarítmico e o de Midilli et al. foram os que melhor se ajustaram aos dados experimentais para as sementes das duas espécies de andiroba.

  8. Work Productivity and Costs Related to Patients with Ankylosing Spondylitis, Rheumatoid Arthritis, and Psoriasis.

    Science.gov (United States)

    Kruntorádová, Klára; Klimeš, Jiří; Šedová, Liliana; Štolfa, Jiří; Doležal, Tomáš; Petříková, Alena

    2014-09-01

    To determine and compare the impact of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriasis on work productivity, to calculate the productivity costs (PC), and to map out factors that influence (functional status and disease activity) work productivity. The Work Productivity and Activity Impairment questionnaire was used to evaluate productivity losses of patients with RA (n = 77), AS (n = 230), and psoriasis (n = 93). Demographic data, patient-reported outcomes (PROs) (Health Assessment Questionnaire [HAQ] and Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and clinical parameters (Disease Activity Score in 28 joints [DAS28], body surface area [BSA], and Psoriasis Area and Severity Index [PASI]) were collected. The correlations among PROs, clinical parameters, and overall productivity loss were examined, and multiple regression models were used to examine relationships among parameters and productivity loss. PC were calculated using the friction cost approach. Mean patient age and disease duration were 47.1 and 15.7 years, respectively. The mean HAQ and DAS28 in patients with RA were 1.22 and 5.6, respectively. The mean BASDAI score in patients with AS was 4.43. The mean BSA and PASI score in patients with psoriasis were 21.1% and 12.9, respectively. The percentage of patients with psoriatic arthritis (in those with psoriasis) was 24.7%. We did not find significant differences in Work Productivity and Activity Impairment domains among various diagnoses. Patients with AS, RA, and psoriasis reported overall work productivity losses of 40.9%, 42.9%, and 42.8%, respectively. Daily activity impairments were approximately 50.0%. Overall work productivity loss strongly correlated with PROs, whereas correlations with clinical parameters were weak. The HAQ and BASDAI were identified as major predictors of productivity impairment. The greatest loss in productivity was in those with psoriatic arthritis; however, it was not significant. In

  9. Histologic scoring indices for evaluation of disease activity in Crohn's disease.

    Science.gov (United States)

    Novak, Gregor; Parker, Claire E; Pai, Rish K; MacDonald, John K; Feagan, Brian G; Sandborn, William J; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

    2017-07-21

    Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and operating characteristics of available histologic disease activity indices in Crohn's disease. Electronic searches of MEDLINE, EMBASE, PubMed, and the Cochrane Library (CENTRAL) databases from inception to 20 July 2016 were supplemented by manual reviews of bibliographies and abstracts submitted to major gastroenterology meetings (Digestive Disease Week, United European Gastroenterology Week, European Crohn's and Colitis Organisation). Any study design (e.g. randomised controlled trial, cohort study, case series) that evaluated a histologic disease activity index in patients with Crohn's disease was considered for inclusion. Study participants included adult patients (> 16 years), diagnosed with Crohn's disease using conventional clinical, radiographic or endoscopic criteria. Two authors independently reviewed the titles and abstracts of the studies identified from the literature search. The full text of potentially relevant citations were reviewed for inclusion and the study investigators were contacted as needed for clarification. Any disagreements regarding study eligibility were resolved by discussion and consensus with a third author.Two authors independently extracted and recorded data using a standard form. The following data were recorded from each eligible study: number of patients enrolled; number of patients per treatment arm; patient characteristics: age and gender distribution; description of histologic disease activity index utilized; and outcomes such as content validity, construct validity, criterion validity, responsiveness, intra-rater reliability, inter-rater reliability, and feasibility. Sixteen reports of 14 studies describing 14 different numerical

  10. Blood Monocyte Subsets and Selected Cardiovascular Risk Markers in Rheumatoid Arthritis of Short Duration in relation to Disease Activity

    Directory of Open Access Journals (Sweden)

    Ewa Klimek

    2014-01-01

    Full Text Available Objectives. To evaluate blood monocyte subsets and functional monocyte properties in patients with rheumatoid arthritis (RA of short duration in the context of cardiovascular (CV risk and disease activity. Methods. We studied conventional markers of CV risk, intima media thickness (IMT, and blood monocyte subsets in 27 patients aged 41 ± 10 years with RA of short duration (median 12 months and 22 healthy controls. The RA subjects were divided into low (DAS28: 2.6–5.1 and high (DAS28 > 5.1 disease activity. Results. RA patients exhibited increased levels of intermediate (CD14++CD16+ monocytes with decreased CD45RA expression compared to controls, increased counts of classical (CD14++CD16− monocytes, and decreased percentages of nonclassical (CD14+CD16++ monocytes. Patients with high disease activity had lower HLA DR expression on classical monocytes compared to low disease activity patients. There were no differences in monocyte subsets between subjects with DAS > 5.1 and DAS ≤ 5.1. There were no significant intergroup differences in IMT and the majority of classical CV risk factors. Conclusions. Patients with RA of short duration show alteration in peripheral blood monocyte subsets despite the fact that there is no evidence of subclinical atherosclerosis. Disease activity assessed with DAS28 was associated with impaired functional properties but not with a shift in monocyte subpopulations.

  11. Prevalence of Asymptomatic Arterial Hypertension and Its Correlation with Inflammatory Activity in Early Rheumatoid Arthritis.

    Science.gov (United States)

    Bajraktari, Ismet H; Rexhepi, Sylejman; Berisha, Idriz; Lahu, Ali; Kryeziu, Avni; Durmishi, Bastri; Bajraktari, Halit; Bahtiri, Elton

    2017-08-15

    Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that worsens during the course of the disease and can cause disability. Early RA refers to the onset of symptoms within the past 3 months. In RA, increased levels of mediators of inflammation may cause arterial stiffness consequently leading to arterial hypertension. The aim of this cross-sectional study was to assess the prevalence of asymptomatic arterial hypertension in early RA patients as well as the correlation with parameters of inflammation. One hundred and seventy-nine early RA patients diagnosed in agreement with ACR/EULAR (American College of Rheumatology/ European League against Rheumatism) 2010 criteria were consecutively included in the study. CRP (C-reactive protein) and anti CCP (Antibodies to cyclic citrullinated peptides) serum levels, WBC (white blood cells) count and ESR (Erythrocyte sedimentation rate), likewise DAS-28 (28-joint disease activity score) were determined in all included patients. Parametric tests were used to compare the characteristics of the groups and to test the correlation of the variables. Statistical data analysis revealed that a majority of the patients were females (n = 141; 78.7%); the mean age at RA onset was 49.13 ± 12.13 years. Overall prevalence of hypertension was 44.13 % (n = 79). In comparison with the normotensive patients, the hypertensive patients were older and had significantly higher values of CRP, ESR, anti-CCP and DAS-28. A highly significant positive correlation between all the study parameters and systolic and diastolic blood pressure was observed. Presence of significantly higher values of CRP, ESR, anti-CCP and DAS-28 in hypertensive patients indicate that inflammation is associated with an increased risk of hypertension. In this context, early screening for arterial hypertension and adequate therapeutic measures should be considered in early RA patients.

  12. Weighting with the Lansbury articular index improves the correlation of ultrasound score with serum matrix metalloproteinase-3 level in rheumatoid arthritis patients.

    Science.gov (United States)

    Gorai, Misa; Ogasawara, Michihiro; Matsuki, Yuko; Yamada, Yusuke; Murayama, Go; Sugisaki, Nagachika; Nemoto, Takuya; Ando, Seiichiro; Minowa, Kentaro; Kon, Takayuki; Tada, Kurisu; Matsushita, Masakazu; Yamaji, Ken; Tamura, Naoto; Takasaki, Yoshinari

    2014-11-01

    To determine whether weighting improves the correlation of ultrasound (US) score with serum matrix metalloproteinase-3 (MMP-3) level in rheumatoid arthritis (RA). As ultrasound examination was performed on 100 RA patients, and the severity of synovial effusion and synovial hypertrophy and the blood flow were semi-quantitatively graded from 0 to 3 by using the gray-scale (GS) and power Doppler (PD) modes. We then calculated the sums of the scores of the 28 joints of each patient in the 2 modes, that is, the GS28 and PD28 scores, as well as the respective scores weighted using the Lansbury articular index (LAI, shoulder and elbow, × 12; wrist, × 8; and knee, × 24)-Lans GS28 and Lans PD28 scores. The Lans PD28 score showed a higher correlation with MMP-3 (r = 0.591; 95% confidence interval, 0.446-0.705, p correlated well with the serum MMP-3 level. Weighting with the LAI can improve the correlation of US findings with serum MMP-3 level. Bidirectional approach based on both serum MMP-3 level and US scores can further improve the assessment of disease activity in RA patients.

  13. Proteasome Activators, PA28α and PA28β, Govern Development of Microvascular Injury in Diabetic Nephropathy and Retinopathy

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    Saeed Yadranji Aghdam

    2016-01-01

    Full Text Available Diabetic nephropathy (DN and diabetic retinopathy (DR are major complications of type 1 and type 2 diabetes. DN and DR are mainly caused by injury to the perivascular supporting cells, the mesangial cells within the glomerulus, and the pericytes in the retina. The genes and molecular mechanisms predisposing retinal and glomerular pericytes to diabetic injury are poorly characterized. In this study, the genetic deletion of proteasome activator genes, PA28α and PA28β genes, protected the diabetic mice in the experimental STZ-induced diabetes model against renal injury and retinal microvascular injury and prolonged their survival compared with wild type STZ diabetic mice. The improved wellbeing and reduced renal damage was associated with diminished expression of Osteopontin (OPN and Monocyte Chemoattractant Protein-1 (MCP-1 in the glomeruli of STZ-injected PA28α/PA28β double knockout (Pa28αβDKO mice and also in cultured mesangial cells and retinal pericytes isolated from Pa28αβDKO mice that were grown in high glucose. The mesangial PA28-mediated expression of OPN under high glucose conditions was suppressed by peptides capable of inhibiting the binding of PA28 to the 20S proteasome. Collectively, our findings demonstrate that diabetic hyperglycemia promotes PA28-mediated alteration of proteasome activity in vulnerable perivascular cells resulting in microvascular injury and development of DN and DR.

  14. Efficacy of Various Scoring Systems for Predicting the 28-Day Survival Rate among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Emergency Intensive Care

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    Zhihong Feng

    2017-01-01

    Full Text Available We aimed to investigate the efficacy of four severity-of-disease scoring systems in predicting the 28-day survival rate among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD requiring emergency care. Clinical data of patients with AECOPD who required emergency care were recorded over 2 years. APACHE II, SAPS II, SOFA, and MEDS scores were calculated from severity-of-disease indicators recorded at admission and compared between patients who died within 28 days of admission (death group; 46 patients and those who did not (survival group; 336 patients. Compared to the survival group, the death group had a significantly higher GCS score, frequency of comorbidities including hypertension and heart failure, and age (P<0.05 for all. With all four systems, scores of age, gender, renal inadequacy, hypertension, coronary heart disease, heart failure, arrhythmia, anemia, fracture leading to bedridden status, tumor, and the GCS were significantly higher in the death group than the survival group. The prediction efficacy of the APACHE II and SAPS II scores was 88.4%. The survival rates did not differ significantly between APACHE II and SAPS II (P=1.519. Our results may guide triage for early identification of critically ill patients with AECOPD in the emergency department.

  15. Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST–RA database

    Science.gov (United States)

    Sokka, T; Kautiainen, H; Pincus, T; Toloza, S; da Rocha Castelar Pinheiro, G; Lazovskis, J; Hetland, M L; Peets, T; Immonen, K; Maillefert, J F; Drosos, A A; Alten, R; Pohl, C; Rojkovich, B; Bresnihan, B; Minnock, P; Cazzato, M; Bombardieri, S; Rexhepi, S; Rexhepi, M; Andersone, D; Stropuviene, S; Huisman, M; Sierakowski, S; Karateev, D; Skakic, V; Naranjo, A; Baecklund, E; Henrohn, D; Gogus, F; Badsha, H; Mofti, A; Taylor, P; McClinton, C; Yazici, Y

    2009-01-01

    Objective: To analyse associations between the clinical status of patients with rheumatoid arthritis (RA) and the gross domestic product (GDP) of their resident country. Methods: The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST–RA) cohort includes clinical and questionnaire data from 6004 patients who were seen in usual care at 70 rheumatology clinics in 25 countries as of April 2008, including 18 European countries. Demographic variables, clinical characteristics, RA disease activity measures, including the disease activity score in 28 joints (DAS28), and treatment-related variables were analysed according to GDP per capita, including 14 “high GDP” countries with GDP per capita greater than US$24 000 and 11 “low GDP” countries with GDP per capita less than US$11 000. Results: Disease activity DAS28 ranged between 3.1 and 6.0 among the 25 countries and was significantly associated with GDP (r  =  −0.78, 95% CI −0.56 to −0.90, r2  =  61%). Disease activity levels differed substantially between “high GDP” and “low GDP” countries at much greater levels than according to whether patients were currently taking or not taking methotrexate, prednisone and/or biological agents. Conclusions: The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in “low GDP” than in “high GDP” countries. These findings may alert healthcare professionals and designers of health policy towards improving the clinical status of patients with RA in all countries. PMID:19643759

  16. Evaluating Transcription Factor Activity Changes by Scoring Unexplained Target Genes in Expression Data.

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    Evi Berchtold

    Full Text Available Several methods predict activity changes of transcription factors (TFs from a given regulatory network and measured expression data. But available gene regulatory networks are incomplete and contain many condition-dependent regulations that are not relevant for the specific expression measurement. It is not known which combination of active TFs is needed to cause a change in the expression of a target gene. A method to systematically evaluate the inferred activity changes is missing. We present such an evaluation strategy that indicates for how many target genes the observed expression changes can be explained by a given set of active TFs. To overcome the problem that the exact combination of active TFs needed to activate a gene is typically not known, we assume a gene to be explained if there exists any combination for which the predicted active TFs can possibly explain the observed change of the gene. We introduce the i-score (inconsistency score, which quantifies how many genes could not be explained by the set of activity changes of TFs. We observe that, even for these minimal requirements, published methods yield many unexplained target genes, i.e. large i-scores. This holds for all methods and all expression datasets we evaluated. We provide new optimization methods to calculate the best possible (minimal i-score given the network and measured expression data. The evaluation of this optimized i-score on a large data compendium yields many unexplained target genes for almost every case. This indicates that currently available regulatory networks are still far from being complete. Both the presented Act-SAT and Act-A* methods produce optimal sets of TF activity changes, which can be used to investigate the difficult interplay of expression and network data. A web server and a command line tool to calculate our i-score and to find the active TFs associated with the minimal i-score is available from https://services.bio.ifi.lmu.de/i-score.

  17. Impacto das políticas de fomento à inovação no Brasil sobre o gasto em atividades inovativas e em atividades de P&D das empresas

    Directory of Open Access Journals (Sweden)

    Ana Paula Avellar

    2009-09-01

    Full Text Available A política tecnológica representa, na atualidade, parte central da agenda econômica nos países desenvolvidos e nos países emergentes. O trabalho pretende realizar um exercício empírico de avaliação de impacto de programas de incentivos fiscais e incentivos financeiros do Brasil, na realização de atividades inovativas e de atividades de P&D das empresas, quais sejam: um programa de incentivo fiscal, o Programa de Desenvolvimento Tecnológico Industrial (PDTI; um programa de incentivo financeiro reembolsável, o Programa de Apoio ao Desenvolvimento Tecnológico da Empresa Nacional (ADTEN e um programa de incentivo financeiro não reembolsável, o Fundo Nacional de Desenvolvimento Científico e Tecnológico (FNDCT Cooperativo. Para capturar os efeitos no comportamento das empresas beneficiárias em relação às não beneficiárias será aplicado o método Propensity Score Matching. O estudo conclui que os programas estimularam os gastos em atividades inovativas e em atividades de P&D das empresas beneficiárias.Technology policies have been part of economical agenda in the developed countries as well as in the periphery. The generalized use of these incentives has culminated in a large international discussion questioning its effective capacity to stimulate (or not the benefited companies. This work intends to develop an evaluating empirical exercise of three Brazilian programs of tax incentives and financial incentives to technological activities: Industrial Technological Developing Program (PDTI, National Fund for Scientific and Technological Development (FNDCT and the Support Program for Technological Development of National Companies (ADTEN. In order to capture the effects of these programs on the behavior of benefited companies in relation to those which were not benefited, concerning the decision of expenses in technological activities and to innovative effort, an econometric method will be applied the Propensity Score Matching

  18. Increased in vivo glial activation in patients with amyotrophic lateral sclerosis: Assessed with [11C]-PBR28

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    Nicole R. Zürcher

    2015-01-01

    Full Text Available Evidence from human post mortem, in vivo and animal model studies implicates the neuroimmune system and activated microglia in the pathology of amyotrophic lateral sclerosis. The study aim was to further evaluate in vivo neuroinflammation in individuals with amyotrophic lateral sclerosis using [11C]-PBR28 positron emission tomography. Ten patients with amyotrophic lateral sclerosis (seven males, three females, 38–68 years and ten age- and [11C]-PBR28 binding affinity-matched healthy volunteers (six males, four females, 33–65 years completed a positron emission tomography scan. Standardized uptake values were calculated from 60 to 90 min post-injection and normalized to whole brain mean. Voxel-wise analysis showed increased binding in the motor cortices and corticospinal tracts in patients with amyotrophic lateral sclerosis compared to healthy controls (pFWE < 0.05. Region of interest analysis revealed increased [11C]-PBR28 binding in the precentral gyrus in patients (normalized standardized uptake value = 1.15 compared to controls (1.03, p < 0.05. In patients those values were positively correlated with upper motor neuron burden scores (r = 0.69, p < 0.05, and negatively correlated with the amyotrophic lateral sclerosis functional rating scale (r = –0.66, p < 0.05. Increased in vivo glial activation in motor cortices, that correlates with phenotype, complements previous histopathological reports. Further studies will determine the role of [11C]-PBR28 as a marker of treatments that target neuroinflammation.

  19. MiDAS Field Guide – a Comprehensive Online Source of Information About the Microbes of Activated Sludge

    DEFF Research Database (Denmark)

    Nierychlo, Marta; McIlroy, Simon Jon; Saunders, Aaron Marc

    activated sludge wastewater treatment systems, linking their identity with available information on their function and distribution. The guide includes the approx. 100 abundant genera that are present in most treatment plants (based on a survey of 25 full-scale Danish wastewater treatment plants...... are provided. The MiDAS Field Guide is a continuously developing resource where all working in the field are invited to contribute....... that would be otherwise excluded from analyses. The MiDAS database importantly provides a common taxonomy for the field that gives a solid foundation for the study of microbial ecology of the activated sludge process and related wastewater treatment processes, such as biofilms and granular sludge. Each genus...

  20. Contribution for new genetic markers of rheumatoid arthritis activity and severity: sequencing of the tumor necrosis factor-alpha gene promoter.

    Science.gov (United States)

    Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana

    2007-01-01

    The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-alpha) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-alpha gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-alpha promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD.

  1. Sustained Response Following Discontinuation of Methotrexate in Patients With Rheumatoid Arthritis Treated With Subcutaneous Tocilizumab: Results From a Randomized, Controlled Trial.

    Science.gov (United States)

    Kremer, Joel M; Rigby, William; Singer, Nora G; Birchwood, Christine; Gill, Darcy; Reiss, William; Pei, Jinglan; Michalska, Margaret

    2018-03-25

    To evaluate whether tocilizumab (TCZ) monotherapy is non-inferior to TCZ + methotrexate (MTX) in maintaining clinical response in patients with rheumatoid arthritis (RA) who achieve low disease activity with TCZ+MTX. Patients with RA who experienced an inadequate response to MTX received MTX plus TCZ 162 mg subcutaneous. At 24 weeks, patients who achieved Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) ≤3.2 were randomized to receive TCZ monotherapy or continue TCZ+MTX until week 52. The primary outcome was the comparison of mean change in DAS28-ESR from weeks 24 to 40 between the TCZ monotherapy and TCZ+MTX arms (non-inferiority margin of 0.6). Secondary outcomes included DAS28-ESR worsening ≥1.2, achievement of DAS28-ESR <2.6 and ≤3.2 and safety and immunogenicity. Of 718 patients enrolled, 294 were randomized at week 24 (TCZ monotherapy, n = 147; TCZ+MTX, n = 147). The mean changes in DAS28-ESR from weeks 24 to 40 were 0.46 and 0.14 in the TCZ monotherapy and TCZ+MTX arms, respectively (weighted difference between the groups, 0.318 [95% CI 0.045, 0.592]); discontinuing MTX in TCZ responders was non-inferior to continuing MTX. Safety events were broadly similar between the randomized treatment groups; the most common serious adverse event was infection, occurring in 2.1% of patients in the TCZ monotherapy group and 2.2% in the TCZ+MTX group. Patients with RA receiving TCZ+MTX who achieve low disease activity can discontinue MTX without significant worsening of disease activity in the 16 weeks following MTX discontinuation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Schizotypal perceptual aberrations of time: correlation between score, behavior and brain activity.

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    Shahar Arzy

    Full Text Available A fundamental trait of the human self is its continuum experience of space and time. Perceptual aberrations of this spatial and temporal continuity is a major characteristic of schizophrenia spectrum disturbances--including schizophrenia, schizotypal personality disorder and schizotypy. We have previously found the classical Perceptual Aberration Scale (PAS scores, related to body and space, to be positively correlated with both behavior and temporo-parietal activation in healthy participants performing a task involving self-projection in space. However, not much is known about the relationship between temporal perceptual aberration, behavior and brain activity. To this aim, we composed a temporal Perceptual Aberration Scale (tPAS similar to the traditional PAS. Testing on 170 participants suggested similar performance for PAS and tPAS. We then correlated tPAS and PAS scores to participants' performance and neural activity in a task of self-projection in time. tPAS scores correlated positively with reaction times across task conditions, as did PAS scores. Evoked potential mapping and electrical neuroimaging showed self-projection in time to recruit a network of brain regions at the left anterior temporal cortex, right temporo-parietal junction, and occipito-temporal cortex, and duration of activation in this network positively correlated with tPAS and PAS scores. These data demonstrate that schizotypal perceptual aberrations of both time and space, as reflected by tPAS and PAS scores, are positively correlated with performance and brain activation during self-projection in time in healthy individuals along the schizophrenia spectrum.

  3. Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: a systematic review

    DEFF Research Database (Denmark)

    Groth Madsen, S.; Danneskiold-Samsøe, B.; Stockmarr, Anders

    2016-01-01

    of correlation measures between fatigue and the covariates. RESULTS: A total of 121 studies were included in the analyses, including > 100 000 RA patients. A high level of fatigue was seen even in well-treated patients, demonstrating fatigue as a major problem in RA. Fatigue was found to be positively correlated...... in MEDLINE and EMBASE, followed by selection of studies according to set criteria, data extraction, and statistical analyses of the relationships in RA between fatigue and the following covariates: disease duration, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the 28-joint Disease Activity...... Score (DAS28), swollen to tender joint count ratio (STR), and pain. Linear regression analyses of fatigue regressed on each of the six covariates, and a multiple regression analysis where fatigue was regressed on the six covariates through a forward selection procedure was carried out with construction...

  4. Clinical and ultrasound evaluation of the response to tocilizumab treatment in patients with rheumatoid arthritis: a case series.

    Science.gov (United States)

    Epis, Oscar; Filippucci, Emilio; Delle Sedie, Andrea; De Matthaeis, Anna; Bruschi, Eleonora

    2014-05-01

    This case series evaluates the clinical and ultrasound response to tocilizumab treatment in patients with rheumatoid arthritis (RA). Six patients with active RA (DAS28 ≥ 3.2) for ≥6 months, refractory to conventional DMARDs or anti-TNF agents, received tocilizumab 8 mg/kg every 4 weeks, as monotherapy or in combination with DMARDs, for 6 months. The following clinical parameters were assessed monthly: number of tender joints (28 and 44 joints), number of swollen joints (28 and 44 joints), DAS28-ESR, DAS28-CRP, VAS score, global health status, health assessment questionnaire, patient global assessment of disease activity, physician global assessment of disease activity, functional assessment of chronic illness therapy (FACIT), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). All patients also underwent a gray-scale ultrasonography (US) assessment with power Doppler evaluation at each visit. All clinical parameters improved during the study, versus baseline. This improvement was statistically significant for most parameters 2 months following tocilizumab initiation and was sustained to the end of the observation period. The number of tender joints (44-joint evaluation), the FACIT score, and ESR and CRP concentrations were significantly improved versus baseline values after the first month of tocilizumab treatment. The course of US evaluations mirrored that of clinical parameters; a faster and more evident response was observed for foot joints, with respect to hand joints. This case series suggested the rapid clinical benefit of tocilizumab. Ultrasound assessment showed that the onset of this effect was faster in the foot joints than in the hand joints.

  5. MENYOAL KESENJANGAN ANTARA DAS SOLLEN ISLAM DENGAN DAS SEIN PRAKSIS KEHIDUPAN KAUM MUSLIMIN

    Directory of Open Access Journals (Sweden)

    Yusuf Suyono

    2016-03-01

    Full Text Available Abstract:This paper embarks from the question why the valuable Islamic ethics cannot be ethos grounded in the nation-state Muslim majority country-including in Indonesia? Phenomena such as the majlis taklim, majlis dhikr, interest pilgrimage exceeds the quota, the Islamic banking activity is equally excited, is real. However, it is not enough. Muslims should master the science, economics, and the strategic role of national politics. Islamic ethics is Dassollen, the Muslims condition is DasSein. ProphetMuḥammad has abled to unite Das sein andDassollenin his life, because Islam hasbecomehis bloodso that he is a mirror and store front of Islampar excellence. Muslims, as his follower, not been able todo like him. Al-Amir ArsalanSyākib, Muḥammad ‘Abduh, MohammadIqbal, Muḥammadal-Ghazālī, Ḥassan Ḥanafihavetried to formulatehow tobridge the gapbetween Das sollenandDasSein forMuslims. Theyhave adeep concern about thewide gapbetweenDasSeinpraxis in life of Muslims with DassollenIslamicteachings in slogan ya’lu walā yu’la ‘alaih. Whileatthe same timetheyseehowthe berufethos of Calvinismcouldencouragethe ethos ofmoderncapitalismto its adherentsin Western Europe, a Zen Buddhistethoscouldpushthe Japaneseintothe Asiantigers, andspirit Confucius encouragethe Korean peopleintothe Asiandragon. Abstrak:Tulisan ini berangkat dari pertanyaan mengapa etika Islam yang adiluhung itu tidak bisa membumi menjadi etos bangsa di negara-negara yang mayoritas penduduknya Muslim–termasuk di Indonesia. Fenomena seperti majlis taklim, majlis zikir, minat menunaikan ibadah haji melebihi kuota, aktivitas perbankan syariah tak kalah bersemangat, adalah nyata. Namun, itu tidak cukup. Umat Islam seharusnya lebih dari itu dalam penguasaan ilmu pengetahuan, ekonomi, dan peran strategis politik kebangsaan. Etika Islam itulah Das Sollen, keadaan kaum Muslimin itulah Das Sein. Muhammad Rasulullah telah mampu menyatukan Das Sein dan Das Sollen dalam hidupnya. Hal

  6. Adalimumab (Humira) restores clinical response in patients with secondary loss of efficacy from infliximab (Remicade) or etanercept (Enbrel): results from the STURE registry at Karolinska University Hospital.

    Science.gov (United States)

    Wick, M C; Ernestam, S; Lindblad, S; Bratt, J; Klareskog, L; van Vollenhoven, R F

    2005-01-01

    To determine whether the tumour necrosis factor-alpha (TNF-alpha) antagonist adalimumab (Humira) can be efficacious after secondary loss of efficacy (i.e. loss of clinical response in patients who had initially demonstrated clinical response) to infliximab (Remicade) or etanercept (Enbrel). We studied 36 patients from the Stockholm TNF-alpha follow-up registry (STURE) who received adalimumab after secondary loss of efficacy to infliximab (group A, n = 27) or etanercept (group B, n = 9), and 26 patients who were started on adalimumab as the first TNF-alpha antagonist (group C). In group A, the baseline disease activity score 28 (DAS28) at infliximab institution was 5.5+/-0.2. During infliximab treatment, the mean best DAS28 was 3.7+/-0.2 (p<0.001), but increased to 5.2+/-0.3 when infliximab was stopped. After 3 months on adalimumab, the mean DAS28 decreased to 4.5+/-0.3 (p<0.003), and then to 4.2+/-0.2 at 6 months (p<0.001). In group B, the baseline DAS28 at etanercept institution was 6.6+/-0.5. During etanercept treatment, the mean best DAS28 was 4.6+/-0.5 (p<0.01), but increased to 5.7+/-0.4 by the time etanercept was stopped. After 3 months on adalimumab, the mean DAS28 decreased to 4.8+/-0.3 (p<0.005), and to 4.1+/-0.2 at 6 months (p<0.001). In group C, the mean baseline DAS28 was 5.6+/-0.3. After 6 months of adalimumab therapy, the DAS28 decreased to 3.5+/-0.4 (p<0.001). ACR20 responses with adalimumab in groups A, B, and C were similar (70-78%). For patients with secondary loss of efficacy from infliximab or etanercept, switching to adalimumab can restore a good clinical response.

  7. Longitudinal associations between physical activity and depression scores in Swedish women followed 32 years.

    Science.gov (United States)

    Gudmundsson, P; Lindwall, M; Gustafson, D R; Östling, S; Hällström, T; Waern, M; Skoog, I

    2015-12-01

    Physical activity is negatively associated with depressive symptoms. However, few studies consider dynamic associations of changes in physical activity and reciprocal relationships. This study aimed to perform comprehensive evaluations of relationships between physical activity and depression scores in women followed from mid- to late life. The Prospective Population Study of Women in Gothenburg, Sweden, provided repeated measures of self-reported physical activity and depressive symptoms between 1974 and 2005 (baseline N = 676, 84.5% response rate). Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale, and physical activity was evaluated by the Saltin-Grimby Physical Activity Level Scale. Latent growth curve analyses were used to evaluate associations of change, and cross-lagged models were used to study the reciprocal relationship between physical activity and depression scores. At baseline, lower levels of physical activity were related to higher depression scores. Individuals with decreasing physical activity over time evidenced higher depression scores at 32-year follow-up. Higher average baseline depression score was related to declining levels of physical activity at subsequent examinations. Reduced physical activity may be a long-term consequence of depression. It is important to address individual changes in physical activity and not merely absolute levels of physical activity in relationship to depression. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. An Analysis of Peer-Reviewed Scores and Impact Factors with Different Citation Time Windows: A Case Study of 28 Ophthalmologic Journals.

    Science.gov (United States)

    Liu, Xue-Li; Gai, Shuang-Shuang; Zhang, Shi-Le; Wang, Pu

    2015-01-01

    An important attribute of the traditional impact factor was the controversial 2-year citation window. So far, several scholars have proposed using different citation time windows for evaluating journals. However, there is no confirmation whether a longer citation time window would be better. How did the journal evaluation effects of 3IF, 4IF, and 6IF comparing with 2IF and 5IF? In order to understand these questions, we made a comparative study of impact factors with different citation time windows with the peer-reviewed scores of ophthalmologic journals indexed by Science Citation Index Expanded (SCIE) database. The peer-reviewed scores of 28 ophthalmologic journals were obtained through a self-designed survey questionnaire. Impact factors with different citation time windows (including 2IF, 3IF, 4IF, 5IF, and 6IF) of 28 ophthalmologic journals were computed and compared in accordance with each impact factor's definition and formula, using the citation analysis function of the Web of Science (WoS) database. An analysis of the correlation between impact factors with different citation time windows and peer-reviewed scores was carried out. Although impact factor values with different citation time windows were different, there was a high level of correlation between them when it came to evaluating journals. In the current study, for ophthalmologic journals' impact factors with different time windows in 2013, 3IF and 4IF seemed the ideal ranges for comparison, when assessed in relation to peer-reviewed scores. In addition, the 3-year and 4-year windows were quite consistent with the cited peak age of documents published by ophthalmologic journals. Our study is based on ophthalmology journals and we only analyze the impact factors with different citation time window in 2013, so it has yet to be ascertained whether other disciplines (especially those with a later cited peak) or other years would follow the same or similar patterns. We designed the survey questionnaire

  9. Interleukin-21 gene polymorphism rs2221903 is associated with disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Malinowski, Damian; Paradowska-Gorycka, Agnieszka; Safranow, Krzysztof; Pawlik, Andrzej

    2017-08-01

    Interleukin-21 (IL-21) is a cytokine which plays a significant role in the pathogenesis and disease activity of rheumatoid arthritis (RA). Genetic polymorphisms in the IL-21 gene may alter the synthesis of IL-21. The aim of this study was to examine IL-21 and IL-21R polymorphisms in patients with RA. We examined 422 patients with RA and 338 healthy controls. Single nucleotide polymorphisms (SNPs) within the IL-21 (rs6822844 G>T, rs6840978 C>T, rs2221903 T>C) and IL-21R (rs2285452 G>A) genes were genotyped using TaqMan genotyping assays. There were no statistically significant differences in the distribution of studied genotypes and alleles between RA patients and the control group. To examine whether IL-21 polymorphisms affect disease activity in RA patients, we compared the distribution of IL-21 genotypes between patients with DAS28 ≤ 2.5 (patients with remission of disease symptoms) and patients with DAS28 > 2.5 (patients with active RA). Among patients with DAS28 > 2.5, increased prevalence of rs2221903 CT and CC genotypes was observed (OR = 1.54; 95% CI: 1.04-2.28; p = 0.035). The results of this study suggest that IL-21 and IL-21R gene polymorphisms are not risk loci for RA susceptibility, whereas the IL-21 rs2221903 polymorphism is associated with disease activity.

  10. 49 CFR 28.152-28.159 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false [Reserved] 28.152-28.159 Section 28.152-28.159 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION §§ 28.152-28.159 [Reserved] ...

  11. 49 CFR 28.171-28.999 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false [Reserved] 28.171-28.999 Section 28.171-28.999 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION §§ 28.171-28.999 [Reserved] ...

  12. 49 CFR 28.132-28.139 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false [Reserved] 28.132-28.139 Section 28.132-28.139 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION §§ 28.132-28.139 [Reserved] ...

  13. 49 CFR 28.161-28.169 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false [Reserved] 28.161-28.169 Section 28.161-28.169 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION §§ 28.161-28.169 [Reserved] ...

  14. 49 CFR 28.141-28.148 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false [Reserved] 28.141-28.148 Section 28.141-28.148 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION §§ 28.141-28.148 [Reserved] ...

  15. 49 CFR 28.104-28.109 - [Reserved

    Science.gov (United States)

    2010-10-01

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  16. 49 CFR 28.112-28.129 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false [Reserved] 28.112-28.129 Section 28.112-28.129 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION §§ 28.112-28.129 [Reserved] ...

  17. Don't worry, be active: positive affect and habitual physical activity.

    Science.gov (United States)

    Pasco, Julie A; Jacka, Felice N; Williams, Lana J; Brennan, Sharon L; Leslie, Eva; Berk, Michael

    2011-12-01

    The aim of ths study was to examine the association between habitual physical activity and positive and negative affect. This cross-sectional study included 276 women aged 20 +, from the Geelong Osteoporosis Study. Habitual physical activity and other lifestyle exposures were assessed by questionnaire, concurrent with anthropometric assessments. Physical activity was categorized as very active, moderately active or sedentary. Positive and negative affect scores were derived from the validated 20 item Positive and Negative Affect Schedule (PANAS) self-report and were categorized into tertiles. There was a pattern of lower positive affect scores for lower levels of physical activity. With very active as the reference category, the odds for having a positive affect score in the highest tertile were sequentially lower for those who were moderately active (OR = 0.53, 95%CI 0.28-1.01) and sedentary (OR = 0.28, 95%CI 0.10-0.75). Associations were sustained after adjusting for body mass index and polypharmacy (OR = 0.50, 95%CI 0.26-0.96 and OR = 0.25, 95%CI 0.09-0.72, respectively). These associations were not explained by age, negative affect score or other exposures. No association was detected between physical activity and negative affect scores. This study reports that higher positive affect scores, encompassing emotions such as interest, excitement, enthusiasm and alertness, are associated with higher levels of habitual physical activity. These observations warrant further investigations into possible mechanistic interplay between neurobiological and psychosocial factors that underpin this association.

  18. Which clinical variable influences health-related quality of life the most after spontaneous subarachnoid hemorrhage? Hunt and Hess scale, Fisher score, World Federation of Neurosurgeons score, Brussels coma score, and Glasgow coma score compared.

    Science.gov (United States)

    Kapapa, Thomas; Tjahjadi, Martin; König, Ralph; Wirtz, Christian Rainer; Woischneck, Dieter

    2013-12-01

    To determine the strength of the correlation between the Hunt and Hess scale, Fisher score, Brussels coma score, World Federation of Neurosurgeons score, and Glasgow coma score and health-related quality of life. Evaluable questionnaires from 236 patients (5.6 years [± standard deviation, 2.854 years] on average after hemorrhage) were included in the analysis. Quality of life was documented using the MOS-36 item short form health survey. Because of the ordinal nature of the variables, Kendall tau was used for calculation. Significance was established as P ≤ 0.05. Weak and very weak correlations were found in general (r ≤ 0.28). The strongest correlations were found between the Glasgow coma score and quality of life (r = 0.236, P = 0.0001). In particular, the "best verbal response" achieved the strongest correlations in the comparison, at r = 0.28/P = 0.0001. The Fisher score showed very weak correlations (r = -0.148/P = 0.012). The Brussels coma score (r = -0.216/P = 0.0001), Hunt and Hess scale (r = -0.197/P = 0.0001), and the World Federation of Neurosurgeons score (r = -0.185/P = 0.0001) revealed stronger correlations, especially in terms of the physical aspects of quality of life. The Glasgow coma scale revealed the strongest, and the Fisher score showed the weakest correlations. Thus the Fisher score, as an indicator of the severity of a hemorrhage, has little significance in terms of health-related quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. The Structural Basis of Exopolygalacturonase Activity in a Family 28 Glycoside Hydrolase

    Energy Technology Data Exchange (ETDEWEB)

    Abbott,D.; Boraston, A.

    2007-01-01

    Family 28 glycoside hydrolases (polygalacturonases) are found in organisms across the plant, fungal and bacterial kingdoms, where they are central to diverse biological functions such as fruit ripening, biomass recycling and plant pathogenesis. The structures of several polygalacturonases have been reported; however, all of these enzymes utilize an endo-mode of digestion, which generates a spectrum of oligosaccharide products with varying degrees of polymerization. The structure of a complementary exo-acting polygalacturonase and an accompanying explanation of the molecular determinants for its specialized activity have been noticeably lacking. We present the structure of an exopolygalacturonase from Yersinia enterocolitica, YeGH28 in a native form (solved to 2.19 {angstrom} resolution) and a digalacturonic acid product complex (solved to 2.10 {angstrom} resolution). The activity of YeGH28 is due to inserted stretches of amino acid residues that transform the active site from the open-ended channel observed in the endopolygalacturonases to a closed pocket that restricts the enzyme to the exclusive attack of the non-reducing end of oligogalacturonide substrates. In addition, YeGH28 possesses a fused FN3 domain with unknown function, the first such structure described in pectin active enzymes.

  20. [Inter-rater concordance of the "Nursing Activities Score" in intensive care].

    Science.gov (United States)

    Valls-Matarín, Josefa; Salamero-Amorós, Maria; Roldán-Gil, Carmen; Quintana-Riera, Salvador

    2015-01-01

    To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  1. Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan.

    Directory of Open Access Journals (Sweden)

    Tomohiro Koga

    Full Text Available To determine prognostic factors of clinically relevant radiographic progression (CRRP in patients with rheumatoid arthritis (RA achieving remission or low disease activity (LDA in clinical practice.Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs. CRRP was defined as the yearly progression of modified total Sharp score (mTSS >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC curve to estimate the performance of relevant variables for predicting CRRP.The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR was 2.32 ± 0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA positivity at baseline (OR = 15.2, 95%CI 2.64-299, time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03-3.45, and the mTSS at baseline (13-unit increase, OR = 1.22, 95%CI 1.06-1.42.ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs.

  2. Safety and effectiveness of certolizumab pegol in patients with rheumatoid arthritis: Interim analysis of post-marketing surveillance.

    Science.gov (United States)

    Kameda, Hideto; Nishida, Keiichiro; Nannki, Toshihiro; Watanabe, Akira; Oshima, Yukiya; Momohara, Shigaki

    2017-01-01

    Objective: To evaluate the safety and effectiveness of certolizumab pegol (CZP) in a real-world setting among Japanese patients with rheumatoid arthritis. Post-marketing surveillance data from 2,579 patients treated with CZP were analyzed. Adverse events (AEs) observed during the 24-week CZP treatment period were recorded. Disease activity was evaluated using DAS28-ESR and DAS28-CRP at baseline, Week 12, Week 24, or at withdrawal. The total period of exposure to CZP was 1313.8 patient-years (PY). AEs were reported in 658 (25.5%) patients, at an event rate (ER) of 73.68/100 PY. The most frequent serious AEs were pneumonia, herpes zoster, and interstitial lung disease, at ER per 100 PY of 2.06, 1.29, and 1.22, respectively. Mean disease activity scores at baseline, as measured by DAS28-ESR and DAS28-CRP, were 4.77 ± 1.34 and 4.21 ± 1.27, respectively. Mean changes from baseline at the last observation were -1.29 ± 1.46 and -1.30 ± 1.42, respectively. EULAR good or moderate responses were achieved in 65% of patients. Longer disease duration, prior biologics use, and treatment without MTX co-therapy were associated with EULAR no response. In this interim analysis, no new safety signals were observed. Clinical response to CZP was observed in approximately two thirds of patients.

  3. Nursing Activities Score and Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Filipe Utuari de Andrade Coelho

    Full Text Available ABSTRACT Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI. Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS and Kidney Disease Improving Global Outcomes (KDIGO were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44.2% had higher NAS when compared to those without AKI (43.7% vs 40.7%, p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001. Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.

  4. Korean Red Ginseng exhibits no significant adverse effect on disease activity in patients with rheumatoid arthritis: a randomized, double-blind, crossover study

    Directory of Open Access Journals (Sweden)

    Soo-Kyung Cho

    2018-04-01

    Full Text Available Background: Panax ginseng is a well-known immune modulator, and there is concern that its immune-enhancing effects may negatively affect patients with rheumatoid arthritis (RA by worsening symptoms or increasing the risk of adverse effects from other drugs. In this randomized, crossover clinical trial, we evaluated the impact of Korean Red Ginseng (KRG on disease activity and safety in RA patients. Methods: A total of 80 female RA patients were randomly assigned to either the KRG (2 g/d, n = 40 treatment or placebo (n = 40 groups for 8 wk, followed by crossover to the other treatment group for an additional 8 wk. The primary outcome was the disease flare rate, defined as worsening disease activity according to the disease activity score 28 joints-erythrocyte sedimentation rate (DAS28-ESR. The secondary outcomes were development of adverse events (AEs and patient reported outcomes. Outcomes were evaluated at baseline and 8 wk and 16 wk. The outcomes were compared using the Chi-square test. Results: Of the 80 patients, 70 completed the full study. Their mean age was 51.9 yr, and most exhibited low disease activity (mean DAS28-ESR 3.5 ± 1.0 at enrollment. After intervention, the flare rate was 3.7% in each group. During KRG treatment, 10 AEs were reported, while five AEs were developed with placebo; however, this difference was not statistically significant (p = 0.16. Gastrointestinal- and nervous system-related symptoms were frequent in the KRG group. Conclusion: KRG is not significantly associated with either disease flare rate or the rate of AE development in RA patients. Keywords: effect, Korean Red Ginseng, rheumatoid arthritis, safety

  5. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    = 10) and selected to cover a wide range of activity at baseline and change in activity, were presented electronically in a partial latin-square design to 9 experienced readers from different countries (Europe, Canada). Readers scored each set of MRI 3 times, using 3 different methods including...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered......) assessed by Z-scores was good and comparable among methods. CONCLUSION: This experiment demonstrates the feasibility of multiple-reader MRI scoring exercises for method comparison, provides evidence for the feasibility, reliability, sensitivity to change, and discriminatory capacity of all 3 tested scoring...

  6. Effects of type of physical exercise and leisure activities on the depression scores of obese Brazilian adolescent girls

    Directory of Open Access Journals (Sweden)

    S.G. Stella

    2005-11-01

    Full Text Available Several studies have indicated that depressive states may lead to hypokinesia with diminished metabolic rate and energy use. Hypokinesia associated with certain eating behaviors may lead to an unfavorable energy balance that can contribute to the emergence and prevalence of obesity among children and adults. The purpose of the present study was to examine the possibility of reducing depression inventory scores in female adolescents with third-degree obesity while testing the effectiveness of different exercise programs in reducing anxiety and depression scores. The sample consisted of 40 female subjects (mean age 16 ± 1.56 years divided into 4 groups (aerobic training, anaerobic training, leisure activities, and control. Subjects had a body mass index of 95% or more in relation to the 50th percentile. The aerobic program consisted of three ergometric bicycle sessions per week over a 3-month period (12 weeks and the activities were prescribed after determining the anaerobic ventilatory threshold (VO2 threshold. Anaerobic training was based on the Wingate anaerobic power test. The leisure program consisted of a varied range of activities (games, exercises, etc.. A nutritionist interviewed the members of these two groups and the control group every week in order to adapt them to the nutritional guidelines proposed for the study. The study showed that all three programs (aerobic exercise, anaerobic exercise and leisure activities were effective in reducing body mass. However, we found a significant reduction when analyzing the depression scores only for aerobic exercise (18.9 ± 9.33 to 10.6 ± 9.56 or 43.9% but no significant alterations for anaerobic exercise (11.36 ± 5.23 to 9.63 ± 4.78 or 15.22% and leisure (17.28 ± 7.55 to 15.07 ± 7.54 or 12.78%, thus indicating that in principle this type of activity could be included to improve emotional well-being of obese adolescent girls.

  7. Instrumental Neutron Activation Analysis- INAA: environmental studies in Das Velhas Basin, Minas Gerais, Brazil

    International Nuclear Information System (INIS)

    Rabelo V, M.A.; Andrade Q, M.T.; Araujo M, R.; Albernaz A, I.; Oliveira, A.H. de

    2006-01-01

    The Instrumental Neutron Activation Analysis - INAA was applied to determine concentrations of several elements in unpolluted areas and in the mining and farming region of the Das Velhas Basin, Minas Gerais State, Brazil. INAA was applied using the TRIGA Mark I IPR - R1 reactor at the Nuclear Technology Development Center of the National Committee of Nuclear Energy (CDTN/CNEN), in Belo Horizonte city, Minas Gerais State. At 100 kW of potency the flux of neutrons is 6.6 10 11 n.cm -2 .s -1 . The samples analyzed were: water; sediment; gravel of gold mine and forage. The obtained results for the Das Velhas Basin in water and sediment samples - mining companies region - show a high level (μg/g) of contamination with the analyzed elements, mainly in the sediment samples. During the period of floods, in farming region hundreds of kilometers away, contamination is found in fish and forage, reaching and harming both people and animals that live in the marginal region. (Author)

  8. Nursing Activities Score and Acute Kidney Injury.

    Science.gov (United States)

    Coelho, Filipe Utuari de Andrade; Watanabe, Mirian; Fonseca, Cassiane Dezoti da; Padilha, Katia Grillo; Vattimo, Maria de Fátima Fernandes

    2017-01-01

    to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001). The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3. avaliar a carga de trabalho de enfermagem em pacientes de terapia intensiva com lesão renal aguda (LRA). estudo quantitativo, em Unidade de Terapia Intensiva, no período de abril a agosto de 2015. O Nursing Activities Score (NAS) e o Kidney Disease Improving Global Outcomes (KDIGO) foram utilizados para medir a carga de trabalho de enfermagem e classificar o estágio da LRA, respectivamente. foram incluídos 190 pacientes. Os pacientes que desenvolveram LRA (44,2%) possuíam NAS superiores quando comparados aos sem LRA (43,7% vs 40,7%), p<0,001. Os pacientes com LRA nos estágios 1, 2 e 3 de LRA demonstraram NAS superiores aos sem LRA, houve relação entre os estágios 2 e 3 com os sem LRA, p=0,002 e p<0,001. o NAS apresentou associação com a existência de LRA, visto que seu valor aumenta com a progressão dos estágios, tendo associação com os estágios 2 e 3 de LRA.

  9. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    ability was assessed using Z-scores (Mann-Whitney test) comparing change in score between patients treated with TNF-blocking drug and placebo. RESULTS: The mean time to score one set of MRI was shortest for the Berlin method. SDC was lowest for the Berlin method and highest for SPARCC. Overall inter...... of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo (n...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered...

  10. Maintenance of Remission with Etanercept-DMARD Combination Therapy Compared with DMARDs Alone in African and Middle Eastern Patients with Active Rheumatoid Arthritis.

    Science.gov (United States)

    Bassiouni, Hassan; Spargo, Catherine Elizabeth; Vlahos, Bonnie; Jones, Heather E; Pedersen, Ron; Shirazy, Khalid

    2018-06-01

    To compare etanercept (ETN) and placebo (PBO) for maintaining low disease activity (LDA) achieved with ETN in patients with rheumatoid arthritis (RA) from Africa and the Middle East. In this subset analysis of the Treat-to-Target trial (ClinicalTrials.gov identifier NCT01981473), 53 adult patients with moderate-to-severe RA nonresponsive to methotrexate were treated with 50 mg ETN/week for 24 weeks (Period 1). Patients achieving LDA were randomized to continue ETN treatment or switched to PBO for an additional 28 weeks (Period 2). The proportion of patients maintaining LDA or remission in each arm at the end of Period 2 was determined. Additional efficacy and patient-reported outcomes (PROs) were also evaluated. During Period 1, 51 patients achieved LDA according to the disease activity score-28 joints-erythrocyte sedimentation rate (DAS28-ESR LDA) and 30 achieved remission. At week 52, nine of 22 and eight of 29 in the ETN and PBO groups, respectively, remained in DAS28-ESR LDA without experiencing a flare. Additionally, six of 14 and five of 16 in the ETN and PBO groups, respectively, remained in remission. Among patients experiencing a flare during Period 2, 13 of 22 and 21 of 29 received ETN or PBO, respectively. The median time to flare was 193 and 87 days in the ETN and PBO groups, respectively. At week 52, consistently more patients in the ETN group than in the PBO group achieved predetermined efficacy and PRO endpoints. These data suggest continuing ETN maintenance therapy is beneficial to patients after they have achieved their treatment target. However, this subset analysis is limited by the small patient population and must be interpreted with caution. Pfizer. ClinicalTrials.gov identifier, NCT0198147.

  11. Structural and biochemical analysis of atypically low dephosphorylating activity of human dual-specificity phosphatase 28.

    Directory of Open Access Journals (Sweden)

    Bonsu Ku

    Full Text Available Dual-specificity phosphatases (DUSPs constitute a subfamily of protein tyrosine phosphatases, and are intimately involved in the regulation of diverse parameters of cellular signaling and essential biological processes. DUSP28 is one of the DUSP subfamily members that is known to be implicated in the progression of hepatocellular and pancreatic cancers, and its biological functions and enzymatic characteristics are mostly unknown. Herein, we present the crystal structure of human DUSP28 determined to 2.1 Å resolution. DUSP28 adopts a typical DUSP fold, which is composed of a central β-sheet covered by α-helices on both sides and contains a well-ordered activation loop, as do other enzymatically active DUSP proteins. The catalytic pocket of DUSP28, however, appears hardly accessible to a substrate because of the presence of nonconserved bulky residues in the protein tyrosine phosphatase signature motif. Accordingly, DUSP28 showed an atypically low phosphatase activity in the biochemical assay, which was remarkably improved by mutations of two nonconserved residues in the activation loop. Overall, this work reports the structural and biochemical basis for understanding a putative oncological therapeutic target, DUSP28, and also provides a unique mechanism for the regulation of enzymatic activity in the DUSP subfamily proteins.

  12. Match score affects activity profile and skill performance in professional Australian Football players.

    Science.gov (United States)

    Sullivan, Courtney; Bilsborough, Johann C; Cianciosi, Michael; Hocking, Joel; Cordy, Justin; Coutts, Aaron J

    2014-05-01

    To examine the influence of quarter outcome and the margin of the score differential on both the physical activity profile and skill performance of players during professional Australian Football matches. Prospective, longitudinal. Physical activity profiles were assessed via microtechnology (Global Positioning System and accelerometer) from 40 professional AF players from the same team during 15 Australian Football League games. Skill performance measures (involvement and effectiveness) and player rank scores (Champion Data(©) Rank) were provided by a commercial statistical provider. The physical performance variables, skill involvements and individual player performance scores were expressed relative to playing time for each quarter. The influence of the quarter result (i.e. win vs. loss) and score margin (i.e. small: 19 points) on activity profile and skill involvements and skill efficiency performance of players were examined. Skill involvements (total disposals/min, long kicks/min, marks/min, running bounces/min and player rank/min) were greater in quarters won (all p14.5 km h(-1), HSR/min), sprints/min and peak speed were higher in losing quarters (all pProfessional AF players are likely to have an increased physical activity profile and decreased skill involvement and proficiency when their team is less successful. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. Assessing pediatric ileocolonic Crohn's disease activity based on global MR enterography scores

    Energy Technology Data Exchange (ETDEWEB)

    Pomerri, Fabio; Zuliani, Monica; Giorgi, Benedetta; Muzzio, Pier Carlo [University of Padova, Department of Medicine-DIMED, Padova (Italy); Al Bunni, Faise [Rovigo Hospital, Radiology Unit, S. Maria della Misericordia, Rovigo (Italy); Guariso, Graziella; Gasparetto, Marco; Cananzi, Mara [University of Padova, Department of Women and Child Health, Padova (Italy)

    2017-03-15

    This study was aimed at correlating a magnetic resonance index of activity (MaRIA) and a magnetic resonance enterography global score (MEGS) with activity indexes in a paediatric population with Crohn's disease (CD). This retrospective study included 32 paediatric patients (median age 14.5 years, 18 male) with proven CD who underwent magnetic resonance enterography (MRE). A correlation analysis was performed on the MRE-based scores, the simplified endoscopic score for CD (SES-CD), the paediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP) levels. Based on PCDAI, comparison of both global MaRIA and MEGS was made between patients with mild and moderate/severe disease activity. Global MaRIA correlated with SES-CD (r = 0.70, p = 0.001) and PCDAI (r = 0.42, p = 0.016). MEGS correlated with PCDAI (r = 0.46, p = 0.007) and CRP levels (r = 0.35, p = 0.046). MEGS differed significantly (p = 0.027) between patients grouped by clinical disease severity. MRE-based global scores correlated with clinical indexes of CD activity. Therefore, they represent a potential useful tool to predict CD activity and severity, as well as a possible promising alternative to endoscopy, to monitor paediatric patients with CD during their follow-up. (orig.)

  14. The relationship between objectively measured physical activity, salivary cortisol, and the metabolic syndrome score in girls.

    Science.gov (United States)

    DuBose, Katrina D; McKune, Andrew J

    2014-08-01

    The relationship between physical activity levels, salivary cortisol, and the metabolic syndrome (MetSyn) score was examined. Twenty-three girls (8.4 ± 0.9 years) had a fasting blood draw, waist circumference and blood pressure measured, and wore an ActiGraph accelerometer for 5 days. Saliva samples were collected to measure cortisol levels. Previously established cut points estimated the minutes spent in moderate, vigorous, and moderate-to-vigorous physical activity. A continuous MetSyn score was created from blood pressure, waist circumference, high-density-lipoprotein (HDL), triglyceride, and glucose values. Correlation analyses examined associations between physical activity, cortisol, the MetSyn score, and its related components. Regression analysis examined the relationship between cortisol, the MetSyn score, and its related components adjusting for physical activity, percent body fat, and sexual maturity. Vigorous physical activity was positively related with 30 min post waking cortisol values. The MetSyn score was not related with cortisol values after controlling for confounders. In contrast, HDL was negatively related with 30 min post waking cortisol. Triglyceride was positively related with 30 min post waking cortisol and area under the curve. The MetSyn score and many of its components were not related to cortisol salivary levels even after adjusting for physical activity, body fat percentage, and sexual maturity.

  15. Association between Children's Physical Activity and Parental Practices Enhancing Children's Physical Activity: The Moderating Effects of Children's BMI z-Score

    Directory of Open Access Journals (Sweden)

    Natalia Liszewska

    2018-01-01

    Full Text Available Objective: Parental practices that aim at increasing children's physical activity were found to be related to children's physical activity. So far, however, the association between these two sets of variables was studied without considering the moderating role of children's BMI z-score, which may determine the effectiveness of parental practices. The present study aims at filling this void.Design: Longitudinal data were collected among 879 dyads of children (6–11 years old and their parents. Seven parental physical activity practices were assessed at baseline. Physical activity, body mass, and height (measured among children were assessed twice (at baseline and 7-month follow-up. Body mass and height were measured objectively. Seven moderation analyses were conducted.Results: Six parental practices emerged to predict physical activity of children: collaborative social control, overall support, stimulation to be active, general encouragement for physical activity, positive social control, and modeling. Children's BMI z-score moderated three associations. The relationships between parental positive social control, overall parental support, and general parental encouragement for physical activity (at baseline, and children's physical activity (at follow-up were significant only among children with low and medium BMI z-score. In turn, collaborative social control and modeling predicted children's physical activity at the follow-up regardless child's BMI z-score.Conclusions: Parental positive social control or overall parental support may be ineffective in children with higher body mass who are in need to increase their physical activity.

  16. Treatment with the first TNF inhibitor in rheumatoid arthritis patients in the Hellenic Registry of Biologic Therapies improves quality of life especially in young patients with better baseline functional status.

    Science.gov (United States)

    Boubouchairopoulou, Nadia; Flouri, Irini; Drosos, Alexandros A; Boki, Kyriaki; Settas, Loukas; Zisopoulos, Dimitrios; Skopouli, Fotini N; Papadopoulos, Ioannis; Iliopoulos, Alexios; Kyriopoulos, John; Boumpas, Dimitrios T; Athanasakis, Konstantinos; Sidiropoulos, Prodromos

    2016-01-01

    To assess in daily practice in patients with rheumatoid arthritis (RA) the effect of treatment with first tumour necrosis factor-α inhibitor (TNFi) in quality of life (Qol), disease activity and depict possible baseline predictors for gains in Qol. Patients followed prospectively by the Hellenic Registry of Biologic Therapies were analysed. Demographics were recorded at baseline, while RA-related characteristics at baseline and every 6 months. Paired t-tests were used to detect divergences between patient-reported (Health Assessment Questionnaire (HAQ), EuroQol (EQ-5D)) and clinical tools (Disease Activity Score-28 joints (DAS28)). Clinical versus self-reported outcomes were examined via cross-tabulation analysis. Multiple regression analysis was performed for identifying baseline predictors of improvements in QALYs. We analysed 255 patients (age (mean±SD) 57.1±13.0, disease duration 9.2±9.1 years, prior non-biologic disease-modifying anti-rheumatic drugs 2.3±1.2). Baseline EQ-5D, HAQ and DAS28 were 0.36 (0.28), 1.01 (0.72) and 5.9 (1.3), respectively, and were all significantly improved after 12 months (0.77 (0.35), 0.50 (0.66), 3.9 (1.5), respectively, p<0.05 for all). 90% of patients who improved from high to a lower DAS28 status (low-remission or moderate) had clinically important improvement in Qol (phi-coefficient=0.531,p<0.05). Independent predictors of gains in Qol were lower baseline HAQ, VAS global and younger age (adjusted R2=0.27). In daily practice TNFi improve both disease activity and Qol for the first 12 months of therapy. 90% of patients who improved from high to a lower DAS28 status had clinically important improvement in Qol. Younger patients starting with lower HAQ and VAS global are more likely to benefit.

  17. Monitoring anti-TNF{alpha} treatment in RA: Responsiveness of magnetic resonance imaging and ultrasonography of the dominant wrist compared to conventional measures of disease activity and structural damage

    DEFF Research Database (Denmark)

    Haavardsholm, Espen A; Ostergaard, Mikkel; Hammer, Hilde Berner

    2008-01-01

    months. Responsiveness was assessed by standardized response means (SRM). Accepted thresholds were applied to classify responsiveness as trivial, low, moderate or good. RESULTS: MRI synovitis (SRM between -0.79 and -0.92) and the MRI total inflammation score comprising synovitis, tenosynovitis and bone...... marrow edema (SRM between -1.05 and -1.24) were highly responsive. Moderate to high responsiveness was found for MRI tenosynovitis and bone marrow edema, all the composite indices (DAS28, SDAI and CDAI) and the 28-swollen joint count. US displayed low to moderate responsiveness. The MRI erosion score...... was a composite measure comprising MRI synovitis, tenosynovitis and bone marrow edema, and this may be a promising outcome measure in clinical studies....

  18. Interleukin-23 in early disease development in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Andersen, Thomas; Hvid, M; Johansen, C

    2015-01-01

    randomized to methotrexate (MTX) plus adalimumab (ADA; n = 75) or MTX plus placebo-ADA (PLA; n = 76). Plasma samples were obtained at baseline and at months 3, 6, and 12 together with values for C-reactive protein (CRP), the 28-joint Disease Activity Score based on CRP (DAS28CRP), scores on the Clinical......OBJECTIVES: To investigate the levels of interleukin (IL)-23 in patients with early rheumatoid arthritis (eRA) and the effect of anti-tumour necrosis factor (anti-TNF)-α treatment on IL-23 levels. METHOD: Treatment-naïve eRA patients from the OPERA cohort were included (n = 151). Patients were...... Disease Activity Index (CDAI) and the Simplified Disease Activity Index (SDAI), visual analogue scale (VAS) for pain/fatigue/physician global and total Sharp/van der Heijde score (TSS). IL-23 was measured at each time point. RESULTS: IL-23 levels decreased significantly in the ADA group from 20.6 pg...

  19. Health-related quality of life: validity, reliability, and responsiveness of SF-36, 15D, EQ-5D [corrected] RAQoL, and HAQ in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Ostergaard, Mikkel

    2008-01-01

    .21-6.47). The longitudinal sample included 80% women, median age 60 years (22-82). Validity: all instruments discriminated between low, moderate, and high DAS28. Reliability: RAQoL and HAQ displayed good repeatability (ICC > 0.95) and internal consistency (Cronbach's alpha > 0.90). Responsiveness: SF-36 bodily pain scale......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...... questionnaires (at 2 weeks and 6 months) included questions about changes in health status since baseline. RESULTS: The cross-sectional sample included 77% women, median age 57 years (range 19-87), disease duration 6 years (0-58), with Disease Activity Score 28-joint count (DAS28) of 3.10 (1...

  20. STAT4 rs7574865 G/T polymorphism is associated with rheumatoid arthritis and disease activity, but not with anti-CCP antibody levels in a Mexican population.

    Science.gov (United States)

    Durán-Avelar, Ma de Jesús; Vibanco-Pérez, Norberto; Hernández-Pacheco, Raquel Rocío; Castro-Zambrano, América Del Carmen; Ortiz-Martínez, Liliana; Zambrano-Zaragoza, José Francisco

    2016-12-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease in whose etiology genetic factors are known to play an important role. Among the genes associated with RA, STAT4 could be an important factor in conducting helper T cells toward the pro-inflammatory Th1 and Th17 lineages. The aim of this study is to determine the association of the STAT4 polymorphism rs7574865 with RA, disease activity, and anti-cyclic citrullinated peptide (CCP) antibody levels in a Mexican population. Genotyping was carried out using the Taqman® system from Applied Biosystems in 140 patients with RA and 150 healthy subjects. Disease activity was evaluated by a rheumatologist using the DAS28 and Spanish-HAQ-DI instruments. Anti-CCP levels were determined by ELISA. Associations of the genotypes of rs7574865 with DAS28, HAQ, and anti-CCP antibody levels with RA were determined. Findings showed that the GT and TT genotypes and the T allele from rs7574865 were all associated as risk factors for RA, independently of their anti-CCP status. An association with moderate-to-high disease activity (DAS28 ≥ 3.2) was also found. Additionally, patients with the GT or TT genotypes showed lower HAQ values than those who carried the GG genotype. No differences in anti-CCP antibody levels or DAS28 and genotypes were found. This work supports the association of the STAT4 rs7574865 polymorphism with RA and disease activity, but not with anti-CCP antibody levels in a Mexican population.

  1. Methotrexate Dosage Reduction Upon Adalimumab Initiation: Clinical and Ultrasonographic Outcomes from the Randomized Noninferiority MUSICA Trial.

    Science.gov (United States)

    Kaeley, Gurjit S; Evangelisto, Amy M; Nishio, Midori J; Goss, Sandra L; Liu, Shufang; Kalabic, Jasmina; Kupper, Hartmut

    2016-08-01

    To examine the clinical and ultrasonographic (US) outcomes of reducing methotrexate (MTX) dosage upon initiating adalimumab (ADA) in MTX-inadequate responders with moderately to severely active rheumatoid arthritis (RA). MUSICA (NCT01185288) was a double-blind, randomized, parallel-arm study of 309 patients with RA receiving MTX ≥ 15 mg/week for ≥ 12 weeks before screening. Patients were randomized to high dosage (20 mg/week) or low dosage (7.5 mg/week) MTX; all patients received 40 mg open-label ADA every other week for 24 weeks. The primary endpoint was Week 24 mean 28-joint Disease Activity Score based on C-reactive protein (DAS28-CRP) to test for noninferiority of low-dosage MTX using a 15% margin. US images were scored using a 10-joint semiquantitative system incorporating OMERACT definitions for pathology, assessing synovial hypertrophy, vascularity, and bony erosions. Rapid improvement in clinical indices was observed in both groups after addition of ADA. The difference in mean DAS28-CRP (0.37, 95% CI 0.07-0.66) comparing low-dosage (4.12, 95% CI 3.88-4.34) versus high-dosage MTX (3.75, 95% CI 3.52-3.97) was statistically significant and non-inferiority was not met. Statistically significant differences were not detected for most clinical, functional, and US outcomes. Pharmacokinetic and safety profiles were similar. In MUSICA, Week 24 mean DAS28-CRP, the primary endpoint, did not meet non-inferiority for the low-dosage MTX group. Although the differences between the 2 MTX dosage groups were small, our study findings did not support routine MTX reduction in MTX inadequate responders initiating ADA.

  2. Relationships between spatial activities and scores on the mental rotation test as a function of sex.

    Science.gov (United States)

    Ginn, Sheryl R; Pickens, Stefanie J

    2005-06-01

    Previous results suggested that female college students' scores on the Mental Rotations Test might be related to their prior experience with spatial tasks. For example, women who played video games scored better on the test than their non-game-playing peers, whereas playing video games was not related to men's scores. The present study examined whether participation in different types of spatial activities would be related to women's performance on the Mental Rotations Test. 31 men and 59 women enrolled at a small, private church-affiliated university and majoring in art or music as well as students who participated in intercollegiate athletics completed the Mental Rotations Test. Women's scores on the Mental Rotations Test benefitted from experience with spatial activities; the more types of experience the women had, the better their scores. Thus women who were athletes, musicians, or artists scored better than those women who had no experience with these activities. The opposite results were found for the men. Efforts are currently underway to assess how length of experience and which types of experience are related to scores.

  3. [Effects of Electroacupuncture on Joint Function in Rheumatoid Arthritis Patients of Liver- and Kidney-Yin Deficiency Type].

    Science.gov (United States)

    Zhou, Yin; Zhu, Jun; Li, Lian-Bo; He, Tian-Feng; Chen, Xiao-Yi; Zheng, Yong-Yao; Chen, Yun-Fei

    2016-10-25

    To compare the effects between electroacupuncture (EA) plus western medicine and simple western medicine in improving clinical symptoms and local joint function of rheumatoid arthritis (RA) patients with yin deficiency of Liver and Kidney. A total of 68 RA patients of yin deficiency of Liver and Kidney were equally randomized into EA+medication group and medication group ( n =34 in each group). Both groups were given once-a-week methotrexate (7.5 mg/time) and once-a-day leflunomide (10 mg/time), while EA+medication group was additionally treated by EA at bilateral Ganshu (BL 18), Shenshu (BL 23), Xuanzhong (GB 39), Zusanli (ST 36), Taichong (LR 3), Hegu (LI 4) 3 times/week. The treatment lasted for 12 weeks. The visual analogue scale (VAS, for assessing rest pain), swollen joint count (SJC), tender joint count (TJC), patient's global assessment (PGA), physician's global assessment (PhGA), traditional Chinese medicine (TCM) symptom scoring, 28 joints activity index (disease activity score, DAS 28), American College of Rheumatology 20 (ACR 20, i.e. 20% of clinical improving rate), and health assessment questionnaire (HAQ) were assessed and erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) levels were examined for comparison. Statistical differences were observed in before-after-treatment comparisons in both groups in reducing rest pain, SJC, TJC, serum CRP content, PGA and PhGA, HAQ scoring and DAS 28 ( P yin deficiency of Liver and Kidney.

  4. MiDAS

    DEFF Research Database (Denmark)

    McIlroy, Simon Jon; Kirkegaard, Rasmus Hansen; McIlroy, Bianca

    A deep understanding of the microbial communities and dynamics in wastewater treatment systems is a powerful tool for process optimization and design (Rittmann et al., 2006). With the advent of amplicon sequencing of the 16S rRNA gene, the diversity within the microbial communities can now...... web platform about the microbes in activated sludge and their associated ADs. The MiDAS taxonomy proposes putative names for each genus-level-taxon that can be used as a common vocabulary for all researchers in the field....

  5. Novel Semiquantitative Bone Marrow Oedema Score and Fracture Score for the Magnetic Resonance Imaging Assessment of the Active Charcot Foot in Diabetes

    Science.gov (United States)

    Meacock, L.; Donaldson, Ana; Isaac, A.; Briody, A.; Ramnarine, R.; Edmonds, M. E.; Elias, D. A.

    2017-01-01

    There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0—no oedema, 1—oedema  50% of bone volume) and fracture (0—no fracture, 1—fracture, and 2—collapse/fragmentation). Interobserver agreement and intraobserver agreement were measured using multilevel modelling and intraclass correlation (ICC). The interobserver agreement for the total BMO and fracture scores was very good (ICC = 0.83, 95% confidence intervals (CI) 0.76, 0.91) and good (ICC = 0.62; 95% CI 0.48, 0.76), respectively. The intraobserver agreement for the total BMO and fracture scores was good (ICC = 0.78, 95% CI 0.6, 0.95) and fair to moderate (ICC = 0.44; 95% CI 0.14, 0.74), respectively. The proposed BMO and fracture scores are reliable and can be used to grade the extent of bone damage in the active Charcot foot. PMID:29230422

  6. Are students' impressions of improved learning through active learning methods reflected by improved test scores?

    Science.gov (United States)

    Everly, Marcee C

    2013-02-01

    To report the transformation from lecture to more active learning methods in a maternity nursing course and to evaluate whether student perception of improved learning through active-learning methods is supported by improved test scores. The process of transforming a course into an active-learning model of teaching is described. A voluntary mid-semester survey for student acceptance of the new teaching method was conducted. Course examination results, from both a standardized exam and a cumulative final exam, among students who received lecture in the classroom and students who had active learning activities in the classroom were compared. Active learning activities were very acceptable to students. The majority of students reported learning more from having active-learning activities in the classroom rather than lecture-only and this belief was supported by improved test scores. Students who had active learning activities in the classroom scored significantly higher on a standardized assessment test than students who received lecture only. The findings support the use of student reflection to evaluate the effectiveness of active-learning methods and help validate the use of student reflection of improved learning in other research projects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. siMS Score: Simple Method for Quantifying Metabolic Syndrome

    OpenAIRE

    Soldatovic, Ivan; Vukovic, Rade; Culafic, Djordje; Gajic, Milan; Dimitrijevic-Sreckovic, Vesna

    2016-01-01

    Objective To evaluate siMS score and siMS risk score, novel continuous metabolic syndrome scores as methods for quantification of metabolic status and risk. Materials and Methods Developed siMS score was calculated using formula: siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130?HDL/1.02 or 1.28 (for male or female subjects, respectively). siMS risk score was calculated using formula: siMS risk score = siMS score * age/45 or 50 (for male or female subjects, respectively) * famil...

  8. Heart valve surgery: EuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons score

    Directory of Open Access Journals (Sweden)

    Muhammad Sharoz Rabbani

    2014-12-01

    Full Text Available Background This is a validation study comparing the European System for Cardiac Operative Risk Evaluation (EuroSCORE II with the previous additive (AES and logistic EuroSCORE (LES and the Society of Thoracic Surgeons’ (STS risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan. Patients and Methods Clinical data of 576 patients undergoing valve replacement surgery between 2006 and 2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration. Results There were 28 deaths (4.8% among 576 patients, which was lower than the predicted mortality of 5.16%, 6.96% and 4.94% by AES, LES and EuroSCORE II but was higher than 2.13% predicted by STS scoring system. For single and double valve replacement procedures, EuroSCORE II was the best predictor of mortality with highest Hosmer and Lemmeshow test (H-L p value (0.346 to 0.689 and area under the receiver operating characteristic (ROC curve (0.637 to 0.898. For valve plus concomitant coronary artery bypass grafting (CABG patients actual mortality was 1.88%. STS calculator came out to be the best predictor of mortality for this subgroup with H-L p value (0.480 to 0.884 and ROC (0.657 to 0.775. Conclusions For Pakistani population EuroSCORE II is an accurate predictor for individual operative risk in patients undergoing isolated valve surgery, whereas STS performs better in the valve plus CABG group.

  9. Joint involvement in patients affected by systemic lupus erythematosus: application of the swollen to tender joint count ratio

    Directory of Open Access Journals (Sweden)

    E. Cipriano

    2015-09-01

    Full Text Available Joint involvement is a common manifestation in systemic lupus erythematosus (SLE. According to the SLE disease activity index 2000 (SLEDAI-2K, joint involvement is present in case of ≥2 joints with pain and signs of inflammation. However this definition could fail to catch all the various features of joint involvement. Alternatively the Swollen to Tender joint Ratio (STR could be used. This new index, which was originally proposed for rheumatoid arthritis (RA patients, is based on the count of 28 swollen and tender joints. Our study is, therefore, aimed to assess joint involvement in a SLE cohort using the STR. SLE patients with joint symptoms (≥1 tender joint were enrolled over a period of one month. Disease activity was assessed by SLEDAI-2K. We performed the swollen and tender joint count (0-28 and calculated the STR. Depending on the STR, SLE patients were grouped into three categories of disease activity: low (STR1.0. We also calculated the disease activity score based on a 28-joint count and the erythrocyte sedimentation rate (DAS28-ESR. We enrolled 100 SLE patients [F/M 95/5, mean±standard deviation (SD age 46.3±10.6 years, mean±SD disease duration 147.1±103.8 months]. The median of tender and swollen joints was 4 (IQR 7 and 1 (IQR 2.5, respectively. The median STR value was 0.03 (IQR 0.6. According to the STR, disease activity was low in 70 patients, moderate in 23 and high in 7. A significant correlation was identified between STR values and DAS28 (r=0.33, p=0.001. The present study suggests a correlation between STR and DAS28, allowing an easier and faster assessment of joint involvement with the former index.

  10. Comparison of discrimination and prognostic value of two US Doppler scoring systems in rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Terslev, Lene; Christensen, Robin

    2014-01-01

    images. The SRM, predictive validity and discriminative ability for both systems were calculated using DAS28 as the measure of disease improvement. RESULTS: Fourty-six patients with RA (80% females) were included. The mean Doppler activity at baseline was QS:24.4% (SD=17.7%) and SQS:2.0 (SD=0.......6). A decrease in Doppler activity was seen for both systems after anti-TNF-α therapy. Sensitivity to change was seen, SRM=-0.52 (95%CI; -0.83 to -0.21; QS) and -0.24 (-0.53 to -0.05; SQS). Predictive value was poor (QS rs=-0.24; SQS rs=-0.05). Construct validity was; QS: rs=0.29, SQS: rs=0.23. CONCLUSIONS: Both...

  11. Kalyan Das

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Kalyan Das. Articles written in Resonance – Journal of Science Education. Volume 5 Issue 12 December 2000 pp 76-76 Book Review. Linear Algebra and Linear Models · Kalyan Das · More Details Fulltext PDF ...

  12. Mental health, fatigue and function are associated with increased risk of disease flare following TNF inhibitor tapering in patients with rheumatoid arthritis: an exploratory analysis of data from the Optimizing TNF Tapering in RA (OPTTIRA) trial.

    Science.gov (United States)

    Bechman, Katie; Sin, Fang En; Ibrahim, Fowzia; Norton, Sam; Matcham, Faith; Scott, David Lloyd; Cope, Andrew; Galloway, James

    2018-01-01

    Tapering of anti-tumour necrosis factor (TNF) therapy appears feasible, safe and effective in selected patients with rheumatoid arthritis (RA). Depression is highly prevalent in RA and may impact on flare incidence through various mechanisms. This study aims to investigate if psychological states predict flare in patients' dose tapering their anti-TNF therapy. This study is a post-hoc analysis of the Optimizing TNF Tapering in RA trial, a multicentre, randomised, open-label study investigating anti-TNF tapering in RA patients with sustained low disease activity. Patient-reported outcomes (Health Assessment Questionnaire, EuroQol 5-dimension scale, Functional Assessment of Chronic Illness Therapy fatigue scale (FACIT-F), 36-Item Short Form Survey (SF-36)) were collected at baseline. The primary outcome was flare, defined as an increase in 28-joint count Disease Activity Score (DAS28) ≥0.6 and ≥1 swollen joint. Discrete-time survival models were used to identify patient-reported outcomes that predict flare. Ninety-seven patients were randomised to taper their anti-TNF dose by either 33% or 66%. Forty-one patients flared. Higher baseline DAS28 score was associated with flare (adjusted HR 1.96 (95% CI 1.18 to 3.24), p=0.01). Disability (SF-36 physical component score), fatigue (FACIT-F) and mental health (SF-36 mental health subscale (MH)) predicted flare in unadjusted models. In multivariate analyses, only SF-36 MH remained a statistically significant predictor of flare (adjusted HR per 10 units 0.74 (95% CI 0.60 to 0.93), p=0.01). Baseline DAS28 and mental health status are independently associated with flare in patients who taper their anti-TNF therapy. Fatigue and function also associate with flare but the effect disappears when adjusting for confounders. Given these findings, mental health and functional status should be considered in anti-TNF tapering decisions in order to optimise the likelihood of success. EudraCT Number: 2010-020738-24; ISRCTN: 28955701

  13. Histologic scoring indices for evaluation of disease activity in Crohn's disease

    NARCIS (Netherlands)

    Novak, Gregor; Parker, Claire E.; Pai, Rish K.; Macdonald, John K.; Feagan, Brian G.; Sandborn, William J.; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

    2017-01-01

    Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and

  14. Eletroforese em acetato de celulose das proteínas do líquido cefalorraqueano: valores normais

    Directory of Open Access Journals (Sweden)

    Izelino Caldas Filho

    1977-09-01

    Full Text Available Foi feita eletroforese das proteinas de LCR colhido por via lombar de 19 pacientes neurologicamente normais entre 10 e 54 anos. A proteinorraquia total variou entre 10 e 28 mg% (método de Meulemans. Sete pacientes eram normais e 12 apresentavam neuroses. As médias das frações separadas pela eletroforese foram: pré-albumina 4.3%; albumina 54.8%; globulina alfa-1 5.9%; globulina alfa-2 8.3%; globulinas beta 15.5%; globulinas gama 11.2%.

  15. [Validating the Spanish version of the Nursing Activities Score].

    Science.gov (United States)

    Sánchez-Sánchez, M M; Arias-Rivera, S; Fraile-Gamo, M P; Thuissard-Vasallo, I J; Frutos-Vivar, F

    2015-01-01

    Validating workload scores ensures that they are appropriate for the purpose for which they were developed. To validate the Nursing Activities Score (NAS) Spanish version. Observational and prospective study. 1,045 patients who were admitted to a medical-surgical unit and a serious burns unit in 2006 were included. The nurse in charge assessed patient workloads by Nine Equivalent of Nursing Manpower use Score and NAS. To assess the internal consistency of the measurements of NAS, item-test correlations, Cronbach's α and Cronbach's α corrected by omitting each of the items were calculated. The intraobserver and interobserver reliability were assessed with the intraclass correlation coefficient by viewing recordings and Kappa (interobserver reliability) was estimated. For the analysis of internal validity, a factorial principal components analysis was performed. Convergent validity was assessed using the Spearman correlation coefficient values obtained from the Nine Equivalent of Nursing Manpower use Score and Spanish-NAS scales. For internal consistency, 164 questionnaires were analysed and a Cronbach's α of 0.373 was calculated. The intraclass correlation coefficient for intraobserver reliability estimate was 0.837 (95% IC: 0.466-0.950) and 0.662 (95% IC: 0.033-0.882) for interobserver reliability. The estimated kappa was 0.371. For internal validity, exploratory factor analysis showed that the first item explained 58.9% of the variance of the questionnaire. For convergent validity 1006 questionnaires were included and a Spearman correlation coefficient of 0.746 was observed. The psychometric properties of Spanish-NAS are acceptable. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  16. Assessment of the Item Selection and Weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

    Science.gov (United States)

    MAHR, ALFRED D.; NEOGI, TUHINA; LAVALLEY, MICHAEL P.; DAVIS, JOHN C.; HOFFMAN, GARY S.; MCCUNE, W. JOSEPH; SPECKS, ULRICH; SPIERA, ROBERT F.; ST.CLAIR, E. WILLIAM; STONE, JOHN H.; MERKEL, PETER A.

    2013-01-01

    Objective To assess the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) with respect to its selection and weighting of items. Methods This study used the BVAS/WG data from the Wegener's Granulomatosis Etanercept Trial. The scoring frequencies of the 34 predefined items and any “other” items added by clinicians were calculated. Using linear regression with generalized estimating equations in which the physician global assessment (PGA) of disease activity was the dependent variable, we computed weights for all predefined items. We also created variables for clinical manifestations frequently added as other items, and computed weights for these as well. We searched for the model that included the items and their generated weights yielding an activity score with the highest R2 to predict the PGA. Results We analyzed 2,044 BVAS/WG assessments from 180 patients; 734 assessments were scored during active disease. The highest R2 with the PGA was obtained by scoring WG activity based on the following items: the 25 predefined items rated on ≥5 visits, the 2 newly created fatigue and weight loss variables, the remaining minor other and major other items, and a variable that signified whether new or worse items were present at a specific visit. The weights assigned to the items ranged from 1 to 21. Compared with the original BVAS/WG, this modified score correlated significantly more strongly with the PGA. Conclusion This study suggests possibilities to enhance the item selection and weighting of the BVAS/WG. These changes may increase this instrument's ability to capture the continuum of disease activity in WG. PMID:18512722

  17. Physical activity, stress, and metabolic risk score in 8- to 18-year-old boys.

    Science.gov (United States)

    Holmes, Megan E; Eisenmann, Joey C; Ekkekakis, Panteleimon; Gentile, Douglas

    2008-03-01

    We examined whether physical activity modifies the relationship between stress and the metabolic risk score in 8- to 18-year-old males (n = 37). Physical activity (PA) and television (TV)/videogame (VG) use were assessed via accelerometer and questionnaire, respectively. Stress was determined from self-report measures. A metabolic risk score (MRS) was created by summing age-standardized residuals for waist circumference, mean arterial pressure, glycosylated hemoglobin, and high-density lipoprotein cholesterol. Correlations between PA and MRS were low (r adolescents.

  18. Increased Kappa/Lambda Hybrid Antibody in Serum Is a Novel Biomarker Related to Disease Activity and Inflammation in Rheumatoid Arthritis.

    Science.gov (United States)

    Yi, Lang; Hao, Mingju; Lu, Tian; Lin, Guigao; Chen, Lida; Gao, Ming; Fan, Gaowei; Zhang, Dong; Wang, Guojing; Yang, Xin; Li, Yulong; Zhang, Kuo; Zhang, Rui; Han, Yanxi; Wang, Lunan; Li, Jinming

    2016-01-01

    The κ/λ hybrid antibodies in normal human serum were reported recently, but their clinical relevance has not yet been explored. Rheumatoid arthritis (RA) is one of the major joint diseases, and the early diagnosis and treatment of RA remain a challenge. Here, we developed a double-sandwich enzyme-linked immunosorbent assay system to quantify relative serum κ/λ hybrid antibody levels in RA patients, osteoarthritis (OA) patients, and healthy controls (HC) in order to assess their potential use as a serological biomarker of early disease and clinical activity and to preliminarily investigate their immunomodulatory roles in RA. Surprisingly, we found that κ/λ hybrid antibody was markedly increased in both early and established RA. Serum κ/λ hybrid antibody levels were significantly correlated with clinical indexes and inflammatory markers in RA. Further analysis showed a positive correlation between κ/λ hybrid antibody levels and the 28-joint disease activity score (DAS28). In conclusion, serum κ/λ hybrid antibodies in RA were identified for the first time. High levels of κ/λ hybrid antibody may be a useful tool in distinguishing early RA from OA and HC. We suggest κ/λ hybrid antibody as a marker for disease activity. The increased κ/λ hybrid antibodies were associated with inflammatory conditions in RA.

  19. The selective estrogen receptor alpha agonist Org 37663 induces estrogenic effects but lacks antirheumatic activity: a phase IIa trial investigating efficacy and safety of Org 37663 in postmenopausal female rheumatoid arthritis patients receiving stable background methotrexate or sulfasalazine.

    Science.gov (United States)

    van Vollenhoven, Ronald F; Houbiers, Jos G A; Buttgereit, Frank; In 't Hout, Joanna; Boers, Maarten; Leij, Susanne; Kvien, Tore K; Dijkmans, Ben A C; Szczepański, Leszek; Szombati, Istvan; Sierakowski, Stanislaw; Miltenburg, André M M

    2010-02-01

    Multiple lines of evidence suggest that sex hormones may play a role in the pathogenesis or clinical expression of rheumatoid arthritis (RA). Studies on the effects of exogenous estrogens in RA patients have yielded contradictory results. We undertook this study to determine the effects of the selective estrogen receptor alpha (ERalpha) agonist Org 37663 in patients with RA, in terms of both its estrogenic effects and its ability to ameliorate disease activity. A 10-week, multicenter, randomized, double-blind, placebo-controlled, parallel group, dose-finding, proof-of-concept trial was initiated to obtain data on the efficacy and safety of Org 37663 in postmenopausal female patients with RA who were receiving background treatment with either methotrexate or sulfasalazine. Patients were randomized to receive placebo or Org 37663 at doses of 4 mg/day, 15 mg/day, or 50 mg/week. The primary efficacy variable was the Disease Activity Score in 28 joints (DAS28). Org 37663 induced a clear biologic, estrogenic response in several organ systems, including a dose-related increase in levels of sex hormone binding globulin. However, the DAS28 decreased similarly for all treatment groups including placebo, indicating lack of clinical efficacy of Org 37663 in this trial. The observed lack of clinical benefit in RA patients treated with an ERalpha agonist, in association with a clear biologic response to the study drug, provides evidence that a biologically relevant ERalpha-mediated estrogenic effect is not associated with a clinically relevant effect on RA symptoms and signs.

  20. Atividades biológicas das lectinas PHA, WGA, jacalina e artocarpina Biological activities of PHA, WGA, jacalin and artocarpin lectins

    Directory of Open Access Journals (Sweden)

    Ana Maria Sell

    2000-05-01

    Full Text Available As lectinas são (glicoproteínas que se ligam a açúcares. O interesse destas moléculas na investigação científica se deve às diversas atividades biológicas a elas atribuídas. Além da identificação de grupos sangüíneos, da caracterização de microorganismos e da estimulação mitogênica de células imunes, as lectinas estão envolvidas nos processos de reconhecimento e das interações celulares. No presente trabalho, revisamos algumas atividades biológicas das lectinas PHA (fitohemaglutinina de Phaseolus vulgaris, WGA (aglutinina de germe de trigo, jacalina e artocarpina (lectinas de Artocarpus integrifolia. PHA, jacalina e artocarpina são mitogênicas para os linfócitos, estimulam a produção de citocinas endógenas, a atração e a ativação de leucócitos. WGA é uma lectina não-mitogênica, no entanto, modula a resposta de defesa estimulando a liberação de superóxido pelos neutrófilos. O entendimento das atividades biológicas permitirá o uso destas moléculas como uma ferramenta útil no diagnóstico e tratamento de muitas doenças.Lectins are ubiquitous (glycoproteins, which exhibit a specific and reversibly carbohydrate binding activity. Because of their structural complexity and variability, they can participate in many physiological functions. Besides the blood groups identification, microorganism characterization and mitogenic immune cell proliferation, they are involved in the cell recognition and cell-cell interaction. In the present work we revised some biological activities of the PHA (Phaseolus vulgaris phytohemagglutinin, WGA (wheat germ agglutinin, jacalin and artocarpin (Artocarpus integrifolia lectins. PHA, jacalin and artocarpin may stimulate lymphocyte proliferation, attract and activate mononuclear cells and stimulate endogenous citokines production. WGA is a nonmitogenic lectin, however it may stimulate neutrophil superoxide production. The understanding of the lectin biological activities may

  1. Convergence Insufficiency Symptom Survey Scores for Reading Versus Other Near Visual Activities in School-Age Children.

    Science.gov (United States)

    Clark, Tiana Y; Clark, Robert A

    2015-11-01

    To measure the difference in Convergence Insufficiency Symptom Survey scores for reading vs favorite near visual activities. Comparative validity analysis of diagnostic tools. At a single clinical private practice, 100 children aged 9-18 with normal binocular vision were recruited to receive either the original survey emphasizing reading or a modified survey replacing "reading" with their favorite near activity. Average survey scores and subscores for questions emphasizing fatigue, discomfort, impaired vision, and cognitive performance were compared using t tests, while responses to individual questions were compared using Mann-Whitney U tests. The average reading survey score was significantly greater than the favorite near activity survey score (14.1 ± 11.5 vs 6.7 ± 5.8, P = .0001). The largest difference resulted from questions emphasizing cognitive performance (subscore 5.8 ± 4.3 vs 2.0 ± 2.1, P = .0000002), although significant differences were also found for fatigue (5.4 ± 3.8 vs 3.0 ± 2.7, P = .0003), discomfort (3.9 ± 4.6 vs 1.8 ± 2.2, P = .004), and impaired vision (3.2 ± 3.9 vs 1.8 ± 2.2, P = .02). Significant differences were found for 7 survey questions, with higher symptom scores for the reading survey in every case. Using survey scores ≥16 to diagnose convergence insufficiency, significantly more children taking the reading survey would have been diagnosed with convergence insufficiency than children taking the favorite near activity survey (19 of 50 [38%] vs 5 of 50 [10%], P = .001). By emphasizing reading, the Convergence Insufficiency Symptom Survey score significantly overestimates near visual symptoms in children with normal binocular vision compared with symptoms caused by preferred near activities that require similar amplitudes of accommodation and convergence. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    DEFF Research Database (Denmark)

    Lukas, C; Braun, J; van der Heijde, D

    2007-01-01

    OBJECTIVE: Magnetic resonance imaging (MRI) of the spine is increasingly important in the assessment of inflammatory activity in clinical trials with patients with ankylosing spondylitis (AS). We investigated feasibility, inter-reader reliability, sensitivity to change, and discriminatory ability...... of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo (n...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered...

  3. S Das

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. S Das. Articles written in Bulletin of Materials Science. Volume 25 Issue 6 November 2002 pp 557-560. 3-D mapping with ellipsometrically determined physical thickness/refractive index of spin coated sol–gel silica layer · S Das P Pal S Roy S Chakraboarty P K Biswas.

  4. The impact of patients reported flares on functional impairment in rheumatoid arthritis patients with low-disease activity

    DEFF Research Database (Denmark)

    Küttel, Dorota Paulina; Christensen, R.; Primdahl, J.

    2015-01-01

    -term outcomes. Objectives: To investigate whether transient patient reported flares can influence functional disability in patients with established low active RA. Methods: Out of 287 patients from the AMBRA trial (1), 268 RA patients with low disease activity (DAS28CRP MCID of 0.22) was compared across three...

  5. Effects of Achieving Target Measures in Rheumatoid Arthritis on Functional Status, Quality of Life, and Resource Utilization: Analysis of Clinical Practice Data.

    Science.gov (United States)

    Alemao, Evo; Joo, Seongjung; Kawabata, Hugh; Al, Maiwenn J; Allison, Paul D; Rutten-van Mölken, Maureen P M H; Frits, Michelle L; Iannaccone, Christine K; Shadick, Nancy A; Weinblatt, Michael E

    2016-03-01

    To evaluate associations between achieving guideline-recommended targets of disease activity, defined by the Disease Activity Score in 28 joints using C-reactive protein level (DAS28-CRP) Clinical Disease Activity Index (CDAI) ≤2.8, and other health outcomes in a longitudinal observational study. Other defined thresholds included low disease activity (LDA), moderate (MDA), or severe disease activity (SDA). To control for intraclass correlation and estimate effects of independent variables on outcomes of the modified Health Assessment Questionnaire (M-HAQ), the EuroQol 5-domain (EQ-5D; a quality-of-life measure), hospitalization, and durable medical equipment (DME) use, we employed mixed models for continuous outcomes and generalized estimating equations for binary outcomes. Among 1,297 subjects, achievement (versus nonachievement) of recommended disease targets was associated with enhanced physical functioning and lower health resource utilization. After controlling for baseline covariates, achievement of disease targets (versus LDA) was associated with significantly enhanced physical functioning based on SDAI ≤3.3 (ΔM-HAQ -0.047; P = 0.0100) and CDAI ≤2.8 (-0.073; P = 0.0003) but not DAS28-CRP measures was associated with enhanced physical functioning and health-related quality of life. Some health outcomes were similar in subjects attaining guideline targets versus LDA. Achieving LDA is a worthy clinical objective in some patients. © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

  6. Bovine CCL28 Mediates Chemotaxis via CCR10 and Demonstrates Direct Antimicrobial Activity against Mastitis Causing Bacteria.

    Directory of Open Access Journals (Sweden)

    Kyler B Pallister

    Full Text Available In addition to the well characterized function of chemokines in mediating the homing and accumulation of leukocytes to tissues, some chemokines also exhibit potent antimicrobial activity. Little is known of the potential role of chemokines in bovine mammary gland health and disease. The chemokine CCL28 has previously been shown to play a key role in the homing and accumulation of IgA antibody secreting cells to the lactating murine mammary gland. CCL28 has also been shown to act as an antimicrobial peptide with activity demonstrated against a wide range of pathogens including bacteria, fungi and protozoans. Here we describe the cloning and function of bovine CCL28 and document the concentration of this chemokine in bovine milk. Bovine CCL28 was shown to mediate cellular chemotaxis via the CCR10 chemokine receptor and exhibited antimicrobial activity against a variety of bovine mastitis causing organisms. The concentration of bovine CCL28 in milk was found to be highly correlated with the lactation cycle. Highest concentrations of CCL28 were observed soon after parturition, with levels decreasing over time. These results suggest a potential role for CCL28 in the prevention/resolution of bovine mastitis.

  7. Das polyzystische Ovarialsyndrom: Im Spannungsfeld von Hormonen und Stoffwechsel

    Directory of Open Access Journals (Sweden)

    Wehr E

    2010-01-01

    Full Text Available Das polyzystische Ovarialsyndrom (PCOS ist eine komplexe Erkrankung und betrifft mindestens 5–10 % aller Frauen. Es ist charakterisiert durch Hyperandrogenismus (klinisch und/oder biochemisch, Oligo- oder Anovulation und polyzystische Ovarien. In der Pathogenese spielt neben der Hyperandrogenämie und der abnormen Gonadotropinsekretion die Insulinresistenz eine zentrale Rolle. Ein genetischer Hintergrund des PCOS wird vermutet, neben verschiedenen Kandidatengenen werden auch genomweite Assoziationsstudien neue Kenntnisse bringen, um in Zukunft sowohl Diagnose als auch Therapie des PCOS zu vereinfachen. Das PCOS bringt ein hohes metabolisches Risiko mit sich, ca. die Hälfte aller betroffenen Frauen ist adipös, viele leiden an Insulinresistenz, Glukosetoleranzstörungen und Diabetes mellitus Typ 2. Weiters sind viele Frauen mit PCOS von unerfülltem Kinderwunsch, Hirsutismus, Akne und androgenetischer Alopezie betroffen. Vor allem Adipositas und Hirsutismus führen zu einer starken psychischen Belastung betroffener Frauen, das Suizidrisiko ist deutlich erhöht. Zur exakten Diagnose des PCOS bedarf es einer genauen Anamnese und körperlichen Untersuchung mit anthropometrischen Messungen und Hirsutismus-Score. Ein Hormonstatus mit Bestimmung von Androgenen ist unerlässlich, ein LHRH-Test kann weitere diagnostische Hinweise liefern. Weiters sollten zur metabolischen Abklärung ein oraler Glukosetoleranztest, eine Messung der Körperfettverteilung und die Bestimmung eines Lipidstatus erfolgen. Therapeutisch ist vor allem bei adipösen Frauen eine Lebensstilintervention am wichtigsten, zusätzlich kommen Insulinsensitizer und orale Kontrazeptiva zum Einsatz. Zusammenfassend ist das PCOS eine extrem häufige Erkrankung mit komplexen Folgen und bedarf einer konsequenten, interdisziplinären individuellen Therapie bei betroffenen Frauen.

  8. CD28 in thymocyte development and peripheral T cell activation in mice exposed to suspended particulate matter

    International Nuclear Information System (INIS)

    Drela, Nadzieja; Zesko, Izabela; Jakubowska, Martyna; Biernacka, Marzena

    2006-01-01

    The CD28:B7 signaling pathway is very important for the activity of mature peripheral T lymphocytes and thymocyte development. The proper development of thymocytes into mature single positive CD4 + and CD8 + T cells is crucial for almost all immune functions. In naturally occurring conditions, T cells maturation in the thymus is influenced by environmental agents. The expression of CD28 and the distribution of CD28 low/high thymocytes have been examined at various stages of thymocyte development in BALB/c mice exposed to air-suspended particulate matter (ASM). Acute exposure to ASM resulted in the decrease of CD28 expression in the total thymocyte population. The increase of the percentage of CD28 low and the decrease of CD28 high thymocytes were observed, which may account for the acceleration of thymocyte development under the conditions of elevated risk resulting from the exposure of animals to environmental xenobiotics. ASM exposure resulted in the increase of the level of proliferation of lymph node T cells induced by anti-CD3 and anti-CD28 monoclonal antibodies activation despite normal expression of CD28 molecule. In contrast, the level of proliferation of spleen T cells was lowered or normal dependently of the concentration of stimuli used for activation. Results of these studies demonstrate that acute exposure of mice to ASM can result in the progression of two contrasting processes in the immune system: upregulation of thymocyte development, which contributes to the maintenance of peripheral T cell pool, and over-activation of lymph node lymphocytes, which may lead to uncontrolled immunostimulation

  9. The Microbial Database for Danish wastewater treatment plants with nutrient removal (MiDas-DK) – a tool for understanding activated sludge population dynamics and community stability

    DEFF Research Database (Denmark)

    Mielczarek, Artur Tomasz; Saunders, Aaron Marc; Larsen, Poul

    2013-01-01

    Since 2006 more than 50 Danish full-scale wastewater treatment plants with nutrient removal have been investigated in a project called ‘The Microbial Database for Danish Activated Sludge Wastewater Treatment Plants with Nutrient Removal (MiDas-DK)’. Comprehensive sets of samples have been collected......, analyzed and associated with extensive operational data from the plants. The community composition was analyzed by quantitative fluorescence in situ hybridization (FISH) supported by 16S rRNA amplicon sequencing and deep metagenomics. MiDas-DK has been a powerful tool to study the complex activated sludge...

  10. Early and sustained efficacy with apremilast monotherapy in biological-naïve patients with psoriatic arthritis: a phase IIIB, randomised controlled trial (ACTIVE).

    Science.gov (United States)

    Nash, Peter; Ohson, Kamal; Walsh, Jessica; Delev, Nikolay; Nguyen, Dianne; Teng, Lichen; Gómez-Reino, Juan J; Aelion, Jacob A

    2018-05-01

    Evaluate apremilast efficacy across various psoriatic arthritis (PsA) manifestations beginning at week 2 in biological-naïve patients with PsA. Patients were randomised (1:1) to apremilast 30 mg twice daily or placebo. At week 16, patients whose swollen and tender joint counts had not improved by ≥10% were eligible for early escape. At week 24, all patients received apremilast through week 52. Among 219 randomised patients (apremilast: n=110; placebo: n=109), a significantly greater American College of Rheumatology 20 response at week 16 (primary outcome) was observed with apremilast versus placebo (38.2% (42/110) vs 20.2% (22/109); P=0.004); response rates at week 2 (first assessment) were 16.4% (18/110) versus 6.4% (7/109) (P=0.025). Improvements in other efficacy outcomes, including 28-joint count Disease Activity Score (DAS-28) using C reactive protein (CRP), swollen joint count, Health Assessment Questionnaire-Disability Index (HAQ-DI), enthesitis and morning stiffness severity, were observed with apremilast at week 2. At week 16, apremilast significantly reduced PsA disease activity versus placebo, with changes in DAS-28 (CRP) (P<0.0001), HAQ-DI (P=0.023) and Gladman Enthesitis Index (P=0.001). Improvements were maintained with continued treatment through week 52. Over 52 weeks, apremilast's safety profile was consistent with prior phase 3 studies in psoriasis and PsA. During weeks 0-24, the incidence of protocol-defined diarrhoea was 11.0% (apremilast) and 8.3% (placebo); serious adverse event rates were 2.8% (apremilast) and 4.6% (placebo). In biological-naïve patients with PsA, onset of effect with apremilast was observed at week 2 and continued through week 52. The safety profile was consistent with previous reports. NCT01925768; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. T helper-independent activation of human CD8+ cells: the role of CD28 costimulation.

    Science.gov (United States)

    Van Gool, S W; Zhang, Y; Kasran, A; de Boer, M; Ceuppens, J L

    1996-07-01

    The concept that activation of MHC class I-restricted CD8+ cells entirely depends on help from MHC class II-restricted CD4+ T cells has recently been supplemented with an alternative model in which CD8+ cells can directly be activated by MHC class I-expressing professional antigen-presenting cells (APC), which are able to deliver an accessory signal. The authors analysed the role of CD28-mediated costimulation for T helper cell-independent activation of purified human CD8+ T cells in two different in vitro models. Freshly isolated CD8+ cells could be activated (proliferation, IL-2 production and cytotoxic activity) by anti-CD3-presenting Fc gamma R+ mouse cells transfected with the human CD28 ligand, CD80, as the only accessory signal. On the other hand, activation of CD8+ cells by allogeneic MHC class I on EBV-transformed B cells, which express two different CD28 ligands, CD80 and CD86, also proceeded very efficiently (proliferation, cytotoxic activity and CD25 expression), but was either not, or only partially, blocked by anti-CD80 and anti-CD86 MoAb or CTLA-4Ig. This indicates that other costimulatory signals are also effective, and that CD28 triggering is not absolutely required for initial T-cell activation. CsA and CD80/CD86-blocking agents were synergistic in completely inhibiting activation of CD8+ cells in the MLR with allogeneic B-cell lines. This combination also induced non-responsiveness of CD8+ cells upon restimulation in the absence of blocking agents. Therefore, although professional APC can apparently provide multiple costimulatory signals for direct activation of CD8+ T cells, the signal derived from CD80/CD86 is unique in providing CsA-resistance.

  12. DAS performance analysis

    International Nuclear Information System (INIS)

    Bates, G.; Bodine, S.; Carroll, T.; Keller, M.

    1984-02-01

    This report begins with an overview of the Data Acquisition System (DAS), which supports several of PPPL's experimental devices. Performance measurements which were taken on DAS and the tools used to make them are then described

  13. Reconhecimento das marcas patrocinadoras dos times de Futebol Brasileiro

    Directory of Open Access Journals (Sweden)

    Giovani Blasi Martino Lanna

    2017-01-01

    Full Text Available Resumo O futebol é uma das maiores paixões dos brasileiros e os fatos que cercam esse esporte são constantemente propagados nos diversos meios de comunicação. A vasta divulgação do esporte desperta o interesse de muitas empresas a querer vincular a sua marca a determinado time de futebol com vistas a maximizar seus retornos de exposição, imagem e vendas. O presente estudo objetivou verificar o reconhecimento das marcas patrocinadoras dos times de futebol brasileiro na percepção dos torcedores. O público alvo do estudo foi composto por estudantes universitários selecionados por amostragem não probabilística por conveniência, totalizando 126 estudantes. A coleta de dados foi realizada por meio de questionário, no mês de junho de 2015, que foi respondido através de entrevista pessoal e individual. Os resultados demonstraram que 28,3% dos respondentes não torcem por nenhum time e 71,7% torcem por algum time. Considerando apenas a parcela dos respondentes que torcem por algum time, 28,9% não reconhecem nenhuma marca patrocinadora do time que torce e 71,1% reconhecem. Observa-se que a maior parcela dos torcedores reconhece as marcas patrocinadoras do time de futebol. Conclui-se que quando o indivíduo torce por algum time de futebol há um reconhecimento considerável das marcas patrocinadoras. ABSTRACT Recognition of sponsoring brands of Brazilian Football teams Football is one of the greatest passions of Brazilians and the facts surrounding this sport are constantly propagated in the media. The wide dissemination of the sport awakens the interest of many companies that want to link their brand to a certain football team in order to maximize your exposure returns, image and sales. This study aimed to verify he recognition of the sponsoring brands of Brazilian football teams in the perception of the fans. The study was composed of college students selected as target for non-probabilistic sampling for convenience, totaling 126

  14. Patient activation in Europe: an international comparison of psychometric properties and patients' scores on the short form Patient Activation Measure (PAM-13).

    Science.gov (United States)

    Rademakers, Jany; Maindal, Helle Terkildsen; Steinsbekk, Aslak; Gensichen, Jochen; Brenk-Franz, Katja; Hendriks, Michelle

    2016-10-12

    To allow better assessment of patients' individual competencies for self-management, the Patient Activation Measure (PAM) has been developed in the USA. Because the American studies have shown the PAM to be a valuable tool, several European countries have translated the instrument into their native languages (Danish, Dutch, German, Norwegian). The aim was to compare the psychometric properties in studies from the different countries and establish whether the scores on the PAM vary between the studies. Data from the four separate studies were subjected to the same data cleaning procedures and statistical analyses. The psychometric properties of the instruments were established with measures of data quality and scale structure. The mean patient activation score and distribution across four predefined activation levels were described and the differences between the four studies were tested with ANOVA (unadjusted and adjusted) followed by a post-hoc Tukey HSD test and the Pearson chi-squared test respectively. The total N of the four studies was 5184. The percentage of missing values was low in all datasets, confirming the good quality of the datasets. Factor analyses revealed moderate to strong factor loadings on the first factor in all datasets. Cronbach's α was high for all version, ranging from .80 (German) to .88 (Dutch). Item-rest correlations varied between .32 and .66, indicating a moderate to strong correlation of the individual items to the sum scale. Both the mean PAM score and the distribution across activation levels differed between the four datasets. After adjustment of the PAM score, patients in Norway in particular had a higher patient activation level. The European translations of PAM-13 (into Danish, Dutch, German and Norwegian) resulted in four instruments with good psychometric capabilities for measuring patient activation. The mean PAM score and the distribution across activation levels differed between the four datasets.

  15. Power of national economy, disease control and employment status in patients with RA-an analytical multi-site ecological study.

    Science.gov (United States)

    Pieringer, Herwig; Puchner, Rudolf; Pohanka, Erich; Danninger, Kathrin

    2016-02-01

    In rheumatology, sufficient disease control is a central part of the treatment concept. However, modern treatment strategies are associated with a substantial economic burden for health care systems. Ecological studies offer the unique opportunity to analyse differences between groups as well as group level effects. In the present analytical multi-site ecological study, we investigated whether more powerful national economies as measured by the gross domestic product per capita (GDPpc) are associated with better disease control in RA patients as measured by the disease activity score 28 (DAS28). We used aggregated data on RA patients from the recently published COMORA study as well as the World Health Organization database. There was a strong negative correlation between DAS28 and GDPpc (r = -0.815; p = 0.0002). Adjustment for sex, smoking status, disease duration or current employment status did not significantly change this association. There was a strong, negative correlation between DAS28 and age (r = -0.870; p < 0.001) and a strong, positive correlation between GDPpc and age (r = 0.737; p = 0.002). Adjustment for age reduced the regression coefficient (DAS28/GDPpc) to -0.000018 (p = 0.054). There was a negative correlation between DAS28 and current employment status (r = -0.642; p = 0.008) and a positive correlation between GDPpc and employment status (r = 0.722; p = 0.002). In conclusion, there is evidence of an association between disease control and GDPpc. This association is alleviated after adjustment for age. Of note, in countries with higher GDPpc, a higher proportion of RA patients are currently employed. This is true despite the fact that RA patients in countries with higher GDPpc are also older.

  16. Combination of Mangifera indica L. extract supplementation plus methotrexate in rheumatoid arthritis patients: a pilot study.

    Science.gov (United States)

    López Mantecón, Ana M; Garrido, Gabino; Delgado-Hernández, René; Garrido-Suárez, Bárbara B

    2014-08-01

    The purpose of the present study was to evaluate the possible therapeutic effects and the safety of Mangifera indica extract (Vimang tablets, 300 mg) combined with methotrexate (MTX) on reducing disease activity in rheumatoid arthritis (RA). Twenty patients with active RA underwent a year of treatment with MTX (12.5 mg/week) associated to non-steroidal anti-inflammatory drugs (NSAIDs) and/or prednisone (5-10 mg/day) were randomly allocated to the experimental group (n=10), that received the extract supplementation (900 mg/day) or preceding usual treatment (n=10) during 180 days. RA activity was evaluated using the tender and swollen joint counts, erythrocyte sedimentation rate, disease activity score-28 (DAS 28), visual analogue scale (VAS) and health assessment questionnaire (HAQ). Treatment's efficacy was demonstrated with ACR criteria. Only the patients of MTX-Vimang group revealed statistically significant improvement in DAS 28 parameters with respect baseline data but no differences were observed between groups. ACR improvements amounted 80% only in MTX-Vimang group at the 90 days (pVimang group, 100% of patients decreased NSAIDs administration (p<0.01) and 70% of those eradicated gastrointestinal side effects (p<0.01) ensuing of the preceding treatment. Other adverse effects were not reported. Copyright © 2013 John Wiley & Sons, Ltd.

  17. VALIDATION OF THE RUSSIAN-LANGUAGE VERSION OF THE RAPID-3 QUESTIONNAIRE

    Directory of Open Access Journals (Sweden)

    A S Starkova

    2011-01-01

    There were high correlations of RAPID-3 values with clinical parameters: the number of swollen joints (R=0.61 and tender joints (R = 0.46, combined DAS 28 indices (R=0.72, simple (R=0.60 and clinical (R=063 disease activity indices (SDAI and CDAI, inflammation activity index (IAI (R=0.62, health assessment questionnaire (HAQ (R=0.64, and quality of life questionnaire (EQ-5D scores (R=0.52. Conclusion. The RAPID-3 index is a reliable, sensitive, and valid tool to evaluate inflammation activity and functional status in patients with RA

  18. [Correlation of RANKL/OPG, dickkopf-1 and bone marrow edema in rheumatoid arthritis with the complaint of knee pain].

    Science.gov (United States)

    Li, Min; Wu, Xiao-hui; Yin, Geng; Xie, Qi-bing

    2015-03-01

    To investigate the correlation of the receptor activator of nuclear factor kappa-B ligand (RANKL)/serum osteoprotegerin (OPG) system, Dickkopf-1 (DKK-1) and bone marrow edema (BME) in rheumatoid arthritis (RA) with the complaint of knee pain. The clinical data of 50 cases of RA with the complaint of knee pain were collected. According to MRI finding, half of them (25 cases) had bone marrow edema (BME). Each patient received the measurement of serum OPG, RANKL, DKK-1, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti cyclic citrullinated peptide antibody (CCP), rheumatoid factort(RF). The clinical symptoms, disease activity score 28 (DAS28), were compared between BME and non-BME griups, and the correlation between RANKL/OPG system, DKK-1 and BME of RA was analyzed. Compared with non BME group, BME group had shorter course (P=0.000), higher DAS28 score (P=0.009), CRP (P=0:000), RF (P=0.033) and CCP (P=0.012). lower level of serum OPG (P=0.000), higher level of RANKL (P=0.000), RANKL/OPG (P=0.000), and DKK-1 (P=0.001). The severity of bone marrow edema was correlated with the serum RANKL (volume r(s)=0.31, P=0.027; degree r(s)=0.33, P=0.022), RANKL/OPG (volume r(s)=0.29, P=0.039; degree r(s)=0.28, P=0.043), DKK-1 (volume r(s)=0.33, P=0.021; degree r(s)=0.34, P=0.019). BME is one of the early signs of bone erosion in RA, there were more active inflammation, autoantibodies, and osteocasts in RA patients with BME.

  19. The 28-day exposure to fenpropathrin decreases locomotor activity and reduces activity of antioxidant enzymes in mice brains.

    Science.gov (United States)

    Nieradko-Iwanicka, Barbara; Borzęcki, Andrzej

    2016-04-01

    Fenpropathrin (Fen) is a pyrethroid (Pyr) insecticide. Pyrs are used in veterinary medicine, in agriculture and for domestic purposes. As their use increases, new questions about their side effects and mode of action in non-target organisms arise. The objective of this work was to characterize dose-response relationship for in vivo motor function and memory in mice exposed to Fen for 28 days and to assess its influence on activity of antioxidant enzymes in mice brains. The experiment was performed using 64 female mice. Fen at the dose of 11.9mg/kg of body mass, 5.95mg/kg or 2.38mg/kg was administered ip to the mice for 28 consecutive days. Motor function and spatial working memory were tested on days 7, 14 and 28. On day 29, the animals were sacrificed and brains were used to determine activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx). Fen significantly decreased locomotor activity in mice receiving the highest dose at every stage of the experiment. Lower doses reduced locomotion on days 7 and 14. Fen did not produce memory impairment. A decrease in activities of SOD and GPx was recorded in mice brains. The decrease of SOD activity in mice brains results from direct inhibition of the enzyme by Fen and/or increased utilization due to excessive free radical formation in conditions of Fen-induced oxidative stress. The reduction in GPx activity is probably due to limited glutathione availability. The reduced locomotor activity is a behavioral demonstration of Fen-induced damage in the dopaminergic system. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  20. Saarland and Rheinland-Pfalz Mines Inspectorate. Annual report 1996. Economic and technical aspects, industrial safety and environmental protection, statistics, activities of the mining authorities; Oberbergamt fuer das Saarland und das Land Rheinland-Pfalz. Jahresbericht 1996. Bergwirtschaft, Bergtechnik, Arbeitsschutz, Umweltschutz, Statistiken, Taetigkeiten der Bergbehoerden

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    The annual report of the Saarland and Rheinland-Pfalz Mines Inspectorate outlines the economic and technical developments in mining in these two German states as well as the activities of the mining authorities in all fields of mining. (orig.) [Deutsch] Der Jahresbericht des Oberbergamtes fuer das Saarland und das Land Rheinland-Pfalz gibt einen Ueberblick zur bergwirtschaftlichen und bergtechnischen Entwicklung in beiden Bundeslaendern und vermittelt einen umfassenden Einblick in die Taetigkeiten der Bergbehoerden in den vielfaeltigen Bergbauzweigen. (orig.)

  1. Evaluation of the Efficacy of Combined Therapy of Methotrexate and Etanercept versus Methotrexate as a Mono-Therapy.

    Science.gov (United States)

    Rexhepi, Sylejman; Rexhepi, Mjellma; Rexhepi, Blerta; Sahatçiu-Meka, Vjollca; Mahmutaj, Vigan

    2018-05-20

    This study aims to evaluate the efficacy of Methotrexate (MTX) alone and combined therapy with Etanercept (ETN) and Methotrexate in patients with active rheumatoid arthritis (RA). In the randomised control study, conducted in the period from March 2014 until March 2016, we evaluated the efficacy of the treatment of patients with RA with MTX as monotherapy and combination treatment with MTX and ETN. In the Clinic of Rheumatology in Prishtina, 90 adult patients with RA were treated in combination with ETN (doses of 50 mg subcutaneously/weekly), with oral MTX (doses up to 20 mg weekly), and MTX alone (doses up to 20 mg weekly) during this period of two years. Clinical response was assessed using European League against Rheumatism (EULAR)/American College of Rheumatology (ACR) Criteria and the Disease Activity Score (DAS28). Radiographic changes were measured in the beginning and at the end of the study using Larsen's method. Of the cohort groups of 90 patients, mean age of 55.63, 15 patients, (16.6 %) were treated with combined therapy (ETN plus MTX) and 75 patients (83.3%) with monotherapy (MTX). After two years of treatment the group with combined therapy resulted with improvement of acute phase reactants as erythrocyte sedimentation rate (ESR) for the first hour (41.1 vs. 10.3 mm/hour) and C - reactive protein (CRP) (40.8 vs. 6 mg/liter), and compared to the group treated with monotherapy, there were no significant changes (ESR: 45.7 vs 34.3 mm/hour; CRP: 48 vs 24 mg/liter). Before the treatment, the severity of the disease was high, wherein the group with combined therapy DAS28 was 5.32, compared to the monotherapy group whom DAS28 was 5.90. After 2 years of treatment, we had significant changes in the results of DAS28, wherein the group treated with ETN plus MTX DAS28 was 2.12 ± 0.15, while in the group of patients treated with MTX DAS28 were 3.75 ± 0.39 (t = 13.03; df = 58; p < 0.0001). The group with combined therapy showed no evidence of radiographic

  2. Plantas medicinais e seus usos pelos sitiantes da Reserva Rio das Pedras, Mangaratiba, RJ, Brasil Medicinal plants and its uses by the ranchers from the Rio das Pedras Reserve, Mangaratiba, RJ, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Franco Trindade Medeiros

    2004-06-01

    Full Text Available Os sitiantes que residem na Reserva Rio das Pedras, localizada no município de Mangaratiba, Estado do Rio de Janeiro, têm origem nos meeiros que trabalhavam nas plantações de banana da antiga fazenda Goiabal. Atualmente, esta fazenda corresponde ao Club Méditerranée, na cota próxima ao oceano Atlântico e à Reserva Rio das Pedras, acima da Rodovia Rio/Santos (BR-101, sendo um remanescente de Floresta Ombrófila Densa no Estado. O objetivo deste estudo foi resgatar informações sobre o uso de plantas medicinais pelos sitiantes que ainda residem nesta Reserva. Através de entrevistas estruturadas e semi-estruturadas aplicadas junto à comunidade, pôde-se fazer um levantamento das plantas presentes ao redor das casas dos mesmos. Ao todo foram citadas 36 espécies medicinais, distribuídas em 34 gêneros e 25 famílias. Estas espécies estão relacionadas a 28 usos medicinais, organizados em sete categorias. Predominaram espécies de plantas herbáceas (21 spp. seguidas das arbustivas (oito spp. e arbóreas (cinco spp.. Constatou-se que a folha foi a parte mais utilizada e o modo de preparo do remédio foi o decocto. Quantificou-se o número de citações por informante para cada táxon, possibilitando a indicação das espécies mais utilizadas na área, como a erva-de-santa-maria (Chenopodium ambrosioides L. e a pitanga (Eugenia uniflora L..The ranchers who live in Rio das Pedras Reserve, which lies in Mangaratiba County, State of Rio da Janeiro, came from sharecroppers who worked at the banana plantation of the farmer Goiabal farm. Nowadays, that farm corresponds to the Méditerranée Club in the area next to the Atlantic Ocean and to Rio das Pedras Reservation, above the Rio/Santos highway (BR-101, it is a remainder of the Dense Ombrophylous Forest in the State. The aim of this study was to collect information about the use of medicinal plants by the ranchers who still live in that Reservation. A survey of the plants, which could be

  3. A regulação judicial das responsabilidades parentais: Direito e ciência em (inter)ação

    OpenAIRE

    Casaleiro, Paula

    2013-01-01

    As transformações do regime de regulação das responsabilidades parentais, como a adoção de critérios legais indeterminados, e a entrada em vigor da Lei n.º 133/99, de 28 de agosto, que introduziu a assessoria técnica complementar, estreitaram a relação do direito e da justiça de família e das crianças com outros saberes, como o serviço social, a medicina ou a psicologia. No presente artigo analisar-se-á o regime de regulação judicial das responsabilidades parentais e a sua aplicação prática, ...

  4. Prevalence of mabDAS-1 positivity in biopsy specimens from the esophagogastric junction.

    Science.gov (United States)

    Rogge-Wolf, Claudia; Seldenrijk, Cornelis A; Das, Kiron M; Timmer, Robin; Breumelhof, Ronald; Smout, André J P M; Amenta, Peter S; Griffel, Louis H

    2002-12-01

    Intestinal metaplasia (IM) is a precursor for malignancies at the esophagogastric junction. A monoclonal antibody, mAbDAS-1, can probably identify cellular characteristics of IM before the appearance of goblet cells. The aim of this study was to examine the prevalence of mAbDAS-1 positivity in biopsies from the squamocolumnar junction (SCJ) and to correlate this positivity with the presence of IM and clinical findings. In 559 patients, reflux symptoms were scored, and the presence of reflux esophagitis and hiatus hernia was evaluated during endoscopy. Two biopsy specimens were obtained from the SCJ. In a subset of patients (n = 99), biopsies from the endoscopically defined cardiac region (2 cm distal to proximal margin of gastric folds) were available. Biopsy specimens were stained with hematoxylin and eosin, Alcian Blue, modified Giemsa, and mAbDAS-1. mAbDAS-1 positivity was observed in the SCJ biopsies of 201 of 486 (41.4%) patients without IM and in 64 of 73 (87.7%) patients with IM. Patients without IM but with antibody positivity showed similar histological characteristics as patients with IM at the SCJ. Biopsies of 123 of 559 patients (22%) revealed a columnar-cuboidal epithelium, which was found to be mAbDAS-1 positive in 64.2% (77 of 123). Tissue specimens from the cardiac region without IM stained positive in 14.2% (13 of 91), 12 of those also stained at the SCJ. In patients without IM, a high prevalence of mAbDAS-1 positivity was observed. Biopsies of these patients showed similar histological characteristics as patients with IM. Although not all patients exhibiting this reactivity may develop IM, mAbDAS-1 reactivity may help in the understanding of the histogenesis of IM at the SCJ.

  5. Sleep quality and correlates of poor sleep in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine Bjerre; Esbensen, Bente Appel; Jennum, Poul

    2015-01-01

    The objective of this study is to examine sleep quality and correlates of poor sleep in patients with rheumatoid arthritis (RA). Five hundred patients with RA were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Sleep quality and disturbances were...... assessed using the Pittsburgh Sleep Quality Index (PSQI). Other instruments included the Multidimensional Fatigue Inventory, the Epworth Sleepiness Scale, and the Health Assessment Questionnaire. Disease activity was assessed according to disease activity score DAS28-CRP-based. Complete scores on PSQI were...... obtained from 384 patients (77 %). In those, the prevalence of poor sleep (PSQI >5) was 61 %, and the mean global PSQI score was 7.54 (SD 4.17). A linear association was found between poor sleep and mental fatigue, reduced activity related to fatigue, physical fatigue, and general fatigue. Mental fatigue...

  6. USE OF MULTIPARAMETER ANALYSIS OF LABORATORY BIOMARKERS TO ASSESS RHEUMATOID ARTHRITIS ACTIVITY

    Directory of Open Access Journals (Sweden)

    A. A. Novikov

    2015-01-01

    Full Text Available The key component in the management of patients with rheumatoid arthritis (RA is regular control of RA activity. The quantitative assessment of a patient’s status allows the development of standardized indications for anti-rheumatic therapy.Objective: to identify the laboratory biomarkers able to reflect RA activity.Subjects and methods. Fifty-eight patients with RA and 30 age- and sex-matched healthy donors were examined. The patients were divided into high/moderate and mild disease activity groups according to DAS28. The serum concentrations of 30 biomarkers were measured using immunonephelometric assay, enzyme immunoassay, and xMAP technology.Results and discussion. Multivariate analysis could identify the factors mostly related to high/moderate RA activity according to DAS28, such as fibroblast growth factor-2, monocyte chemoattractant protein-1, interleukins (IL 1α, 6, and 15, and tumor necrosis factor-α and could create a prognostic model for RA activity assessment. ROC analysis has shown that this model has excellent diagnostic efficiency in differentiating high/moderate versus low RA activity.Conclusion. To create a subjective assessment-independent immunological multiparameter index of greater diagnostic accuracy than the laboratory parameters routinely used in clinical practice may be a qualitatively new step in assessing and monitoring RA activity.

  7. Exercise dependence score in patients with longstanding eating disorders and controls: the importance of affect regulation and physical activity intensity.

    Science.gov (United States)

    Bratland-Sanda, Solfrid; Martinsen, Egil W; Rosenvinge, Jan H; Rø, Oyvind; Hoffart, Asle; Sundgot-Borgen, Jorunn

    2011-01-01

    To examine associations among exercise dependence score, amount of physical activity and eating disorder (ED) symptoms in patients with longstanding ED and non-clinical controls. Adult female inpatients (n = 59) and 53 age-matched controls participated in this cross sectional study. Assessments included the eating disorders examination, eating disorders inventory, exercise dependence scale, reasons for exercise inventory, and MTI Actigraph accelerometer. Positive associations were found among vigorous, not moderate, physical activity, exercise dependence score and ED symptoms in patients. In the controls, ED symptoms were negatively associated with vigorous physical activity and not correlated with exercise dependence score. Exercise for negative affect regulation, not weight/appearance, and amount of vigorous physical activity were explanatory variables for exercise dependence score in both groups. The positive associations among exercise dependence score, vigorous physical activity and ED symptoms need proper attention in the treatment of longstanding ED. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

  8. Increased Kappa/Lambda Hybrid Antibody in Serum Is a Novel Biomarker Related to Disease Activity and Inflammation in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Lang Yi

    2016-01-01

    Full Text Available The κ/λ hybrid antibodies in normal human serum were reported recently, but their clinical relevance has not yet been explored. Rheumatoid arthritis (RA is one of the major joint diseases, and the early diagnosis and treatment of RA remain a challenge. Here, we developed a double-sandwich enzyme-linked immunosorbent assay system to quantify relative serum κ/λ hybrid antibody levels in RA patients, osteoarthritis (OA patients, and healthy controls (HC in order to assess their potential use as a serological biomarker of early disease and clinical activity and to preliminarily investigate their immunomodulatory roles in RA. Surprisingly, we found that κ/λ hybrid antibody was markedly increased in both early and established RA. Serum κ/λ hybrid antibody levels were significantly correlated with clinical indexes and inflammatory markers in RA. Further analysis showed a positive correlation between κ/λ hybrid antibody levels and the 28-joint disease activity score (DAS28. In conclusion, serum κ/λ hybrid antibodies in RA were identified for the first time. High levels of κ/λ hybrid antibody may be a useful tool in distinguishing early RA from OA and HC. We suggest κ/λ hybrid antibody as a marker for disease activity. The increased κ/λ hybrid antibodies were associated with inflammatory conditions in RA.

  9. Spatial arrangement and functional role of α subunits of proteasome activator PA28 in hetero-oligomeric form

    Energy Technology Data Exchange (ETDEWEB)

    Sugiyama, Masaaki, E-mail: sugiyama@rri.kyoto-u.ac.jp [Research Reactor Institute, Kyoto University, Osaka 590-0494 (Japan); Sahashi, Hiroki [Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya 467-8603 (Japan); Kurimoto, Eiji [Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya 467-8603 (Japan); Faculty of Pharmacy, Meijo University, Nagoya 468-8503 (Japan); Takata, Shin-ichi [J-PARC Center, Japan Atomic Energy Agency, Ibaraki 319-1195 (Japan); Yagi, Hirokazu; Kanai, Keita; Sakata, Eri [Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya 467-8603 (Japan); Minami, Yasufumi [Department of Biotechnology, Maebashi Institute of Technology, Gunma 371-0816 (Japan); Tanaka, Keiji [Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506 (Japan); Kato, Koichi, E-mail: kkatonmr@ims.ac.jp [Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya 467-8603 (Japan); Okazaki Institute for Integrative Bioscience, National Institutes of Natural Sciences, Okazaki, Aichi 444-8787 (Japan); Institute for Molecular Science, National Institutes of Natural Sciences, Okazaki, Aichi 444-8787 (Japan)

    2013-03-01

    Highlights: ► Homologous α and β subunits are alternatively arranged in the PA28 heptameric ring. ► The flexible loops of the three α subunits surround the site of substrate entry. ► The loops serve as gatekeepers that selectively hinder passage of longer peptides. - Abstract: A major form of proteasome activator PA28 is a heteroheptamer composed of interferon-γ-inducible α and β subunits, which share approximately 50% amino acid identity and possess distinct insert loops. This activator forms a complex with the 20S proteasome and thereby stimulates proteasomal degradation of peptides in an ATP-independent manner, giving rise to smaller antigenic peptides presented by major histocompatibility complex class I molecules. In this study, we performed biophysical and biochemical characterization of the structure and function of the PA28 hetero-oligomer. Deuteration-assisted small-angle neutron scattering demonstrated three α and four β subunits are alternately arranged in the heptameric ring. In this arrangement, PA28 loops surround the central pore of the heptameric ring (site for peptide entry). Activating the 20S proteasome with a PA28 mutant that lacked the α subunit loops cleaved model substrates longer than a nonapeptide with better efficiency when compared to wild-type PA28. Based on these data, we hypothesize that the flexible PA28 loops act as gatekeepers, which function to select the length of peptide substrates to be transported between the proteolytic chamber and the extra-proteasomal medium.

  10. Atividades antioxidante, antinociceptiva e anti-inflamatória das folhas de Mucuna pruriens (L. DC Antioxidant, antinociceptive and anti-inflammatory activity of Mucuna pruriens (L. DC. leaves

    Directory of Open Access Journals (Sweden)

    E.V.S. Motta

    2013-01-01

    Full Text Available A espécie Mucuna pruriens (L. DC. (Fabaceae é popularmente conhecida no Brasil como "café berão" e "pó de mico". Suas sementes são bastante estudadas sendo empregadas na medicina popular para o tratamento de desordens nervosas e do aparelho reprodutor, porém poucas informações sobre a composição química e atividade farmacológica das folhas dessa espécie são descritas na literatura. Assim, os objetivos desse estudo foram: a determinação do perfil fitoquímico, a avaliação da atividade antioxidante in vitro, e a avaliação das atividades anti-inflamatória e antinociceptiva in vivo do extrato metanólico das folhas de M. pruriens nas concentrações de 100 e 300 mg/kg. O estudo fitoquímico foi realizado por meio da pesquisa qualitativa dos constituintes químicos e determinação quantitativa do teor de fenóis totais e flavonoides. O potencial antioxidante foi avaliado pelos métodos do DPPH e poder de redução. As atividades anti-inflamatória e antinociceptiva foram a ante foi promissor, com CI50 de 13,2∝g/mL pelo método do DPPH, e CE50 de 47,9∝g/mL pelo método que avalia o poder de redução. Em relação à atividade anti-inflamatória, o extrato foi capaz de inibir o edema de orelha em 63% (100mg/kg e 28% (300mg/kg. Quanto à atividade antinociceptiva, houve redução do número de contorções abdominais de 64% (100 mg/kg e 69% (300 mg/kg. Estes resultados indicam que M. pruriens apresenta um potencial farmacológico promissor e reforçam o conceito de que a pesquisa de plantas com usos etnofarmacológicos pode revelar um número substancial de respostas em ensaios in vitro e in vivo.The species Mucuna pruriens (L. DC. (Fabaceae is popularly known in Brazil as "café berão" and "pó de mico". Its seeds have been widely studied and used in folk medicine for the treatment of nervous and reproductive system disorders; however, few studies are related to the chemical composition and pharmacological activity of its

  11. P K Das

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. P K Das. Articles written in Bulletin of Materials Science. Volume 23 Issue 4 August 2000 pp 249-253 Nitride Ceramics. Optimization of time–temperature schedule for nitridation of silicon compact on the basis of silicon and nitrogen reaction kinetics · J Rakshit P K Das.

  12. Auditory short-term memory activation during score reading.

    Science.gov (United States)

    Simoens, Veerle L; Tervaniemi, Mari

    2013-01-01

    Performing music on the basis of reading a score requires reading ahead of what is being played in order to anticipate the necessary actions to produce the notes. Score reading thus not only involves the decoding of a visual score and the comparison to the auditory feedback, but also short-term storage of the musical information due to the delay of the auditory feedback during reading ahead. This study investigates the mechanisms of encoding of musical information in short-term memory during such a complicated procedure. There were three parts in this study. First, professional musicians participated in an electroencephalographic (EEG) experiment to study the slow wave potentials during a time interval of short-term memory storage in a situation that requires cross-modal translation and short-term storage of visual material to be compared with delayed auditory material, as it is the case in music score reading. This delayed visual-to-auditory matching task was compared with delayed visual-visual and auditory-auditory matching tasks in terms of EEG topography and voltage amplitudes. Second, an additional behavioural experiment was performed to determine which type of distractor would be the most interfering with the score reading-like task. Third, the self-reported strategies of the participants were also analyzed. All three parts of this study point towards the same conclusion according to which during music score reading, the musician most likely first translates the visual score into an auditory cue, probably starting around 700 or 1300 ms, ready for storage and delayed comparison with the auditory feedback.

  13. Crianças com fenilcetonúria: avaliação audiológica básica e supressão das otoemissões Children with phenylketonuria: basic audiological evaluation and suppression of otoacoustic emissions

    Directory of Open Access Journals (Sweden)

    Patrícia Souza Ribeiro

    2012-01-01

    Full Text Available OBJETIVO: Avaliar a via auditiva de crianças com fenilcetonúria tratadas precocemente, por meio de audiometria, imitanciometria e supressão das emissões otoacústicas transientes. MÉTODOS:Estudo prospectivo transversal comparativo com amostra composta por 28 crianças, sendo 12 com fenilcetonúria e 16 sem a doença. Foi realizada a pesquisa dos limiares de audibilidade por via aérea e óssea, logoaudiometria, imitanciometria e supressão das emissões otoacústicas transientes. RESULTADOS: A audiometria e a logoaudiometria estiveram normais em todos os participantes. Foram encontrados piores resultados para o índice de reconhecimento de fala (IRF no grupo com fenilcetonúria. A imitanciometria revelou curva normal para todas as crianças, mas a pesquisa dos reflexos estapedianos demonstrou que as crianças do grupo com fenilcetonúria apresentaram aumento nos seus limiares nas frequências de 2 e 4 kHz. A supressão das emissões otoacústicas transientes não revelou diferença na comparação entre os grupos. CONCLUSÃO: A avaliação audiológica básica não identifica alterações na audição das crianças com fenilcetonúria, mas há pior discriminação ao IRF e aumento nos limiares de reflexos estapedianos nessas crianças, podendo indicar distúrbios do processamento auditivo. O estudo da supressão das otoemissões demonstra integridade do sistema eferente olivococlear medial nas crianças com fenilcetonúria.PURPOSE: To evaluate the auditory pathways of children with early-treated phenylketonuria through audiometry, immitance tests, and suppression of transient otoacoustic emissions. METHODS: Prospective cross-sectional study with sample composed by 28 children: 12 with phenylketonuria and 16 without the disease. Participants underwent auditory evaluations composed of air- and bone-conduction pure-tone audiometry, speech audiometry, immittance tests and suppression of transient otoacoustic emissions. RESULTS: All participants

  14. P Chaitanya Das

    Indian Academy of Sciences (India)

    P Chaitanya Das G Srinivasa Murthy C P Gopalakrishnan P C Deshmukh · More Details Fulltext PDF. Volume 9 Issue 7 July 2004 pp 77-85 Classroom. Motion of Charged Particles in Electromagnetic Fields and Special Theory of Relativity · P Chaitanya Das G Srinivasa Murthy P C Deshmukh K Satish Kumar T A Venkatesh.

  15. S K Das

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. S K Das. Articles written in Bulletin of Materials Science. Volume 24 Issue 4 August 2001 pp 373-378 Metals and Alloys. Evaluation of solid–liquid interface profile during continuous casting by a spline based formalism · S K Das · More Details Abstract Fulltext PDF. A numerical ...

  16. Validity and responsiveness of a self-administered foot evaluation questionnaire in rheumatoid arthritis.

    Science.gov (United States)

    Yano, Koichiro; Ikari, Katsunori; Ochi, Kensuke; Ishida, Osamu; Sakuma, Yu; Yoshida, Shinji; Koyama, Takuma; Koenuma, Naoko; Momohara, Shigeki

    2015-05-01

    A self-administered foot evaluation questionnaire (SAFE-Q) was developed by the Japanese Society for Surgery of the Foot (JSSF). The aim of this study is to evaluate the validity and responsiveness of the SAFE-Q in patients with rheumatoid arthritis (RA). In total, 180 patients with RA answered the SAFE-Q. Of 180 patients, 34 answered the SAFE-Q twice, preoperatively and postoperatively, to assess responsiveness. Construct validity was tested by comparing the 5 SAFE-Q subscales and the JSSF standard rating system for the RA foot and ankle scale (JSSF-RA), a Japanese version of the Health Assessment Questionnaire (JHAQ), disease activity score in 28 joints (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI). Responsiveness was examined by calculating the standardized response mean (SRM) and effect size (ES) 3 months after surgery. There were moderate correlations between the SAFE-Q and the JSSF-RA and JHAQ. Conversely, a low correlation was observed between the SAFE-Q and DAS28, SDAI, and CDAI. The responsiveness was high, with an SRM of 0.9 and ES of 0.7 for pain subscales. SAFE-Q is a useful tool for assessing the foot and ankle in RA patients.

  17. EVALUATION OF A DECRESE IN WORK PRODUCTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Olga Yuryevna Vakulenko

    2013-01-01

    Full Text Available Objective. To study the association between the clinical manifestations and work ability in patients with rheumatoid arthritis (RA and to elaborate mathematical methods for predicting work productivity indicators according to the evaluation of the functional status of patients and disease activity.Material and Methods. A total of 185 RA patients were examined; 105 of them were employed. The mean age was 48.2±11.3 years; RA duration was 77.9±70.7 months; DAS28 4.68±1.53; visual analogue scale (VAS score was 40.6±22.2; HAQ was 1.3±0.7. The employed patients in the test group had a longer duration but weaker activity of RA according to DAS28 as compared to those in the control group (p<0.05. The WPAI indicators in the test and control groups, respectively, were as follows: presenteeism – 39.0±26.3 vs. 57.9±16.8%; total productivity decrease (TPD – 54.6±34.1 vs. 65.2±23.3%; daily activity (DA – 52.3±26.3 vs. 55.3±14.8%. The multiple regression method was used to create prognostic equations. A significant divergence of the distribution of absenteeism rates from the normal distribution prevented selection of regression equations.Results. HAQ, VAS pain, and DAS28 turned out to be optimal for selecting equations. The Spearman correlation coefficients with WPAI indicators were higher than 0.4 in all the cases. The following prognostic equations were obtained:Presenteeism (% = 0.66 + 11.31 • HAQ + 0.44 • VAS pain + 2.17 • DAS28 (R2 = 0.46, TPD (% = 8.53 + 3.90 • HAQ + 0.47 • VAS pain + 4.73 • DAS28 (R2 = 0.28, DA (% = 11.27 + 11.87 • HAQ + 0.36 • VAS pain + 1.96 • DAS28 (R2 = 0.44.Verification of the predicted WPAI values using the data of an additional group has demonstrated the coincidence of the predicted and actual values for presenteeism and TPD. However, the correlation coefficient between the predicted and actual presenteeism indicators was considerably higher (0.68 vs. 0.51. The predicated DA differed

  18. The Effectiveness of Aquatic Exercises in the Treatment of Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Tuncay Çakır

    2014-04-01

    Full Text Available Objective: Rheumatoid Arthritis (RA is a chronic destructive inflammatory disorder. This study is aimed to investigate the effects of balneotherapy and aquatherapy in the treatment of RA patients. Materials and Methods: A total of 59 patients who fulfilled the American College of Rheumatology diagnostic criteria for RA were included this study. Patients were randomly assigned into three groups. Group 1 (n=20 received balneotherapy, group 2 (n=20 received an aquatic exercise program and group 3 (n=19 was accepted as control group. These programs were applied five times a week, over three weeks (15 sessions. Patients were evaluated for clinical and laboratory parameters. Clinical parameters included pain,duration of morning stiffness, number of swollen and tender joints, disease activity score (DAS28, Modified health assessment questionnaire (mHAQ, physician’s and patient’s global assessment and hand grip strength. Laboratory evaluation included erythrocyte sedimentation rate(ESR and C-reactive protein (CRP. The assessment parameters were measured before, at the end of and after 3 months of the therapy. Results: The mean age of the patients was 54±10.7 (25-75 years and the mean disease duration was 122.3±98.1 (1-424 months. In aquatic exercise group we observed an improvement in DAS28 scores (p0.05. Conclusion: This study shows that aquatic exercise program is beneficial in the management of DAS28, pain, HAQ parameters and should be taken in to consideration in planning exercise therapy for RA patients. (Turkish Journal of Osteoporosis 2014;20: 10-5

  19. Simultaneous Treatment with Subcutaneous Injection of Golimumab and Intra-articular Injection of Triamcinolone Acetonide (K-Method in Patients with Rheumatoid Arthritis Undergoing Switching of Biologics: Retrospective Case–Control Study

    Directory of Open Access Journals (Sweden)

    Katsuaki Kanbe

    2016-01-01

    Full Text Available Background Tight control of severe rheumatoid arthritis (RA in patients with high disease activity, even when using biologics, is sometimes difficult using a treat-to-target strategy. Switching from one biologic to another is associated with lower efficacy than that in treatment-naive cases. We developed the K-method that involves simultaneous treatment with golimumab and intra-articular joint injection of triamcinolone acetonide (TA in patients undergoing switching of biologics. We performed this retrospective case–control study to investigate the efficacy of achieving an immediate treatment response using the K-method. Methods This study involved 20 patients with RA (control group, 10 patients; K-method group, 10 patients. Patients in the control group were switched to golimumab from other biologics without intra-articular injection of TA. The K-method involved injection of 1 mL of TA (40 mg/mL and 2 mL of 1% lidocaine hydrochloride into swollen or painful joints on the same day as golimumab treatment. A quick response one day after treatment was compared between the two groups according to the disease activity score 28 based on C-reactive protein (DAS28 CRP, clinical disease activity index (CDAI, simplified disease activity index (SDAI, European League Against Rheumatism (EULAR response, and remission rate. These parameters were investigated for 24 weeks. Results The K-method group showed significant improvements in DAS28 CRP, CDAI, and SDAI at one day, 12 weeks, and 24 weeks compared with the control group. The number of swollen and tender joints and the patient and doctor global visual analog scale scores were also significantly different between the two groups. The remission rates based on DAS28 CRP were 30% at one day, 50% at 12 weeks, and 60% at 24 weeks in the K-method group. The EULAR good/moderate response rates were 80% at one day, 90% at 12 weeks, and 90% at 24 weeks in the K-method group; however, these rates were only 10%, 40

  20. O Impacto das Regras do Programa Bolsa Família Sobre a Fecundidade das Beneficiárias

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    Luis Antonio Winck Cechin

    2015-09-01

    Full Text Available Este trabalho investiga um possível incentivo do Programa Bolsa Família ao aumento da fecundidade de suas beneficiárias em decorrência de suas regras, dado que a quantidade de recursos transferidos depende do número de filhos da família. O diferencial deste estudo reside na análise desse impacto em um maior período de exposição das beneficiárias aos efeitos do PBF. Aplica-se o algoritmo de seleção de covariadas proposto por Imbens (2014 e o método de Propensity Score Matching. Os resultados apontaram que o PBF gera pequeno incentivo à geração do segundo filho, sendo que as regiões Centro-Oeste e Nordeste apresentaram os maiores valores de impacto.

  1. B P Das

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. B P Das. Articles written in Bulletin of Materials Science. Volume 25 Issue 6 November 2002 pp 517-519. Structural, dielectric and electrical properties of Sm-modified Pb(SnTi)O3 ferroelectric system · B P Das R N P Choudhary P K Mahapatra · More Details Abstract Fulltext ...

  2. Clinical and radiographic outcome of a treat-to-target strategy using methotrexate and intra-articular glucocorticoids with or without adalimumab induction

    DEFF Research Database (Denmark)

    Hørslev-Petersen, K; Hetland, M L; Ørnbjerg, L M

    2015-01-01

    OBJECTIVES: To study clinical and radiographic outcomes after withdrawing 1 year's adalimumab induction therapy for early rheumatoid arthritis (eRA) added to a methotrexate and intra-articular triamcinolone hexacetonide treat-to-target strategy (NCT00660647). METHODS: Disease-modifying antirheuma......OBJECTIVES: To study clinical and radiographic outcomes after withdrawing 1 year's adalimumab induction therapy for early rheumatoid arthritis (eRA) added to a methotrexate and intra-articular triamcinolone hexacetonide treat-to-target strategy (NCT00660647). METHODS: Disease.......12). Erosive progression (Δerosion score (ES)/year) was year 1:0.57/0.06 (p=0.02); year 2:0.38/0.05 (p=0.005). Proportion of patients without erosive progression (ΔES≤0) was year 1: 59%/76% (p=0.03); year 2:64%/79% (p=0.04). CONCLUSIONS: An aggressive triamcinolone and synthetic DMARD treat-to-target strategy...... was (re)initiated in 12/12 patients and cumulative triamcinolone dose was 160/120 mg (p=0.15). The treatment target (disease activity score, 4 variables, C-reactive protein (DAS28CRP) ≤3.2 or DAS28>3.2 without swollen joints) was achieved at all visits in ≥85% of patients in year 2; remission rates were...

  3. Subclinical atherosclerosis in young patients with rheumatoid arthritis and low disease activity

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    F. Ragni Alunni

    2011-09-01

    Full Text Available Background: There is an increasing body of evidence suggesting that subjects with rheumatoid arthritis (RA are characterized by acceleration of atherosclerotic process of arterial wall. However, all investigations performed so far to evaluate subclinical atherosclerosis in RA included subjects without selection for age and degree of disease activity that may represent confounding factors in such an evaluation. Objectives: To verify signs of accelerated subclinical atherosclerosis in young subject suffering from RA but with low disease activity. Methods: Thirty-two patients with RA and 28 age- and sex-matched control subjects with non-inflammatory rheumatic diseases were enrolled. Inclusion criteria were age less than 60 and low disease activity with score £3.2 according to DAS28, while subjects with traditional risk factors for and/or overt cardiovascular disease were ruled out from the study. Both patients and controls underwent evaluation of carotid and femoral artery intima-media thickness by ultrasounds. Results: Patients had higher intima-media thickness than controls of all the sites evaluated at carodit artery level, whereas there were no differences at the comparison of the superficial and common femoral artery wall. At the univariate analysis, a positive correlation between LDL cholesterol levels and intima-media thickness at the carotid bifurcation was found. Conclusions: Young patients with RA and low disease activity have acceleration of atherosclerosis development as shown by increased intima-media thickness of carotid artery with respect to subjects without inflammatory rheumatic disease. It is conceivable that the organic damage of arterial wall could be the result of persistent endothelial dysfunction induced by chronic inflammation and immune dysregulation which characterize RA.

  4. Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis.

    LENUS (Irish Health Repository)

    Adams, Roisin

    2012-02-01

    BACKGROUND: The growth of economic analyses and in particular cost-utility analyses (CUA), which use the QALY as a measure of outcome, has heightened the interest in the methodologies used to calculate the QALY. The EQ-5D has produced quite different utility values from that of the SF-6D. This article seeks to understand these differences using a cohort of patients with inflammatory arthritis. OBJECTIVE: To examine the relationship between the disease-specific measure, Health Assessment Questionnaire (HAQ) disability index (DI) and the preference-based measures, SF-6D, EQ-5D and European League Against Arthritis (EULAR) Disease Activity Score (DAS) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: Patients with RA and PsA (n = 504) attending a tertiary rheumatology referral centre completed the HAQ, SF-6D and the EQ-5D before starting biological therapy and again 12 months later. The SF-36 was converted into a utility using the preference-based SF-6D. Clinical outcomes such as the DAS, joint counts and laboratory measures were also recorded. We calculated single index utility scores from the preference-based instruments using UK population norms. We used regression analysis to derive a mapping function and calculated utility scores from the HAQDI and the DAS 28. RESULTS: The mean utility observed at baseline for RA was 0.43 for the EQ-5D and 0.54 for the SF-6D and for PsA was 0.49 for the EQ-5D and 0.57 for the SF-6D. The utility gain demonstrated by the EQ-5D was over twice that of the SF-6D. The EQ-5D scored 17% of the RA group as less than 0 (state defined as worse than death); 7% of this group remained less than 0 at follow-up. The distribution of the utility estimates was similar for both RA and PsA. CONCLUSIONS: Our findings draw attention to the impact of states worse than death on the overall distribution for the EQ-5D derived utilities and how these impact on its use in practice. EQ-5D-derived QALY changes are over twice

  5. Genetic parameter estimates among scale activity score and farrowing disposition with reproductive traits in swine.

    Science.gov (United States)

    Schneider, J F; Rempel, L A; Rohrer, G A; Brown-Brandl, T M

    2011-11-01

    The primary objective of this study was to determine if certain behavior traits were genetically correlated with reproduction. If 1 or both of the behavior traits were found to be correlated, a secondary objective was to determine if the behavior traits could be useful in selecting for more productive females. A scale activity score taken at 5 mo of age and a farrowing disposition score taken at farrowing were selected as the behavioral traits. Scale activity score ranged from 1 to 5 and farrowing disposition ranged from 1 to 3. Reproductive traits included age at puberty, number born alive, number born dead, litter birth weight, average piglet birth weight, number weaned, litter weaning weight, average weaning weight, wean-to-estrus interval, ovulation rate including gilts, and postweaning ovulation rate. Genetic correlations between scale activity score and reproduction ranged from -0.79 to 0.61. Three of the correlations, number born alive (P < 0.01), average piglet birth weight (P < 0.001), and wean-to-estrus interval (P = 0.014), were statistically significant but included both favorable and antagonistic correlations. In contrast, all but 1 of the farrowing disposition correlations was favorable and ranged from -0.66 to 0.67. Although only the correlation with litter birth weight was significant (P = 0.018), the consistent favorable direction of all farrowing disposition correlations, except average weaning weight, shows a potential for inclusion of farrowing disposition into a selection program.

  6. Clinical performance of two visual scoring systems in detecting and assessing activity status of occlusal caries in primary teeth

    DEFF Research Database (Denmark)

    Braga, M M; Ekstrand, K R; Martignon, S

    2010-01-01

    This study aimed to compare the clinical performance of two sets of visual scoring criteria for detecting caries severity and assessing caries activity status in occlusal surfaces. Two visual scoring systems--the Nyvad criteria (NY) and the ICDAS-II including an adjunct system for lesion activity...

  7. Novel pandemic influenza A(H1N1 viruses are potently inhibited by DAS181, a sialidase fusion protein.

    Directory of Open Access Journals (Sweden)

    Gallen B Triana-Baltzer

    2009-11-01

    Full Text Available The recent emergence of a novel pandemic influenza A(H1N1 strain in humans exemplifies the rapid and unpredictable nature of influenza virus evolution and the need for effective therapeutics and vaccines to control such outbreaks. However, resistance to antivirals can be a formidable problem as evidenced by the currently widespread oseltamivir- and adamantane-resistant seasonal influenza A viruses (IFV. Additional antiviral approaches with novel mechanisms of action are needed to combat novel and resistant influenza strains. DAS181 (Fludase is a sialidase fusion protein in early clinical development with in vitro and in vivo preclinical activity against a variety of seasonal influenza strains and highly pathogenic avian influenza strains (A/H5N1. Here, we use in vitro, ex vivo, and in vivo models to evaluate the activity of DAS181 against several pandemic influenza A(H1N1 viruses.The activity of DAS181 against several pandemic influenza A(H1N1 virus isolates was examined in MDCK cells, differentiated primary human respiratory tract culture, ex-vivo human bronchi tissue and mice. DAS181 efficiently inhibited viral replication in each of these models and against all tested pandemic influenza A(H1N1 strains. DAS181 treatment also protected mice from pandemic influenza A(H1N1-induced pathogenesis. Furthermore, DAS181 antiviral activity against pandemic influenza A(H1N1 strains was comparable to that observed against seasonal influenza virus including the H274Y oseltamivir-resistant influenza virus.The sialidase fusion protein DAS181 exhibits potent inhibitory activity against pandemic influenza A(H1N1 viruses. As inhibition was also observed with oseltamivir-resistant IFV (H274Y, DAS181 may be active against the antigenically novel pandemic influenza A(H1N1 virus should it acquire the H274Y mutation. Based on these and previous results demonstrating DAS181 broad-spectrum anti-IFV activity, DAS181 represents a potential therapeutic agent for

  8. The Transcriptional Repressive Activity of KRAB Zinc Finger Proteins Does Not Correlate with Their Ability to Recruit TRIM28.

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    Kristin E Murphy

    Full Text Available KRAB domain Zinc finger proteins are one of the most abundant families of transcriptional regulators in higher vertebrates. The prevailing view is that KRAB domain proteins function as potent transcriptional repressors by recruiting TRIM28 and promoting heterochromatin spreading. However, the extent to which all KRAB domain proteins are TRIM28-dependent transcriptional repressors is currently unclear. Our studies on mouse ZFP568 revealed that TRIM28 recruitment by KRAB domain proteins is not sufficient to warrant transcriptional repressive activity. By using luciferase reporter assays and yeast two-hybrid experiments, we tested the ability of ZFP568 and other mouse KRAB domain proteins to repress transcription and bind TRIM28. We found that some mouse KRAB domain proteins are poor transcriptional repressors despite their ability to recruit TRIM28, while others showed strong KRAB-dependent transcriptional repression, but no TRIM28 binding. Together, our results show that the transcriptional repressive activity of KRAB-ZNF proteins does not correlate with their ability to recruit TRIM28, and provide evidence that KRAB domains can regulate transcription in a TRIM28-independent fashion. Our findings challenge the current understanding of the molecular mechanisms used by KRAB domain proteins to control gene expression and highlight that a high percentage of KRAB domain proteins in the mouse genome differ from the consensus KRAB sequence at amino acid residues that are critical for TRIM28 binding and/or repressive activity.

  9. The let-7/Lin28 axis regulates activation of hepatic stellate cells in alcoholic liver injury.

    Science.gov (United States)

    McDaniel, Kelly; Huang, Li; Sato, Keisaku; Wu, Nan; Annable, Tami; Zhou, Tianhao; Ramos-Lorenzo, Sugeily; Wan, Ying; Huang, Qiaobing; Francis, Heather; Glaser, Shannon; Tsukamoto, Hidekazu; Alpini, Gianfranco; Meng, Fanyin

    2017-07-07

    The let-7/Lin28 axis is associated with the regulation of key cellular regulatory genes known as microRNAs in various human disorders and cancer development. This study evaluated the role of the let-7/Lin28 axis in regulating a mesenchymal phenotype of hepatic stellate cells in alcoholic liver injury. We identified that ethanol feeding significantly down-regulated several members of the let-7 family in mouse liver, including let-7a and let-7b. Similarly, the treatment of human hepatic stellate cells (HSCs) with lipopolysaccharide (LPS) and transforming growth factor-β (TGF-β) significantly decreased the expressions of let-7a and let-7b. Conversely, overexpression of let-7a and let-7b suppressed the myofibroblastic activation of cultured human HSCs induced by LPS and TGF-β, as evidenced by repressed ACTA2 (α-actin 2), COL1A1 (collagen 1A1), TIMP1 (TIMP metallopeptidase inhibitor 1), and FN1 (fibronectin 1); this supports the notion that HSC activation is controlled by let-7. A combination of bioinformatics, dual-luciferase reporter assay, and Western blot analysis revealed that Lin28B and high-mobility group AT-hook (HMGA2) were the direct targets of let-7a and let-7b. Furthermore, Lin28B deficiency increased the expression of let-7a/let-7b as well as reduced HSC activation and liver fibrosis in mice with alcoholic liver injury. This feedback regulation of let-7 by Lin28B is verified in hepatic stellate cells isolated by laser capture microdissection from the model. The identification of the let-7/Lin28 axis as an important regulator of HSC activation as well as its upstream modulators and down-stream targets will provide insights into the involvement of altered microRNA expression in contributing to the pathogenesis of alcoholic liver fibrosis and novel therapeutic approaches for human alcoholic liver diseases. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

  10. Factors influencing spinal sagittal balance, bone mineral density, and Oswestry Disability Index outcome measures in patients with rheumatoid arthritis.

    Science.gov (United States)

    Masamoto, Kazutaka; Otsuki, Bungo; Fujibayashi, Shunsuke; Shima, Koichiro; Ito, Hiromu; Furu, Moritoshi; Hashimoto, Motomu; Tanaka, Masao; Lyman, Stephen; Yoshitomi, Hiroyuki; Tanida, Shimei; Mimori, Tsuneyo; Matsuda, Shuichi

    2018-02-01

    To identify the factors influencing spinal sagittal alignment, bone mineral density (BMD), and Oswestry Disability Index (ODI) outcome measures in patients with rheumatoid arthritis (RA). We enrolled 272 RA patients to identify the factors influencing sagittal vertical axis (SVA). Out of this, 220 had evaluation of bone mineral density (BMD) and vertebral deformity (VD) on the sagittal plane; 183 completed the ODI questionnaire. We collected data regarding RA-associated clinical parameters and standing lateral X-ray images via an ODI questionnaire from April to December 2012 at a single center. Patients with a history of spinal surgery or any missing clinical data were excluded. Clinical parameters included age, sex, body mass index, RA disease duration, disease activity score 28 erythrocyte sedimentation rate (DAS28-ESR), serum anti-cyclic citrullinated peptide antibody, serum rheumatoid factor, serum matrix metalloproteinase-3, BMD and treatment type at survey, such as methotrexate (MTX), biological disease-modifying anti-rheumatic drugs, and glucocorticoids. We measured radiological parameters including pelvic incidence (PI), lumbar lordosis (LL), and SVA. We statistically identified the factors influencing SVA, BMD, VD, and ODI using multivariate regression analysis. Multivariate regression analysis showed that larger SVA correlated with older age, higher DAS28-ESR, MTX nonuse, and glucocorticoid use. Lower BMD was associated with female, older age, higher DAS28-ESR, and MTX nonuse. VD was associated with older age, longer disease duration, lower BMD, and glucocorticoid use. Worse ODI correlated with older age, larger PI-LL mismatch or larger SVA, higher DAS28-ESR, and glucocorticoid use. In managing low back pain and spinal sagittal alignment in RA patients, RA-related clinical factors and the treatment type should be taken into consideration.

  11. Antimicrobial activity of plants used as medicinals on an indigenous reserve in Rio das Cobras, Paraná, Brazil.

    Science.gov (United States)

    Moura-Costa, Gislaine F; Nocchi, Samara R; Ceole, Ligia F; de Mello, João Carlos P; Nakamura, Celso Vataru; Dias Filho, Benedito Prado; Temponi, Livia G; Ueda-Nakamura, Tania

    2012-09-28

    A considerable percentage of global biodiversity is located in Brazil, a country that also has rich cultural and ethnic diversity. In the community of Rio das Cobras, Paraná, plants are still widely used in the health care not only by indigenous people but also by the non-indigenous population that inhabits the region. The investigation of the efficacy and safety of these plants in the treatment of infectious diseases provides insights for future studies of these species allowing the appropriated use by the indigenous people, since few or none study has been conducted so far. Evaluate the antimicrobial activity and cytotoxicity of some plants used as medicinal on an indigenous reserve in Rio das Cobras, Paraná, Brazil. The aqueous extracts were obtained by decoction and the 50% and 70% hydroalcoholic extracts by turbo extraction. The extracts were tested against strains of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Candida albicans, Candida parapsilosis, Candida tropicalis, Leishmania amazonensis, Poliovirus and HSV-1. Cytotoxicity assay using VERO cells were also performed. None of the extracts had a selectivity index (SI)>1 for any of the tested bacteria. Only Campomanesia eugenioides and Schinus terebinthifolius had an SI>1.0 for all of the tested Candida species. The best anti-Leishmania activity was obtained with Zanthoxylum rhoifolium and Schinus terebinthifolius. Extracts of Cordia americana were the most effective against herpes simplex virus type 1. Zanthoxylum rhoifolium was the most effective against Poliovirus, and Ocimum gratissimum was effective against both Poliovirus and Herpes Simplex virus. Among the plants investigated in the present study, Zanthoxylum rhoifolium had the fewest cytotoxic effect. The plants investigated in the present study exhibited potential for future pharmacological uses, but additional studies, especially with regard to in vivo toxicity, must be conducted. The results of this

  12. Mesozooplankton of the estuarine system of Barra das Jangadas, Pernambuco, Brazil

    OpenAIRE

    Cavalcanti, Eliane A. H.; Neumann-Leitão, Sigrid; Vieira, Dilma A. do N.

    2008-01-01

    Estudos sobre o mesozooplâncton foram realizados no sistema estuarino de Barra das Jangadas, Pernambuco, Brasil (8º14'36"S, 34º56'28"W) visando analisar a estrutura da comunidade. As amostras foram obtidas com rede de plâncton, com malha de 300 µm, durante os períodos, seco (janeiro/2001) e chuvoso (julho/2001), nas marés de sizígia e de quadratura, em intervalos de três horas. Foram identificados 37 taxa, destacando-se Copepoda com as espécies Pseudodiaptomus acutus (F. Dahl, 1894), Pseudodi...

  13. Improvement of Risk Prediction After Transcatheter Aortic Valve Replacement by Combining Frailty With Conventional Risk Scores.

    Science.gov (United States)

    Schoenenberger, Andreas W; Moser, André; Bertschi, Dominic; Wenaweser, Peter; Windecker, Stephan; Carrel, Thierry; Stuck, Andreas E; Stortecky, Stefan

    2018-02-26

    This study sought to evaluate whether frailty improves mortality prediction in combination with the conventional scores. European System for Cardiac Operative Risk Evaluation (EuroSCORE) or Society of Thoracic Surgeons (STS) score have not been evaluated in combined models with frailty for mortality prediction after transcatheter aortic valve replacement (TAVR). This prospective cohort comprised 330 consecutive TAVR patients ≥70 years of age. Conventional scores and a frailty index (based on assessment of cognition, mobility, nutrition, and activities of daily living) were evaluated to predict 1-year all-cause mortality using Cox proportional hazards regression (providing hazard ratios [HRs] with confidence intervals [CIs]) and measures of test performance (providing likelihood ratio [LR] chi-square test statistic and C-statistic [CS]). All risk scores were predictive of the outcome (EuroSCORE, HR: 1.90 [95% CI: 1.45 to 2.48], LR chi-square test statistic 19.29, C-statistic 0.67; STS score, HR: 1.51 [95% CI: 1.21 to 1.88], LR chi-square test statistic 11.05, C-statistic 0.64; frailty index, HR: 3.29 [95% CI: 1.98 to 5.47], LR chi-square test statistic 22.28, C-statistic 0.66). A combination of the frailty index with either EuroSCORE (LR chi-square test statistic 38.27, C-statistic 0.72) or STS score (LR chi-square test statistic 28.71, C-statistic 0.68) improved mortality prediction. The frailty index accounted for 58.2% and 77.6% of the predictive information in the combined model with EuroSCORE and STS score, respectively. Net reclassification improvement and integrated discrimination improvement confirmed that the added frailty index improved risk prediction. This is the first study showing that the assessment of frailty significantly enhances prediction of 1-year mortality after TAVR in combined risk models with conventional risk scores and relevantly contributes to this improvement. Copyright © 2018 American College of Cardiology Foundation

  14. Caracterização das frações que constituem as proteínas e os carboidratos, e respectivas taxas de digestão, do feno de capim-tifton 85 de diferentes idades de rebrota

    Directory of Open Access Journals (Sweden)

    Ribeiro Karina Guimarães

    2001-01-01

    Full Text Available Avaliaram-se a composição bromatológica, as frações da proteína bruta (A, B1, B2, B3 e C e dos carboidratos totais (A, B1, B2 e C e as respectivas taxas de digestão das frações B1, B2 e B3 de proteínas e das frações A + B1 e B2 de carboidratos e do feno de capim-tifton 85, obtido de plantas colhidas com 28, 35, 42 e 56 dias de rebrota, adubadas com 75 kg/ha/corte de N. Os teores protéicos dos fenos com idades de rebrota de 28 a 56 dias variaram de 17,58 a 12,58%. Os valores das frações protéicas A, B1, B2, B3 e C apresentaram-se, respectivamente, entre 22,10 e 35,53%; 0,24 e 4,55%; 30,37 e 31,34%; 26,55 e 36,62%; e 5,75 e 6,76%, como proporções da proteína bruta total, nos fenos com idades de rebrota entre 28 e 56 dias. As taxas de digestão das frações protéicas B1, B2 e B3 encontraram-se entre 0,319 e 1,324; 0,0724 e 0,0936; e 0,0077 e 0,012 h -1, respectivamente, nos fenos com idades de rebrota entre 28 e 56 dias. Os teores de carboidratos totais variaram de 72,98 a 78,77%, em fenos com 28 a 56 dias de rebrota. Os valores das frações A, B1, B2 e C de carboidratos apresentaram-se entre 2,73 e 5,44%; 1,91 e 2,35%; 77,49 e 80,59%; e 13,59 e 17,87%, respectivamente, como proporções dos carboidratos totais, em fenos com idades entre 28 e 56 dias de rebrota. As taxas de digestão das frações de carboidratos A + B1 e B2 encontraram-se entre 0,181 e 0,20 e 0,04 e 0,0466 h -1, respectivamente, em fenos com idades entre 28 e 56 dias de rebrota.

  15. Clinical Observation of Employment of Umbilical Cord Derived Mesenchymal Stem Cell for Juvenile Idiopathic Arthritis Therapy

    Directory of Open Access Journals (Sweden)

    Liming Wang

    2016-01-01

    Full Text Available Juvenile idiopathic arthritis (JIA, known as Juvenile rheumatoid arthritis, is the most common type of arthritis in children aged under 17. It may cause sequelae due to lack of effective treatment. The goal of this study is to explore the therapeutic effect of umbilical cord mesenchymal stem cells (UC-MSCs for JIA. Ten JIA patients were treated with UC-MSCs and received second infusion three months later. Some key values such as 28-joint disease activity score (DAS28, TNF-α, IL-6, and regulatory T cells (Tregs were evaluated. Data were collected at 3 months and 6 months after first treatment. DAS28 score of 10 patients was between 2.6 and 3.2 at three months after infusion. WBC, ESR, and CRP were significantly decreased while Tregs were remarkably increased and IL-6 and TNF-α were declined. Similar changes of above values were found after 6 months. At the same time, the amount of NSAIDS and steroid usage in patients was reduced. However, no significant changes were found comparing the data from 3 and 6 months. These results suggest that UC-MSCs can reduce inflammatory cytokines, improve immune network effects, adjust immune tolerance, and effectively alleviate the symptoms and they might provide a safe and novel approach for JIA treatment.

  16. Environment-dependent regulation of spliceosome activity by the LSM2-8 complex in Arabidopsis.

    Science.gov (United States)

    Carrasco-López, Cristian; Hernández-Verdeja, Tamara; Perea-Resa, Carlos; Abia, David; Catalá, Rafael; Salinas, Julio

    2017-07-07

    Spliceosome activity is tightly regulated to ensure adequate splicing in response to internal and external cues. It has been suggested that core components of the spliceosome, such as the snRNPs, would participate in the control of its activity. The experimental indications supporting this proposition, however, remain scarce, and the operating mechanisms poorly understood. Here, we present genetic and molecular evidence demonstrating that the LSM2-8 complex, the protein moiety of the U6 snRNP, regulates the spliceosome activity in Arabidopsis, and that this regulation is controlled by the environmental conditions. Our results show that the complex ensures the efficiency and accuracy of constitutive and alternative splicing of selected pre-mRNAs, depending on the conditions. Moreover, miss-splicing of most targeted pre-mRNAs leads to the generation of nonsense mediated decay signatures, indicating that the LSM2-8 complex also guarantees adequate levels of the corresponding functional transcripts. Interestingly, the selective role of the complex has relevant physiological implications since it is required for adequate plant adaptation to abiotic stresses. These findings unveil an unanticipated function for the LSM2-8 complex that represents a new layer of posttranscriptional regulation in response to external stimuli in eukaryotes. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  17. Synthesis and structure-activity relationship of the first nonpeptidergic inverse agonists for the human cytomegalovirus encoded chemokine receptor US28.

    Science.gov (United States)

    Hulshof, Janneke W; Casarosa, Paola; Menge, Wiro M P B; Kuusisto, Leena M S; van der Goot, Henk; Smit, Martine J; de Esch, Iwan J P; Leurs, Rob

    2005-10-06

    US28 is a human cytomegalovirus (HCMV) encoded G-protein-coupled receptor that signals in a constitutively active manner. Recently, we identified 1 [5-(4-(4-chlorophenyl)-4-hydroxypiperidin-1-yl)-2,2-diphenylpentanenitrile] as the first reported nonpeptidergic inverse agonist for a viral-encoded chemokine receptor. Interestingly, this compound is able to partially inhibit the viral entry of HIV-1. In this study we describe the synthesis of 1 and several of its analogues and unique structure-activity relationships for this first class of small-molecule ligands for the chemokine receptor US28. Moreover, the compounds have been pharmacologically characterized as inverse agonists on US28. By modification of lead structure 1, it is shown that a 4-phenylpiperidine moiety is essential for affinity and activity. Other structural features of 1 are shown to be of less importance. These compounds define the first SAR of ligands on a viral GPCR (US28) and may therefore serve as important tools to investigate the significance of US28-mediated constitutive activity during viral infection.

  18. Prognostic Factors Toward Clinically Relevant Radiographic Progression in Patients With Rheumatoid Arthritis in Clinical Practice: A Japanese Multicenter, Prospective Longitudinal Cohort Study for Achieving a Treat-to-Target Strategy.

    Science.gov (United States)

    Koga, Tomohiro; Okada, Akitomo; Fukuda, Takaaki; Hidaka, Toshihiko; Ishii, Tomonori; Ueki, Yukitaka; Kodera, Takao; Nakashima, Munetoshi; Takahashi, Yuichi; Honda, Seiyo; Horai, Yoshiro; Watanabe, Ryu; Okuno, Hiroshi; Aramaki, Toshiyuki; Izumiyama, Tomomasa; Takai, Osamu; Miyashita, Taiichiro; Sato, Shuntaro; Kawashiri, Shin-Ya; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Origuchi, Tomoki; Nakamura, Hideki; Aoyagi, Kiyoshi; Eguchi, Katsumi; Kawakami, Atsushi

    2016-04-01

    To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) in clinical practice.We performed a multicenter prospective study in Japan of biological disease-modifying antirheumatic drug (bDMARD)-naive RA patients with moderate to high disease activity treated with conventional synthetic DMARDs (csDMARDs) at study entry. We longitudinally observed 408 patients for 1 year and assessed disease activity every 3 months. CRRP was defined as yearly progression of modified total Sharp score (mTSS) > 3.0 U. We also divided the cohort into 2 groups based on disease duration (<3 vs ≥3 years) and performed a subgroup analysis.CRRP was found in 10.3% of the patients. A multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: CRP at baseline (0.30 mg/dL increase, 95% confidence interval [CI] 1.01-1.11), time-integrated Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) during the 1 year postbaseline (12.4-unit increase, 95%CI 1.17-2.59), RA typical erosion at baseline (95%CI 1.56-21.1), and the introduction of bDMARDs (95%CI 0.06-0.38). The subgroup analysis revealed that time-integrated DAS28-ESR is not a predictor whereas the introduction of bDMARDs is a significant protective factor for CRRP in RA patients with disease duration <3 years.We identified factors that could be used to predict the development of CRRP in RA patients treated with DMARDs. These variables appear to be different based on the RA patients' disease durations.

  19. Increased baseline RUNX2, caspase 3 and p21 gene expressions in the peripheral blood of disease-modifying anti-rheumatic drug-naïve rheumatoid arthritis patients are associated with improved clinical response to methotrexate therapy.

    Science.gov (United States)

    Tchetina, Elena V; Demidova, Natalia V; Markova, Galina A; Taskina, Elena A; Glukhova, Svetlana I; Karateev, Dmitry E

    2017-10-01

    To investigate the potential of the baseline gene expression in the whole blood of disease-modifying anti-rheumatic drug-naïve rheumatoid arthritis (RA) patients for predicting the response to methotrexate (MTX) treatment. Twenty-six control subjects and 40 RA patients were examined. Clinical, immunological and radiographic parameters were assessed before and after 24 months of follow-up. The gene expressions in the whole blood were measured using real-time reverse transcription polymerase chain reaction. The protein concentrations in peripheral blood mononuclear cells were quantified using enzyme-linked immunosorbent assay. Receiver operating characteristic curve analyses were used to suggest thresholds that were associated with the prediction of the response. Decreases in the disease activity at the end of the study were accompanied by significant increases in joint space narrowing score (JSN). Positive correlations between the expressions of the Unc-51-like kinase 1 (ULK1) and matrix metalloproteinase 9 (MMP-9) genes with the level of C-reactive protein and MMP-9 expression with Disease Activity Score of 28 joints (DAS28) and swollen joint count were noted at baseline. The baseline tumor necrosis factor (TNF)α gene expression was positively correlated with JSN at the end of the follow-up, whereas p21, caspase 3, and runt-related transcription factor (RUNX)2 were correlated with the ΔDAS28 values. Our results suggest that the expressions of MMP-9 and ULK1 might be associated with disease activity. Increased baseline gene expressions of RUNX2, p21 and caspase 3 in the peripheral blood might predict better responses to MTX therapy. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  20. Effets thérapeutiques et anti-inflammatoires de la cryothérapie dans les rhumatismes inflammatoires

    OpenAIRE

    Guillot , Xavier

    2016-01-01

    Cryotheapy i widely and empirically used in an adjuvant setting in inflammatory rheumatic diseases, with a low level of evidence. We performed a systematic review of the literature and, by pooling data from 6 non-controlled studies, we could show that local cryotherapy (local or whole-body cryotherapy) applaied twice a day for 7-15 days significantly reduced the pain VAS and the DAS28 activity score in rheumatoid arthritis. Furthermore, local cryotherapy (ice packs or cold gas) showed signifi...

  1. Histórico das hepatites virais History of viral hepatitis

    Directory of Open Access Journals (Sweden)

    José Carlos Ferraz da Fonseca

    2010-06-01

    Full Text Available INTRODUÇÃO: A história das hepatites virais remonta milhares de anos e é fascinante. Quando o ser humano sofreu pela primeira vez a invasão do seu organismo por tais agentes, iniciou-se um ciclo natural e repetitivo capaz de infectar bilhões de seres humanos, dizimar e sequelar milhares de vida. MÉTODOS: Este artigo rever informações científicas disponíveis sobre o histórico das hepatites virais. Todas as informações foram obtidas através de extensa revisão bibliográfica, compreendendo artigos originais e de revisão e consultas na rede internet. RESULTADOS: Existem relatos de surtos de icterícia epidêmica na China há mais de 5.000 anos e na Babilônia, há mais de 2.500 anos. A história catastrófica das grandes epidemias ou pandemias ictéricas são conhecidas e geralmente estão associadas às grandes guerras. Na guerra da Secessão Americana, 40 mil casos ocorreram entre militares da União. Em 1885, um surto de icterícia catarral acometeu 191 trabalhadores do estaleiro de Bremen (Alemanha após vacinação contra varíola. Em 1942, 28.585 soldados contraíram hepatite após inoculação da vacina contra a febre amarela. O número de casos de hepatite durante a Segunda Grande Guerra foi estimado em 16 milhões. Somente no século XX, foram identificados os principais agentes causadores das hepatites virais. O vírus da hepatite B foi o primeiro a ser descoberto. CONCLUSÕES: Neste artigo, a revisão da história das grandes epidemias ocasionadas pelos vírus das hepatites e a descoberta desses agentes revelam singulares peculiaridades, citando como exemplo, a descoberta acidental ou por acaso dos vírus da hepatite B e D.INTRODUCTION: The history of viral hepatitis goes back thousands of years and is a fascinating one. When humans were first infected by such agents, a natural repetitive cycle began, with the capacity to infect billions of humans, thus decimating the population and causing sequelae in thousands of lives

  2. Das biochemische Rezidiv beim Prostatakarzinom

    Directory of Open Access Journals (Sweden)

    Rauchenwald M

    2010-01-01

    Full Text Available Als biochemisches Rezidiv (BCR wird der Wiederanstieg des nach kurativer Therapie des Prostatakarzinoms (PCa abgefallenen PSA-Werts bezeichnet. Der PSA-Verlauf nach kurativer Therapie ist von der primären Behandlungsmethode abhängig, weshalb auch unterschiedliche Definitionen dafür vorliegen. Der Verlauf selbst scheint prognostische Bedeutung zu haben. Ein Wiederanstieg des PSA-Werts geht der klinischen Progression voraus, wodurch frühzeitig eine Therapie eingeleitet werden kann. Der ideale Zeitpunkt für eine Sekundärbehandlung ist allerdings noch ungenügend definiert. Fast die Hälfte der BCR treten innerhalb der ersten 2 Jahre, ¾ innerhalb der ersten 5 Jahre nach Primärtherapie auf. Als Risikofaktoren für einen BCR werden ein primäres Tumorstadium ≥ T2c, PSA 15, Samenblaseninvasion, Lymphknotenbefall sowie Gleason-Score ≥ 8 angesehen. Von klinischer Bedeutung ist vor allem die Unterscheidung zwischen lokoregionärem und systemischem Rezidiv. Hierzu werden als Parameter neben dem primären Tumorstadium und Gleason-Score das posttherapeutische Intervall und die PSA-Dynamik empfohlen. Als diagnostische Maßnahmen erscheinen nur die Skelettszintigraphie und die Positronenemissionstomographie mit Acetat- oder Cholintracern und diese ebenfalls nur bei entsprechend hohen PSA-Werten sinnvoll. Therapeutisch kommt nach primärer Radikaloperation und Verdacht auf einen lokalen Progress in erster Linie die Salvagebestrahlung zur Anwendung, nach primärer Radiatio wird allerdings vorwiegend die hormonelle Manipulation einer Salvageoperation oder alter“nativen lokaltherapeutischen Maßnahmen vorgezogen.

  3. Indicações para ceratoplastia penetrante no Hospital das Clínicas-UNICAMP Penetrating keratoplasty indications in "Hospital das Clínicas-UNICAMP"

    Directory of Open Access Journals (Sweden)

    Vanessa Gonçalves Crespi Flores

    2007-06-01

    Full Text Available OBJETIVO: Determinar as principais causas de indicação de transplante penetrante no Hospital das Clínicas-UNICAMP no período de janeiro de 1999 a dezembro de 2003. MÉTODOS: Estudo de série de casos, retrospectivo, não comparativo. Os autores revisaram os prontuários de 857 pacientes submetidos à ceratoplastia penetrante no Hospital das Clínicas-UNICAMP entre 1999-2003 e os classificaram em categorias diagnósticas de indicação para cirurgia. RESULTADOS: Dentre os 857 prontuários revisados a idade variou de 0-88 anos (média 44 anos±1,2. Dentre as principais causas de indicação de transplante de córnea encontramos: ceratocone em 427 casos (49,82%; úlcera de córnea infecciosa perfurada ou não, 152 casos (17,74%; falência de transplante prévio, 87 casos (10,15%; ceratopatia bolhosa, 72 casos (8,40%; distrofia de Fuchs, 59 casos (6,88%; seqüela de tracoma, 28 casos (3,27%; outras causas, 32 casos (3,74%. Entre as crianças até 10 anos a principal causa de indicação de transplante foram as úlceras infecciosas (77,78% e entre 11-50 anos o ceratocone foi a principal causa (71,65%. CONCLUSÕES: Este estudo foi composto por uma população jovem e as principais causas de indicação de transplante foram o ceratocone e os transplantes tectônicos.PURPOSE: To determine the main causes of penetrating keratoplasty indications at "Hospital das Clínicas-UNICAMP" (January, 1999 to December, 2003. METHODS: A non-comparative, retrospective series of case studies. The authors reviewed the files of 857 patients who underwent penetrating keratoplasty at "Hospital das Clínicas-UNICAMP" between 1999-2003 and classified them into different categories according to diagnostic indication for surgery. RESULTS: The age range was between 0-88 years (average 44 years ±1.2. The main causes of penetrating keratoplasty were: keratoconus in 427 cases (49.82%; 152 cases (17.74% of corneal ulceration (perforated or not; corneal graft failure in 87

  4. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

    Directory of Open Access Journals (Sweden)

    Isidoro González-Álvaro

    Full Text Available To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI in patients with chronic polyarthritis.Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR] including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC analysis. The areas under ROC (AUC were compared to those of validated indexes (SDAI, CDAI, DAS28. ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI.The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5, moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756 and CDAI (AUCs: 0.789 and 0.728. HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values.The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

  5. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

    Science.gov (United States)

    González-Álvaro, Isidoro; Castrejón, Isabel; Ortiz, Ana M; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

    2016-01-01

    To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

  6. Das Bauhaus in Bewegung - wie das Bauhausgebäude in Dessau funktioniert

    OpenAIRE

    Seyler Thomas

    2016-01-01

    Analyse und Deutung des Bauhausentwurfs - wie das Bauhaus funktioniert Ein Architekt analysiert und deutet den Bauhausentwurf Das Bauhaus in Dessau gilt als Inbegriff einer räumlich freien Anordnung. Diese lässt sich jedoch auf den Prozess einer Entfaltung zurückführen. Der Autor erklärt Schritt für Schritt die Systematik des Entwurfs aus seiner beruflichen Erfahrung.

  7. Efficacy and safety at 24 weeks of daily clinical use of tofacitinib in patients with rheumatoid arthritis.

    Science.gov (United States)

    Iwamoto, Naoki; Tsuji, Sosuke; Takatani, Ayuko; Shimizu, Toshimasa; Fukui, Shoichi; Umeda, Masataka; Nishino, Ayako; Horai, Yoshiro; Koga, Tomohiro; Kawashiri, Shin-Ya; Aramaki, Toshiyuki; Ichinose, Kunihiro; Hirai, Yasuko; Tamai, Mami; Nakamura, Hideki; Terada, Kaoru; Origuchi, Tomoki; Eguchi, Katsumi; Ueki, Yukitaka; Kawakami, Atsushi

    2017-01-01

    We evaluated the efficacy and safety of tofacitinib in patients with rheumatoid arthritis (RA) in a real-world setting. Seventy consecutive patients, for whom tofacitinib was initiated between November 2013 and May 2016, were enrolled. All patients fulfilled the 2010 ACR/EULAR classification criteria for RA. All patients received 5 mg of tofacitinib twice daily and were followed for 24 weeks. Clinical disease activity indicated by disease activity score (DAS)28-ESR, the simplified disease activity index, and the clinical disease activity index as well as adverse events (AEs) were evaluated. Statistical analysis was performed to determine which baseline variables influenced the efficacy of tofacitinib at 24 weeks. Fifty-eight patients (82.9%) continued tofacitinib at 24 weeks. Clinical disease activity rapidly and significantly decreased, and this efficacy continued throughout the 24 weeks: i.e., DAS28-ESR decreased from 5.04 ± 1.33 at baseline to 3.83 ± 1.11 at 4 weeks and 3.53 ± 1.17 at 24 weeks (Ptofacitinib treatment. The efficacy of tofacitinib was not changed in patients without concomitant use of methotrexate (MTX) or patients whose treatment with tocilizumab (TCZ) failed. Multivariable logistic analysis showed that the number of biologic DMARDs (bDMARDs) previously used was independently associated with achievement of DAS-low disease activity. Our present study suggests that tofacitinib is effective in real-world settings even without concomitant MTX use or after switching from TCZ. Our results also suggest that its efficacy diminishes if started after use of multiple bDMARDs.

  8. An examination of presenteeism measures: the association of three scoring methods with health, work life, and consumer activation.

    Science.gov (United States)

    Terry, Paul E; Xi, Min

    2010-12-01

    The objective of this study was to assess the validity of 3 scoring techniques for presenteeism measures by exploring their relationship with patient activation, health, job satisfaction, and socioeconomic characteristics. The sample consisted of 631 employees from 2 predominantly white-collar employee groups in the northern Midwest. Employees completed the World Health Organization's Health and Work Performance Questionnaire, a wellness profile, and the Patient Activation Measure. Absolute measures reflect self-rated performance, while relative and stratified measures compare self-rated performance to that of co-workers. Multivariate analyses were used to validate scoring measures. All measures of presenteeism were positively correlated with being nonwhite, income, and smoking. The significance of age, employment, mental health, and patient activation depends on how presenteeism is defined. Practitioners must carefully consider which scoring method best addresses their program goals and objectives. Clearer measurement guidelines are needed.

  9. Primary radiotherapy or postoperative radiotherapy in patients with head and neck cancer. Comparative analysis of inflammation-based prognostic scoring systems

    Energy Technology Data Exchange (ETDEWEB)

    Selzer, Edgar; Grah, Anja [Medical University of Vienna, Department of Radiotherapy, Vienna (Austria); Heiduschka, Gregor; Thurnher, Dietmar [Medical University of Vienna, Otorhinolaryngology - Head and Neck Surgery, Vienna (Austria); Kornek, Gabriela [Medical University of Vienna, Medicine I - Division of Clinical Oncology, Vienna (Austria)

    2015-01-13

    Inflammation-based scoring systems have potential value in evaluating the prognosis of cancer patients; however, detailed comparative analyses in well-characterized head and neck cancer patient collectives are missing. We analyzed overall survival (OS) in locally advanced head and neck cancer patients who were treated with curative intent by primary radiotherapy (RT) alone, by RT in combination with cetuximab (RIT) or with cisplatin (RCHT), and by primary surgery followed by postoperative radiotherapy (PORT). The primary RT collective (N = 170) was analyzed separately from the surgery plus RT group (N = 148). OS was estimated using the Kaplan-Meyer method. Cox proportional-hazard regression models were applied to compare the risk of death among patients stratified according to risk factors and the inflammation-based Glasgow Prognostic Score (GPS), the modified GPS (mGPS), the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the prognostic index (PI). A prognostic relevance of the scoring systems for OS was observed in the primarily irradiated, but not in the PORT collective. OS was 35.5, 18.8, and 15.4 months, respectively, according to GPS 0, 1, and 2. OS according to mGPS 0-2 was identical. The PLR scoring system was not of prognostic relevance, while OS was 27.3 months in the NLR 0 group and 17.3 months in the NLR 1 group. OS was 35.5 months in PI 0, 16.1 months in PI 1, and 22.6 months in PI 2. GPS/mGPS scoring systems are able to discriminate between three risk groups in primarily, but not postoperatively irradiated locally advanced head and neck cancer patients. (orig.) [German] Entzuendungsbasierte Bewertungssysteme haben eine potenzielle Bedeutung fuer die Beurteilung der Prognose von Krebspatienten. Derzeit fehlen jedoch ausreichend detailliert durchgefuehrte Analysen in Kollektiven von Patienten mit Kopf-Hals-Tumoren. Untersucht wurde das Gesamtueberleben (''overall survival'', OS) von Patienten mit lokal

  10. Prevalence of Coxitis and its Correlation with Inflammatory Activity in Rheumatoid Arthritis.

    Science.gov (United States)

    Bajraktari, Ismet H; Krasniqi, Blerim; Rexhepi, Sylejman; Bexheti, Sadi; Bahtiri, Elton; Bajraktari, Halit; Luri, Besim

    2018-02-15

    Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterised by intra-articular and extra-articular manifestations but very rarely with coxitis. This study aimed to investigate the prevalence of coxitis, clinical changes, and its correlation with the parameters of inflammatory activity. A cohort of 951 patients diagnosed with ACR/EULAR (American College of Rheumatology/European League against Rheumatism) 2010 criteria was enrolled in this prospective, observational and analytic research study. The CBC (Complete Blood Count), ESR (Erythrocyte sedimentation rate), CRP(C - reactive protein), Anti CCP (Antibodies to cyclic citrullinated peptides), X-ray examination of palms and pelvis, and the activity of the disease as measured by DAS - 28 (28 - joint disease activity score) were carried out in all subjects. Independent samples t-test was used to compare the group's characteristics, whereas Pearson correlation test was used to analyse the correlation between study variables. Of the total number of the subjects, 730 (76.8 %) were females, whereas 221 (23.2%) were males. The average age was 51.3, y/o while the most of them were between 40 - 49 y/o (32.6%). The prevalence of coxitis was 14.2%, mostly found in males (19.46%). The echosonografic prevalence of changes was 21.45%, while the radiological changes were 16.3%; in both cases, the changes were more expressed in males. The analysis showed that inflammatory parameters were significantly higher in patients with coxitis. Coxitis has high economic cost because it ends up with a mandatory need for a total hip joint prosthesis. Thus the results of this study can serve to plan and initiate early preventive measures.

  11. Successful pipeline installation for Parque das Conchas development; Subsea installation

    Energy Technology Data Exchange (ETDEWEB)

    Bartz, Cesar

    2010-07-01

    Subsea 7 has successfully delivered again in Brazilian deep-waters. The subsea engineering and construction company has recently completed pipeline installation activities for the Parque das Conchas (BC-10) development, offshore Brazil. (AG)

  12. Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial.

    Science.gov (United States)

    Sørensen, J; Primdahl, J; Horn, H C; Hørslev-Petersen, K

    2015-01-01

    To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient clinics and general practice, prescription and non-prescription medicine, dietary supplements, other health-care resources, and complementary and alternative care. Measures of effectiveness and costs were collected by self-reported questionnaires at inclusion and after 12 and 24 months. Incremental cost-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Changes in disease activity, functional status, and health-related quality of life were not statistically significantly different for the three groups, although the mean scores were better for the shared care and nurse care groups compared with the rheumatologist group. Shared care and nurse care were non-significantly less costly than rheumatologist care. As both shared care and nurse care were associated with slightly better EQ-5D improvements and lower costs, they dominated rheumatologist care. At EUR 10,000 per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Shared care and nurse care seem to cost less but provide broadly similar health outcomes compared with rheumatologist outpatient care. However, it is still uncertain whether nurse care and shared care are cost-effective in comparison with rheumatologist outpatient care.

  13. I M L Das

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. I M L Das. Articles written in Bulletin of Materials Science. Volume 33 Issue 4 August 2010 pp 383-390 Electrical Properties. Temperature dependence of electromechanical properties of PLZT /57/43 ceramics · A K Shukla V K Agrawal I M L Das Janardan Singh S L Srivastava.

  14. Down-titration and discontinuation strategies of tumor necrosis factor-blocking agents for rheumatoid arthritis in patients with low disease activity.

    Science.gov (United States)

    van Herwaarden, Noortje; den Broeder, Alfons A; Jacobs, Wilco; van der Maas, Aatke; Bijlsma, Johannes W J; van Vollenhoven, Ronald F; van den Bemt, Bart J F

    2014-09-29

    -guided anti-TNF dose tapering (137 participants). These studies include only adalimumab and etanercept; controlled data on other anti-TNF agents are absent. Two studies were available in full text; one was assessed as having low risk of bias and the other high risk. Five studies were available only as one or more abstracts. Because data provided in these abstracts were limited, risk of bias was unclear. Clinical heterogeneity between the trials was high.Dose reduction of anti-TNF (etanercept data only) showed no statistically significant or clinical relevant difference in disease activity score in 28 joints (DAS28) (mean difference (MD) 0.10, 95% confidence interval (CI) -0.11 to 0.31) (scale 0.9 to 8; higher score indicates worse disease activity). The proportion of participants who maintained low disease activity was slightly lower among participants given reduced doses of the anti-TNF agent (risk ratio (RR) 0.87, 95% CI 0.78 to 0.98, absolute risk difference (ARD) 9%). Radiographic outcome was slightly worse, but this was not clinically meaningful, compared with continuation of anti-TNF (MD 0.11, 95% CI 0.08 to 0.14) (scale 0 to 448; higher score indicates greater joint damage). Function was not statistically different between anti-TNF dose reduction and continuation (MD 0.10, 95% CI 0.00 to 0.20) (scale 0 to 3; higher score indicates worse functioning). Reinstalment of anti-TNF after failure of dose reduction showed a 5% risk of persistent flare. Data on numbers of serious adverse events (SAEs) (RR 0.58, 95% CI 0.23 to 1.45, ARD -2%) and withdrawals due to adverse events (AEs) (RR 0.57, 95% CI 0.17 to 1,92, ARD -1%) were inconclusive. Most outcomes were based on moderate quality evidence.Participants who discontinued anti-TNF (adalimumab and etanercept data) had higher mean DAS28 (DAS28-erythrocyte sedimentation rate (ESR): MD 1.10, 95% CI 0.86 to 1.34) and DAS28-C-reactive protein (CRP): MD 0.57 95% CI -0.09 to 1.23) and were less likely to maintain a low disease

  15. Twitter Activity Associated With U.S. News and World Report Reputation Scores for Urology Departments.

    Science.gov (United States)

    Ciprut, Shannon; Curnyn, Caitlin; Davuluri, Meena; Sternberg, Kevan; Loeb, Stacy

    2017-10-01

    To analyze the association between US urology department Twitter presence and U.S. News and World Report (USNWR) reputation scores, to examine the content, informational value, and intended audience of these platforms, and to identify objectives for Twitter use. We identified Twitter accounts for urology departments scored in the 2016-2017 USNWR. Correlation coefficients were calculated between Twitter metrics (number of followers, following, tweets, and Klout influence scores) with USNWR reputation scores. We also performed a detailed content analysis of urology department tweets during a 6-month period to characterize the content. Finally, we distributed a survey to the urology department accounts via Twitter, inquiring who administers the content, and their objectives for Twitter use. Among 42 scored urology departments with Twitter accounts, the median number of followers, following, and tweets were 337, 193, and 115, respectively. All of these Twitter metrics had a statistically significant positive correlation with reputation scores (P twitter use among urology departments was visibility and reputation, and urologists are considered the most important target audience. There is statistically significant correlation between Twitter activity and USNWR reputation scores for urology departments. Our results suggest that Twitter provides a novel mechanism for urology departments to communicate about academic and educational topics, and social media engagement can enhance reputation. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Obesidade: Estudo das Representações Sociais de Endocrinologistas em Hospital Público.

    OpenAIRE

    Dinorah Fernandes Gioia Martins

    1998-01-01

    O presente trabalho teve como objetivo estudar a psicodinâmica das Representações Sociais (RS) de endocrinologistas de hospital público sobre obesidade, identificando-as e buscando detectar seu inconsciente relativo, ou seja, a lógica emocional segundo a qual se estruturam. Foram realizadas 10 (dez) entrevistas com médicos endocrinologistas de rede pública, (05 do sexo feminino e 05 do sexo masculino) com idade variável de 28 a 44 anos de idade. O tempo de especialização variou de dois a dezo...

  17. Role of hydrotherapy in the amelioration of oxidant-antioxidant status in rheumatoid arthritis patients.

    Science.gov (United States)

    Mateen, Somaiya; Moin, Shagufta; Khan, Abdul Q; Zafar, Atif; Fatima, Naureen; Shahzad, Sumayya

    2017-06-14

    Rheumatoid arthritis (RA) is an inflammatory autoimmune disease. Reactive oxygen species (ROS) are involved in the pathophysiology of RA. Moderate intensity exercises have been reported to have anti-oxidant and anti-inflammatory effects. The aim of this study was to evaluate the effect of hydrotherapy on oxidant-antioxidant status in RA patients. Forty RA patients and 30 age- and sex-matched healthy controls were included in this study. RA patients were subdivided into two groups: the first group (n = 20) received treatment with conventional RA drugs, while the second group (n = 20) received hydrotherapy along with the conventional drugs for a period of 12 weeks. Disease Activity Score of 28 joints (DAS-28), ROS level, protein oxidation, lipid peroxidation, DNA damage and the activities of antioxidant enzymes were evaluated before and after 12 weeks of treatment. RA patients showed a significant change in the oxidative stress biomarkers (ROS, P hydrotherapy has decreased protein, lipid and DNA oxidation by increasing the activities of antioxidant enzymes (SOD and GPx). Our results indicate that hydrotherapy along with drugs has reduced the severity of disease (DAS-28) by ameliorating the oxidant-antioxidant status in RA patients. Thus, in addition to conventional drugs, RA patients should be advised to have hydrotherapy (moderate intensity exercise) in their treatment regimen. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  18. 49 CFR 28.160 - Communications.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Communications. 28.160 Section 28.160 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.160 Communications...

  19. Shared care or nursing consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis outpatients with low disease activity--patient outcomes from a 2-year, randomised controlled trial

    DEFF Research Database (Denmark)

    Primdahl, Jette; Sørensen, Jan; Horn, Hans Christian

    2014-01-01

    were randomised to 2-year follow-up by either: (1) planned rheumatologist consultations, (2) shared care without planned consultations or (3) planned nursing consultations. The primary outcome was change in disease activity. DAS28-CRP, Health Assessment Questionnaire, visual analogue scale (VAS......)-pain, fatigue, global health, confidence and satisfaction, quality-of-life by the Short Form 12 and self-efficacy measured by the RA Self-Efficacy questionnaire and the Arthritis Self-Efficacy Scale, were recorded annually and safety measures were recorded. x-Rays of hands and feet were taken at baseline...... and at 2-year follow-up. Mixed effect models were used to explore differences between the three groups over time. RESULTS: At 2-year follow-up, the group allocated to nursing consultations had lower disease activity than the group that underwent rheumatologist consultations (DAS28-CRP -0.3, p=0...

  20. Heparin modulates the endopeptidase activity of Leishmania mexicana cysteine protease cathepsin L-Like rCPB2.8.

    Directory of Open Access Journals (Sweden)

    Wagner A S Judice

    Full Text Available Cysteine protease B is considered crucial for the survival and infectivity of the Leishmania in its human host. Several microorganism pathogens bind to the heparin-like glycosaminoglycans chains of proteoglycans at host-cell surface to promote their attachment and internalization. Here, we have investigated the influence of heparin upon Leishmania mexicana cysteine protease rCPB2.8 activity.THE DATA ANALYSIS REVEALED THAT THE PRESENCE OF HEPARIN AFFECTS ALL STEPS OF THE ENZYME REACTION: (i it decreases 3.5-fold the k 1 and 4.0-fold the k -1, (ii it affects the acyl-enzyme accumulation with pronounced decrease in k 2 (2.7-fold, and also decrease in k 3 (3.5-fold. The large values of ΔG  =  12 kJ/mol for the association and dissociation steps indicate substantial structural strains linked to the formation/dissociation of the ES complex in the presence of heparin, which underscore a conformational change that prevents the diffusion of substrate in the rCPB2.8 active site. Binding to heparin also significantly decreases the α-helix content of the rCPB2.8 and perturbs the intrinsic fluorescence emission of the enzyme. The data strongly suggest that heparin is altering the ionization of catalytic (Cys(25-S(-/(His(163-Im(+ H ion pair of the rCPB2.8. Moreover, the interaction of heparin with the N-terminal pro-region of rCPB2.8 significantly decreased its inhibitory activity against the mature enzyme.Taken together, depending on their concentration, heparin-like glycosaminoglycans can either stimulate or antagonize the activity of cysteine protease B enzymes during parasite infection, suggesting that this glycoconjugate can anchor parasite cysteine protease at host cell surface.

  1. The TAIGA timing array HiSCORE - first results

    Directory of Open Access Journals (Sweden)

    Tluczykont M.

    2017-01-01

    Full Text Available Observations of gamma rays up to several 100 TeV are particularly important to spectrally resolve the cutoff regime of the long-sought Pevatrons, the cosmic-ray PeV accelerators. One component of the TAIGA hybrid detector is the TAIGA-HiSCORE timing array, which currently consists of 28 wide angle (0.6 sr air Cherenkov timing stations distributed on an area of 0.25 km2. The HiSCORE concept is based on (non-imaging air shower front sampling with Cherenkov light. First results are presented.

  2. 49 CFR 28.102 - Application.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Application. 28.102 Section 28.102 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.102 Application. This part...

  3. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis?

    NARCIS (Netherlands)

    van der Heijde, Désirée; Landewé, Robert; Hermann, Kay-Geert; Rudwaleit, Martin; Østergaard, Mikkel; Oostveen, Ans; O'Connor, Phil; Maksymowych, Walter P.; Lambert, Robert G.; Lukas, Cédric; Jurik, Anne Grethe; Boers, Maarten; Baraliakos, Xenofon; Braun, Jürgen

    2007-01-01

    This report summarizes the discussion during a module update at OMERACT 8 on scoring methods for activity in the spine on magnetic resonance imaging. The conclusion was that the 3 available scoring methods are all very good with respect to discrimination and feasibility: the Ankylosing Spondylitis

  4. Significance of magnetic resonance imaging for early rheumatoid arthritis activity

    Directory of Open Access Journals (Sweden)

    E Y Pogozeva

    2009-01-01

    Full Text Available Objective. To assess possibility of magnetic resonance image (MRI application for rheu- matoid arthritis (RA activity and severity assessment.Material and methods. 100 pts with RA who fulfilled the 1987 ACR criteria with disease duration less than 12 months were included. Standard clinical examination with evaluation of tender and swollen joint counts, acute phase markers, hand and foot X-ray and hand MRI with 0,2 T Artoscan apparatus (ESAOTE Biomedica, Italy were performed.Results. MRI showed hand joint synovitis in 94,5%, erosions – in 67,3% of cases. X-ray examination revealed erosions in only 20,8% of pts. Localization of erosions revealed by X-ray and MRI coincided in 36,4% of cases and in 61,8% of pts erosions were detected only by MRI. MRI confirmed clinical conclusion about presence or absence of metacarpophalangeal and wrist joint synovitis in 64,5% and 74,5% of cases respectively. In8,2% and 21,8% MRI revealed signs of synovitis in clinically intact joints. MRI synovitis score correlated with clinical and laboratory measures of disease activityDAS 28 (r=0,37, p=0,001, CRP(r=0,30, p=0,001, ESR (r=0,42, p=0,001, HAQ (r=0,24, p=0,001. Weak correlation was revealed between ESR and presence of erosions (r=0,29, CRP, ESR and MRI signs of bone marrow edema (r=0,27, p=0,005 and r=0,29, p=0,002 respectively. Relationship between laboratory and clinical features was weaker and referred only to CRP level and swollen joint count (p=0,05.Conclusion. MRI signs may be used as additional and independent measures of inflammatory activity (particularly synovitis score and severity of RA

  5. Analysis of association between polymorphisms of MTHFR, MTHFD1 and RFC1 genes and efficacy and toxicity of methotrexate in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Vejnovic Dubravka

    2016-01-01

    Full Text Available A folate analogue methotrexate (MTX is the most commonly used disease-modifying drug in the treatment of rheumatoid arthritis. However, the clinical response of RA patients treated with MTX shows interindividual differences and 30% of patients discontinue therapy due to the side effects. In a group of 184 RA patients treated with MTX we have investigated whether polymorphisms in MTHFR (rs1801133, rs1801131, MTHFD1 (rs2236225 and RFC1 (rs144320551 genes may have impact on MTX efficacy and/or adverse drugs effects (ADEs. The efficacy of the MTX therapy has been estimated using the disease activity score in 28 joints (DAS28-ESR based on EULAR criteria and relative DAS28 values (rDAS28 and all adverse drug events were recorded. Patients were genotyped for selected polymorphism by PCR-RFLP method. According to the EULAR response criteria after 6 months of MTX therapy 146 (79.3% patients were classified as responders, (17 patients (11.6% were good and 129 patients (88.4% were moderate responders and 38 patients (20.7% as non-responders. ADEs were observed in 53 (28.8% patients. The majority of ADEs were mild (36 (19.56% patients to moderate (12 (6.25% patients. Five patients (2.7% had serious ADEs. Association studies have been conducted between obtained genotypes and the efficacy and toxicity of MTX. We have observed no association between polymorphisms and efficacy or toxicity of MTX in RA patients. [Projekat Ministarstva nauke Republike Srbije, br. 175091

  6. Similar activation of signal transduction pathways by the herpesvirus-encoded chemokine receptors US28 and ORF74

    DEFF Research Database (Denmark)

    McLean, Katherine A; Holst, Peter J; Martini, Lene

    2004-01-01

    The virally encoded chemokine receptors US28 from human cytomegalovirus and ORF74 from human herpesvirus 8 are both constitutively active. We show that both receptors constitutively activate the transcription factors nuclear factor of activated T cells (NFAT) and cAMP response element binding...

  7. 31 CFR 28.540 - Advertising.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Advertising. 28.540 Section 28.540... Basis of Sex in Employment in Education Programs or Activities Prohibited § 28.540 Advertising. A recipient shall not in any advertising related to employment indicate preference, limitation, specification...

  8. 49 CFR 28.111 - Notice.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Notice. 28.111 Section 28.111 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.111 Notice. The Department shall...

  9. 49 CFR 28.140 - Employment.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Employment. 28.140 Section 28.140 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.140 Employment. (a) No qualified...

  10. 49 CFR 28.101 - Purpose.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Purpose. 28.101 Section 28.101 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.101 Purpose. The purpose of this...

  11. Determining Pathways to Improvements in Fatigue in Rheumatoid Arthritis: Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.

    Science.gov (United States)

    Druce, Katie L; Jones, Gareth T; Macfarlane, Gary J; Basu, Neil

    2015-09-01

    There is debate as to the role of inflammatory disease activity in the etiology of rheumatoid arthritis (RA)-related fatigue. We undertook this study to determine the relationship of fatigue to disease activity by examining pathways associated with change in fatigue in subjects starting anti-tumor necrosis factor (anti-TNF) therapy for the first time. Participants who had been recruited to the British Society for Rheumatology Biologics Register for RA provided information on fatigue (Short Form 36 [SF-36] vitality scale) and other health status variables at the start of anti-TNF therapy and 6 months later. The Disease Activity Score in 28 joints (DAS28) and inflammation (erythrocyte sedimentation rate [ESR]/C-reactive protein [CRP] level) were also reported. A path analysis model comprising changes in fatigue, pain, disease activity, disability, and mental health, along with effects of sex and a history of depression, was used to examine those with high levels of fatigue at baseline (score of ≤12.5 units on the SF-36 vitality scale). The DAS28 was substituted for ESR/CRP to delineate the specific role of inflammation. With a total of 2,652 participants, we identified a well-fitting model (χ2  = 0.18, P = 0.98) accounting for 40% of the variance in fatigue change. There was no direct pathway from change in inflammation to change in fatigue; instead, significant pathways to change in fatigue were observed from changes in disease activity, pain, mental health, and disability, along with effects of sex and a history of depression. A total of 82% of the effect of change in disease activity was indirect, of which ∼50% was mediated through a change in pain. Improvements in fatigue do not appear to be driven by inflammatory disease activity; instead, they appear to result indirectly from improvements in pain. Additional significant pathways through disability and mental health suggest potentially modifiable factors that could be targeted to improve clinically

  12. A summary risk score for the prediction of Alzheimer disease in elderly persons.

    Science.gov (United States)

    Reitz, Christiane; Tang, Ming-Xin; Schupf, Nicole; Manly, Jennifer J; Mayeux, Richard; Luchsinger, José A

    2010-07-01

    To develop a simple summary risk score for the prediction of Alzheimer disease in elderly persons based on their vascular risk profiles. A longitudinal, community-based study. New York, New York. Patients One thousand fifty-one Medicare recipients aged 65 years or older and residing in New York who were free of dementia or cognitive impairment at baseline. We separately explored the associations of several vascular risk factors with late-onset Alzheimer disease (LOAD) using Cox proportional hazards models to identify factors that would contribute to the risk score. Then we estimated the score values of each factor based on their beta coefficients and created the LOAD vascular risk score by summing these individual scores. Risk factors contributing to the risk score were age, sex, education, ethnicity, APOE epsilon4 genotype, history of diabetes, hypertension or smoking, high-density lipoprotein levels, and waist to hip ratio. The resulting risk score predicted dementia well. According to the vascular risk score quintiles, the risk to develop probable LOAD was 1.0 for persons with a score of 0 to 14 and increased 3.7-fold for persons with a score of 15 to 18, 3.6-fold for persons with a score of 19 to 22, 12.6-fold for persons with a score of 23 to 28, and 20.5-fold for persons with a score higher than 28. While additional studies in other populations are needed to validate and further develop the score, our study suggests that this vascular risk score could be a valuable tool to identify elderly individuals who might be at risk of LOAD. This risk score could be used to identify persons at risk of LOAD, but can also be used to adjust for confounders in epidemiologic studies.

  13. 31 CFR 28.405 - Housing.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Housing. 28.405 Section 28.405 Money... in Education Programs or Activities Prohibited § 28.405 Housing. (a) Generally. A recipient shall not... offer different services or benefits related to housing, except as provided in this section (including...

  14. Larvicidal activity of oil-resin fractions from the Brazilian medicinal plant Copaifera reticulata Ducke (Leguminosae-Caesalpinoideae against Aedes aegypti (Diptera, Culicidae Atividade larvicida das frações do óleo-resina da planta medicinal brasileira Copaifera reticulata Ducke (Leguminosae-Caesalpinoideae sobre o Aedes aegypti (Diptera, Culicidae

    Directory of Open Access Journals (Sweden)

    Heloísa Helena Garcia da Silva

    2007-06-01

    Full Text Available Oil-resin fractions from Copaifera reticulata Ducke (Leguminosae-Caesalpinoideae were evaluated for larvicidal activity on third larval instars of Aedes aegypti, in searching for alternative control methods for this mosquito. The bioactive fractions were chemically monitored by thin-layer chromatography, ¹H and 13C nuclear magnetic resonance and mass spectrometry. Bioassays were performed using five repetitions, at a temperature of 28 ± 1°C, relative humidity of 80 ± 5% and light and dark cycles of 12h. Mortality was indicated by darkening of the cephalic capsule after 24h of exposure of the larvae to the solutions. The most active fractions were CRM1-4 (sesquiterpenes and CRM5-7 (labdane diterpenes, which showed LC50 values of 0.2 and 0.8ppm, respectively.A atividade larvicida das frações do óleo-resina de Copaifera reticulata Ducke (Leguminosae-Caesalpinoideae foi avaliada em larvas de 3º estádio de Aedes aegypti, na busca de alternativas para o controle desse mosquito. As frações bioativas foram monitoradas quimicamente através de cromatografia de camada delgada, analisada por ressonância magnética nuclear de hidrogênio (¹H e 13C e espectrometria de massas. Os bioensaios foram realizados à temperatura de 28±1°C, 80±5% de umidade relativa e fotofase de 12h, com cinco repetições. A mortalidade foi determinada através do escurecimento da cápsula cefálica, após 24h de exposição das larvas às soluções. As frações mais ativas foram CRM1-4 (sesquiterpenos e CRM5-7 (diterpeno labdano, que mostraram os valores de CL50 de 0,2 e 0,8ppm, respectivamente.

  15. Total glucosides of paeony can reduce the hepatotoxicity caused by Methotrexate and Leflunomide combination treatment of active rheumatoid arthritis.

    Science.gov (United States)

    Xiang, Nan; Li, Xiao-Mei; Zhang, Miao-Jia; Zhao, Dong-Bao; Zhu, Ping; Zuo, Xiao-Xia; Yang, Min; Su, Yin; Li, Zhan-Guo; Chen, Zhu; Li, Xiang-Pei

    2015-09-01

    Total glucosides of paeony (TGP) have been confirmed to exert anti-inflammatory and hepatoprotective effects. Methotrexate (MTX) and Leflunomide (LEF) combination has a better efficacy in the treatment of active rheumatoid arthritis (RA), but hepatotoxicity was observed. In this study, we investigated the effect of TGP on hepatic dysfunction caused by MTX and LEF in patients with active RA. A total of 268 patients with active RA (disease activity score in 28 joints, DAS28>3.2) were enrolled in this study. All patients were randomly assigned to two groups, the therapeutic group in which patients were treated with TGP (1.8 g/day) combined with MTX and LEF (MTX 10mg/week plus LEF 20mg/day) while in the control group, patients were treated without TGP up to 12 weeks. The efficacy and liver abnormalities were observed. The incidence of abnormal liver function within 12 weeks in TGP group was significantly lower than that in control group (11.38% vs 23.26%, P=0.013). The proportion of patients with ALT/AST >3 times ULN (upper limits of normal) was significantly lower in TGP group than control group (1.63% vs 7.75%, P=0.022). More patients achieved remission, good and moderate response in TGP group than control group at 4, 8 and 12 weeks, but the difference was not significant (P>0.05). The proportions of all adverse events were comparable in the two groups except for diarrhea. Our study demonstrates that TGP can significantly reduce the incidence and severity of liver damage caused by MTX+LEF in the treatment of active RA patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. The Pancreatitis Activity Scoring System predicts clinical outcomes in acute pancreatitis: findings from a prospective cohort study.

    Science.gov (United States)

    Buxbaum, James; Quezada, Michael; Chong, Bradford; Gupta, Nikhil; Yu, Chung Yao; Lane, Christianne; Da, Ben; Leung, Kenneth; Shulman, Ira; Pandol, Stephen; Wu, Bechien

    2018-03-15

    The Pancreatitis Activity Scoring System (PASS) has been derived by an international group of experts via a modified Delphi process. Our aim was to perform an external validation study to assess for concordance of the PASS score with high face validity clinical outcomes and determine specific meaningful thresholds to assist in application of this scoring system in a large prospectively ascertained cohort. We analyzed data from a prospective cohort study of consecutive patients admitted to the Los Angeles County Hospital between March 2015 and March 2017. Patients were identified using an emergency department paging system and electronic alert system. Comprehensive characterization included substance use history, pancreatitis etiology, biochemical profile, and detailed clinical course. We calculated the PASS score at admission, discharge, and at 12 h increments during the hospitalization. We performed several analyses to assess the relationship between the PASS score and outcomes at various points during hospitalization as well as following discharge. Using multivariable logistic regression analysis, we assessed the relationship between admission PASS score and risk of severe pancreatitis. PASS score performance was compared to established systems used to predict severe pancreatitis. Additional inpatient outcomes assessed included local complications, length of stay, development of systemic inflammatory response syndrome (SIRS), and intensive care unit (ICU) admission. We also assessed whether the PASS score at discharge was associated with early readmission (re-hospitalization for pancreatitis symptoms and complications within 30 days of discharge). A total of 439 patients were enrolled, their mean age was 42 (±15) years, and 53% were male. Admission PASS score >140 was associated with moderately severe and severe pancreatitis (OR 3.5 [95% CI 2.0, 6.3]), ICU admission (OR 4.9 [2.5, 9.4]), local complications (3.0 [1.6, 5.7]), and development of SIRS (OR 2.9 [1

  17. Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: A systematic review

    Science.gov (United States)

    Silvestre-Rangil, Javier; Bagan, Leticia; Bagan, Jose V.

    2016-01-01

    Background Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. Material and Methods A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment. Results Eight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP, IL-6 and TNFα showed a non significant tendency to decrease as a result of treatment. Conclusions Nonsurgical treatment improved the periodontal condition of patients with periodontitis and RA, with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies are therefore needed to more firmly establish possible significant relations between the two disease processes. Key words:Periodontitis, rheumatoid arthritis, periodontal treatment. PMID:26946202

  18. Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI) Z-score among Brazilian adolescents.

    Science.gov (United States)

    Enes, Carla C; Slater, Betzabeth

    2013-06-01

    To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI) z-score change among adolescents. The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004) (hereafter, baseline) and 299 in wave II (2005) (hereafter, follow-up). BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04) and sweetened natural fruit juices (β = 0.05, p = 0.03) was positively associated with the rise in BMI z-score. Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

  19. Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI Z-score among Brazilian adolescents*

    Directory of Open Access Journals (Sweden)

    Carla C. Enes

    2013-06-01

    Full Text Available Objective: To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI z-score change among adolescents. Methods: The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004 (hereafter, baseline and 299 in wave II (2005 (hereafter, follow-up. BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. Results: The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04 and sweetened natural fruit juices (β = 0.05, p = 0.03 was positively associated with the rise in BMI z-score. Conclusions: Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

  20. 31 CFR 28.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Recruitment. 28.510 Section 28.510... Basis of Sex in Employment in Education Programs or Activities Prohibited § 28.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  1. Interpretation of ambiguities by schoolchildren with low birth weight from Embu das Artes, São Paulo state, Brazil.

    Science.gov (United States)

    Pessoa, Rebeca Rodrigues; Araújo, Sarah Cueva Cândido Soares de; Isotani, Selma Mie; Puccini, Rosana Fiorini; Perissinoto, Jacy

    To assess the development of language regarding the ability to recognize and interpret lexical ambiguity in low-birth-weight schoolchildren enrolled at the school system in the municipality of Embu das Artes, Sao Paulo state, compared with that of schoolchildren with normal birth weight. A case-control, retrospective, cross-sectional study conducted with 378 schoolchildren, both genders, aged 5 to 9.9 years, from the municipal schools of Embu das Artes. Study Group (SG) comprising 210 schoolchildren with birth weight Control Group (CG) composed of 168 school children with birth weight ≥ 2500 g. Participants of both groups were compared with respect to the skills of recognition and verbal interpretation of sentences containing lexical ambiguity using the Test of Language Competence. Variables of interest: Age and gender of children; age and schooling of mothers. Statistical analysis: Descriptive analysis to characterize the sample and score per group; Student's t test for comparison between the total scores of each skill/subtest; Chi-square test to compare items within each subtest; multiple regression analysis for the intervening variables. Participants of the SG presented lower scores for ambiguous sentences compared with those of participants of the CG. Multiple regression analysis showed that child's current age was a predictor for all metalinguistic skills regarding interpretation of ambiguities in both groups. Participants of the SG presented lower specific and total scores than those of participants of the CG for ambiguity skills. The child's current age factor positively influenced the ambiguity skills in both groups.

  2. Simultaneous Response in Several Domains in Patients with Psoriatic Disease Treated with Etanercept as Monotherapy or in Combination with Conventional Synthetic Disease-modifying Antirheumatic Drugs.

    Science.gov (United States)

    Behrens, Frank; Meier, Lothar; Prinz, Jörg C; Jobst, Jürgen; Lippe, Ralph; Löschmann, Peter-Andreas; Lorenz, Hanns-Martin

    2018-04-01

    To evaluate patients with psoriatic arthritis (PsA) receiving etanercept (ETN) monotherapy or ETN plus conventional synthetic disease-modifying antirheumatic drugs (csDMARD) to determine the proportion achieving a clinically meaningful response in arthritis, psoriasis, and quality of life simultaneously. A prospective, multicenter, 52-week observational study in patients with active PsA evaluated treatment with ETN in clinical practice (ClinicalTrials.gov: NCT00293722). This analysis assessed simultaneous achievement of 3 treatment targets: low disease activity (LDA) based on 28-joint count Disease Activity Score (DAS28); body surface area (BSA) involvement ≤ 3%; and a score > 45 on the Medical Outcomes Study Short Form-12 (SF-12) physical component summary. Of 579 patients, 380 received ETN monotherapy and 199 received combination ETN plus csDMARD. At 52 weeks, data for all 3 disease domains were available for 251 patients receiving monotherapy and 151 receiving combination therapy. In the monotherapy and combination therapy groups, 61 (24.3%) and 37 (24.5%) patients, respectively, achieved all 3 treatment targets simultaneously. A significantly greater proportion of patients receiving monotherapy versus combination therapy achieved SF-12 > 45 (43.0% vs 31.8%; p < 0.05) and DAS28 LDA (72.5% vs 62.3%; p < 0.05). Conversely, BSA ≤ 3% was reached by a significantly greater proportion receiving combination therapy (75.5% vs 56.6%; p < 0.001). However, baseline BSA involvement was higher for the monotherapy group. While nearly half the patients achieved arthritis and psoriasis treatment targets simultaneously and one-fourth reached all 3 treatment targets, combining ETN and csDMARD did not substantially improve clinical response compared with ETN monotherapy in this real-world PsA patient population.

  3. The influence of thyroid diseases, diabetes mellitus, primary hyperparathyroidism, vitamin B12 deficiency and other comorbid autoimmune diseases on treatment outcome in patients with rheumatoid arthritis: An exploratory cohort study

    DEFF Research Database (Denmark)

    Emamifar, Amir; Jensen Hansen, Inger Marie

    2018-01-01

    To investigate the impact of comorbid diseases on rheumatoid arthritis (RA) outcome. All patients diagnosed with RA since 2006, who were registered in our local Danbio registry, were included in this cohort study. Patients’ demographics, serology results, and Disease Activity Score in 28 joints......-C-reactive protein (DAS28-CRP) at the time of diagnosis and after 4 months of treatment initiation were collected. Patients’ electronic hospital records were evaluated for a positive history of thyroid diseases, diabetes mellitus, primary hyperparathyroidism, vitamin B12 deficiency, and the presence of other...... diagnosed autoimmune diseases. 1035 RA patients were included. The observed prevalence of thyroid diseases was 11.8%, DM 10.4%, primary hyperparathyroidism 2.8%, vitamin B12 deficiency 5.8%, and other diagnosed autoimmune diseases 1.6%. There were significant associations between presence of thyroid...

  4. Utility of the Spelling Sensitivity Score to Analyze Spellings of Children with Specific Language Impairment

    Science.gov (United States)

    Werfel, Krystal L.; Krimm, Hannah

    2015-01-01

    The purpose of this study was to examine the utility of the Spelling Sensitivity Score (SSS) beyond percentage correct scoring in analyzing the spellings of children with specific language impairment (SLI). Participants were 31 children with SLI and 28 children with typical language in grades 2-4. Spellings of individual words were scored using…

  5. Selecting score types for longitudinal evaluations: the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers in children with developmental disabilities

    Directory of Open Access Journals (Sweden)

    Tsai YP

    2016-05-01

    Full Text Available Yu-Pei Tsai,1,2 Li-Chen Tung,1,3 Ya-Chen Lee,4 Yu-Lin Wang,1,5 Yun-Shan Yen,1 Kuan-Lin Chen4,6 1Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, 2Department of Special Education, National Chiayi University, Chiayi, 3School of Medicine, Chung Shan Medical University, Taichung, 4Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 5Department of Sports Management, Chia Nan University of Pharmacy and Science, 6Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Objective: The objective of this study was to examine the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT in children with developmental disabilities (DD.Methods: The responsiveness of a measure is its ability to detect change over time, and it is fundamental to an outcome measure for detecting changes over time. We compared the responsiveness of four types of scores (ie, raw scores, developmental ages [DAs], percentile ranks [PRs], and developmental quotients [DQs] in the five subtests of the CDIIT. The CDIIT was administrated three times at intervals of 3 months on 32 children with DD aged between 5 months and 64 months (mean =30.6, standard deviation [SD] =17.8. The CDIIT is a pediatric norm-referenced assessment commonly used for clinical diagnosis of developmental delays in five developmental areas: cognition, language, motor, social, and self-care skills. The responsiveness was analyzed using three methods: effect size, standardized response mean, and paired t-test.Results: The effect size results showed that at the 3-month and 6-month follow-ups, responsiveness was small or moderate in the raw scores and DAs of most of the subtest scores of the CDIIT, but the level of responsiveness varied in the PRs and DQs. The standardized response mean results of the 3-month

  6. "Das Konkrete ist das Abstrakte, an das man sich schließlich gewöhnt hat." (Laurent Schwartz) Über den Ablauf des mathematischen Verstehens

    Science.gov (United States)

    Lowsky, Martin

    Die im Titel genannte Aussage findet sich in den Lebenserinnerungen von Laurent Schwartz (1915-2002), einem der fruchtbarsten Mathematiker, Mitglied der Gruppe Bourbaki. Im Original lautet die Aussage: "un objet concret est un objet abstrait auquel on a fini par s'habituer." Schwartz erläutert sie am Beispiel des Integrals über {e^{-1/2{x^2}}} , das den Wert Wurzel aus 2π hat und in dem sich also die Zahlen e und π verknüpfen. Was Schwartz aber vor allem ausdrücken will, ist dies: Das mathematische Verständnisd geht langsam vor sich und es bedarf der Anstrengung. "Es ist eine Frage der Zeit und der Energie", sagt Schwartz, und gerade dies mache es so schwer, die höhere Mathematik unter das Volk zu bringen. Das Lernen und Lehren von Mathematik laufe eben mühevoll und langsam ab.

  7. A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

    NARCIS (Netherlands)

    Suppiah, Ravi; Mukhtyar, Chetan; Flossmann, Oliver; Alberici, Federico; Baslund, Bo; Batra, Rajbir; Brown, Denise; Holle, Julia; Hruskova, Zdenka; Jayne, David R. W.; Judge, Andrew; Little, Mark A.; Palmisano, Alessandra; Stegeman, Coen; Tesar, Vladimir; Vaglio, Augusto; Westman, Kerstin; Luqmani, Raashid

    Methods. A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment

  8. Involvement of IL-33 in the pathogenesis of rheumatoid arthritis: the effect of etanercept on the serum levels of IL-33.

    Science.gov (United States)

    Kageyama, Yasunori; Torikai, Eiji; Tsujimura, Kunio; Kobayashi, Masato

    2012-02-01

    To investigate the role of interleukin (IL)-33 in rheumatoid arthritis (RA) patients, we measured the serum levels of IL-33 in RA patients before and after the administration of etanercept. Twenty-four patients with RA were treated with etanercept. Clinical and laboratory examinations, including serum levels of C-reactive protein (CRP) and hemoglobin (Hb); white blood cell (WBC) and red blood cell (RBC) counts; and the Disease Activity Score of 28 joints including CRP (DAS28-CRP), were performed at the baseline and at 3 and 6 months after the initial treatment with etanercept. The mean serum IL-33 levels had decreased significantly at 3 and 6 months after the initial treatment with etanercept. Serum IL-33 levels showed a significant correlation with the number of tender joints, CRP, DAS28-CRP, and the WBC count, and an inverse correlation with the RBC count and Hb level. These findings indicated that the decrease of serum IL-33 levels was a novel function of etanercept, shown for the first time in this study. Measurement of serum levels of IL-33 may become a useful control marker for RA treatment.

  9. QUAL O FUTURO DAS ESCOLAS NO CAMPO?

    Directory of Open Access Journals (Sweden)

    Célia Regina Vendramini

    2015-09-01

    Full Text Available RESUMO:Tendo como ponto de partida a questão sobre o futuro das escolas rurais ou do campo, o artigo aborda o contexto social, político e econômico que suporta ou não a existência das escolas, bem como uma análise sobre a situação das escolas em diferentes contextos, particularmente no Brasil, em Portugal e nos Estados Unidos. Problematizamos as respostas dadas pelo poder público, acadêmicos e organizações e movimentos sociais sobre o fechamento, a redução do número de alunos e de comunidades rurais com escola, as condições de funcionamento, a distância percorrida pelos alunos, além das implicações das escolas para a vitalidade do campo. Concluímos que o futuro das escolas está diretamente relacionado com o futuro do campo.

  10. Alimentary Habits, Physical Activity, and Framingham Global Risk Score in Metabolic Syndrome

    International Nuclear Information System (INIS)

    Soares, Thays Soliman; Piovesan, Carla Haas; Gustavo, Andréia da Silva; Macagnan, Fabrício Edler; Bodanese, Luiz Carlos; Feoli, Ana Maria Pandolfo

    2014-01-01

    Metabolic syndrome is a complex disorder represented by a set of cardiovascular risk factors. A healthy lifestyle is strongly related to improve Quality of Life and interfere positively in the control of risk factors presented in this condition. To evaluate the effect of a program of lifestyle modification on the Framingham General Cardiovascular Risk Profile in subjects diagnosed with metabolic syndrome. A sub-analysis study of a randomized clinical trial controlled blind that lasted three months. Participants were randomized into four groups: dietary intervention + placebo (DIP), dietary intervention + supplementation of omega 3 (fish oil 3 g/day) (DIS3), dietary intervention + placebo + physical activity (DIPE) and dietary intervention + physical activity + supplementation of omega 3 (DIS3PE). The general cardiovascular risk profile of each individual was calculated before and after the intervention. The study included 70 subjects. Evaluating the score between the pre and post intervention yielded a significant value (p < 0.001). We obtained a reduction for intermediate risk in 25.7% of subjects. After intervention, there was a significant reduction (p < 0.01) on cardiovascular age, this being more significant in groups DIP (5.2%) and DIPE (5.3%). Proposed interventions produced beneficial effects for reducing cardiovascular risk score. This study emphasizes the importance of lifestyle modification in the prevention and treatment of cardiovascular diseases

  11. Alimentary Habits, Physical Activity, and Framingham Global Risk Score in Metabolic Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Thays Soliman; Piovesan, Carla Haas; Gustavo, Andréia da Silva; Macagnan, Fabrício Edler; Bodanese, Luiz Carlos; Feoli, Ana Maria Pandolfo, E-mail: anamariafeoli@hotmail.com [Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil)

    2014-04-15

    Metabolic syndrome is a complex disorder represented by a set of cardiovascular risk factors. A healthy lifestyle is strongly related to improve Quality of Life and interfere positively in the control of risk factors presented in this condition. To evaluate the effect of a program of lifestyle modification on the Framingham General Cardiovascular Risk Profile in subjects diagnosed with metabolic syndrome. A sub-analysis study of a randomized clinical trial controlled blind that lasted three months. Participants were randomized into four groups: dietary intervention + placebo (DIP), dietary intervention + supplementation of omega 3 (fish oil 3 g/day) (DIS3), dietary intervention + placebo + physical activity (DIPE) and dietary intervention + physical activity + supplementation of omega 3 (DIS3PE). The general cardiovascular risk profile of each individual was calculated before and after the intervention. The study included 70 subjects. Evaluating the score between the pre and post intervention yielded a significant value (p < 0.001). We obtained a reduction for intermediate risk in 25.7% of subjects. After intervention, there was a significant reduction (p < 0.01) on cardiovascular age, this being more significant in groups DIP (5.2%) and DIPE (5.3%). Proposed interventions produced beneficial effects for reducing cardiovascular risk score. This study emphasizes the importance of lifestyle modification in the prevention and treatment of cardiovascular diseases.

  12. Tracking of leisure time physical activity during 28 yr in adults: the Tromsø study.

    Science.gov (United States)

    Morseth, Bente; Jørgensen, Lone; Emaus, Nina; Jacobsen, Bjarne K; Wilsgaard, Tom

    2011-07-01

    Physical activity plays an important role in the prevention of many serious diseases. To develop targeted strategies that encourage physical activity, knowledge of stability of physical activity levels over time is essential. The aim of this study was to examine tracking of leisure time physical activity in adults in Northern Norway during three decades. We followed 5432 women and men who attended the Tromsø Study in 1979-1980, as well as repeated examinations after 7 and 28 yr. Baseline age was 20-54 yr (mean age=35.8 yr). Physical activity was assessed by self-administered questionnaires. Tracking of physical activity, defined as maintenance of relative rank of physical activity level, was estimated by Spearman correlation coefficient and by weighted κ statistics. Tracking in terms of predictability of later values from earlier measurements was analyzed by generalized estimating equations. A higher-than-expected proportion of subjects maintained their physical activity level from examination 1 to 2 (58%) and 3 (53%). κ statistics showed agreement of 0.41 and 0.29, respectively. Belonging to a specific physical activity level at baseline increased the odds of belonging to the same category at later examinations (sedentary odds ratio (OR)=3.9 (95% confidence interval (CI)=3.5-4.4), moderately active OR=2.2 (95% CI=2.0-2.4), active OR=2.9 (95% CI=2.6-3.3), and highly active OR=14.0 (95% CI=8.7-22.5)). Being physically active in young adulthood increased the odds of being physically active later in life (moderately active OR=3.4 (95% CI=3.0-3.9), active OR=5.4 (95% CI=4.6-6.4), and highly active OR=13.0 (95% CI=7.4-22.8)). This study showed tracking of leisure time physical activity during 28 yr in a cohort of adults.

  13. Mutation of Asn28 Disrupts the Dimerization and Enzymatic Activity of SARS 3CL

    Energy Technology Data Exchange (ETDEWEB)

    Barrila, J.; Gabelli, S; Bacha, U; Amzel, M; Freire, E

    2010-01-01

    Coronaviruses are responsible for a significant proportion of annual respiratory and enteric infections in humans and other mammals. The most prominent of these viruses is the severe acute respiratory syndrome coronavirus (SARS-CoV) which causes acute respiratory and gastrointestinal infection in humans. The coronavirus main protease, 3CL{sup pro}, is a key target for broad-spectrum antiviral development because of its critical role in viral maturation and high degree of structural conservation among coronaviruses. Dimerization is an indispensable requirement for the function of SARS 3CL{sup pro} and is regulated through mechanisms involving both direct and long-range interactions in the enzyme. While many of the binding interactions at the dimerization interface have been extensively studied, those that are important for long-range control are not well-understood. Characterization of these dimerization mechanisms is important for the structure-based design of new treatments targeting coronavirus-based infections. Here we report that Asn28, a residue 11 {angstrom} from the closest residue in the opposing monomer, is essential for the enzymatic activity and dimerization of SARS 3CLpro. Mutation of this residue to alanine almost completely inactivates the enzyme and results in a 19.2-fold decrease in the dimerization K{sub d}. The crystallographic structure of the N28A mutant determined at 2.35 {angstrom} resolution reveals the critical role of Asn28 in maintaining the structural integrity of the active site and in orienting key residues involved in binding at the dimer interface and substrate catalysis. These findings provide deeper insight into complex mechanisms regulating the activity and dimerization of SARS 3CL{sup pro}.

  14. Depressive symptoms predict future simple disease activity index scores and simple disease activity index remission in a prospective cohort of patients with early inflammatory polyarthritis.

    Science.gov (United States)

    Leblanc-Trudeau, Charlotte; Dobkin, Patricia L; Carrier, Nathalie; Cossette, Pierre; de Brum-Fernandes, Artur J; Liang, Patrick; Masetto, Ariel; Boire, Gilles

    2015-12-01

    To determine whether depressive symptoms assessed in treated patients with early inflammatory polyarthritis (EPA) influence disease activity during follow-up. Consecutively recruited EPA patients were actively treated to remission. Simple disease activity index (SDAI) and Center for Epidemiologic Studies Depression Scale (CES-D) scores were calculated at inclusion and up to 42 months into disease. SDAI scores were log-transformed to compute univariate and multivariate linear regressions. Parametric interval-censored Kaplan-Meier and survival regressions using Weibull distribution were used to assess time to and predictors of SDAI remission. A total of 275 EPA patients were recruited at a median of 4 months into disease. In multivariate linear regression models, accounting for baseline demographic, clinical, serological and functional variables and 12-month inflammation markers, CES-D scores at 12 months into disease were correlated (r(2) = 0.14) with subsequent SDAI scores. Patients with 12-month high CES-D (≥19; suggestive of depression) had a lower proportion of SDAI remission (31.3% vs 84.3%; P < 0.001) and reached SDAI remission less rapidly [hazard ratio = 0.25 (95% CI 0.12, 0.53); P < 0.001]. Each follow-up SDAI correlated significantly with 12-month depressive symptoms, a median of 7 months after initiation of treatment. CES-D scores suggestive of depression at 12 months were strongly correlated with delay and failure to reach remission later on. Depressive symptoms in treated EPA patients represent important clinical issues with long-term association with disease activity. Interventions to alleviate persistent depressive symptoms in treated EPA warrant careful evaluation of their potential to improve disease remission rates. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. State Mines Inspectorate of Saarland and Rheinland-Pfalz, Mines InspectorateSaarbruecken/ Mines Inspectorate Rheinland-Pfalz. Annual report 2000. Economic and technical aspects, industrial safety and enviromental protection, statistics, activities of the mining authorities; Oberbergamt fuer das Saarland und das Land Rheinland-Pfalz, Bergamt Saarbruecken/Bergamt Rheinland-Pfalz. Jahresbericht 2000. Bergwirtschaft, Bergtechnik, Arbeitsschutz, Umweltschutz, Statistiken, Taetigkeiten der Bergbehoerden

    Energy Technology Data Exchange (ETDEWEB)

    Boettcher, R.; Hugo, K.H.; Kuhn, M.; Strauch, T. (comps.)

    2001-07-01

    The annual report of the Saarland and Rheinland-Pfalz State Mines Inspectorate and the Mines Inspectorates of the two states provide an insight into the many activities of mines inspectorates and of the current trends in mining engineering. The importance of mining and regional raw materials management is stressed. [German] Der vorliegende Jahresbericht des Oberbergamtes fuer das Saarland und das Land Rheinland-Pfalz sowie der Bergaemter in beiden Bundeslaendern gibt einen Einblick in das vielfaeltige Arbeitsgebiet der Bergbehoerden. Gleichzeitig vermittelt er einen Ueberblick ueber die bergtechnische Entwicklung und unterstreicht die volkswirtschaftliche Bedeutung des Bergbaus und der standortgebundenen Rohstoffwirtschaft. (orig.)

  16. State Mines Inspectorate of Saarland and Rheinland-Pfalz, Mines Inspectorate Saarbruecken / Mines Inspectorate Rheinland-Pfalz. Annual report 2001. Economic and technical aspects, industrial safety and environmental protection, statistics, activities of the mining authorities; Oberbergamt fuer das Saarland und das Land Rheinland-Pfalz, Bergamt Saarbruecken / Bergamt Rheinland-Pfalz. Jahresbericht 2001. Bergwirtschaft, Bergtechnik, Arbeitsschutz, Umweltschutz, Statistiken, Taetigkeiten der Bergbehoerden

    Energy Technology Data Exchange (ETDEWEB)

    Boettcher, R.; Hugo, K.H.; Kuhn, M.; Strauch, T. (comps.)

    2002-07-01

    The annual report of the Saarland and Rheinland-Pfalz State Mines Inspectorate and the Mines Inspectorates of the two states provide an insight into the many activities of mines inspectorates and of the current trends in mining engineering. The importance of mining and regional raw materials management is stressed. [German] Der vorliegende Jahresbericht des Oberbergamtes fuer das Saarland und das Land Rheinland-Pfalz sowie der Bergaemter in beiden Bundeslaendern gibt einen Einblick in das vielfaeltige Arbeitsgebiet der Bergbehoerden. Gleichzeitig vermittelt er einen Ueberblick ueber die bergtechnische Entwicklung und unterstreicht die volkswirtschaftliche Bedeutung des Bergbaus und der standortgebundenen Rohstoffwirtschaft.

  17. Alcohol Use Among Active Duty Women: Analysis AUDIT Scores From the 2011 Health-Related Behavior Survey of Active Duty Military Personnel.

    Science.gov (United States)

    Jeffery, Diana D; Mattiko, Mark

    2016-01-01

    Numerous studies document higher substance use among military men after deployment; similar studies focused on military women are limited. This study examines alcohol use of active duty women and deployment factors, social/environmental/attitudinal factors, and psychological/intrapersonal factors. Secondary data analysis of the 2011 Survey of Health-Related Behavior of active duty military personnel was conducted using bivariate statistics and multiple regression analyses with Alcohol Use Disorders Identification Test scores as the dependent variable. Nearly 94% had low risk for alcohol use disorders. Length of combat experience and extent of combat exposure were unrelated to Alcohol Use Disorders Identification Test scores; noncombat deployment was unrelated after controlling for marital status, age of first drink, pay grade, and branch of service. Significant motivators (p risk propensity, lifetime prevalence of suicidal ideation, and depressed mood were significant predictors in the regression model after controlling for covariates. Findings suggest that some active duty women use alcohol to cope with adverse emotional states, whereas others use alcohol consistent with propensity for high-risk behaviors. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  18. Efficacy and safety at 24 weeks of daily clinical use of tofacitinib in patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Naoki Iwamoto

    Full Text Available We evaluated the efficacy and safety of tofacitinib in patients with rheumatoid arthritis (RA in a real-world setting.Seventy consecutive patients, for whom tofacitinib was initiated between November 2013 and May 2016, were enrolled. All patients fulfilled the 2010 ACR/EULAR classification criteria for RA. All patients received 5 mg of tofacitinib twice daily and were followed for 24 weeks. Clinical disease activity indicated by disease activity score (DAS28-ESR, the simplified disease activity index, and the clinical disease activity index as well as adverse events (AEs were evaluated. Statistical analysis was performed to determine which baseline variables influenced the efficacy of tofacitinib at 24 weeks.Fifty-eight patients (82.9% continued tofacitinib at 24 weeks. Clinical disease activity rapidly and significantly decreased, and this efficacy continued throughout the 24 weeks: i.e., DAS28-ESR decreased from 5.04 ± 1.33 at baseline to 3.83 ± 1.11 at 4 weeks and 3.53 ± 1.17 at 24 weeks (P<0.0001, vs. baseline. 15 AEs including 5 herpes zoster infection occurred during tofacitinib treatment. The efficacy of tofacitinib was not changed in patients without concomitant use of methotrexate (MTX or patients whose treatment with tocilizumab (TCZ failed. Multivariable logistic analysis showed that the number of biologic DMARDs (bDMARDs previously used was independently associated with achievement of DAS-low disease activity.Our present study suggests that tofacitinib is effective in real-world settings even without concomitant MTX use or after switching from TCZ. Our results also suggest that its efficacy diminishes if started after use of multiple bDMARDs.

  19. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis?

    DEFF Research Database (Denmark)

    van der Heijde, Désirée; Landewé, Robert; Hermann, Kay-Geert

    2007-01-01

    This report summarizes the discussion during a module update at OMERACT 8 on scoring methods for activity in the spine on magnetic resonance imaging. The conclusion was that the 3 available scoring methods are all very good with respect to discrimination and feasibility: the Ankylosing Spondylitis...... spine MRI score for activity (ASspiMRI-a), the Berlin method (a modification of the ASspiMRI-a), and the Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging Index for Assessment of Spinal Inflammation in AS (SPARCC). All 3 methods were judged to be similar with respect...... to responsiveness and discrimination, although the differences in between-reader intraclass correlation coefficients (ICC) were judged to be relevant (the SPARCC method provided consistently higher ICC). The Berlin and SPARCC methods were preferred most frequently. The development of a new method combining the best...

  20. Most patients who reach disease remission following anti-TNF therapy continue to report fatigue: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.

    Science.gov (United States)

    Druce, Katie L; Bhattacharya, Yagnaseni; Jones, Gareth T; Macfarlane, Gary J; Basu, Neil

    2016-10-01

    RA-related fatigue is common and debilitating, but does not always respond to immunotherapy. In the context of anti-TNF therapy, we aimed to examine whether patients achieving disease remission experienced remission of fatigue. Data from the British Society for Rheumatology Biologics Register for RA were used. In participants with severe baseline fatigue [36-item Short Form Health Survey (SF-36) vitality score ⩽12.5], we identified those in disease remission [28-joint DAS (DAS28) 12.5) and complete remission (SF-36 vitality score >50) at follow-up. Demographic (e.g. sex, age), clinical (e.g. inflammation, joint erosion and co-morbidities) and psychosocial (e.g. SF-36 domains and HAQ) characteristics were compared between responder and non-responder groups. Severe baseline fatigue was reported by 2652 participants, of whom 271 (10%) achieved a DAS28 <2.6 by 6 months. In total, 225 participants (83%) reported partial remission and were distinguished from those who did not by better health status on all psychosocial domains. Far fewer [n = 101 (37.3%)] reported full fatigue remission. In addition to reporting clinically poorer health status, they were distinguished on the basis of a history of hypertension, depression and stroke as well as baseline treatment use of steroids and antidepressants. Despite achieving clinical remission, many RA patients do not achieve complete remission of their fatigue. Therefore, despite being important in overall disease control, reductions in disease activity are not always sufficient to ameliorate fatigue, so other symptom-specific management approaches must be considered for those for whom fatigue does not resolve. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Índice de incapacitação das lombalgias em motoristas de caminhão

    Directory of Open Access Journals (Sweden)

    Amarilda Aparecida dos Santos Pedroso

    2013-12-01

    Full Text Available Introdução: As lombalgias são causas de morbidade e incapacidade na realização de atividades de vida diária. Motoristas de caminhão apresentam risco aumentado de desenvolvimento da lombalgia em razão das demandas mecânico-posturais características da profissão. Objetivo: Investigar o nível de interferência das lombalgias nas atividades de vida diária de motoristas de caminhão. Métodos: Foi realizado um estudo transversal, no qual foram entrevistados 30 motoristas de caminhão, do sexo masculino, com idade entre 25 e 35 anos e com mais de cinco anos de experiência na profissão. Apenas os indivíduos que referiram dor lombar crônica, persistente há mais de três meses, foram instruídos a responder o questionário sobre o índice de incapacitação de Oswestry para dor lombar, com intuito de classificar os níveis de interferência das lombalgias nas atividades de vida diária. Resultados: Vinte e nove motoristas de caminhão atenderam aos critérios de inclusão do estudo (média de idade 31,83±3,63 anos, tempo de experiência 8,93±2,4 anos e média de 13,66±2,47 horas diárias de trabalho. Vinte e dois motoristas (75,86% apresentavam incapacidade mínima (score 8,45±6,58 e sete (24,14%, incapacidade moderada (score 27,14±6,3. Conclusão: Apenas 24,14% da amostra estudada apresentou incapacidade moderada, interferindo assim na realização de atividades de vida diária, tais como: problemas ao sentar, levantar peso e ficar de pé.

  2. Teoria das Restrições, Lean Manufacturing e Seis Sigma: limites e possibilidades de integração

    Directory of Open Access Journals (Sweden)

    Diego Augusto de Jesus Pacheco

    2014-12-01

    Full Text Available O principal objetivo deste estudo foi analisar os pontos de convergência e as divergências entre a Teoria das Restrições, o Lean Manufacturing e o Seis Sigma quando usados de maneira integrada para a melhoria contínua operacional de sistemas produtivos. O eixo principal de discussão desse estudo foi buscar identificar na literatura características de exclusão e similaridades entre as três abordagens quando aplicadas de maneira integrada em sistemas produtivos. Para conduzir essa pesquisa, fez-se uma ampla pesquisa bibliográfica, entre 1995 e 2011, nas principais bases de dados nacionais e internacionais, em busca do estado da arte sobre o tema. Os resultados desse estudo sugerem que Teoria das Restrições, Lean Manufacturing e Seis Sigma possuem diversos elementos complementares que se sobrepõem aos pontos divergentes e que há um vasto campo de pesquisa a ser explorado sobre o tema. Como resultado, o presente estudo apresenta a análise crítica comparativa de 28 critérios relevantes à compreensão das três abordagens assim como uma agenda de pesquisa sobre o tema identificada a partir das lacunas encontradas.

  3. Thioredoxin 1 in Prostate Tissue Is Associated with Gleason Score, Erythrocyte Antioxidant Enzyme Activity, and Dietary Antioxidants

    Directory of Open Access Journals (Sweden)

    Terrence M. Vance

    2015-01-01

    Full Text Available Background. Prostate cancer is the most common noncutaneous cancer and second leading cause of cancer-related mortality in men in the US. Growing evidence suggests that oxidative stress is involved in prostate cancer. Methods. In this study, thioredoxin 1 (Trx 1, an enzyme and subcellular indicator of redox status, was measured in prostate biopsy tissue from 55 men from the North Carolina-Louisiana Prostate Cancer Project. A pathologist blindly scored levels of Trx 1. The association between Trx 1 and the Gleason score, erythrocyte antioxidant enzyme activity, and dietary antioxidant intake was determined using Fisher’s exact test. Results. Trx 1 levels in benign prostate tissue in men with incident prostate cancer were positively associated with the Gleason score (P=0.01 and inversely associated with dietary antioxidant intake (P=0.03. In prostate cancer tissue, Trx 1 levels were associated with erythrocyte glutathione peroxidase activity (P=0.01. No association was found for other erythrocyte enzymes. Greater Gleason score of malignant tissue corresponds to a greater difference in Trx 1 levels between malignant and benign tissue (P=0.04. Conclusion. These results suggest that the redox status of prostate tissue is associated with prostate cancer grade and both endogenous and exogenous antioxidants.

  4. Effect of Glucocorticoids on the Clinical and Radiographic Efficacy of Tofacitinib in Patients with Rheumatoid Arthritis: A Posthoc Analysis of Data from 6 Phase III Studies.

    Science.gov (United States)

    Charles-Schoeman, Christina; van der Heijde, Désirée; Burmester, Gerd R; Nash, Peter; Zerbini, Cristiano A F; Connell, Carol A; Fan, Haiyun; Kwok, Kenneth; Bananis, Eustratios; Fleischmann, Roy

    2018-02-01

    Tofacitinib has been investigated for the treatment of rheumatoid arthritis (RA) in phase III studies in which concomitant glucocorticoids (GC) were allowed. We analyzed the effect of GC use on efficacy outcomes in patients with RA receiving tofacitinib and/or methotrexate (MTX) or conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in these studies. Our posthoc analysis included data from 6 phase III studies (NCT01039688; NCT00814307; NCT00847613; NCT00853385; NCT00856544; NCT00960440). MTX-naive patients or patients with inadequate response to csDMARD or biological DMARD received tofacitinib 5 or 10 mg twice daily alone or with csDMARD, with or without concomitant GC. Patients receiving GC (≤ 10 mg/day prednisone or equivalent) before enrollment maintained a stable dose throughout. Endpoints included the American College of Rheumatology (ACR) 20/50/70 response rates, rates of Clinical Disease Activity Index (CDAI)-defined low disease activity (LDA; CDAI ≤ 10) and remission (CDAI ≤ 2.8), and changes from baseline in CDAI, 28-joint count Disease Activity Score (DAS28-4)-erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain visual analog scale (VAS), and modified total Sharp score. Of 3200 tofacitinib-treated patients, 1258 (39.3%) received tofacitinib monotherapy and 1942 (60.7%) received tofacitinib plus csDMARD; 1767 (55.2%) received concomitant GC. ACR20/50/70 response rates, rates of CDAI LDA and remission, and improvements in CDAI, DAS28-4-ESR, HAQ-DI, and pain VAS with tofacitinib were generally similar with or without GC in monotherapy and combination therapy studies. GC use did not appear to affect radiographic progression in tofacitinib-treated MTX-naive patients. MTX plus GC appeared to inhibit radiographic progression to a numerically greater degree than MTX alone. Concomitant use of GC with tofacitinib did not appear to affect clinical or radiographic efficacy. MTX plus GC showed a

  5. siMS Score: Simple Method for Quantifying Metabolic Syndrome.

    Science.gov (United States)

    Soldatovic, Ivan; Vukovic, Rade; Culafic, Djordje; Gajic, Milan; Dimitrijevic-Sreckovic, Vesna

    2016-01-01

    To evaluate siMS score and siMS risk score, novel continuous metabolic syndrome scores as methods for quantification of metabolic status and risk. Developed siMS score was calculated using formula: siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130-HDL/1.02 or 1.28 (for male or female subjects, respectively). siMS risk score was calculated using formula: siMS risk score = siMS score * age/45 or 50 (for male or female subjects, respectively) * family history of cardio/cerebro-vascular events (event = 1.2, no event = 1). A sample of 528 obese and non-obese participants was used to validate siMS score and siMS risk score. Scores calculated as sum of z-scores (each component of metabolic syndrome regressed with age and gender) and sum of scores derived from principal component analysis (PCA) were used for evaluation of siMS score. Variants were made by replacing glucose with HOMA in calculations. Framingham score was used for evaluation of siMS risk score. Correlation between siMS score with sum of z-scores and weighted sum of factors of PCA was high (r = 0.866 and r = 0.822, respectively). Correlation between siMS risk score and log transformed Framingham score was medium to high for age groups 18+,30+ and 35+ (0.835, 0.707 and 0.667, respectively). siMS score and siMS risk score showed high correlation with more complex scores. Demonstrated accuracy together with superior simplicity and the ability to evaluate and follow-up individual patients makes siMS and siMS risk scores very convenient for use in clinical practice and research as well.

  6. Estimation of Symptom Severity Scores for Patients with Schizophrenia Using ERP Source Activations during a Facial Affect Discrimination Task.

    Science.gov (United States)

    Kim, Do-Won; Lee, Seung-Hwan; Shim, Miseon; Im, Chang-Hwan

    2017-01-01

    Precise diagnosis of psychiatric diseases and a comprehensive assessment of a patient's symptom severity are important in order to establish a successful treatment strategy for each patient. Although great efforts have been devoted to searching for diagnostic biomarkers of schizophrenia over the past several decades, no study has yet investigated how accurately these biomarkers are able to estimate an individual patient's symptom severity. In this study, we applied electrophysiological biomarkers obtained from electroencephalography (EEG) analyses to an estimation of symptom severity scores of patients with schizophrenia. EEG signals were recorded from 23 patients while they performed a facial affect discrimination task. Based on the source current density analysis results, we extracted voxels that showed a strong correlation between source activity and symptom scores. We then built a prediction model to estimate the symptom severity scores of each patient using the source activations of the selected voxels. The symptom scores of the Positive and Negative Syndrome Scale (PANSS) were estimated using the linear prediction model. The results of leave-one-out cross validation (LOOCV) showed that the mean errors of the estimated symptom scores were 3.34 ± 2.40 and 3.90 ± 3.01 for the Positive and Negative PANSS scores, respectively. The current pilot study is the first attempt to estimate symptom severity scores in schizophrenia using quantitative EEG features. It is expected that the present method can be extended to other cognitive paradigms or other psychological illnesses.

  7. Estimation of Symptom Severity Scores for Patients with Schizophrenia Using ERP Source Activations during a Facial Affect Discrimination Task

    Directory of Open Access Journals (Sweden)

    Do-Won Kim

    2017-08-01

    Full Text Available Precise diagnosis of psychiatric diseases and a comprehensive assessment of a patient's symptom severity are important in order to establish a successful treatment strategy for each patient. Although great efforts have been devoted to searching for diagnostic biomarkers of schizophrenia over the past several decades, no study has yet investigated how accurately these biomarkers are able to estimate an individual patient's symptom severity. In this study, we applied electrophysiological biomarkers obtained from electroencephalography (EEG analyses to an estimation of symptom severity scores of patients with schizophrenia. EEG signals were recorded from 23 patients while they performed a facial affect discrimination task. Based on the source current density analysis results, we extracted voxels that showed a strong correlation between source activity and symptom scores. We then built a prediction model to estimate the symptom severity scores of each patient using the source activations of the selected voxels. The symptom scores of the Positive and Negative Syndrome Scale (PANSS were estimated using the linear prediction model. The results of leave-one-out cross validation (LOOCV showed that the mean errors of the estimated symptom scores were 3.34 ± 2.40 and 3.90 ± 3.01 for the Positive and Negative PANSS scores, respectively. The current pilot study is the first attempt to estimate symptom severity scores in schizophrenia using quantitative EEG features. It is expected that the present method can be extended to other cognitive paradigms or other psychological illnesses.

  8. HUMANIZAÇÃO DO DISCURSO DAS MARCAS DIANTE DAS NOVAS EXPERIÊNCIAS DE CONSUMO

    Directory of Open Access Journals (Sweden)

    Rogério Luiz Covaleski

    2014-01-01

    Full Text Available Tendo em vista que o processo de consumo não se resume à compra de mercadorias, e que vivenciamos um momento de negociação de discursos entre consumidores e anunciantes, potencializado pelas ferramentas dos meios de comunicação pós-massivos, este artigo pretende refletir sobre o fenômeno da humanização do discurso das marcas. Para isso, tomaremos como referência as considerações sobre a mudança do fluxo comunicacional da linguagem publicitária (BEKESAS, 2012, as características da cibercultura (LEMOS; LÉVY, 2010, a cultura da participação (SHIRKY, 2011 e a necessidade de uma conduta ética para a manutenção da credibilidade das empresas (BLACKSHAW, 2010. Neste trabalho, também citaremos casos ilustrativos da humanização dos discursos das marcas colhidas nas redes sociais na Internet, como forma de exemplificar os esforços das empresas em manter a integridade da imagem da marca no atual cenário do refluxo comunicacional. Palavras-chave: Discurso. Marcas. Consumo. Refluxo comunicacional. Mídias sociais.

  9. Monitoring Crohn's disease during anti-TNF-α therapy: validation of the magnetic resonance enterography global score (MEGS) against a combined clinical reference standard

    International Nuclear Information System (INIS)

    Prezzi, Davide; Bhatnagar, Gauraang; Makanyanga, Jesica; Halligan, Steve; Taylor, Stuart Andrew; Vega, Roser

    2016-01-01

    To assess the ability of magnetic resonance enterography global score (MEGS) to characterise Crohn's disease (CD) response to anti-TNF-α therapy. Thirty-six CD patients (median age 26 years, 20 males) commencing anti-TNF-α therapy with concomitant baseline MRI enterography (MRE) were identified retrospectively. Patients' clinical course was followed and correlated with subsequent MREs. Scan order was randomised and MEGS (a global activity score) was applied by two blinded radiologists. A physician's global assessment of the disease activity (remission, mild, moderate or severe) at the time of MRE was assigned. The cohort was divided into clinical responders and non-responders and MEGS compared according to activity status and treatment response. Interobserver agreement was assessed. Median MEGS decreased significantly between baseline and first follow-up in responders (28 versus 6, P < 0.001) but was unchanged in non-responders (26 versus 18, P = 0.28). The median MEGS was significantly lower in clinical remission (9) than in moderate (14) or severe (29) activity (P < 0.001). MEGS correlated significantly with clinical activity (r = 0.53; P < 0.001). Interobserver Bland-Altman limits of agreement (BA LoA) were -19.7 to 18.5. MEGS decreases significantly in clinical responders to anti-TNF-α therapy but not in non-responders, demonstrates good interobserver agreement and moderate correlation with clinical disease activity. (orig.)

  10. HLA-DRB1 shared epitope alleles in patients with rheumatoid arthritis: relation to autoantibodies and disease severity in a south Indian population.

    Science.gov (United States)

    Konda Mohan, Vasanth; Ganesan, Nalini; Gopalakrishnan, Rajasekhar; Venkatesan, Vettriselvi

    2017-10-01

    To investigate the presence of the 'shared epitope' (SE) in the HLA-DRB1 alleles in patients with RA and to ascertain the frequency of the HLA-DRB1 alleles with autoantibodies (anti-cyclic citrullinated peptide [anti-CCP] rheumatoid factor [RF]) and disease severity. A total of 200 RA patients and 200 apparently healthy subjects participated in the study. HLA-DRB1 were genotyped using polymerase chain reaction with sequence-specific primer (PCR-SSP). Anti-CCP and RF in serum were determined by in vitro quantitative enzyme-linked immunosorbent assay (ELISA) method. Erythrocyte sedimentation rate (ESR) was measured by Westergren method. Disease activity was assessed by using the disease activity score-28 (DAS-28). Chi-square test and Student's t-test were used in the statistical analysis. A significant increase in the frequency of HLA-DRB1*01, *04, *10 and *14 were identified in RA patients and showed a strong association with the disease susceptibility. While the frequencies of HLA-DRB1*03, *07, *11 and *13 were significantly lower in RA patients than in controls. The other HLA-DRB1 alleles *08, *09, *12, *15 and *16 showed no significant difference. The frequency of anti-CCP and RF antibodies did not showed significant difference in SE-positive patients compared with SE-negative patients. DAS-28 values of RA patients showed no significant difference between SE-positive and SE-negative groups. Our results indicate that HLA-DRB1*01, *04, *10 and *14 alleles are related with RA, while HLA-DRB1*03, *07, *11 and *13 protect against RA in our population. On the other hand, we failed to provide evidence for the association of the autoantibodies and DAS-28 with SE-positive RA patients. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  11. 49 CFR 28.110 - Self-evaluation.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Self-evaluation. 28.110 Section 28.110 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.110 Self-evaluation...

  12. 49 CFR 28.170 - Compliance procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance procedures. 28.170 Section 28.170 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.170 Compliance...

  13. Teaching Foreign Cultural Literacy with Margarethe von Trotta's "Das Versprechen"

    Science.gov (United States)

    Kuttenberg, Eva

    2003-01-01

    This article describes model units for an in-depth cultural analysis of "Das Versprechen" in undergraduate college courses including intermediate German, German culture and civilization, advanced conversation and composition, and film. Practical suggestions for pre-viewing, viewing, and post-viewing activities as well as assessment in…

  14. Integrated MRI and [11 C]-PBR28 PET Imaging in Amyotrophic Lateral sclerosis.

    Science.gov (United States)

    Alshikho, Mohamad J; Zürcher, Nicole R; Loggia, Marco L; Cernasov, Paul; Reynolds, Beverly; Pijanowski, Olivia; Chonde, Daniel B; Izquierdo Garcia, David; Mainero, Caterina; Catana, Ciprian; Chan, James; Babu, Suma; Paganoni, Sabrina; Hooker, Jacob M; Atassi, Nazem

    2018-05-08

    To characterize [ 11 C]-PBR28 brain uptake using positron emission tomography (PET) in people with amyotrophic lateral sclerosis (ALS), and primary lateral sclerosis (PLS). We have previously shown increased [ 11 C]-PBR28 uptake in the precentral gyrus in a small group of ALS patients. Herein, we confirm our initial finding, study the longitudinal changes, and characterize the gray vs. white matter distribution of [ 11 C]-PBR28 uptake in a larger cohort of patients with ALS and PLS. Eighty-five participants including 53 ALS, 11 PLS and 21 healthy controls underwent integrated [ 11 C]-PBR28 PET-MR brain imaging. Patients were clinically assessed using the upper motor neuron burden (UMNB), and the revised ALS functional rating scale (ALSFRS-R). [ 11 C]-PBR28 uptake was quantified as standardized uptake value ratio (SUVR), and compared between groups. Cortical thickness, and fractional anisotropy were compared between groups and correlated with SUVR and the clinical data. [ 11 C]-PBR28 uptake and ALSFRS-R were compared longitudinally over six-month in ten ALS individuals. Whole brain voxel-wise, surface-based and region of interest analyses revealed increased [ 11 C]-PBR28 uptake in the precentral and paracentral gyri in ALS, and in the sub-cortical white matter for the same regions in PLS, compared to controls. The increase in [ 11 C]-PBR28 uptake co-localized and correlated with cortical thinning, reduced fractional anisotropy, increased mean diffusivity, and correlated with higher UMNB score. No significant changes were detected in [ 11 C]-PBR28 uptake over six-month despite clinical progression. Glial activation measured by in vivo [ 11 C]-PBR28 PET is increased in pathologically relevant regions in people with ALS and correlates with clinical measures. This article is protected by copyright. All rights reserved. © 2018 American Neurological Association.

  15. Erosividade e características hidrológicas das chuvas de Rio Grande (RS Erosivity and hydrological characteristics of rainfalls in Rio Grande (RS, Brazil

    Directory of Open Access Journals (Sweden)

    Marcos Gabriel Peñalva Bazzano

    2010-02-01

    ,0 % do intermediário e 24,2 % do atrasado. Da erosividade anual, 49,1 % correspondeu a chuvas do padrão avançado, 28,9 % a chuvas do padrão intermediário e 22,1 % a chuvas do padrão atrasado. O método da distribuição extrema tipo I foi adequado para obter as curvas de intensidade-duração-frequência. Os períodos de retorno da chuva podem ser calculados por meio das equações, utilizando os valores dos parâmetros encontrados, ou pelos gráficos das curvas de intensidade-duração-frequência.Specific rainfall characteristics vary among regions and their erosion potential must be known for the planning of agricultural and civil engineering activities. For Rio Grande (RS, Brazil, the erosivity and relationships with the precipitation and rainfall coefficient, rainfall hydrologic patterns and return period were determined based on rainfall data of 23 years. For each erosive rainfall the segments of the rainfall chart with the same intensity were separated together and the data registered in worksheets. The mean monthly and annual rainfall erosivity, the EI30 index in the International System of Units and the rainfall patterns were estimated using software Chuveros. The mean monthly values of precipitation and erosivity index were expressed as percentage of the mean annual values of these variables, resulting in the curve of accumulated distribution of precipitation and erosivity index in function of time. The rainfall coefficient (Rc was calculated. Pearson correlations and linear regressions between the erosivity index EI30 and the mean annual values of precipitation and rainfall coefficient were calculated. The rainfall return period was calculated for 2, 5, 10, 20, 50, and 100 years. The mean annual value of EI30 was 5135 MJ mm ha-1 h-1, which is to be used as "R" Factor in the Universal Soil Loss Equation (USLE for Rio Grande and surrounding regions with similar climatic conditions. The regression equations for EI30 and precipitation and rainfall

  16. Influência das novas tecnologias na gestão das finanças pessoais: desenho de um robo-advisor

    OpenAIRE

    Pérez Ares, Iago Roi

    2016-01-01

    A crise económica global atual, junto com a profunda evolução das novas tecnologias, está a produzir a necessidade de aumentar a eficiência da gestão de numerosas atividades da nossa vida. Desta forma, uma das principais preocupações na vida das pessoas, como demonstram numerosos estudos, é a sua gestão das finanças familiares. Se a isto lhe for adicionado a crescente desconfiança no sector bancário, produzida em parte pela duvidosa gestão dos seus responsáveis, entende-se que a gestão patri...

  17. Activation of the Arabidopsis membrane-bound transcription factor bZIP28 is mediated by site-2 protease, but not site-1 protease.

    Science.gov (United States)

    Iwata, Yuji; Ashida, Makoto; Hasegawa, Chisa; Tabara, Kazuki; Mishiba, Kei-Ichiro; Koizumi, Nozomu

    2017-08-01

    The unfolded protein response (UPR) is a homeostatic cellular response conserved in eukaryotic cells to alleviate the accumulation of unfolded proteins in the endoplasmic reticulum (ER). Arabidopsis bZIP28 is a membrane-bound transcription factor activated by proteolytic cleavage in response to ER stress, thereby releasing its cytosolic portion containing the bZIP domain from the membrane to translocate into the nucleus where it induces the transcription of genes encoding ER-resident molecular chaperones and folding enzymes. It has been widely recognized that the proteolytic activation of bZIP28 is mediated by the sequential cleavage of site-1 protease (S1P) and site-2 protease (S2P). In the present study we provide evidence that bZIP28 protein is cleaved by S2P, but not by S1P. We demonstrated that wild-type and s1p mutant plants produce the active, nuclear form of bZIP28 in response to the ER stress inducer tunicamycin. In contrast, tunicamycin-treated s2p mutants do not accumulate the active, nuclear form of bZIP28. Consistent with these observations, s2p mutants, but not s1p mutants, exhibited a defective transcriptional response of ER stress-responsive genes and significantly higher sensitivity to tunicamycin. Interestingly, s2p mutants accumulate two membrane-bound bZIP28 fragments with a shorter ER lumen-facing C-terminal domain. Importantly, the predicted cleavage sites are located far from the canonical S1P recognition motif previously described. We propose that ER stress-induced proteolytic activation of bZIP28 is mediated by the sequential actions of as-yet-unidentified protease(s) and S2P, and does not require S1P. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

  18. Clinical response to anti-TNFα therapy in patients with rheumatoid arthritis faulted or intolerance in non-biological DMARD in the Hospital San Juan de Dios in the period January 2006 to December 2011

    International Nuclear Information System (INIS)

    Salas Mena, Claudio

    2014-01-01

    Various clinical studies are performed globally using anti-TNFα therapy and has proven its clinical effectiveness in the management of rheumatoid arthritis patients, that have failed or have presented intolerance to the use of non-biological DMARDs. The clinical response to treatment of anti-TNFα was determined in patients with rheumatoid arthritis who have presented without respond, have showed intolerance or secondary effects to DMARDs no biological, in the Servicio de Reumatologia del Hospital San Juan de Dios, in the period January 2006 to December 2011. Study has been descriptive, retrospective, observational, by reviewing dossiers of patients with rheumatoid arthritis to initiate anti-TNFα therapy where has valued the DAS28 and initial VES, then at 6 months and 12 months after starting treatment. In the period analyzed, 47 patients evaluated with traditional DMARD failure who have received anti-TNFα therapy, according to DAS28, 32 patients were cataloged as severe activity and 15 of them with moderate activity. A total of 41 patients have used etanercept, with adalimumab 6 patients. The DAS28 initial average was 5,63 in all patients, 6,16 in the subgroup of patients with severe activity, and 4,49 in the subgroup of moderate activity. After 6 months of treatment, the DAS28 has descended to 3,25 in all patients, with 3,67 in the subgroup of severe clinical activity, and 2,35 in the subgroup of moderate clinical activity. One year after treatment values DAS28 have been 3,13 for all patients, 3,53 in severe activity and 2,28 in the subgroup of activity clinical moderate. In all groups and subgroups of patients, difference was demonstrated statistically significant at p less than 0,05. Between the subgroups of patients according to clinical activity is keeped without significant difference, or the type of anti-TNFα therapy employed. The anti-TNFα therapy has proven to be effective for improvement of clinical activity of rheumatoid arthritis, regardless of

  19. Field trial on progesterone cycles, metabolic profiles, body condition score and their relation to fertility in Estonian Holstein dairy cows.

    Science.gov (United States)

    Samarütel, J; Ling, K; Waldmann, A; Jaakson, H; Kaart, T; Leesmäe, A

    2008-08-01

    Resumption of luteal activity postpartum and fertility were investigated in an Estonian Holstein high milk production and good fertility dairy herd. Body condition was scored after every 10 days in 54 multiparous dairy cows (71 lactations) calving inside from December to March during 4-year period. Blood samples were taken 1-14 days before calving and 1-14, 28-42 and 63-77 days after calving: analytes estimated were serum aspartate aminotransferase (AST), glucose, ketone bodies, total cholesterol, non-esterified fatty acids and triglycerides. The general linear mixed model was used to compare the data for cows with different characteristics in luteal activity postpartum based on their milk progesterone profiles. Forty-five per cent of cases had abnormal profiles; delayed resumption of ovarian cyclicity postpartum (DC) was the most prevalent abnormality. There was no difference in body condition scores between the groups. The DC and prolonged luteal phase groups had higher serum AST activity (p fertility.

  20. Fluctuation in Spatial Ability Scores during the Menstrual Cycle.

    Science.gov (United States)

    Moody, M. Suzanne

    Whether or not fluctuations in spatial ability as measured by S. G. Vandenberg's Mental Rotations Test occur during the menstrual cycle was studied with 133 female students from 9 undergraduate educational psychology and nursing classes. For comparison, 28 male students also took the test. Scores from 55 females fell into the relevant menstrual…

  1. Ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) activities in prostate cancer patients: influence of Gleason score, treatment and bone metastasis.

    Science.gov (United States)

    Battisti, Vanessa; Maders, Liési D K; Bagatini, Margarete D; Battisti, Iara E; Bellé, Luziane P; Santos, Karen F; Maldonado, Paula A; Thomé, Gustavo R; Schetinger, Maria R C; Morsch, Vera M

    2013-04-01

    The relation between adenine nucleotides and cancer has already been described in literature. Considering that the enzymes ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) act together to control nucleotide levels, we aimed to investigate the role of these enzymes in prostate cancer (PCa). E-NPP and ADA activities were determined in serum and platelets of PCa patients and controls. We also verified the influence of the Gleason score, bone metastasis and treatment in the enzyme activities. Platelets and serum E-NPP activity increased, whereas ADA activity in serum decreased in PCa patients. In addition, Gleason score, metastasis and treatment influenced E-NPP and ADA activities. We may propose that E-NPP and ADA are involved in the development of PCa. Moreover, E-NPP and ADA activities are modified in PCa patients with distinct Gleason score, with bone metastasis, as well as in patients under treatment. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  2. CDK-mediated activation of the SCFFBXO28 ubiquitin ligase promotes MYC-driven transcription and tumourigenesis and predicts poor survival in breast cancer

    Science.gov (United States)

    Cepeda, Diana; Ng, Hwee-Fang; Sharifi, Hamid Reza; Mahmoudi, Salah; Cerrato, Vanessa Soto; Fredlund, Erik; Magnusson, Kristina; Nilsson, Helén; Malyukova, Alena; Rantala, Juha; Klevebring, Daniel; Viñals, Francesc; Bhaskaran, Nimesh; Zakaria, Siti Mariam; Rahmanto, Aldwin Suryo; Grotegut, Stefan; Nielsen, Michael Lund; Szigyarto, Cristina Al-Khalili; Sun, Dahui; Lerner, Mikael; Navani, Sanjay; Widschwendter, Martin; Uhlén, Mathias; Jirström, Karin; Pontén, Fredrik; Wohlschlegel, James; Grandér, Dan; Spruck, Charles; Larsson, Lars-Gunnar; Sangfelt, Olle

    2013-01-01

    SCF (Skp1/Cul1/F-box) ubiquitin ligases act as master regulators of cellular homeostasis by targeting key proteins for ubiquitylation. Here, we identified a hitherto uncharacterized F-box protein, FBXO28 that controls MYC-dependent transcription by non-proteolytic ubiquitylation. SCFFBXO28 activity and stability are regulated during the cell cycle by CDK1/2-mediated phosphorylation of FBXO28, which is required for its efficient ubiquitylation of MYC and downsteam enhancement of the MYC pathway. Depletion of FBXO28 or overexpression of an F-box mutant unable to support MYC ubiquitylation results in an impairment of MYC-driven transcription, transformation and tumourigenesis. Finally, in human breast cancer, high FBXO28 expression and phosphorylation are strong and independent predictors of poor outcome. In conclusion, our data suggest that SCFFBXO28 plays an important role in transmitting CDK activity to MYC function during the cell cycle, emphasizing the CDK-FBXO28-MYC axis as a potential molecular drug target in MYC-driven cancers, including breast cancer. PMID:23776131

  3. Detection of activities of daily living impairment in Alzheimer's disease and mild cognitive impairment using information and communication technology

    Directory of Open Access Journals (Sweden)

    Sacco G

    2012-12-01

    Full Text Available Guillaume Sacco,1–3 Véronique Joumier,1,4 Nelly Darmon,1 Arnaud Dechamps,1,5 Alexandre Derreumaux,1,3 Ji-Hyun Lee,2 Julie Piano,2 Nathalie Bordone,2 Alexandra Konig,1,6 Bernard Teboul,3 Renaud David,1,2 Olivier Guerin,1,3 François Bremond,1,4 Philippe Robert1,21EA CoBTeK, Université de Nice Sophia-Antipolis, 2Centre Mémoire de Ressource et de Recherche, CHU de Nice, 3Plateforme Patient du Centre d'Innovation et d'Usage en Santé, CHU de Nice, 4Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA, Sophia-Antipolis, France; 5University of Pancasila, Department of Psychology, Jakarta, Indonesia; 6University of Maastricht, Faculty of Psychology and Neuropsychology, Department of Psychiatry and Neuropsychology, Maastricht, The NetherlandsBackground: One of the key clinical features of Alzheimer's disease (AD is impairment in daily functioning. Patients with mild cognitive impairment (MCI also commonly have mild problems performing complex tasks. Information and communication technology (ICT, particularly techniques involving imaging and video processing, is of interest in order to improve assessment. The overall aim of this study is to demonstrate that it is possible using a video monitoring system to obtain a quantifiable assessment of instrumental activities of daily living (IADLs in AD and in MCI.Methods: The aim of the study is to propose a daily activity scenario (DAS score that detects functional impairment using ICTs in AD and MCI compared with normal control group (NC. Sixty-four participants over 65 years old were included: 16 AD matched with 10 NC for protocol 1 (P1 and 19 MCI matched with 19 NC for protocol 2 (P2. Each participant was asked to undertake a set of daily tasks in the setting of a “smart home” equipped with two video cameras and everyday objects for use in activities of daily living (8 IADLs for P1 and 11 for P2, plus 4 temporal execution constraints. The DAS score was then computed

  4. Naphthalene degradation and biosurfactant activity by Bacillus cereus 28BN

    Energy Technology Data Exchange (ETDEWEB)

    Tuleva, B.; Christova, N. [Inst. of Microbiology, Bulgarian Academy of Sciences, Sofia (Bulgaria); Jordanov, B.; Nikolova-Damyanova, B. [Inst. of Organic Chemistry, Sofia (Bulgaria); Petrov, P. [National Center of Infectious and Parasitic Diseases, Sofia (Bulgaria)

    2005-08-01

    Biosurfactant activity and naphthalene degradation by a new strain identified as Bacillus cereus 28BN were studied. The strain grew well and produced effective biosurfactants in the presence of n-alkanes, naphthalene, crude oil and vegetable oils. The biosurfactants were detected by the surface tension lowering of the medium, thin layer chromatography and infrared spectra analysis. With (2%) naphthalene as the sole carbon source, high levels of rhamnolipids at a concentration of 2.3 g l{sup -1} were determined in the stationary growth. After 20 d of incubation 72 {+-} 4% of the initial naphthalene was degraded. This is the first report for a Bacillus cereus rhamnolipid producing strain that utilized naphthalene under aerobic conditions. The strain looks promising for application in environmental technologies. (orig.)

  5. 31 CFR 28.525 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Fringe benefits. 28.525 Section 28... the Basis of Sex in Employment in Education Programs or Activities Prohibited § 28.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any...

  6. Grade and location of power Doppler are predictive of damage progression in rheumatoid arthritis patients in clinical remission by anti-tumour necrosis factor α.

    Science.gov (United States)

    Raffeiner, Bernd; Grisan, Enrico; Botsios, Costantino; Stramare, Roberto; Rizzo, Gaia; Bernardi, Livio; Punzi, Leonardo; Ometto, Francesca; Doria, Andrea

    2017-08-01

    To investigate power Doppler (PD) signal, grade and location and their association with radiographic progression in RA patients in remission. A prospective observational study was conducted in 125 consecutive RA patients in stable 28-joint DAS (DAS28) remission (⩾6 months) achieved on anti-TNF-α. At baseline, patients in stable remission underwent radiographic and US examination of the wrists and MCP, PIP and MTP joints. Semi-quantitative PD scoring (0-3) was recorded. We scored PD according to two locations: capsular or within synovial tissue without bone contact (location 1) and with bone contact or penetrating bone cortex (location 2). Radiographic progression was evaluated at the 1 year follow-up and defined as a change in van der Heijde-modified total Sharp score >0. Risk ratios (RRs) of radiographic progression according to presence, grade and location of PD were calculated. Four patients were excluded because of missing data. At baseline, 59/121 (48.7%) patients had a PD signal in one or more joints. PD location 2 was found in 74.6% patients (44/59). At the 1 year follow-up, 17/121 patients experienced radiographic progression: all had PD signal in one or more joints at baseline (RR 2.47, P location 2 (RR 3.49, P < 0.0001). Higher PD grades and PD in contact with/or penetrating bone are associated with radiographic progression in patients in DAS28 remission. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. The Microbial Database for Danish wastewater treatment plants with nutrient removal (MiDas-DK) - a tool for understanding activated sludge population dynamics and community stability.

    Science.gov (United States)

    Mielczarek, A T; Saunders, A M; Larsen, P; Albertsen, M; Stevenson, M; Nielsen, J L; Nielsen, P H

    2013-01-01

    Since 2006 more than 50 Danish full-scale wastewater treatment plants with nutrient removal have been investigated in a project called 'The Microbial Database for Danish Activated Sludge Wastewater Treatment Plants with Nutrient Removal (MiDas-DK)'. Comprehensive sets of samples have been collected, analyzed and associated with extensive operational data from the plants. The community composition was analyzed by quantitative fluorescence in situ hybridization (FISH) supported by 16S rRNA amplicon sequencing and deep metagenomics. MiDas-DK has been a powerful tool to study the complex activated sludge ecosystems, and, besides many scientific articles on fundamental issues on mixed communities encompassing nitrifiers, denitrifiers, bacteria involved in P-removal, hydrolysis, fermentation, and foaming, the project has provided results that can be used to optimize the operation of full-scale plants and carry out trouble-shooting. A core microbial community has been defined comprising the majority of microorganisms present in the plants. Time series have been established, providing an overview of temporal variations in the different plants. Interestingly, although most microorganisms were present in all plants, there seemed to be plant-specific factors that controlled the population composition thereby keeping it unique in each plant over time. Statistical analyses of FISH and operational data revealed some correlations, but less than expected. MiDas-DK (www.midasdk.dk) will continue over the next years and we hope the approach can inspire others to make similar projects in other parts of the world to get a more comprehensive understanding of microbial communities in wastewater engineering.

  8. Thrombus scintigraphy with Ga-67 DFO-DAS-Fibrinogen, 2

    International Nuclear Information System (INIS)

    Kawasaki, Yukiko

    1987-01-01

    In our previous in vivo study 67 Ga DFO-DAS-Fibrinogen was assessed for its usefulness as a radiopharmaceutical for the detection of thrombin in experimental animals (Report 1). The present study was undertaken to appraise the diagnostic value of 67 Ga DFO-DAS-Fibrinogen in human disease, especially in relation to blood coagulability as well as to thrombolytic drug regimen being given, in an effort to investigate its clinical applicability. Involved in this study were 48 patients with thrombosis proven by X-ray CT and other examinations. Of these 48, 42 had arterial thrombosis (20 with aortic aneurysm including the dissecting form, 11 in postoperative condition following vascular surgery with a prosthesis, 9 with intracardiac thrombosis accompanying heart disease, and 1 each with occlusive arteriosclerosis and cerebral infarction) and 6 had venous thrombosis. The 67 Ga DFO-DAS-Fibrinogen test proved to be positive in 55 % of arterial thrombin and in 50 % of venous thrombin. It is interesting to note that as high a positivity rate as 80 % was obtained for aortic aneurysm, although the positivity rate was disappointingly low for left atrial thrombin. No distinct correlation was noted to exist between the degree of accumulation of the tracer in thrombotic lesions and any of factors conceivably of clinical releavance, i.e. time elapsing from onset till testing, thrombolytic medication being given, and hematological factors. 67 Ga DFO-DAS-Fibrinogen appeared to be a radiodiagnostic agent that could possibly indicate the existing activity status of thrombosis. (author)

  9. 31 CFR 28.500 - Employment.

    Science.gov (United States)

    2010-07-01

    ... benefits of, or be subjected to discrimination in employment, or recruitment, consideration, or selection... §§ 28.500 through 28.550 apply to: (1) Recruitment, advertising, and the process of application for...-sponsored activities, including social or recreational programs; and (10) Any other term, condition, or...

  10. Value of Entheseal Ultrasonography and Serum Cartilage Oligomeric Matrix Protein in the Preclinical Diagnosis of Psoriatic Arthritis

    Directory of Open Access Journals (Sweden)

    Moataz Mohammed Samy Elbeblawy

    2010-03-01

    Full Text Available Objective: To evaluate the utility of entheseal ultrasonography and serum COMP in the preclinical diagnosis of psoriatic arthritis. Methods: 60 psoriatic patients were divided into: 30 patients with psoriasis (group I and 30 patients with psoriatic arthritis as control (group II. They underwent independent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of Achilles tendons. Psoriatic arthritis disease activity and severity was assessed by modified DAS28 and Steinbrockers scores. Serum levels of COMP were measured for all patients by ELISA. Results: On clinical examination, no entheseal abnormalities were detected in group I while they were present in 23.3% of group II with statistically significant difference between them (P 0.05. Serum COMP were significantly elevated in group I and II with no statistically significant difference between them (mean ± SD 5.9 ± 3 and 6.8 ± 12 respectively, P > 0.05. Entheseal ultrasound was more specific (67% while serum COMP was more sensitive (87% in the preclinical diagnosis of psoriatic arthritis. Serum COMP levels were significantly correlated with CRP in both groups and with DAS28 and Steinbrockers scores in group II (P < 0.01. Conclusion: Entheseal ultrasonography and serum COMP levels may be used complementary to each other for preclinical diagnosis of psoriatic arthritis. Serum COMP seems to be promising prognostic marker for psoriatic arthritis patients.

  11. Psicoterapia das depressões

    Directory of Open Access Journals (Sweden)

    Sidnei Schestatsky

    1999-05-01

    Full Text Available Os autores examinam o status atual das psicoterapias no tratamento das depressões, principalmente das quatro formas melhor testadas empiricamente nos últimos 10 anos: psicoterapia interpessoal, psicoterapia cognitiva e comportamental, e psicoterapia psicodinâmica breve. São descritos os principais estudos de eficácia dessas psicoterapias assim como uma revisão metaanalítica sobre o assunto. Conclui-se que já há sólidas evidências de bons resultados nas depressões ambulatoriais e unipolares quando tratadas por intervenções psicossociais, combinadas ou não com farmacoterapia.It is examined the present status of psychotherapeutic treatment of depression, specially the impact of the four types of psychotherapy best empirically tested for the past 10 years: interpersonal therapy, cognitive and behavioral therapies, and brief psychodynamic therapy. Both the main efficacy studies of those therapies as well as a meta-analytic review of their results are described. The conclusion is that there are already strong evidences of good outcome when ambulatorial unipolar depression is treated by psychossocial interventions, alone or in combination with pharmacotherapy.

  12. Electroencephalographic activity in response to procedural pain in preterm infants born at 28 and 33 weeks gestational age.

    Science.gov (United States)

    Maimon, Neta; Grunau, Ruth E; Cepeda, Ivan L; Friger, Michael; Selnovik, Leonel; Gilat, Shlomo; Shany, Eilon

    2013-12-01

    Preterm infants undergo frequent painful procedures in the neonatal intensive care unit. Electroencephalography (EEG) changes in reaction to invasive procedures have been reported in preterm and full-term neonates. Frontal EEG asymmetry as an index of emotion during tactile stimulation shows inconsistent findings in full-term infants, and has not been examined in the context of pain in preterm infants. Our aim was to examine whether heel lance for blood collection induces changes in right-left frontal asymmetry, suggesting negative emotional response, in preterm neonates at different gestational age (GA) at birth and different duration of stay in the neonatal intensive care unit. Three groups of preterm infants were compared: set 1: group 1 (n=24), born and tested at 28 weeks GA; group 2 (n=22), born at 28 weeks GA and tested at 33 weeks; set 2: group 3 (n=25), born and tested at 33 weeks GA. EEG power was calculated for 30-second artifact-free periods, in standard frequency bandwidths, in 3 phases (baseline, up to 5 min after heel lance, 10 min after heel lance). No significant differences were found in right-left frontal asymmetry, or in ipsilateral or contralateral somatosensory response, across phases. In contrast, the Behavioral Indicators of Infant Pain scores changed across phase (P<0.0001). Infants in group 1 showed lower Behavioral Indicators of Infant Pain scores (P=0.039). There are technical challenges in recording EEG during procedures, as pain induces motor movements. More research is needed to determine the most sensitive approach to measure EEG signals within the context of pain in infancy.

  13. A vantagem competitiva das nações e a vantagem competitiva das empresas: o que importa na localização?

    Directory of Open Access Journals (Sweden)

    Martim Francisco de Oliveira e Silva

    2012-06-01

    Full Text Available Há dois enfoques dominantes para explicar o desempenho das empresas: a visão da Organização Industrial e a Visão Baseada em Recursos, ambos amplamente pesquisados. Entretanto, a relação entre o desempenho das empresas e a competitividade das nações ainda é pouco explorada. Este estudo buscou verificar se o desempenho das empresas se relaciona ao ambiente de seus países e quais fatores destes são mais relevantes. Foram encontradas evidências da relação entre os indicadores de competitividade dos países e o desempenho sustentável de suas empresas. O estudo relacionou de maneira pioneira os conceitos da vantagem competitiva das nações e da vantagem competitiva das empresas, testou empiricamente o modelo do Diamante Competitivo do professor Michael Porter, destacou três variáveis habitualmente negligenciadas na linha de pesquisas das fontes de desempenho de empresas (a Sofisticação dos Compradores, o PIB e as Compras Governamentais e criou um indicador de desempenho que também traduz sua sustentabilidade, associado à linha da pesquisa da persistência dos retornos extraordinários.

  14. Desvelando a Internet das Coisas

    Directory of Open Access Journals (Sweden)

    Lucia Santaella

    2013-12-01

    Full Text Available O presente artigo pretende relatar as origens da Internet das Coisas, seu estado de arte e evidenciar seus principais vetores. Para tal, o estudo percorrerá as eras midiáticas de Santaella (2007, p. 179-189, a par da discussão das máquinas de Turing, da arquitetura Von Neumann até chegar à Internet e seu estado atual, implementada nas coisas.

  15. Improvement of psoriasis-associated arthritis and skin lesions by treatment with molecular hydrogen: A report of three cases.

    Science.gov (United States)

    Ishibashi, Toru; Ichikawa, Miki; Sato, Bunpei; Shibata, Shinji; Hara, Yuichi; Naritomi, Yuji; Okazaki, Ken; Nakashima, Yasuharu; Iwamoto, Yukihide; Koyanagi, Samon; Hara, Hiroshi; Nagao, Tetsuhiko

    2015-08-01

    Psoriasis, a chronic inflammatory skin disease, is caused by infiltrating lymphocytes and associated cytokines, including tumor necrosis factor (TNF)α, interleukin (IL)-6, and IL-17. Effective treatments, including pathogenesis-based biological agents against psoriasis, are currently under development. Although the role of reactive oxygen species (ROS) in the pathogenesis of psoriasis has been investigated, it remains to be fully elucidated; ROS-targeted therapeutic strategies are also lacking at present. Therefore, the objective of the present study was to assess whether H2, a ROS scavenger, has a therapeutic effect on psoriasis-associated inflammation by reducing hydroxyl radicals or peroxynitrite in the immunogenic psoriasis cascade. Three methods were used to administer H2: Drop infusion of saline containing 1 ppm H2 (H2-saline), inhalation of 3% H2 gas, and drinking of water containing a high concentration (5-7-ppm) of H2 (high-H2 water). Treatment efficacy was estimated using the disease activity score 28 (DAS28) system, based on C-reactive protein levels, and the psoriasis area and severity index (PASI) score, determined at baseline and following each H2 treatment. Furthermore, levels of TNFα, IL-6, and IL-17 were analyzed. The DAS28 and PASI score of the three patients decreased during H2 treatment, regardless of the administration method. The psoriatic skin lesions almost disappeared at the end of the treatment. IL-6 levels decreased during H2 treatment in Case 1 and 2. IL-17, whose concentration was high in Case 1, was reduced following H2 treatment, and TNFα also decreased in Case 1. In conclusion, H2 administration reduced inflammation associated with psoriasis in the three cases examined and it may therefore be considered as a treatment strategy for psoriasis-associated skin lesions and arthritis.

  16. Validity and reliability of Nintendo Wii Fit balance scores.

    Science.gov (United States)

    Wikstrom, Erik A

    2012-01-01

    Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Descriptive laboratory study. Sports medicine research laboratory. Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Participants completed a single-limb-stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT

  17. AN ASSOCIATION OF CYTOKINE LEVELS WITH DISEASE ACTIVITY, AUTOANTIBODY LEVELS, AND JOINT DESTRUCTIVE CHANGES IN EARLY RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    A. S. Avdeeva

    2015-01-01

    Full Text Available Objective: to assess the association of cytokine profile measures with disease activity, autoantibody levels, and joint destructive changes in patients with early rheumatoid arthritis (RA.Subjects and methods. Forty-five patients, including 35 women, with early RA were examined. Their median age was 53.5 [46; 59.5] years; the duration of the disease – 7.0 [4.0; 11.5] months; DAS28 – 5.8 [4.9; 6.4]; 91 and 96% of the patents were positive for rheumatoid factor (RF and anticyclic citrullinated peptide antibodies, respectively. Serum cytokine concentrations were estimated using the xMAP multiplex technology. The modified Sharp method was employed to quantify radiographic changes.Results and discussion. A group of 30 patients with high disease activity (DAS28 >5.1 had higher levels of interleukin (IL-6 (62.3 [36.1; 127.5] pg/ml and IP-10 (6367.8 [3682.7; 10691.3] pg/ml than 15 patients with moderate/low disease activity (DAS28 ≤5.1 (35.8 [13.4; 64.2] and 3222.6 [1881.0; 5671.9] pg/ml, respectively, p < 0.05. The patients highly positive for IgM RF had higher levels (pg/ml of proinflammatory cytokines, such as IL-1β, IL-2, IL-6, IL-12, IL-15, interferon-γ, and tumor necrosis factor-α; the chemokine monocyte chemotactic protein-1 and the growth factors IL-7 and vascular endothelial growth factor (4.8 [2.8; 19.3], 23.0 [7.1; 55.8], 64.2 [41.6; 170.5], 52.2 [30.9; 126.9], 2.4 [0.2; 11.2], 210.8 [119.9; 584.2], 90.7 [42.7; 307/9], 57.5 [26.1; 93.8], 54.9 [37.1; 123.7], and 143.3 [70.6; 249.6] pg/ml than those who were negative/lowly positive for IgM RF (2.3 [1.9; 3.1], 4.9 [2.9; 16.8], 24.9 [20.4; 45.4], 25.6 [19.9; 57.1], 0.2 [0.01; 1.65], 94.4 [86.3; 138.9], 37.3 [23.6; 47.7], 20.9 [12.3; 33.9], 32.6 [28.1; 37.8], 74.2 [53.5; 147.6], respectively (p < 0.05.Conclusion. There are significant differences in cytokine profile measures in patients with early RA in relation to disease activity and serum autoantibody levels.

  18. The efficacy and safety of etanercept in patients with rheumatoid arthritis and spondyloarthropathy on hemodialysis.

    Science.gov (United States)

    Senel, Soner; Kisacik, Bunyamin; Ugan, Yunus; Kasifoglu, Timucin; Tunc, Ercan; Cobankara, Veli

    2011-10-01

    We aimed to evaluate the efficacy and safety of long-term use of etanercept therapy in patients with spondyloarthropathy (SpA) and rheumatoid arthritis (RA) on hemodialysis (HD). Selected RA or SpA patients treated with etanercept under HD were retrospectively evaluated. Etanercept-related adverse events were closely recorded for all patients. At the follow-up, erythrocyte sedimentation rate and C-reactive protein levels were monitored. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for SpA patients and Disease Activity Score (DAS28) for RA patients were measured at every 3 or 6 months. In total five end-stage renal disease (ESRD) patients were enrolled to the study. The causes of ESRD in the study subjects were amyloidosis (n = 2), analgesic nephropathy (n = 2), and nephrolithiasis (n = 1). Three were diagnosed as SpA and two were RA. All patients used etanercept. The median age was 39 years (range 22-72 years). The median disease duration was 12 years (range 2-20 years). The median follow-up after etanercept therapy was 18 months (range 5-33 months). DAS28 score decreased after the treatment and did not increase during follow-up in RA patients. BASDAI score decreased after the treatment during follow-up in three patients with SpA. At the follow-up, only one patient was diagnosed with septic arthritis. As a result of our study, etanercept treatment in RA and SpA patients on HD seems to be safe, well tolerated, and effective in most of the patients. Above all, due to impaired host defense in patients with ESRD, enhanced risk of infections should be kept in mind during follow-up period and larger trials are needed to prove the safety of etanercept in HD patients.

  19. Atividade antimicrobiana e sinérgica das frações das folhas de Schinopsis brasiliensis Engl. frente a clones multirresistentes de Staphylococcus aureus Antimicrobial and synergic activity of fractions from the leaves of Schinopsis brasiliensis Engl. against Staphylococcus aureus multiresistant clones

    Directory of Open Access Journals (Sweden)

    A.M. Saraiva

    2013-01-01

    Full Text Available No presente estudo objetivou-se avaliar a atividade antimicrobiana e sinérgica de 4 frações das folhas de Schinopsis brasiliensis Engl (F1', F2', F1" e F2" frente às cepas Staphylococcus aureus MRSA multirresistentes. Os métodos utilizados foram poços de difusão em ágar, concentração mínima inibitória (CMI - diluição em ágar, e bioautografia. Nos resultados bioautográficos observou-se três halos de inibição relacionados, no mínimo, à quatro constituintes ativos; sendo dois deles isolados das folhas (galato de metila e ácido gálico. A F2" (200∝g/mL apresentou halos de inibição de 16 e 19mm frente as cepas de S. aureus multirresistente e Klebsiella pneumoniae, e CMI 100∝g/mL, respectivamente. Quanto as análises das associações das frações F1" ou F2" (25 e 50∝g/mL com a tetraciclina e oxacilina, mostraram ações aditiva e sinérgica para a F2" (50∝g/mL, embora não suficiente para que a CMI atingisse valores inferiores a 2 e 4∝g/mL, necessário para serem classificadas como cepas sensíveis a oxacilina e tetraciclina, respectivamente. "Assim, conclui-se que a F2" das folhas de S. brasiliensis apresentou potencial antimicrobiano frente às cepas de S. aureus MRSA multirresistentes e que as associações das frações com os antibióticos testados não apresentaram benefícios não justificando o uso concomitante.The aim of this study was to evaluate the antimicrobial and synergic activity of 4 leaf fractions of Schinopsis brasiliensis Engl (F1', F2', F1" and F2" against multidrug-resistant Staphylococcus aureus strains. The used methods were agar well diffusion, minimum inhibitory concentration (MIC - agar dilution, and bioautography. The bioautographic results showed three inhibition zones that corresponded to at least four active compounds, two of which (methyl gallate and gallic acid have already been isolated from leaves. The F2" (200∝g/mL fraction showed inhibition zones of 16 mm and 19 mm against S

  20. Interferon-regulated chemokine score associated with improvement in disease activity in refractory myositis patients treated with rituximab.

    Science.gov (United States)

    López De Padilla, Consuelo M; Crowson, Cynthia S; Hein, Molly S; Strausbauch, Michael A; Aggarwal, Rohit; Levesque, Marc C; Ascherman, Dana P; Oddis, Chester V; Reed, Ann M

    2015-01-01

    The purpose of this study was to investigate whether serum interferon (IFN)-regulated chemokine and distinct cytokine response profiles are associated with clinical improvement in patients with refractory inflammatory myopathy treated with rituximab. In a randomised, placebo-phase trial Rituximab in Myositis Trial (RIM), 200 refractory adult and paediatric myositis subjects received rituximab. Following rituximab, clinical response and disease activity were assessed. Serum samples and clinical data were collected at baseline and several time-points after rituximab treatment. Multiplexed sandwich immunoassays quantified serum levels of IFN-regulated chemokines and other pro-inflammatory cytokines. Composite IFN-regulated chemokine and Th1, Th2, Th17 and regulatory cytokine scores were computed. Baseline IFN-regulated chemokine, Th1, Th2, Th17 and regulatory cytokine scores correlated with baseline physician global VAS, whereas the baseline Th1, Th2 and Th17 cytokine scores correlated with baseline muscle VAS. We also found baseline IFN-regulated chemokine scores correlated with specific non-muscular targets such as baseline cutaneous (r=0.29; p=0.002) and pulmonary (r=0.18; p=0.02) VAS scores. Among all cytokine/chemokines examined, the baseline score of IFN-regulated chemokines demonstrated the best correlation with changes in muscle VAS at 8 (r=-0.19; p=0.01) and 16 weeks (r=-0.17; p=0.03) following rituximab and physician global VAS at 16 weeks (r=-0.16; p=0.04). In vitro experiments showed increased levels of IL-8 (p=0.04), MCP-1 (p=0.04), IL-6 (p=0.03), IL-1β (p=0.04), IL-13 (p=0.04), IL-10 (p=0.02), IL-2 (p=0.04) and IFN-γ (p=0.02) in supernatants of TLR-3 stimulated PBMCs from non-responder compared to patients responders to rituximab. IFN-regulated chemokines before treatment is associated with improvement in disease activity measures in refractory myositis patients treated with rituximab.

  1. O DESAFIO DA PRIVACIDADE NA INTERNET DAS COISAS

    Directory of Open Access Journals (Sweden)

    Carlos Cesar Santos

    2015-12-01

    Full Text Available Na ultima década a internet tornou-se uma ferramenta presente no cotidiano das pessoas e das organizações e por vez indispensável ao bom funcionamento dos negócios. Com o crescente incremento das infraestruturas de redes e popularização em massa da rede de alta velocidade, emerge um avanço relacionado à utilização da internet tornando-a uma plataforma global para deixar máquinas e objetos inteligentes capazes de comunicarem-se de forma autônoma. Esta possibilidade permite que conteúdos e serviços estejam em torno das pessoas, sempre disponíveis, facilitando a comunicação e abrindo o caminho para novas aplicações, possibilitando novas formas de trabalho, de interação e de entretenimento, fazendo com que um novo padrão de vida e de trabalho seja desenvolvido. Este novo padrão torna-se possível através dos avanços das Tecnologias da Informação e Comunicação - TICs até uma nova concepção definida como Internet of Things - IoT. Entretanto, com uma variada coleta de dados e informações, para variados fins, no cotidiano das pessoas e das organizações, a coleta autônoma dos dados e das informações torna a privacidade um dos principais desafios em relação à IoT. Neste contexto, este artigo objetiva discutir em âmbito teórico a privacidade dos usuários da tecnologias da Internet das Coisas, diante de sua legalidade, explorando possíveis soluções neste cenário ainda em construção.

  2. Relationships between luteal activity, fertility, blood metabolites and body condition score in multiparous Estonian Holstein dairy cows under different management.

    Science.gov (United States)

    Samarütel, Jaak; Waldmann, Andres; Ling, Katri; Jaakson, Hanno; Kaart, Tanel; Leesmäe, Andres; Kärt, Olav

    2008-11-01

    The objective was to compare the relationships between luteal activity and fertility, and relate these parameters to metabolic indices and body condition changes in multiparous Estonian Holstein cows on two commercial dairy farms under different management and levels of production and nutrition (higher, H, n=54 (71 lactations) and lower, L, n=39 (39 lactations)). For statistical analysis cows were categorized according to their milk progesterone (P4) profiles as follows: normal ovarian function; delayed start of cyclicity (DC) (interval from calving to first luteal response (P45 ng/ml up to and more than 50 d respectively, followed by regular cyclicity); cessation of luteal activity (prolonged interluteal interval, P4bodies, non-esterified fatty acids, total cholesterol) and aspartate aminotransferase, body condition scores (BCS) and fertility parameters between the two farms, and also fertility parameters between the farms within P4 categories. Differences in milk fat/protein ratio, ketone body levels and BCS indicated a deeper negative energy balance (NEB) during the first month after calving on farm L. On both farms nearly 50% of the recently calved dairy cows suffered from ovarian dysfunction during the post-partum period. Delayed start of cyclicity was the most prevalent abnormal P4 profile, 25% and 28% on farms H and L, respectively. Prolonged luteal activity accounted for one-third of atypical ovarian patterns on farm H, and cessation of luteal activity on farm L. On farm L, DC cows had lower BCS values from day 10 to day 90 after calving compared with normal cows (Pcows lost more BCS (1.2 units) during the 40 d after calving than normal resumption cows (0.75 units; P<0.05). On farm H with moderate NEB the delayed start of ovulation post partum did not impair subsequent reproductive performance.

  3. 21-Gene Recurrence Score for prognosis and prediction of taxane benefit after adjuvant chemotherapy plus endocrine therapy: results from NSABP B-28/NRG Oncology.

    Science.gov (United States)

    Mamounas, Eleftherios P; Tang, Gong; Paik, Soonmyung; Baehner, Frederick L; Liu, Qing; Jeong, Jong-Hyeon; Kim, S Rim; Butler, Steven M; Jamshidian, Farid; Cherbavaz, Diana B; Sing, Amy P; Shak, Steven; Julian, Thomas B; Lembersky, Barry C; Wickerham, D Lawrence; Costantino, Joseph P; Wolmark, Norman

    2018-02-01

    The 21-gene recurrence score (RS) predicts outcome and benefit from adjuvant chemotherapy benefit in breast cancer patients treated with adjuvant endocrine therapy. In the NSABP B-28 study, we evaluated the 21-gene RS for its prognostic impact and its ability to predict benefit from paclitaxel (P) in node-positive, estrogen receptor-positive (ER+) breast cancer patients treated with adjuvant chemotherapy plus tamoxifen. The B-28 trial compared doxorubicin/cyclophosphamide (AC) with AC followed by P in 3060 patients. Tamoxifen for 5 years was also given to patients > 50 years and those < 50 years with ER+ and/or progesterone receptor-positive (PR+) tumors. The present study includes 1065 ER-positive, tamoxifen-treated patients with RS assessment. Median follow-up time was 11.2 years. In univariate analyses, RS was a significant predictor of outcome. In multivariate analyses, RS remained a significant independent predictor of outcome beyond clinico-pathologic factors, age, and type of surgery (p < 0.001). In the study population (n = 1065), the disease-free survival (DFS) hazard ratio (HR) with adding P to AC was 0.87 (95% CI 0.72-1.05; p = 0.14). RS was not a significant predictor of P benefit: for DFS, HRs for adding P to AC in RS low, intermediate, and high subgroups were 1.01 (95% CI 0.69-1.47; p = 0.99), 0.84 (95% CI 0.62-1.14; p = 0.26), and 0.81 (95% CI 0.60-1.10; p = 0.21), respectively (interaction p = 0.64). Similar findings were observed for the other study endpoints. RS maintains significant prognostic impact in ER-positive, node-positive patients treated with adjuvant chemotherapy plus tamoxifen. However, RS did not significantly predict benefit from adding paclitaxel to AC chemotherapy. (Trial Registration: PDQ: NSABP-B-28).

  4. Processing Approaches for DAS-Enabled Continuous Seismic Monitoring

    Science.gov (United States)

    Dou, S.; Wood, T.; Freifeld, B. M.; Robertson, M.; McDonald, S.; Pevzner, R.; Lindsey, N.; Gelvin, A.; Saari, S.; Morales, A.; Ekblaw, I.; Wagner, A. M.; Ulrich, C.; Daley, T. M.; Ajo Franklin, J. B.

    2017-12-01

    Distributed Acoustic Sensing (DAS) is creating a "field as laboratory" capability for seismic monitoring of subsurface changes. By providing unprecedented spatial and temporal sampling at a relatively low cost, DAS enables field-scale seismic monitoring to have durations and temporal resolutions that are comparable to those of laboratory experiments. Here we report on seismic processing approaches developed during data analyses of three case studies all using DAS-enabled seismic monitoring with applications ranging from shallow permafrost to deep reservoirs: (1) 10-hour downhole monitoring of cement curing at Otway, Australia; (2) 2-month surface monitoring of controlled permafrost thaw at Fairbanks, Alaska; (3) multi-month downhole and surface monitoring of carbon sequestration at Decatur, Illinois. We emphasize the data management and processing components relevant to DAS-based seismic monitoring, which include scalable approaches to data management, pre-processing, denoising, filtering, and wavefield decomposition. DAS has dramatically increased the data volume to the extent that terabyte-per-day data loads are now typical, straining conventional approaches to data storage and processing. To achieve more efficient use of disk space and network bandwidth, we explore improved file structures and data compression schemes. Because noise floor of DAS measurements is higher than that of conventional sensors, optimal processing workflow involving advanced denoising, deconvolution (of the source signatures), and stacking approaches are being established to maximize signal content of DAS data. The resulting workflow of data management and processing could accelerate the broader adaption of DAS for continuous monitoring of critical processes.

  5. IL-1β-induced matrix metalloproteinase-13 is activated by a disintegrin and metalloprotease-28-regulated proliferation of human osteoblast-like cells

    International Nuclear Information System (INIS)

    Ozeki, Nobuaki; Kawai, Rie; Yamaguchi, Hideyuki; Hiyama, Taiki; Kinoshita, Katsue; Hase, Naoko; Nakata, Kazuhiko; Kondo, Ayami; Mogi, Makio; Nakamura, Hiroshi

    2014-01-01

    We reported previously that matrix metalloproteinase (MMP)-13 accelerates bone remodeling in oral periradicular lesions, and indicated a potentially unique role for MMP-13 in wound healing and regeneration of alveolar bone. The ADAM (a disintegrin and metalloprotease) family is a set of multifunctional cell surface and secreted glycoproteins, of which ADAM-28 has been localized in bone and bone-like tissues. In this study, we show that interleukin (IL)-1β induces the expression of MMP-13 and ADAM-28 in homogeneous α7 integrin-positive human skeletal muscle stem cell (α7 + hSMSC)-derived osteoblast-like (α7 + hSMSC-OB) cells, and promotes proliferation while inhibiting apoptosis in these cells. At higher concentrations, however, IL-1β failed to induce the expression of these genes and caused an increase in apoptosis. We further employed ADAM-28 small interfering RNA (siRNA) to investigate whether IL-1β-induced MMP-13 expression is linked to this IL-1β-mediated changes in cell proliferation and apoptosis. Silencing ADAM-28 expression potently suppressed IL-1β-induced MMP-13 expression and activity, decreased cell proliferation and increased apoptosis in α7 + hSMSC-OB cells. In contrast, MMP-13 siRNA had no effect on ADAM-28 expression, suggesting ADAM-28 regulates MMP-13. Exogenous MMP-13 induced α7 + hSMSC-OB cell proliferation and could rescue ADAM-28 siRNA-induced apoptosis, and we found that proMMP-13 is partially cleaved into its active form by ADAM-28 in vitro. Overall, our results suggest that IL-1β-induced MMP-13 expression and changes in cell proliferation and apoptosis in α7 + hSMSC-OB cells are regulated by ADAM-28. - Highlights: • IL-1β induces the MMP-13 and ADAM-28 expression in human osteoblast-like cells. • IL-1β-induced MMP-13 expression increases proliferation and decreased apoptosis. • MMP-13 expression induced by IL-1β is regulated by ADAM-28. • proMMP-13 appears to be cleaved into its active form via ADAM-28

  6. IL-1β-induced matrix metalloproteinase-13 is activated by a disintegrin and metalloprotease-28-regulated proliferation of human osteoblast-like cells

    Energy Technology Data Exchange (ETDEWEB)

    Ozeki, Nobuaki; Kawai, Rie; Yamaguchi, Hideyuki; Hiyama, Taiki; Kinoshita, Katsue; Hase, Naoko; Nakata, Kazuhiko [Department of Endodontics, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi 464-8651 (Japan); Kondo, Ayami [Department of Medicinal Biochemistry, School of Pharmacy, Aichi Gakuin University, 1-100 Kusumoto, Chikusa-ku, Nagoya, Aichi 464-8650 (Japan); Mogi, Makio, E-mail: makio@dpc.agu.ac.jp [Department of Medicinal Biochemistry, School of Pharmacy, Aichi Gakuin University, 1-100 Kusumoto, Chikusa-ku, Nagoya, Aichi 464-8650 (Japan); Nakamura, Hiroshi [Department of Endodontics, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi 464-8651 (Japan)

    2014-04-15

    We reported previously that matrix metalloproteinase (MMP)-13 accelerates bone remodeling in oral periradicular lesions, and indicated a potentially unique role for MMP-13 in wound healing and regeneration of alveolar bone. The ADAM (a disintegrin and metalloprotease) family is a set of multifunctional cell surface and secreted glycoproteins, of which ADAM-28 has been localized in bone and bone-like tissues. In this study, we show that interleukin (IL)-1β induces the expression of MMP-13 and ADAM-28 in homogeneous α7 integrin-positive human skeletal muscle stem cell (α7{sup +}hSMSC)-derived osteoblast-like (α7{sup +}hSMSC-OB) cells, and promotes proliferation while inhibiting apoptosis in these cells. At higher concentrations, however, IL-1β failed to induce the expression of these genes and caused an increase in apoptosis. We further employed ADAM-28 small interfering RNA (siRNA) to investigate whether IL-1β-induced MMP-13 expression is linked to this IL-1β-mediated changes in cell proliferation and apoptosis. Silencing ADAM-28 expression potently suppressed IL-1β-induced MMP-13 expression and activity, decreased cell proliferation and increased apoptosis in α7{sup +}hSMSC-OB cells. In contrast, MMP-13 siRNA had no effect on ADAM-28 expression, suggesting ADAM-28 regulates MMP-13. Exogenous MMP-13 induced α7{sup +}hSMSC-OB cell proliferation and could rescue ADAM-28 siRNA-induced apoptosis, and we found that proMMP-13 is partially cleaved into its active form by ADAM-28 in vitro. Overall, our results suggest that IL-1β-induced MMP-13 expression and changes in cell proliferation and apoptosis in α7{sup +}hSMSC-OB cells are regulated by ADAM-28. - Highlights: • IL-1β induces the MMP-13 and ADAM-28 expression in human osteoblast-like cells. • IL-1β-induced MMP-13 expression increases proliferation and decreased apoptosis. • MMP-13 expression induced by IL-1β is regulated by ADAM-28. • proMMP-13 appears to be cleaved into its active form via

  7. Immediate Postoperative Pain Scores Predict Neck Pain Profile up to 1 Year Following Anterior Cervical Discectomy and Fusion.

    Science.gov (United States)

    Adogwa, Owoicho; Elsamadicy, Aladine A; Vuong, Victoria D; Mehta, Ankit I; Vasquez, Raul A; Cheng, Joseph; Bagley, Carlos A; Karikari, Isaac O

    2018-05-01

    Retrospective cohort review. To assess whether immediate postoperative neck pain scores accurately predict 12-month visual analog scale-neck pain (VAS-NP) outcomes following Anterior Cervical Discectomy and Fusion surgery (ACDF). This was a retrospective study of 82 patients undergoing elective ACDF surgery at a major academic medical center. Patient reported outcomes measures VAS-NP scores were recorded on the first postoperative day, then at 6-weeks, 3, 6, and 12-months after surgery. Multivariate correlation and logistic regression methods were utilized to determine whether immediate postoperative VAS-NP score accurately predicted 1-year patient reported VAS-NP Scores. Overall, 46.3% male, 25.6% were smokers, and the mean age and body mass index (BMI) were 53.7 years and 28.28 kg/m 2 , respectively. There were significant correlations between immediate postoperative pain scores and neck pain scores at 6 weeks VAS-NP ( P = .0015), 6 months VAS-NP ( P = .0333), and 12 months VAS-NP ( P = .0247) after surgery. Furthermore, immediate postoperative pain score is an independent predictor of 6 weeks, 6 months, and 1 year VAS-NP scores. Our study suggests that immediate postoperative patient reported neck pain scores accurately predicts and correlates with 12-month VAS-NP scores after an ACDF procedure. Patients with high neck pain scores after surgery are more likely to report persistent neck pain 12 months after index surgery.

  8. Kajian Degradasi Lahan Sebagai Dasar Pengendalian Banjir di DAS Juwana

    Directory of Open Access Journals (Sweden)

    Arina Miardini

    2016-10-01

    Full Text Available Adanya pemanfaatan lahan yang intensif dan ekspolitatif dapat menurunkan daya dukung dan fungsi lingkungan DAS yang menyebabkan lahan menjadi terdegradasi. Tingginya luasan lahan kritis menjadi ancaman terhadap daya dukung DAS yang akan berdampak pada ketidakseimbangan hidrologi dalam DAS. Salah satu akibat ketidakseimbangan hidrologi dalam DAS adalah terjadinya banjir. DAS Juwana merupakan DAS Prioritas I berdasarkan penetapan 108 DAS prioritas. Salah satu indikator untuk menentukan degradasi dalam DAS dapat diketahui berdasarkan nilai koefisien aliran. Penelitian ini bertujuan untuk mengidentifikasi karakteristik fisik DAS yang berpengaruh dalam penentuan koefisien aliran, menghitung koefisien aliran dengan mempertimbangkan parameter karakteristik fisik DAS dan memberikan rekomendasi pengelolaan banjir di DAS Juwana yang potensial banjir dalam mendukung upaya pengelolaan DAS dari hulu sampai hilir. Koefisien aliran dihitung denggan menggunakan metode cook yang memperhitungkan parameter kemiringan lereng, infiltrasi tanah, tutupan vegetasi dan simpanan permukaan. Perumusan pengendalian banjir dilakukan dengan melakukan penatagunaan lahan yang disesuaikan dengan arahan fungsi penggunaan lahan sehingga diharapkan menurunkan nilai koefisien aliran dan debit banjir. Karakteristik fisik DAS Juwana yang mempengaruhi penentuan koefisien aliran berdasarkan metode Cook yaitu Kemiringan lereng dengan rata-rata skor C sebesar 0,178, kerapatan aliran dengan rata-rata skor 0,084, infiltrasi dengan rata-rata skor 0,115 dan tutupan vegetasi dengan rata-rata skor 0,127. Kontribusi masing masing parameter dalam penilaian koefisien aliran yang memiliki pengaruh paling terbesar sampai paling terkecil dalam besarnya koefisien aliran yaitu kemiringan lereng yang memiliki pengaruh sebesar 35,39%, kemudian tutupan vegetasi sebesar 25,25%, infiltrasi sebesar 22,86% dan terakhir adalah kerapatan aliran yang berkontribusi sebesar 16,70%. Nilai koefisien aliran di DAS

  9. Predicting high risk of exacerbations in bronchiectasis: the E-FACED score

    Directory of Open Access Journals (Sweden)

    Martinez-Garcia MA

    2017-01-01

    Full Text Available Martinez-Garcia MA,1,2 Athanazio RA,3 Girón R,4 Máiz-Carro L,5 de la Rosa D,6 Olveira C,7 de Gracia J,2,8 Vendrell M,9 Prados-Sánchez C,10 Gramblicka G,11 Corso Pereira M,12 Lundgren FL,13 Fernandes De Figueiredo M,14 Arancibia F,15 Rached SZ3 1Pulmonary Service, Polytechnic and University La Fe Hospital, Valencia, Spain; 2CIBERes, CIBER de Enfermedades Respiratorias. Madrid. Spain; 3Pulmonary Division, Heart Institute (Incor, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; 4Pneumology Service, Hospital La Princesa, 5Pneumology Service, Hospital Ramón y Cajal, Madrid, 6Pneumology Unit, Hospital Plató, Barcelona, 7Pneumology, Málaga Regional University Hospital, Instituto de Biomedicina de Málaga (IBIMA, Málaga University, Spain; 8Pneumology Service, Hospital Vall d’Hebron, Barcelona, 9Bronchiectasis Group IDIBGI, Dr. Trueta University Hospital. UdG. Ciberes CB06/06/0030, 10Unidad de Fibrosis Quística y Bronquiectasias. Hospital Universitario La Paz. Madrid. Spain; 11Pneumology Service, Hospital del Tórax Dr A Cetrángolo, Buenos Aires, Argentina; 12Pneumology Service, Universidade Estadual de Campinas UNICAMP, Sao Paulo, 13Pneumology Service, Hospital Octávio de Freitas, Recife, 14Pneumology Service, Hospital de Messejana, Fortaleza, Brazil; 15Pneumology Service, Instituto Nacional del Tórax, Santiago de Chile, Chile Background: Although the FACED score has demonstrated a great prognostic capacity in bronchiectasis, it does not include the number or severity of exacerbations as a separate variable, which is important in the natural history of these patients.Objective: Construction and external validation of a new index, the E-FACED, to evaluate the predictive capacity of exacerbations and mortality.Methods: The new score was constructed on the basis of the complete cohort for the construction of the original FACED score, while the external validation was undertaken with six cohorts from three

  10. Baseline patient reported outcomes are more consistent predictors of long-term functional disability than laboratory, imaging or joint count data in patients with early inflammatory arthritis: A systematic review.

    Science.gov (United States)

    Gwinnutt, James M; Sharp, Charlotte A; Symmons, Deborah P M; Lunt, Mark; Verstappen, Suzanne M M

    2018-03-15

    To assess baseline predictors of long-term functional disability in patients with inflammatory arthritis (IA). We conducted a systematic review of the literature from 1990 to 2017 using MEDLINE and EMBASE. Studies were included if (i) they were prospective observational studies, (ii) all patients had IA with symptom duration ≤2 years at baseline, (iii) follow-up was at least 5 years, and (iv) baseline predictors of HAQ score at long-term follow-up (i.e., ≥5 years following baseline) were assessed. Information on the included studies and estimates of the association between baseline variables and long-term HAQ scores were extracted from the full manuscripts. Of 1037 abstracts identified by the search strategy, 37 met the inclusion/exclusion criteria and were included in the review. Older age at baseline and female gender were reported to be associated with higher long-term HAQ scores in the majority of studies assessing these relationships, as were higher baseline HAQ and greater pain scores (total patients included in analyses reporting significant associations/total number of patients analysed: age 9.8k/10.7k (91.6%); gender 9.9k/11.3k (87.4%); HAQ 4.0k/4.0k (99.0%); pain 2.8k/2.9k (93.6%)). Tender joint count, erythrocyte sedimentation rate (ESR) and DAS28 were also reported to predict long-term HAQ score; other disease activity measures were less consistent (tender joints 2.1k/2.5k (84.5%); erythrocyte sedimentation rate 1.6k/2.2k (72.3%); DAS28 888/1.1k (79.2%); swollen joints 684/2.6k (26.6%); C-reactive protein 279/510 (54.7%)). Rheumatoid factor (RF) and erosions were not useful predictors (RF 546/4.6k (11.9%); erosions 191/2.7k (7.0%)), whereas the results for anti-citrullinated protein antibody positivity were equivocal (ACPA 2.0k/3.8k (52.9%)). Baseline age, gender, HAQ and pain scores are associated with long-term disability and knowledge of these may aid the assessment of prognosis. Copyright © 2018 The Authors. Published by Elsevier Inc. All

  11. Induction of activator protein (AP)-1 and nuclear factor-kappaB by CD28 stimulation involves both phosphatidylinositol 3-kinase and acidic sphingomyelinase signals.

    Science.gov (United States)

    Edmead, C E; Patel, Y I; Wilson, A; Boulougouris, G; Hall, N D; Ward, S G; Sansom, D M

    1996-10-15

    A major obstacle in understanding the signaling events that follow CD28 receptor ligation arises from the fact that CD28 acts as a costimulus to TCR engagement, making it difficult to assess the relative contribution of CD28 signals as distinct from those of the TCR. To overcome this problem, we have exploited the observation that activated human T cell blasts can be stimulated via the CD28 surface molecule in the absence of antigenic challenge; thus, we have been able to observe the response of normal T cells to CD28 activation in isolation. Using this system, we observed that CD28 stimulation by B7-transfected CHO cells induced a proliferative response in T cells that was not accompanied by measurable IL-2 production. However, subsequent analysis of transcription factor generation revealed that B7 stimulation induced both activator protein-1 (AP-1) and nuclear factor-kappaB (NF-kappaB) complexes, but not NF-AT. In contrast, engagement of the TCR by class II MHC/superantigen, either with or without CD28 ligation, resulted in the induction of NF-AT, AP-1, and NF-kappaB as well as IL-2 production. Using selective inhibitors, we investigated the signaling pathways involved in the CD28-mediated induction of AP-1 and NF-kappaB. This revealed that NF-kappaB generation was sensitive to chloroquine, an inhibitor of acidic sphingomyelinase, but not to the phosphatidylinositol 3-kinase inhibitor, wortmannin. In contrast, AP-1 generation was inhibited by wortmannin and was also variably sensitive to chloroquine. These data suggest that in activated normal T cells, CD28-derived signals can stimulate proliferation at least in part via NF-kappaB and AP-1 generation, and that this response uses both acidic sphingomyelinase and phosphatidylinositol 3-kinase-linked pathways.

  12. Das Muťafi-Lazische

    OpenAIRE

    Kutscher, Silvia; Mattissen, Johanna; Wodarg, Anke

    1995-01-01

    Die in der vorliegenden Publikation untersuchte Sprache ist ein Dialekt des Lazischen, der in Muťafi und Umgebung gesprochen wird. Dieser Dialekt ist bis zu diesem Zeitpunkt noch nicht wissenschaftlich untersucht worden. Da er einige Charakteristika aufweist, die in anderen lazischen Dialekten nicht zu finden sind, hielten wir es für notwendig, unsere Untersuchungsergebnisse zu veröffentlichen. Eine auffällige Besonderheit findet sich z.B. im Kasussystem: Sowohl das Georgische als auch das Za...

  13. Safety and effectiveness of 24-week treatment with iguratimod, a new oral disease-modifying antirheumatic drug, for patients with rheumatoid arthritis: interim analysis of a post-marketing surveillance study of 2679 patients in Japan.

    Science.gov (United States)

    Mimori, Tsuneyo; Harigai, Masayoshi; Atsumi, Tatsuya; Fujii, Takao; Kuwana, Masataka; Matsuno, Hiroaki; Momohara, Shigeki; Takei, Syuji; Tamura, Naoto; Takasaki, Yoshinari; Ikeuchi, Satoshi; Kushimoto, Satoru; Koike, Takao

    2017-09-01

    To determine the real-world safety and effectiveness of iguratimod (IGU) for rheumatoid arthritis (RA), a 52-week, Japanese, post-marketing surveillance study was conducted. An interim analysis at week 24 was performed. This study included all RA patients who received IGU following its introduction to the market. All adverse events (AEs) and adverse drug reactions (ADRs) were collected. Effectiveness was evaluated by the change in Disease Activity Score 28-C-reactive protein (DAS28-CRP) from baseline to week 24. Safety was analyzed in 2679 patients. The overall incidences of AEs, ADRs, and serious ADRs were 38.41, 31.65, and 3.21%, respectively; the most commonly reported serious ADRs were pneumonia/bacterial pneumonia, interstitial lung disease, and Pneumocystis jiroveci pneumonia. Concomitant glucocorticoid use and comorbid conditions associated with respiratory disease were identified as risk factors for serious infections. Pulmonary alveolar hemorrhage and increased international normalized ratio of prothrombin time were observed with concomitant use of IGU and warfarin. The DAS28-CRP decreased from baseline to week 24. Although a safety concern was identified with concomitant use of IGU and warfarin, this real-world study showed no other new safety concerns and similar effectiveness to clinical trials. IGU is a new therapeutic option for RA patients.

  14. Treatment factors influencing survival in pancreatic carcinoma; Der Einfluss der Therapie auf das Ueberleben von Patienten mit Pankreaskarzinom. Eine Analyse von Einzelfaktoren

    Energy Technology Data Exchange (ETDEWEB)

    Warszawski, N.; Warszawski, A.; Schneider, B.M.; Roettinger, E.M. [Ulm Univ. (Germany). Abt. Radiologie 2 (Strahlentherapie); Link, K.H.; Gansauge, F. [Ulm Univ. (Germany). Abt. fuer Allgemeinchirurgie; Lutz, M.P. [Ulm Univ. (Germany). Abt. Innere Medizin 1

    1999-07-01

    Purpose: To identify the impact of treatment factors on overall survival in patients with pancreatic carcinoma. Patients and methods: We performed a follow-up study on 38 patients with adenocarcinoma of the pancreas treated from 1984 to 1998. 18/38 patients were resected. Irradiated volume included the primary tumor (or tumor bed) and regional lymph nodes. Thirty-seven patients received in addition chemotherapy consisting of mitoxantrone, 5-fluorouracil and cis-platin, either i.v. (14/38) or i.a. (23/38). The influence of treatment related factors on the overall survival was tested. Biologically effective dose was calculated by the linear-quadratic model ({alpha}/{beta}=25 Gy) and by losing 0.85 Gy per day starting accelerated repopulation at day 28. Results: Treatment factors influencing overall survival were resection (p=0.02), overall treatment time (p=0.03) and biologically effective dose (p<0.002). Total dose and kind of chemotherapy had no significant influence. Treatment volume had a negative correlation (r=-0.5, p=0.06) with overall survival, without any correlation between tumor size, tumor stage, and treatment volume. In multivariate analysis only biologically effective dose remained significant (p=0.02). Conclusions: Among with surgery, biologically effective dose strongly influences overall survival in patients treated for pancreatic carcinoma. Treatment volume should be kept as small as possible and all efforts should be made to avoid treatments splits in radiation therapy. (orig.) [Deutsch] Ziel: Behandlungsfaktoren zu identifizieren, die einen Einfluss auf das Ueberleben von Patienten mit Pankreaskarzinom haben. Patienten und Methode: In einer nichtrandomisierten Studie wurden 38 Patienten ausgewertet, die von 1984 bis 1998 wegen eines Adenokarzinoms des Pankreas behandelt worden waren. Bei 18/38 Patienten war eine Resektion vorgenommen worden. Das Bestrahlungsvolumen beinhaltete den Primaertumor bzw. das Tumorbett und die regionaeren Lymphknoten

  15. Differences in allergen-induced T cell activation between allergic asthma and rhinitis: Role of CD28, ICOS and CTLA-4

    Directory of Open Access Journals (Sweden)

    Lacoeuille Yannick

    2011-02-01

    Full Text Available Abstract Background Th2 cell activation and T regulatory cell (Treg deficiency are key features of allergy. This applies for asthma and rhinitis. However with a same atopic background, some patients will develop rhinitis and asthma, whereas others will display rhinitis only. Co-receptors are pivotal in determining the type of T cell activation, but their role in allergic asthma and rhinitis has not been explored. Our objective was to assess whether allergen-induced T cell activation differs from allergic rhinitis to allergic rhinitis with asthma, and explore the role of ICOS, CD28 and CTLA-4. Methods T cell co-receptor and cytokine expressions were assessed by flow cytometry in PBMC from 18 house dust mite (HDM allergic rhinitics (R, 18 HDM allergic rhinitics and asthmatics (AR, 13 non allergic asthmatics (A and 20 controls, with or without anti-co-receptors antibodies. Results In asthmatics (A+AR, a constitutive decrease of CTLA-4+ and of CD4+CD25+Foxp3+ cells was found, with an increase of IFN-γ+ cells. In allergic subjects (R + AR, allergen stimulation induced CD28 together with IL-4 and IL-13, and decreased the proportion of CTLA-4+, IL-10+ and CD4+CD25+Foxp3+ cells. Anti-ICOS and anti-CD28 antibodies blocked allergen-induced IL-4 and IL-13. IL-13 production also involved CTLA-4. Conclusions T cell activation differs between allergic rhinitis and asthma. In asthma, a constitutive, co-receptor independent, Th1 activation and Treg deficiency is found. In allergic rhinitis, an allergen-induced Treg cell deficiency is seen, as well as an ICOS-, CD28- and CTLA-4-dependent Th2 activation. Allergic asthmatics display both characteristics.

  16. DRAGON score predicts functional outcomes in acute ischemic stroke patients receiving both intravenous tissue plasminogen activator and endovascular therapy.

    Science.gov (United States)

    Wang, Arthur; Pednekar, Noorie; Lehrer, Rachel; Todo, Akira; Sahni, Ramandeep; Marks, Stephen; Stiefel, Michael F

    2017-01-01

    The DRAGON score, which includes clinical and computed tomographic (CT) scan parameters, predicts functional outcomes in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA). We assessed the utility of the DRAGON score in predicting functional outcome in stroke patients receiving both IV tPA and endovascular therapy. A retrospective chart review of patients treated at our institution from February 2009 to October 2015 was conducted. All patients with computed tomography angiography (CTA) proven large vessel occlusions (LVO) who underwent intravenous thrombolysis and endovascular therapy were included. Baseline DRAGON scores and modified Rankin Score (mRS) at the time of hospital discharge was calculated. Good outcome was defined as mRS ≤3. Fifty-eight patients with LVO of the anterior circulation were studied. The mean DRAGON score of patients on admission was 5.3 (range, 3-8). All patients received IV tPA and endovascular therapy. Multivariate analysis demonstrated that DRAGON scores ≥7 was associated with higher mRS ( P DRAGON scores ≤6. Patients with DRAGON scores of 7 and 8 on admission had a mortality rate of 3.8% and 40%, respectively. The DRAGON score can help predict better functional outcomes in ischemic stroke patients receiving both IV tPA and endovascular therapy. This data supports the use of the DRAGON score in selecting patients who could potentially benefit from more invasive therapies such as endovascular treatment. Larger prospective studies are warranted to further validate these results.

  17. Analisis Laju Sedimen DAS Serayu Hulu dengan Menggunakan Model SWAT

    Directory of Open Access Journals (Sweden)

    Nugroho Christanto

    2018-03-01

    Full Text Available Wilayah DAS Serayu Hulu merupakan DAS prioritas yang memerlukan langkah pengelolaan yang komprehensif. Aplikasi model Soil and Water Assessment Tool (SWAT dapat digunakan sebagai media untuk  perencanaan konservasi ataupun evaluasi respon DAS (debit aliran permukaan, sedimen dan pencemaran sungai. Tujuan utama dari penelitian ini adalah menjalankan model SWAT di DAS Serayu Hulu untuk mengetahui laju sedimen di wilayah ini. Pemodelan SWAT membutuhkan sejumlah input parameter berupa relief, tanah, tutupan lahan dan pengelolaan lahan. Pedogeomorfologi digunakan sebagai batas satuan tanah karena tidak tersedianya peta tanah di wilayah penelitian. Hasil Penerapan model SWAT di DAS Serayu Hulu menghasilkan nilai yang cukup memuaskan, hal ini ditunjukkan nilai R2 mencapai 0,94. Hasil pemodelan SWAT dengan menggunakan data selama 10 tahun (2004-2013 menunjukkan bahwa DAS Serayu Hulu memiliki rerata hasil sedimen sebesar 1.926.900 ton/tahun. Sub DAS 8,9 11, 17, 18, dan 19 merupakan penghasil sedimen tertinggi di DAS Serayu Hulu dengan hasil sedimen 43.931– 121.434 ton/ha/tahun.

  18. Contribuição das incubadoras tecnológicas na internacionalização das empresas incubadas

    Directory of Open Access Journals (Sweden)

    Raquel Engelman

    2013-03-01

    Full Text Available Neste trabalho, teve-se como propósito verificar como as incubadoras tecnológicas brasileiras contribuem para a internacionalização das empresas incubadas no ponto de vista dos gestores das incubadoras. Para atender a esse propósito, desenvolveu-se um modelo que, além de oferecer suporte à pesquisa, possa servir de base para estudos e ações sobre internacionalização de empresas de base tecnológica incubadas. O modelo foi elaborado a partir da literatura sobre as duas áreas de interesse do trabalho. De um lado, foram abordadas referências sobre internacionalização de empresas, fazendo-se um levantamento sobre os fatores que influenciam sua internacionalização, principalmente micro e pequenas empresas de base tecnológica; de outro, foram estudados aspectos sobre o processo de incubação de empreendimentos tecnológicos, bem como as ações e os serviços disponibilizados pelas incubadoras. A pesquisa descritiva foi realizada com 40 incubadoras tecnológicas brasileiras (50% da população e que atenderam aos seguintes critérios: estar em efetiva operação há um tempo superior a dois anos e com pelo menos uma empresa graduada. A partir de questionários identificou-se que 40% das incubadoras da amostra possuem programa formal voltado para a internacionalização das incubadas e 60% das incubadoras têm empresas que iniciaram processo de internacionalização. Os resultados apontaram uma relação positiva entre incubação e internacionalização. A pesquisa forneceu indicações de ações e serviços que são efetivos na internacionalização das empresas.

  19. Validity and Reliability of Nintendo Wii Fit Balance Scores

    Science.gov (United States)

    Wikstrom, Erik A.

    2012-01-01

    Context: Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. Objective: To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Design: Descriptive laboratory study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty-five recreationally active participants (age  =  27.0 ± 9.8 years, height  =  170.9 ± 9.2 cm, mass  =  72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Intervention(s): Participants completed a single-limb–stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Main Outcome Measure(s): Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. Results: All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC]  =  0.80) to poor (ICC  =  0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with

  20. Association of the TYMS 3G/3G genotype with poor response and GGH 354GG genotype with the bone marrow toxicity of the methotrexate in RA patients.

    Science.gov (United States)

    Jekic, Biljana; Lukovic, Ljiljana; Bunjevacki, Vera; Milic, Vera; Novakovic, Ivana; Damnjanovic, Tatjana; Milasin, Jelena; Popovic, Branka; Maksimovic, Nela; Damjanov, Nemanja; Radunovic, Goran; Kovacevic, Ljiljana; Krajinovic, Maja

    2013-03-01

    Gamma-glutamyl hydrolase (GGH), cyclin D1 (CCND1) and thymidylate synthase (TS) genes encode enzymes that are involved in methotrexate (MTX) action. In a group of 184 RA patients treated with MTX, we have investigated whether selected polymorphisms in these genes modulate MTX efficacy and/or have impact on adverse drug effects (ADEs). The efficacy of the MTX therapy has been estimated using the disease activity score in 28 joints (DAS28-ESR) based on EULAR criteria and relative DAS28 values (rDAS28). All adverse drug events were recorded. Patients were genotyped for selected polymorphisms of the GGH (-354 G > T and 452 C > T), CCND1 (870 A > G) and TYMS (variable number of tandem repeats, VNTR, and G to C substitution of triple repeat, 3R allele) gene. Association studies have been performed between obtained genotypes and the efficacy and toxicity of MTX. According to the EULAR response criteria, 146 RA patients (79.3 %) were classified as responders (good/moderate response) and 38 (20.7 %) as non-responders (poor response). Higher frequency of the TYMS 3 G/3 G genotype has been found among non-responders as compared to individuals with remaining genotypes (p = 0.02). ADEs were recorded in 53 patients. Among those patients eight experienced bone marrow toxicity, all of them carried GGH -354GG genotype (p = 0.003). No other significant association were observed. The 3 G/3 G genotype of the TYMS gene may indicate predisposition of poor response to MTX and GG genotype of GGH -354 T > G polymorphism may have high predictive value for myelosuppression in RA patients.

  1. IAEA activities in nuclear safety: future perspectives. Spanish Nuclear Safety Council, Madrid, 28 May 1998

    International Nuclear Information System (INIS)

    ElBaradei, M.

    1998-01-01

    The document represents the conference given by the Director General of the IAEA at the Spanish Nuclear Safety Council in Madrid, on 28 May 1998, on Agency's activities in nuclear safety. The following aspects are emphasized: Agency's role in creating a legally binding nuclear safety regime, non-binding safety standards, services provided by the Agency to assist its Member States in the Application of safety standards, Agency's nuclear safety strategy, and future perspective concerning safety aspects related to radioactive wastes, residues of past nuclear activities, and security of radiological sources

  2. Application of the FOUR Score in Intracerebral Hemorrhage Risk Analysis.

    Science.gov (United States)

    Braksick, Sherri A; Hemphill, J Claude; Mandrekar, Jay; Wijdicks, Eelco F M; Fugate, Jennifer E

    2018-06-01

    The Full Outline of Unresponsiveness (FOUR) Score is a validated scale describing the essentials of a coma examination, including motor response, eye opening and eye movements, brainstem reflexes, and respiratory pattern. We incorporated the FOUR Score into the existing ICH Score and evaluated its accuracy of risk assessment in spontaneous intracerebral hemorrhage (ICH). Consecutive patients admitted to our institution from 2009 to 2012 with spontaneous ICH were reviewed. The ICH Score was calculated using patient age, hemorrhage location, hemorrhage volume, evidence of intraventricular extension, and Glasgow Coma Scale (GCS). The FOUR Score was then incorporated into the ICH Score as a substitute for the GCS (ICH Score FS ). The ability of the 2 scores to predict mortality at 1 month was then compared. In total, 274 patients met the inclusion criteria. The median age was 73 years (interquartile range 60-82) and 138 (50.4%) were male. Overall mortality at 1 month was 28.8% (n = 79). The area under the receiver operating characteristic curve was .91 for the ICH Score and .89 for the ICH Score FS . For ICH Scores of 1, 2, 3, 4, and 5, 1-month mortality was 4.2%, 29.9%, 62.5%, 95.0%, and 100%. In the ICH Score FS model, mortality was 10.7%, 26.5%, 64.5%, 88.9%, and 100% for scores of 1, 2, 3, 4, and 5, respectively. The ICH Score and the ICH Score FS predict 1-month mortality with comparable accuracy. As the FOUR Score provides additional clinical information regarding patient status, it may be a reasonable substitute for the GCS into the ICH Score. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. CDK-mediated activation of the SCF(FBXO) (28) ubiquitin ligase promotes MYC-driven transcription and tumourigenesis and predicts poor survival in breast cancer.

    Science.gov (United States)

    Cepeda, Diana; Ng, Hwee-Fang; Sharifi, Hamid Reza; Mahmoudi, Salah; Cerrato, Vanessa Soto; Fredlund, Erik; Magnusson, Kristina; Nilsson, Helén; Malyukova, Alena; Rantala, Juha; Klevebring, Daniel; Viñals, Francesc; Bhaskaran, Nimesh; Zakaria, Siti Mariam; Rahmanto, Aldwin Suryo; Grotegut, Stefan; Nielsen, Michael Lund; Szigyarto, Cristina Al-Khalili; Sun, Dahui; Lerner, Mikael; Navani, Sanjay; Widschwendter, Martin; Uhlén, Mathias; Jirström, Karin; Pontén, Fredrik; Wohlschlegel, James; Grandér, Dan; Spruck, Charles; Larsson, Lars-Gunnar; Sangfelt, Olle

    2013-07-01

    SCF (Skp1/Cul1/F-box) ubiquitin ligases act as master regulators of cellular homeostasis by targeting key proteins for ubiquitylation. Here, we identified a hitherto uncharacterized F-box protein, FBXO28 that controls MYC-dependent transcription by non-proteolytic ubiquitylation. SCF(FBXO28) activity and stability are regulated during the cell cycle by CDK1/2-mediated phosphorylation of FBXO28, which is required for its efficient ubiquitylation of MYC and downsteam enhancement of the MYC pathway. Depletion of FBXO28 or overexpression of an F-box mutant unable to support MYC ubiquitylation results in an impairment of MYC-driven transcription, transformation and tumourigenesis. Finally, in human breast cancer, high FBXO28 expression and phosphorylation are strong and independent predictors of poor outcome. In conclusion, our data suggest that SCF(FBXO28) plays an important role in transmitting CDK activity to MYC function during the cell cycle, emphasizing the CDK-FBXO28-MYC axis as a potential molecular drug target in MYC-driven cancers, including breast cancer. © 2013 The Authors. Published by John Wiley and Sons, Ltd on behalf of EMBO.

  4. Validity and predictive ability of the juvenile arthritis disease activity score based on CRP versus ESR in a Nordic population-based setting

    DEFF Research Database (Denmark)

    Nordal, E B; Zak, M; Aalto, K

    2012-01-01

    To compare the juvenile arthritis disease activity score (JADAS) based on C reactive protein (CRP) (JADAS-CRP) with JADAS based on erythrocyte sedimentation rate (ESR) (JADAS-ESR) and to validate JADAS in a population-based setting.......To compare the juvenile arthritis disease activity score (JADAS) based on C reactive protein (CRP) (JADAS-CRP) with JADAS based on erythrocyte sedimentation rate (ESR) (JADAS-ESR) and to validate JADAS in a population-based setting....

  5. Tendências temporais e espaciais da qualidade das águas superficiais da sub-bacia do Rio das Velhas, estado de Minas Gerais

    OpenAIRE

    Trindade, Ana Laura Cerqueira; Almeida, Katiane Cristina de Brito; Barbosa, Pedro Engler; Oliveira, Sílvia Maria Alves Corrêa

    2016-01-01

    RESUMO Este artigo apresenta uma análise da tendência temporal e espacial da qualidade das águas superficiais da sub-bacia do Rio das Velhas, inserida na bacia do Rio São Francisco, em Minas Gerais, Brasil. Foram analisados 16.625 dados coletados no período de 2002 a 2011 pelo programa de monitoramento de qualidade das águas superficiais efetuado pelo Instituto Mineiro de Gestão das Águas (Igam). Testes estatísticos, multivariados e não paramétricos foram utilizados para avaliar 11 variáveis ...

  6. Archaeozoology of marine mollusks from Sambaqui da Tarioba, Rio das Ostras, Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Rosa C. C. L. de Souza

    2010-06-01

    Full Text Available A reference inventory of prehistoric marine mollusks from the Rio das Ostras region was created based on an excavation carried out at the Sambaqui da Tarioba shellmound. Patterns of richness and biogeography were studied, and the representativeness of bivalve and gastropod diversities found at this archaeological site were inferred. A total of 47 taxa belonging to 28 families, most of which from unconsolidated substrates, was identified. The shellmound species composition does not differ from the present-day composition. All recorded species are characteristic of a wide transition zone between the south of the states of Espírito Santo (21°S and Rio Grande do Sul (32°S. Thus, the data show little evidence of evolution in the composition, richness,and biodiversity distribution patterns of mollusks in the Rio das Ostras region. Likewise, a reconstitution of the paleoenvironment from the functional characteristics of the shellmound species indicates that the locality's geomorphology and climate remained largely unchanged in the last 4,000 years BP.

  7. Alimentary habits, physical activity, and Framingham global risk score in metabolic syndrome.

    Science.gov (United States)

    Soares, Thays Soliman; Piovesan, Carla Haas; Gustavo, Andréia da Silva; Macagnan, Fabrício Edler; Bodanese, Luiz Carlos; Feoli, Ana Maria Pandolfo

    2014-04-01

    Metabolic syndrome is a complex disorder represented by a set of cardiovascular risk factors. A healthy lifestyle is strongly related to improve Quality of Life and interfere positively in the control of risk factors presented in this condition. To evaluate the effect of a program of lifestyle modification on the Framingham General Cardiovascular Risk Profile in subjects diagnosed with metabolic syndrome. A sub-analysis study of a randomized clinical trial controlled blind that lasted three months. Participants were randomized into four groups: dietary intervention + placebo (DIP), dietary intervention + supplementation of omega 3 (fish oil 3 g/day) (DIS3), dietary intervention + placebo + physical activity (DIPE) and dietary intervention + physical activity + supplementation of omega 3 (DIS3PE). The general cardiovascular risk profile of each individual was calculated before and after the intervention. The study included 70 subjects. Evaluating the score between the pre and post intervention yielded a significant value (p study emphasizes the importance of lifestyle modification in the prevention and treatment of cardiovascular diseases.

  8. Por que a elasticidade-preço das importações é baixa no Brasil? Evidências a partir das desagregações das importações por categorias de uso

    Directory of Open Access Journals (Sweden)

    Cláudio Hamilton Matos dos Santos

    Full Text Available Resumo Estudos recentes indicam que a elasticidade-preço das importações brasileiras é baixa. Este trabalho procura racionalizar o referido resultado revisitando as estimativas das importações do país desagregadas por “categoria de uso”. Os resultados reportados sugerem que a baixa elasticidade-preço das importações agregadas reflete fundamentalmente a baixa elasticidade-preço das importações de combustíveis, bens intermediários e de alguns tipos de serviços - notadamente, transporte, aluguel de equipamentos e pagamentos de royalties - produtos que, somados, respondem por pouco menos de dois terços do total importado. Isso ocorre porque vários desses produtos têm pouca ou nenhuma possibilidade de substituição por similares nacionais, devido principalmente a deficiências estruturais na oferta nacional.

  9. Das, Prof. Saumitra

    Indian Academy of Sciences (India)

    Fellow Profile. Elected: 2009 Section: General Biology. Das, Prof. Saumitra Ph.D. (Calcutta), FNASc, FNA. Date of birth: 20 January 1962. Specialization: Molecular Virology, Molecular Biology and Cell Biology Address: Microbiology and Cell Biology Department, Indian Institute of Science, Bengaluru 560 012, Karnataka

  10. Verwaiste und vergriffene Werke - Kommt das 20. Jahrhundert endlich in die Digitale Bibliothek?

    Directory of Open Access Journals (Sweden)

    Armin Talke

    2013-10-01

    Full Text Available Am 20.September 2013 hat das am 27. Juni vom Bundestag (Fn 2 verabschiedete Gesetz zur Nutzung verwaister und vergriffener Werke auch den Bundesrat passiert. Es entspricht weitgehend dem Entwurf der Bundesregierung (Fn 3. Kleinere, vom Rechtsausschuss vorgeschlagene (Fn 4 Änderungen sind eingeflossen. Der Regelung liegt zum Teil die Richtlinie 2012/28/EU vom 25. Oktober 2012 über bestimmte zulässige Nutzungen verwaister Werke zugrunde. Nachdem lange Zeit von vielen Interessengruppen eine Weiterentwicklung des Urheberrechts gefordert wurde, haben die Deutschen Gesetzgebungsorgane mit der Regelung in §§ 61 ff UrhG zu den verwaisten und in §§ 13d und e UrhWahrnG zu den vergriffenen Werken, neben den gleichzeitig verabschiedeten Vorgaben für ein „Zweitverwertungsrecht”, in aller Eile vor der Sommerpause und der Bundestagswahl einen kleinen Fortschritt getan. In europarechtlicher Hinsicht wäre die Regelung so schnell gar nicht notwendig gewesen: Die Umsetzungsfrist läuft nach Art. 9 Abs.1 der Richtlinie erst zum 29.9.2014 ab. Auch inhaltlich übertrifft das Gesetz mit der Normierung der Lizenzierung „vergriffener” Werke durch Verwertungsgesellschaften die zwingenden Vorgaben der Richtlinie. Ein neues „Kapitel in der Geschichte des Urheberrechts”, das von der Bundesjustizministerin schon im Juni 2010 angemahnt worden war (Fn 5, ist damit allerdings noch nicht geschrieben. Die Richtlinie und das Gesetz erlauben die Digitalisierung von noch urheberrechtlich geschützten Werktypen verschiedenster Art, die in unterschiedlichen Kultureinrichtungen vorhanden sind. Die folgenden Ausführungen beziehen sich vorwiegend auf die Nutzung gedruckter Literatur. In September, 2013, the German legislators adopted the law on orphan works and out-of-print-works. Both categories affect works which are still under copyright. The clash of interests, however, of cultural institutions holding items of these works, and rightsholders, are not serious, as

  11. Pediatric blunt cerebrovascular injury: the McGovern screening score.

    Science.gov (United States)

    Herbert, Joseph P; Venkataraman, Sidish S; Turkmani, Ali H; Zhu, Liang; Kerr, Marcia L; Patel, Rajan P; Ugalde, Irma T; Fletcher, Stephen A; Sandberg, David I; Cox, Charles S; Kitagawa, Ryan S; Day, Arthur L; Shah, Manish N

    2018-03-16

    OBJECTIVE The objective of this study was to assess the incidence, diagnosis, and treatment of pediatric blunt cerebrovascular injury (BCVI) at a busy Level 1 trauma center and to develop a tool for accurately predicting pediatric BCVI and the need for diagnostic testing. METHODS This is a retrospective cohort study of a prospectively collected database of pediatric patients who had sustained blunt trauma (patient age range 0-15 years) and were treated at a Level 1 trauma center between 2005 and 2015. Digital subtraction angiography, MR angiography, or CT angiography was used to confirm BCVI. Recently, the Utah score has emerged as a screening tool specifically targeted toward evaluating BCVI risk in the pediatric population. Using logistical regression and adding mechanism of injury as a logit, the McGovern score was able to use the Utah score as a starting point to create a more sensitive screening tool to identify which pediatric trauma patients should receive angiographic imaging due to a high risk for BCVI. RESULTS A total of 12,614 patients (mean age 6.6 years) were admitted with blunt trauma and prospectively registered in the trauma database. Of these, 460 (3.6%) patients underwent angiography after blunt trauma: 295 (64.1%), 107 (23.3%), 6 (1.3%), and 52 (11.3%) patients underwent CT angiography, MR angiography, digital subtraction angiography, and a combination of imaging modalities, respectively. The BCVI incidence (n = 21; 0.17%) was lower than that in a comparable adult group (p tools for BCVI, misclassified 6 (28.6%), 6 (28.6%), 7 (33.3%), and 10 (47.6%) patients with BCVI, respectively, as "low risk" and not in need of subsequent angiographic imaging. By incorporating the mechanism of injury into the score, the McGovern score only misclassified 4 (19.0%) children, all of whom were managed conservatively with no treatment or aspirin. CONCLUSIONS With a low incidence of pediatric BCVI and a nonsurgical treatment paradigm, a more conservative approach

  12. 28 CFR 30.3 - What programs and activities of the Department are subject to these regulations?

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false What programs and activities of the Department are subject to these regulations? 30.3 Section 30.3 Judicial Administration DEPARTMENT OF JUSTICE... Department are subject to these regulations? The Attorney General publishes in the Federal Register a list of...

  13. The ratio of nurse consultation and physician efficiency index of senior rheumatologists is significantly higher than junior physicians in rheumatology residency training

    DEFF Research Database (Denmark)

    Emamifar, Amir; van Bui Hansen, Morten Hai; Jensen Hansen, Inger Marie

    2017-01-01

    To elucidate the difference between ratios of nurse consultation sought by senior rheumatologists and junior physicians in rheumatology residency training, and also to evaluate physician efficiency index respecting patients with rheumatoid arthritis (RA). Data regarding outpatient visits for RA...... patients between November 2013 and 2015 were extracted. The mean interval (day) between consultations, the nurse/physician visits ratio, and physician efficiency index (nurse/physician visits ratio × mean interval) for each senior and junior physicians were calculated. Disease Activity Score in 28 joints....../physician visits ratio (P = .01) and mean efficiency index (P = .04) of senior rheumatologists were significantly higher than that of junior physicians. Regression analysis showed a positive correlation between physician postgraduate experience and physician efficiency index adjusted for DAS28 at baseline...

  14. A Novel Risk Score in Predicting Failure or Success for Antegrade Approach to Percutaneous Coronary Intervention of Chronic Total Occlusion: Antegrade CTO Score.

    Science.gov (United States)

    Namazi, Mohammad Hasan; Serati, Ali Reza; Vakili, Hosein; Safi, Morteza; Parsa, Saeed Ali Pour; Saadat, Habibollah; Taherkhani, Maryam; Emami, Sepideh; Pedari, Shamseddin; Vatanparast, Masoomeh; Movahed, Mohammad Reza

    2017-06-01

    Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach. This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach. A total of 188 patients were studied. Mean ± SD age was 59 ± 9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR = 6.7, CI = 1.97-23.17, score = 2), absence of stump (OR = 5.8, CI = 1.95-17.9, score = 2), presence of calcification (OR = 3.21, CI = 1.46-7.07, score = 1), presence of bending (OR = 2.8, CI = 1.28-6.10, score = 1), presence of near side branch (OR = 2.7, CI = 1.08-6.57, score = 1), and absence of retrograde filling (OR = 2.5, CI = 1.03-6.17, score = 1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate. Most factors associated with failure of CTO-PCI are related to lesion characteristics. A new risk score (range 0-8) is developed to predict CTO-PCI success or failure rate during antegrade approach as a guide before attempting PCI of CTO lesions.

  15. Enantiospecific tritium labeling of 28-homocastasterone.

    Science.gov (United States)

    Elbert, Tomáš; Patil, Mahadeo R; Marek, Aleš

    2017-03-01

    A regiospecific and enantiospecific synthesis of tritium-labeled 28-homocastasterone is reported. Appropriate chlorocarbonate, efficiently synthesized from the starting 28-homocastasterone in an overall yield of 46%, undergoes catalytic tritium dechlorination by the T 2 /Pd[0]/Et 3 N system, providing 28-[3β- 3 H]homocastasterone, in a good yield, radiochemical purity (>97%), and with a high specific activity (5.8 Ci/mmol). Copyright © 2016 John Wiley & Sons, Ltd.

  16. Avaliação do perfil de armazenamento e descontaminação das escovas dentais

    Directory of Open Access Journals (Sweden)

    Faldryene de Sousa Queiroz

    Full Text Available INTRODUÇÃO: A escova dental é um instrumento de higiene bucal eficiente na prevenção de doenças; no entanto, também é um meio favorável a proliferação e disseminação de microrganismos. OBJETIVO: O objetivo deste trabalho foi avaliar quais os cuidados relativos ao armazenamento e à descontaminação das escovas dentais, realizados por famílias assistidas por um projeto de extensão universitária. METODOLOGIA: A metodologia consistiu na realização de um estudo observacional, por meio da aplicação de um formulário específico. RESULTADO: Das 88 pessoas entrevistadas, constatou-se que 71,6% lavavam toda a escova com água corrente e 10,2% passavam os dedos nas cerdas para retirar o excesso de água. Quanto ao armazenamento das escovas, 37,5% guardavam dentro do armário do banheiro, enquanto 28,4% armazenavam todas juntas, em cima da pia. Com relação à transmissibilidade, 88,6% sabiam que as escovas podiam ser um meio de transmissão de doenças; porém, 40,9% não sabiam como ocorreria tal transmissão. Sobre a desinfecção de escovas dentais, 71,6% nunca tinham ouvido falar e 77,3% não utilizavam nenhuma solução desinfetante. CONCLUSÃO: Observou-se que a maioria das famílias não está realizando os procedimentos necessários para manter suas escovas livres de contaminação.

  17. 75 FR 16492 - Agency Information Collection Activities: Form G-28, and Form G-28I, Revision of an Existing...

    Science.gov (United States)

    2010-04-01

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Citizenship and Immigration Services Agency Information... Attorney. OMB Control No. 1615-0105. The Department of Homeland Security, U.S. Citizenship and Immigration... of Homeland Security sponsoring the collection: Form G-28, and Form G-28I. U.S. Citizenship and...

  18. O impacto das redes sociais no marketing: perspectiva portuguesa

    OpenAIRE

    Rosa, Nuno Gonçalo Henriques da

    2010-01-01

    Mestrado em Marketing As mudanças ocorridas nos últimos anos, no panorama dos media, associados aos desenvolvimentos tecnológicos, originaram novos comportamentos no consumidor. O poder das comunicações das marcas deixou de estar centrada apenas nas iniciativas das empresas, o que permitiu um novo relacionamento das marcas com o consumidor, transformando-o num Prosumer. As Redes Sociais e a importância que as suas plataformas assumem na nossa vida, o que para alguns autores é uma extensão ...

  19. Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Karagülle, Oğuz; Dişçi, Rian; Avcı, Aslıhan; Durak, İlker; Karagülle, Müfit Zeki

    2017-01-01

    Oxidative stress has been shown to play a contributory role in the pathogenesis of rheumatoid arthritis (RA). Recent studies have provided evidence for antioxidant properties of spa therapy. The purpose of this study is to investigate whether spa therapy with saline balneotherapy has any influence on the oxidant/antioxidant status in patients with RA and to assess clinical effects of spa therapy. In this investigator-blind randomized controlled trial, we randomly assigned 50 patients in a 1:1 ratio to spa therapy plus standard drug treatment (spa group) or standard drug treatment alone (control group). Spa group followed a 2-week course of spa therapy regimen consisting of a total of 12 balneotherapy sessions in a thermal mineral water pool at 36-37 °C for 20 min every day except Sunday. All clinical and biochemical parameters were assessed at baseline and after spa therapy (2 weeks). The clinical parameters were pain intensity, patient global assessment, physician global assessment, Health Assessment Questionnaire disability index (HAQ-DI), Disease Activity Score for 28-joints based on erythrocyte sedimentation rate (DAS28-4[ESR]). Oxidative status parameters were malondialdehyde (MDA), nonenzymatic superoxide radical scavenger activity (NSSA), antioxidant potential (AOP), and superoxide dismutase (SOD). The NSSA levels were increased significantly in the spa group ( p = 0.003) but not in the control group ( p = 0.509); and there was a trend in favor of spa therapy for improvements in NSSA levels compared to control ( p = 0.091). Significant clinical improvement was found in the spa group compared to the control in terms of patient global assessment ( p = 0.011), physician global assessment ( p = 0.043), function (HAQ-DI) ( p = 0.037), disease activity (DAS28-4[ESR]) (0.044) and swollen joint count (0.009), and a trend toward improvement in pain scores (0.057). Spa therapy with saline balneotherapy exerts antioxidant effect in patients with RA as reflected by the

  20. Das, Prof. Gobardhan

    Indian Academy of Sciences (India)

    Das, Prof. Gobardhan Ph.D. (Imtech), FNASc. Date of birth: 10 December 1966. Specialization: Immunology, Infectious Diseases, Cell Biology Address: Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110 067, U.T.. Contact: Office: (011) 2670 4559, 2673 8824. Residence: (0124) 424 2351

  1. Second Chandra Instrument Activated August 28

    Science.gov (United States)

    1999-08-01

    Cambridge, MA--NASA's Chandra X-ray Observatory opened a new era in astronomy Saturday, August 28, by making the most precise measurements ever recorded of the energy output from the 10 million degree corona of a star. Last weekend's observations came after the successful activation of an instrument developed by MIT that will allow a one-thousand-fold improvement in the capability to measure X-ray spectra from space. The new measurements, made with the High Energy Transmission Grating Spectrometer, join spectacular images taken last week by Chandra of the aftermath of a gigantic stellar explosion. The spectrometer is one of four key instruments aboard Chandra, and the second to be activated. The others will be turned on over the next two weeks. The spectrometer activated yesterday spreads the X-rays from Chandra's mirrors into a spectrum, much as a prism spreads light into its colors. The spectrum then can be read by Chandra's imaging detectors like a kind of cosmic bar code from which scientists can deduce the chemical composition and temperature of the corona. A corona is a region of hot gas and magnetic loops that extend hundreds of thousands of miles above the star's visible surface and is best studied with X-rays. "The success of the new spectrometer is definitely a major milestone for modern astronomy," said MIT Professor Claude R. Canizares, principal investigator for the instrument and associate director of the Chandra X-ray Observatory Center (CXC). "Within the first hour we had obtained the best X-ray spectrum ever recorded for a celestial source. We can already see unexpected features that will teach us new things about stars and about matter at high temperatures." The spectrometer measured X-rays from the star Capella, which is 40 light years away in the constellation Auriga. Capella is actually two stars orbiting one another and possibly interacting in ways that pump extra heat into the corona, which appears more active than that of the Sun. How a star

  2. Comparing the Effects of Group and Home-based Physical Activity on Mental Health in the Elderly.

    Science.gov (United States)

    Mortazavi, Seyede Salehe; Shati, Mohsen; Ardebili, Hassan Eftekhar; Mohammad, Kazem; Beni, Reza Dorali; Keshteli, A H

    2013-11-01

    The present study focuses on comparing the effects of home-based (HB) and group-based (GB) physical activity on mental health in a sample of older adults in Shahr-e-kord. In this quasi-experimental study, a twice-weekly physical activity program for 2 months was provided either individually at home or in a group format for 181 people who were divided into two groups (HB and GB). The outcome, mental health, was measured with the 28-item General Health Questionnaire (GHQ-28). Mental health status improved after participation in the physical activity program. The decrease in GHQ-28 total score in GB group, 3 months after intervention, was 3.61 ± 2.28 (P effects of GB physical activity on mental health compared with HB physical activity, adjusted for related baseline variables, were significant. These findings reveal the probable effects of GB rather than HB physical activity on mental health among the elderly.

  3. Tradução e adaptação transcultural do instrumento de avaliação do quadril "Harris Hip Score" Translation and cultural adaptation of the Harris Hip Score into portuguese

    Directory of Open Access Journals (Sweden)

    Rodrigo Pereira Guimarães

    2010-01-01

    Full Text Available OBJETIVO: O Harris Hip Score é instrumento de avaliação específica, desenvolvido originalmente para avaliar os resultados da artroplastia total de quadril. O objetivo deste estudo foi traduzir e adaptar culturalmente este instrumento para a língua portuguesa. MÉTODO: O método de tradução e adaptação cultural do Harris Hip Score envolveu quatro etapas: 1 - tradução inicial; 2 - retrotradução; 3 - apreciação das versões com elaboração da versão de consenso; 4 - pré-teste comentado com elaboração da versão final. RESULTADOS: A versão de consenso foi aplicada em 30 pacientes com afecção do quadril, sendo verificadas dificuldades no entendimento de algumas expressões, as quais foram substituídas por termos de mais fácil entendimento. Na reaplicação do questionário com a nova versão houve entendimento por 100% dos pacientes no que diz respeito ao sentido semântico, idiomático e contextual. CONCLUSÃO: A versão brasileira do Harris Hip Score permitiu a disponibilização de mais este instrumento para avaliação da qualidade de vida de pacientes com afecções do quadril. Há necessidade de um estudo de avaliação da confiabilidade e validade da versão adaptada culturalmente, a qual já está em desenvolvimento.OBJECTIVE: The Harris Hip Score is a specific evaluation tool, originally developed to assess the results of hip arthroplasty. The objective of this study was to translate and cross-culturally adapt the Harris Hip Score for the Portuguese language. METHOD: The method of translating and culturally adapting the Harris Hip Score involved four steps: 1 - initial translation, 2 - back-translation, 3 - evaluation of the pre-final versions with the development of a consensus version, 4 - commented pre-test with development of the final version. RESULTS: The consensus version was applied to thirty patients with hip disorders. Some difficulties were identified in understanding some expressions, which were replaced

  4. Implementing Data Acquisition Systems DAS1 and DAS2 at Cernavoda Full-Scope Simulator Main Control Room based on the SIEN2007 solution

    International Nuclear Information System (INIS)

    Ionescu, Ana Maria; Tutuianu, Bogdan; Ionescu, Teodor

    2009-01-01

    Modern personnel training, re-training and licensing is a guarantee of NPP's safe reliable operation. Cernavoda NPP personnel training system is the main objective of its specialized department built up as Training Center (TC), directly supervised by Administration of the National Nuclearelectrica Society (SNN) and National Regulatory Body for Nuclear Activities (CNCAN). It was implemented to ensure the abilities, skills and knowledge required by the safe reliable operation of the nuclear reactor by the Main Control Room (MCR) operators. This objective was reached through training lessons taught and tested on the Full Scope Simulator (FSS), the TC's main training tool, a replica of the MCR of the real plant. Its description is the subject of this paper. The TC's FSS includes a computer network equipped with a software connected to the specialized program DATAPATH supplied for Cernavoda FSS by the FSS provider, delivered by L-3/ MAPPS. An alternative to DATAPATH Communication of the L 3/MAPPS Simulation System, developed by Cernavoda Full Scope Simulator Staff, was presented in the previous edition of the symposium (see the SIEN 2007 paper). This original solution is now already applied in order to connect to simulation process Data Acquisition Systems DAS1 and DAS2, two new systems already installed in the real MCR but not included by the Cernavoda FSS initial design. Communication between simulation software and DAS1 and DAS2, considered to be simple receivers of simulated data both as much alike as the two DASs from real plant, is performed in parallel with DATAPATH in a safe mode and without affecting simulation process. This paperwork presents the above mentioned application of this communication solution, developed by the Cernavoda NPP Full Scope Simulator Staff with details about the hardware/software solutions and their performance, training impact, cost and benefits. (authors)

  5. Percentual de degradação das forças liberadas por ligaduras elásticas Force decay rate of orthodontic elastomeric ligatures

    Directory of Open Access Journals (Sweden)

    Emanoela Volles de Souza

    2008-04-01

    Full Text Available OBJETIVO: avaliar ligaduras elásticas da marca Morelli, dos tipos modular e bengala, nas cores cinza e cristal para determinação do percentual de degradação das forças geradas pelas mesmas. METODOLOGIA: as ligaduras elásticas foram estiradas em estiletes de aço inoxidável com diâmetro de 4mm, imersas em solução de saliva artificial a 37ºC, sendo a intensidade das forças liberadas medidas nos tempos de zero hora, 24 horas, 1 semana, 2 semanas, 3 semanas e 4 semanas, em máquina de ensaios de tração. RESULTADOS E CONCLUSÕES: as ligaduras do tipo bengala liberaram, em média e no período de 4 semanas, maior intensidade de força que as do tipo modular. O percentual de degradação das forças liberadas por todas as ligaduras aumentou de forma acentuada entre zero e 24 horas e de forma gradativa após este período, com exceção do 28º dia quando, provavelmente, houve perda das propriedades elásticas das ligaduras. Não foi observado um comportamento constante das ligaduras bengala e modular em relação às cores cinza e cristal.PURPOSE: to evaluate gray and clear module and cane-loaded elastomeric ligatures of the brand Morelli to determine the percentage of decay of the forces they deliver. METHODS: the elastomeric ligatures were stretched over 4mm diameter stainless steel dowels and placed in synthetic saliva bath at 37ºC. The intensity of the forces delivered were taken at start, after 24 hours, one week, two weeks, three weeks and four weeks at a tensile test machine. RESULTS AND CONCLUSIONS: the cane-loaded ligatures delivered, in a period of 4 weeks, in average, greater force intensity than the modules. The percentage of force decay of all ligatures increased rapidly between zero and 24 hours and gradually after that period, except for the 28th day, when probably there was a loss of elastic properties of the ligatures. The researchers did not note any constant behavior in the cane-loaded and module ligatures in relation

  6. Antibodies to Mutated Citrullinated Vimentin in Rheumatoid Arthritis: Diagnostic Value, Association with Radiological Damage and Axial Skeleton Affection

    Directory of Open Access Journals (Sweden)

    Howaida E. Mansour

    2010-05-01

    Full Text Available Abstract Background: Early definitive diagnosis and effective treatment are mandatory in rheumatoid arthritis (RA as it can halt the disease progression and subsequent joints destruction. Objective: To investigate the diagnostic and prognostic value of anti-mutated citrullinated vimentin (anti-MCV and its correlation with disease activity, peripheral and axial skeleton affection in RA patients. Patients and methods: A total of 123 patients with different rheumatic diseases were enrolled in a prospective-two year study at Ain Shams University hospital: 64 patients with RA and 59 patients with other rheumatic diseases as controls. RA patients were fulfilling the traditional and the new ACR/EULAR diagnostic criteria for RA. They have been followed up for two years. At baseline, all RA patients were subjected to: Clinical assessment of disease activity by taking full histories, general and local examination, measurement of 28 joint count of tender and swollen joints with calculation of disease activity score (DAS-28 for each patient. Complete blood count, erythrocytes sedimentation rate, C-reactive protein and rheumatoid factor titers were performed. Anti-MCV IgG immunoglobulins’ assay was performed at the study endpoint by ELISA. RA patients were then classified into; anti-MCV positive and anti-MCV negative groups for statistical comparison. Plain X-ray was performed on the peripheral joints and scored by the Simple Erosion Narrowing score (SEN-score. Magnetic Resonance Imaging (MRI scans were carried out to 22 RA patients on cervical and lumbosacral regions. Results: Anti-MCV antibodies were found to be of high sensitivity (79.6% and specificity (96.6% in diagnosing RA. The area under the curve was 0.893 at 95% confidence interval (CI, confers an odds ratio of 23.5. Anti-MCV positive RA patients had significantly higher DAS-28 and SEN-scores than anti-MCV negative patients; who were found to have more benign disease with lower incidence of

  7. 24 CFR 594.28 - Environmental reviews.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Environmental reviews. 594.28... Grant Amounts § 594.28 Environmental reviews. (a) For all proposed actions or activities that are not considered categorically excluded under 24 CFR 50.20, HUD will perform the appropriate environmental reviews...

  8. Alternativas técnicas para o controle das alterações dimensionais das resinas acrílicas em prótese total

    OpenAIRE

    GOMEZ Tomas; MORI Matsuyoshi; CORRÊA Gerson de Arruda; MATSON Edmir

    1998-01-01

    Os autores propõem uma nova técnica para diminuição dos problemas provenientes das alterações dimensionais das resinas acrílicas utilizadas na confecção das próteses totais. Com essa proposta, conseguiu-se praticamente eliminar essas alterações dimensionais tão prejudiciais às próteses totais.

  9. The relationship of live animal muscular and skeletal scores, ultrasound measurements and carcass classification scores with carcass composition and value in steers.

    Science.gov (United States)

    Conroy, S B; Drennan, M J; Kenny, D A; McGee, M

    2009-11-01

    This study examined the relationship of muscular and skeletal scores and ultrasound measurements in the live animal, and carcass conformation and fat scores with carcass composition and value using 336 steers, slaughtered at 2 years of age. Live animal scores and measurements were recorded at 8 to 12 months of age and pre-slaughter. Following slaughter, each carcass was classified for conformation and fatness and the right side dissected into meat, fat and bone. Carcass conformation scores and fat scores were both measured on a continuous 15-point scale and ranged from 2.0 to 12.0 and from 2.8 to 13.3, respectively. Pre-slaughter muscular scores showed positive correlations (P carcass meat proportion, proportion of high-value cuts in the carcass, conformation score and carcass value, significant negative correlations with carcass fat (r = -0.13) and bone (r = -0.81) proportions, and generally low non-significant relationships with the proportion of high-value cuts in meat and carcass fat score. Pre-slaughter ultrasound muscle depth and carcass conformation score showed similar correlations with carcass traits to those using the pre-slaughter muscular scoring procedure. Pre-slaughter ultrasound fat depth showed positive correlations (P carcass fat proportion (r = 0.59) and fat score (r = 0.63), and significant negative correlations (-0.23 to -0.50) with carcass meat and bone proportions, high-value cuts in the carcass and in meat, and carcass value. Pre-slaughter skeletal scores generally showed poor correlations ranging from -0.38 to 0.52 with the various carcass traits. Corresponding correlations (-0.26 to 0.44) involving records collected at 8 to 12 months of age were lower than those using pre-slaughter records. A one-unit increase in carcass conformation score increased carcass meat proportion and value by 11.2 g/kg and 5.6 cents/kg, respectively. Corresponding values for fat score were -8.2 g/kg and -5.1 cents/kg. In conclusion, both pre-slaughter live animal

  10. Planejamento das Atividades de Auditoria Interna na UFSC

    OpenAIRE

    Platt Neto, Orion Augusto; Vieira, Audí Luiz

    2006-01-01

    Este artigo aborda o planejamento das unidades de auditoria interna que integram o sistema de controle interno do Poder Executivo Federal junto às instituições Federais de Ensino Superior (IFES). O objetivo deste artigo é apresentar noções e instrumentos do planejamento das atividades nas unidades de auditoria interna vinculadas às IFES. Neste sentido, apresenta-se o embasamento normativo, as competências e as atividades das unidades de auditoria interna. Para auxiliar a consec...

  11. Lageroptimierung 2.0: Das Online-WMS

    OpenAIRE

    Wolf, Oliver; Geißen, Tim; Rahn, Jonas; Haselberger, Julia

    2012-01-01

    Das Fraunhofer-Institut für Materialfluss und Logistik IML unterstützt zahlreiche Unternehmen sowohl bei der Auswahl des richtigen Warehouse Management Systems als auch durch die Entwicklung einer Plattform, die das Anbieten, Mieten und Anwenden logistischer IT-Unterstützung in der Cloud möglich macht. Von »warehouse logistics« zur »Logistics Mall« - vom konventionell betriebenen Warehouse Management System zum WMS aus der Steckdose.

  12. Metabolic profile of santa inês ewes whith low body condition score during peripartum

    Directory of Open Access Journals (Sweden)

    Nayara Resende Nasciutti

    2012-02-01

    Full Text Available The objective of this study was to analyse the variations in the metabolic profile of protein, energy enzyme and mineral of Santa Inês ewes with low body condition score (BCS during peripartum. Blood samples were collected from 12 animals by jugular venipuncture to determine the serum biochemical profiles of protein, energy, mineral and enzyme metabolisms. Samples were collected on the following days: days 28, 21, 14, and 7 before lambing, at birth and, at days 2, 4, 7, 14, 21, and 28 postpartum (dpp. The samples were centrifuged and the serum analysed by Automated-Analyser. There was no alteration of the BCS during the 28 dpp, between 0.6 and 2.1 ± 2.4 ± 0.5, and was considered, as lean. The values of the total serum protein, globulin, albumin, and albumin/globulin ratio were reduced effective from the period before birth until 28dpp. The values of beta-hydroxybutyrate, calcium, phosphorus and magnesium remained below those of reference values. The concentrations of alanin aminotransferase (ALT were decreased particularly during the weeks before delivery. It was concluded that Santa Inês sheep with low body condition score demonstrated a reduction in the metabolism of proteins, energy, mineral and enzyme during peripartum.

  13. Can the painDETECT Questionnaire score and MRI help predict treatment outcome in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Rifbjerg-Madsen, Signe; Christensen, Anton Wulf; Boesen, Mikael

    2014-01-01

    contrast-enhanced MRI (DCE-MRI) is performed. METHOD AND ANALYSIS: The painDETECT Questionnaire (PDQ), originally developed to screen for a neuropathic pain component, is applied to indicate the presence of central sensitisation. Adults diagnosed with RA are included when either (A) initiating disease......-inflammatory treatment, to explore the prognostic value of a screening questionnaire for central sensitisation, hand inflammation assessed by conventional MRI, and the interaction between them regarding treatment outcome evaluated by clinical status (DAS28-CRP). For the purpose of further exploratory analyses, dynamic...

  14. Activity and Participation Assessment of Patients with Traumatic Brain Injury:Study with WHO-DAS 2.0 Chinese Version%脑外伤康复患者WHO-DAS 2.0评定研究

    Institute of Scientific and Technical Information of China (English)

    施红梅; 王桂圆; 张静; 陈迪

    2014-01-01

    Objective To investigate the condition of activity and participation of patients with traumatic brain injury (TBI). Methods 34 inpatients with TBI were assessed with World Health Organization Disability Assessment Schedule (WHO-DAS) 2.0 (International Chi-nese Version of fully structured interviewer administered 36 question). Results The patients with TBI had mild difficulty (2.10±1.33) in un-derstanding and communicating, moderate in getting around (3.20 ± 1.56), self-care (3.06 ± 1.41) and getting along with people (2.43 ± 1.33), and moderate to severe in life activities (3.86±1.33) and participation in society (3.51±1.19). Conclusion The patients with TBI feel difficul-ty major in life activities, participation in society, and getting around.%目的:探讨脑外伤患者活动和参与功能状况。方法使用世界卫生组织残疾评定方案2.0(WHO-DAS 2.0)国际中文版(检查者评定版)对34例住院康复的脑外伤患者进行评定。结果脑外伤康复患者理解与交流维度平均为轻度障碍(2.10±1.33),四处走动维度中度障碍(3.20±1.56),生活自理维度中度障碍(3.06±1.41),与人相处维度轻中度障碍(2.43±1.33),生活活动维度中重度障碍(3.86±1.33),社会参与维度中重度障碍(3.51±1.19)。结论脑外伤患者的活动与参与障碍主要表现在生活活动、社会参与、四处走动等方面。

  15. Efeito de diferentes períodos de controle das plantas daninhas na produtividade da cultura da cebola Effect of different weed control periods on onion crop yield

    Directory of Open Access Journals (Sweden)

    D.J. Soares

    2004-12-01

    Full Text Available Foi realizado um experimento em Monte Alto-SP, visando estudar os efeitos de diferentes períodos de controle das plantas daninhas sobre a produção de bulbos da cultura da cebola (Allium cepa, cultivar 'Mercedes', no sistema de transplantio. O delineamento experimental utilizado foi o de blocos ao acaso, com quatro repetições. Parte dos tratamentos experimentais foi disposta num esquema fatorial 4 x 6, em que constituíram variáveis quatro períodos em que se fez o controle (0-0, 0-7, 0-14 e 0-21 DAT e seis períodos em que se reiniciou o controle das plantas daninhas prolongando até a colheita: 28, 42, 56, 70, 84 e 98 DAT. Duas testemunhas foram adotadas: uma com controle e outra sem controle das plantas daninhas durante todo o ciclo da cultura. Lycopersicon esculentum, Portulaca oleracea, Eragrostis pilosa e Galinsoga parviflora foram as plantas daninhas mais importantes na área. Não houve interação entre os diferentes períodos de controle das plantas daninhas. O controle inicial destas plantas deve se prolongar até 14 DAT e ser reiniciado aos 28 DAT, a fim de prevenir reduções significativas na produtividade em relação à testemunha no limpo A convivência com as plantas daninhas durante todo o ciclo da cebola reduziu a produtividade em 94,5%.An experiment was carried out in Monte Alto, SP to study the effects of different of weed control periods on the yield of onion (Allium cepa bulb, 'Mercedes' cultivar, under the transplanting system. The experiment was arranged in a completely randomized block design, with four replications. The treatments were arranged in 4 x 6 factorial design with four initial weed removal periods (after transplanting until 0, 7, 14 and 21 days and six final weed removal periods (from 28, 42, 56, 70, 84 or 98 days after transplanting until harvest. Two controls were adapted with and without weed control throughout the onion cycle. Lycopersicon esculentum, Portulaca oleracea, Eragrostis pilosa and

  16. 28 CFR 0.28 - General functions.

    Science.gov (United States)

    2010-07-01

    ... Affairs § 0.28 General functions. The Office of Public Affairs is headed by a Director of Public Affairs who shall: (a) Handle matters pertaining to relations with the public generally. (b) Disseminate... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General functions. 0.28 Section 0.28...

  17. Is the AIMS65 score useful in predicting outcomes in peptic ulcer bleeding?

    Science.gov (United States)

    Jung, Sung Hoon; Oh, Jung Hwan; Lee, Hye Yeon; Jeong, Joon Won; Go, Se Eun; You, Chan Ran; Jeon, Eun Jung; Choi, Sang Wook

    2014-02-21

    To evaluate the applicability of AIMS65 scores in predicting outcomes of peptic ulcer bleeding. This was a retrospective study in a single center between January 2006 and December 2011. We enrolled 522 patients with upper gastrointestinal haemorrhage who visited the emergency room. High-risk patients were regarded as those who had re-bleeding within 30 d from the first endoscopy as well as those who died within 30 d of visiting the Emergency room. A total of 149 patients with peptic ulcer bleeding were analysed, and the AIMS65 score was used to retrospectively predict the high-risk patients. A total of 149 patients with peptic ulcer bleeding were analysed. The poor outcome group comprised 28 patients [male: 23 (82.1%) vs female: 5 (10.7%)] while the good outcome group included 121 patients [male: 93 (76.9%) vs female: 28 (23.1%)]. The mean age in each group was not significantly different. The mean serum albumin levels in the poor outcome group were slightly lower than those in the good outcome group (P = 0.072). For the prediction of poor outcome, the AIMS65 score had a sensitivity of 35.5% (95%CI: 27.0-44.8) and a specificity of 82.1% (95%CI: 63.1-93.9) at a score of 0. The AIMS65 score was insufficient for predicting outcomes in peptic ulcer bleeding (area under curve = 0.571; 95%CI: 0.49-0.65). The AIMS65 score may therefore not be suitable for predicting clinical outcomes in peptic ulcer bleeding. Low albumin levels may be a risk factor associated with high mortality in peptic ulcer bleeding.

  18. Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation.

    Science.gov (United States)

    Berman, Daniel S; Abidov, Aiden; Kang, Xingping; Hayes, Sean W; Friedman, John D; Sciammarella, Maria G; Cohen, Ishac; Gerlach, James; Waechter, Parker B; Germano, Guido; Hachamovitch, Rory

    2004-01-01

    Recently, a 17-segment model of the left ventricle has been recommended as an optimally weighted approach for interpreting myocardial perfusion single photon emission computed tomography (SPECT). Methods to convert databases from previous 20- to new 17-segment data and criteria for abnormality for the 17-segment scores are needed. Initially, for derivation of the conversion algorithm, 65 patients were studied (algorithm population) (pilot group, n = 28; validation group, n = 37). Three conversion algorithms were derived: algorithm 1, which used mid, distal, and apical scores; algorithm 2, which used distal and apical scores alone; and algorithm 3, which used maximal scores of the distal septal, lateral, and apical segments in the 20-segment model for 3 corresponding segments of the 17-segment model. The prognosis population comprised 16,020 consecutive patients (mean age, 65 +/- 12 years; 41% women) who had exercise or vasodilator stress technetium 99m sestamibi myocardial perfusion SPECT and were followed up for 2.1 +/- 0.8 years. In this population, 17-segment scores were derived from 20-segment scores by use of algorithm 2, which demonstrated the best agreement with expert 17-segment reading in the algorithm population. The prognostic value of the 20- and 17-segment scores was compared by converting the respective summed scores into percent myocardium abnormal. Conversion algorithm 2 was found to be highly concordant with expert visual analysis by the 17-segment model (r = 0.982; kappa = 0.866) in the algorithm population. In the prognosis population, 456 cardiac deaths occurred during follow-up. When the conversion algorithm was applied, extent and severity of perfusion defects were nearly identical by 20- and derived 17-segment scores. The receiver operating characteristic curve areas by 20- and 17-segment perfusion scores were identical for predicting cardiac death (both 0.77 +/- 0.02, P = not significant). The optimal prognostic cutoff value for either 20

  19. Oswestry Disability Index scoring made easy.

    Science.gov (United States)

    Mehra, A; Baker, D; Disney, S; Pynsent, P B

    2008-09-01

    Low back pain effects up to 80% of the population at some time during their active life. Questionnaires are available to help measure pain and disability. The Oswestry Disability Index (ODI) is the most commonly used outcome measure for low back pain. The aim of this study was to see if training in completing the ODI forms improved the scoring accuracy. The last 100 ODI forms completed in a hospital's spinal clinic were reviewed retrospectively and errors in the scoring were identified. Staff members involved in scoring the questionnaire were made aware of the errors and the correct method of scoring explained. A chart was created with all possible scores to aid the staff with scoring. A prospective audit on 50 questionnaires was subsequently performed. The retrospective study showed that 33 of the 100 forms had been incorrectly scored. All questionnaires where one or more sections were not completed by the patient were incorrectly scored. A scoring chart was developed and staff training was implemented. This reduced the error rate to 14% in the prospective audit. Clinicians applying outcome measures should read the appropriate literature to ensure they understand the scoring system. Staff must then be given adequate training in the application of the questionnaires.

  20. 49 CFR 28.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 28.150 Section 28.150 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28...

  1. Differences in physical-fitness test scores between actively and passively recruited older adults : Consequences for norm-based classification

    NARCIS (Netherlands)

    van Heuvelen, M.J.G.; Stevens, M.; Kempen, G.I.J.M.

    This study investigated differences in physical-fitness test scores between actively and passively recruited older adults and the consequences thereof for norm-based classification of individuals. Walking endurance, grip strength, hip flexibility, balance, manual dexterity, and reaction time were

  2. Factors associated with sustained remission in patients with rheumatoid arthritis.

    Science.gov (United States)

    Martire, María Victoria; Marino Claverie, Lucila; Duarte, Vanesa; Secco, Anastasia; Mammani, Marta

    2015-01-01

    To find out the factors that are associated with sustained remission measured by DAS28 and boolean ACR EULAR 2011 criteria at the time of diagnosis of rheumatoid arthritis. Medical records of patients with rheumatoid arthritis in sustained remission according to DAS28 were reviewed. They were compared with patients who did not achieved values of DAS28<2.6 in any visit during the first 3 years after diagnosis. We also evaluated if patients achieved the boolean ACR/EULAR criteria. Variables analyzed: sex, age, smoking, comorbidities, rheumatoid factor, anti-CCP, ESR, CRP, erosions, HAQ, DAS28, extra-articular manifestations, time to initiation of treatment, involvement of large joints, number of tender joints, number of swollen joints, pharmacological treatment. Forty five patients that achieved sustained remission were compared with 44 controls. The variables present at diagnosis that significantly were associated with remission by DAS28 were: lower values of DAS28, HAQ, ESR, NTJ, NSJ, negative CRP, absence of erosions, male sex and absence of involvement of large joints. Only 24.71% achieved the boolean criteria. The variables associated with sustained remission by these criteria were: lower values of DAS28, HAQ, ESR, number of tender joints and number of swollen joints, negative CRP and absence of erosions. The factors associated with sustained remission were the lower baseline disease activity, the low degree of functional disability and lower joint involvement. We consider it important to recognize these factors to optimize treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  3. Ikea das Rendas

    OpenAIRE

    Bergman, Aeron; Salinas, Alejandra

    2008-01-01

    FIALENA fabric design by Anna Svanfeldt for IKEA of Sweden. It took Maria da Guia 2 months to reproduce the Ikea pattern using traditional Portuguese improvised knots. 2008 Installasjon i Museu das Rendas, Vila do Conde, Portugal, 01.09.2008 - 01.10.2008. Sponsor: City of Villa do Conde.

  4. Self-Esteem in People with Physical Disabilities: Differences between Active and Inactive Individuals

    Directory of Open Access Journals (Sweden)

    Nemček Dagmar

    2017-05-01

    Full Text Available The aim of the study was to determine the status of SE in people with physical disabilities (PwPD and compare SE scores between active and inactive individuals. The sample of PwPD (n = 186 was divided into two groups of those who are regularly participating in sport (active; n = 88 and those who are not participating in any sport in their leisure (inactive; n = 98. The Rosenberg Self-Esteem Scale (RSES was used as a primary research method. 10-item scale measures global self-worth by measuring positive and negative feelings about the self. Higher scores (from 10 to 40 points indicate higher SE. The Pearson chi-square test was used to determine the differences of 10 RSES items and total scores between active and inactive PwPD. We found that the mean score of RSES in PwPD was 28.83 points; active PwPD observed total score of RSES 30.01 points and group of inactive PwPD showed the lowest SE by achieving 27.76 points. Mean scores comparison of each RSES item between active and inactive PwPD revealed higher SE in the group of active PwPD. Significantly higher SE was presented by 4 from 10 RSES items and by total score in the group of active PwPD. The results of our study confirmed that actively living PwPD have significantly higher SE comparing those PwPD who are living sedentary life style.

  5. [Cardiovascular risk by Framingham and SCORE in patients 40-65 years old].

    Science.gov (United States)

    González, Carmen; Rodilla, Enrique; Costa, José A; Justicia, Jorge; Pascual, José M

    2006-04-15

    The aim of this study was to compare the clinical and treatment implications of 2 cardiovascular risk stratification systems in a population of patients 40-65 years old. 929 non diabetic patients (40-65 years old) (51% female) with no evidence of previous cardiovascular disease were included in the study. The risk of cardiovascular death was assessed with the charts of the Systematic Coronary Risk Evaluation (SCORE), and coronary risk by the Framingham function (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults -NCEP-ATP-III-). Patients were considered of high risk if risk of cardiovascular death was >or= 5% and coronary risk was > 20%, respectively. 4.1% of patients were considered as high risk by SCORE and 2.5% by Framingham. Only 0.2% of females were classified as high risk with either system. 8.2% and 4.8% of male population were considered as high risk by SCORE and Framingham, respectively. There was a low level of concordance between both systems. Patients classified as high risk by SCORE but not by Framingham were older, smoke less and had a better lipid profile. According to European Guidelines 28% of male and 23% of female were candidates to hypolipemic treatment, that proportion was higher, 43% of males and 28% of females, by NCEP-ATP-III guidelines. In Spanish patients 40-65 years old, SCORE charts almost duplicate the number of high risk individuals compared to Framingham. although the number of patients candidates to hypolipemic treatment is lower with the European than ATP-III guidelines. Differences were more evident in male.

  6. 31 CFR 28.410 - Comparable facilities.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Comparable facilities. 28.410 Section... on the Basis of Sex in Education Programs or Activities Prohibited § 28.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such...

  7. Effects of Biologic Agents in Patients with Rheumatoid Arthritis and Amyloidosis Treated with Hemodialysis.

    Science.gov (United States)

    Kuroda, Takeshi; Tanabe, Naohito; Nozawa, Yukiko; Sato, Hiroe; Nakatsue, Takeshi; Kobayashi, Daisuke; Wada, Yoko; Saeki, Takako; Nakano, Masaaki; Narita, Ichiei

    Objective Our objective was to examine the safety and effects of therapy with biologics on the prognosis of rheumatoid arthritis (RA) patients with reactive amyloid A (AA) amyloidosis on hemodialysis (HD). Methods Twenty-eight patients with an established diagnosis of reactive AA amyloidosis participated in the study. The survival was calculated from the date of HD initiation until the time of death, or up to end of June 2015 for the patients who were still alive. HD initiation was according to the program of HD initiation for systemic amyloidosis patients associated with RA. Results Ten patients had been treated with biologics before HD initiation for a mean of 28.2 months (biologic group), while 18 had not (non-biologic group). HD was initiated in patients with similar characteristics except for the tender joint count, swollen joint count, and disease activity score (DAS)28-C-reactive protein (CRP). History of biologics showed that etanercept was frequently used for 8 patients as the first biologic. There was no significant difference in the mortality rate according to a Kaplan-Meier analysis (p=0.939) and or associated risk of death in an age-adjusted Cox proportional hazards model (p=0.758) between both groups. Infections were significantly more frequent causes of death in the biologic group than in the non-biologic group (p=0.021). However, treatment with biologics improved the DAS28-CRP score (p=0.004). Conclusion Under the limited conditions of AA amyloidosis treated with HD, the use of biologics might affect infection and thus may not improve the prognosis. Strict infection control is necessary for the use of biologics with HD to improve the prognosis.

  8. 31 CFR 28.450 - Athletics.

    Science.gov (United States)

    2010-07-01

    ... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 28.450 Athletics. (a) General. No person...) Opportunity to receive coaching and academic tutoring; (vi) Assignment and compensation of coaches and tutors...

  9. A comparison of disease burden in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.

    Directory of Open Access Journals (Sweden)

    Brigitte Michelsen

    Full Text Available The main objective of this study was to compare disease burden in rheumatoid arthritis (RA, psoriatic arthritis (PsA and axial spondyloarthritis (ax-SpA.In this cross-sectional study, all the RA (1093, PsA (365 and ax-SpA (333 patients who visited the out-patient clinic of the Hospital of Southern Norway Trust during the year 2013 were included; the RA patients all had a RA diagnosis verified by the treating rheumatologist, the PsA patients all fulfilled the ClASsification for Psoriatic ARthritis (CASPAR criteria and the ax-SpA patients all fulfilled the Assessment of SpondyloArthritis international Society (ASAS classification criteria for ax-SpA. Patient-reported health status, demographic variables, medications, and composite scores of disease activity were assessed. The main analyses were performed using General Linear Models adjusted for age, sex and multiple comparisons. Correlation analyses were performed using Spearman's rho.The reported pain, joint pain, patient's global assessment and fatigue were similar in PsA and ax-SpA, but significantly lower in RA. The 28-joint Disease Activity Score (DAS28 (0.3±0.1, p = 0.003, Clinical Disease Activity Index (CDAI (1.0±0.4, p = 0.028 and Routine Assessment of Patient Index Data 3 (RAPID3 (0.4±0.1, p = 0.004 were all significantly higher in PsA vs. RA. RAPID3 showed moderate to high correlation with DAS28 (rho = 0.521, p<0.001 and CDAI (rho = 0.768, p<0.001 in RA and PsA, and with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI (rho = 0.902, p<0.001 and Bath Ankylosing Spondylitis Functional Index (BASFI (0.865, p<0.001 in ax-SpA and PsA.In conclusion, patient- reported outcome measures were similar in our population of PsA and ax-SpA patients, but significantly lower for the RA patients. Composite disease activity measures were lower in RA than in PsA and ax-SpA, but the magnitude of these differences was small and probably not of clinical significance. Our study indicates that

  10. 49 CFR 28.131 - Illegal use of drugs.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Illegal use of drugs. 28.131 Section 28.131 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.131 Illegal use of...

  11. 28 CFR 30.6 - What procedures apply to the selection of programs and activities under these regulations?

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false What procedures apply to the selection of programs and activities under these regulations? 30.6 Section 30.6 Judicial Administration DEPARTMENT OF... consult with local elected officials. (b) Each state that adopts a process shall notify the Attorney...

  12. Incidencia de caídas en un hospital de nivel 1: factores relacionados Incidence of falls in a University Hospital: factors related

    Directory of Open Access Journals (Sweden)

    Juan Manuel Laguna-Parras

    2011-12-01

    Full Text Available Introducción: las caídas son un riesgo real que acontece en el medio hospitalario, y constituyen un indicador de calidad asistencial. La Organización Mundial de la Salud (OMS define el término caída como "la consecuencia de cualquier acontecimiento que precipita al individuo hacia el suelo en contra de su voluntad". Objetivo: analizar la incidencia de caídas, el perfil de los pacientes que sufren caídas en el hospital e identificar las posibles causas y efectos de la misma. Metodología: estudio descriptivo sobre las caídas registradas en el Complejo Hospitalario de Jaén durante la estancia hospitalaria. La obtención de datos se hizo directamente por las supervisoras. Se elaboró una hoja de recogida de datos cuyas anotaciones se transmitieron a una base de datos electrónica. Las variables que se recogieron fueron datos de filiación del paciente, fecha y hora de la caída, unidad donde se produce la caída, puntuación escala Morse, caídas previas, circunstancias de la caída, factores relacionados como medicación, trastornos cognitivos, funcionales, factores del entorno, cuidados tras la caída y necesidad de dispositivos de apoyo. Resultados: durante el periodo analizado se notificaron un total de 36 caídas, lo que representa una incidencia del 0,18%. La mayor frecuencia de caídas se ha producido en las unidades de Salud Mental y Cuidados Paliativos. Conclusiones: el estudio de las diferentes variables del registro nos permite afirmar que la mayoría de las caídas que ocurrían en nuestro hospital se producían en pacientes con una edad media de 63 años, no existen diferencias entre sexos, la mayoría tenían un riesgo bajo de caída según la escala Morse, producidas en el turno de tarde, sin caídas previas y que el lugar donde más caídas se produjeron fué en la habitación.Introduction: falls are a real risk that occurs in hospitals; falls are health a care quality indicator. The World Health Organization (WHO defines

  13. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor alpha inhibitors

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Hermann, Kay-Geert A

    2010-01-01

    To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).......To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA)....

  14. Propagandas de medicamentos psicoativos: análise das informações científicas Psychoactive drug advertising: analysis of scientific information

    Directory of Open Access Journals (Sweden)

    Patrícia C Mastroianni

    2008-06-01

    Full Text Available OBJETIVO: Segundo a Organização Mundial da Saúde, as propagandas de medicamentos devem ser fidedignas, exatas, verdadeiras, informativas, equilibradas, atualizadas e passíveis de comprovação. O objetivo do estudo foi avaliar as propagandas de medicamentos psicoativos divulgadas a médicos, em relação à concordância das informações contidas nas peças publicitárias com as suas respectivas referências bibliográficas e à acessibilidade dessas referências citadas. MÉTODOS: A coleta de dados foi realizada durante o ano de 2005, em Araraquara, SP. Foram coletadas e analisadas propagandas de 152 medicamentos, num total de 304 referências. As referências bibliográficas foram solicitadas aos serviços de atendimento ao cliente dos laboratórios e consultadas nas bibliotecas da rede UNESP (Ibict, Athenas, BIREME (SciELO, PubMed, periódicos catalogados de acesso livre e periódicos CAPES. As afirmações das propagandas foram conferidas com as das referências por meio da técnica de análise de conteúdo. RESULTADOS: Das referências citadas nas propagandas, 66,7% foram acessadas. De 639 afirmações identificadas, foi possível analisar 346 (54%. Verificou-se que 67,7% das afirmações das propagandas conferiam com suas referências e as demais não conferiam ou conferiam parcialmente. Entre as propagandas analisadas, foi observada média de 2,5 (1-28 referências citadas por propaganda. No corpo das propagandas, foram identificadas 639 informações que estavam explicitamente associadas à pelo menos uma das referências citadas (média de 3,5 informações por propaganda. CONCLUSÕES: Os resultados evidenciaram a dificuldade de acesso às referências. As mensagens de eficácia, segurança, custos, entre outras, nem sempre estão respaldadas por estudos científicos. São necessárias mudanças nas exigências legais e fiscalização efetiva das promoções de medicamentos.OBJECTIVE: According to the World Health Organization

  15. Uma leitura semiótica das multidões

    Directory of Open Access Journals (Sweden)

    Alexandre Rocha da Silva

    2016-12-01

    Full Text Available Uma leitura semiótica das multidões tem o objetivo de problematizar as funções do incomensurável na semiose. Tal problematização envolve os problemas da imanência, do primado da mediação que caracteriza o pensamento semiótico contemporâneo e da desconstrução das identidades operada pelas teorias queer. Para tanto, metodologicamente, (1 apresentamos os conceitos de multidão desenvolvidos por Charles Sanders Peirce, Antônio Negri e Michael Hardt; (2 discutimos o caráter descritivo das categorias faneroscópicas de Peirce para propor a Zeroidade como condição e imanência de toda a semiose; (3 identificamos a dupla face – virtual e mediada – da singularidade e (4 demonstramos de que maneira a singularidade, que é uma potência, dá lugar na semiose a identidades. É o caráter indissociável da singularidade, da identidade e das crenças/hábitos que permite a este artigo denunciar falsas dicotomias e afirmar o perspectivismo como horizonte fundamental para os estudos semióticos das multidões.

  16. Making the invisible visible: bioelectrical impedance analysis demonstrates unfavourable body composition in rheumatoid arthritis patients in clinical practice.

    Science.gov (United States)

    Konijn, N P C; van Tuyl, L H D; Bultink, I E M; Lems, W F; Earthman, C P; van Bokhorst-de van der Schueren, M A E

    2014-01-01

    To examine differences between the assessment of body composition by body mass index (BMI) and bioelectrical impedance analysis (BIA) in patients with rheumatoid arthritis (RA). The body composition of RA patients was assessed during their visit to the outpatient department of a Dutch academic hospital using BMI, fat-free mass index (FFMI), and fat mass index (FMI). FFMI and FMI were determined by single-frequency BIA. Sixty-five consecutive RA patients (83% women, mean age 58 years, median disease duration 7 years) with moderately active disease [mean Disease Activity Score using 28 joint counts (DAS28) = 3.40; mean Rheumatoid Arthritis Disease Activity Index (RADAI) score = 3.49] and moderate disability [mean Health Assessment Questionnaire (HAQ) score = 0.87] were included. Based on BMI, 2% of our study population were underweight, 45% had a healthy body composition, and 54% were overweight or obese. Based on BIA, 18% of the patients showed a low FFMI and 74% had a high or very high FMI. Low FFMI was found in 44% of the women with a normal BMI, and high FMI was found in 40% of the women and 75% of the men with a normal BMI. A high frequency of unfavourable body composition, predominantly reduced FFMI and elevated FMI, was found in a cohort of RA patients with moderately active disease, turning BMI into an unreliable method for assessment of body composition in RA. BIA, however, might be the preferred method to assess FFMI and FMI in RA patients in clinical practice, as it is easy to use and relatively inexpensive.

  17. Observations on muscle activity in REM sleep behavior disorder assessed with a semi-automated scoring algorithm

    DEFF Research Database (Denmark)

    Jeppesen, Jesper; Otto, Marit; Frederiksen, Yoon

    2018-01-01

    OBJECTIVES: Rapid eye movement (REM) sleep behavior disorder (RBD) is defined by dream enactment due to a failure of normal muscle atonia. Visual assessment of this muscle activity is time consuming and rater-dependent. METHODS: An EMG computer algorithm for scoring 'tonic', 'phasic' and 'any......' submental muscle activity during REM sleep was evaluated compared with human visual ratings. Subsequently, 52 subjects were analyzed with the algorithm. Duration and maximal amplitude of muscle activity, and self-awareness of RBD symptoms were assessed. RESULTS: The computer algorithm showed high congruency...... sleep without atonia. CONCLUSIONS: Our proposed algorithm was able to detect and rate REM sleep without atonia allowing identification of RBD. Increased duration and amplitude of muscle activity bouts were characteristics of RBD. Quantification of REM sleep without atonia represents a marker of RBD...

  18. Modelo predictivo del grado de discapacidad en adultos con lesión medular: resultados desde el WHO-DAS II

    Directory of Open Access Journals (Sweden)

    Claudia Patricia Henao Lema

    2011-08-01

    Full Text Available Objective: To establish a prediction model of the degree of disability in adults with Spinal Cord Injury (SCI based on the use of the WHO-DAS II . Methods: The disability degree was correlated with three variable groups: clinical, sociodemographic and those related with rehabilitation services. A model of multiple linearregression was built to predict disability. 45 people with sciexhibiting diverse etiology, neurological level and completenessparticipated. Patients were older than 18 and they had more than a six-month post-injury. The WHO-DAS II and the ASIA impairment scale(AIS were used. Results: Variables that evidenced a significant relationship with disability were the following: occupationalsituation, type of affiliation to the public health care system, injury evolution time, neurological level, partial preservation zone,ais motor and sensory scores and number of clinical complications during the last year. Complications significantly associated todisability were joint pain, urinary infections, intestinal problemsand autonomic disreflexia. None of the variables related to rehabilitation services showed significant association with disability. The disability degree exhibited significant differencesin favor of the groups that received the following services: assistive devices supply and vocational, job or educational counseling. Conclusions: The best prediction disability model inadults with sci with more than six months post-injury was built withvariables of injury evolution time, AIS sensory score and injury-related unemployment.

  19. Kohapärimuslik luule nädalalehes Das Inland / Die Sagendichtung in der Wochenschrift Das Inland

    Directory of Open Access Journals (Sweden)

    Liina Lukas

    2012-01-01

    Full Text Available Das spätromantische Interesse für Ortsüberlieferungen, angeregt von den “Deutschen Sagen” (1816–1818 der Brüder Grimm, blühte im Baltikum in den 1830er und 1840er Jahren auf und gipfelte – im estnischen Sprachgebiet – in der zweisprachigen Ausgabe des estnischen Nationalepos “Kalevipoeg” / “Kalew’s Sohn” (1857–1861, dem Friedrich Reinhold Kreutzwald seine Endgestalt gab, aber das von mehreren Sammlern und Bearbeitern geprägt wurde. Literarische Bearbeitungen von Volkssagen fanden schnell ihren Weg in Zeitungen und Zeitschriften, in Gedichtbände und Anthologien – oft in modischer Balladenform, die dem mythisch-romantischen Inhalt der Volkssage am besten zu entsprechen schien. Die Blütezeit der Sagendichtung im Baltikum sind die 1840er Jahre, als vor allem in der Zeitschrift „Das Inland“ mehrere dichterischen Bearbeitungen estnischer und lettischer Volkssagen erschienen (von Heinrich Blindner, Otto Dreistern, Eduard Pabst, Minna von Mädler, Theodor Rutenberg, Robert Falck, P. Otto u. a. 1845 erschien hier das nach einer Sage von Friedrich Robert Faehlmann verfasste Gedicht „Koit und Hämarik / Morgenroth und Abendroth“ von Minna von Mädler – fünf Jahre vor der Fassung von Friedrich Reinhold Kreutzwalds estnischsprachiger Ballade „Koit ja Hämarik“. Zwischen 1831 und 1836 verfasste Friedrich Reinhold Kreutzwald seine deutschsprachigen Balladen, von denen „Die Belagerung von Bewerin im Jahre 1207“ 1846 im „Inland“ gedruckt wurde. Das Jahr 1846 kann als „Balladenjahr“ der Zeitschrift bezeichnet werden. Die eigentliche Domäne der deutschbaltischen (lyro-epischen Dichtung ist die historische Ballade, die fußend auf baltischen Chroniken und Familiengeschichten zumeist von Ruinen alter Schlösser und den sie einst bewohnenden historischen Personen und deren Heldentaten berichtet. Doch schon im Jahre 1847 kann man im Inland die Kritik gegenüber diesem Balladenboom vernehmen, u.a. mit dem

  20. Positive and negative symptom scores are correlated with activation in different brain regions during facial emotion perception in schizophrenia patients: a voxel-based sLORETA source activity study.

    Science.gov (United States)

    Kim, Do-Won; Kim, Han-Sung; Lee, Seung-Hwan; Im, Chang-Hwan

    2013-12-01

    Schizophrenia is one of the most devastating of all mental illnesses, and has dimensional characteristics that include both positive and negative symptoms. One problem reported in schizophrenia patients is that they tend to show deficits in face emotion processing, on which negative symptoms are thought to have stronger influence. In this study, four event-related potential (ERP) components (P100, N170, N250, and P300) and their source activities were analyzed using EEG data acquired from 23 schizophrenia patients while they were presented with facial emotion picture stimuli. Correlations between positive and negative syndrome scale (PANSS) scores and source activations during facial emotion processing were calculated to identify the brain areas affected by symptom scores. Our analysis demonstrates that PANSS positive scores are negatively correlated with major areas of the left temporal lobule for early ERP components (P100, N170) and with the right middle frontal lobule for a later component (N250), which indicates that positive symptoms affect both early face processing and facial emotion processing. On the other hand, PANSS negative scores are negatively correlated with several clustered regions, including the left fusiform gyrus (at P100), most of which are not overlapped with regions showing correlations with PANSS positive scores. Our results suggest that positive and negative symptoms affect independent brain regions during facial emotion processing, which may help to explain the heterogeneous characteristics of schizophrenia. © 2013 Elsevier B.V. All rights reserved.

  1. Assessing the Effects of the 2003 Resident Duty Hours Reform on Internal Medicine Board Scores

    Science.gov (United States)

    Romano, Patrick S.; Itani, Kamal M.F.; Rosen, Amy K.; Small, Dylan; Lipner, Rebecca S.; Bosk, Charles L.; Wang, Yanli; Halenar, Michael J.; Korovaichuk, Sophia; Even-Shoshan, Orit; Volpp, Kevin G.

    2014-01-01

    Purpose To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were −5.43 (−7.63, −3.23), −3.44 (−5.65, −1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations. PMID:24556772

  2. Das perguntas wittgensteinianas à pedagogia das competências: ou desmontando a caixa-preta de Perrenoud

    Directory of Open Access Journals (Sweden)

    Rafael Ferreira de Souza Mendes Pereira

    2015-03-01

    Full Text Available Este artigo faz parte de uma pesquisa de mestrado que se propõe a analisar conceitos educacionais e curriculares por meio da filosofia da linguagem elaborada por Ludwig Wittgenstein. Dessa perspectiva, examinamos alguns pressupostos teóricos da chamada pedagogia das competências e interrogamos se esse modelo pedagógico, em nome de pretensa renovação do ensino, não encorajaria a reificação de conceitos mentais concernentes ao processo de aprendizagem. Com este fim, abordamos a reformulação que essa pedagogia oferece a respeito de conceitos como aprender, saber, compreender, destacando as ambiguidades daí decorrentes. Argumenta-se que é possível obter uma leitura mais rigorosa das suas propostas de modernização pedagógica se investigarmos o uso dado a esses conceitos nos jogos de linguagem em que eles são mobilizados. Wittgenstein, na segunda fase de sua produção intelectual, mostrou como a negligência linguística à dinâmica que dá significado aos conceitos e metáforas referentes à nossa vida mental fez com que diversas filosofias assumissem um perfil metafísico. Este artigo não apenas examina como um fenômeno análogo pode ocorrer no campo pedagógico, como também defende que as ferramentas analíticas construídas por Wittgenstein podem ser usadas contra os diferentes dogmatismos pedagógicos. Desse modo, o artigo aponta vias alternativas de problematização acerca do significado das reformas dos sistemas escolares que têm buscado fundamentos naquela pedagogia.

  3. Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

    Science.gov (United States)

    Gatot, D.; Mardia, A. I.

    2018-03-01

    Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

  4. CDK-mediated activation of the SCF(FBXO) (28) ubiquitin ligase promotes MYC-driven transcription and tumourigenesis and predicts poor survival in breast cancer

    DEFF Research Database (Denmark)

    Cepeda, Diana; Ng, Hwee-Fang; Sharifi, Hamid Reza

    2013-01-01

    SCF (Skp1/Cul1/F-box) ubiquitin ligases act as master regulators of cellular homeostasis by targeting key proteins for ubiquitylation. Here, we identified a hitherto uncharacterized F-box protein, FBXO28 that controls MYC-dependent transcription by non-proteolytic ubiquitylation. SCF(FBXO28...... results in an impairment of MYC-driven transcription, transformation and tumourigenesis. Finally, in human breast cancer, high FBXO28 expression and phosphorylation are strong and independent predictors of poor outcome. In conclusion, our data suggest that SCF(FBXO28) plays an important role...... in transmitting CDK activity to MYC function during the cell cycle, emphasizing the CDK-FBXO28-MYC axis as a potential molecular drug target in MYC-driven cancers, including breast cancer....

  5. The SeaDAS Processing and Analysis System: SeaWiFS, MODIS, and Beyond

    Science.gov (United States)

    MacDonald, M. D.; Ruebens, M.; Wang, L.; Franz, B. A.

    2005-12-01

    The SeaWiFS Data Analysis System (SeaDAS) is a comprehensive software package for the processing, display, and analysis of ocean data from a variety of satellite sensors. Continuous development and user support by programmers and scientists for more than a decade has helped to make SeaDAS the most widely used software package in the world for ocean color applications, with a growing base of users from the land and sea surface temperature community. Full processing support for past (CZCS, OCTS, MOS) and present (SeaWiFS, MODIS) sensors, and anticipated support for future missions such as NPP/VIIRS, enables end users to reproduce the standard ocean archive product suite distributed by NASA's Ocean Biology Processing Group (OBPG), as well as a variety of evaluation and intermediate ocean, land, and atmospheric products. Availability of the processing algorithm source codes and a software build environment also provide users with the tools to implement custom algorithms. Recent SeaDAS enhancements include synchronization of MODIS processing with the latest code and calibration updates from the MODIS Calibration Support Team (MCST), support for all levels of MODIS processing including Direct Broadcast, a port to the Macintosh OS X operating system, release of the display/analysis-only SeaDAS-Lite, and an extremely active web-based user support forum.

  6. Das DELA-NOBA Projekt

    DEFF Research Database (Denmark)

    Daryai-Hansen, Petra; Meister, Maive; Tonello, Elisa

    2015-01-01

    in the English language classroom in Argentina and Denmark var et delprojekt under et større internationalt samarbejde, koordineret af Michael Byram, og belyste, hvordan interkulturelt medborgerskab kan styrkes i grundskolens læringsrum (Byram et al. under udgivelse). Grundidéen i interkulturelle......Artiklen præsenterer et udviklings- og forskningsprojekt på Randersgades Skole. I projektet deltog elever fra 7.v og en 5./6. klasse fra Argentina i et arrangeret kultur- og sprogmøde inden for rammerne af deres engelskundervisning. Projektet Green Kidz. Intercultural environmental citizenship...... langues-Ansatz noch weitreichend unbekannt. Das Projekt Developing the Language Awareness/ Éveil aux langues Approach in the Nordic and Baltic Countries (DELA- NOBA), das von 2013 bis 2016 von NordPlus Horizontal finanziert wird, etabliert eine Zusammenarbeit zwischen Universitäten und Pilotschulen aus...

  7. [Investigation of the clinical usefullness of leukocytapheresis on rheumatoid arthritis resistant to or failed with the other treatments].

    Science.gov (United States)

    Sawada, Jin; Kimoto, Osamu; Suzuki, Daisuke; Shimoyama, Kumiko; Ogawa, Noriyoshi

    2009-12-01

    To examine therapeutic effect of leukocytapheresis (LCAP) for rheumatoid arthritis (RA) resistant to various treatments. Thirteen patients with RA (mean age : 60.8+/-11.4, male : female=5 : 8), 1 who were resistant to disease-modifying anti-rheumatic drugs (DMARDs) and biologics, or 2 who failed with those medicines because of side effects or complications. We performed LCAP, which was carried out once a week for a total of five sessions, with a throughput of about 0.1 L/kg. Before and after LCAP, we evaluated the effect of LCAP therapy. DAS28 (CRP) score was 5.70+/-1.12 before LCAP, 4.57+/-1.19 (P<0.05) just after the final LCAP and 4.83+/-1.35 (P<0.05) about 4 weeks after LCAP. DAS28 score decreased in all patients after LCAP. No serious adverse events were observed except temporary anemia. LCAP therapy may be useful and safe for patients with RA resistant to conventional medication. Patients who show good clinical response by LCAP needs to be clarified.

  8. Tendências temporais e espaciais da qualidade das águas superficiais da sub-bacia do Rio das Velhas, estado de Minas Gerais

    Directory of Open Access Journals (Sweden)

    Ana Laura Cerqueira Trindade

    Full Text Available RESUMO Este artigo apresenta uma análise da tendência temporal e espacial da qualidade das águas superficiais da sub-bacia do Rio das Velhas, inserida na bacia do Rio São Francisco, em Minas Gerais, Brasil. Foram analisados 16.625 dados coletados no período de 2002 a 2011 pelo programa de monitoramento de qualidade das águas superficiais efetuado pelo Instituto Mineiro de Gestão das Águas (Igam. Testes estatísticos, multivariados e não paramétricos foram utilizados para avaliar 11 variáveis físicas, químicas e microbiológicas de 29 estações de monitoramento. Os resultados das análises de tendência Mann-Kendall/Sazonal de Mann-Kendall sugeriram que a maioria dos cursos d'água da região apresentam valores estáveis das variáveis ao longo do período estudado, com maiores alterações associadas a coliformes termotolerantes, demanda bioquímica de oxigênio (DBO, nitrato e índice de qualidade das águas (IQA, principalmente nas proximidades dos grandes centros urbanos. A análise de Cluster definiu três grandes grupos de estações de monitoramento, agrupadas segundo a qualidade de suas águas, correspondentes aos níveis de alta poluição, poluição moderada e baixa poluição. No entanto, ao longo de toda a sub-bacia, foi observada a degradação da qualidade da água durante o período estudado, principalmente relacionada ao lançamento de esgotos domésticos. Uma importante constatação foi a alteração da qualidade da água no baixo Rio das Velhas, apontada pela tendência de redução do IQA em estações localizadas nessa região, o que merece atenção dos órgãos governamentais para ações de manejo.

  9. Tendências temporais e espaciais da qualidade das águas superficiais da sub-bacia do Rio das Velhas, estado de Minas Gerais

    Directory of Open Access Journals (Sweden)

    Ana Laura Cerqueira Trindade

    2016-10-01

    Full Text Available RESUMO Este artigo apresenta uma análise da tendência temporal e espacial da qualidade das águas superficiais da sub-bacia do Rio das Velhas, inserida na bacia do Rio São Francisco, em Minas Gerais, Brasil. Foram analisados 16.625 dados coletados no período de 2002 a 2011 pelo programa de monitoramento de qualidade das águas superficiais efetuado pelo Instituto Mineiro de Gestão das Águas (Igam. Testes estatísticos, multivariados e não paramétricos foram utilizados para avaliar 11 variáveis físicas, químicas e microbiológicas de 29 estações de monitoramento. Os resultados das análises de tendência Mann-Kendall/Sazonal de Mann-Kendall sugeriram que a maioria dos cursos d'água da região apresentam valores estáveis das variáveis ao longo do período estudado, com maiores alterações associadas a coliformes termotolerantes, demanda bioquímica de oxigênio (DBO, nitrato e índice de qualidade das águas (IQA, principalmente nas proximidades dos grandes centros urbanos. A análise de Cluster definiu três grandes grupos de estações de monitoramento, agrupadas segundo a qualidade de suas águas, correspondentes aos níveis de alta poluição, poluição moderada e baixa poluição. No entanto, ao longo de toda a sub-bacia, foi observada a degradação da qualidade da água durante o período estudado, principalmente relacionada ao lançamento de esgotos domésticos. Uma importante constatação foi a alteração da qualidade da água no baixo Rio das Velhas, apontada pela tendência de redução do IQA em estações localizadas nessa região, o que merece atenção dos órgãos governamentais para ações de manejo.

  10. Hepcidin plasma levels are not associated with changes in haemoglobin in early rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Østgård, R D; Glerup, H; Jurik, A G

    2017-01-01

    Objective: A reduction in haemoglobin level is a frequent complication among rheumatoid arthritis (RA) patients. Hepcidin has been linked to disturbed erythropoiesis. The objective of this study was to investigate the longitudinal changes in hepcidin in patients with early RA. Method: Hepcidin...... with disease-modifying anti-rheumatic drugs (DMARDs) and with additional adalimumab (ADA, n = 42) or placebo (PLA, n = 38) during 52 weeks, using a treat-to-target strategy, aiming for a 28-joint Disease Activity Score (DAS28) levels [median (interquartile range)] were 9...... = 0.48, p levels of haemoglobin and hepcidin at baseline or during the 52 week follow-up. No change in haemoglobin levels was seen as a function of hepcidin changes. In a mixed statistical model, no single factor was connected with the regulation...

  11. AGOR 28

    Science.gov (United States)

    2015-12-18

    and transporting them to a vendor in Seattle for measurements . The measuring will take place between the 28th and 30th. • Steering Hydraulics...the suction lower down on the hull. • CTD Handling Device – The cylinder has been reinstalled and tested. The repaired sensor is now measuring rod...Communications – FCC Station license applied for and approved. FBB activated. Iridium SIM Card in route from service provider. Inmarsat C’s and

  12. Work ability as a determinant of old age disability severity: evidence from the 28-year Finnish Longitudinal Study on Municipal Employees.

    Science.gov (United States)

    von Bonsdorff, Mikaela B; Seitsamo, Jorma; Ilmarinen, Juhani; Nygård, Clas-Håkan; von Bonsdorff, Monika E; Rantanen, Taina

    2012-08-01

    Lower occupational class correlates with a higher disability risk later in life. However, it is not clear whether the demands made by mental and physical work relative to individual resources in midlife predict well-being in old age. This study investigated prospectively whether work ability in midlife predicts disability severity in activities of everyday living in old age. Data come from the population-based 28-year follow-up called Finnish Longitudinal Study of Municipal Employees. A total of 2879 occupationally active persons aged 44-58 years answered a questionnaire on work ability at baseline in 1981 and activities of daily living in 2009. At baseline, perceived work ability relative to lifetime best was categorized into excellent, moderate, and poor work ability. At follow-up, disability scales were constructed based on the severity and frequency of difficulties reported in self-care activities of daily living (ADL) and instrumental activities of daily living (IADL). There was a graded prevalence of ADL and IADL disability severity, according to excellent, moderate and poor midlife work ability (pwork ability had an 11 to 20% higher mean ADL or IADL disability severity score, compared with those with excellent midlife work ability (reference), incidence rate ratios (IRR) ranging from 1.11 (95% CI 1.01-1.22) to 1.20 (95% CI 1.10-1.30). Those with poor midlife work ability had a mean ADL or IADL disability severity score 27 to 38% higher than the referent, IRRs ranging from 1.27 (95% CI 1.09-1.47) to 1.38 (95% CI 1.25-1.53). Adjusting for socio-economics, lifestyle factors and chronic diseases only slightly attenuated the associations. Work ability, an indicator of the de- mands made by mental and physical work relative to individuals' mental and physical resources, predicted disability severity 28 years later among middle-aged municipal employees.

  13. Effect of Xerostomia on the Functional Capacity of Subjects with Rheumatoid Arthritis.

    Science.gov (United States)

    Lins E Silva, Marília; Carvalho, Camila Nunes; Carvalho, Alessandra de Albuquerque Tavares; Leão, Jair Carneiro; Duarte, Angela Luzia Pinto; Gueiros, Luiz Alcino

    2016-10-01

    To evaluate the intensity of xerostomia and hyposalivation in subjects with rheumatoid arthritis (RA) as well as the effects of these conditions on functional incapacity and disease activity. The study sample comprised 236 individuals of both sexes who had RA. All the individuals were submitted to clinical evaluation and unstimulated sialometry. Functional capacity was determined by using the Health Assessment Questionnaire (HAQ), xerostomia was assessed using the Xerostomia Inventory, and disease activity was evaluated with the 28-joint Disease Activity Score (DAS28). The effect of Sjögren syndrome (SS) was analyzed, and the sample was divided into 2 groups: RA (191 subjects) and RA/SS (45 subjects). The Xerostomia Inventory showed positive and significant correlation with fatigue (r = 0.243; p xerostomia (OR 3.89, 95% CI 1.84-8.23, p Xerostomia demonstrated an adverse effect on quality of life of subjects with RA, being associated with a reduction in functional capacity. In this clinical setting, xerostomia can be monitored as a marker of worse clinical evolution.

  14. Sarma, Prof. Dipankar Das

    Indian Academy of Sciences (India)

    Home; Fellowship. Fellow Profile. Elected: 1993 Section: Chemistry. Sarma, Prof. Dipankar Das Ph.D. (IISc), FNA, FNASc, FTWAS Council Service: 2016-. Date of birth: 15 September 1955. Specialization: Strongly Interacting Electron Systems, Disordered Systems, Nanomaterials and Energy Materials Address: Professor ...

  15. The effect of routine hoof trimming on locomotion score, ruminating time, activity and milk yield of dairy cows

    NARCIS (Netherlands)

    Hertem, van T.; Parmet, Y.; Steensels, M.; Maltz, E.; Antler, A.; Schlageter Tello, A.A.; Lokhorst, C.; Romanini, C.E.B.; Viazzi, S.; Bahr, C.; Berckmans, D.; Halachmi, I.

    2014-01-01

    The objective of this study was to quantify the effect of hoof trimming on cow behavior (ruminating time, activity, and locomotion score) and performance (milk yield) over time. Data were gathered from a commercial dairy farm in Israel where routine hoof trimming is done by a trained hoof trimmer

  16. Dyslipidemia Pattern in Rheumatoid Arthritis Patients with Correlation of Disease Activity

    Directory of Open Access Journals (Sweden)

    Prakash Joshi

    2017-06-01

    Full Text Available Rheumatoid arthritis (RA is a multi-factorial disease which affects the immune system and ultimately various tissues in the body that typically affects middle-aged individuals. Our objectives were to evaluate prevalence of dyslipidemias and its pattern in RA patients in Central India and correlate dyslipidemia with disease activity. This cross-sectional study was conducted on RA patients at Sri Aurobindo Institute of Medical Sciences and Post Graduate Institute, Indore (M.P. between January 2014 and December 2015. Lipid profiles were determined following 12-hour overnight fasting, and the association of lipid profiles with and disease activity was determined. The maximum number of cases presented in the age group was 41-50(36%. Disease is more prevalent in female population. Maximum number of pateints (34 patients had duration of illness ranged between 1 to 10 years. Most of the patients presented with high disease activity (90%. Total cholesterol levels were significantly higher in female cases as compared to controls. Similar to total cholesterol, LDL cholesterol was significantly higher in female cases as compared to controls. There was no significant difference of HDL, VLDL and TG between cases and controls. Mean lipid profile values were similar in male cases and controls. Positive correlation of DAS-28 (ESR was observed with total cholesterol and LDL levels in female patients only. No correlation of HDL, LDL and triglyceride were observed with DAS- 28 (ESR in both male and female patients. Lipid profiles were similar in both treatment naive and on treatment patients. No significant difference in mean lipid profile values expect HDL was observed in two groups created on the basis of RA factor. A lipid profile value has no positive or negative correlation with duration of illness. [J Contemp Med 2017; 7(2.000: 132-137

  17. Longterm Safety and Efficacy of Subcutaneous Tocilizumab Monotherapy: Results from the 2-year Open-label Extension of the MUSASHI Study.

    Science.gov (United States)

    Ogata, Atsushi; Amano, Koichi; Dobashi, Hiroaki; Inoo, Masayuki; Ishii, Tomonori; Kasama, Tsuyoshi; Kawai, Shinichi; Kawakami, Atsushi; Koike, Tatsuya; Miyahara, Hisaaki; Miyamoto, Toshiaki; Munakata, Yasuhiko; Murasawa, Akira; Nishimoto, Norihiro; Ogawa, Noriyoshi; Ojima, Tomohiro; Sano, Hajime; Shi, Kenrin; Shono, Eisuke; Suematsu, Eiichi; Takahashi, Hiroki; Tanaka, Yoshiya; Tsukamoto, Hiroshi; Nomura, Akira

    2015-05-01

    To evaluate the longterm safety and efficacy of subcutaneous tocilizumab (TCZ-SC) as monotherapy in patients with rheumatoid arthritis (RA). Of 346 patients who received 24 weeks of double-blind treatment with either TCZ-SC monotherapy, 162 mg every 2 weeks (q2w); or intravenous TCZ (TCZ-IV) monotherapy, 8 mg/kg every 4 weeks; 319 patients continued to receive TCZ-SC q2w in the 84-week open-label extension (OLE) of the MUSASHI study (JAPICCTI-101117). Efficacy, safety, and immunogenicity were evaluated for all patients treated with TCZ during 108 weeks. The proportions of patients who achieved American College of Rheumatology 20/50/70 responses, low disease activity [28-joint Disease Activity Score (DAS28) ≤ 3.2], or remission (DAS28 < 2.6) at Week 24 were maintained until Week 108. The incidences of adverse events and serious adverse events were 498.3 and 16.9 per 100 patient-years (PY), respectively. The overall safety of TCZ-SC monotherapy was similar to that of TCZ-IV monotherapy. Rates of injection site reactions (ISR) through 108 weeks remained similar to rates through 24 weeks. ISR were mild and did not cause any patient withdrawals. No serious hypersensitivity events (including anaphylactic reactions) occurred. Anti-TCZ antibodies were present in 2.1% of patients treated with TCZ-SC monotherapy. TCZ-SC monotherapy maintained a favorable safety profile and consistent efficacy throughout the 108-week study. Like TCZ-IV, TCZ-SC could provide an additional treatment option for patients with RA.

  18. The C.L.E.A.R. Score: a new comprehensive assessment method for academic physicians in military medical centers.

    Science.gov (United States)

    Buller, Jerome L; Tetteh, Hassan A

    2012-07-01

    Evaluation of medical officer performance is a critical leadership role. This study offers a comprehensive evaluation system for military physicians. The Comprehensive Assessment equation (COMPASS equation), a modified Cobb-Douglas equation, was developed to evaluate academic physicians. The COMPASS equation assesses military physicians within five comprehensive dimensions: (1) Clinical (2) Leadership, (3) Educational (4) Administrative, and (5) Research productivity excellence to yield a composite "C.L.E.A.R. Score." The COMPASS equation's fidelity was tested with a cohort of military physicians within the department of Obstetrics and Gynecology in the Capital District Region and a C.L.E.A.R. score was calculated for individual physicians. Mean C.L.E.A.R score was 53.6 +/- 28.8 (range 10.1-98.5). The responsiveness of the model was tested using two hypothetical physician models: "low-performing-faculty" and "super-faculty," and calculated C.L.E.A.R. scores were 6.3 and 153.4, respectively. The C.L.E.A.R. score appears to recognize and assess the performance excellence of military physicians. Weighting measured characteristics of the COMPASS equation can be used to promote organizational priorities. Thus, leaders of military medicine can communicate institutional priorities and inculcate them through use of the COMPASS equation to reward and recognize the activities of military medical officers that are commensurate with institutional goals.

  19. Auditoria de enfermagem: o impacto das anotaçóes de enfermagem no contexto das glosas hospitalares

    OpenAIRE

    Ferreira, Tânia S; de Souza-Braga, André Luiz; Cavalcanti-Valente, Geilsa Soraia; Ferreira de Souza, Deise; Moreira Carvalho-Alves, Enilda

    2009-01-01

    Este estudo tratou da nossa observação frente ao impacto das anotações de enfermagem no contexto das glosas hospitalares. Nesta perspectiva, a pesquisa se norteia pela seguinte questão: como o profissional de enfermagem pode contribuir através dos registros para não ocorrência da glosa? Temos como objetivo identificar o impacto causado pelo não registro de enfermagem contrapondo às eventuais glosas, evidenciando os principais tipos decorrentes destes registros. Metodologicamente a pesquisa ut...

  20. X-linked adrenoleukodystrophy: correlation between Loes score and diffusion tensor imaging parameters.

    Science.gov (United States)

    Ono, Sergio Eiji; de Carvalho Neto, Arnolfo; Gasparetto, Emerson Leandro; Coelho, Luiz Otávio de Mattos; Escuissato, Dante Luiz; Bonfim, Carmem Maria Sales; Ribeiro, Lisandro Lima

    2014-01-01

    The present study was aimed at evaluating the correlation between diffusion tensor imaging parameters and Loes score as well as whether those parameters could indicate early structural alterations. Diffusion tensor imaging measurements were obtained in 30 studies of 14 patients with X-linked adrenoleukodystrophy and were correlated with Loes scores. A control group including 28 male patients was created to establish agematched diffusion tensor imaging measurements. Inter- and intraobserver statistical analyses were undertaken. Diffusion tensor imaging measurements presented strong Pearson correlation coefficients (r) of -0.86, 0.89, 0.89 and 0.84 for fractional anisotropy and mean, radial and axial diffusivities (p tensor measurements at early stage of the disease indicates that mean and radial diffusivities might be useful to predict the disease progression. Measurements of diffusion tensor parameters can be used as an adjunct to the Loes score, aiding in the monitoring of the disease and alerting for possible Loes score progression in the range of interest for therapeutic decisions.

  1. Prevalência das manifestações clínicas iniciais da granulomatose de Wegener no Brasil: relato de seis casos e revisão da literatura Wegener's granulomatosis: prevalence of the initial clinical manifestations - report of six cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Carlos Ewerton Maia Rodrigues

    2010-04-01

    Full Text Available OBJETIVOS: Descrever as manifestações clínicas iniciais da Granulomatose de Wegener (GW diagnosticada no Brasil. PACIENTES E MÉTODOS: Análise retrospectiva de seis prontuários do Serviço de Reumatologia do Hospital Geral de Fortaleza (HGF, assim como a realização de um levantamento bibliográfico dos casos de GW descritos no Brasil obtidos dos bancos de dados LILACS, SciELO e MEDLINE. RESULTADOS: O estudo identificou 49 pacientes; 15 (31% do sexo masculino e 34 (69% do sexo feminino. A forma sistêmica ocorreu em 35 pacientes (73%: 28 adultos, cinco crianças e dois adolescentes. A doença limitada ocorreu em 13 adultos e uma criança. A média da idade adulta no início da doença foi de 42,2 anos (18 a 65 anos. O quadro clínico agudo, com sintomas há menos de três meses do diagnóstico, ocorreu em 41% (20/49 da casuística e a forma insidiosa, em 59% (29/49 dos pacientes. A prevalência das manifestações clínicas iniciais nos adultos com doença sistêmica (n = 28 foi 64% (18/28 das vias aéreas superiores (VAS, 36% (10/28 pulmonares, 18% (5/28 renais, 25% (7/28 oculares, 11% (3/28 cutâneas, 25% (7/28 musculoesqueléticas e 7% (2/28 neurológicas. Na forma limitada do adulto (n = 13, os sintomas prevalentes foram 84% (11/13 VAS, 23% (3/13 oculares e 15% (2/13 pulmonares. CONCLUSÃO: No Brasil, a prevalência das manifestações clínicas iniciais da GW foi semelhante aos resultados da literatura. A falta de especificidade dos sintomas pode retardar o diagnóstico na forma insidiosa da doença e aumentar a morbimortalidade das formas agudas.OBJECTIVES: To describe the initial clinical manifestations of Wegener's Granulomatosis (WG in Brazil. PATIENTS AND METHODS: Retrospective analysis of six medical records of WG patients followed-up at the Rheumatology Department of Hospital Geral of Fortaleza (HGF, as well as a bibliographic survey of cases of WG in Brazil on LILACS, SciELO, and MEDLINE databases. RESULTS: The study

  2. Das IHS und die Rolle der Forschungsinstitute

    OpenAIRE

    Keuschnigg, Christian

    2014-01-01

    Das Institut für Höhere Studien und wissenschaftliche Forschung (IHS) ist ein unabhängiges Forschungsinstitut und leistet Forschung und Ausbildung auf Spitzenniveau für Politik, Wirtschaft und Gesellschaft. Im Wettbewerb zwischen Universitäten und angewandten Forschungsinstituten ist das IHS einzigartig, weil es unter einem Dach Grundlagenforschung und forschungsnahe Lehre mit angewandter Forschung für die wissenschaftliche Politikberatung verbindet. Mit den drei Disziplinen Ökonomie, Soziolo...

  3. Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

    Science.gov (United States)

    Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

    2015-01-01

    Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

  4. Improvements in fundamental movement skill competency mediate the effect of the SCORES intervention on physical activity and cardiorespiratory fitness in children.

    Science.gov (United States)

    Cohen, Kristen E; Morgan, Philip J; Plotnikoff, Ronald C; Barnett, Lisa M; Lubans, David R

    2015-01-01

    Numerous studies have identified a positive association between fundamental movement skill (FMS) competency and physical activity in children; however, the causal pathways have not been established. The aim of this study is to determine if changes in FMS competency mediated the effect of the Supporting Children's Outcomes using Rewards, Exercise and Skills (SCORES) intervention on physical activity and cardiorespiratory fitness in children. Eight primary schools (25 classes) and 460 children (aged 8.5 ± 0.6, 54% girls) were randomised to the SCORES intervention or control group for the 12-month study. The outcomes were accelerometer-determined moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness. The hypothesised mediators were actual FMS competency and perceived sport competence. Mediation analyses were conducted using multilevel linear analysis in MPlus. From the original sample, 138 (30.0%) and 370 (80.4%) children provided useable physical activity and cardiorespiratory fitness data at post-test assessments. There were significant treatment effects for locomotor skills and overall FMSs. Changes in MVPA were associated with changes in object-control skills, overall FMSs and perceived competence. The overall FMSs had a significant mediating effect on MVPA (AB = 2.09, CI = 0.01-4.55). Overall FMSs (AB = 1.19, CI = 0.002-2.79) and locomotor skills (AB = 0.74, CI = 0.01-1.69) had a significant mediating effect on cardiorespiratory fitness. The results of this study conclude that actual but not perceived movement skill competency mediated the effect of the SCORES intervention on physical activity and cardiorespiratory fitness.

  5. ANALISIS WILAYAH KONSERVASI DAERAH ALIRAN SUNGAI (DAS KURANJI DENGAN APLIKASI SWAT

    Directory of Open Access Journals (Sweden)

    Fadli Irsyad

    2015-12-01

    Full Text Available Degradasi lahan merupakan penyebab utama tingginya runoff dibandingkan dengan faktor lainnya. Perubahan tata guna lahan yang terjadi pada suatu kawasan menyebabkan terjadinya perubahan kondisi catchment area dan dapat menyebabkan perubahan aliran permukaan (runoff.  Jika limpasan yang terjadi saat hujan kecil dan infiltrasi air ke dalam tanah besar, maka air terlebih dahulu disimpan di dalam tanah sehingga akan meningkatkan ketersediaan air tanah. DAS Kuanji merupakan salah satu DAS di Kota Padang yang memiliki luas 202,7 km2 dan terdiri dari 5 sub-DAS. Penelitian ini dilakukan pada kawasan DAS Kuranji yang secara geografis terletak pada 100o20’31,20” – 100o33’50.40” BT dan 00o55’59.88” - 00o47’24” LS. Penelitian ini dilaksanakan pada bulan Maret – Juni 2013. Penelitian ini menggunakan aplikasi open sources software MapWindows GIS 4.8 RC1 (4.8.1 dari www.mapwindow.org.  Tahapan awal dalam penelitian ini yakni pengumpuan data, analisis SWAT di DAS Kuranji, dan penentuan wilayah konservasi DAS Kuranji. Hasil peneltian yang menggunakan MWSWAT untuk DAS Kuranji didapatkan HRU DAS sebanyak 2.034 HRU. Limpasan terbesar yang terjadi yakni 84 mm dengan luasan 75,195 ha, dan tersebar di empat kecamatan (Pauh, Padang Utara, Nanggalo, dan Kototengah. Wilayah konservasi yang direkomendasikan yakni  Limau Manih (81,56 ha, Lambung Bukit (42,27 ha, Gunung Sarik (86,32 ha, Kuranji (60,20 ha, dan Lubuk Minturun (64,45 ha. Kata kunci: Alih Fungsi Lahan,  DAS Kuranji, Konservasi, Limpasan, MWSWAT.

  6. Predicting long-term mortality after Fontan procedures: A risk score based on 6707 patients from 28 studies

    NARCIS (Netherlands)

    Alsaied, Tarek; Bokma, Jouke P.; Engel, Mark E.; Kuijpers, Joey M.; Hanke, Samuel P.; Zuhlke, Liesl; Zhang, Bin; Veldtman, Gruschen R.

    2017-01-01

    Reported long-term outcome measures vary greatly between studies in Fontan patients making comprehensive appraisal of mortality hazard challenging. We sought to create a clinical risk score to assist monitoring of Fontan patients in the outpatient setting. A systematic review was conducted to

  7. "Always Look on the Bright Side of Life!" - Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints.

    Science.gov (United States)

    Jahangard, Leila; Rahmani, Anahita; Haghighi, Mohammad; Ahmadpanah, Mohammad; Sadeghi Bahmani, Dena; Soltanian, Ali R; Shirzadi, Shahriar; Bajoghli, Hafez; Gerber, Markus; Holsboer-Trachsler, Edith; Brand, Serge

    2017-01-01

    Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples. Subjects and Methods: The non-clinical sample consisted of 206 young adults ( M = 21.3 years; age range: 18-24 years; 57.3% males). They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality. Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity. Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.

  8. Efficient Delivery and Visualization of Long Time-Series Datasets Using Das2 Tools

    Science.gov (United States)

    Piker, C.; Granroth, L.; Faden, J.; Kurth, W. S.

    2017-12-01

    For over 14 years the University of Iowa Radio and Plasma Wave Group has utilized a network transparent data streaming and visualization system for most daily data review and collaboration activities. This system, called Das2, was originally designed in support of the Cassini Radio and Plasma Wave Science (RPWS) investigation, but is now relied on for daily review and analysis of Voyager, Polar, Cluster, Mars Express, Juno and other mission results. In light of current efforts to promote automatic data distribution in space physics it seems prudent to provide an overview of our open source Das2 programs and interface definitions to the wider community and to recount lessons learned. This submission will provide an overview of interfaces that define the system, describe the relationship between the Das2 effort and Autoplot and will examine handling Cassini RPWS Wideband waveforms and dynamic spectra as examples of dealing with long time-series data sets. In addition, the advantages and limitations of the current Das2 tool set will be discussed, as well as lessons learned that are applicable to other data sharing initiatives. Finally, plans for future developments including improved catalogs to support 'no-software' data sources and redundant multi-server fail over, as well as new adapters for CSV (Comma Separated Values) and JSON (Javascript Object Notation) output to support Cassini closeout and the HAPI (Heliophysics Application Programming Interface) initiative are outlined.

  9. Explicit treatment of active-site waters enhances quantum mechanical/implicit solvent scoring: Inhibition of CDK2 by new pyrazolo[1,5-a]pyrimidines.

    Science.gov (United States)

    Hylsová, Michaela; Carbain, Benoit; Fanfrlík, Jindřich; Musilová, Lenka; Haldar, Susanta; Köprülüoğlu, Cemal; Ajani, Haresh; Brahmkshatriya, Pathik S; Jorda, Radek; Kryštof, Vladimír; Hobza, Pavel; Echalier, Aude; Paruch, Kamil; Lepšík, Martin

    2017-01-27

    We present comprehensive testing of solvent representation in quantum mechanics (QM)-based scoring of protein-ligand affinities. To this aim, we prepared 21 new inhibitors of cyclin-dependent kinase 2 (CDK2) with the pyrazolo[1,5-a]pyrimidine core, whose activities spanned three orders of magnitude. The crystal structure of a potent inhibitor bound to the active CDK2/cyclin A complex revealed that the biphenyl substituent at position 5 of the pyrazolo[1,5-a]pyrimidine scaffold was located in a previously unexplored pocket and that six water molecules resided in the active site. Using molecular dynamics, protein-ligand interactions and active-site water H-bond networks as well as thermodynamics were probed. Thereafter, all the inhibitors were scored by the QM approach utilizing the COSMO implicit solvent model. Such a standard treatment failed to produce a correlation with the experiment (R 2  = 0.49). However, the addition of the active-site waters resulted in significant improvement (R 2  = 0.68). The activities of the compounds could thus be interpreted by taking into account their specific noncovalent interactions with CDK2 and the active-site waters. In summary, using a combination of several experimental and theoretical approaches we demonstrate that the inclusion of explicit solvent effects enhance QM/COSMO scoring to produce a reliable structure-activity relationship with physical insights. More generally, this approach is envisioned to contribute to increased accuracy of the computational design of novel inhibitors. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. The scoring of movements in sleep.

    Science.gov (United States)

    Walters, Arthur S; Lavigne, Gilles; Hening, Wayne; Picchietti, Daniel L; Allen, Richard P; Chokroverty, Sudhansu; Kushida, Clete A; Bliwise, Donald L; Mahowald, Mark W; Schenck, Carlos H; Ancoli-Israel, Sonia

    2007-03-15

    The International Classification of Sleep Disorders (ICSD-2) has separated sleep-related movement disorders into simple, repetitive movement disorders (such as periodic limb movements in sleep [PLMS], sleep bruxism, and rhythmic movement disorder) and parasomnias (such as REM sleep behavior disorder and disorders of partial arousal, e.g., sleep walking, confusional arousals, night terrors). Many of the parasomnias are characterized by complex behaviors in sleep that appear purposeful, goal directed and voluntary but are outside the conscious awareness of the individual and therefore inappropriate. All of the sleep-related movement disorders described here have specific polysomnographic findings. For the purposes of developing and/or revising specifications and polysomnographic scoring rules, the AASM Scoring Manual Task Force on Movements in Sleep reviewed background literature and executed evidence grading of 81 relevant articles obtained by a literature search of published articles between 1966 and 2004. Subsequent evidence grading identified limited evidence for reliability and/or validity for polysomnographic scoring criteria for periodic limb movements in sleep, REM sleep behavior disorder, and sleep bruxism. Published scoring criteria for rhythmic movement disorder, excessive fragmentary myoclonus, and hypnagogic foot tremor/alternating leg muscle activation were empirical and based on descriptive studies. The literature review disclosed no published evidence defining clinical consequences of excessive fragmentary myoclonus or hypnagogic foot tremor/alternating leg muscle activation. Because of limited or absent evidence for reliability and/or validity, a standardized RAND/UCLA consensus process was employed for recommendation of specific rules for the scoring of sleep-associated movements.

  11. Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

    Science.gov (United States)

    Księżopolska-Orłowska, Krystyna; Pacholec, Anna; Jędryka-Góral, Anna; Bugajska, Joanna; Sadura-Sieklucka, Teresa; Kowalik, Katarzyna; Pawłowska-Cyprysiak, Karolina; Łastowiecka-Moras, Elżbieta

    2016-01-01

    Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. Sixty-four employed women aged 24-65 years participated in the study. All patients underwent individual and instrumental kinesiotherapy. Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation. The following study instruments were used: to assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity: VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index); and patients' own prognosis of fitness for work: the 6th question from Work Ability Index (WAI). Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. All patients improved after rehabilitation. The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation programme (p cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η(2) = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η(2) = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients' own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent

  12. Serum interleukin-18 and interleukin-10 levels in systemic lupus erythematosus: correlation with SLEDAI score and disease activity parameters

    Directory of Open Access Journals (Sweden)

    Sahar Abou El-Fetouh

    2014-01-01

    Conclusion The circulating IL-18 and IL-10 concentrations were significantly elevated in SLE patients and correlated with the SLEDAI score. The study emphasized that there exists an upregulated proinflammatory as well as anti-inflammatory responses in patients with active SLE; however, the anti-inflammatory response is not enough to suppress the active disease. Identifying the exact contribution of the currently studied cytokines might provide future insights for targeted therapeutic strategies in SLE.

  13. Association between IL-6 production in synovial explants from rheumatoid arthritis patients and clinical and imaging response to biologic treatment: A pilot study.

    Directory of Open Access Journals (Sweden)

    Martin Andersen

    Full Text Available The need for biomarkers which can predict disease course and treatment response in rheumatoid arthritis (RA is evident. We explored whether clinical and imaging responses to biologic disease modifying anti-rheumatic drug treatment (bDMARD were associated with the individual's mediator production in explants obtained at baseline.RA Patients were evaluated by disease activity score 28 joint C-reactive protein (DAS 28-, colour Doppler ultrasound (CDUS and 3 Tesla RA magnetic resonance imaging scores (RAMRIS. Explants were established from synovectomies from a needle arthroscopic procedure prior to initiation of bDMARD. Explants were incubated with the bDMARD in question, and the productions of interleukin-6 (IL-6, monocyte chemo-attractive protein-1 (MCP-1 and macrophage inflammatory protein-1-beta (MIP-1b were measured by multiplex immunoassays. The changes in clinical and imaging variables following a minimum of 3 months bDMARD treatment were compared to the baseline explant results. Mixed models and Spearman's rank correlations were performed. P-values below 0.05 were considered statistically significant.16 patients were included. IL-6 production in bDMARD-treated explants was significantly higher among clinical non-responders compared to responders (P = 0.04, and a lack of suppression of IL-6 by the bDMARDS correlated to a high DAS-28 (ρ = 0.57, P = 0.03, CDUS (ρ = 0.53, P = 0.04 and bone marrow oedema (ρ = 0.56, P = 0.03 at follow-up. No clinical association was found with explant MCP-1 production. MIP-1b could not be assessed due to a large number of samples below the detection limit.Synovial explants appear to deliver a disease-relevant output testing which when carried out in advance of bDMARD treatment can potentially pave the road for a more patient tailored treatment approach with better treatment effects.

  14. The sick-building syndrome; Das Sick-Building-Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Henne, A.; Neumann, H.F.; Winneke, G.

    1992-12-31

    The sick-building syndrome is characterized by the presence of general, non-specific symptoms (e.g., headache, tiredness, respiratory problems, eye trouble, vertigo, nausea, unspecific hypersensitivity) in association with a particular indoor ambience. It is clearly distinguishable from `building-related illness`, referring to a well-defined clinical syndrome due to staying in a building and for which a cause can, in general, be established. Disorders in the case of the sick-building syndrome are manifold and confirmed objectifiable results are hardly available so far. Yet there are some organ-related methods for the confirmation of findings concerning, for instance, the eyes, the skin and the area of the nose. The causes of the incidence of sick-building syndrome are more or less unclear. It is a multifactorial phenomenon involving physical, biological, chemical, individual-specific and psychological factors. Buildings where sick-building syndrome occurs typically exhibit certain properties. The European Community has already made proposals for the investigation of incriminated buildings. A systematic survey by questionnaire together with individual interviews plays an import part towards clarifying the syndrome. (orig./UWA) [Deutsch] Das Sick-Building-Syndrom beschreibt das Vorhandensein von allgemeinen, nicht spezifischen Symptomen (z.B. Kopfschmerzen, Muedigkeit, Atembeschwerden, Augenreizungen, Schwindelgefuehl, Uebelkeit, unspezifische Ueberempfindlichkeit), assoziiert mit einer besonderen Innenraumumgebung. Deutlich hiervon abzugrenzen ist die ``Building related illness``, bei der ein klinisch definiertes Krankheitsbild vorliegt, das durch den Aufenthalt im Gebaeude verursacht wird und fuer das im allgemeinen eine Ursache ermittelt werden kann. Das Beschwerdebild beim Sick-Building-Syndrom ist vielfaeltig, und gesicherte, objektivierbare Befunde liegen hierzu bisher kaum vor. Dennoch gibt es einige organbezogenen Methoden zur Befundabsicherung, z.B. fuer das

  15. Cystic fibrosis in adults. Short-term and long-term reproducibility of the Brody score for lung morphology in low-dose MDCT scans

    Energy Technology Data Exchange (ETDEWEB)

    Weber, K.; Paolini, M.; Schmitz, M.; Coppenrath, E.; Reiser, M.; Mueller-Lisse, U.G. [Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie; Fischer, R.; Huber, R. [Ludwig-Maximilians-Univ. Muenchen (Germany). Medical Hospital V

    2014-01-15

    Purpose: The semi-quantitative Brody score measures the severity of cystic fibrosis (CF)-related lung disease. We investigated the short-term (28 - 60 days) and long-term (2 - 7 years) intra- and inter-observer reproducibility of the Brody score in low-dose multidetector row computed tomography examinations performed in inspiration (LDCTs) of adult CF patients. Materials and Methods: Composite Brody scores and respective underlying bronchiectasis, mucus plugging, peribronchial thickening, parenchymal opacity, and hyperinflation subscores were evaluated twice (time interval, 1 - 84 months) by each of 3 independent radiologists (1 - 20 years of professional diagnostic radiology experience) in LDCTs (4 - 64 rows, 120 KVp, 10 - 15 mAs/slice, CTDIw approx. 1.0 mGy, effective dose approx. 0.5 mSv) of 15 adult patients with CF-related lung disease (8 female, 7 male, age, 18 - 50 years, mean, 33 years). Results: The average reproducibility of the Brody score was within +/-7 % (range, 2 - 30 %) between radiologists, and +/-6 % (3 - 12 %) within radiologists (short-term, 28 - 60 days, 4 %, 0 - 12 %, long-term, 2 - 7 years, 12 %, 1 - 36 %). For the different subscores, the reproducibility was within +/-25 % (15 - 41 %) between radiologists and +/-23 % (12 - 46 %) within radiologists. Conclusion: The Brody score shows high average inter-observer reproducibility in LDCTs of adult CF patients. The Brody score also demonstrates high average intra-observer reproducibility if subsequent assessments are made within 28 - 61 days. With time intervals of 2 - 7 years between subsequent evaluations, however, intra-observer reproducibility decreases. Respective subscores each demonstrate lower intra- and inter-observer reproducibility than does the composite Brody score. (orig.)

  16. Factors Associated With Surgery Clerkship Performance and Subsequent USMLE Step Scores.

    Science.gov (United States)

    Dong, Ting; Copeland, Annesley; Gangidine, Matthew; Schreiber-Gregory, Deanna; Ritter, E Matthew; Durning, Steven J

    2018-03-12

    We conducted an in-depth empirical investigation to achieve a better understanding of the surgery clerkship from multiple perspectives, including the influence of clerkship sequence on performance, the relationship between self-logged work hours and performance, as well as the association between surgery clerkship performance with subsequent USMLE Step exams' scores. The study cohort consisted of medical students graduating between 2015 and 2018 (n = 687). The primary measures of interest were clerkship sequence (internal medicine clerkship before or after surgery clerkship), self-logged work hours during surgery clerkship, surgery NBME subject exam score, surgery clerkship overall grade, and Step 1, Step 2 CK, and Step 3 exam scores. We reported the descriptive statistics and conducted correlation analysis, stepwise linear regression analysis, and variable selection analysis of logistic regression to answer the research questions. Students who completed internal medicine clerkship prior to surgery clerkship had better performance on surgery subject exam. The subject exam score explained an additional 28% of the variance of the Step 2 CK score, and the clerkship overall score accounted for an additional 24% of the variance after the MCAT scores and undergraduate GPA were controlled. Our finding suggests that the clerkship sequence does matter when it comes to performance on the surgery NBME subject exam. Performance on the surgery subject exam is predictive of subsequent performance on future USMLE Step exams. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Localization of thrombi using the Ga-67-DFO-DAS fibrinogen

    International Nuclear Information System (INIS)

    Takahashi, Eriko; Ohta, Yoshiko; Kawasaki, Sachiko; Maki, Masako; Hiroe, Michiaki; Kusakabe, Kiyoko; Kohno, Atsushi; Shigeta, Akiko

    1985-01-01

    This report shows demonstrable thrombus imaging with Ga-67-DFO-DAS fibrinogen in a patient with Marfan's syndrome. Significant Ga-67-DFO-DAS fibrinogen deposition was noted in the leakage surrounding replased graft of ascending aorta and lesion of pulmonary parenchyma which was suspicious of pulmonary infarction. This results promises that Ga-67-DFO-DAS fibrinogen is a useful tool for evaluation of the clotting under various forms of therapy. (author)

  18. Study on water-sediment interaction in samples from Rio das Velhas - Minas Gerais State - Brazil using instrumental neutron activation analysis, and argon plasma coupled mass spectroscopy

    International Nuclear Information System (INIS)

    Veado, Maria Adelaide R.V.; Oliveira, Arno H. de; Revel, G.; Pinte, G.; Toulhoat, P.

    1999-01-01

    Sorption of the metallic elements in aqueous solutions in surface of the hydroxides affects the transport of heavy elements in the freshwaters. Sorption and the chemistry of the hydroxides are important studies for knowledge in geology, waters and waste treatment, and environment studies. In the industrial mining region areas, the river surface waters are subject to modifications in its physical and chemistries properties: pH, DBO, conductivity and alkalinity. Instrumental neutron activation analysis and inductively coupled plasma-mass spectrometry (ICP-MS), have ben used for the determination of toxic heavy metals and others pollutants in the Das Velhas river in State of Minas Gerais, in south-east Brazil. Water samples were collected with acidification on site, which provoked a change of its natural pH. Consequently, metallic elements associated to hydroxides and to particles in suspension were liberated. The objective of this paper is to show the different behavior of any elements, in water of Das Velhas river, with relation of its chemical forms (cations or anions), the solubility degree, the pH and the presence of rare earth elements. (author)

  19. Números reais e curiosidades das somas infinitas

    OpenAIRE

    Moreno, Priscila Klitzke

    2016-01-01

    Podemos encontrar muitas surpresas interessantes no estudo das somas infinitas de números reais (series). Nessa perspectiva, este trabalho traz um estudo sobre as somas infinitas e mostra algumas curiosidades sobre elas, em especial sobre a serie harmônica. Começamos nosso estudo sobre somas infinitas, considerando exemplos com interpretações geométricas que tornam o estudo de series mais atraente. Discutimos também propriedades aritméticas, comutativa e associativa, das somas ...

  20. A Polygenic Risk Score of glutamatergic SNPs associated with schizophrenia predicts attentional behavior and related brain activity in healthy humans.

    Science.gov (United States)

    Rampino, Antonio; Taurisano, Paolo; Fanelli, Giuseppe; Attrotto, Mariateresa; Torretta, Silvia; Antonucci, Linda Antonella; Miccolis, Grazia; Pergola, Giulio; Ursini, Gianluca; Maddalena, Giancarlo; Romano, Raffaella; Masellis, Rita; Di Carlo, Pasquale; Pignataro, Patrizia; Blasi, Giuseppe; Bertolino, Alessandro

    2017-09-01

    Multiple genetic variations impact on risk for schizophrenia. Recent analyses by the Psychiatric Genomics Consortium (PGC2) identified 128 SNPs genome-wide associated with the disorder. Furthermore, attention and working memory deficits are core features of schizophrenia, are heritable and have been associated with variation in glutamatergic neurotransmission. Based on this evidence, in a sample of healthy volunteers, we used SNPs associated with schizophrenia in PGC2 to construct a Polygenic-Risk-Score (PRS) reflecting the cumulative risk for schizophrenia, along with a Polygenic-Risk-Score including only SNPs related to genes implicated in glutamatergic signaling (Glu-PRS). We performed Factor Analysis for dimension reduction of indices of cognitive performance. Furthermore, both PRS and Glu-PRS were used as predictors of cognitive functioning in the domains of Attention, Speed of Processing and Working Memory. The association of the Glu-PRS on brain activity during the Variable Attention Control (VAC) task was also explored. Finally, in a second independent sample of healthy volunteers we sought to confirm the association between the Glu-PRS and both performance in the domain of Attention and brain activity during the VAC.We found that performance in Speed of Processing and Working Memory was not associated with any of the Polygenic-Risk-Scores. The Glu-PRS, but not the PRS was associated with Attention and brain activity during the VAC. The specific effects of Glu-PRS on Attention and brain activity during the VAC were also confirmed in the replication sample.Our results suggest a pathway specificity in the relationship between genetic risk for schizophrenia, the associated cognitive dysfunction and related brain processing. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  1. 49 CFR 28.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

  2. O \\"reino das plantas\\" nos livros didáticos de ciências: análise das imagens

    OpenAIRE

    Rená Manoel de Souza e Silva

    2017-01-01

    As imagens sempre desempenharam papel fundamental na compreensão do conhecimento científico e, portanto, também nos livros didáticos de ciências. Porém, pesquisas têm mostrado que as imagens não são transparentes; por isso, defendemos a fundamental compreensão dos professores em relação ao uso das imagens no processo de ensino-aprendizagem, e na orientação da leitura e no uso desse recurso como suporte das atividades pedagógicas. Esta pesquisa analisou as imagens presentes nos livros didático...

  3. THE RELATIONSHIP OF FoxP3+ T REGULATORY CELLS TO DISEASE ACTIVITY AND ANTIBODY LEVELS IN EARLY RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    A. S. Avdeeva

    2017-01-01

    Full Text Available Objective: to analyze the relationship of the count of FoxP3+ T regulatory cells (Tregs to the clinical and laboratory parameters of disease activity and the levels of antibodies in a group of patients with early rheumatoid arthritis (RA.Subjects and methods. The investigation enrolled 45 patients with early RA (2010 ACR/EULAR criteria who had not previously received treatment with methotrexate, including 39 women; median age was 52.0 [32.5; 57.5] years; disease duration, 5 [4; 6] months, DAS28 5.01 [4.18; 5.8]; 71.1% of the patients were rheumatoid factor (RF positive and 88.9% were anti-cyclic citrullinated peptide positive. The relative and absolute counts of Treg (FoxP3+CD25+; CD152+surface; CD152+intracellular; FoxP3+CD127-; CD25+CD127-; FoxP3+ICOS+; FoxP3+CD154+; FoxP3+CD274+ were measured by immunofluorescence staining and multicolor flow cytometry. A control group consisted of 20 healthy donors who were matched for sex and age with the examined patients.Results and discussion. DАS28 was high, moderate, and low in 22 (48.9%, 20 (44.4%, and 3 (6.7% patients, respectively. As compared with the healthy donors, the patients with early RA were observed to have lower values in the percentage of FoxP3+CD25+ cells, in the percentage and absolute count of FoxP3+ICOS+ cells, in the percentage and absolute count of FoxP3+CD154+ and FoxP3+ CD274+ T cells; p<0.05 in all cases. Negative correlation was recorded between the percentage of FoxP3+CD25+ and C-reactive protein (CRP (r=-0.4; that of CD152+intracellular and DAS28 (r=-0.35, ESR (r=-0.46, CRP (r=-0.54; that of FoxP3+CD127 and CRP (r=-0.42; that of CD25+CD127 and DAS28 (r=-0.38, SDAI (r=-0.41, CDAI (r=-0.36, ESR (r=-0.39, CRP (r=-0.47; p<0.05 in all cases.The patients who were seronegative for RF were found to have higher values in the percentage of CD25+CD127, in the percentage and absolute count of Foxp3+CD154+ and Foxp3+CD274+ T lymphocytes.Conclusion. The given data may indicate that the

  4. Bowel Endometriosis Syndrome: a new scoring system for pelvic organ dysfunction and quality of life.

    Science.gov (United States)

    Riiskjær, M; Egekvist, A G; Hartwell, D; Forman, A; Seyer-Hansen, M; Kesmodel, U S

    2017-09-01

    Is it possible to develop a validated score that can identify women with Bowel Endometriosis Syndrome (BENS) and be used to monitor the effect of medical and surgical treatment? The BENS score can be used to identify women with BENS and to monitor the effect of medical and surgical treatment of women suffering from bowel endometriosis. Endometriosis is a heterogeneous disease with extensive variation in anatomical and clinical presentation, and symptoms do not always correspond to the disease burden. Current endometriosis scoring systems are mainly based on anatomical and surgical findings. The score was developed and validated from a cohort of 525 women with medically or surgically treated bowel endometriosis from Aarhus and Copenhagen University Hospitals, Denmark. Patients filled in questionnaires on pelvic pain, quality of life (QoL) and urinary, sexual and bowel function. Items were selected for the final score using clinical and statistical criteria. The chosen variables were included in a multivariate analysis. Individual score values were designated items to form the BENS score, which was divided into 'no BENS', 'minor BENS' and 'major BENS.' Internal and external validations were performed. The six most important items were 'pelvic pain', 'use of analgesics', 'dyschezia', 'straining to urinate', 'fecal urgency' and 'satisfaction with sexual life'. The range of the BENS score (0-28) was divided into 0-8 (no BENS), 9-16 (minor BENS) and 17-28 (major BENS). External validation showed a significant association between BENS score and QoL (P = 0.0001). The BENS scoring system is limited by the fact that it was developed from a single endometriosis unit in Denmark, making it susceptible to social, cultural and demographic bias. It is the first endometriosis classification system to be based directly on the symptomatology of the patient. Validation in other languages will promote comparison of treatments and results across borders. No external funding was either

  5. Inhibitory activity of Lactobacillus curvatus CWBI-B28 against ...

    African Journals Online (AJOL)

    user

    2006-11-16

    Nov 16, 2006 ... A bacteriocin-producing strain of Lactobacillus curvatus CWBI-B28 isolated from raw meat was shown ... Key words: Lactobacillus curvatus, Bacteriocin, hydrogen peroxide, ... Lactic acid bacteria (LAB) have long been used in food .... Pronase and catalase solutions were added to two of these tubes to.

  6. Association of mallampatti score as a risk factor for obstructive sleep apnea

    International Nuclear Information System (INIS)

    Naqvi, S.U.; Shahab, A.; Zia, S.; Adil, S.O.; Tariq, S.

    2017-01-01

    Objectives: To determine the association of Mallampatti Score as a risk factor for Obstructive Sleep Apnea (OSA). Methodology: This is a prospective questionnaire based survey included 103 individuals Results: Mean BMI of patients was 23.83+-6.03 kg/m2. There were 28 (27.2%) overweight and 22 (21.4%) obese patients. High risk on Berlin questionnaire was found in 12 (11.7%) patients. Both Berlin Questionnaire and Epworth questioner showed a negative association with Mallampati; the low risk group of these variables in our study with a p-value of 0.034 and 0.016 respectively i.e they are good for exclusion of OSA if found negative. Comparison of general characteristics with Mallampatti score and snoring showed significant association among patients with >25 years of age (p=0.02), low risk of Berlin score (p=0.034) and normal Epworth Sleep Score (p=0.016). Fifteen (14.5%) of overweight and obese individuals had higher Mallampatti score III and lV but the P-values were not significant (0.283 and 0.386). Conclusion: There is strong association between high Mallampatti score and O.S.A. Therefore we suggest that high mallampatti can be taken as a risk factor / screening tool limitation for O.S.A. (author)

  7. Desafio ao uso das preparações alcoólicas para higienização das mãos nos serviços de saúde

    Directory of Open Access Journals (Sweden)

    Maria Fernanda do Prado

    2014-09-01

    Full Text Available Objetivo: Propor uma reflexão teórica sobre os aspectos relacionados ao uso das preparações alcoólicas para higienização das mãos, no contexto dos serviços de saúde, na perspectiva das recomendações internacionais e nacionais, da eficácia antimicrobiana e fatores associados. Método: Reflexão teórica acerca do uso das preparações alcoólicas para a higienização das mãos nos serviços de saúde, fundamentada nas normativas internacionais e nacionais vigentes. Resultados: A comprovação da eficácia antimicrobiana das preparações alcoólicas por métodos rigorosos que simulam condições práticas de uso é fundamental para a utilização destes produtos nos serviços de saúde. Coexistem ainda outras variáveis envolvidas na eficácia do procedimento de higienização das mãos, tais como a sua duração, o volume do produto a ser aplicado e a aceitabilidade. Conclusão: Identificam-se lacunas nas normativas oficiais, referentes aos aspectos supracitados que podem comprometer um dos componentes mais importantes do controle de infecções e a segurança do paciente.

  8. An Objective Fluctuation Score for Parkinson's Disease

    Science.gov (United States)

    Horne, Malcolm K.; McGregor, Sarah; Bergquist, Filip

    2015-01-01

    Introduction Establishing the presence and severity of fluctuations is important in managing Parkinson’s Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system. Methods The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm. Results This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations. Conclusion The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges. PMID:25928634

  9. {sup 11}C-PBR28 imaging in multiple sclerosis patients and healthy controls: test-retest reproducibility and focal visualization of active white matter areas

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eunkyung; Gallezot, Jean-Dominique; Planeta, Beata; Lin, Shu-Fei; Lim, Keunpoong; Chen, Ming-Kai; Huang, Yiyun; Carson, Richard E. [Yale School of Medicine, PET Center, Department of Diagnostic Radiology, 801 Howard Avenue, PO Box 208048, New Haven, CT (United States); Delgadillo, Aracely; Liu, Shuang; O' Connor, Kevin C.; Lee, Jae-Yun; Chastre, Anne; Pelletier, Daniel [Yale School of Medicine, Department of Neurology, New Haven, CT (United States); Seneca, Nicholas; Leppert, David [Hoffmann-La Roche Ltd, Pharmaceuticals Division, Basel (Switzerland)

    2015-04-02

    Activated microglia play a key role in inflammatory demyelinating injury in multiple sclerosis (MS). Microglial activation can be measured in vivo using a positron emission tomography (PET) ligand {sup 11}C-PBR28. We evaluated the test-retest variability (TRV) and lesion detectability of {sup 11}C-PBR28 binding in MS subjects and healthy controls (HCs) with high-resolution PET. Four clinically and radiologically stable relapsing-remitting MS subjects (age 41 ± 7 years, two men/two women) and four HCs (age 42 ± 8 years, 2 two men/two women), matched for translocator protein genotype [two high- and two medium-affinity binders according to DNA polymorphism (rs6971) in each group], were studied for TRV. Another MS subject (age 41 years, male) with clinical and radiological activity was studied for lesion detectability. Dynamic data were acquired over 120 min after injection of 634 ± 101 MBq {sup 11}C-PBR28. For the TRV study, subjects were scanned twice, on average 1.4 weeks apart. Volume of distribution (V{sub T}) derived from multilinear analysis (MA1) modeling (t* = 30 min, using arterial input data) was the main outcome measure. Mean test V{sub T} values (ml cm{sup -3}) were 3.9 ± 1.4 in the whole brain gray matter (GM), 3.6 ± 1.2 in the whole brain white matter (WM) or normal-appearing white matter (NAWM), and 3.3 ± 0.6 in MS WM lesions; mean retest V{sub T} values were 3.7 ± 1.0 in GM, 3.3 ± 0.9 in WM/NAWM, and 3.3 ± 0.7 in MS lesions. Test-retest results showed a mean absolute TRV ranging from 7 to 9 % across GM, WM/NAWM, and MS lesions. High-affinity binders demonstrated 30 % higher V{sub T} than medium-affinity binders in GM. Focal {sup 11}C-PBR28 uptake was detected in two enhancing lesions of the active MS patient. High-resolution {sup 11}C-PBR28 PET can visualize focal areas where microglial activation is known to be present and has good test-retest reproducibility in the human brain. {sup 11}C-PBR28 PET is likely to be valuable for monitoring both

  10. Cerambycidae (Coleoptera do Parque Nacional da Serra das Confusões, Piauí, Brasil: novas espécies e novos registros

    Directory of Open Access Journals (Sweden)

    Maria Helena M. Galileo

    2013-12-01

    Full Text Available Três novas espécies são descritas do Piauí, em Cerambycinae: Compsibidion pictum, sp. nov. (Neoibidionini; em Lamiinae: Adetus differentis sp. nov. (Apomecynini e Mimasyngenes piauiensis sp. nov. (Desmiphorini. De 75 espécies procedentes do Riacho dos Bois (Parque Nacional da Serra das Confusões, 50 são novos registros para o Piauí. Três subfamílias são reconhecidas: uma espécie de Prioninae, 46 espécies de Cerambycinae e 28 espécies de Lamiinae.

  11. Peran Industri Dan Produk Tekstil Pada Kelestarian Sumberdaya Lingkungan Perairan DAS Citarum

    OpenAIRE

    sudradjat, ade

    2002-01-01

    Telah diketahui bahwa sebagian besar industri yang beroperasi di DAS Citarum adalah industri tekstil, yang sebagian besar belum mengolah limbahnya dengan baik dan membuangnya ke DAS Citarum. Oleh karena itulah maka tidak mengherankan jika keberadaan industri- industri tekstil tersebut sering dinyatakan sebagai salah satu penyebab utama tercemarnya kualitas lingkungan perairan DAS Citarum.Untuk mengetahui dengan benar tentang peran industri tekstil di DAS Citarum maka paper ini disusun. Paper ...

  12. PERAN INDUSTRI DAN PRODUK TEKSTIL PADA KELESTARIAN SUMBERDAYA LINGKUNGAN PERAIRAN DAS CITARUM

    OpenAIRE

    sudradjat, ade

    2011-01-01

    Telah diketahui bahwa sebagian besar industri yang beroperasi di DAS Citarum adalah industri tekstil, yang sebagian besar belum mengolah limbahnya dengan baik dan membuangnya ke DAS Citarum. Oleh karena itulah maka tidak mengherankan jika keberadaan industri- industri tekstil tersebut sering dinyatakan sebagai salah satu penyebab utama tercemarnya kualitas lingkungan perairan DAS Citarum.Untuk mengetahui dengan benar tentang peran industri tekstil di DAS Citarum maka paper ini disusun. Paper ...

  13. Financiamento das pequenas e médias empresas: análise das empresas do distrito do Porto em Portugal

    Directory of Open Access Journals (Sweden)

    Fernando Oliveira Tavares

    2015-06-01

    Full Text Available RESUMO Neste artigo, o objetivo é conhecer e analisar as formas de financiamento e produtos mais utilizados pelas pequenas e médias empresas do distrito do Porto, em Portugal. Pretende-se ainda perceber a aceitabilidade e a propensão para utilização de formas de financiamento alternativas e compreender quais as dificuldades das empresas no acesso ao crédito. O método utilizado é quantitativo e exploratório, um inquérito foi enviado a 1.600 empresas do distrito do Porto, acerca das diferentes formas de financiamento das organizações. Os resultados permitem concluir que o crédito bancário é a principal fonte de financiamento das pequenas e médias empresas, seguindo-se o autofinanciamento. O financiamento pela emissão de ações e obrigações é residual. Os resultados apresentam três fatores preponderantes quando as empresas têm necessidade de financiar-se: o crescimento da empresa, o custo do empréstimo e os aspetos burocráticos. Apesar de tratar-se de um estudo exploratório, os três fatores encontrados são um contributo para o estudo sobre o financiamento de pequenas e médias empresas, merecendo atenção por parte de investidores, gestores e detentores de capital.

  14. Comparison of an expert system with other clinical scores for the evaluation of severity of asthma.

    Science.gov (United States)

    Gautier, V; Rédier, H; Pujol, J L; Bousquet, J; Proudhon, H; Michel, C; Daurès, J P; Michel, F B; Godard, P

    1996-01-01

    "Asthmaexpert" was produced at the special request of several clinicians in order to obtain a better understanding of the medical decisions taken by clinical experts in the management of asthmatic patients. In order to assess the severity of asthma, a new score called Artificial Intelligence score (AI score), produced by Asthmaexpert, was compared with three other scores (Aas, Hargreave and Brooks). One hundred patients were enrolled prospectively in the study during their first consultation in the out-patient clinic. Distribution of severity level according to the different scores was studied, and the reliability between AI and other scores was evaluated by Kappa and MacNemar tests. Correlations with functional parameters were performed. The AI score assessed higher levels of severity than the other scores (Kappa = 18, 28 and 10% for Aas, Hargreave and Brooks, respectively) with significant MacNemar test in all cases. There was a significant correlation between AI score and forced expiratory volume in one second (FEV1) (r = 0.73). These data indicate that the AI score is a severity score which defines higher levels of severity than the chosen scores. Correlations for functional parameters are good. This score appears easy to use for the first consultation of an asthmatic patient.

  15. Setting and validating the pass/fail score for the NBDHE.

    Science.gov (United States)

    Tsai, Tsung-Hsun; Dixon, Barbara Leatherman

    2013-04-01

    This report describes the overall process used for setting the pass/fail score for the National Board Dental Hygiene Examination (NBDHE). The Objective Standard Setting (OSS) method was used for setting the pass/fail score for the NBDHE. The OSS method requires a panel of experts to determine the criterion items and proportion of these items that minimally competent candidates would answer correctly, the percentage of mastery and the confidence level of the error band. A panel of 11 experts was selected by the Joint Commission on National Dental Examinations (Joint Commission). Panel members represented geographic distribution across the U.S. and had the following characteristics: full-time dental hygiene practitioners with experience in areas of preventive, periodontal, geriatric and special needs care, and full-time dental hygiene educators with experience in areas of scientific basis for dental hygiene practice, provision of clinical dental hygiene services and community health/research principles. Utilizing the expert panel's judgments, the pass/fail score was set and then the score scale was established using the Rasch measurement model. Statistical and psychometric analysis shows the actual failure rate and the OSS failure rate are reasonably consistent (2.4% vs. 2.8%). The analysis also showed the lowest error of measurement, an index of the precision at the pass/fail score point and that the highest reliability (0.97) are achieved at the pass/fail score point. The pass/fail score is a valid guide for making decisions about candidates for dental hygiene licensure. This new standard was reviewed and approved by the Joint Commission and was implemented beginning in 2011.

  16. Study of morphometry to debit drainage basin (DAS) arau Padang city

    Science.gov (United States)

    Utama, Lusi; Amrizal, Berd, Isril; Zuherna

    2017-11-01

    High intensity rain that happened in Padang city cause the happening of floods at DAS Arau. Floods that happened in Padang besides caused high rain intensity, require to be by research about morphometry that is cause parameter the happening of floods. Morphometry drainage basin physical network (DAS) quantitatively related to DAS geomorphology that is related to form of DAS, river network, closeness of stream, ramp, usage of farm, high and gradient steepness of river. Form DAS will influence rain concentration to outlet. Make an index to closeness of stream depict closeness of river stream at one particular DAS. Speed of river stream influenced by storey, level steepness of river. Steepness storey, level is comparison of difference height of river downstream and upstream. Ever greater of steepness of river stream, excelsior speed of river stream that way on the contrary. High to lower speed of river stream influence occurrence of floods, more than anything else if when influenced by debit big. Usage of farm in glove its link to process of infiltration where if geology type which is impermeable, be difficult the happening of infiltration, this matter will enlarge value of run off. Research by descriptive qualitative that is about characteristic of DAS. Method the used is method survey with data collecting, in the form of rainfall data of year 2005 until year 2015 and Image of DEM IFSAR with resolution 5 meter, analyzed use Software ARGIS. Result of research got by DAS reside in at condition of floods gristle.

  17. HIV-1 transgenic rat CD4+ T cells develop decreased CD28 responsiveness and suboptimal Lck tyrosine dephosphorylation following activation

    International Nuclear Information System (INIS)

    Yadav, Anjana; Pati, Shibani; Nyugen, Anhthu; Barabitskaja, Oxana; Mondal, Prosanta; Anderson, Michael; Gallo, Robert C.; Huso, David L.; Reid, William

    2006-01-01

    Impaired CD4+ T cell responses, resulting in dysregulated T-helper 1 (Th1) effector and memory responses, are a common result of HIV-1 infection. These defects are often preceded by decreased expression and function of the α/β T cell receptor (TCR)-CD3 complex and of co-stimulatory molecules including CD28, resulting in altered T cell proliferation, cytokine secretion and cell survival. We have previously shown that HIV Tg rats have defective development of T cell effector function and generation of specific effector/memory T cell subsets. Here we identify abnormalities in activated HIV-1 Tg rat CD4+ T cells that include decreased pY505 dephosphorylation of Lck (required for Lck activation), decreased CD28 function, reduced expression of the anti-apoptotic molecule Bcl-xL, decreased secretion of the mitogenic lympokine interleukin-2 (IL-2) and increased activation induced apoptosis. These events likely lead to defects in antigen-specific signaling and may help explain the disruption of Th1 responses and the generation of specific effector/memory subsets in transgenic CD4+ T cells

  18. Evaluation of a novel photo optical imaging (Lightscan) with musculoskeletal ultrasound and clinical examination in the assessment of inflammatory activity in PIP joints in patients with rheumatoid arthritis and osteoarthritis

    OpenAIRE

    Amitai, Isabella

    2016-01-01

    Objectives: Lightscan is a novel rapid, low cost and non-invasive imaging technology to assess inflammatory activity in proximal interphalangeal (PIP) joints, which can easily be performed. The results are calculated automatically. This is the first comparative study of photo optical imaging (POI), ‘Lightscan’, with musculoskeletal ultrasonography (US), clinical examination (CE) and DAS28 (only RA) in patients with rheumatoid arthritis (RA), osteoarthritis (OA) and in healthy subjects. Me...

  19. Tendência das taxas de mortalidade infantil e de seus componentes em Guarulhos-SP, no período de 1996 a 2011

    Directory of Open Access Journals (Sweden)

    Daniel Hideki Bando

    Full Text Available OBJETIVO: analisar as tendências das taxas de mortalidade infantil (TMI e seus componentes em Guarulhos-SP, no período 1996-2011. MÉTODOS: regressão linear segmentada, para estimar as variações percentuais anuais (VPA. RESULTADOS: em 1996, a TMI e de seus componentes neonatal precoce, neonatal tardio e pós-neonatal foram, respectivamente, de 31,6, 16,7, 3,4 e 11,6 por 1000 nascidos vivos; em 2011, essas taxas foram de 12,6, 5,9, 1,6 e 5,1 respectivamente; houve diminuição significativa das TMI em todo o período; de 1996 a 2002, a VPA foi de -9,9, e de 2002 a 2011, foi de -3,7; o componente neonatal apresentou igual padrão; o componente neonatal precoce apresentou diminuição de 1996 a 2002 (VPA: -12,8, permanecendo estável até 2011; verificou-se diminuição do componente neonatal tardio de 1996 a 2009 (VPA: -2,8; o componente pós-neonatal apresentou redução em todo o período (VPA: -5,7. CONCLUSÃO: observou-se tendência de diminuição das TMI e de seus componentes.

  20. Ground Motion Analysis of Co-Located DAS and Seismometer Sensors

    Science.gov (United States)

    Wang, H. F.; Fratta, D.; Lord, N. E.; Lancelle, C.; Thurber, C. H.; Zeng, X.; Parker, L.; Chalari, A.; Miller, D.; Feigl, K. L.; Team, P.

    2016-12-01

    The PoroTomo research team deployed 8700-meters of Distributed Acoustic Sensing (DAS) cable in a shallow trench and 400-meters in a borehole at Brady Hot Springs, Nevada in March 2016 together with an array of 246, three-component geophones. The seismic sensors occupied a natural laboratory 1500 x 500 x 400 meters overlying the Brady geothermal field. The DAS cable was laid out in three parallel zig-zag lines with line segments approximately 100-meters in length and geophones were spaced at approximately 50-m intervals. In several line segments, geophones were co-located within one meter of the DAS cable. Both DAS and the conventional geophones recorded continuously over 15 days. A large Vibroseis truck (T-Rex) provided the seismic source at approximately 250 locations outside and within the array. The Vibroseis protocol called for excitation in one vertical and two orthogonal horizontal directions at each location. For each mode, three, 5-to-80-Hz upsweeps were made over 20 seconds. In addition, a moderate-sized earthquake with a local magnitude of 4.3 was recorded on March 21, 2016. Its epicenter was approximately 150-km away. Several DAS line segments with co-located geophone stations were used to test relationships between the strain rate recorded by DAS and ground velocity recorded by the geophones.

  1. D-score: a search engine independent MD-score.

    Science.gov (United States)

    Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

    2013-03-01

    While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. DAS: A Data Management System for Instrument Tests and Operations

    Science.gov (United States)

    Frailis, M.; Sartor, S.; Zacchei, A.; Lodi, M.; Cirami, R.; Pasian, F.; Trifoglio, M.; Bulgarelli, A.; Gianotti, F.; Franceschi, E.; Nicastro, L.; Conforti, V.; Zoli, A.; Smart, R.; Morbidelli, R.; Dadina, M.

    2014-05-01

    The Data Access System (DAS) is a and data management software system, providing a reusable solution for the storage of data acquired both from telescopes and auxiliary data sources during the instrument development phases and operations. It is part of the Customizable Instrument WorkStation system (CIWS-FW), a framework for the storage, processing and quick-look at the data acquired from scientific instruments. The DAS provides a data access layer mainly targeted to software applications: quick-look displays, pre-processing pipelines and scientific workflows. It is logically organized in three main components: an intuitive and compact Data Definition Language (DAS DDL) in XML format, aimed for user-defined data types; an Application Programming Interface (DAS API), automatically adding classes and methods supporting the DDL data types, and providing an object-oriented query language; a data management component, which maps the metadata of the DDL data types in a relational Data Base Management System (DBMS), and stores the data in a shared (network) file system. With the DAS DDL, developers define the data model for a particular project, specifying for each data type the metadata attributes, the data format and layout (if applicable), and named references to related or aggregated data types. Together with the DDL user-defined data types, the DAS API acts as the only interface to store, query and retrieve the metadata and data in the DAS system, providing both an abstract interface and a data model specific one in C, C++ and Python. The mapping of metadata in the back-end database is automatic and supports several relational DBMSs, including MySQL, Oracle and PostgreSQL.

  3. 10 CFR 1.28 - Office of Public Affairs.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Office of Public Affairs. 1.28 Section 1.28 Energy NUCLEAR... Office of Public Affairs. The Office of Public Affairs— (a) Develops policies, programs, and procedures for the Chairman's approval for informing the public of NRC activities; (b) Prepares, clears, and...

  4. O desenvolvimento das competências coletivas no terceiro setor

    Directory of Open Access Journals (Sweden)

    Lorena Tello‐Gamarra

    2015-11-01

    Full Text Available Dentro da abordagem de competências que se focam na gestão de recursos humanos, a abordagem de competências coletivas é uma área de pesquisa emergente. O objetivo da presente pesquisa é compreender as competências coletivas em um projeto voluntário do terceiro setor. O método utilizado foi o estudo de caso, tendo como objeto de estudo o terceiro setor, mais especificamente um projeto social. Para isto, se fez a escolha da Organização Não Governamental Parceiros Voluntários (PV com o projeto «Desenvolvimento de Princípios de Transparência e Prestação de Contas em Organizações da Sociedade Civil». Entre os resultados teóricos se identificaram 7 dimensões das competências coletivas. No que tange aos resultados empíricos referidos ao entendimento das competências coletivas no projeto voluntário do terceiro setor, observaram‐se 4 resultados: (1 todas as dimensões das competências coletivas foram comprovadas no projeto; (2 essas dimensões conseguiram ser determinantes para o desempenho do projeto, (3 as 7 dimensões influenciaram também o desempenho de toda a ONG, (4 as dimensões das competências coletivas do projeto contribuíram para que as organizações sociais pratiquem os princípios da transparência e da prestação de contas em suas atividades. Finalmente, o fato da confirmação das dimensões das competências coletivas como elemento‐chave do desenvolvimento abre a possiblidade de avançar na operacionalização deste construto.

  5. Assessment of Musculoskeletal Function and its Correlation with Radiological Joint Score in Children with Hemophilia A.

    Science.gov (United States)

    Gupta, Samriti; Garg, Kapil; Singh, Jagdish

    2015-12-01

    To evaluate the functional independence of children with hemophilia A and its correlation to radiological joint score. The present cross sectional study was conducted at SPMCHI, SMS Medical College, Jaipur, India. Children in the age group of 4-18 y affected with severe, moderate and mild hemophilia A and with a history of hemarthrosis who attended the OPD, emergency or got admitted in wards of SPMCHI, SMS Medical College were examined. Musculoskeletal function was measured in 98 patients using Functional Independence Score in Hemophilia (FISH) and index joints (joints most commonly affected with repeated bleeding) were assessed radiologically with plain X rays using Pettersson score. The mean FISH score was 28.07 ± 3.90 (range 17-32) with squatting, running and step climbing as most affected tasks. The mean Pettersson score was 3.8 ± 3.2. A significant correlation was found between mean Pettersson score and FISH (r = -0.875, P hemophilia A.

  6. Análise e caracterização das questões das provas da Olimpíada Brasileira de Física

    Directory of Open Access Journals (Sweden)

    Joao Paulo Casaro Erthal

    2014-07-01

    Full Text Available http://dx.doi.org/10.5007/2175-7941.2015v32n1p142 No Brasil, anualmente, são organizadas e praticadas olimpíadas escolares em diversas áreas do conhecimento, tais como: língua portuguesa, matemática, biologia, física, entre outras. A Olimpíada Brasileira de Física (OBF tem como objetivo despertar e estimular nos estudantes o interesse pela física, proporcionando desafios e incentivando-os a seguir carreiras científicas e tecnológicas. Este trabalho visa investigar os conteúdos exigidos nas provas da OBF e a forma como estes são abordados, com a finalidade de traçar um perfil das provas da OBF, aplicadas aos estudantes do ensino médio. Para isso, realizou-se uma análise das questões das provas do período de 1999 a 2013, distribuindo os conteúdos das questões das provas em seis áreas de conhecimento da física: mecânica, ondulatória, física térmica, eletromagnetismo, óptica geométrica e física moderna. Após a análise foram construídos gráficos que auxiliaram a identificar peculiaridades destas provas. Os resultados mostram uma evolução no perfil da prova, que atualmente possui uma abordagem mais contextualizada e interdisciplinar quando comparada às edições anteriores, em consonância ao que está descrito nos documentos oficiais da educação brasileira.

  7. 28 CFR 54.200 - Application.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Application. 54.200 Section 54.200 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage § 54.200 Application...

  8. Calculating a Continuous Metabolic Syndrome Score Using Nationally Representative Reference Values.

    Science.gov (United States)

    Guseman, Emily Hill; Eisenmann, Joey C; Laurson, Kelly R; Cook, Stephen R; Stratbucker, William

    2018-02-26

    The prevalence of metabolic syndrome in youth varies on the basis of the classification system used, prompting implementation of continuous scores; however, the use of these scores is limited to the sample from which they were derived. We sought to describe the derivation of the continuous metabolic syndrome score using nationally representative reference values in a sample of obese adolescents and a national sample obtained from National Health and Nutrition Examination Survey (NHANES) 2011-2012. Clinical data were collected from 50 adolescents seeking obesity treatment at a stage 3 weight management center. A second analysis relied on data from adolescents included in NHANES 2011-2012, performed for illustrative purposes. The continuous metabolic syndrome score was calculated by regressing individual values onto nationally representative age- and sex-specific standards (NHANES III). Resultant z scores were summed to create a total score. The final sample included 42 obese adolescents (15 male and 35 female subjects; mean age, 14.8 ± 1.9 years) and an additional 445 participants from NHANES 2011-2012. Among the clinical sample, the mean continuous metabolic syndrome score was 4.16 ± 4.30, while the NHANES sample mean was quite a bit lower, at -0.24 ± 2.8. We provide a method to calculate the continuous metabolic syndrome by comparing individual risk factor values to age- and sex-specific percentiles from a nationally representative sample. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  9. Aspectos das fortalezas e fragilidades no uso das metodologias ativas de aprendizagem

    Directory of Open Access Journals (Sweden)

    Maria José Sanches Marin

    Full Text Available A implementação de novos modelos de ensino-aprendizagem vem ocorrendo na Faculdade de Medicina de Marília (Famema há mais de uma década. O presente estudo analisa as fortalezas e fragilidades dos métodos ativos de aprendizagem na ótica dos estudantes. Para a coleta de dados, realizaram-se entrevistas com estudantes dos cursos de Enfermagem e Medicina. Os dados foram interpretados por meio dos parâmetros da hermenêutica dialética. Os sentidos extraídos das falas dos estudantes indicam que as metodologias ativas estimulam o estudo constante, a independência e a responsabilidade, possibilitam a integração das dimensões biopsicossociais, preparam para o trabalho em equipe e aproximam os alunos dos usuários e da equipe. No entanto, nem todos estão preparados para isso; algumas vezes, sentem-se perdidos em busca de conhecimentos, além de apresentarem dificuldades quanto a sua inserção na equipe de saúde. A construção de novos modelos de aprendizagem requer constante empenho, visando ao seu aperfeiçoamento.

  10. Droht den "kleinen Sprachen" das Aussterben?

    Directory of Open Access Journals (Sweden)

    Anita Lemić

    2014-12-01

    Full Text Available Die Prozesse der Globalisierung sind die Ursache für viele Änderungen in der Weltgemeinschaft, vor allem die Entfernung von Unterscheidungsmerkmalen (in Bezug darauf, dass „zwischen vielen ethnischen Zeichen, das was dauernd ist, ist die Dichotomisierung/Differenzierung eines „Wir-und-die-Anderen“ (Grbić, 2003, 93-64. Diese Zeichen wirken als Zeichen der Resozialisierung, die die bestehenden Identitäten löschen und sich an der Schaffung neuer Strukturen beteiligen. Die Zeit der Romantik in Europa ermöglichte die Schaffung von Nationalstaaten und ihr Hauptmerkmal war die Nationalsprache. Diese Art der sozialen Differenzierung hatte das Ziel, die Illusion einer vollständig homogenisierten Gesellschaft zu schaffen und damit den Prozess der Zerstörung der „kleinen“ Sprachen zu beginnen. Sprache und Kultur erwiesen sich als Grundlage der Gemeinschaftserhaltung. Die Homogenisierung ermöglicht Aktivitäten mit dem Ziel, einem Individuum zu helfen, sich als Individuum und als Mitglied der Gemeinschaft zu behaupten. Keine dieser beiden Identitäten kann ohne die Wechselwirkung mit der Umgebung erreicht werden. Die sprachliche Interaktion mit anderen Mitgliedern ist das Schlüsselsegment, das Menschen von anderen Lebensformen unterscheidet. Durch den Austausch von Erfahrungen mit anderen kommt der Mensch auf allen Ebenen voran und mit der Erfindung der Schrift öffnete er die Tür zur Entwicklung der Zivilisation. In dieser Arbeit beschäftigen wir uns mit der Frage der „Prestige“-Sprachen, die auf der Grundlage der Macht der Gemeinschaft der Muttersprachler ihren Bereich weit über die Grenzen des eigenen Landes hinaus erweitern und so eine politische und wirtschaftliche Vormachtstellung schaffen, aber auch mit den Auswirkungen jener Sprachen auf die Dekonstruktion oder möglicherweise vollständige Ausrottung der Sprachen, die auf diese Weise an Einfluss verlieren, unmodern werden und sich die Frage der Notwendigkeit ihrer

  11. DETERMINAÇÃO DAS DEFORMAÇÕES RESIDUAIS LONGITUDINAIS DECORRENTES DAS TENSÕES DE CRESCIMENTO EM Eucalyptus spp.

    OpenAIRE

    Rafael Beltrame

    2010-01-01

    O presente estudo foi desenvolvido com o objetivo de determinar as deformações residuais longitudinais (DRL), decorrentes das tensões de crescimento em árvores em pé e vivas de diferentes clones de Eucalyptus spp. Para tanto, foram selecionados 12 clones do gênero Eucalyptus com 9 anos de idade, por meio da área basal (G), sendo, estes, plantados em um espaçamento 3,0 x 2,7 m . Para as medições das variáveis do estudo, foram selecionadas 12 árvores de cada clone, onde foram medidas as vari...

  12. O impacto das crenças e das percepções de diversidade na relação entre diversidade e eficácia do trabalho em equipa

    OpenAIRE

    Ferreira, Inês de Moura

    2011-01-01

    Mestrado em Psicologia Social e das Organizações Apesar das várias tipologias e abordagens para explicar e compreender os efeitos da diversidade no funcionamento e na eficácia do trabalho em equipa, os resultados das investigações empíricas têm-se revelado muitas vezes inconclusivos e contraditórios. O presente estudo pretende contribuir para uma melhor compreensão dos efeitos da diversidade no desempenho das equipas, não só pela forma alternativa de definir e operacionalizar a...

  13. Das DNA-Puzzle

    Science.gov (United States)

    Kirchner, Stefan

    Im Jahre 1953 wurde von James Watson und Francis Crick erstmalig der strukturelle Aufbau der sogenannten DNA (Desoxyribonukleinsäure) beschrieben, welche das Erbgut jedes Lebewesens enthält. Der wesentliche Teil des Erbguts wird dabei durch eine sehr lange Folge der vier Basen Adenin (A), Cytosin (C), Guanin (G) und Thymin (T) codiert. Seit einigen Jahren ist es möglich, die Folge der vier Basen zu einer gegebenen DNA zu bestimmen. Biologen bezeichnen diesen Vorgang als Sequenzierung.

  14. Filosofia das ciências sociais: temas atuais

    OpenAIRE

    Kincaid, Harold

    2014-01-01

    A filosofia das ciências sociais, concebida da maneira adequada, tem algo a oferecer aos que praticam as ciências sociais. Os cientistas sociais adotam em suas pesquisas, ainda que de forma implícita, alguma filosofia de sua ciência. Para evitar impasses, é melhor explicitar essa filosofia e ser criticamente consciente dos seus méritos. A filosofia das ciências sociais, por sua vez, não pode ser praticada sem um envolvimento íntimo com a pesquisa social. O artigo esboça alguns desenvolvimento...

  15. Das Bild behinderter Menschen in den Medien

    OpenAIRE

    Radtke, Peter

    2006-01-01

    Das Bild von Behinderung und behinderten Menschen in den Medien“ - dieses Thema führt sehr leicht zur Schwarz-Weiß-Malerei. Bekanntlich fällt es schwer, es allen recht zu machen. So nimmt es nicht Wunder, dass sich Betroffene und ihre Angehörigen in den Medien sowohl quantitativ als auch qualitativ oftmals nicht angemessen repräsentiert fühlen. [...] In dieser Situation bilden die Medien die wichtigste und oft einzige Informationsquelle über das Leben und die Möglichkeiten von Menschen mit e...

  16. Das Curriculum Health Technology Assessment (HTA, Version 2.0

    Directory of Open Access Journals (Sweden)

    Perleth, Matthias

    2017-10-01

    Full Text Available Health Technology Assessments (HTAs liefern für zahlreiche Entscheidungen im Gesundheitswesen relevante Informationen. Die Erstellung von HTA-Berichten erfordert gut ausgebildete, interdisziplinär arbeitende Spezialisten, die angemessene Interpretation und Umsetzung in Entscheidungen erfordert Verständnis seitens der Entscheidungsträger.Der Verein zur Förderung der Technologiebewertung im Gesundheitswesen (Health Technology Assessment e.V. und das Deutsche Netzwerk Evidenzbasierte Medizin e.V. haben bereits 2006 ein HTA-Curriculum entwickelt, das als Grundlage für HTA-Fortbildungskurse sowohl für Nutzer von HTA-Informationen wie auch für HTA-Autoren dient. Das Curriculum ist u.a. Grundlage für Fortbildungskurse an mehreren Universitäten. Aufgrund methodischer Weiterentwicklungen wurde nun eine Überarbeitung des Curriculums erforderlich. Das Curriculum greift auf Struktur und Inhalte international etablierter Studiengänge zurück, berücksichtigt aber auch die Besonderheiten der Regulation von Technologien und der Entscheidungsfindung in den Gesundheitssystemen der deutschsprachigen Länder. Es ist in insgesamt 10 Module untergliedert, die neben Grundlagen und Prinzipien von HTA u.a. auf die Statusbestimmung von Technologien, Prioritätensetzung, Wissens- und Informationsmanagement, Methodik der Erstellung von HTA-Berichten und Interessenkonflikte eingehen. Gegenüber der ursprünglichen Version wurden viele Inhalte präzisiert und Erfahrungen aus Lehrveranstaltungen, die das Curriculum umsetzen, wurden berücksichtigt.

  17. Correlations between IL6 and the main clinical and biological parameters in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mihaela Chicu

    2016-09-01

    Full Text Available Introduction: Cytokines are a family of complex peptide with hormone-like activity. They are soluble proteins without enzymatic activity and serves as the main intracellular mediators. Many cytokines achieves its effects by binding to special receptors membrane, and their adjustment is via soluble receptors. Cytokines are characterized by pleiotropism, overlapping and mutual adjustment. Proinflammatory cytokine involved in major rheumatoid arthritis are TNF, IL1α, IL1β, IL8.The biological effects of IL6 overlap in large part over those of TNF. If TNF is involved in induction of apoptosis or programmed cell death, IL6 is specifically associated with angiogenic factors activation and the occurrence of neovascularity to the synovium; favors articular cartilage degradation by increasing the release of MMP, decreasing PG, recruit osteoclasts, apoptosis of osteoblasts, release of degradative enzymes and the inflammatory mediators - iNOS, COX2 - TNF, IL6, IL8.Material and methods: Based on these data we proposed and realized – for the first time in Romania – the measurement of IL6 levels and the correlation with values of DAS28 score, HAQ, ESR, CRP, Hb and the immunological parameters too. The study was conducted on a group of 80 sick diagnosed with RA in various stages of evolution, under treatment with disease-modifying medication , type Methotrexate, Arava.Conclusions: Levels of IL-6 correlate a direct manner with those of acute phase reactants ,ESR, CRP and indirect values of Hb, IgG; the clinical parameters (number of tender and swollen joints, DAS28, HAQ are not influenced by values IL6.

  18. Validação da metodologia de quantificação espectrofotométrica das saponinas de Pfaffia glomerata (Spreng. Pedersen - Amaranthaceae

    Directory of Open Access Journals (Sweden)

    C.L.S. Vigo

    Full Text Available Realizou-se validação analítica espectrofotométrica das saponinas totais das raízes de Pfaffia glomerata. Em testes iniciais utilizou-se saponina Merck em cinco concentrações (0,08-0,28 mg/ml para obtenção da curva de calibração e verificação da linearidade, repetibilidade e reprodutibilidade. As raízes foram avaliadas em extratos hidroalcoólicos purificados com n-butanol. O reagente cromogênico escolhido foi Cloreto de Cobalto 0,2% em pico experimental em 284nm. O tempo de leitura ideal foi de 10-20 minutos após o início da reação. O método mostrou linearidade para a faixa de concentrações utilizadas (R²= 0,9963. A precisão (coeficientes de variação situou-se entre 7-12%, indicando boa reprodutibilidade. O limite de quantificação situou-se em 0,08 mg/ml e o limite de detecção em 0,02 mg/ml. A exatidão do procedimento forneceu erro relativo de 6,3; 3,4; 3,5; 1,8 e 0,3% para as concentrações utilizadas. Os dados da curva-padrão foram aplicados em várias amostras de raízes levando ao valor média de 13,5±2,0%. Os dados obtidos permitem a quantificação espectrofotométrica das saponinas totais das raízes de P. glomerata.

  19. Determination of 28 elements in American cigarette tobacco by neutron-activation analysis

    International Nuclear Information System (INIS)

    Iskander, F.Y.; Bauer, T.L.; Klein, D.E.

    1986-01-01

    The concentrations of 28 toxic and other elements in cigarette tobacco of twelve brands commercially manufactured in the USA were determined using instrumental neutron-activation analysis. The elements determined were Al, As, Ba, Br, Ca, Ce, Cl, Co, Cr, Cs, Eu, Fe, Hf, K, La, Mg, Mn, Na, Ni, Rb, Sb, Sc, Se, Sr, Th, Ti, V and Zn. The concentrations of the determined elements in the American cigarettes were compared with the elemental concentrations reported for Iranian, Pakistani and Japanese brands. It was concluded that the concentrations of As, Br, Ca, Eu, K and Zn in the samples under investigation are lower than those reported for the analysis of University of Kentucky reference cigarettes, whereas the concentrations of Mn and Na are higher. The contents of Al, Cl, Co, Cr, Cs, Fe, La, Sb, Sc, and Se are similar to those in the reference cigarettes. (author)

  20. Quality of sleep, physical activity and fatigue in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Jennum, Poul Jørgen

    2012-01-01

    a rheumatology outpatient clinic were recruited consecutively to participate in an observational cross-sectional study. The self-administered questionnaire covered the Health Assessment Questionnaire (HAQ), Visual Analogue Scale (VAS) for pain and fatigue, Physical Activity Scale (PAS), Multidimensional Fatigue...... to Physical Activity (PA) and fatigue. Understanding PA, fatigue and the impact on sleep disturbances could illuminate ways to promote sufficient sleep in RA patients. Thus, the aim of this study was to examine the association between sleep disturbance, PA, and fatigue. Methods A total of 500 RA patients from...... of 58 years), and 80% were women. The mean disease duration was 14 years and mean DAS score was 2.7. The prevalence of poor sleep quality was 61 %. Higher level of general fatigue, mental fatigue, physical fatigue, reduced activity and reduced motivation was reported in patients with poor sleep quality...