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Sample records for ra patients methods

  1. A novel method predicting clinical response using only background clinical data in RA patients before treatment with infliximab.

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    Miyoshi, Fumihiko; Honne, Kyoko; Minota, Seiji; Okada, Masato; Ogawa, Noriyoshi; Mimura, Toshihide

    2016-11-01

    The aim of the present study was to generate a novel method for predicting the clinical response to infliximab (IFX), using a machine-learning algorithm with only clinical data obtained before the treatment in rheumatoid arthritis (RA) patients. We obtained 32 variables out of the clinical data on the patients from two independent hospitals. Next, we selected both clinical parameters and machine-learning algorithms and decided the candidates of prediction method. These candidates were verified by clinical variables on different patients from two other hospitals. Finally, we decided the prediction method to achieve the highest score. The combination of multilayer perceptron algorithm (neural network) and nine clinical parameters shows the best accuracy performance. This method could predict the good or moderate response to IFX with 92% accuracy. The sensitivity of this method was 96.7%, while the specificity was 75%. We have developed a novel method for predicting the clinical response using only background clinical data in RA patients before treatment with IFX. Our method for predicting the response to IFX in RA patients may have advantages over the other previous methods in several points including easy usability, cost-effectiveness and accuracy.

  2. Productivity loss due to absenteeism and presenteeism by different instruments in patients with RA and subjects without RA

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    Braakman-Jansen, Louise Marie Antoinette; Kuper, Ina H.; van de Laar, Mart A F J; Taal, Erik

    2012-01-01

    Objectives. To explore the impact of at-work productivity loss on the total productivity cost by different instruments in patients recently diagnosed with RA and controls without RA. Methods. Cross-sectional data were collected from outpatients with RA between December 2007 and February 2008. The

  3. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

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    Yanagawa, Noriyo, E-mail: noriyo_yana@ybb.ne.jp [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Sakai, Fumikazu [Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298 (Japan); Takemura, Tamiko [Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935 (Japan); Ishikawa, Satoru [Department of Respiratory Medicine, National Hospital Organization Chiba-East-Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712 (Japan); Takaki, Yasunobu [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Hishima, Tsunekazu [Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Kamata, Noriko [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan)

    2013-11-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups.

  4. Rapid Method for Ra-226 and Ra-228 in Water Samples

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    Maxwell, Sherrod, L. III

    2006-02-10

    The measurement of radium isotopes in natural waters is important for oceanographic studies and for public health reasons. Ra-226 (1620 year half-life) is one of the most toxic of the long-lived alpha emitters present in the environment due to its long life and its tendency to concentrate in bones, which increases the internal radiation dose of individuals. The analysis of radium-226 and radium-228 in natural waters can be tedious and time-consuming. Different sample preparation methods are often required to prepare Ra-226 and Ra-228 for separate analyses. A rapid method has been developed at the Savannah River Environmental Laboratory that effectively separates both Ra-226 and Ra-228 (via Ac-228) for assay. This method uses MnO{sub 2} Resin from Eichrom Technologies (Darien, IL, USA) to preconcentrate Ra-226 and Ra-228 rapidly from water samples, along with Ba-133 tracer. DGA Resin{reg_sign} (Eichrom) and Ln-Resin{reg_sign} (Eichrom) are employed in tandem to prepare Ra-226 for assay by alpha spectrometry and to determine Ra-228 via the measurement of Ac-228 by gas proportional counting. After preconcentration, the manganese dioxide is dissolved from the resin and passed through stacked Ln-Resin-DGA Resin cartridges that remove uranium and thorium interferences and retain Ac-228 on DGA Resin. The eluate that passed through this column is evaporated, redissolved in a lower acidity and passed through Ln-Resin again to further remove interferences before performing a barium sulfate microprecipitation. The Ac-228 is stripped from the resin, collected using cerium fluoride microprecipitation and counted by gas proportional counting. By using vacuum box cartridge technology with rapid flow rates, sample preparation time is minimized.

  5. THE IMMUNOLOGICAL CHARACTERISTIC OF RA PATIENTS WITH ANAEMIA

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    A. E. Sizikov

    2014-07-01

    Full Text Available Abstract. The aim of the investigation was to study the immunological characteristics of RA patients with anaemia. Clinical and laboratory data including the percentage of the main lymphocyte subclasses, phagocyte and DTH-effector activity, serum concentration of immunoglobulins, the percentage of cells producing IFNγ and/or IL-4 and percent of monocytes producing TNF. We revealed some significant clinical, laboratory and immunological differences between RA patients and healthy donors and between patients with and without anaemia. Our data demonstrate RA anemic patients to have more severe disorders than patients without anaemia. We also revealed some significant immunological differences between RA patients and healthy donors and between patients with and without anaemia, including percent of cells producing IFNγ and/or IL-4. Our data permit to conclude that RA patients have many different immunological disturbances, more severe in anaemic patients.

  6. Polymorphism analysis of IL17RA gene to the IL17RA concentration and chronicity differences in nefritis lupus NL patients

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    Mahrus Ismail

    2014-12-01

    Full Text Available Nefritis lupus (NL is autoimmune disease and one of serious complication from Systemic Eritematosus Lupus (LES. Clinical manifestation of NL was variated, there are hematuria microscopic asymptomatic until renal failure. In addition of clinical manifestation, the NL disorder degree also measured from histopathological grade. Although, the mechanism that mixed up with pathogenesis of NL was known, however the cytokine also play a role to the disease process. The cytokine that assumpted have a role to the inflammation is IL-17RA, the increase production of IL-17RA influenced to the in-flammation and NL chronicity degree. The aim of this study to analyzed the relationship between polymorphism of IL-17RA gene, blood IL-17RA con-centration with the NL disorder degree. These studies were used cross sectional with control case design. The sample were used 40 patients consist NL pa-tients and Lupus patient without nephritis as a control. The polymorphisms of IL-17RA gene were investigated by using PCR method and gene sequence analysis. The alterations of allele frequency of IL-17RA gene were analyzed by bioinformatics method. The bloods IL-17RA concentration were in-vestigated by ELISA method. The NL chronicity degrees were investigated by NL histopathological grade. The hypothesis were proofed by data normality test and homogeneity test, Chi-square and Odds ratio, Spearman correlation by using SPSS 17.0 for windows. The result of showed that there are sig-nificantly different between IL-17RA gene mutant genotype frequency of NL patient (NL with the control patient with value OR 8.48. There are sig-nificantly different between G allele of IL-17RA gene of NL patient (case with the control patient with the value OR 4.17. There are no significantly di-fferent between IL-17RA concentrations of NL patient (case with the different chronicity value. There are positive correlation with the OR value 4.17 bet-ween IL-17RA concentrations with the chronicity value

  7. Productivity loss due to absenteeism and presenteeism by different instruments in patients with RA and subjects without RA.

    Science.gov (United States)

    Braakman-Jansen, Louise M A; Taal, Erik; Kuper, Ina H; van de Laar, Mart A F J

    2012-02-01

    To explore the impact of at-work productivity loss on the total productivity cost by different instruments in patients recently diagnosed with RA and controls without RA. Cross-sectional data were collected from outpatients with RA between December 2007 and February 2008. The control group was formed by subjects without RA matched on age and gender. Absenteeism and presenteeism were estimated by the Quantity and Quality (QQ) Questionnaire, Work Productivity and Activity Impairment Questionnaire General Health V2.0 (WPAI-GH) and Health and Labor Questionnaire (HLQ) questionnaires. Differences between groups were tested by Mann-Whitney U-test. Costs were valued by the human capital approach. Data were available from 62 patients with a paid job and 61 controls. QQ- and WPAI-GH scores of presenteeism were moderately correlated (r = 0.61) while the HLQ presenteeism score correlated poorly with the other instruments (r = 0.34). The contribution of presenteeism on total productivity costs was estimated at ∼70% in the RA group. The mean costs per person per week due to presenteeism varied between €79 and €318 per week in the RA group, dependent on the instrument used. The costs due to presenteeism were about two to four times higher in the RA group compared with the control group. This study indicates that the impact of presenteeism on the total productivity costs in patients with RA is high. However, work productivity in individuals without RA was not optimal either, which implies a risk of overestimation of cost when a normal score is not taken into account. Finally, different presenteeism instruments lead to different results.

  8. Energy efficient LoRa GPS tracker for dementia patients.

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    Hadwen, Tim; Smallbon, Vanessa; Qing Zhang; D'Souza, Matthew

    2017-07-01

    Continuous GPS tracking devices always suffer short battery life when used by caregivers to reduce the risk of wandering to dangerous areas by dementia patients. Currently the best existing tracker for dementia patients on the market only supports less than 10 hours battery life with a gigantic battery. It not only requires daily battery charging from patients/caregivers, but also becomes a very restrictive device. In this paper we inspected individual energy consumption of the components in a GPS tracker and proposed a novel energy efficient, small wristband by integrating the latest LoRa communication and GPS duty cycling technologies. We verify our prototype's communication distance and energy efficiency through extensive experiments in the real world. Our model and data show the GPS wristband is able to support up to 40 hours continuous GPS tracking with a frequent 60 seconds location update rate. Its range also spans 3km, effectively monitoring patient locations.

  9. Radiation exposure of relatives of patients treated with Ra-223 dichloride; Strahlenexposition von Angehoerigen bei Therapie mit Ra-223-Dichlorid

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    Wanke, C.; Szermerski, B.; Solle, A.; Geworski, L. [Medizinische Hochschule Hannover (Germany). Stabsstelle Strahlenschutz und Abt. Medizinische Physik; Pinkert, J. [Bayer Vital GmbH, Leverkusen (Germany); Kranert, W.T. [Frankfurt Univ. (Germany). Klinik fuer Nuklearmedizin; Andreeff, M. [Universitaetsklinikum ' ' Carl Gustav Carus' ' TU Dresden (Germany). Klinik fuer Nuklearmedizin

    2015-07-01

    Since November 2013, a radiopharmaceutical containing Ra-223 dichloride as active substance is approved in the European Union for patients with castration resistant prostate cancer with symptomatic bone metastases and no known visceral metastases. Ra-223 (T{sub 1/2} = 11.43 d) decays via a chain of 4 alpha and 2 beta decays. This therapy is presently the only application of an alpha emitter in clinical routine therapy. To show that the exposure of relatives and caregivers of patients treated with Ra-223 dichloride in an outpatient setting does not exceed a value of 1 mSv, the multicenter study ''RAPSODY'' was conducted. As Ra-223 and most of its progeny emit alpha particles, the internal exposure had to be evaluated in particular. Within this study, measurements of the radiation emitted from the patient were performed using standard dose-rate meters. Wipe-tests were taken in the patients' homes to identify significant contaminations and evaluated by liquid scintillation counting. Samples of saliva and sweat were taken and measured using gamma spectrometry. Ra-223 disintegrates to the noble gas Rn-219 and was measured in the exhaled breath from the patients using conventional Radon Monitors. Furthermore, a computational fluid dynamics simulation (CFD) was performed to assess the radioactivity in the air, which could be inhaled by persons close to the patient. Conclusions: The potential exposure of relatives and caregivers by external irradiation and incorporation of radioactivity exhaled or excreted by the patient with saliva or sweat is well below 1 mSv. No objections are seen regarding outpatient treatment. This paper summarizes contents of a poster presented at the Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging.

  10. [Risk factors for osteoporotic fractures of spine in RA patients].

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    Sun, Yu; Liu, Qiming; Zhao, Qinghua; Zhang, Jian; Li, Feng; Zhang, Ke

    2015-09-15

    To investigate the risk factors of osteoporotic fractures (OPF) in patients with RA. From February 2011 to March 2015, 244 patients with rheumatoid arthritis (RA) were treated in Department of Orthopedics, Huaibei People's Hospital, according to the occurrence of osteoporotic fractures (OPF) into the OPF group (n=31) and the non OPF group (n=213), observed two groups general information, glucocorticoid usinge, -28 joint disease activity score (DAS28), health status Questionnaire (HAQ), C-reactive protein (CRP), anti-cyclic citrullinated peptide (CCP) antibody, erythrocyte sedimentation rate (ESR), etc. OPF group the mean age and disease duration for (64.3±10.9) years and (9.0±3.3) years were significantly higher than that of non OPF group (57.4±11.2) years and (6.0±2.7) years (POPF group and non OPF group ESR, CRP, anti CCP, HAQ and DAS28 difference was not statistically significant (P>0.05); OPF group sharp score (56.0±18.4), hormone use time (785 d), and hormone cumulant (7,100 mg·d) were significantly higher than that in non OPF group [sharp score (86.1±17.1), hormone use time (191 d), and hormone cumulant (1,900 mg·d)], the difference was statistically significant (POPF femoral neck, Ward area, total femur area and thoracic spine 2-3 bone mineral density T value significantly lower than non OPF group (P<0.05). Age and osteoporosis are risk factors for the occurrence of osteoporotic fractures in patients with rheumatoid arthritis, so patients should conduct a risk assessment to guide rational drug use.

  11. Drugs or disease: evaluating salivary function in RA patients

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    Sandra Regina TORRES

    Full Text Available Abstract Oral complications of RA may include temporomandibular joint disorders, mucosa alterations and symptoms of dry mouth. The aim of this study was to evaluate the salivary gland function of subjects with rheumatoid arthritis (RA comparing it to healthy controls. Subjects with other systemic conditions known to affect salivary functions were excluded. A questionnaire was applied for the evaluation of xerostomia. Resting and chewing-stimulated salivary flow rates (SFR were obtained under standard conditions. There were 145 subjects included of the study (104 RA and 38 controls. About 66.7% of the RA subjects and 2.4% in control group presented xerostomia. The median resting SFR were 0.24 ml/min for RA subjects and 0.40 mL/min for controls (p = 0.04. The median stimulated SFR were 1.31 mL/min for RA subjects and 1.52 ml/min for controls (p = 0.33. No significant differences were found between resting and stimulated SFR of RA subjects not using xerogenic medications and controls. There was significantly higher number of subjects presenting hyposalivation in the RA group than among controls, even when subjects using xerogenic medications were eliminated from the analysis. In conclusion, hyposalivation and xerostomia were more frequent among RA subjects not using xerogenic medication than among controls, although there were no significant differences in the median SFR between groups.

  12. Assessing Medication Adherence in Patients with Rheumatoid Arthritis (RA)

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    2017-03-24

    the moat useful method Jn the dnlcal aetting The Morisky Medle1tion Adherence Scale ( MMAS ) waa developed to UHH medlcebon adherence Intent 1nd hll...been v1Ud11ed in sever.I common dl1HM but not In RA There ue several v1ri1tion1 of the MMAS but we used the MMA $a8 which hll eight qu11tion1 The...than 1 minute 1IO oomplei. lh• MMAS -3 OBJECTIVES The p.n.m1ry cbjec:trve i i to dtt1rm1ne tf there 11 a conellt>on between the COR Uil, COR5, and

  13. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Patient Education in the Management of Rheumatoid Arthritis (RA)

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    Brosseau, Lucie; Wells, George A.; Tugwell, Peter; Egan, Mary; Dubouloz, Claire-Jehanne; Welch, Vivian A.; Trafford, Laura; Sredic, Danjiel; Pohran, Kathryn; Smoljanic, Jovana; Vukosavljevic, Ivan; De Angelis, Gino; Loew, Laurianne; McEwan, Jessica; Bell, Mary; Finestone, Hillel M.; Lineker, Sydney; King, Judy; Jelly, Wilma; Casimiro, Lynn; Haines-Wangda, Angela; Russell-Doreleyers, Marion; Laferriere, Lucie; Lambert, Kim

    2012-01-01

    Background and purpose: The objective of this article is to create guidelines for education interventions in the management of patients ([greater than] 18 years old) with rheumatoid arthritis (RA). Methods: The Ottawa Methods Group identified and synthesized evidence from comparative controlled trials using Cochrane Collaboration methods. The…

  14. HMM_RA: An Improved Method for Alpha-Helical Transmembrane Protein Topology Prediction

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    Changhui Yan

    2008-01-01

    Full Text Available α-helical transmembrane (TM proteins play important and diverse functional roles in cells. The ability to predict the topology of these proteins is important for identifying functional sites and inferring function of membrane proteins. This paper presents a Hidden Markov Model (referred to as HMM_RA that can predict the topology of α-helical transmembrane proteins with improved performance. HMM_RA adopts the same structure as the HMMTOP method, which has five modules: inside loop, inside helix tail, membrane helix, outside helix tail and outside loop. Each module consists of one or multiple states. HMM_RA allows using reduced alphabets to encode protein sequences. Thus, each state of HMM_RA is associated with n emission probabilities, where n is the size of the reduced alphabet set. Direct comparisons using two standard data sets show that HMM_RA consistently outperforms HMMTOP and TMHMM in topology prediction. Specifically, on a high-quality data set of 83 proteins, HMM_RA outperforms HMMTOP by up to 7.6% in topology accuracy and 6.4% in α-helices location accuracy. On the same data set, HMM_RA outperforms TMHMM by up to 6.4% in topology accuracy and 2.9% in location accuracy. Comparison also shows that HMM_RA achieves comparable performance as Phobius, a recently published method.

  15. Follow-up study of late effects in /sup 224/Ra treated ankylosing spondylitis patients

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    Wick, R.R.; Goessner, W.

    1983-01-01

    Fifteen hundred thirty-one patients treated with /sup 224/Ra from 14 hospitals in the F.R.G. and 267 control patients with ankylosing spondylitis not treated with any form of ionizing radiation are being followed. Since 1970 three cases of malignant tumour in the skeleton have been found among /sup 224/Ra-treated patients with skeletal doses below 90 rad compared with 0.4-0.6 expected. Two of these three cases were tumours of the bone marrow. An effect of /sup 224/Ra on the haematopoietic system cannot be excluded. Also, seven cases of cataract were found among 274 /sup 224/Ra patients. The mean time since /sup 224/Ra treatment was 26 yr. The mean age at diagnosis was 66 yr. The cataract incidence was not unusual for people of this age.

  16. Specificities of anti-neutrophil autoantibodies in patients with rheumatoid arthritis (RA)

    DEFF Research Database (Denmark)

    Brimnes, J; Halberg, P; Jacobsen, Søren

    1997-01-01

    The objective of this study was to characterize antigens recognized by neutrophil-specific autoantibodies from patients with RA. Sera from 62 RA patients were screened by indirect immunofluorescence (IIF). Positive sera were further tested by ELISAs for antibodies against various granule proteins......D from nuclei. In conclusion, anti-neutrophil autoantibodies from RA patients recognize different antigens in the cytoplasm and in the nucleus. Lactoferrin is one of the common antigens recognized, but also unknown nuclear antigens of 25-35 kD mol. wt are involved....

  17. An easy method for Ra-226 determination in river waters by liquid-scintillation counting

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    Moreno, H. P.; Vioque, I.; Manjón, G.; García-Tenorio, R.

    1999-01-01

    226Ra activity concentration in river water was determined using a low background liquid scintillation counter. Radium was extracted from the samples as Ra-BaSO4 precipitate which, afterwards, was dissolved with EDTA in ammonia medium. Solution was transferred into a low potassium glass vial and then mixed with a scintillation cocktail. Two different scintillation cocktails were selected for comparison. Efficiency, recovery yield and α/β separation were studied with both liquid scintillation cocktails. One single measurement, made one month after radium separation, allows to calculate the226Ra concentration as well as to assess the presence of alpha contamination of the sample. In the case of negligible interferences,224Ra concentrations can be subsequently evaluated in the same sample by the measurement made just after chemical separation of radium. This method has been applied for the determination of226Ra and224Ra activity concentrations in river water collected from different locations along the Odiel river estuary area (South-west of Spain). The presence of chemical industry, the wastes of which are released into the river, could be connected with radium activity concentration enhancements in the water.

  18. Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra

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    Schmitt, E. (Universitatsklinik Friedrichsheim, Frankfurt, West Germany); Ruckbeil, C.; Wick, R.R.

    1983-01-01

    Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

  19. Rheumatologists' knowledge, attitude and current management of fatigue in patients with rheumatoid arthritis (RA).

    NARCIS (Netherlands)

    Repping-Wuts, H.; Riel, P.L.C.M. van; Achterberg, T. van

    2008-01-01

    To describe rheumatologists' knowledge, attitude and current management of fatigue in patients with rheumatoid arthritis (RA), a postal questionnaire was sent to all rheumatologists (N = 204) and trainees (N = 49), members of the Dutch Society of Rheumatology. The overall response rate was 44% (N =

  20. Association of IL-1ra and adiponectin with C-peptide and remission in patients with type 1 diabetes

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    Pfleger, C.; Hansen, L.; Herder, C.

    2008-01-01

    with recent-onset type 1 diabetes. RESEARCH DESIGN AND METHODS: Serum was obtained from 256 newly diagnosed patients (122 males and 134 females, median age 9.6 years). Stimulated C-peptide, blood glucose, and A1C were determined in addition to circulating concentration of cytokines at 1, 6, and 12 months...... after diagnosis. Analyses were adjusted for sex, age, and BMI percentile. RESULTS: Anti-inflammatory IL-1ra was positively associated with C-peptide after 6 (P = 0.0009) and 12 (P = 0.009) months. The beneficial association of IL-1ra on beta-cell function was complemented by the negative association...... of IL-1 beta with C-peptide after 1 month (P = 0.009). In contrast, anti-inflammatory adiponectin was elevated in patients with poor metabolic control after 6 and 12 months (P

  1. Factors associated with influenza and pneumococcal vaccine uptake among rheumatoid arthritis patients in Denmark invited to participate in a pneumococcal vaccine trial (Immunovax_RA)

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    Nguyen, MTT; Lindegaard, H.; Hendricks, O.

    2017-01-01

    Objective: This study investigates predictors of influenza and pneumococcal vaccine coverage among rheumatoid arthritis (RA) patients, and explores possible differences according to type of RA therapy. Method: RA patients from two clinics in the region of Southern Denmark were informed about...... the survey during scheduled follow-up visits. The questionnaire included questions concerning previous influenza and pneumococcal vaccine uptake, attitudes about vaccination, and socio-demographic factors. Factors associated with recalled vaccine uptake were assessed by multivariate logistic regression......-rheumatic drugs (bDMARDs). Self-reported uptake of vaccination against seasonal influenza ever was 59% overall; 57% among patients receiving cDMARDs and 61% in patients receiving bDMARDs. Self-reported vaccine uptake against pneumococcal diseases was only 6% overall. Older age, educational level, and information...

  2. The performance of matrices in daily clinical practice to predict rapid radiologic progression in patients with early RA.

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    De Cock, D; Vanderschueren, G; Meyfroidt, S; Joly, J; Van der Elst, K; Westhovens, R; Verschueren, P

    2014-04-01

    To compare in daily clinical practice the reliability of matrices that forecast rapid radiologic progression (RRP) at year one, at year two, and over 2 years in patients with early rheumatoid arthritis (RA). Overall, 74 early RA patients with X-rays of hands and feet at baseline, year one, and year two were included. Initial DMARD combination therapy with steroids (ICTS) or DMARD monotherapy (IMT) was initiated according to patients' RA severity, based on rheumatologist opinion. The images were scored via the modified Sharp/van der Heijde (SvH) method. A total Sharp score progression of equal or higher than five per year was considered RRP. Six matrices were tested: ASPIRE CRP/ESR matrices, the BEST matrix, two SWEFOT matrices, and the ESPOIR matrix. Patients were placed in each of them yielding a RRP probability. The performance was tested by Area Under the Curve analysis reflecting the predictive value. Four patients developed RRP in year one, five in year two, and four over 2 years. With regard to face validity, the predicted probability did not correspond to the risk in reality: the one ICTS patient who developed RRP over 2 years was always found in the lowest RRP categories of all matrices. The ASPIRE CRP matrix yielded at least a moderate predicting value for the three time points. The other matrices showed moderate to no predicting value. The performance of all matrices was disappointing and it is impossible to fully rely on the existing matrices in daily clinical practice. © 2013 Published by Elsevier Inc.

  3. Stages of change, barriers, benefits, and preferences for exercise in RA patients: a cross-sectional study.

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    Henchoz, Y; Zufferey, P; So, A

    2013-01-01

    To determine the distribution of exercise stages of change in a rheumatoid arthritis (RA) cohort, and to examine patients' perceptions of exercise benefits, barriers, and their preferences for exercise. One hundred and twenty RA patients who attended the Rheumatology Unit of a University Hospital were asked to participate in the study. Those who agreed were administered a questionnaire to determine their exercise stage of change, their perceived benefits and barriers to exercise, and their preferences for various features of exercise. Eighty-nine (74%) patients were finally included in the analyses. Their mean age was 58.4 years, mean RA duration 10.1 years, and mean disease activity score 2.8. The distribution of exercise stages of change was as follows: precontemplation (n = 30, 34%), contemplation (n = 11, 13%), preparation (n = 5, 6%), action (n = 2, 2%), and maintenance (n = 39, 45%). Compared to patients in the maintenance stage of change, precontemplators exhibited different demographic and functional characteristics and reported less exercise benefits and more barriers to exercise. Most participants preferred exercising alone (40%), at home (29%), at a moderate intensity (64%), with advice provided by a rheumatologist (34%) or a specialist in exercise and RA (34%). Walking was by far the preferred type of exercise, in both the summer (86%) and the winter (51%). Our cohort of patients with RA was essentially distributed across the precontemplation and maintenance exercise stages of change. These subgroups of patients exhibit psychological and functional differences that make their needs different in terms of exercise counselling.

  4. Development of a liquid scintillation method for in vitro determination of {sup 226}Ra and {sup 228} Ra in bioassay samples

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    Fernandes, Paulo Cesar P.; Sousa, Wanderson O.; Juliao, Ligia M.Q.C.; Dantas, Bernardo M., E-mail: pcesar@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    Radium isotopes are dispersed in the environment according to their physicochemical characteristics. The intake of {sup 226}Ra and {sup 228}Ra in humans can occur by inhalation and ingestion and the risk of internal exposure are related to their long half-lives, characteristics of the emission and biokinetics of the isotopes in the human body. The goal of this work is to develop a methodology for the analysis of {sup 226}Ra and {sup 228}Ra in excreta samples (urine and feces), using liquid scintillation technique. Excreta samples were provided by non-exposed humans for the purpose of standardizing the methodology and the establishment of a background level of radium excretion. Radium isotopes were concentrated and separated from the constituents of the sample by co-precipitation with barium sulphate. The precipitate of Ba(Ra)SO{sub 4} was filtrated and weighted for the determination of the chemical yield. The filter containing the precipitate was transferred to a scintillation vial. In the scintillation vial, 8 mL of water, 8 mL of Instagel XF and 4 mL of UltimaGold were added, forming a gel suspension, after stirring the solution. The {sup 226}Ra and {sup 228}Ra activities were determined 21 days after the precipitation of samples. The samples were counted in a liquid scintillation spectrometer. The technique presented adequate sensitivity and reproducibility for the analysis of urine and feces. The activities of {sup 226}Ra and {sup 228}Ra in excreta samples provide useful information for the identification of the main route of intake and for the assessment of the internal exposure of occupationally exposed workers and inhabitants of high background areas. (author)

  5. Specificities of anti-neutrophil autoantibodies in patients with rheumatoid arthritis (RA)

    DEFF Research Database (Denmark)

    Brimnes, J; Halberg, P; Jacobsen, Søren

    1997-01-01

    neutrophils showed IgG reactions at 25-35 kD, in the 55-kD region, at 80 kD, and at 110 kD. Most sera reacted with more than one band. Except for the 55-kD antigen, none of the antigens appeared in lymphocytes. The most notable reactivity in subcellular fractions was with lactoferrin and with bands of 25-35 k......D from nuclei. In conclusion, anti-neutrophil autoantibodies from RA patients recognize different antigens in the cytoplasm and in the nucleus. Lactoferrin is one of the common antigens recognized, but also unknown nuclear antigens of 25-35 kD mol. wt are involved....

  6. Early vascular alterations in SLE and RA patients--a step towards understanding the associated cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Maria José Santos

    Full Text Available Accelerated atherosclerosis represents a major problem in both systemic lupus erythematosus (SLE and rheumatoid arthritis (RA patients, and endothelial damage is a key feature of atherogenesis. We aimed to assess early endothelial changes in SLE and RA female patients (127 SLE and 107 RA without previous CV events. Biomarkers of endothelial cell activation (intercellular adhesion molecule-1 (sICAM-1, vascular cell adhesion molecule-1 (sVCAM-1, thrombomodulin (TM, and tissue factor (TF were measured and endothelial function was assessed using peripheral artery tonometry. Reactive hyperemia index (RHI, an indicator of microvascular reactivity, and augmentation index (AIx, a measure of arterial stiffness, were obtained. In addition, traditional CV risk factors, disease activity and medication were determined. Women with SLE displayed higher sICAM-1 and TM and lower TF levels than women with RA (p = 0.001, p<0.001 and p<0.001, respectively. These differences remained significant after controlling for CV risk factors and medication. Serum levels of vascular biomarkers were increased in active disease and a moderate correlation was observed between sVCAM-1 levels and lupus disease activity (rho = 0.246 and between TF levels and RA disease activity (rho = 0.301. Although RHI was similar across the groups, AIx was higher in lupus as compared to RA (p = 0.04. Also in active SLE, a trend towards poorer vasodilation was observed (p = 0.06. In conclusion, women with SLE and RA present with distinct patterns of endothelial cell activation biomarkers not explained by differences in traditional CV risk factors. Early vascular alterations are more pronounced in SLE which is in line with the higher CV risk of these patients.

  7. Measuring the radium quartet (228Ra, 226Ra, 224Ra, 223Ra) in seawater samples using gamma spectrometry.

    Science.gov (United States)

    van Beek, P; Souhaut, M; Reyss, J-L

    2010-07-01

    Radium isotopes are widely used in marine studies (eg. to trace water masses, to quantify mixing processes or to study submarine groundwater discharge). While 228Ra and 226Ra are usually measured using gamma spectrometry, short-lived Ra isotopes (224Ra and 223Ra) are usually measured using a Radium Delayed Coincidence Counter (RaDeCC). Here we show that the four radium isotopes can be analyzed using gamma spectrometry. We report 226Ra, 228Ra, 224Ra, 223Ra activities measured using low-background gamma spectrometry in standard samples, in water samples collected in the vicinity of our laboratory (La Palme and Vaccarès lagoons, France) but also in seawater samples collected in the plume of the Amazon river, off French Guyana (AMANDES project). The 223Ra and 224Ra activities determined in these samples using gamma spectrometry were compared to the activities determined using RaDeCC. Activities determined using the two techniques are in good agreement. Uncertainties associated with the 224Ra activities are similar for the two techniques. RaDeCC is more sensitive for the detection of low 223Ra activities. Gamma spectrometry thus constitutes an alternate method for the determination of short-lived Ra isotopes. 2009 Elsevier Ltd. All rights reserved.

  8. Mercury flux from salt marsh sediments: Insights from a comparison between 224Ra/228Th disequilibrium and core incubation methods

    Science.gov (United States)

    Shi, Xiangming; Mason, Robert P.; Charette, Matthew A.; Mazrui, Nashaat M.; Cai, Pinghe

    2018-02-01

    In aquatic environments, sediments are the main location of mercury methylation. Thus, accurate quantification of methylmercury (MeHg) fluxes at the sediment-water interface is vital to understanding the biogeochemical cycling of mercury, especially the toxic MeHg species, and their bioaccumulation. Traditional approaches, such as core incubations, are difficult to maintain at in-situ conditions during assays, leading to over/underestimation of benthic fluxes. Alternatively, the 224Ra/228Th disequilibrium method for tracing the transfer of dissolved substances across the sediment-water interface, has proven to be a reliable approach for quantifying benthic fluxes. In this study, the 224Ra/228Th disequilibrium and core incubation methods were compared to examine the benthic fluxes of both 224Ra and MeHg in salt marsh sediments of Barn Island, Connecticut, USA from May to August, 2016. The two methods were comparable for 224Ra but contradictory for MeHg. The radiotracer approach indicated that sediments were always the dominant source of both total mercury (THg) and MeHg. The core incubation method for MeHg produced similar results in May and August, but an opposite pattern in June and July, which suggested sediments were a sink of MeHg, contrary to the evidence of significant MeHg gradients between overlying water and porewater at the sediment-water interface. The potential reasons for such differences are discussed. Overall, we conclude that the 224Ra/228Th disequilibrium approach is preferred for estimating the benthic flux of MeHg and that sediment is indeed an important MeHg source in this marshland, and likely in other shallow coastal waters.

  9. A Mutation in IL4RA Is Associated with the Degree of Pathology in Human TB Patients.

    Science.gov (United States)

    Hölscher, Christoph; Heitmann, Lisa; Owusu-Dabo, Ellis; Horstmann, Rolf D; Meyer, Christian G; Ehlers, Stefan; Thye, Thorsten

    2016-01-01

    The contribution of interleukin- (IL-) 4 receptor-alpha- (Rα-) dependent events in the pathogenesis of tuberculosis (TB) is controversial. We have recently shown IL-13 overexpression in mice to cause recrudescent Mtb replication and centrally necrotizing granulomas strongly resembling pathology of human TB. A deletion of IL-4Rα completely abrogates TB tissue pathology in these mice. To validate our results in human TB patients, we here determined the association of distinct variants of the IL4, IL13, IL4RA, IL13RA1, and IL13RA2 genes with cavity formation in a large Ghanaian cohort of HIV-negative individuals with newly diagnosed pulmonary TB. In fact, the structural variant of the IL4RA I50V, previously shown to result in enhanced signal transduction, was significantly associated with greater cavity size, and a variant of IL13RA2 was associated with disease in females. To evaluate whether the human-like TB pathology in IL-13-overexpressing mice is specifically mediated through the IL-4Rα subunit, we analyzed IL-13 transgenic mice with a genetic ablation of the IL-4Rα. In these mice, the IL-13-mediated increased susceptibility, human-like pathology of collagen deposition around centrally necrotizing granulomas, and alternative macrophage activation were abolished. Together, our genetic association study in human TB patients further supports the assumption that IL-13/IL-4Rα-dependent mechanisms are involved in mediating tissue pathology of human TB.

  10. Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin: supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens.

    Science.gov (United States)

    Jordan, Karin; Gralla, Richard; Rizzi, Giada; Kashef, Kimia

    2016-11-01

    Antiemetic guideline recommendations are inconsistent as to whether a neurokinin-1 receptor antagonist (NK1 RA) should be administered with a 5-hydroxytryptamine-3 (5HT3) RA + dexamethasone (DEX) in patients receiving carboplatin. Patients receiving cisplatin routinely receive an NK1 RA-containing regimen with a resulting 14-22 % benefit in no emesis rates over a 5-HT3 RA/DEX control. Recent studies suggest a similar benefit in patients receiving carboplatin. NEPA is the first fixed antiemetic combination agent and comprises the highly selective NK1 RA, netupitant, and pharmacologically distinct 5-HT3 RA, palonosetron (PALO). This paper presents the efficacy of NEPA in the subset of patients receiving carboplatin in a phase 3 trial (NCT01376297), in the context of aprepitant (APR) data in the carboplatin setting. One hundred ninety-six patients (47 % of all study patients: n = 145 NEPA + DEX; n = 51 APR + PALO + DEX) received carboplatin in a multinational, double-blind, randomized phase 3 study. Complete response (CR: no emesis/rescue) and no significant nausea (NSN: score ≤25 on 100 mm visual analog scale) rates were calculated. Cycle 1-4 overall (0-120 h) CR rates were similar for NEPA (80, 91, 92, and 93 %) and APR (82, 88, 88, and 90 %). Overall NSN rates were also similar (NEPA 84-96 %; APR 82-90 %). Response rates for NEPA and APR regimens were similar and consistent with prior studies evaluating the contribution of adding NK1 RAs in patients receiving carboplatin. Considering such evidence, guideline groups/practitioners should consider giving a NK1 RA antiemetic triplet in patients receiving carboplatin.

  11. Value of body mass index in the diagnosis of obesity according to DEXA in well-controlled RA patients.

    Science.gov (United States)

    Tello-Winniczuk, Nina; Vega-Morales, David; García-Hernandez, Pedro A; Esquivel-Valerio, Jorge A; Garza-Elizondo, Mario A; Arana-Guajardo, Ana C

    Rheumatoid arthritis (RA) has an indirect effect on body composition. Body mass index (BMI) is not a valid predictor of body fat in RA patients. To evaluate the accuracy of BMI in identifying obesity diagnosed according to dual energy X-ray absorptiometry (DXA) in well-controlled RA patients. An observational, cross-sectional, descriptive, analytical study. We used 3 different cutoffs for obesity as determined by DXA: >35% total fat, >40% total fat, and >35% central fat mass (central obesity). One hundred one patients were included. We found that 35% total fat corresponded to a BMI of 24kg/m2, with a sensitivity of 90% and specificity of 75% (area under the curve [AUC] 0.917); 40% total fat to a BMI of 25kg/m2, with a sensitivity of 86% and specificity of 39% (AUC 0.822); and 35% central fat mass to a BMI of 22kg/m2, with a sensitivity of 97% and specificity of 84% (AUC 0.951). Obesity according to DXA was underdiagnosed when the classic BMI cutoffs were used in well-controlled RA patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  12. Expression of Biomarkers CXCR4, IL11-RA, TFF1, MLF1P in Advanced Breast Cancer Patients with Bone Metastatic: a Diagnostic Study

    Directory of Open Access Journals (Sweden)

    Cosphiadi Irawan

    2017-02-01

    Full Text Available Aim: to analyze expression of biomarkers CXCR4, IL11-RA, TFF1 and MLF1P, and clinicopathology in advanced breast cancer patients with bone metastatic. Methods: this is a cross-sectional study. Analysis was done against a total of 92 breast cancer patients, including 46 bone metastatic patients and 46 non-bone metastatic patients. Immunohistochemistry and microarray analysis was performed in 81 formalin fixed paraffin embedded (FFPE samples from 81 patients were used. Data were collected through medical records, immunohistochemistry (IHC, and microarray with nanoString nCounterTM. Results: this article is part one of a two stage reporting research results. In part one we got the results of the IHC analysis, IL11-RA with cut-off ≥103.5 showed OR 3.803 (95 % confidence interval [CI], 1.375-10.581, p=0.010, MLF1P with cut-off ≥83.0 OR 2.784 (95% CI, 1.009-7.681, p=0.048, and ER+ OR 7.640 (95 % CI, 2.599-22.459, p<0.000, were associated with bone metastastic incidences in advanced breast cancer, and were statistically significantly different. A combination of IL-11RA, MLF1P and ER+, showed an accuracy of approaching 80% to discriminate between bone metastatic and non bone metastatic in advanced breast cancer patients. Conclusion: IL11-RA, MLF1P, and ER+ were the determinants that were associated with increasing bone metastasis incidence.

  13. Reliability testing of tendon disease using two different scanning methods in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bruyn, George A W; Möller, Ingrid; Garrido, Jesus

    2012-01-01

    To assess the intra- and interobserver reliability of musculoskeletal ultrasonography (US) in detecting inflammatory and destructive tendon abnormalities in patients with RA using two different scanning methods....

  14. Dissolution of [²²⁶Ra]BaSO₄ and partial separation of ²²⁶Ra from radium/barium sulfate: A new treatment method for NORM waste from petroleum industry.

    Science.gov (United States)

    Al Abdullah, Jamal; Al Masri, M S; Amin, Yusr

    2016-01-01

    Complete dissolution of [(226)Ra]BaSO4 precipitate was successfully performed using NaNO2 as a reducing agent in acidic solution at room temperature. Results showed a significant effect of acid and NaNO2 concentrations and temperature on the dissolution efficiency. The method was successfully used for separation of radium from NORM scale samples from the petroleum industry; sufficient volume reduction of NORM waste was achieved. The obtained (226)Ra solution was purified using two separation methods. The dissolution method can be of great interest in the development of radiochemical analysis of radium isotopes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Breaking communication barriers for RA patients of South Asian origin: the use of a bilingual educational audio CD and linguistically appropriate peer support and education.

    Science.gov (United States)

    Kumar, Kanta; John, Holly; Gordhan, Chandrika; Situnayake, Deva; Raza, Karim; Bacon, Paul A

    2011-03-01

    People from the Indian subcontinent represent one of the largest ethnic groups in the UK. Patient education resources are required to address language barriers, poor literacy and (potentially discordant) cultural beliefs. We have investigated a novel strategy to meet this need. Rheumatoid arthritis (RA) patients of South Asian origin who prefer to communicate in a South Asian language were invited to a face-to-face interaction with a trained patient volunteer to provide linguistically appropriate peer support and education, and given a bilingual educational audio CD. Qualitative methods were used to assess this approach; three focus groups were held and 15 patients participated in total. Four important themes were identified: (1) The need for information about RA; all patients agreed that this was vital to learn how to live with their chronic disease. (2) Currently available approaches to education; particular concerns related to a lack of time in clinic, language barriers, difficulties in communicating via interpreters and that most written information was available only in English. (3) Support provided by a trained patient volunteer; patients appreciated that they were listened to, and were motivated by the volunteers' positive attitude. (4) The usefulness of the audio CD; patients appreciated that information was presented in a language they could understand, via a convenient medium and which offered a helpful perspective on their illness. This approach is a successful way of delivering information and encouraged patients from a difficult-to-reach community to become more involved in their disease management. Copyright © 2010 John Wiley & Sons, Ltd.

  16. PADI4 and HLA-DRB1 are genetic risks for radiographic progression in RA patients, independent of ACPA status: results from the IORRA cohort study.

    Directory of Open Access Journals (Sweden)

    Taku Suzuki

    Full Text Available INTRODUCTION: Rheumatoid arthritis (RA is a systemic, chronic inflammatory disease influenced by both genetic and environmental factors, leading to joint destruction and functional impairment. Recently, a large-scaled GWAS meta-analysis using more than 37,000 Japanese samples were conducted and 13 RA susceptibility loci were identified. However, it is not clear whether these loci have significant impact on joint destruction or not. This is the first study focused on the 13 loci to investigate independent genetic risk factors for radiographic progression in the first five years from onset of RA. METHODS: Sharp/van der Heijde score of hands at 5-year disease duration, which represents joint damage, were measured retrospectively and used as an outcome variable in 865 Japanese RA patients. Genetic factors regarded as putative risk factors were RA-susceptible polymorphisms identified by the Japanese GWAS meta-analysis, including HLA-DRB1 (shared epitope, SE, rs2240340 (PADI4, rs2230926 (TNFAIP3, rs3093024 (CCR6, rs11900673 (B3GNT2, rs2867461 (ANXA3, rs657075 (CSF2, rs12529514 (CD83, rs2233434 (NFKBIE, rs10821944 (ARID5B, rs3781913 (PDE2A-ARAP1, rs2841277 (PLD4 and rs2847297 (PTPN2. These putative genetic risk factors were assessed by a stepwise multiple regression analysis adjusted for possible non-genetic risk factors: autoantibody positivity (anti-citrullinated peptide antibody [ACPA] and rheumatoid factor, history of smoking, gender and age at disease onset. RESULTS: The number of SE alleles (P = 0.002 and risk alleles of peptidyl arginine deiminase type IV gene (PADI4, P = 0.04 had significant impact on progressive joint destruction, as well as following non-genetic factors: ACPA positive (P = 0.0006, female sex (P = 0.006 and younger age of onset (P = 0.02. CONCLUSIONS: In the present study, we found that PADI4 risk allele and HLA-DRB1 shared epitope are independent genetic risks for radiographic progression in Japanese

  17. Discontinuation of infliximab after attaining low disease activity in patients with rheumatoid arthritis: RRR (remission induction by Remicade in RA) study.

    Science.gov (United States)

    Tanaka, Y; Takeuchi, T; Mimori, T; Saito, K; Nawata, M; Kameda, H; Nojima, T; Miyasaka, N; Koike, T

    2010-07-01

    Tumour necrosis factor (TNF) inhibitors enable tight control of disease activity in patients with rheumatoid arthritis (RA). Discontinuation of TNF inhibitors after acquisition of low disease activity (LDA) is important for safety and economic reasons. To determine whether infliximab might be discontinued after achievement of LDA in patients with RA and to evaluate progression of articular destruction during the discontinuation. 114 patients with RA who had received infliximab treatment, and whose Disease Activity Score, including a 28-joint count (DAS28) was 24 weeks by infliximab treatment, the drug was discontinued and DAS28 in 102 patients was evaluated at year 1. Fifty-six patients (55%) continued to have DAS28Remicade in RA (RRR) failed: disease in 29 patients flared within 1 year and DAS28 was >3.2 at year 1 in 17 patients. Yearly progression of mTSS (DeltaTSS) remained 1 year without progression of radiological articular destruction.

  18. Large country differences in work outcomes in patients with RA - an analysis in the multinational study COMORA.

    Science.gov (United States)

    van der Zee-Neuen, Antje; Putrik, Polina; Ramiro, Sofia; Keszei, Andras P; Hmamouchi, Ihsane; Dougados, Maxime; Boonen, Annelies

    2017-09-29

    We aimed to explore whether country of residence or specific country characteristics are associated with work outcomes in rheumatoid arthritis (RA). Data from the 17 countries participating in the Comorbidities in RA (COMORA) study were used. Work outcomes were measured by the Work Productivity and Activity Impairment Questionnaire, addressing employment (yes/no), absenteeism (percentage of time; 3 categories) and presenteeism (percentage of at-work productivity restrictions; 4 categories). Contribution of country of residence, gross domestic product (GDP), Human Development Index (HDI), unemployment rate, social protection expenditures (SPE) or world region to work outcomes was investigated in adjusted (ordered) logistic regressions. The patients (n = 2395) were younger than 60 years; mean age 48 (SD 9.2) years, 1972 (84%) female and 1065 (45%) employed. Large country differences were found. Taking the country with the best work outcome as reference, Moroccan patients had the lowest odds of being employed (OR 0.2 (95% CI 0.1; 0.3) vs. Germany) and highest odds of absenteeism (OR 13.2 (3.6; 48.3) vs. Japan). Patients in Taiwan had the highest odds of presenteeism (OR 13.0 (5.5; 30.9) vs. Venezuela). All country indices except SPE were associated with work outcomes. For example, patients in low-GDP countries had lower odds of employment (OR 0.6 (0.5; 0.8)), higher odds of absenteeism (OR 2.8 (2.0; 4.1)), but lower odds of presenteeism (OR 0.5 (0.4; 0.7)) compared to higher-GDP countries. Substantial differences in work outcomes among patients with RA were observed between countries. Lower economic wealth and human development of countries were associated with worse employment and higher absenteeism, but lower presenteeism.

  19. Reduced FOXP3(+) regulatory T cells in patients with primary sclerosing cholangitis are associated with IL2RA gene polymorphisms.

    Science.gov (United States)

    Sebode, Marcial; Peiseler, Moritz; Franke, Björn; Schwinge, Dorothee; Schoknecht, Tanja; Wortmann, Frederike; Quaas, Alexander; Petersen, Britt-Sabina; Ellinghaus, Eva; Baron, Udo; Olek, Sven; Wiegard, Christiane; Weiler-Normann, Christina; Lohse, Ansgar W; Herkel, Johannes; Schramm, Christoph

    2014-05-01

    Recently, genome wide association studies in primary sclerosing cholangitis (PSC) revealed associations with gene polymorphisms that potentially could affect the function of regulatory T cells (Treg). The aim of this study was to investigate Treg in patients with PSC and to associate their numbers with relevant gene polymorphisms. Treg frequency in blood was assessed by staining for CD4(+)CD25(high)FOXP3(+)CD127(low) lymphocytes and determination of Treg-specific FOXP3 gene locus demethylation. Single nucleotide polymorphisms (SNP) in the interleukin-2 receptor alpha (IL2RA), the interleukin-2 (IL2) and interleukin-21 (IL21) gene locus were analysed. Liver biopsies taken at the time of diagnosis were stained for FOXP3 and CD3. Treg function was assessed in a CFSE-based suppression assay. The frequency of Treg in peripheral blood of PSC patients was significantly decreased. We confirmed this finding by demonstrating a reduction of non-methylated DNA in the Treg-specific demethylated FOXP3 gene region of peripheral blood cells in PSC patients. Reduced peripheral Treg numbers were significantly associated with homozygosity for the major allele of the SNP "rs10905718" in the IL2RA gene. Intrahepatic FOXP3(+) cell numbers at the time of initial diagnosis were decreased in PSC as compared to PBC. In addition to reduced numbers, the suppressive capacity of Treg isolated from PSC patients seemed to be impaired as compared to healthy controls. Our findings indicate that Treg impairment may play a role in the immune dysregulation observed in PSC. Reduced Treg numbers in patients with PSC are associated with polymorphisms in the IL2RA gene. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  20. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatiod arthritis. Results from 34 countries participating in the Quest-RA programme

    NARCIS (Netherlands)

    Grøn, K.L.; Ørnbjerg, L.M.; Hetland, M.L.; Aslam, F.; Khan, N.A.; Jacobs, J.W.G.; Henrohn, D.; Rasker, Hans J.; Kauppi, M.J.; Lang, H.C.; Mota, L.M.H.; Aggarwal, A.; Yamanaka, H.; Badsha, H.; Gossec, L.; Cutolo, M.; Ferraccioli, G.; Gremese, E.; Bong Lee, E.; Inanc, N.; Direskeneli, H.; Taylor, Peter; Huisman, Marieke; Alten, R.; Pohl, C.; Oyoo, O.; Stropuviene, S.; Drosos, A.A.; Kerzberg, E.; Ancuta, C.; Mofti, A.; Bergman, M.; Detert, J.; Selim, Z.I.; Abda, E.A.; Rexhepi, B.; Sokka, T.

    2014-01-01

    OBJECTIVES: The aim is to assess the prevalence of comorbidities and to further analyse to which degree fatigue can be explained by comorbidity burden, disease activity, disability and gross domestic product (GDP) in patients with rheumatoid arthritis (RA).METHODS: Nine thousands eight hundred

  1. Real life Dosages and Costs of TNFα inhibitor therapy for RA patients in Denmark

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela; Sørensen, Jan; Hetland, Merete Lund

    2009-01-01

    about the true long run cost. Taking the actual medication practice into account is important for the evaluation of the costs and optimal sequencing of new and existing biological treatments. Objectives: To investigate the drug cost of TNF-inhibitors in the treatment of RA using real-life data from...... of treatment. Cost estimates based on short term observational data or on instruction leaflets from manufacturers may provide wrong cost assessments of TNF-alpha therapy. It is important to take the long term cost structure into account to arrive at unbiased treatment cost estimates.......Background: When estimating the cost of biological treatment many analyses rely on cross sectional data or standard consumption patterns indicated in the manufacturers' instruction leaflet. Unless such consumption patterns truly reflect routine clinical practice they may result in wrong assumptions...

  2. Scintigraphic, radiological and clinical results after /sup 224/Ra therapy in patients with Bechterew's disease

    Energy Technology Data Exchange (ETDEWEB)

    Redecker, S.; Crone-Muenzebrock, W.; Weh, L.; Montz, R. (Hamburg Univ. (Germany, F.R.))

    1982-04-01

    53 patients with ancylosing spondylitis (clinical stages II and III) were treated with 1 MBq Ra 224 over a period of ten weeks. In 44 patients the orthopaedic findings were improved, in 9 patients they remained unchanged. An iridocyclitis developed in 3 patients, in 1 case an uveitis could be observed 33 patients were reexamined clinically, radiologically including total body scan and by laboratory means after an average period of 7.1 years. The stiftness of the spine was slightly improved compared with the pre-therapeutical status. Radiologically the spine findings were unchanged in 7 patients, progradient in 16, and clearly deteriorated in 8 cases. Scintiscanning of the skeleton of 21 patients showed a normal activity in 6 patients, 8 patients had a slight increase of the activity, mainly in the sacroiliac region 7 patients revealed a highly increased activity in the sacro-iliac region and lumbovertebral spine. Differential blood count and electrophoresis were unchanged before and after therapy. In 60% of the cases the erythrocyte sedimentation rate was diminished compared with pretherapy findings, in 40% the rate was unchanged or increased. Subjectively 10% of the patients reported no pain symptoms, 50% felt better, 30% were unchanged and 10% felt more poorly than before.

  3. Emergency Radiobioassay Method for Determination of ⁹⁰Sr and ²²⁶Ra in a Spot Urine Sample.

    Science.gov (United States)

    Sadi, Baki B; Fontaine, Allison; McAlister, Daniel; Li, Chunsheng

    2015-08-04

    A new radiobioassay method has been developed for simultaneous determination of (90)Sr and (226)Ra in a spot urine sample. The method is based on a matrix removal procedure to purify the target radionuclides from a urine sample followed by an automated high performance ion chromatographic (HPIC) separation of (90)Sr and (226)Ra and offline radiometric detection by liquid scintillation counting (LSC). A Sr-resin extraction chromatographic cartridge was used for matrix removal and purification of (90)Sr and (226)Ra from a urine sample prior to its introduction to the HPIC system. The HPIC separation was carried out through cation exchange chromatography using methanesulfonic acid (75 mM) as the mobile phase at 0.25 mL/min flow rate. The performance criteria of the method was evaluated against the American National Standard Institute ANSI/HPS N13.30-2011 standard for the root mean squared error (RMSE) of relative bias (Br) and relative precision (SB) at two different spiked activity levels. The RMSE of Br and SB for (90)Sr and (226)Ra were found to be satisfactory (≤0.25). The minimum detectable activity (MDA) of the method for (90)Sr and (226)Ra are 2 Bq/L and 0.2 Bq/L, respectively. The MDA values are at least 1/10th of the concentrations of (90)Sr (190 Bq/L) and (226)Ra (2 Bq/L) excreted in urine on the third day following an acute exposure (inhalation) that would lead to an effective dose of 0.1 Sv in the first year. The sample turnaround time is less than 8 h for simultaneous determination of (90)Sr and (226)Ra.

  4. Patient-reported outcomes from a phase 3 study of baricitinib versus placebo or adalimumab in rheumatoid arthritis: secondary analyses from the RA-BEAM study

    Science.gov (United States)

    Keystone, Edward C; Taylor, Peter C; Tanaka, Yoshiya; Gaich, Carol; DeLozier, Amy M; Dudek, Anna; Zamora, Jorge Velasco; Cobos, Jose Arturo Covarrubias; Rooney, Terence; de Bono, Stephanie; Arora, Vipin; Linetzky, Bruno; Weinblatt, Michael E

    2017-01-01

    Background To assess the effect of baricitinib on patient-reported outcomes (PROs) in patients with active rheumatoid arthritis and an inadequate response to methotrexate (MTX). Methods In this double-blind phase 3 study, patients were randomised 3:3:2 to placebo (n=488), baricitinib 4 mg once daily (n=487), or adalimumab 40 mg biweekly (n=330) with background MTX. PROs included the SF-36, EuroQol 5-D (EQ-5D) index scores and visual analogue scale, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient’s Global Assessment of Disease Activity (PtGA), patient’s assessment of pain and Work Productivity and Activity Impairment Questionnaire-Rheumatoid Arthritis (WPAI-RA), and measures collected in electronic patient daily diaries: duration and severity of morning joint stiffness (MJS), Worst Ttiredness and Worst Joint Pain. The primary study endpoint was at week 12. Treatment comparisons were assessed with logistic regression for categorical measures or analysis of covariance for continuous variables. Results Compared with placebo and adalimumab, baricitinib showed statistically significant improvements (p≤0.05) in HAQ-DI, PtGA, pain, FACIT-F, SF-36 physical component score, EQ-5D index scores and WPAI-RA daily activity at week 12. Improvements were maintained for measures assessed to week 52. Statistically significant improvement in patient diary measures (MJS duration and severity), worst tiredness and worst joint pain were observed for baricitinib versus placebo and adalimumab at week 12 (p≤0.05). Conclusions Baricitinib provided significantly greater improvement in most PROs compared with placebo and adalimumab, including physical function MJS, pain, fatigue and quality of life. Improvement was maintained to the end of the study (week 52). Trial registration NCT01710358. PMID:28798049

  5. Identification of a HERV-K env surface peptide highly recognized in Rheumatoid Arthritis (RA) patients: a cross-sectional case-control study.

    Science.gov (United States)

    Mameli, G; Erre, G L; Caggiu, E; Mura, S; Cossu, D; Bo, M; Cadoni, M L; Piras, A; Mundula, N; Colombo, E; Buscetta, G; Passiu, G; Sechi, L A

    2017-07-01

    Endogenous retroviruses (HERV) are believed to be pathogenic in several autoimmune diseases. Among them, HERV-K viruses have been reported recently to be involved in the pathogenesis of rheumatoid arthritis (RA). In this study we have explored the role of humoral immune response against HERV-K as a potential pathogenetic mechanism in RA. Four different peptides from the extracellular portion of the env protein of HERV-K (env-su19-37 , env-su109-126 , env-su164-186 , env-su209-226 ) were selected by bioinformatic analysis on the basis of their putative immunogenicity. Indirect enzyme-linked immunosorbent assay (ELISA) was then carried out to quantify antibodies against those peptides on blood samples of 70 consecutive RA patients and 71 healthy controls (HC). Differences between the two groups were analysed using the Mann-Whitney test. Potential correlations between RA laboratory, clinical descriptors and immunoglobulin (Ig)G levels were explored by bivariate regression analysis. Serum autoantibodies against one of four tested peptides of HERV-K (env-su19-37 ) were significantly higher in RA than in HC (19 versus 3%, P = 0·0025). Subgroup analysis showed no association between anti-HERV-K peptide humoral response and clinical, serological and clinimetric RA disease descriptors. Serum from RA patients in our series reacted significantly against HERV-K env-su19-37 peptide in comparison to the general population suggesting a role for the HERV-K- related, secondary antigenic-driven immune response in the pathogenesis of RA. Further studies are needed to confirm these results and to explore the role of this HERV-K surface peptide as a potential therapeutic target. © 2017 British Society for Immunology.

  6. Increased CD45RA+ FoxP3(low regulatory T cells with impaired suppressive function in patients with systemic lupus erythematosus.

    Directory of Open Access Journals (Sweden)

    Xiujun Pan

    Full Text Available BACKGROUND: The role of naturally occurring regulatory T cells (Treg in the control of the development of systemic lupus erythematosus (SLE has not been well defined. Therefore, we dissect the phenotypically heterogeneous CD4(+FoxP3(+ T cells into subpopulations during the dynamic SLE development. METHODLOGY/PRINCIPAL FINDINGS: To evaluate the proliferative and suppressive capacities of different CD4(+ T cell subgroups between active SLE patients and healthy donors, we employed CD45RA and CD25 as surface markers and carboxyfluorescein diacetatesuccinimidyl ester (CFSE dilution assay. In addition, multiplex cytokines expression in active SLE patients was assessed using Luminex assay. Here, we showed a significant increase in the frequency of CD45RA(+FoxP3(low naive Treg cells (nTreg cells and CD45RA(-FoxP3(low (non-Treg cells in patients with active SLE. In active SLE patients, the increased proportions of CD45RA(+FoxP3(low nTreg cells were positively correlated with the disease based on SLE disease activity index (SLEDAI and the status of serum anti-dsDNA antibodies. We found that the surface marker combination of CD25(+CD45RA(+ can be used to defined CD45RA(+FoxP3(low nTreg cells for functional assays, wherein nTreg cells from active SLE patients demonstrated defective suppression function. A significant correlation was observed between inflammatory cytokines, such as IL-6, IL-12 and TNFα, and the frequency of nTreg cells. Furthermore, the CD45RA(+FoxP3(low nTreg cell subset increased when cultured with SLE serum compared to healthy donor serum, suggesting that the elevated inflammatory cytokines of SLE serum may promote nTreg cell proliferation/expansion. CONCLUSIONS/SIGNIFICANCE: Our results indicate that impaired numbers of functional CD45RA(+FoxP3(low naive Treg cell and CD45RA(-FoxP3(low non-suppressive T cell subsets in inflammatory conditions may contribute to SLE development. Therefore, analysis of subsets of FoxP3(+ T cells, using a

  7. A simple method for calibration of Lucas scintillation cell counting system for measurement of 226Ra and 222Rn

    Directory of Open Access Journals (Sweden)

    N.K. Sethy

    2014-10-01

    Full Text Available Known quantity of radium from high grade ore solution was chemically separated and carefully kept inside the cavity of a Lucas Cell (LC. The 222Rn gradually builds up and attain secular equilibrium with its parent 226Ra. This gives a steady count after a suitable buildup period (>25 days. This secondary source was used to calibrate the radon counting system. The method is validated in by comparison with identical measurement with AlphaGuard Aquakit. The radon counting system was used to evaluate dissolved radon in ground water sample by gross alpha counting in LC. Radon counting system measures the collected radon after a delay of >180 min by gross alpha counting. Simultaneous measurement also carried out by AlphaGuard Aquakit in identical condition. AlphaGuard measures dissolved radon from water sample by constant aeration in a closed circuit without giving any delay. Both the methods are matching with a correlation coefficient of >0.9. This validates the calibration of Lucas scintillation cell counting system by designed encapsulated source. This study provides an alternative for calibration in absence of costly Radon source available in the market.

  8. Validation of a Gamma Spectrometric Method for the Measurement of {sup 226,228}Ra in Environmental Media Relevant to the Offshore Oil and Gas Industry

    Energy Technology Data Exchange (ETDEWEB)

    Bandong, B B; Kreek, S A; Bazan, J M; Torretto, P C; Dixon, J A; Edwards, W L; Guthrie, E B; Ruth, M A; Zaka, F A; Hall, H L

    2003-04-04

    The offshore production of oil and gas leads to naturally occurring {sup 226,228}Ra being brought to the surface along with produced water. Assessment of potential environmental exposures, if any, requires accurate, precise and practical methods for the measurement of low concentrations of {sup 226,228}Ra. A method for the simultaneous measurement of {sup 226,228}Ra in marine sediments, biota and produced water at a sensitivity of 0.01 pCi/g using high-sensitivity, high-resolution gamma spectrometry was subjected to an interlaboratory exercise using U.S. commercial laboratories to validate its accuracy, precision, robustness, and sample throughput. The prescribed method involves direct counting for solid samples and a simple Pb({sup 133}Ba,Ra)SO{sub 4} co-precipitation procedure for water samples followed by gamma counting. Analytical results received from the participating laboratories were subjected to data analysis and statistical evaluation to validate the overall performance of the prescribed method. Relatively good precision and high accuracy of data were achieved when the participating laboratories followed the prescribed procedure closely. The consistency of results among laboratories was not correlated to the {sup 226,228}Ra concentrations in the samples. Most of the results that failed the acceptance criteria were either due to the absence of geometric and secular equilibrium between {sup 226}Ra and its signature decay daughters, or due to insufficient counting statistics when laboratories are working close to their detection limits. No significant bias or systematic errors were observed, except for produced water samples where results were biased high compared to the known values.

  9. Risk of leukaemia following intravenous treatment with {sup 224}Ra - results of a long term follow-up study of ankylosing spondylitis patients; Leukaemierisiko nach intravenoeser {sup 224}Ra-Behandlung - Ergebnisse einer Langzeitstudie an Bechterew-Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenbiologie; Chmelevsky, D. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Goessner, W. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Pathologie

    1993-12-31

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived {alpha}-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of {sup 224}Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals; this would result in an cumulative {alpha}-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p < 0.001) and 6 cases of leukaemia in the control group (vs. 3.3 - 3.5 exp., p = 0.14). Subclassification of the leukaemias shows a clear preference for chronic myeloid leukaemia (CML) in the exposure group (4 cases obs. vs. 0.8 cases exp., p = 0.009), whereas in the control group the observed cases of CML are within the range of expectancy. Similar observations have not been made in another group of patients, now observed by Spiess and co-workers, who have been treated at a higher dose/dose rate range. This increased incidence of leukaemias in our exposure group is in one line with results from animal experiments with bone seeking {alpha}-emitters given at low dose rates. The induction of myeloid leukaemia has been demonstrated in mice down to dose rates of only a few mGy/day also for {sup 239}Pu, an {alpha}-emitter which like {sup 224}Ra deposits preferentially on the bone surface. (orig.) [Deutsch] Im Rahmen einer epidemiologischen Studie zum somatischen Strahlenspaetschadenrisiko nach

  10. Impact of a magnetic resonance imaging-guided treat-to-target strategy on disease activity and progression in patients with rheumatoid arthritis (the IMAGINE-RA trial)

    DEFF Research Database (Denmark)

    Møller-Bisgaard, Signe; Hørslev-Petersen, Kim; Ejbjerg, Bo Jannik

    2015-01-01

    . This demonstrates that additional methods for prognostication and monitoring of the disease activity are needed. Bone marrow edema (BME) detected by magnetic resonance imaging (MRI) has proved to be an independent predictor of subsequent radiographic progression. Guiding the treatment based on the presence....../absence of BME may therefore be clinically beneficial. We present the design of a randomized controlled trial (RCT) aiming to evaluate whether an MRI-guided treatment strategy compared to a conventional treatment strategy in anti-CCP-positive erosive RA is better to prevent progression of erosive joint damage...... swollen joints and treatment with synthetic disease-modifying antirheumatic drugs (DMARDs) will be included. Patients will be randomized to either a treatment strategy based on conventional laboratory and clinical examinations (control group) or a treatment strategy based on conventional laboratory...

  11. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients.

    Science.gov (United States)

    Grondal, Lollo; Tengstrand, Birgitta; Nordmark, Birgitta; Wretenberg, Per; Stark, Andre

    2008-04-01

    Our knowledge of frequency of foot involvement in rheumatoid arthritis (RA) is still often based on a study from Finland in 1956. Great changes in the treatment of RA may have led to a different situation. We investigated the distribution of joint involvement in RA patients today, with special attention given to the feet and subjective walking ability. 1,000 RA patients answered a questionnaire concerning joints affected, joint surgery, foot problems, and subjectively experienced reasons for walking incapacity. In 45% of the patients, the forefoot was involved at the start of the disease. In 17%, the hindfoot/ankle was involved at the start. Only hand symptoms were commoner. 80% of patients reported current foot problems, 86% in the forefoot and 52% in the hindfoot/ankle. Difficulty in walking due to the feet was reported by 71%. For 41% of patients, the foot was the most important part of the lower extremity causing reduced walking capacity, and for 32% it was the only part. After the hand, the foot was the most frequently symptomatic joint complex at the start of the disease, but also during active medical treatment. The foot caused walking disability in three-quarters of the cases and-4 times as often as the knee or the hip-it was the only joint to subjectively impair gait.

  12. Anti-hnRNP B1 (RA33 Autoantibodies Are Associated with the Clinical Phenotype in Russian Patients with Rheumatoid Arthritis and Systemic Sclerosis

    Directory of Open Access Journals (Sweden)

    Aleksey Maslyanskiy

    2014-01-01

    Full Text Available Heterogeneous nuclear ribonucleoproteins (hnRNPs are potent autoantigenic targets in systemic autoimmune rheumatic diseases (SARD. Loss of tolerance to the RA33 complex consisting of hnRNP A2 and its alternatively spliced variants B1 and B2 has been the interest of rheumatologists. A novel ELISA for the detection of anti-hnRNP B1 autoantibodies has been developed to investigate the prevalence thereof in 397 patients with SARD, including patients with rheumatoid arthritis (RA, spondyloarthropathy (SPA, juvenile chronic arthritis, systemic lupus erythematosus (SLE, systemic sclerosis (SSc, and Sjögren’s syndrome (SS, in comparison to 174 controls. Anti-hnRNP B1 autoantibodies were significantly more prevalent in patients with SARD than controls (47/397, 11.8% versus 2/174, 1.1%; P<0.001. In particular, anti-hnRNP B1 were found more frequently in the disease cohorts than in the controls and were present in 24/165 (14.5% patients with RA, 6/58 (10.3% SPA, 11/65 (16.9% SSc, and 4/50 (8.0% SLE. In RA patients, anti-hnRNP B1 autoantibodies correlated significantly with C-reactive protein levels and erythrocyte sedimentation rate, while in patients with SSc it was associated with features of arterial wall stiffness and presence of hypertension. Anti-hnRNP B1 autoantibodies occur in SARD and seem to be correlated with distinct clinical characteristics in patients with RA and SSc.

  13. A unique drug distribution process for radium Ra 223 dichloride injection and its implication for product quality, patient privacy, and delineation of professional responsibilities.

    Science.gov (United States)

    Dansereau, Raymond N

    2014-11-01

    On May 15, 2013, Bayer Healthcare Pharmaceuticals announced that it had received marketing approval for the therapeutic radioactive medication radium Ra 223 dichloride injection (Xofigo; Ra 223). The product acquisition and distribution process for hospital-based nuclear pharmacies and nuclear medicine services is unlike any other. The product is distributed as a low-risk compounded sterile preparation through a single compounding nuclear pharmacy located in Denver, Colorado, pursuant to a prescription. This model for drug distribution and delivery to the user institution has implications for product quality, patient privacy, and delineation of professional responsibilities. © The Author(s) 2014.

  14. Successful extension of tocilizumab infusion intervals from 4 weeks to 6 or 5 weeks in 90% of RA patients with good response to 4-week intervals.

    Science.gov (United States)

    Saiki, Osamu; Uda, Hiroshi

    2017-01-01

    A period of 4 weeks (w) has been recommended as the interval between tocilizumab (TCZ) infusions for rheumatoid arthritis (RA). However, treating the patients with TCZ (8 mg/kg), we experienced that longer intervals were also effective. We conducted the study to investigate whether the intervals of TCZ infusions could extend from 4w to 5 or 6w. This was a retrospective observational study. RA patients who had shown good response to TCZ infusions at 4w intervals were enrolled, and the intervals of TCZ infusions were extended to 5w. Next, the intervals of TCZ infusion were extended to 6w for the patients who had maintained good response with 5w intervals. The patients who had maintained good response for more than two years were estimated as responders. One hundred patients were enrolled in the present study, and 62 patients maintained good response with 6w-interval infusions, and 28 patients with 5w-interval infusions, indicating that 90% of patients who had shown good response with 4w intervals could extend the intervals from 4w to 5 or 6w. The present study provides evidence that most of RA patients who showed good response to TCZ infusions at 4w could extend the intervals to 6w or 5w. This finding should be of great interest for both financial and labour reasons.

  15. Acne RA-1,2, a novel UV-selective face cream for patients with acne: Efficacy and tolerability results of a randomized, placebo-controlled clinical study.

    Science.gov (United States)

    Cestone, Enza; Michelotti, Angela; Zanoletti, Valentina; Zanardi, Andrea; Mantegazza, Raffaella; Dossena, Maurizia

    2017-06-01

    General skincare measures such as the use of moisturisers and products containing adequate photoprotection are important components of acne patients' management to complement the pharmacological regimen. Acne RA-1,2 is a novel dermato-cosmetic product which contains selective photofilters and active ingredients against the multifactorial pathophysiology of acne. To evaluate the tolerability of Acne RA-1,2 and its effect on the clinical signs of acne. This double-blind, placebo-controlled study randomized 40 adult patients with 10-25 comedones per half face to once-daily application of Acne RA-1,2 or placebo for 8 weeks. Evaluations after 4 and 8 weeks included the number of comedones, transepidermal water loss (TEWL), sebum production, and tolerability. In the Acne RA-1,2 group, there was a significant 35% decrease in the mean number of comedones from 26 at baseline to 17 at Week 8 (P<.001), a 7% significant reduction in TEWL (9.32 to 8.66 g/h/m(2) ; P<.001), and a 24% significant reduction in sebum production (154.8 to 117.6 μg/cm(2) ; P<.001). The reductions in TEWL and sebum production were significantly greater than those in the placebo group at Weeks 4 and 8 (P<0.05). There were no adverse events. Acne RA-1,2 was well tolerated and effective at reducing comedones and sebum production and improving epidermal barrier function. These results suggest that Acne RA-1,2 is useful against acne-prone facial skin, particularly as it targets sebum production, which topical pharmacological acne therapies do not address. © 2017 Wiley Periodicals, Inc.

  16. Proliferatory defect of invariant population and accumulation of non-invariant CD1d-restricted natural killer T cells in the joints of RA patients.

    Science.gov (United States)

    Gutowska-Owsiak, Danuta; Birchall, Martin A; Moots, Robert J; Christmas, Stephen E; Pazmany, Laszlo

    2014-05-01

    While numerical and functional defects of invariant NKT cells have been demonstrated in rheumatoid arthritis (RA), the detailed characterization of proliferative and secretory responses following CD1d-mediated presentation is lacking; the presence of non-invariant populations has never been assessed in human autoimmunity. We have evaluated both invariant and non-invariant populations in the blood and synovial fluid from patients to assess feasibility of NKT cell-directed manipulations in RA. NKT cell populations were quantified by anti-CD4/anti-Vα24 staining and/or CD1d tetramers. Proliferation was measured in cultures of mononuclear cells following stimulations with αGalCer and cytokine secretion determined by multi-bead assay. We have confirmed a proliferative defect of iNKT cells in both peripheral blood and synovial fluid from RA patients, but no changes in baseline frequencies. Moreover, we have detected an enlargement of non-invariant cell pool in synovial fluid samples. In addition, we noted an evident Th2 shift following exposure to αGalCer and pronounced IL-6 secretion. While RA patients suffer from defective proliferative responses of invariant NKT cells, non-invariant cells accumulate at the site of inflammation. While stimulation with αGalCer results in reduced TNF-α and increased suppressive IL-10, abundantly produced IL-6 could potentially contribute to the induction of Th17 cells in the joints.

  17. [Clinical features of atypical refractory anemia (RA)].

    Science.gov (United States)

    Matsuda, A; Jinnai, I; Kusumoto, S; Shiramatsu, F; Bessho, M; Saito, M; Hirashima, K

    1991-08-01

    Twenty-three patients with bicytopenia or pancytopenia were retrospectively studied. The patients with underlying disorders, blast count of more than 5% on bone marrow (BM) aspirate, blast count of more than 1% on peripheral blood or ringed sideroblast count of more than 15% on BM aspirate were excluded. According to Yoshida's criteria, 23 patients were classified into 6 subtypes [AA (aplastic anemia)1: typical AA, AA2: atypical AA, MDS (myelodysplastic syndrome)3: typical RA (refractory anemia, MDS4-6: atypical RA], and AA1 7 cases; AA2 2 cases; MDS3 5 cases; MDS4 1 case; MDS5 2 cases; MDS6 6 cases. To clarify the clinical features of atypical RA group (MDS4-6), we investigated ferrokinetics, RBC life span, karyotype, serum Epo (erythropoietin) concentration, response to therapy and prognosis. Results were as follows: 1) all three RA patients who were younger than 30 years old were included in atypical RA group, 2) in ferrokinetics study PID (plasma iron disappearance time) values of MDS4 and MDS6 patients ranged between those of AA1 and those of MDS3 patients (5 of 7 patients), 3) two cases who developed leukemia belonged to typical RA group, 4) patients with atypical RA showed response to therapy and their prognosis were better than those with typical RA. These observations suggest that atypical RA have different clinical features from typical RA.

  18. Ex Vivo Comparison of Mtwo and RaCe Rotary File Systems in Root Canal Deviation: One File Only versus the Conventional Method.

    Science.gov (United States)

    Aminsobhani, Mohsen; Razmi, Hasan; Nozari, Solmaz

    2015-07-01

    Cleaning and shaping of the root canal system is an important step in endodontic therapy. New instruments incorporate new preparation techniques that can improve the efficacy of cleaning and shaping. The aim of this study was to compare the efficacy of Mtwo and RaCe rotary file systems in straightening the canal curvature using only one file or the conventional method. Sixty mesial roots of extracted human mandibular molars were prepared by RaCe and Mtwo nickel-titanium (NiTi) rotary files using the conventional and only one rotary file methods. The working length was 18 mm and the curvatures of the root canals were between 15-45°. By superimposing x-ray images before and after the instrumentation, deviation of the canals was assessed using Adobe Photoshop CS3 software. Preparation time was recorded. Data were analyzed using three-way ANOVA and Tukey's post hoc test. There were no significant differences between RaCe and Mtwo or between the two root canal preparation methods in root canal deviation in buccolingual and mesiodistal radiographs (P>0.05). Changes of root canal curvature in >35° subgroups were significantly more than in other subgroups with smaller canal curvatures. Preparation time was shorter in one file only technique. According to the results, the two rotary systems and the two root canal preparation methods had equal efficacy in straightening the canals; but the preparation time was shorter in one file only group.

  19. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatoid arthritis. Results from 34 countries participating in the Quest-RA program

    DEFF Research Database (Denmark)

    Grøn, Kathrine Lederballe; Ornbjerg, Lykke Midtbøll; Hetland, Merete Lund

    2014-01-01

    OBJECTIVES: The aim is to assess the prevalence of comorbidities and to further analyse to which degree fatigue can be explained by comorbidity burden, disease activity, disability and gross domestic product (GDP) in patients with rheumatoid arthritis (RA). METHODS: Nine thousands eight hundred...... seventy-four patients from 34 countries, 16 with high GDP (>24.000 US dollars [USD] per capita) and 18 low-GDP countries (visual analogue scale...... [VAS] [10=worst]), disease activity in 28 joints (DAS28), and physical disability (Health Assessment Questionnaire score [HAQ]) were assessed. Univariate and multivariate linear regression analyses were performed to assess the association between fatigue and comorbidities, disease activity, disability...

  20. Hypothalamic-pituitary-adrenal axis activity in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Eijsbouts, A.M.M.; Hoogen, F.H.J. van den; Laan, R.F.J.M.; Hermus, A.R.M.M.; Sweep, C.G.J.; Putte, L.B.A. van de

    2005-01-01

    OBJECTIVE: To study the hypothalamic-pituitary-adrenal (HPA) axis in patients with rheumatoid arthritis (RA). METHODS: Fifty patients with RA participated in 3 groups: recent onset active RA (n = 20), longstanding active RA (n = 20) and long-standing RA in remission (n = 10), and were compared with

  1. Determination of 226Ra and 224Ra in drinking waters by liquid scintillation counting.

    Science.gov (United States)

    Manjón, G; Vioque, I; Moreno, H; García-Tenorio, R; García-León, M

    1997-04-01

    A method for the determination of Ra-isotopes in water samples has been developed. Ra is coprecipitated with Ba as sulphate. The precipitate is then dissolved with EDTA and counted with a liquid scintillation system after mixing with a scintillation cocktail. The study of the temporal evolution of the separated activity gives the isotopic composition of the sample, i.e. the 224Ra and 226Ra contribution to the total activity. The method has been applied to some Spanish drinking waters.

  2. Chôra

    DEFF Research Database (Denmark)

    Isar, Nicoletta

    2009-01-01

    , for whom "il y a khôra" (there is chôra), Sallis keeps the definite article (the chôra) as an index of certain differentiation in chôra. This article takes as a point of departure Sallis' thesis regarding the manifestation of the chôra, grounded in the manner in which the chôra is apprehended, that is......, as in a dream. Sallis' interpretation opens up the possibility for a new reading of the dialogue, and offers a tool to examine phenomena occurred in the aftermath of the Platonic cosmogony. One of the most fascinating episodes of the afterlife of the Platonic chôra is the Byzantine chôra, presented...

  3. Ex Vivo Comparison of Mtwo and RaCe Rotary File Systems in Root Canal Deviation: One File Only versus the Conventional Method

    Directory of Open Access Journals (Sweden)

    Mohsen Aminsobhani

    2016-01-01

    Full Text Available Objectives: Cleaning and shaping of the root canal system is an important step in endodontic therapy. New instruments incorporate new preparation techniques that can improve the efficacy of cleaning and shaping. The aim of this study was to compare the efficacy of Mtwo and RaCe rotary file systems in straightening the canal curvature using only one file or the conventional method.Materials and Methods: Sixty mesial roots of extracted human mandibular molars were prepared by RaCe and Mtwo nickel-titanium (NiTi rotary files using the conventional and only one rotary file methods. The working length was 18 mm and the curvatures of the root canals were between 15-45°. By superimposing x-ray images before and after the instrumentation, deviation of the canals was assessed using Adobe Photoshop CS3 software. Preparation time was recorded. Data were analyzed using three-way ANOVA and Tukey’s post hoc test.Results: There were no significant differences between RaCe and Mtwo or between the two root canal preparation methods in root canal deviation in buccolingual and mesiodistal radiographs (P>0.05. Changes of root canal curvature in >35° subgroups were significantly more than in other subgroups with smaller canal curvatures. Preparation time was shorter in one file only technique.Conclusion: According to the results, the two rotary systems and the two root canal preparation methods had equal efficacy in straightening the canals; but the preparation time was shorter in one file only group.

  4. Are RA patients from a non-endemic HCV population screened for HCV? A cross-sectional analysis of three different settings.

    Science.gov (United States)

    Skinner-Taylor, Cassandra Michelle; Erhard-Ramírez, Alejandro; Garza-Elizondo, Mario Alberto; Esquivel-Valerio, Jorge Antonio; Abud-Mendoza, Carlos; Martínez-Martínez, Marco Ulises; Vega-Morales, David; Arana-Guajardo, Ana

    In Mexico, other risk factors are associated with hepatitis C virus (HCV): prior heroin users, living alone, widower, and northern region residence. Rheumatoid arthritis (RA) patients are considered immunosuppressed and HCV testing is recommended before treatment. The aim of the study was to describe the characteristics of HCV testing in RA patients in three different medical care settings in a non-endemic area. A retrospective observational study was performed using medical records from 960 RA patients describing the indications for HCV testing. The test was performed in 28.6% and the HCV overall frequency was 0.36%. Population characteristics were not associated with an increased risk of HCV infection; therefore, anti-HCV positivity was low. The main reason for testing was before starting biological agents. Due to the low pre-test probability, testing for HCV infection should be personalized; i.e., according to disease prevalence in a particular geographical location and the individual risk factors. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  5. sup 2 sup 2 sup 6 Ra measurement in Mo, Cd and Nd sub 2 O sub 3 samples with the emanation method

    CERN Document Server

    Barabash, A S; Kornoukhov, V N; Orekhov, I V

    2001-01-01

    Measurements of sup 2 sup 2 sup 6 Ra content in materials and chemical reagents used to construct the double beta decay sources in the NEMO-3 experiment have been done with the emanation method technique. Three different radon emanation technologies were used in these studies. The first was the 'traditional' method of dissolving the sample. The second was an extraction of Rn from a melted sample and finally a technique of heating fine-grained powder was used. It is shown that there is good agreement of the data received with the emanation method and low background high purity germanium detectors. The sensitivity of this method is 0.02 mBq/l of solution (for the 'standard' emanation method) or 0.02 mBq/kg (for methods in which radon is extracted from a powder or melt).

  6. Determination of Ra-224 and Ra-226 in drinking waters

    Science.gov (United States)

    Semenishchev, V. S.; Betenekov, N. D.; Tomashova, L. A.; Voronina, A. V.

    2017-09-01

    Activity of 224Ra and 226Ra were determined in some types of natural drinking water. An improved method of radiochemical analysis of radium was developed. The method included radium preconcentration by the granulated titanium dioxide and further thin alpha source preparation by radium sorption onto a thin-layer manganese dioxide disk based on cellulose triacetate (MnO2-CTA). It was shown that time of radium sorption on MnO2-CTA should be 1 day; sorption degree of 75 % was achieved. Longer sorption resulted in sorption degree of 85 % but the quality of alpha spectrum was lower due to radium diffusion into the MnO2 film. 22 samples of commercially available mineral waters, 4 samples from springs and 4 samples from wells near Yekaterinburg city were analyzed. The results demonstrated that mineral waters contain more 226Ra (0.4-125 mBq L-1) than fresh underground water (0.5-29 mBq L-1); no samples were found with 226Ra activity exceeding maximum allowable level (490 mBq L-1). Activities of 224Ra in fresh waters were found to be 0.5 to 20 mBq L-1 that was also less than the maximum allowable level.

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

    DEFF Research Database (Denmark)

    Sokka, T; Kautiainen, H; Pincus, T

    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 que...

  8. SF Treg cells transcribing high levels of Bcl-2 and microRNA-21 demonstrate limited apoptosis in RA

    NARCIS (Netherlands)

    van der Geest, Kornelis S. M.; Smigielska, Katarzyna; Park, Ji-Ah; Abdulahad, Wayel H.; Kim, Hye-Won; Kroesen, Bart-Jan; van den Berg, Anke; Boots, Annemieke M. H.; Lee, Eun-Bong; Brouwer, Elisabeth

    Objective. The aim of this study was to investigate the turnover of Treg cells in the SF of RA patients. Methods. Treg cells were enumerated in peripheral blood and SF of RA patients and analysed by flow cytometry for expression of the proliferation marker Ki-67 and binding of the apoptosis marker

  9. Developing a Construct to Evaluate Flares in Rheumatoid Arthritis: A Conceptual Report of the OMERACT RA Flare Definition Working Group

    DEFF Research Database (Denmark)

    Alten, Rieke; Choy, Ernest H; Christensen, Robin

    2011-01-01

    is intended to enhance patient-HCP communication. This article describes the conceptual framework being used by the OMERACT RA Flare Definition Working Group in developing a standardized method for description and measurement of "flare in RA" to guide individual patient treatment.......Rheumatoid arthritis (RA) patients and healthcare professionals (HCP) recognize that episodic worsening disease activity, often described as a "flare," is a common feature of RA that can contribute to impaired function and disability. However, there is no standard definition to enable measurement...... of its intensity and impact. The conceptual framework of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Definition Working Group includes an anchoring statement, developed at OMERACT 9 in 2008: "flare in RA" is defined as worsening of signs and symptoms of sufficient intensity...

  10. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatoid arthritis. Results from 34 countries participating in the Quest-RA program

    DEFF Research Database (Denmark)

    Grøn, Kathrine Lederballe; Ørnbjerg, Lykke Midtbøll; Hetland, Merete Lund

    2014-01-01

    OBJECTIVES: The aim is to assess the prevalence of comorbidities and to further analyse to which degree fatigue can be explained by comorbidity burden, disease activity, disability and gross domestic product (GDP) in patients with rheumatoid arthritis (RA). METHODS: Nine thousands eight hundred...... [VAS] [10=worst]), disease activity in 28 joints (DAS28), and physical disability (Health Assessment Questionnaire score [HAQ]) were assessed. Univariate and multivariate linear regression analyses were performed to assess the association between fatigue and comorbidities, disease activity, disability...... and GDP. RESULTS: Overall, patients reported a median of 2 comorbid conditions of which hypertension (31.5%), osteoporosis (17.6%), osteoarthritis (15.5%) and hyperlipidaemia (14.2%) were the most prevalent. The majority of comorbidities were more common in high-GDP countries. The median fatigue score...

  11. Factors that influence fatigue status in patients with severe rheumatoid arthritis (RA) and good disease outcome following 6 months of TNF inhibitor therapy: a comparative analysis.

    LENUS (Irish Health Repository)

    Minnock, Patricia

    2015-11-01

    The objective of the present study is to determine the factors associated with persistent fatigue in patients with severe rheumatoid arthritis (RA) and good disease response to 6 months of tumour necrosis factor inhibitor therapy. Eligible patients with either persistent (PF) or no fatigue (NF) were compared. Using validated questionnaires and bivariate analysis, this cross-sectional survey explored if clinical characteristics, pain, self-efficacy, sleep and mood\\/depression differed between groups. Patients with PF (PF; NF) (n = 28; 28) reported significantly more overall pain (11.3 ± 9.4 (0-33); 6.9 ± 8.9 (0-33)), more recent and current pain intensity (41.4 ± 26.6 (0-80) 24.4 ± 26.6 (0-100) and depression (11.8 ± 7.5 (1-35); 8.2 ± 6.6 (0-26)), than the NF group. There was no significant difference between groups in self-efficacy and both groups experienced poor sleep quality (Pittsburgh Sleep Quality Index >5). Despite having good disease response, the PF group had significantly higher rheumatoid factor incidence, disease activity score-28, early morning stiffness duration and lower incidence of ever-failing disease-modifying anti-rheumatic drugs than the NF group. These findings enhance the fatigue literature in patients with RA prescribed tumour necrosis factor (TNF) inhibition therapy, identifying the potentially modifiable factors of pain and depression, previously demonstrated to be strongly associated with fatigue in non-biologic populations. In addition, this study highlights the association between persistent fatigue and an on-going state of low disease activity. This infers that more judicious disease management could minimise the symptom burden of pain and depression and consequentially fatigue.

  12. Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of ASP2408, a Potent Selective T-Cell Costimulation Modulator After Single and Multiple Ascending Doses in Healthy Volunteers and RA Patients.

    Science.gov (United States)

    Zhu, Tong; Keirns, James; Howieson, Corrie; Kaibara, Atsunori; Goldwater, Ronald; Kivitz, Alan J; Chindalore, Vishala; Cohen, Stanley; Santos, Vicki; Akinlade, Bolanle; Kernstock, Robert; Delgado-Herrera, Leticia; Blahunka, Paul C; Karrer, Erik E; Garg, Jay P; Samberg, Nancy; Zeiher, Bernhardt G

    2016-09-01

    ASP2408 is a next-generation anti-cytotoxic T lymphocyte antigen-4 fusion protein engineered for improved CD86 binding affinity as a treatment for rheumatoid arthritis (RA). In 72 healthy subjects (n = 6/treatment), ASP2408 was administered as single ascending doses intravenously at 0.003 to 10.0 mg/kg or subcutaneously at 0.3 to 3.0 mg/kg. It showed decreased clearance and prolonged half-life with increasing doses, consistent with target-mediated disposition. The apparent bioavailability was 36.3%-56.7% across single subcutaneous doses. Sixteen RA patients (n = 8/treatment) on stable methotrexate received 3 × 3.0 mg/kg subcutaneously every 4 weeks or every 2 weeks. Similar to single-dose treatment, ASP2408 concentrations peaked 2 to 3 days postdose, with a median t1/2 of approximately 8 days. Using CD86 receptor occupancy (RO) as a mechanistic biomarker, ASP2408 demonstrated dose-dependent binding to its target. ASP2408 3.0 mg/kg subcutaneously every 4 weeks and every 2 weeks led to a mean %CD86 RO ≥ 74.7% and ≥ 81.5%, respectively, within each dosing interval. ASP2408 was well tolerated across studies with no evidence of dose-limiting toxicity or clinically significant changes in clinical laboratory test results, vital signs, or 12-lead electrocardiograms. ASP2408 elicited antidrug antibodies in the majority of patients, but with no clinical sequelae. © 2016, The American College of Clinical Pharmacology.

  13. TARGETED INFORMATION ON METHOTREXATE AND LIFTING ALCOHOL RESTRICTIONS IN PATIENTS WITH RA AND PSA IS SAFE AND REDUCES PATIENTS' NEGATIVE BELIEFS

    DEFF Research Database (Denmark)

    Larsen, Janni Lisander; Nordin, Henrik

    as a cytotoxic agent. Thus patients often associate the drug to cancer treatment and thereby resent the treatment. However, the doses used in the treatment of arthritis of restrictions on alcohol...... restrictions asking patients to adhere to national Danish guidelines (5). Objectives To investigate the effects of altered information strategy and the safety of increased alcohol limits for patients with Rheumatoid Arthritis and Psoriatic Arthritis. Methods Patients in a single outpatient clinic receiving MTX...... for Rheumatoid Arthritis or Psoriatic Arthritis were interviewed by postal delivered questionnaire for their beliefs regarding MTX and their alcohol consumption (6). Informed consent was obtained. The patients were on stable treatment for at least 6 months prior to answering the questionnaire. Liver enzyme...

  14. The role of inflammation, the autonomic nervous system and classical cardiovascular disease risk factors on subendocardial viability ratio in patients with RA: a cross-sectional and longitudinal study.

    Science.gov (United States)

    Sandoo, Aamer; Protogerou, Athanassios D; Hodson, James; Smith, Jacqueline P; Zampeli, Evi; Sfikakis, Petros P; Kitas, George D

    2012-11-28

    Evidence indicates that rheumatoid arthritis (RA) patients have increased susceptibility to myocardial ischaemia that contributes to myocardial infarction. The subendocardial viability ratio (SEVR) can be measured using pulse wave analysis and reflects myocardial oxygen supply and demand. The objective of the present study was to examine specific predictors of SEVR in RA patients, with a specific focus on inflammation and classical cardiovascular disease (CVD) risk factors. Two patient cohorts were included in the study; a primary cohort consisting of 220 RA patients and a validation cohort of 127 RA patients. All patients underwent assessment of SEVR using pulse wave analysis. Thirty-one patients from the primary cohort who were about to start anti-inflammatory treatment were prospectively examined for SEVR at pretreatment baseline and 2 weeks, 3 months and 1 year following treatment. Systemic markers of disease activity and classical CVD risk factors were assessed in all patients. The SEVR (mean ± standard deviation) for RA in the primary cohort was 148 ± 27 and in the validation cohort was 142 ± 25. Regression analyses revealed that all parameters of RA disease activity were associated with SEVR, along with gender, blood pressure and heart rate. These findings were the same in the validation cohort. Analysis of longitudinal data showed that C-reactive protein (P < 0.001), erythrocyte sedimentation rate (P < 0.005), Disease Activity Score in 28 joints (P < 0.001), mean blood pressure (P < 0.005) and augmentation index (P < 0.001) were significantly reduced after commencing anti-TNFα treatment. Increasing C-reactive protein was found to be associated with a reduction in SEVR (P = 0.02) and an increase in augmentation index (P = 0.001). The present findings reveal that the SEVR is associated with markers of disease activity as well as highly prevalent classical CVD risk factors in RA, such as high blood pressure and diabetes. Further prospective studies are

  15. Association of variants in IL2RA with progression of joint destruction in rheumatoid arthritis.

    Science.gov (United States)

    Knevel, R; de Rooy, D P C; Zhernakova, A; Gröndal, G; Krabben, A; Steinsson, K; Wijmenga, C; Cavet, G; Toes, R E M; Huizinga, T W J; Gregersen, P K; van der Helm-van Mil, A H M

    2013-07-01

    Heritability studies have suggested an important role of genetic predisposition in the progression of joint destruction in rheumatoid arthritis (RA); the heritability is estimated at 45-58%. Several single-nucleotide polymorphisms (SNPs) have been identified as being associated with RA susceptibility. Our objective was to study the association of several of these loci with progression of joint destruction. We studied 1,750 RA patients in 4 independent data sets with 4,732 radiographs scored using the modified Sharp/van der Heijde method. Thirteen susceptibility SNPs that were not previously associated with joint destruction were tested in 596 Dutch RA patients. Subsequently, significant SNPs were studied in data sets of RA patients from North America and Iceland. Data were summarized in inverse-weighted variance meta-analyses. Further, the association with circulating protein levels was studied and the associated region was fine-mapped. In stage 1, 3 loci (AFF3, IL2RA, and BLK) were significantly associated with the rate of joint destruction and were further analyzed in the additional data sets. In the combined meta-analyses, the minor (C) allele of IL2RA (rs2104286) was associated with less progression of joint destruction (P = 7.2 × 10(-4) ). Furthermore, the IL2RA (rs2104286) protective genotype was associated with lower (0.85-fold [95% confidence interval 0.77-0.93], P = 1.4 × 10(-3) ) circulating levels of soluble interleukin-2 receptor α (sIL-2Rα). Additionally, lower sIL-2Rα levels were associated with a lower rate of joint destruction (P = 3.4 × 10(-3) ). The association of IL2RA with the rate of joint destruction was further localized to a 40-kb region encompassing the IL2RA intron 1 and the 5' region of IL2RA and RBM17. The present genetic and serologic data suggest that inherited altered genetic constitution at the IL2RA locus may predispose to a less destructive course of RA. Copyright © 2013 by the American College of Rheumatology.

  16. High intensity exercise or conventional exercise for patients with rheumatoid arthritis?: outcome expectations of patients, rheumatologists, and physiotherapists.

    NARCIS (Netherlands)

    Munneke, M.; Jong, Z. de; Zwinderman, A.H.; Ronday, H.K.; Ende, C.H.M. van den; Vliet Vlieland, T.P.M.; Hazes, J.M.W.

    2004-01-01

    OBJECTIVE: To examine the outcome expectations of RA patients, rheumatologists, and physiotherapists regarding high intensity exercise programmes compared with conventional exercise programmes. METHODS: An exercise outcome expectations questionnaire was administered to 807 RA patients, 153

  17. High intensity exercise or conventional exercise for patients with rheumatoid arthritis? Outcome expectations of patients, rheumatologists, and physiotherapists

    NARCIS (Netherlands)

    Munneke, M.; de Jong, Z.; Zwinderman, A. H.; Ronday, H. K.; van den Ende, C. H. M.; Vliet Vlieland, T. P. M.; Hazes, J. M. W.

    2004-01-01

    OBJECTIVE: To examine the outcome expectations of RA patients, rheumatologists, and physiotherapists regarding high intensity exercise programmes compared with conventional exercise programmes. METHODS: An exercise outcome expectations questionnaire was administered to 807 RA patients, 153

  18. QUEST-RA: quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Kautiainen, Hannu; Toloza, Sergio

    2007-01-01

    clinical assessment and a patient self-report questionnaire, which was translated into each language. Data on demographic, disease and treatment-related variables were collected and analysed using descriptive statistics. Variation in disease activity on DAS28 (disease activity score on 28-joint count...

  19. Determining the Lowest Optimally Effective Methotrexate Dose for Individual RA Patients Using Their Dose Response Relation in a Tight Control Treatment Approach.

    Directory of Open Access Journals (Sweden)

    Sandhya C Nair

    Full Text Available To determine the optimal methotrexate dose in individual patients and to explore whether this optimal dose and the level of disease activity at that dose could be predicted.Data from CAMERA II trial comparing MTX and MTX with 10 mg of prednisone both in a tight control treatment strategy in early RA was used. For each patient a curve for disease activity over time was fitted and the MTX dose after which further step-up did not result in relevant improvement in disease activity anymore was determined the 'lowest optimally effective MTX dose (LOED'. The association of demographic and clinical characteristics at baseline with this LOED and with the level of disease activity reached at LOED was studied.In 204 (100 MTX and 104 MTX with prednisone out of 236 patients LOED could be defined. 10 mg/wk was the most prevalent LOED in patients treated with MTX and prednisone and 10 mg/wk, 20 mg/wk and 30 mg/wk in the MTX strategy. Although the specific LOED could not reliably be predicted, higher baseline disease activity, height and lower weight were associated with higher LOEDs (i.e at least 15 mg/wk. A score was presented to decide on a starting dose of 10 mg/wk or (at least 15 mg/wk. The level of disease activity at LOED could not be reliably predicted.A starting dose of 10 mg/wk might be a good choice for most patients and is frequently already the optimal dose. However, a subgroup of patient can be determined who would require higher MTX doses.

  20. Early administration of IL-6RA does not prevent radiation-induced lung injury in mice

    Directory of Open Access Journals (Sweden)

    Inoue Takehiro

    2010-04-01

    Full Text Available Abstract Background Radiation pneumonia and subsequent radiation lung fibrosis are major dose-limiting complications for patients undergoing thoracic radiotherapy. Interleukin-6 (IL-6 is a pleiotropic cytokine and plays important roles in the regulation of immune response and inflammation. The purpose of this study was to investigate whether anti-IL-6 monoclonal receptor antibody (IL-6RA could ameliorate radiation-induced lung injury in mice. Methods BALB/cAnNCrj mice having received thoracic irradiation of 21 Gy were injected intraperitoneally with IL-6RA (MR16-1 or control rat IgG twice, immediately and seven days after irradiation. Enzyme-linked immunosorbent assay was used to examine the plasma level of IL-6 and serum amyloid A (SAA. Lung injury was assessed by histological staining with haematoxylin and eosin or Azan, measuring lung weight, and hydroxyproline. Results The mice treated with IL-6RA did not survive significantly longer than the rat IgG control. We observed marked up-regulation of IL-6 in mice treated with IL-6RA 150 days after irradiation, whereas IL-6RA temporarily suppressed early radiation-induced increase in the IL-6 release level. Histopathologic assessment showed no differences in lung section or lung weight between mice treated with IL-6RA and control. Conclusions Our findings suggest that early treatment with IL-6RA after irradiation alone does not protect against radiation-induced lung injury.

  1. ra-nollenergibyggnader

    OpenAIRE

    Allard, Ingrid

    2011-01-01

    Det nya EU-direktivet EPBD2, Energy Performance of Buildings Directive (recast), som antogs 2010, specificerar att alla nya byggnader ska vara så kallade nära-nollenergibyggnader år 2021. En nära-nollenergibyggnad definieras som en byggnad med mycket hög energiprestanda, som till mycket hög grad förses med förnybar energi. Hur detta ska tolkas och var kravnivån ska sättas för energianvändningen är upp till varje land att besluta. I Sverige pågår just nu en debatt om detta och Energimyndighete...

  2. Sodium excretion is higher in patients with rheumatoid arthritis than in matched controls

    National Research Council Canada - National Science Library

    Sarah Marouen; Guilhem du Cailar; Rachel Audo; Cedric Lukas; Gaelle Vial; Anne Tournadre; Emmanuel Barrat; Jean Ribstein; Bernard Combe; Jacques Morel; Claire I Daien

    2017-01-01

    .... We aimed to compare sodium intake in patients with rheumatoid arthritis (RA) vs. matched controls. Methods This case-control study included 24 patients with RA at diagnosis and 24 controls matched by age, gender and body mass index...

  3. Identification of moaA3 gene in patient isolates of Mycobacterium tuberculosis in Kerala, which is absent in M. tuberculosis H37Rv and H37Ra

    Directory of Open Access Journals (Sweden)

    Radhakrishnan Indulakshmi

    2005-10-01

    Full Text Available Abstract Background Tuberculosis is endemic to developing countries like India. Though the whole genome sequences of the type strain M. tuberculosis H37Rv and the clinical strain M. tuberculosis CDC1551 are available, the clinical isolates from India have not been studied extensively at the genome level. This study was carried out in order to have a better understanding of isolates from Kerala, a state in southern India. Results A PCR based strategy was followed making use of the deletion region primers to understand the genome level differences between the type strain H37Rv and the clinical isolates of M. tuberculosis from Kerala. PCR analysis of patient isolates using RD1 region primers revealed the amplification of a 386 bp region, in addition to the expected 652 bp amplicon. Southern hybridization of genomic DNA with the 386 bp amplicon confirmed the presence of this new region in a majority of the patient isolates from Kerala. Sequence comparison of this amplicon showed close homology with the moaA3 gene of M. bovis. In M. bovis this gene is present in the RvD5 region, an IS6110 mediated deletion that is absent in M. tuberculosis H37Rv. Conclusion This study demonstrates the presence of moaA3 gene, that is absent in M. tuberculosis H37Rv and H37Ra, in a large number of local isolates. Whether the moaA3 gene provides any specific advantage to the field isolates of the pathogen is unclear. Field strains from Kerala have fewer IS6110 sequences and therefore are likely to have fewer IS6110 dependent rearrangements. But as deletions and insertions account for much of the genomic diversity of M. tuberculosis, the mechanisms of formation of sequence polymorphisms in the local isolates should be further examined. These results suggest that studies should focus on strains from endemic areas to understand the complexities of this pathogen.

  4. Evaluation of Real-World Experience with Tofacitinib Compared with Adalimumab, Etanercept, and Abatacept in RA Patients with 1 Previous Biologic DMARD: Data from a U.S. Administrative Claims Database.

    Science.gov (United States)

    Harnett, James; Gerber, Robert; Gruben, David; Koenig, Andrew S; Chen, Connie

    2016-12-01

    Real-world data comparing tofacitinib with biologic disease-modifying antirheumatic drugs (bDMARDs) are limited. To compare characteristics, treatment patterns, and costs of patients with rheumatoid arthritis (RA) receiving tofacitinib versus the most common bDMARDs (adalimumab [ADA], etanercept [ETN], and abatacept [ABA]) following a single bDMARD in a U.S. administrative claims database. This study was a retrospective cohort analysis of patients aged ≥ 18 years with an RA diagnosis (ICD-9-CM codes 714.0x-714.4x; 714.81) and 1 previous bDMARD filling ≥ 1 tofacitinib or bDMARD claim in the Truven MarketScan Commercial and Medicare Supplemental claims databases (November 1, 2012-October 31, 2014). Monotherapy was defined as absence of conventional synthetic DMARDs within 90 days post-index. Persistence was evaluated using a 60-day gap. Adherence was assessed using proportion of days covered (PDC). RA-related total, pharmacy, and medical costs were evaluated in the 12-month pre- and post-index periods. Treatment patterns and costs were adjusted using linear models including a common set of clinically relevant variables of interest (e.g., previous RA treatments), which were assessed separately using t-tests and chi-squared tests. Overall, 392 patients initiated tofacitinib; 178 patients initiated ADA; 118 patients initiated ETN; and 191 patients initiated ABA. Tofacitinib patients were older versus ADA patients (P = 0.0153) and had a lower proportion of Medicare supplemental patients versus ABA patients (P = 0.0095). Twelve-month pre-index bDMARD use was greater in tofacitinib patients (77.6%) versus bDMARD cohorts (47.6%-59.6%). Tofacitinib patients had greater 12-month pre-index RA-related total costs versus bDMARD cohorts (all P 0.10) proportion of patients were persistent with tofacitinib (42.6%) versus ADA (37.6%), ETN (42.4%), and ABA (43.5%). Mean PDC was 0.55 for tofacitinib versus 0.57 (ADA), 0.59 (ETN), and 0.44 (ABA; P = 0.0003). Adjusted analyses

  5. Gene expression analysis in RA: towards personalized medicine

    Science.gov (United States)

    Burska, A N; Roget, K; Blits, M; Soto Gomez, L; van de Loo, F; Hazelwood, L D; Verweij, C L; Rowe, A; Goulielmos, G N; van Baarsen, L G M; Ponchel, F

    2014-01-01

    Gene expression has recently been at the forefront of advance in personalized medicine, notably in the field of cancer and transplantation, providing a rational for a similar approach in rheumatoid arthritis (RA). RA is a prototypic inflammatory autoimmune disease with a poorly understood etiopathogenesis. Inflammation is the main feature of RA; however, many biological processes are involved at different stages of the disease. Gene expression signatures offer management tools to meet the current needs for personalization of RA patient's care. This review analyses currently available information with respect to RA diagnostic, prognostic and prediction of response to therapy with a view to highlight the abundance of data, whose comparison is often inconclusive due to the mixed use of material source, experimental methodologies and analysis tools, reinforcing the need for harmonization if gene expression signatures are to become a useful clinical tool in personalized medicine for RA patients. PMID:24589910

  6. Contrasting genetic association of IL2RA with SLE and ANCA – associated vasculitis

    Directory of Open Access Journals (Sweden)

    Todd John A

    2009-03-01

    Full Text Available Abstract Background Autoimmune diseases are complex and have genetic and environmental susceptibility factors. The objective was to test the genetic association of systemic lupus erythematosus (SLE and anti-neutrophil cytoplasmic antibody (ANCA – associated systemic vasculitis (AAV with SNPs in the IL2RA region and to correlate genotype with serum levels of IL-2RA. Methods Using a cohort of over 700 AAV patients, two SLE case-control studies and an SLE trio collection (totalling over 1000 SLE patients, and a TaqMan genotyping approach, we tested 3 SNPs in the IL2RA locus, rs11594656, rs2104286 & rs41295061, each with a prior association with autoimmune disease; rs11594656 and rs41295061 with type 1 diabetes (T1D and rs2104286 with multiple sclerosis (MS and T1D. Results We show that SLE is associated with rs11594656 (P = 3.87 × 10-7 and there is some evidence of association of rs41295061 with AAV (P = 0.0122, which both have prior association with T1D. rs2104286, an MS and T1D – associated SNP in the IL2RA locus, is not associated with either SLE or AAV. Conclusion We have confirmed a previous suggestion that the IL2RA locus is associated with SLE and showed some evidence of association with AAV. Soluble IL-2RA concentrations correlate with rs11594656 genotype in quiescent disease in both AAV and SLE. Differential association of autoimmune diseases and SNPs within the IL2RA locus suggests that the IL2RA pathway may prove to play differing, as yet undefined, roles in each disease.

  7. Remission induction by Raising the dose of Remicade in RA (RRRR study: Rationale and study protocol for a randomized controlled trial comparing for sustained clinical remission after discontinuation of infliximab in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Koji Oba

    2017-12-01

    Full Text Available Infliximab, an inhibitor of TNF-α, is one of the most widely used biological disease-modifying antirheumatic drugs. Recent studies indicated that baseline serum TNF-α could be considered as a key indicator for optimal dosing of infliximab for RA treatment to achieve the clinical response and its sustained remission. The Remission induction by Raising the dose of Remicade in RA (RRRR study is an open-label, parallel group, multicenter randomized controlled trial to compare the proportions of clinical remission based on the simplified disease activity index (SDAI after 1 year of treatment and its sustained remission rate after another 1 year between the investigational treatment strategy (for which the dose of infliximab was chosen based on the baseline serum TNF and the standard strategy of 3 mg/kg per 8 weeks of infliximab administration in infliximab-naïve patients with RA showing an inadequate response to MTX. The primary endpoint is the proportion of patients who kept discontinuation of infliximab 1 year after discontinued infliximab at the time of 54 weeks after the first administration of infliximab. The secondary endpoints are the proportion of clinical remission based on SDAI and changes in SDAI from baseline at each time point, other clinical parameters, quality of life measures and adverse events. Target sample size of randomized patients is 400 patients in total. The main results of the RRRR study are expected to be published at the end of 2017.

  8. LCA versus RA - an introduction

    DEFF Research Database (Denmark)

    Olsen, Stig Irving

    2000-01-01

    Risk Assessment (RA) of chemicals is an environmental management tool used to assess the risk of specific chemicals, which are harmful to man or the environment under certain circumstances of use or in certain environmental recipients. Life Cycle Assessment (LCA) or environmental assessment...... of products is another environmental management tool that gains more and more ground, and which is often thought of as universal due to its basic holistic philosophy. As the environmental impacts of one product can only be seen in relation to the impacts of other products providing the same functions, LCA...... is a comparative tool. The primary purpose of this article is to identify harmonies, discrepancies and relations between the two tools, exemplified by the risk assessment principles of the European Commission (EC) as stated in 'Technical Guidance Document' (EC, 1996) and the LCA method 'EDIP' (Environmental Design...

  9. Competition of IL-1 and IL-1ra determines lymphocyte response to delayed stimulation with PHA.

    Science.gov (United States)

    Dabrowski, M P; Stankiewicz, W; Płusa, T; Chciałowski, A; Szmigielski, S

    2001-06-01

    Human peripheral blood mononuclear cells (PBMC) left in microcultures for 24h without mitogen do not respond to subsequent stimulation with PHA. They regain reactivity if the native culture medium is absorbed with other party lymphocytes or partially replaced with the medium from a PHA-stimulated culture. The observations suggest that, during the incubation, some inhibitory agent had accumulated in the culture medium. The study was performed to determine the nature of the observed phenomenon in respect of the possible role of monocytes and their products IL-1 and IL-1 receptor antagonist (IL-1ra), and to test for immunodiagnostic purposes the significance of quantifying the lymphocyte response to delayed stimulation with PHA in patients suffering from inflammatory prosesses. Lymphocyte response to delayed stimulation with PHA, calculated as the lymphocyte-monokine interaction (LM) index, was determined in the microcultures of PBMC isolated from the blood of healthy donors or of patients with acute tonsilitis. The values of LM indices were compared with the ratios of IL-1ra/IL-1beta concentration estimated by enzyme-linked immunosorbent assay method in the culture supernatants. The influences of exogenous IL-1beta, IL-1ra, anti-IL1ra antibodies and antibiotic cefaclor on the monokine concentrations and on the values of LM index were tested. The results show that the level of lymphocyte response to delayed stimulation with PHA (LM index) is inversely proportional to the ratio of IL-1ra/IL-1beta concentration in the culture. The low LM values at high IL-1ra/IL-1beta ratios in PBMC cultures from healthy donors, reversed proportions found in patients' PBMC (acute tonsilitis), and the cefaclor-induced reduction of LM value with correlated increase of the IL-1ra/IL-1beta ratio suggest that the LM assay may prove to be useful for immunodiagnostic purposes.

  10. IL-1Ra: its role in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    M. Cutolo

    2011-09-01

    Full Text Available Interleukin-1 (IL-1 is one of the pivotal cytokines in initiating and driving the processes of rheumatoid arthritis (RA, and the body’s natural response, IL-1 receptor antagonist (IL-1Ra, has been shown conclusively to block its effects. IL-1 mediate several clinical symptoms of the inflammatory reaction (i.e. fever, pain, sleep disturbances. IL-1 is considered a key mediator in RA joint damage because of its greater capacity (greater than TNF of increasing matrix degradation by inducing the production of MMPs and PGE2 in synovial cells, as well by its role as mediator of bone and cartilage destruction. In addition, IL-1 decreases the repair process by suppressing matrix synthesis and shows a strong synergism with TNF in inducing many inflammatory genes at both local and systemic level. The induced endogenous production of IL-1Ra, in presence of the RA synovitis, is too low to contrast the high affinity of IL-1 for the cell receptors. Therefore, IL-1Ra presence should result in very effective prevention of IL-1 signal transduction particularly in the inflammatory site. In laboratory and animal studies inhibition of IL-1 by either antibodies to IL-1 or IL-1Ra proved beneficial to the outcome. IL-1Ra is a member of the IL-1 superfamily. The effects of different DMARDs on IL-1Ra levels in RA patients support the important role that selected anticytokine treatments might exert in the pathophysiology of the disease. However, since anti TNFα therapy it is not effective in all RA patients, nor does it fully control the arthritic process in affected joints of good responders and complete TNF suppression should be avoided, the combined treatment with intermediate doses of TNF and IL-1 blockers, reaching synergistic suppression of arthritis, seems warranted in RA.

  11. Does Regular Use of a Complementary Medicine of Olea Europe and Ficus carica Have Adverse Effects on Lipid Profile and Fasting Blood Glucose of Rheumatoid Arthritis (RA) Patients Under Treatment with DMARD Regimens Containing Methotrexate?

    Science.gov (United States)

    Bahadori, Shahnaz; Ahmadzadeh, Arman; Shams Ardekani, Mohammad Reza; Kamalinejad, Mohammad; Keshavarz, Mansoor; Salamzadeh, Jamshid

    2016-01-01

    Rheumatoid arthritis (RA) patients are vulnerable to cardiovascular morbidity and mortality in which atherosclerosis plays a major role. In this study, the lipid profile and fasting blood sugar (FBS) of RA patients receiving a complementary medicine of olive and fig, as add-on therapy for routine disease-modifying antirheumatic drugs (DMARDs) regimen containing low dose methotrexate (MTX), were studied. A randomized controlled clinical trial was designed. Adult RA patients were randomly allocated in two groups receiving routine DMARDs regimen (control group) and routine DMARDs regimen plus the herbal supplementary formulation of olive oil, fig and olive fruits (intervention group). Patients were followed every 4 weeks for total study period of 16 weeks. In addition to demographic and medical history of the patients, the total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), the atherogenic index of plasma (AIP) defined as log(TG/HDL-C), and the fasting blood sugar (FBS) were determined and recorded. 56 patients (control = 27 and intervention = 29), with mean ± sd age of 50.9 ± 12.3 years completed the study. Average MTX dose received by intervention and control groups were 24.30 ± 18.39 and 17.61 ± 15.53 mg/week, respectively (p = 0.11). Repeated measures analysis of variance (ANOVA) revealed that differences between lipid profile indicators and FBS in the two study groups were not statistically significant (P>0.05). No additional substantial adverse reaction was seen in the study groups. Our findings are more reassuring for patients and their doctors to trust on the safety of the investigated complementary preparation to be used as add-on therapy to manage rheumatoid arthritis.

  12. Radium Ra 223 dichloride in castration-resistant prostate cancer.

    Science.gov (United States)

    Joung, J Y; Ha, Y S; Kim, I Y

    2013-08-01

    Radium Ra 223 dichloride (Xofigo®, formerly Alpharadin) is one of the representative α-particle-emitting isotopes that delivers radiation with a higher biological effect to a more localized area. Preclinical studies in mouse, rat and canine models have demonstrated that radium Ra 223 dichloride has a definite skeletal affinity and antitumor effect with a relatively low toxicity on bone marrow. More recently, in a large randomized phase III trial (ALSYMPCA), patients with bone metastasis and castration-resistant prostate cancer (CRPC) received six cycles of 50 kBq/kg of radium Ra 223 dichloride in 4-week intervals. In these men, radium Ra 223 dichloride improved the median overall survival by 3.6 months when compared to the placebo group. Collectively, these results suggest that radium Ra 223 dichloride is a promising candidate for managing bone metastases in patients with CRPC. Copyright 2013 Prous Science, S.A.U. or its licensors. All rights reserved.

  13. Determining the lowest optimally effective methotrexate dose for individual RA patients using their dose response relation in a tight control treatment approach

    NARCIS (Netherlands)

    Nair, Sandhya C.; Jacobs, Johannes W G|info:eu-repo/dai/nl/075134373; Bakker, Marije F.|info:eu-repo/dai/nl/304812498; Jahangier, Z. Nazira; Bijlsma, Johannes W J|info:eu-repo/dai/nl/069357536; Van Laar, Jacobs M.; Lafeber, Floris P J G|info:eu-repo/dai/nl/073410071; Welsing, Paco M J|info:eu-repo/dai/nl/288401921

    2016-01-01

    Objective: To determine the optimal methotrexate dose in individual patients and to explore whether this optimal dose and the level of disease activity at that dose could be predicted. Methods: Data from CAMERA II trial comparing MTX and MTX with 10 mg of prednisone both in a tight control treatment

  14. Radium isotope ((223)Ra, (224)Ra, (226)Ra and (228)Ra) distribution near Brazil's largest port, Paranaguá Bay, Brazil.

    Science.gov (United States)

    Dias, Thais H; de Oliveira, Joselene; Sanders, Christian J; Carvalho, Franciane; Sanders, Luciana M; Machado, Eunice C; Sá, Fabian

    2016-10-15

    This work investigates the (223)Ra, (224)Ra, (226)Ra and (228)Ra isotope distribution in river, estuarine waters and sediments of the Paranaguá Estuarine Complex (PEC). The stratification of the Ra isotopes along water columns indicate differing natural sources. In sediments, the radium isotope activities was inversely proportional to the particle size. The highest concentrations of (223)Ra, (224)Ra, (226)Ra and (228)Ra in the water column were found in the bottom more saline waters and towards the inner of the estuary. These relatively high concentrations towards the bottom of the estuary may be attributed to the influence of tidally driven groundwater source and desorption from particles at the maximum turbidity zone. The apparent river water ages from the radium isotope ratios, (223)Ra/(224)Ra and (223)Ra/(228)Ra, indicate that the principal rivers that flow into the estuary have residence times from between 6 and 11days. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Association between Acne and Serum Pro-inflammatory Cytokines (IL-1α, IL-1β, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) in Mustard Gas-Exposed Patients: Sardasht-Iran Cohort Study.

    Science.gov (United States)

    Askari, Nayere; Ghazanfari, Tooba; Yaraee, Roya; Vaez Mahdavi, Mohammad Reza; Soroush, Mohammad-Reza; Mohammad Hassan, Zuhair; Khodashenas, Zohre; Shams, Jalaleddin; Faghihzadeh, Soghrat

    2017-02-01

    Acne vulgaris is a very common chronic inflammatory disorder, yet its pathogenesis is not clearly understood. As part of the SICS, this study was conducted to evaluate the association between the incidence of acne vulgaris in SM-exposed subjects (20 years after the exposure) and serum levels of proinflammatory cytokines (IL-1α, IL-1β, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) in an attempt to better understand the pathogenesis of long-term skin disorders of these individuals. Serum concentrations of cytokines (IL-1α, IL-1β, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) were measured using sandwich ELISA technique. The median of serum levels of IL-1β, IL-8 and RANTES were significantly higher in the exposed patients with acne than those without acne (P = 0.05, 0.03 and 0.001 respectively). There was no significant difference in serum levels of IL-1α, IL-1Ra and IL-6 between the exposed subgroups. We found a positive association between serum levels of pro-inflammatory cytokines (IL-1β, IL-8, IL-12 and RANTES) and acne among SM-exposed population.

  16. Periodontitis in established rheumatoid arthritis patients: a cross-sectional clinical, microbiological and serological study

    Science.gov (United States)

    2012-01-01

    Introduction The association between rheumatoid arthritis (RA) and periodontitis is suggested to be linked to the periodontal pathogen Porphyromonas gingivalis. Colonization of P. gingivalis in the oral cavity of RA patients has been scarcely considered. To further explore whether the association between periodontitis and RA is dependent on P. gingivalis, we compared host immune responses in RA patients with and without periodontitis in relation to presence of cultivable P. gingivalis in subgingival plaque. Methods In 95 RA patients, the periodontal condition was examined using the Dutch Periodontal Screening Index for treatment needs. Subgingival plaque samples were tested for presence of P. gingivalis by anaerobic culture technique. IgA, IgG and IgM antibody titers to P. gingivalis were measured by ELISA. Serum and subgingival plaque measures were compared to a matched control group of non-RA subjects. Results A higher prevalence of severe periodontitis was observed in RA patients in comparison to matched non-RA controls (27% versus 12%, p periodontitis had higher DAS28 scores than RA patients with no or moderate periodontitis (p periodontitis had higher IgG- and IgM-anti P. gingivalis titers than non-RA controls with severe periodontitis (p periodontitis is related to severity of RA. RA patients with severe periodontitis have a more robust antibody response against P. gingivalis than non-RA controls, but not all RA patients have cultivable P. gingivalis. PMID:23075462

  17. Understanding Rheumatoid Arthritis (RA): Research

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Research Past Issues / Summer 2014 Table of ... a project plan to address relevant challenges for rheumatoid arthritis. Read Part 1 on Lupus in MedlinePlus magazine, ...

  18. Automated measurement of {sup 224}Ra and {sup 226}Ra in water

    Energy Technology Data Exchange (ETDEWEB)

    Dimova, N. [Department of Oceanography, Environmental Radioactivity Measurement Facility, Florida State University, Tallahassee, FL 32306 (United States); Burnett, W.C. [Department of Oceanography, Environmental Radioactivity Measurement Facility, Florida State University, Tallahassee, FL 32306 (United States)]. E-mail: wburnett@mailer.fsu.edu; Horwitz, E.P. [PG Research Foundation, 8205 S. Cass Avenue, Suite III, Darien, IL 60561 (United States); Lane-Smith, D. [Durridge Co., Inc., 7 Railroad Avenue, Suite D, Bedford, MA 01730 (United States)

    2007-04-15

    We present a new simple approach for automated, non-destructive measurement of the alpha-emitting radium isotopes ({sup 223}Ra, {sup 224}Ra, and {sup 226}Ra) in water based on the emanation of their respective radon daughters ({sup 219}Rn, {sup 220}Rn, and {sup 222}Rn). The method combines the high adsorption uptake of MnO{sub 2} Resin for radium (K {sub d}=2.4x10{sup 4} ml/g) over a wide pH range with the simplicity of the activity registration using a commercial radon-in-air analyzer (RAD7, DURRIDGE Company, Inc). Radium is first adsorbed onto the MnO{sub 2} Resin by passing a water sample through the resin packed in a gas-tight glass cartridge. The same cartridge is then connected to the radon analyzer via a simple tubing system to circulate air through the resin and a drying system. The efficiency of the proposed system is determined by running standards prepared in the same manner. Our results indicate that the efficiency for {sup 226}Ra is >22% if both {sup 218}Po and {sup 214}Po counts are collected. This is comparable with typical efficiencies for alpha spectrometry but with much less sample preparation. We estimate that an MDA of 0.8 pCi/L for {sup 226}Ra may be obtained with this new approach using a 1 L water sample and less than 4 h of counting.

  19. Evaluation of the quality of pet foods using fast techniques and official methods Avaliação da qualidade de rações utilizando métodos rápidos e métodos oficiais

    Directory of Open Access Journals (Sweden)

    Cibele Cristina Osawa

    2008-12-01

    Full Text Available This paper was designed to evaluate the rancidity of 18 pet food samples using the Diamed FATS kits and official AOCS methods for the quantification of free fatty acids, peroxide value and concentrations of malonaldehyde and alkenal in the lipid extracted. Although expiration dates have passed, the samples presented good quality evidencing little oxidative rancidity. The results of this study suggest that the Brazilian pet food market is replete with products of excellent quality due to the competitiveness of this market sector.O presente trabalho teve como objetivo avaliar 18 amostras de rações, utilizando kits Diamed FATS e métodos oficiais da AOCS para quantificações de ácidos graxos livres, índice de peróxido e concentrações de malonaldeído e alquenais no lipídio extraído. Embora estivessem fora do prazo de validade, as amostras apresentaram boa qualidade, indicada pelos baixos valores de rancidez oxidativa. Os resultados deste estudo sugerem que o mercado brasileiro de rações conta com produtos de excelente qualidade, devido à competitividade do setor.

  20. Recovery of Ra-223 from natural thorium irradiated by protons

    Energy Technology Data Exchange (ETDEWEB)

    Vasiliev, Aleksandr N.; Ostapenko, Valentina S. [Lomonosov Moscow State Univ. (Russian Federation); Russian Academy of Sciences, Moscow-Troitsk (Russian Federation). Inst. for Nuclear Research; Lapshina, Elena V.; Ermolaev, Stanislav V.; Zhuikov, Boris L. [Russian Academy of Sciences, Moscow-Troitsk (Russian Federation). Inst. for Nuclear Research; Danilov, Sergey S. [Lomonosov Moscow State Univ. (Russian Federation); Kalmykov, Stepan N. [Lomonosov Moscow State Univ. (Russian Federation); National Research Center ' Kurchatov Institute' (NRC ' Kurchatov Institute' ), Moscow (Russian Federation)

    2016-11-01

    Irradiation of natural thorium with medium-energy protons is considered to be a prospective approach to large-scale production of {sup 225}Ac and {sup 223}Ra. In addition to the earlier-developed method of {sup 225}Ac isolation, the present work focuses on the simultaneous recovery of {sup 223}Ra from the same thorium target. Radiochemical procedure is based on liquid-liquid extraction, cation exchange and extraction chromatography. The procedure provides separation of radium from spallation and fission products generated in the thorium target. High chemical yield (85-90%) and radionuclide purity of {sup 223}Ra (> 99.8% except {sup 224}Ra and {sup 225}Ra isotopes) have been achieved.

  1. Developing a construct to evaluate flares in rheumatoid arthritis: a conceptual report of the OMERACT RA Flare Definition Working Group.

    Science.gov (United States)

    Alten, Rieke; Pohl, Christof; Choy, Ernest H; Christensen, Robin; Furst, Daniel E; Hewlett, Sarah E; Leong, Amye; May, James E; Sanderson, Tessa C; Strand, Vibeke; Woodworth, Thasia G; Bingham, Clifton O

    2011-08-01

    this outcome/response, thus expanding an understanding of the true impact of a therapy to limit disease activity. Clinically, this approach is intended to enhance patient-HCP communication. This article describes the conceptual framework being used by the OMERACT RA Flare Definition Working Group in developing a standardized method for description and measurement of "flare in RA" to guide individual patient treatment.

  2. Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA Study

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Kautiainen, Hannu; Pincus, Theodore

    2010-01-01

    of biologic agents offers potential for reduced work disability rates, but the conclusions are based on surrogate disease activity measures derived from studies primarily from Western countries. METHODS: The Quantitative Standard Monitoring of Patients with RA (QUEST-RA) multinational database of 8......ABSTRACT: INTRODUCTION: Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also more significantly with demographic, functional, occupational, and societal variables. Recent reports suggest that the use......,039 patients in 86 sites in 32 countries, 16 with high gross domestic product (GDP) (>24K US dollars (USD) per capita) and 16 low-GDP countries (disability status at onset and over the course of RA and clinical status of patients who continued working or had stopped working...

  3. Comparing three patient-controlled analgesia methods.

    Science.gov (United States)

    Hoare, K; Sousa, K H; Person, L; De Ryke, P; Piper, J

    2000-02-01

    Among 301 patients randomly assigned to use one of three methods for patient-controlled analgesia (PCA), no statistically significant differences were found for self-reported pain or acceptability of PCA method. Methods yielded differences in on-demand bolus analgesia use and number of symptoms.

  4. Avaliação da expressão de interleucina 1 beta (IL-1β e antagonista do receptor de interleucina 1 (IL-1Ra em pacientes com hanseníase Evaluation of the expression of interleukin 1 beta(IL-1β and interleukin 1 receptor antagonist (IL-1Ra in leprosy patients

    Directory of Open Access Journals (Sweden)

    Rosane Dias Costa

    2008-01-01

    Full Text Available A hanseníase é uma doença infectocontagiosa espectral que acompanha-se por uma série de eventos imunológicos desencadeados pela resposta do hospedeiro frente ao agente etiológico, o Mycobacterium leprae. Evidências sugerem que a indução e manutenção da resposta imune/inflamatória na hanseníase estão vinculadas a interações de múltiplas células e fatores solúveis, particularmente através da ação de citocinas. Nesse estudo, foram mensurados níveis de IL-1β e IL-1Ra de 37 casos novos de hanseníase acompanhados ao longo do tratamento e 30 controles sadios pelo teste ELISA. A coleta de sangue periférico foi realizada em quatro tempos para os casos de hanseníase (pré-tratamento com PQT, 2ª dose, 6ª dose e pós-PQT e em único momento para os controles. Na comparação dos níveis das moléculas de casos no pré-PQT e controles, houve diferença estatisticamente significativa somente para IL-1β. Nossos resultados sugerem a participação dessa citocina no processo imune/inflamatório.Leprosy is an infectious and contagious spectral disease accompanied by a series of immunological events triggered by the host's response to the etiologic agent, Mycobacterium leprae. Evidence suggests that the induction and maintenance of the immune/inflammatory response in leprosy are linked to multiple cell interactions and soluble factors, mainly through the action of cytokines. The ELISA test was used to measure the levels of IL-1β and IL-1Ra in 37 new leprosy patients followed-up during treatment and 30 healthy controls. Peripheral blood was collected four times during the treatment of leprosy patients (MDT pretreatment, 2nd dose, 6th dose and post-MDT, and only once from the controls. The comparison of molecular levels in pre-MDT patients and controls showed a statistically significant difference for IL-1β. The results suggest the participation of this cytokine in the genesis of the immune/inflammatory process.

  5. Patient and clinician views on the quality of foot health care for rheumatoid arthritis outpatients: a mixed methods service evaluation.

    Science.gov (United States)

    de Souza, Savia; Williams, Ruth; Lempp, Heidi

    2016-01-01

    Feet are often the first site of joint involvement in rheumatoid arthritis (RA) and get progressively worse if unmanaged, leading to permanent disability and negatively impacting patients' quality of life. Podiatrists are specialists in the assessment, diagnosis and management of foot and ankle problems, however, RA outpatients often rely on referral from rheumatology clinicians to gain access to musculoskeletal podiatry services on the UK National Health Service (NHS). Therefore, the aim of this evaluation was to identify the foot health needs of rheumatoid arthritis patients and if they are being met by rheumatology clinicians. A mixed methods approach was used: collecting qualitative data from patients and quantitative data from clinicians. Two focus groups were conducted with nine RA patients from a tertiary rheumatology outpatient clinic in the UK and the data were thematically analysed to inform a clinician survey. Thirteen rheumatology clinicians, from the same centre, completed the online survey. Resultant data were analysed to produce descriptive statistics. Patient focus group data generated four main themes: (1) need for foot health information, (2) feet ignored during routine consultations, (3) frequency of foot examination and (4) access to podiatry. Survey data highlighted that (i) 69-85 % of clinicians provided patients with foot health information sometimes, (ii) feet were examined in 47 % of routine consultations, (iii) 54 % of clinicians did not examine feet routinely because they are not included in the disease activity score with 28 joints (DAS-28), (iv) 31 % of clinicians referred patients to podiatry upon RA diagnosis, (v) 0 % of clinicians referred patients to podiatry for periodic review, (vi) 54 % of clinicians believed patients will self-report foot problems and (vii) 62 % of clinicians felt competent in foot examination. RA patients' foot health needs were not being fully met by rheumatology clinicians. Patients want foot health

  6. Early recognition improves prognosis in elderly onset RA. .

    Science.gov (United States)

    Negoescu, Andra; Ostör, Andrew J K

    2014-01-01

    Although commonly diagnosed in the third to fifth decades of life, the incidence and prevalence of RA continue to increase up to the ninth decade. Age at onset is particularly relevant as the presentation may differ in elderly onset RA (EORA) compared with young onset RA (YORA). Patients with EORA frequently report a more acute presentation, especially if positive for rheumatoid factor (RF). Fever, fatigue and weight loss appear to be more common in EORA. Although small joints are most frequently involved in the RA population overall, there is common involvement of large joints in EORA and these proximal symptoms may mimic polymyalgia rheumatica (PMR). In YORA, approximately 80% of patients are seropositive for RF however a lower frequency has been reported in EORA. Anti-CCP antibodies have been detected in over 70% of patients with RA and are highly specific for RA. The value of anti-CCP antibodies is even higher in patients with an atypical presentation (e.g. PMR-like symptoms), or those who are RF negative. X-rays of the hands and feet should always be performed in patients with a suspected inflammatory arthritis. Baseline joint erosions are present in a similar proportion in patients with YORA and EORA. In the elderly, the differential diagnosis of RA is extensive as many conditions present in a similar way e.g. PMR, osteoarthritis, polyarticular gout, pseudogout and malignancy. Anti-CCP antibodies are very useful for identifying EORA patients with a polymyalgic onset. Ultrasonography or MRI can also be helpful in differentiating PMR from EORA.

  7. Mitochondrial haplogroups in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Duhn, Pernille Hurup; Sode, Jacob; Hagen, Christian Munch

    2017-01-01

    Objective To describe the distribution of specific mitochondrial DNA (mtDNA) haplogroups (hgs) in a cohort of patients with rheumatoid arthritis (RA). Methods Two-hundred nineteen consecutive patients with RA had mtDNA isolated from their blood, sequenced and haplotyped. Patients were diagnosed...

  8. SU-F-J-08: Quantitative SPECT Imaging of Ra-223 in a Phantom

    Energy Technology Data Exchange (ETDEWEB)

    Yue, J; Hobbs, R; Sgouros, G; Frey, E [Johns Hopkins University Baltimore, MD (United States)

    2016-06-15

    Purpose: Ra-223 therapy of prostate cancer bone metastases is being used to treat patients routinely. However, the absorbed dose distribution at the macroscopic and microscopic scales remains elusive, due to the inability to image the small activities injected. Accurate activity quantification through imaging is essential to calculate the absorbed dose in organs and sub-units in radiopharmaceutical therapy, enabling personalized absorbed dose-based treatment planning methodologies and more effective and optimal treatments. Methods: A 22 cm diameter by 20 cm long cylindrical phantom, containing a 3.52 cm diameter sphere, was used. A total of 2.01 MBq of Ra-223 was placed in the phantom with 177.6 kBq in the sphere. Images were acquired on a dual-head Siemens Symbia T16 gamma camera using three 20% full-width energy windows and centered at 84, 154, and 269 keV (120 projections, 360° rotation, 45 s per view). We have implemented reconstruction of Ra-223 SPECT projections using OS-EM (up to 20 iterations of 10 subsets) with compensation for attenuation using CT-based attenuation maps, collimator-detector response (CDR) (including septal penetration, scatter and Pb x-ray modeling), and scatter in the patient using the effective source scatter estimation (ESSE) method. The CDR functions and scatter kernels required for ESSE were computed using the SIMIND MC simulation code. All Ra-223 photon emissions as well as gamma rays from the daughters Rn-219 and Bi-211 were modeled. Results: The sensitivity of the camera in the three combined windows was 107.3 cps/MBq. The visual quality of the SPECT images was reasonably good and the activity in the sphere was 27% smaller than the true activity. This underestimation is likely due to partial volume effect. Conclusion: Absolute quantitative Ra-223 SPECT imaging is achievable with careful attention to compensate for image degrading factors and system calibration.

  9. Lightcurve of NEA 1993 RA

    Science.gov (United States)

    Vaduvescu, Ovidiu; Aznar Macias, Amadeo

    2018-01-01

    The near-Earth asteroid (NEA) 1993 RA was observed with the 2.5-m Isaac Newton Telescope (INT) in full Moon conditions for 8h total during three successive nights (2017 Oct 3-6). The composite lightcurve could be fit by a 3-order period P = 5.64 ± 0.01 h with amplitude of 0.13 mag; other solutions are possible.

  10. ANTI-HETEROGENEOUS NUCLEAR RIBONUCLEOPROTEIN B1 (ANTI-RA33 ANTIBODIES IN RHEUMATOID ARTHRITIS AND SYSTEMIC SCLEROSIS

    Directory of Open Access Journals (Sweden)

    P. A. Kuznetsova

    2017-01-01

    Full Text Available Anti-heterogeneous nuclear ribonucleoprotein (RNP autoantibodies (AAbs are encountered in many autoimmune rheumatic diseases (ARDs. The potential diagnostic value of the RA33 AAb complex consisting of RNP A2 and alternative domains of the splicing proteins RNP B1 and RNP B2 is now of interest to rheumatologists. Subjects and methods. The authors studied the frequency of anti-RNP B1 AAbs in 300 patients with systemic ARDs, including those with rheumatoid arthritis (RA, ankylosing spondylitis (AS, systemic lupus erythematosus (SLE, systemic sclerosis (SSc, and Sjö gren's syndrome (SS and in 53 people without ARDs, who constituted a control group. Serum anti-RNP B1 AAbs were assessed by enzyme immunoassay. Results and discussion. The frequency of anti-RNP B1 AAbs in patients with ARDs was much higher than that in the control group: 170/300 (56.6% and 8/53 (13% patients, respectively. Anti-RNP B1 AAbs were detected in 78.5% (113/144 of the patients with RA; 40.3% (23/57 of those with AS, in 67.5% (27/40 of those with SSc, in 36.4% (16/44 of those with SLE, and in 13.3% (2/15 of those with SS. The diagnostic sensitivity of the marker for RA was 78.5%, its diagnostic specificity was 84.9%; the likelihood ratio of positive and negative results was 5.24 and 0.24, respectively. In the patients with RA, the level of anti-RNP B1 AAbs significantly correlated with that of C-reactive protein and erythrocyte sedimentation rate, while in those with SSc the detection of anti-RNP B1 AAbs was related to the rigidity of the vascular wall and the presence of hypertension. The frequency of anti-RNP B1 AAbs among the RA patients seronegative for rheumatoid factor and anti-cyclic citrullinated peptide antibodies was 15.4%. Conclusion. Anti-RNP B1 AAs are a useful laboratory marker (with the upper limit of the normal range being 3.3 U/ml, but are of limited value in the diagnosis of RA. Anti-RNP B1 AAbs may be regarded as an additional diagnostic marker for RA.

  11. Compilation of Spectroscopic Data of Radium (Ra I and Ra II)

    NARCIS (Netherlands)

    Dammalapati, U.; Jungmann, K.; Willmann, L.

    2016-01-01

    Energy levels, wavelengths, lifetimes, and hyperfine structure constants for the isotopes of the first and second spectra of radium, Ra I and Ra II, have been compiled. Wavelengths and wavenumbers are tabulated for 226Ra and for other Ra isotopes. Isotope shifts and hyperfine structure constants of

  12. Compilation of spectroscopic data of Radium (Ra I and Ra II)

    CERN Document Server

    Dammalapati, U; Willmann, L

    2016-01-01

    Energy levels, wavelengths, lifetimes and hyperfine structure constants for the isotopes of the first and second spectra of radium, Ra I and Ra II have been compiled. Wavelengths and wave numbers are tabulated for 226Ra and for other Ra isotopes. Isotope shifts and hyperfine structure constants of even and odd-A isotopes of neutral radium atom and singly ionized radium are included. Experimental lifetimes of the states for both neutral and ionic Ra are also added, where available. The information is beneficial for present and future experiments aimed at different physics motivations using neutral Ra and singly ionized Ra.

  13. Conceptualising patient empowerment: a mixed methods study.

    Science.gov (United States)

    Bravo, Paulina; Edwards, Adrian; Barr, Paul James; Scholl, Isabelle; Elwyn, Glyn; McAllister, Marion

    2015-07-01

    In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess effectiveness of interventions designed to promote it. The aim in this study was to develop a conceptual map of patient empowerment, including components of patient empowerment and relationships with other constructs such as health literacy, self-management and shared decision-making. A mixed methods study was conducted comprising (i) a scoping literature review to identify and map the components underpinning published definitions of patient empowerment (ii) qualitative interviews with key stakeholders (patients, patient representatives, health managers and health service researchers) to further develop the conceptual map. Data were analysed using qualitative methods. A combination of thematic and framework analysis was used to integrate and map themes underpinning published definitions of patient empowerment with the views of key UK stakeholders. The scoping literature review identified 67 articles that included a definition of patient empowerment. A range of diverse definitions of patient empowerment was extracted. Thematic analysis identified key underpinning themes, and these themes were used to develop an initial coding framework for analysis of interview data. 19 semi-structured interviews were conducted with key stakeholders. Transcripts were analysed using the initial coding framework, and findings were used to further develop the conceptual map. The resulting conceptual map describes that patient empowerment can be conceived as a state ranging across a spectrum from low to high levels of patient empowerment, with the level of patient empowerment potentially measurable using a set of indicators. Five key components of the conceptual map were identified: underpinning ethos, moderators

  14. Tocilizumab: a novel humanized anti-interleukin 6 (IL-6) receptor antibody for the treatment of patients with non-RA systemic, inflammatory rheumatic diseases.

    Science.gov (United States)

    Alten, Rieke; Maleitzke, Tazio

    2013-06-01

    Tocilizumab is a highly effective therapeutic agent for the treatment of rheumatoid arthritis and systemic juvenile idiopathic arthritis. Furthermore, a large amount of case study data reveals that tocilizumab can be an effective therapy for not only rheumatoid arthritis but also for other mostly rare inflammatory rheumatic diseases. By blocking the interleukin-6 pathway tocilizumab can be a useful therapeutic alternative when conventional treatment fails. It is successful in treating diseases such as the adult-onset Still's disease, amyloidosis, giant cell arteritis, multiple myeloma, polymyalgia rheumatica, relapsing polychondritis, remitting seronegative symmetrical synovitis with pitting edema-syndrome, systemic lupus erythematosus, systemic sclerosis, and Takayasu arteritis. Studies underway are now recruiting patients to acquire further data on treating patients with non-rheumatic arthritis, inflammatory diseases. This review focuses on tocilizumab as a promising agent for treating rare and orphan diseases in rheumatology for which no satisfactory treatment is yet available.

  15. Effect of radium-223 dichloride (Ra-223) on hospitalisation: An analysis from the phase 3 randomised Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) trial.

    Science.gov (United States)

    Parker, Christopher; Zhan, Lin; Cislo, Paul; Reuning-Scherer, Jonathan; Vogelzang, Nicholas J; Nilsson, Sten; Sartor, Oliver; O'Sullivan, Joe M; Coleman, Robert E

    2017-01-01

    Symptomatic skeletal events (SSEs) commonly occur in patients with bone metastases, often leading to hospitalisations and decreased quality-of-life. In the ALSYMPCA trial, radium-223 significantly improved overall survival (hazard ratio 0.70, 95% confidence interval [CI] 0.58-0.83, P radium-223 (218/589; 37.0%) versus placebo patients (133/292; 45.5%) had at least one hospitalisation event (P = 0.016). However, mean number of hospitalisation events per patient was similar (radium-223 0.69 versus placebo 0.79, P = 0.226), likely due to the significantly longer follow-up time for radium-223 (7.82 months versus 6.92 months for placebo; P radium-223 (4.44 versus 6.68, respectively, P = 0.004). The reduction in hospitalisation days with radium-223 was observed both before first SSE (2.35 days versus 3.36 days, respectively) and after SSE (7.74 days versus 9.19 days, respectively). Our data suggest that this reduced hospital days along with the survival benefit and reduction in time to SSEs with radium-223 treatment may contribute to improvements in health-related quality-of-life in patients with castration-resistant prostate cancer with symptomatic bone metastases (ALSYMPCA ClinicalTrials.gov number, NCT00699751.). Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Compilation of spectroscopic data of Radium (Ra I and Ra II)

    OpenAIRE

    Dammalapati, U.; Jungmann, K.; Willmann, L.

    2016-01-01

    Energy levels, wavelengths, lifetimes and hyperfine structure constants for the isotopes of the first and second spectra of radium, Ra I and Ra II have been compiled. Wavelengths and wave numbers are tabulated for 226Ra and for other Ra isotopes. Isotope shifts and hyperfine structure constants of even and odd-A isotopes of neutral radium atom and singly ionized radium are included. Experimental lifetimes of the states for both neutral and ionic Ra are also added, where available. The informa...

  17. Carbamylation/citrullination of IgG Fc in bronchiectasis, established RA with bronchiectasis and RA smokers: a potential risk factor for disease

    Directory of Open Access Journals (Sweden)

    David Hutchinson

    2017-09-01

    Full Text Available Bronchiectasis (BR and smoking are risk factors for rheumatoid arthritis (RA development. The mechanisms by which smoking and BR trigger RA are unknown, but are associated with concurrent rheumatoid factor (RF and anti-cyclic citrullinated peptide antibody (anti-CCP positivity. Anti-carbamylated protein antibodies (anti-CarP have also been observed in BR patients and can be induced by smoking. Given that RF only has one antigen, immunoglobulin G (IgG we have suggested that post-translational modifications to the Fc region of the heavy chain of IgG (IgGH are a potential explanation for the clustering of the RA-associated autoantibodies in RA. Protein analysis was undertaken on 22 individuals. Four of the individuals had a diagnosis of BR at the time of protein analysis and subsequently developed RA up to 18 months following blood sampling. Four smoking RA patients and 4 patients with both BR and RA and 10 healthy controls were also studied. We identified modified arginines (Arg frequently in the variable region and CH3 domains of IgG in patients and control subjects alike, but only observed carbamylated Lys and/or citrullinated Arg modifications in the RF binding site of the IgG CH2 domain of 5/12 (41.7% patients investigated (1 BR, 2 RA and 2 BRRA, but in no control subjects (0/10, 0% p=0.02. This is the first report of citrullination and carbamylation at the RF binding site of IgG in RA. These results point towards the concept of a universal antigen in RA, an antigen that is post-translationally modified at the Fc region of IgGH.

  18. Cardiovascular disease in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Naranjo, Antonio; Sokka, Tuulikki; Descalzo, Miguel

    2008-01-01

    ABSTRACT: INTRODUCTION: We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross......-sectional cohort of nonselected consecutive outpatients with RA (The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis Program, or QUEST-RA) who were receiving regular clinical care. METHODS: The study involved a clinical assessment by a rheumatologist and a self-report questionnaire...

  19. Interleukin-4 (IL4 and Interleukin-4 receptor (IL4RA polymorphisms in asthma: a case control study

    Directory of Open Access Journals (Sweden)

    Lorente Félix

    2005-11-01

    Full Text Available Abstract Background IL4/IL4RA pathway plays an important role in atopy and asthma. Different polymorphisms in IL4 and IL4RA genes have been described. Particularly, -33C>TIL4 and 576Q>RIL4RA SNPs have been independently associated to atopy and asthma. The purpose of this study was to analyse these polymorphisms in a population of patients with a well-characterized asthma phenotype. Methods A total of 212 unrelated Caucasian individuals, 133 patients with asthma and 79 healthy subjects without symptoms or history of asthma or atopy and with negative skin prick tests were recruited. Lung function was measured by spirometry and asthma was specialist physician-diagnosed according to the ATS (American Thoracic Society criteria and classified following the GINA (Global Initiative for Asthma guidelines. Skin prick tests were performed according to EAACI recommendations. -33C>TIL4 was studied with TaqMan assay and 576Q>RIL4RA by PCR-RFLP technique. Hardy-Weinberg equilibrium was analysed in all groups. Dichotomous variables were analysed using χ2, Fisher exact test, Monte Carlo simulation test and odds ratio test. To model the effects of multiple covariates logistic regression was used. Results No statistically significant differences between the group of patients with asthma and the controls were found when the allele and genotype distribution of -33C>TIL4 and 576Q>RIL4RA polymorphisms were compared. However, the T allele of the -33C>TIL4 SNP was more frequent in patients with persistent asthma. Multivariate analysis adjusted for age and sex confirmed that carriers of allele T had an increased risk of persistent asthma (OR:2.77, 95%CI:1.18–6.49; p = 0.019. Analysis of combination of polymorphisms showed that patients carrying both the T allele of -33C>TIL4 and the A allele of 576Q>RIL4RA had an increased risk of asthma. This association was particularly observed in persistent asthma [Fisher's p value = 0.0021, Monte Carlo p value (after 104

  20. Determination of Ra-223 in human excretion samples by means of α-spectrometry; Bestimmung von {sup 223}Ra in Ausscheidungsproben mittels α-Spektrometrie

    Energy Technology Data Exchange (ETDEWEB)

    Zoriy, M.V.; Froning, M.; Hill, P. [Forschungszentrum Juelich GmbH (Germany). Geschaeftsbereich Strahlenschutz und Sicherheit

    2015-07-01

    To ensure the safety of occupationally exposed person for possible incorporation of {sup 223}Ra during the handling with Alpharadin / Xofigo {sup registered}, the determination of {sup 223}Ra activity in its excretion sample (e.g, in a stool sample) might be of great importance. To assess the {sup 223}Ra activity in human faeces samples a new analytical method was developed in our laboratory. The determination is performed by means of grid-ionization a-spectrometry. After a relatively simple sample preparation procedure (usually within max. 6 hours) and the addition of an internal standard, a direct determination of {sup 223}Ra with the grid ionization chamber (GIK) is possible. The method was optimized and successfully tested. The procedure-related LOD for {sup 223}Ra in a 24-hour faeces sample was 0.1 Bq/Probe.

  1. Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA.

    Science.gov (United States)

    Platten, Michael; Kisten, Yogan; Kälvesten, Johan; Arnaud, Laurent; Forslind, Kristina; van Vollenhoven, Ronald

    2017-01-01

    To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA). Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the SWEdish FarmacOTherapy study. Fully automated JSW measurements of bilateral metacarpals 2, 3 and 4 were compared with the joint space narrowing (JSN) score in SHS. Multilevel mixed model statistics were applied to calculate the significance of the association between ΔJSW and ΔBMD over 1 year, and the JSW differences between damaged and undamaged joints as evaluated by the JSN. Based on 576 joints of 96 patients with eRA, a significant reduction from baseline to 1 year was observed in the JSW from 1.69 (±0.19) mm to 1.66 (±0.19) mm (p0) joints: 1.68 mm (95% CI 1.70 to 1.67) vs 1.54 mm (95% CI 1.63 to 1.46). Similarly the unadjusted multilevel model showed significant differences in JSW between undamaged (1.68 mm (95% CI 1.72 to 1.64)) and damaged joints (1.63 mm (95% CI 1.68 to 1.58)) (p=0.0048). This difference remained significant in the adjusted model: 1.66 mm (95% CI 1.70 to 1.61) vs 1.62 mm (95% CI 1.68 to 1.56) (p=0.042). To measure the JSW with this fully automated digital tool may be useful as a quick and observer-independent application for evaluating cartilage damage in eRA. NCT00764725.

  2. Temporomandibular disorders in patients with rheumatoid arthritis: A ...

    African Journals Online (AJOL)

    Objectives: The aim of this study is to evaluate the prevalence and type of temporomandibular disorders (TMD) in patients with rheumatoid arthritis (RA). Materials and Methods: Fifty‑four patients having RA treatment at Cukurova University in Rheumatology Clinic were enrolled to the study. Demographic and rheumatologic ...

  3. Social participation in early and established rheumatoid arthritis patients

    NARCIS (Netherlands)

    Benka, Jozef; Nagyova, Iveta; Rosenberger, Jaroslav; Macejova, Zelmira; Lazurova, Ivica; van der Klink, J.L.L.; Groothoff, Johan W.; van Dijk, Jitse P.

    2016-01-01

    Purpose: The aim of the study was to examine whether rheumatoid arthritis (RA) patients with different levels of restriction in social participation differ in disease related as well as psychosocial variables and whether a similar pattern can be found among early and established RA patients. Method:

  4. First Measurement of the Atomic Electric Dipole Moment of $^{225}$Ra

    CERN Document Server

    Parker, R H; Kalita, M R; Lemke, N D; Bailey, K G; Bishof, M N; Greene, J P; Holt, R J; Korsch, W; Lu, Z -T; Mueller, P; O'Connor, T P; Singh, J T

    2015-01-01

    The radioactive radium-225 ($^{225}$Ra) atom is a favorable case to search for a permanent electric dipole moment (EDM). Due to its strong nuclear octupole deformation and large atomic mass, $^{225}$Ra is particularly sensitive to interactions in the nuclear medium that violate both time-reversal symmetry and parity. We have developed a cold-atom technique to study the spin precession of $^{225}$Ra atoms held in an optical dipole trap, and demonstrated the principle of this method by completing the first measurement of its atomic EDM, reaching an upper limit of $|$$d$($^{225}$Ra)$|$ $<$ $5.0\\!\\times\\!10^{-22}$ $e \\cdot$cm (95$\\%$ confidence).

  5. Patients with newly diagnosed Rheumatoid Arthritis are at increased risk of Diabetes Mellitus

    DEFF Research Database (Denmark)

    Emamifar, Amir; Levin, Klaus; Jensen Hansen, Inger Marie

    2017-01-01

    AIMS: To reveal the prevalence of Diabetes Mellitus (DM) in patients with newly diagnosed Rheumatoid Arthritis (RA) and evaluate the association between clinical characteristics of RA and DM as well as treatment response in newly diagnosed RA patients with DM. METHODS: Newly diagnosed, adult, RA......-C-reactive protein (DAS28-CRP) at the time of diagnosis and after 4 months (±1-2 months) of treatment initiation were extracted from Danbio Registry. To reveal the presence of DM, patients' electronic medical records were reviewed. The prevalence of DM in our patients was compared (using an age- and gender......, RF, anti-CCP as well as ANA. Additionally, presence of DM in the RA patients was not a negative predictor of treatment response measured by the European League Against Rheumatism (EULAR) response criteria and ∆DAS28-CRP. CONCLUSION: Newly diagnosed RA patients are at higher risk of DM (13% versus 5...

  6. Increased levels of peptidylarginine deiminase 2 in synovial fluid from anti-CCP-positive rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Damgaard, Dres; Senolt, Ladislav; Nielsen, Claus H

    2016-01-01

    OBJECTIVE: To quantify peptidylarginine deiminase 2 (PAD2) in SF of RA patients and OA patients, and to determine the association between PAD2 levels, disease activity and inflammatory markers in RA. METHODS: Blood and SF samples were obtained from 39 RA patients and 40 patients with OA. PAD2...... content and PAD activity were measured by means of in-house assays. TNF-α, IL-1β, IL-6, IL-8, IL-10 and IL-12 were measured using flow cytometry. RESULTS: PAD2 levels and PAD activity were higher in SF from RA than OA patients (P cytokine levels (P

  7. Retinoic Acid 4-Hydroxylase Inducibility and Clinical Response to Isotretinoin in Acne Patients

    Science.gov (United States)

    Wang, Frank; Kwak, Heh Shin R.; Elbuluk, Nada; Kaczmarek, Anya L.; Hamilton, Ted; Voorhees, John J.; Fisher, Gary J.; Kang, Sewon

    2011-01-01

    Background The cytochrome P450 enzyme CYP26 (retinoic acid 4-hydroxylase) initiates the catabolism of all-trans retinoic acid (tRA) and limits the effects of tRA. The CYP26 enzyme acts on tRA, but not 13-cis RA (isotretinoin), a retinoid used to treat severe acne. However, 13-cis RA can isomerize to tRA, which can then be metabolized by CYP26. Objective In healthy subjects, we assessed the variability of CYP26 enzymatic activity. We then investigated whether response to oral 13-cis RA among acne patients correlates with variability in CYP26 expression. Methods In healthy subjects, we isolated microsomal fractions from the epidermis of keratome biopsies and measured CYP26 enzymatic activity in untreated skin and skin treated with tRA. Enzymatic activity was determined based on rate of formation of 4-hydroxy RA (pg/min) per mg microsomal protein. Using real-time PCR we quantified CYP26 mRNA induction after tRA application in acne patients who responded or did not respond to one course of 13-cis RA. Results In normal skin (N=118), CYP26 enzymatic activity was widely variable (1–180 pg/min per mg microsomal fraction; mean 42.7 ± 3.5). Furthermore, CYP26 enzymatic activity was inducible in a dose-dependent manner in normal skin following tRA application, but not correlated with age or sex (N=29). In acne patients, CYP26 mRNA induction following 0.1% tRA application did not differ (P>0.05) between subjects who responded (N=8, 587±325 fold) or did not respond (N=8, 657±227 fold) to one course of 13-cis RA. Limitations The small number of acne patients treated with 13-cis RA was a major limitation. Conclusion Factors other than CYP26 activity may determine response to isotretinoin in acne. PMID:19525031

  8. The use of kinesiology taping method in patients with rheumatoid hand--pilot study.

    Science.gov (United States)

    Szczegielniak, Jan; Łuniewski, Jacek; Bogacz, Katarzyna; Sliwiński, Zbigniew

    2012-01-01

    Rheumatoid arthritis (RA) most frequently affects smaller joints in the hands and feet. Among the most common deformations resulting from the progression of the disease are ulnar deviation, Boutonniere deformity, swan neck deformity, contractures and limited range of movement in the hand and wrist joints, muscular atrophy of long and short muscles. The topic of this article is the influence of using Kinesiology Taping method on the functioning of the hand of the patient suffering from rheumatoid arthritis. The research involved 20 patients suffering from rheumatoid arthritis (16 women, 4 men), treated in the Hospital in Kup. Average age of patients was 62.2. Research subjects, apart from pharmacological treatment in the hospital ward, received standard physiotherapy. In case of 10 patients additional K-Active Tape applications were used to correct ulnar positioning of the hand and improve hand functioning. Prior to physiotherapy, all patients were given a hand functioning test and a dynamometer measurement was made. The tests were repeated after the 2-week rehabilitation process has been completed. The results were subjected to statistical analysis with the use of the Wilcoxon test and the U Mann-Whitney test. The assessment of the correlation between analysed parameters was made with the use of linear correlation test. In the group where Kinesiology Tape applications were used, hand muscle strength increased significantly (p0.8). Results suggest Kinesiology Taping method useful for physiotherapy of rheumatoid hand.

  9. Treatment of ankylosing spondylitis with [{sup 224}Ra]-Radiumchloride; Therapie der Spondylitis ankylosans mit [{sup 224}Ra]-Radiumchlorid

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, C. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Braun, J. [Rheumazentrum Ruhrgebiet Herne (Germany)

    2001-07-01

    Ankylosing spondylitis (AS) is a chronic disease which in 30-50% of the patients leads to considerable episodes of pain, a remarkable reduction of quality of life and disablement. For treatment mostly nonsteroidal antiphlogistic drugs are used which are able to reduce pain in approximately 80% of the patients only. Those drugs however, have to be withdrawn in approximately 30% of the patients due to its known toxicity (mainly in the gastrointestinal tract). Basis medication (DMARDs) is helpful in a minority of AS patients only. Recently [{sup 224}Ra]-Radiumchloride, which has been used previously between 1955 and 1990, has been made available again for treatment of AS. Whereas biokinetics, radiation exposure and the risk-profile of [{sup 224}Ra]-Radiumchloride are documented well by experimental and clinical data, most of the historical studies about the efficacy of this radiopharmaceutical do not fulfill the requirements of modern therapy studies. Therefore as many patients as possible should be recruited for a prospective long-time Phase IV study. A close and well-coordinated cooperation between rheumatologists and nuclear medicine physicians is needed, when [{sup 224}Ra]-Radiumchloride is used for treatment of AS. (orig.) [German] Die meist chronisch, oft auch in Schueben verlaufende Spondylitis ankylosans (AS) fuehrt bei 30-50% der Patienten zu betraechtlichen Schmerzen und einer nicht selten erheblichen Einschraenkung der Lebensqualitaet und Behinderung. Die am haeufigsten zur Therapie verwendeten nichtsteroidalen Antiphlogistika koennen nur bei etwa 80% der Patienten die Schmerzen lindern. Allerdings muessen diese Medikamente bei 20-30% der AS-Patienten wegen ihrer bekannten Toxizitaet - vor allem im Gastrointestinaltrakt - abgesetzt werden. Basistherapeutika (DMARDs) helfen bei der AS nur sehr begrenzt. Mit [{sup 224}Ra]-Radiumchlorid steht seit kurzem ein bereits in den Jahren 1945-1990 fuer die Behandlung der AS verwendetes Radiopharmakon wieder zur

  10. ICMPv6 RA Flooding Vulnerability Research

    National Research Council Canada - National Science Library

    Linas Jočys

    2016-01-01

    .... It is know that ICMPv6 is technologically vulnerable. One of those vulnerabilities is the ICMPv6 RA flooding vulnerability, which can lead to systems in Local Area Network slow down or full stop...

  11. Understanding Rheumatoid Arthritis (RA): Treatment and Causes

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Treatment and Causes Past Issues / Summer 2014 Table of Contents How Is Rheumatoid Arthritis Treated? Doctors have many ways to treat this ...

  12. RA Construction KC, LLC Information Sheet

    Science.gov (United States)

    RA Construction KC, LLC (the Company) is located in Gladstone, Missouri. The settlement involves renovation activities conducted at a property constructed prior to 1978, located in Kansas City, Missouri.

  13. Napadi na računarske sisteme

    OpenAIRE

    Vuletić V. Dejan

    2012-01-01

    Računarski sistemi su kritični segment ljudskog društva u 21. veku. Ekonomski sektor, odbrana, bezbednost, energetika, telekomunikacije, industrijska proizvodnja, finansije i druge vitalne infrastrukture zavise od računarskih sistema koje rade u lokalnim, nacionalnim ili globalnim razmerama. Poseban problem jeste što se zbog ubrzanog razvoja informaciono-komunikacione tehnologije i nezaustavljivog rasta njene primene u svim sferama ljudskog društva uvećava njegova ranjivost ...

  14. Article sur barrage de Téra

    African Journals Online (AJOL)

    ENI DOSSO

    Situé dans le Liptako nigérien, en zone de socle, où les ressources en eau souterraines sont limitées, le département de Téra et, en particulier, son chef lieu, la ville de Téra, est confrontée à un problème aigu d'approvisionnement en eau potable des populations. Aussi, comme solution à ce manque d'eau qui bloque.

  15. Verjetnostni model računanja:

    OpenAIRE

    Žerovnik, Janez

    1989-01-01

    In article a survey of a probabilistic model of computation is given. Some classes of probabilistic algorithms are defined. Preliminary sections give definition of classical (deterministic) model of computation and introduction to the theory of time complexity of computation. V preglednem članku predstavimo verjetnostni model računanja in podamo definicijo nekaterih razredov časovne zahtevnosti verjetnostnih algoritmov. V začetnih razdelkih vpeljemo klasični (deterministični) model računan...

  16. Risk of second malignant neoplasm and mortality in patients with rheumatoid arthritis treated with biological DMARDs

    DEFF Research Database (Denmark)

    Dreyer, Lene; Cordtz, René L; Hansen, Inger Marie J

    2017-01-01

    OBJECTIVE: To study the risk of a second malignant neoplasm (SMN) and mortality in patients with rheumatoid arthritis (RA) with a history of a primary cancer diagnosis and treated with biological disease-modifying antirheumatic drugs (bDMARD). METHODS: Among patients with RA (n=15 286) registered...

  17. Unmet demands for health care among patients with rheumatoid arthritis: Indications for underuse?

    NARCIS (Netherlands)

    Jacobi, Catharina E.; Rupp, Ines; Boshuizen, Hendriek C.; Triemstra, Mattanja; Dinant, Huibert J.; van den Bos, Geertrudis A. M.

    2004-01-01

    Objective. To assess the prevalence of unmet health care demands among rheumatoid arthritis (RA) patients, and to determine if these unmet demands indicate underuse. Methods. A total of 679 patients with RA participated in a questionnaire survey and clinical examination. Unmet health care demands

  18. Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss

    NARCIS (Netherlands)

    Wijbrandts, C.A.; Klaasen, R.; Dijkgraaf, M.G.W.; Gerlag, D.M.; van Eck-Smit, B.L.; Tak, P.P.

    2009-01-01

    OBJECTIVE: To explore the effects of anti-TNFalpha antibody therapy on bone mineral density (BMD) of the lumbar spine and femur neck in patients with rheumatoid arthritis (RA). METHODS: /B> 50 patients with active RA (DAS28 >/= 3.2) who started adalimumab (40 mg subcutaneously / 2 weeks) were

  19. Adrenaline-induced immunological changes are altered in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Kittner, JM; Jacobs, R; Pawlak, CR; Heijnen, CJ; Schedlowski, M; Schmidt, RE

    Objective. To investigate whether in rheumatoid arthritis (RA) patients the immunological changes induced by adrenaline are different from healthy controls (HC). Methods. Fifteen female RA patients and 14 HC were infused with 1 mug/kg adrenaline over 20 min. Blood was drawn before, immediately

  20. Investigation of Telomerase/Telomeres system in Bone Marrow Mesenchymal Stem Cells derived from IPF and RA-UIP

    Directory of Open Access Journals (Sweden)

    Antoniou Katerina M

    2012-07-01

    Full Text Available Abstract Objective Idiopathic Pulmonary Fibrosis and Rheumatoid Arthritis associated usual interstitial pneumonia seem to have the same poor outcome as there is not an effective treatment. The aim of the study is to explore the reparative ability of bone marrow mesenchymal stem cells by evaluating the system telomerase/telomeres and propose a novel therapeutic approach. Methods BM-MSCs were studied in 6 IPF patients, 7 patients with RA-UIP and 6 healthy controls. We evaluated the telomere length as well as the mRNA expression of both components of telomerase (human telomerase reverse transcriptase, h-TERT and RNA template complementary to the telomeric loss DNA, h-TERC. Results We found that BM-MSCs from IPF, RA-UIP cases do not present smaller telomere length than the controls (p = 0.170. There was no significant difference regarding the expression of both h-TERT and h-TERC genes between patients and healthy controls (p = 0.107 and p = 0.634 respectively. Conclusions We demonstrated same telomere length and telomerase expression in BM-MSCs of both IPF and RA-UIP which could explain similarities in pathogenesis and prognosis. Maintenance of telomere length in these cells could have future implication in cell replacement treatment with stem cells of these devastating lung disorders.

  1. A new primary cleft lip repair technique tailored for Asian patients that combines three surgical concepts: Comparison with rotation--advancement and straight-line methods.

    Science.gov (United States)

    Funayama, Emi; Yamamoto, Yuhei; Furukawa, Hiroshi; Murao, Naoki; Shichinohe, Ryuji; Hayashi, Toshihiko; Oyama, Akihiko

    2016-01-01

    Various techniques have been described for unilateral cleft lip repair. These may be broadly classified into three types of procedure/concept: the straight-line method (SL; Rose-Thompson effect); rotation-advancement (RA; upper-lip Z-plasty); and the triangular flap method (TA; lower-lip Z-plasty). Based on these procedures, cleft lip repair has evolved in recent decades. The cleft lip repair method in our institution has also undergone several changes. However, we have found that further modifications are needed for Asian patients who have wider philtral dimples and columns than Caucasians, while following the principles of the original techniques mentioned above. Here, we have incorporated the advantages of each procedure and propose a refined hybrid operating technique, seeking a more appropriate procedure for Asian patients. To evaluate our new technique, a comparison study was performed to evaluate RA, SL, and our technique. We have used our new technique to treat 137 consecutive cleft lip cases of all types and degrees of severity, with or without a cleft palate, since 2009. In the time since we adopted the hybrid technique, we have observed improved esthetics of the repaired lip. Our technique demonstrated higher glance impression average scores than RA/SL. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Persistence of octupole correlations in sup 2 sup 3 sup 1 Ra

    CERN Document Server

    Fraile-Prieto, L M; Mach, H; Boutami, R; Aas, A J; Fogelberg, B; García-Raffi, L M; Grant, I S; Gulda, K; Hageboe, E; Kurcewicz, W; Kvasil, J; López, M J; Løvhøiden, G; Martínez, T; Rubio, B; Taín, J L; Tengblad, O

    2001-01-01

    The structure of sup 2 sup 3 sup 1 Ra, the heaviest odd Ra nucleus currently accessible for detailed spectroscopic investigation, has been studied in the beta sup - decay of sup 2 sup 3 sup 1 Fr. The main purpose has been to verify whether fast B(E1) rates and significant octupole correlations recently established in sup 2 sup 2 sup 9 Ra persist in sup 2 sup 3 sup 1 Ra. The excited states in sup 2 sup 3 sup 1 Ra have been determined for the first time. Spins and parities have been deduced from conversion electron measurements, while level half-lives in the ps and ns ranges have been measured with the Advanced Time Delayed beta gamma gamma(t) method. The moderately fast B(E1) rates found for transitions connecting the lowest-lying K suppi=5/2 sup+- and K suppi=1/2 sup+- bands, reveal the persistence of octupole collective effects in sup 2 sup 3 sup 1 Ra, although the B(E1) rates are lower than in sup 2 sup 2 sup 9 Ra. These findings reinforce the differences in the B(E1) systematics between isotonic Ra and Th ...

  3. Conceptualising patient empowerment: a mixed methods study

    NARCIS (Netherlands)

    Bravo, P.; Edwards, A.; Barr, P.J.; Scholl, I.; Elwyn, G.; Mcallister, M.

    2015-01-01

    BACKGROUND: In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess

  4. Group education for patients with Rheumatoid Arthritis and their partners.

    NARCIS (Netherlands)

    Riemsma, R.P.; Taal, Erik; Rasker, Johannes J.

    2003-01-01

    Objective: To determine the effects of group education followed by booster sessions for people with rheumatoid arthritis (RA), and to determine whether participation of a significant other influenced the effects. - Methods: A total of 218 RA patients, each of them with a partner, took part in the

  5. Addition of the Neurokinin-1-Receptor Antagonist (RA) Aprepitant to a 5-Hydroxytryptamine-RA and Dexamethasone in the Prophylaxis of Nausea and Vomiting Due to Radiation Therapy With Concomitant Cisplatin

    Energy Technology Data Exchange (ETDEWEB)

    Jahn, Franziska, E-mail: franziska.jahn@uk-halle.de [Department of Hematology/Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Riesner, Anica [Department of Gastroenterology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Jahn, Patrick [Nursing Research Unit, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Sieker, Frank; Vordermark, Dirk [Department of Radiation Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany); Jordan, Karin [Department of Hematology/Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) (Germany)

    2015-08-01

    Purpose: To assess, in a prospective, observational study, the safety and efficacy of the addition of the neurokinin-1-receptor antagonist (NK1-RA) aprepitant to concomitant radiochemotherapy, for the prophylaxis of radiation therapy–induced nausea and vomiting. Patients and Methods: This prospective observational study compared the antiemetic efficacy of an NK1-RA (aprepitant), a 5-hydroxytryptamine-RA, and dexamethasone (aprepitant regimen) versus a 5-hydroxytryptamine-RA and dexamethasone (control regimen) in patients receiving concomitant radiochemotherapy with cisplatin at the Department of Radiation Oncology, University Hospital Halle (Saale), Germany. The primary endpoint was complete response in the overall phase, defined as no vomiting and no use of rescue therapy in this period. Results: Fifty-nine patients treated with concomitant radiochemotherapy with cisplatin were included in this study. Thirty-one patients received the aprepitant regimen and 29 the control regimen. The overall complete response rates for cycles 1 and 2 were 75.9% and 64.5% for the aprepitant group and 60.7% and 54.2% for the control group, respectively. Although a 15.2% absolute difference was reached in cycle 1, a statistical significance was not detected (P=.22). Furthermore maximum nausea was 1.58 ± 1.91 in the control group and 0.73 ± 1.79 in the aprepitant group (P=.084); for the head-and-neck subset, 2.23 ± 2.13 in the control group and 0.64 ± 1.77 in the aprepitant group, respectively (P=.03). Conclusion: This is the first study of an NK1-RA–containing antiemetic prophylaxis regimen in patients receiving concomitant radiochemotherapy. Although the primary endpoint was not obtained, the absolute difference of 10% in efficacy was reached, which is defined as clinically meaningful for patients by international guidelines groups. Randomized phase 3 studies are necessary to further define the potential role of an NK1-RA in this setting.

  6. 228Ra, 226Ra, 224Ra and 223Ra in potential sources and sinks of land-derived material in the German Bight of the North Sea: implications for the use of radium as a tracer

    NARCIS (Netherlands)

    Schmidt, C.; Hanfland, C.; Regnier, P.; Van Cappellen, P.; Schlüter, M.; Knauthe, U.; Stimac, I.; Geibert, W.

    2011-01-01

    Activities of the naturally occurring radium nuclides 228Ra, 226Ra, 224Ra and 223Ra were determined in waters of the open German Bight and adjacent nearshore areas in the North Sea, in order to explore the potential use of radium isotopes as natural tracers of land–ocean interaction in an

  7. Quantification of {sup 235} U and {sup 226} Ra in soil samples by means of Gamma spectroscopy; Cuantificacion de {sup 235} U y {sup 226} Ra en muestras de suelo por medio de espectrometria gamma

    Energy Technology Data Exchange (ETDEWEB)

    Quintero P, E.; Rojas M, V.P.; Montes M, F.R.; Gaso P, M.I.; Cervantes N, M.L. [Gerencia de Innovacion Tecnologica, A.P. 18-1027, C.P. 11801 Mexico D.F. (Mexico)

    2000-07-01

    In this work it is presented the Gamma Spectroscopy method which is realized in the Environmental Radiological Surveillance Laboratory using the option of deconvolution of a commercial software for the quantification of {sup 235} U and {sup 226} Ra; also is presented the method for the {sup 226} Ra correction activity. (Author)

  8. Changes in priorities for improvement in patients with rheumatoid arthritis during 1 year of anti-tumour necrosis factor treatment

    NARCIS (Netherlands)

    ten Klooster, Peter M.; Veehof, M.M.; Taal, Erik; van Riel, Piet L.C.M.; van de Laar, Mart A F J

    2007-01-01

    Objectives: To examine priorities for health status improvement in patients with active rheumatoid arthritis (RA) during anti-tumour necrosis factor (TNF) treatment. Methods: Data were used from 173 patients with RA starting treatment with TNF-blocking agents. Outcome measures included assessment of

  9. Changes in priorities for improvement in patients with rheumatoid arthritis during 1 year of anti-tumour necrosis factor treatment.

    NARCIS (Netherlands)

    Klooster, P.M. ten; Veehof, M.M.; Taal, E.; Riel, P.L.C.M. van; Laar, M.A.F.J. van de

    2007-01-01

    OBJECTIVES: To examine priorities for health status improvement in patients with active rheumatoid arthritis (RA) during anti-tumour necrosis factor (TNF) treatment. METHODS: Data were used from 173 patients with RA starting treatment with TNF-blocking agents. Outcome measures included assessment of

  10. Confirmatory factor analysis of the arthritis impact measurement scales 2 short form in patient with rheumatoid arthritis

    NARCIS (Netherlands)

    ten Klooster, Peter M.; Veehof, M.M.; Taal, Erik; van Riel, Piet L.C.M.; van de Laar, Mart A F J

    2008-01-01

    Objective: To examine the factorial validity of the short form Arthritis Impact Measurement Scales 2 (AIMS2-SF) in patients with rheumatoid arthritis (RA). - Methods: Data were from a sample of 279 patients with active RA who completed the long form AIMS2 before starting treatment with tumor

  11. Confirmatory factor analysis of the Arthritis Impact Measurement Scales 2 short form in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Klooster, PM ten; Veehof, M.M.; Taal, E.; Riel, P.L.C.M. van; Laar, M.A.A.M. van de

    2008-01-01

    OBJECTIVE: To examine the factorial validity of the short form Arthritis Impact Measurement Scales 2 (AIMS2-SF) in patients with rheumatoid arthritis (RA). METHODS: Data were from a sample of 279 patients with active RA who completed the long form AIMS2 before starting treatment with tumor necrosis

  12. Short term effects of corticosteroid pulse treatment on disease activity and the wellbeing of patients with active rheumatoid arthritis

    NARCIS (Netherlands)

    Jacobs, JWG; Geenen, R; Evers, AWM; van Jaarsveld, CHM; Kraaimaat, FW; Bijlsma, JWJ

    Objective-To investigate the short term effects of corticosteroid pulse treatment (CPT) ability, and psychological wellbeing of patients with active rheumatoid arthritis (RA). Methods-Of 66 consecutive patients with active RA admitted for CPT, erythrocyte sedimentation rate, C reactive protein

  13. ICMPv6 RA Flooding Vulnerability Research

    Directory of Open Access Journals (Sweden)

    Linas Jočys

    2016-06-01

    Full Text Available ICMPv6 is the newest version of internet control message protocol, whose main purpose is to send error message indicating packet processing failure. It is know that ICMPv6 is technologically vulnerable. One of those vulnerabilities is the ICMPv6 RA flooding vulnerability, which can lead to systems in Local Area Network slow down or full stop. This paper will discuss Windows (XP, 7, 8.1 and Linux Ubuntu 14 operating systems resistance to RA flooding attack research and countermeasures to minimize this vulnerability.

  14. 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

    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......-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Results: 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...

  15. Greek rheumatoid arthritis patients have elevated levels of antibodies against antigens from Proteus mirabilis.

    Science.gov (United States)

    Christopoulos, Georgios; Christopoulou, V; Routsias, J G; Babionitakis, A; Antoniadis, C; Vaiopoulos, G

    2017-03-01

    Patients with rheumatoid arthritis (RA) from different ethnic groups present elevated levels of antibodies against Proteus mirabilis. This finding implicates P. mirabilis in the development of RA. The aim of this study was to investigate the importance of P. mirabilis in the etiopathogenesis of RA in Greek RA patients. In this study, 63 patients with RA and 38 healthy controls were included. Class-specific antibodies IgM, IgG, and IgA against three human cross-reactive and non-cross-reactive synthetic peptides from P. mirabilis-hemolysin (HpmB), urease C (UreC), and urease F (UreF)-were performed in all subjects, using the ELISA method. RA patients had elevated levels of IgM, IgG, and IgA antibodies against HpmB and UreC Proteus peptide which are significantly different compared to healthy controls: p = 0.005, p Greek RA patients present elevated levels of antibodies against P. mirabilis antigenic epitopes, such as in North European populations, albeit Greek RA patients presenting the cross-reaction antigen in a low percentage. These results indicate that P. mirabilis through the molecular mimicry mechanism leads to inflammation and damage of the joints in RA.

  16. 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

    OBJECTIVES: The objective of this study was to evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared to conventional measures of disease activity and structural damage in RA patients during the first year of anti-TNFalpha treatment. METHODS: A cohort...

  17. A rotating target for Ra production

    NARCIS (Netherlands)

    Sohani, M.; Wilschut, H. W.

    2012-01-01

    A target wheel with pyrolytic graphite targets is designed and constructed at the TRI mu P facility to boost the production rate of Ra isotopes. Simulation, design properties and production results are discussed. (C) 2012 Elsevier B.V. All rights reserved.

  18. Chôra : Creation and Pathology

    DEFF Research Database (Denmark)

    Isar, Nicoletta

    2009-01-01

    Plato's dialogue the Timaeus describes not only the making of the cosmos (order), but also the condition of what is not order, neither for the human body nor for the universe. What is disorder in cosmogonic terms it is disease for the human body. Timaeus applies to the concept chôra in discussing...

  19. Nuclear structure of Ra at high spin

    Indian Academy of Sciences (India)

    However, nuclear structure at high spin and excitation energies (∼ 6 MeV) would require a coupling of excited 1p–1h with 208Pb core. The coupling between single- particle orbitals and collective vibrations of core complicates the simple shell model picture. With increasing neutron number, Ra isotopes show an abrupt ...

  20. Impact of salivary flow and lysozyme content and output on the oral health of rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Anna Zalewska

    2011-01-01

    Full Text Available Purpose:The aim of the study was to examine salivary flow rate, DMF index, lysozyme concentration and its output in two groups of rheumatoid patients and to compare the results with those of healthy controls.Material/Methods:Rheumatoid arthritis (RA patients were divided into two study groups: with reduced salivary flow rate ≤0.15 ml/min (RA HS, hyposalivation and with normal salivary secretion rate >0.2 ml/min (RA NS, normal salivation. The healthy control group (C was recruited from the Department of Conservative Dentistry. Salivary lysozyme concentration was determined by radial immunodiffusion. ANOVA followed by LSD test were used for the statistical analysis.Results:We found that lysozyme concentration was higher and lysozyme output and salivary flow rate were statistically lower in the RA HS group in comparison to the RA NS and C groups. The DMF index was statistically higher in both RA groups in comparison to the control group.Conclusions:RA disease impacts negatively on oral health and salivary parameters. Hyposalivation of RA patients increases the negative influence of RA on oral health. RA patients should receive more stomatological attention.

  1. IL-1Ra (recombinant human IL-1 receptor antagonist in the treatment of rheumatoid arthritis: the efficacy

    Directory of Open Access Journals (Sweden)

    L. Cozzi

    2011-09-01

    Full Text Available Interleukin 1 receptor antagonist (IL-1Ra is a naturally occurring IL-1 inhibitor, acting as a “receptor antagonist”, which blocks IL-1 mediated signal transduction. In 1990 IL-1Ra was cloned and later on, a large numbers of studies led to disclosure of the crucial importance of the imbalance between IL-1 and IL-1Ra in the pathogenesis of rheumatoid arthritis (RA. In 1991, almost 8 years after the initial isolation of IL-1, recombinant IL-1Ra (IL-1ra, Kineret was introduced in clinical trials involving patients with RA. Between 2001 and 2002 IL-1ra was approved by the US Food and Drug Administration and by the European Agency for the Evaluation of the Medicinal Products and in 2003 it was registered in Italy, too. In RA recombinant IL-1ra has been evaluated in 5 randomized, placebo-controlled clinical trials involving more than 2900 patients. Two of the trials involved the use of IL-1ra as monotherapy versus placebo and two trials in combination with methotrexate (MTX; the last trial explored the use of a fixed 100 mg/day IL-1ra dosage in a RA patient population including a wide array of co-morbid conditions as well as concomitant medications. The studies confirmed both the efficacy and the safety of IL-1ra in patients with active and severe RA. 43% of patients receiving 150 mg/day IL-1ra achieved a 20% response according to the American College of Rheumatology criteria (ACR20, compared to 27% in the placebo group. In the MTX combination therapy study, 42% of the patients receiving 1 mg/Kg/day of IL-1ra achieved an ACR20, 24% an ACR50 and 10% an ACR70. In each study, significant improvements in the Health Assessment Questionnaire scores (HAQ were observed. There were rapid gains in the number of days at work or domestic activity in the treated patients, and the increases in productivity were dose related. At early 24 weeks, there was significant reduction of both the score for progression of joint space narrowing (JSN and the Total modified

  2. Foot health in patients with rheumatoid arthritis-a scoping review.

    Science.gov (United States)

    Stolt, Minna; Suhonen, Riitta; Leino-Kilpi, Helena

    2017-09-01

    Rheumatoid arthritis affects joints and can cause significant impairments in daily life. The foot is often the first site of symptoms and foot problems are strongly related to RA. The aim of this review was, therefore, to describe foot health in patients with rheumatoid arthritis and to identify how patients perform foot self-care. With this knowledge interventions to support foot health and functional ability in RA patients can be developed. The design of the review was a scoping review. A systematic literature search of three electronic databases, MEDLINE, CINAHL and Embase, was conducted in June 2016. The search yielded 1205 studies, of which 32 were selected for the review. The data were analysed by means of content analysis. Foot problems in RA patients are prevalent and impair their daily activities. Foot pain and foot structural deformities were the most prevalent problems. RA patients have difficulties caring their own feet and in finding proper footwear. Many different instruments were used to measure different aspects of foot health. Patients with RA have a high prevalence of foot and ankle problems. These foot problems are a major burden to patients themselves. RA patients' ability to self-care ability can be diminished, since RA also affects joints in the hands. In future cross-cultural validation studies are needed to ensure psychometrically sound instrumentation. Methods to alleviate foot pain and to prevent foot problems in RA patients need to be developed and tested.

  3. Leflunomide and methotrexate reduce levels of activated matrix metalloproteinases in complexes with α2 macroglobulin in serum of rheumatoid arthritis patients

    NARCIS (Netherlands)

    Tchetverikov, I.; Kraan, M.C.; El, B. van; Hanemaaijer, R.; Groot, J. de; Huizinga, T.W.J.

    2008-01-01

    Objective: To analyse the effects of leflunomide and methotrexate treatment on matrix metalloproteinase (MMP) activity levels in a2 macroglobulin/MMP (α2M/MMP) complexes in the systemic circulation of rheumatoid arthritis (RA) patients. Methods: A total of 102 RA patients from a prospective,

  4. Dynamic contrast-enhanced, extremity-dedicated MRI identifies synovitis changes in the follow-up of rheumatoid arthritis patients treated with rituximab

    DEFF Research Database (Denmark)

    Cimmino, Marco A; Parodi, Massimiliano; Zampogna, Giuseppe

    2014-01-01

    OBJECTIVES: The aim of this study is to assess prospectively the effect of rituximab (RTX) on MRI features of wrist joint disease in patients affected by rheumatoid arthritis (RA). METHODS: Ten patients (6F/4M, mean age 52.9±15.5 years) diagnosed with IgM rheumatoid factor, anti-CCP positive, RA ...

  5. Efeitos da oferta de forragem, do método de pastejo, dos dias de avaliação e da raça no comportamento e temperamento de ovinos Effect of forage supply, methods of grazing, evaluation days and breed on the behavior and the temperament of sheep

    Directory of Open Access Journals (Sweden)

    José Manuel Díaz Gómez

    2010-08-01

    Full Text Available Objetivou-se estudar comportamento e o temperamento de ovinos de três raças (Suffolk, Texel, Ile de France submetidas a dois métodos de pastejo (contínuo e rotacionado, com duas ofertas de forragem (10 e 20 kg de MS de pastagem de azevém/100 kg de peso vivo/dia durante quatro avaliações, entre agosto e novembro de 2006. Utilizou-se o delineamento completamente casualizado em parcelas subsubdivididas, de modo que os métodos de pastejo e as ofertas de forragem constituíram as parcelas, as raças as subparcelas e os dias de avaliação as subsubparcelas. Foram utilizadas 48 fêmeas ovinas com peso médio inicial de 27,59 kg e idade entre 15 e 25 meses. Na avaliação do temperamento, efetuaram-se medidas comportamentais pelo teste de arena, tipo de marcha e tempo de fuga e atributos fisiológicos, como temperatura corporal e frequências cardiorrespiratórias. No método contínuo com baixa oferta de forragem, observou-se maior número de micções. Conforme as avaliações ocorreram, houve aumento da movimentação, das tentativas de fuga, mas menor número de vocalizações durante o isolamento. A raça Ile de France apresentou maior número de tentativas de fuga e de dejeções durante o isolamento. No pastejo rotacionado com alta oferta de forragem, o ganho de peso foi menor. A movimentação no isolamento e na presença do observador foi negativamente relacionada ao ganho de peso. As variáveis descritoras do temperamento apresentaram baixa repetibilidade. O temperamento dos ovinos foi modificado principalmente pelo dia de avaliação e pela raça, ao contrário do sistema de pastejo e da oferta de pasto, embora esses fatores tenham apresentado interação com os dias de avaliação e a raça do animal.This work aimed to study the temperament and the behavior of three sheep breeds (Suffolk, Texel, Ile de France submitted to two grazing methods (continuous and rotational with two forage supplies (10 and 20 kg of Italian ryegrass DM/100

  6. A rapid analysis of {sup 226}Ra in raw materials and by-products using gamma-ray spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chung Sup; Chung, Kun Ho; Kim, Chang Jong; Ji, Young Yong [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2017-03-15

    A gamma-ray peak of {sup 226}Ra (186.2 keV) overlaps with one of {sup 235}U (185.7 keV) in a gamma-ray spectrometry system. Though reference peaks of {sup 235}U can be used to correct the peak interference of {sup 235}U in the analysis of {sup 226}Ra, this requires a complicated calculation process and a high limit of quantitation. On the other hand, evaluating {sup 226}Ra using the correction constant in the overlapped peak can make a rapid measurement of {sup 226}Ra without the complicated calculation process as well as overcome the disadvantage in the indirect measurement of {sup 214}Bi, which means the confinement of {sup 222}Rn gas in a sample container and a time period to recover the secular equilibrium. About 93 samples with 6 species for raw-materials and by-products were prepared to evaluate the activity of {sup 226}Ra using the correction constant. The results were compared with the activity of {sup 214}Bi, which means the indirect measurement of {sup 226}Ra, to validate the method of the direct measurement of {sup 226}Ra using the correction constant. The difference between the direct and indirect measurement of {sup 226}Ra was generally below about ± 20%. However, in the case of the phospho gypsum, a large error of about 50% was found in the comparison results, which indicates the disequilibrium between {sup 238}U and {sup 226}Ra in the materials. Application results of the contribution ratio of {sup 226}Ra were below about ± 10% . The direct measurement of {sup 226}Ra using the correction constant can be an effective method for its rapid measurement of raw materials and by-products because the activity of {sup 226}Ra can be produced with a simple calculation without the consideration of the integrity of a sample container and the time period to recover the secular equilibrium.

  7. Study of the specific concentrations of {sup 40}K, {sup 224}Ra, {sup 226}Ra and {sup 228}Ra in some seasonings marketed in Rio de Janeiro City

    Energy Technology Data Exchange (ETDEWEB)

    Garcêz, Ricardo W.D.; Lopes, José M.; Silva, Leandro B.; Silva, Ademir X. da [Coordenacao de Pos-Graduacao e Pesquisa de Engenharia (PEN/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Lima, Marco A.F., E-mail: rgarcez@nuclear.ufrj.br [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil). Instituto de Biologia

    2017-07-01

    The seasoning are vegetables substances used in foods to enhance their flavor, aroma and color. This work presents an investigation of the activity concentration of Naturally Occurring Radioactive Materials (NORMs) in 28 samples of seasoning utilized by brazilian population. The seasoning samples were measured using gamma spectroscopy technique with a high-purity germanium (HPGe) detector, a non-destructive nuclear method and with the LabSOCS software for the calculation of the efficiency curve. The analysis shows that the activity concentration of {sup 40}K was measured in all samples and ranges from 21.0 Bq/kg to 1288 Bq/kg. The highest concentration activity of {sup 40}K was measured to 'cheiro verde', a local seasoning made of chives (Allium Schoenoprasum) and parsley (Petroselinum Crispum), while annatto, made with the fruit of Bixa Orelhana, had the lowest activity concentration. Brazil nut (Bertholletia Excelsa) presented the highest concentrations for {sup 226}Ra and {sup 228}Ra with 24 Bq/kg and 25.7 Bq/kg, respectively and black pepper (Piper Nigrum) presented the highest concentration for {sup 224}Ra with 33.9 Bq/kg. The highest effective dose for members of the public due to ingestion was 23.5 μSv/y due to Brazil nut and the lowest effective dose was found for annatto: 0.13 μSv/y. The syrian seasoning sample present specific concentration of 6.1±1.1 Bq/kg for {sup 137}Cs and 0.08 μSv/y of effective dose. The values found in this work do not represent a risk to human health. (author)

  8. Effect of fibromyalgia on bone mineral density in patients with fibromylagia and rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    M A Buyukbese

    2013-01-01

    Full Text Available Objectives: Fibromyalgia (FM may t cause a decrease in bone mineral density (BMD because of decreased mobility. The condition is relatively frequent in rheumatoid arthritis (RA and RA patients with FM have more disability than those without FM. We evaluated the effect of FM on BMD and investigated the effect of FM on BMD in RA patients. Materials and Methods: We included age-matched 56 FM, 52 RA patients, and 37 healthy females as controls. Twenty three of all RA subjects met 1990 ACR FM criteria. Patients using the antiresorptive drugs, those on hormone replacement therapy, patients with thyroid or parathyroid dysfunction were excluded. Self-reported pain and fatigue severity, functional items of FM impact questionnaire were questioned in FM and RA patients. In all subjects, BMD of the lumbar spine and femur neck were determined by dual X-ray absorptiometry, and T-scores were recorded. Results: Self-reported pain and fatigue scores in FM subjects were significantly higher than in RA patients (P00.05. There was a significant negative correlation between self-reported pain score and lumbar spine BMD in FM subjects (r=–0.41, P=0.006. Conclusions: In spite of functional disability, FM does not cause a decrease in BMD. The presence of FM in RA patients does not result in a change in BMD.

  9. Removal of 226Ra and 228Ra from TENORM sludge waste using surfactants solutions.

    Science.gov (United States)

    Attallah, M F; Hamed, Mostafa M; El Afifi, E M; Aly, H F

    2015-01-01

    The feasibility of using surfactants as extracting agent for the removal of radium species from TENORM sludge produced from petroleum industry is evaluated. In this investigation cationic and nonionic surfactants were used as extracting agents for the removal of radium radionuclides from the sludge waste. Two surfactants namely cetyltrimethylammonium bromide (CTAB) and Triton X-100 (TX100) were investigated as the extracting agents. Different parameters affecting the removal of both (226)Ra and (228)Ra by the two surfactants as well as their admixture were studied by the batch technique. These parameters include effect of shaking time, surfactants concentration and temperature as well as the effect of surfactants admixture. It was found that, higher solution temperature improves the removal efficiency of radium species. Combined extraction of nonionic and cationic surfactants produces synergistic effect in removal both (226)Ra and (228)Ra, where the removals reached 84% and 80% for (226)Ra and (228)Ra, respectively, were obtained using surfactants admixture. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Land- and water-based exercises in rheumatoid arthritis patients: a ...

    African Journals Online (AJOL)

    Objective. To compare the effects of a 3-month land- and waterbased exercise programme among rheumatoid arthritis (RA) sufferers. Methods. Patients with RA Functional Class I and II (N=10) were randomly assigned to a land-based exercise group (Group L) (N=4), water-based exercise group (Group W) (N=4) or a ...

  11. Effects of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial.

    NARCIS (Netherlands)

    Ende, C.H.M. van den; Breedveld, F.C.; Cessie, S. le; Dijkmans, B.A.C.; Mug, A.W. de

    2000-01-01

    Objectives: To investigate the effects of a dynamic, intensive exercise regimen on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA). Methods: 64 patients with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital

  12. Uso terapêutico da radiofrequência pulsátil no gânglio dorsal da raiz de L2 na lombalgia discogênica Uso terapéutico de la radiofrecuencia pulsátil en el ganglio dorsal de la raíz de L2 en la lumbalgia discogénica Pulsed radiofrequency on L2 dorsal root ganglion as a therapeutic method for lumbar discogenic pain

    Directory of Open Access Journals (Sweden)

    Fabrício Dias Assis

    2009-06-01

    Full Text Available OBJETIVO: Avaliar a eficácia da radiofrequência pulsátil sobre o gânglio da raiz dorsal de L2 no tratamento dos pacientes com lombalgia discogênica. MÉTODOS: Realizou-se análise retrospectiva de 50 pacientes portadores de lombalgia crônica discogênica atendidos no período de janeiro de 2004 a julho de 2007. O processo diagnóstico foi constituído por exame físico, ressonância magnética e bloqueio diagnóstico do gânglio da raiz dorsal de L2. Todos os pacientes foram submetidos à radiofrequência pulsátil no gânglio da raiz dorsal de L2 e acompanhados por, no mínimo, 12 meses. A intensidade de dor foi medida pela escala visual analógica (EVA de dor. RESULTADOS: A análise estatística mostrou melhora significativa da intensidade de dor (pOBJETIVO: evaluar la eficacia de la radiofrecuencia pulsátil sobre el ganglio de la raíz dorsal de L2 en el tratamiento de los pacientes con lumbalgia discogénica. MÉTODOS: fue realizado un análisis retrospectivo de 50 pacientes portadores de lumbalgia crónica discogénica, atendidos en el periodo de Enero de 2004 a Julio de 2007. El proceso diagnóstico constó de un examen físico, resonancia magnética y bloqueo diagnóstico del ganglio de la raíz dorsal de L2. Todos los pacientes fueron sometidos a la radiofrecuencia pulsátil en el ganglio de la raíz dorsal de L2 y seguidos por 12 meses, como mínimo. La intensidad del dolor fue medida por la escala visual analógica del dolor. RESULTADOS: el análisis estadístico mostró mejoría significativa de la intensidad del dolor (pOBJECTIVE: to evaluate the effectiveness of pulsate radio-frequency on L2 dorsal root ganglion for chronic discogenic low back pain. Of L2 in the treatment of the patient with discogenic low back pain. METHODS: Between January 2004 and July 2007, 50 patients with diagnosis of low back discogenic pain were retrospectively assessed based on physical examination, magnetic resonance imaging findings and selective L

  13. Ra isotopes in trees: Their application to the estimation of heartwood growth rates and tree ages

    Science.gov (United States)

    Hancock, Gary J.; Murray, Andrew S.; Brunskill, Gregg J.; Argent, Robert M.

    2006-12-01

    The difficulty in estimating growth rates and ages of tropical and warm-temperate tree species is well known. However, this information has many important environmental applications, including the proper management of native forests and calculating uptake and release of atmospheric carbon. We report the activities of Ra isotopes in the heartwood, sapwood and leaves of six tree species, and use the radial distribution of the 228Ra/226Ra activity ratio in the stem of the tree to estimate the rate of accretion of heartwood. A model is presented in which dissolved Ra in groundwater is taken up by tree roots, translocated to sapwood in a chemically mobile (ion-exchangeable) form, and rendered immobile as it is transferred to heartwood. Uptake of 232Th and 230Th (the parents of 228Ra and 226Ra) is negligible. The rate of heartwood accretion is determined from the radioactive decay of 228Ra (half-life 5.8 years) relative to long-lived 226Ra (half-life 1600 years), and is relevant to growth periods of up to 50 years. By extrapolating the heartwood accretion rate to the entire tree ring record the method also appears to provide realistic estimates of tree age. Eight trees were studied (three of known age, 72, 66 and 35 years), including three Australian hardwood eucalypt species, two mangrove species, and a softwood pine (P. radiata). The method indicates that the rate of growth ring formation is species and climate dependent, varying from 0.7 rings yr-1 for a river red gum (E. camaldulensis) to around 3 rings yr-1 for a tropical mangrove (X. mekongensis).

  14. SU-E-T-588: Optimization of Imaging Following 223Ra Administration in Targeted Alpha-Emitting Radionuclide Therapy of Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Benabdallah, N; Bernardini, M [Hopital Europeen George Pompidou, Paris, Ile de France (France); Desbree, A [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-roses, Ile-de-France (France); Labriolle-Vaylet, C de [Hopital Trousseau, Paris, Ile de France (France); Franck, D [Institut de Radioprotection et de Suretu Nucleaire, Fontenay Aux Roses, Ile de France (France)

    2015-06-15

    Purpose: With a growing demand of alpha-emitting radiopharmaceuticals, especially Xofigo ({sup 223}RaCl{sub 2}) which is used in the treatment of metastatic bone disease, the optimization of dosimetry becomes necessary. Indeed, in Europe, as stated on the council directive 2013/59/euratom, exposures of target volumes for radiotherapeutic purposes shall be individually planned taking into account that doses to non-target volumes and tissues shall be as low as reasonably achievable. To that aim, the possibility of imaging {sup 223}Ra was first investigated. Methods: The experiments were conducted at the Hopital Europeen Georges Pompidou with an Infinia Hawkeye 4 gamma camera, equipped with a medium-energy collimator. Imaging parameters, such as sensibility, spatial resolution and energy spectrum, were determined using several physical phantoms with a source of 6 MBq of {sup 223}Ra. Bone metastases were modeled with a NEMA Body Phantom to investigate image degradation based on the concentration of {sup 223}Ra. Results: The acquired energy spectrum allowed to visualize several photon peaks: at 85, 154 and 270 keV. Camera sensitivity measured from the phantom study was 102.3 cps/MBq for the 85 keV ± 20 %, 89.9 cps/MBq for the 154 ± 20 % window and 65.4 cps/MBq for the 270 ± 10 % window. The spatial resolution (full-width at half-maximum) was respectively 1.7, 1.9 and 1.8 cm for the three energy windows. SPECT/CT images of NEMA Body Phantom without and with attenuation have permitted to determine the best reconstruction parameters. Conclusion: This study has demonstrated that it is possible to obtain clinically relevant information from images of {sup 223}Ra. All these results will be valuable to analyze biodistribution imaging of the radiopharmaceutical in the patient body and go further in the reconstruction of patient images in order to personalize the dosimetry.

  15. A comparative study of different radiometric methodologies for the determination of 226Ra in water

    Directory of Open Access Journals (Sweden)

    Ibrahim F. Al-Hamarneh

    2018-02-01

    Full Text Available An evaluation of various radiometric methods to analyze 226Ra in water has been employed on a set of 10 standard solutions of different concentrations in the range of 1–10 Bq/L−1. The analysis was carried out using well-established procedures by means of gamma-ray, alpha-particle and liquid scintillation spectrometry. The feasibility of the various methods has been quantified in terms of relative standard error and percentage error. Correlations between the various methods have been presented and discussed. In general, good agreement was found in the results of various methodologies, which assures the accuracy of the methods and allows for the validation of instrumentation and procedures. Of the different methods adopted here, a combined procedure for the determination of 226Ra along with 228Ra using Quantulus 1220 ultra-low level background liquid scintillation counting gave the most accurate results.

  16. Foot-related health care use in patients with rheumatoid arthritis in an outpatient secondary care center for rheumatology and rehabilitation in the Netherlands: A cohort study with a maximum of fifteen years of followup

    NARCIS (Netherlands)

    Marsman, A.F.; Dahmen, R.; Roorda, L.D.; van Schaardenburg, D.; Dekker, J.; Britsemmer, K.; Knol, D.L.; van der Leeden, M.

    2013-01-01

    Objective To describe foot-related health care use over time in a cohort of rheumatoid arthritis (RA) patients in an outpatient secondary care center for rheumatology and rehabilitation in The Netherlands. Methods A total of 1,087 patients with recent-onset RA from 1995 to September 2010 were

  17. Factors affecting {sup 223}Ra therapy: clinical experience after 532 cycles from a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Etchebehere, Elba C. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Campinas State University (Unicamp), Department of Nuclear Medicine, Campinas (Brazil); Milton, Denai R. [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Araujo, John C. [The University of Texas MD Anderson Cancer Center, Department of Genitourinary Medical Oncology, Houston, TX (United States); Swanston, Nancy M.; Macapinlac, Homer A.; Rohren, Eric M. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States)

    2016-01-15

    The aim of this study was to identify baseline features that predict outcome in {sup 223}Ra therapy. We retrospectively reviewed 110 patients with metastatic castration-resistant prostate cancer treated with {sup 223}Ra. End points were overall survival (OS), progression-free survival (PFS), bone event-free survival (BeFS), and bone marrow failure (BMF). The following parameters were evaluated prior to the first {sup 223}Ra cycle: serum levels of hemoglobin (Hb), prostate-specific antigen (PSA), alkaline phosphatase (ALP), Eastern Cooperative Oncology Group (ECOG) status, pain score, use of chemotherapy, and external beam radiation therapy (EBRT). During/after {sup 223}Ra we evaluated: the total number of radium cycles (Ra{sub Tot}), the PSA doubling time (PSA{sub DT}), and the use of chemotherapy, EBRT, abiraterone, and enzalutamide. A significant reduction of ALP (p < 0.001) and pain score (p = 0.041) occurred throughout the {sup 223} Ra cycles. The risk of progression was associated with declining ECOG status [hazard ratio (HR) = 3.79; p < 0.001] and decrease in PSA{sub DT} (HR = 8.22; p < 0.001). Ra{sub Tot}, ALP, initial ECOG status, initial pain score, and use of abiraterone were associated with OS (p ≤ 0.008), PFS (p ≤ 0.003), and BeFS (p ≤ 0.020). Ra{sub Tot}, ALP, initial ECOG status, and initial pain score were significantly associated with BMF (p ≤ 0.001) as well as Hb (p < 0.001) and EBRT (p = 0.009). On multivariable analysis, only Ra{sub Tot} and abiraterone remained significantly associated with OS (p < 0.001; p = 0.033, respectively), PFS (p < 0.001; p = 0.041, respectively), and BeFS (p < 0.001; p = 0.019, respectively). Additionally, Ra{sub Tot} (p = 0.027) and EBRT (p = 0.013) remained significantly associated with BMF. Concomitant use of abiraterone and {sup 223}Ra seems to have a beneficial effect, while the EBRT may increase the risk of BMF. (orig.)

  18. MRI comes of age in RA clinical trials

    DEFF Research Database (Denmark)

    Peterfy, Charles; Østergaard, Mikkel; Conaghan, Philip G

    2013-01-01

    The success of modern rheumatoid arthritis (RA) therapies and treatment strategies has led to extended placebo phases being unethical in RA randomised controlled trials (RCTs). Modern trials therefore increasingly involve active comparator designs, and this together with some technical issues has...... in support of claims of inhibition of progression of structural damage in RA trials....

  19. Immunomodulation of RA Patients’ PBMC with a Multiepitope Peptide Derived from Citrullinated Autoantigens

    Directory of Open Access Journals (Sweden)

    Smadar Gertel

    2017-01-01

    Full Text Available Citrullinated peptides are used for measuring anticitrullinated protein antibodies (ACPA in rheumatoid arthritis (RA. Accumulation of citrullinated proteins in the inflamed synovium suggests that they may be good targets for inducing peripheral tolerance. In view of the multiplicity of citrullinated autoantigens described as ACPA targets, we generated a multiepitope citrullinated peptide (Cit-ME from the sequences of major citrullinated autoantigens: filaggrin, β-fibrinogen, vimentin, and collagen type II. We assessed the ability of Cit-ME or the citrullinated β60-74 fibrinogen peptide (β60-74-Fib-Cit which bears immunodominant citrullinated epitopes (i to modify cytokine gene expression and (ii to modulate Treg and Th17 subsets in PBMC derived from newly diagnosed untreated RA patients. RA patient’s PBMC incubated with Cit-ME or β60-74-Fib-Cit, showed upregulation of TGF-β expression (16% and 8%, resp., and increased CD4+Foxp3+ Treg (22% and 19%, resp.. Both peptides were shown to downregulate the TNF-α and IL-1β expression; in addition, Cit-ME reduced CD3+IL17+ T cells. We showed that citrullinated peptides can modulate the expression of anti- and proinflammatory cytokines in PBMC from RA patients as well as the proportions of Treg and Th17 cells. These results indicate that citrullinated peptides could be active in vivo and therefore might be used as immunoregulatory agents in RA patients.

  20. Exploring a new ultrasound score as a clinical predictive tool in patients with rheumatoid arthritis starting abatacept

    DEFF Research Database (Denmark)

    D'Agostino, Maria-Antonietta; Boers, Maarten; Wakefield, Richard J

    2016-01-01

    Objectives: To explore whether changes in a composite ( power Doppler/greyscale ultrasound (PDUS)) synovitis score, developed by the OMERACT-EULAR-Ultrasound Task Force, predict disease activity outcomes in rheumatoid arthritis (RA). Methods: Patients with RA who were methotrexate inadequate resp...

  1. Mensuração do tamanho cardíaco pelo método VHS (vertebral heart size em cães sadios da raça American pit bull terrier Measurement of heart size by VHS (vertebral heart size method in healthy American pit bull terrier

    Directory of Open Access Journals (Sweden)

    Mauro José Lahm Cardoso

    2011-01-01

    Full Text Available Vários métodos surgiram com a finalidade de aumentar a acurácia e diminuir a subjetividade na avaliação das radiografias. O melhor aceito é o VHS (vertebral heart size, ou tamanho do coração em relação à unidade de vértebra torácica. O objetivo deste trabalho foi aplicar o método de mensuração pelo VHS em cães da raça American pit bull terrier clinicamente sadios, com a finalidade de se estabelecer o valor médio de VHS para esta raça. Realizaram-se radiografias de tórax, na projeção lateral direita, que foram avaliadas empiricamente e realizadas as medidas necessárias para obtenção do VHS, além da obtenção da relação profundidade/largura (P/L torácica. Nenhum animal apresentou alteração através da análise empírica. Os valores de VHS obtidos apresentaram distribuição normal, assim como a relação P/L, com média de 10,9±0,4 vértebras para o VHS e 0,80±0,07 para a relação P/L. O valor do VHS apresentou diferença significativa (P>0,05 em comparação com os resultados obtidos por BUCHANAN & BÜCHELER (1995. Porém, o valor de VHS deste estudo é semelhante ao descrito por diversos autores nos estudo de raças específicas, confirmando a necessidade de se estabelecer valores de VHS específicos para cada raça.In order to increase accuracy and reduce the subjectivity in the evaluation of radiographies, several methods have emerged. The most accepted of these methods is the Vertebral Heart Size method (VHS, or the heart's size versus the thoracic vertebra's unit. The intention of this research was to apply the VHS measurement method in clinically healthy American pit bull terrier, with the purpose of establishing the average VHS for this breed. Chest x-rays in lateral projection were taken, and these were empirically evaluated and measured so that a VHS value was obtained, as well as the thoracic depth/width (D/W relation for each animal. None of the animals had abnormal results when evaluated via empiric

  2. Document management system "Raštvedyba"

    OpenAIRE

    Fokina, Julija

    2007-01-01

    SUMMARY Document management system “Raštvedyba” Modern people really very rarely think about how important is the electic power nowdays. We understand it’s importance only when we don’t have it because of emergency or something like that. This way we have the evening with “candle”, without radio and television, all home appliences don’t work at all. Although energetic specialists apply the best disaster facilities to avoid the emergency situations, sometimes it doesnt help and people ...

  3. Comparison of two nutritional assessment methods in gastroenterology patients

    OpenAIRE

    Filipović, Branka F; Gajić, Milan; Milinić, Nikola; Milovanović, Branislav; Filipović, Branislav R; Cvetković, Mirjana; Šibalić, Nela

    2010-01-01

    AIM: To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two methods: subjective global assessment (SGA) and nutritional risk index (NRI).

  4. Ra-226 bioaccumulation and growth indices in fish.

    Science.gov (United States)

    Shi, Xiaopei; Smith, Richard; Seymour, Colin; Mothersill, Carmel

    2017-06-01

    To determine the accumulated activity of Ra-226 in fathead minnows fed with environmentally relevant levels of Ra-226 for 5 months in water at 20 °C, and to evaluate the influence of this level of Ra-226 on the growth of fathead minnows. Fathead minnows were fed with fish food containing 10-10,000 mBq/g Ra-226 for 5 months. At the end of the experiment, the fish were sacrificed, flash frozen in liquid nitrogen and kept at -20 °C. Longitudinal sections of 40 μm thickness were cut at the middle of the fish body using a cryostat. The activity of Ra-226 in each section was determined using autoradiography with a nuclear track detector CR-39. According to the weight and the width of the fish, the activity of Ra-226 in the whole fish body could be estimated. In addition, the length and the weight of the fish were measured and the condition factor was calculated to evaluate the growth and fitness of the fish. There is a positive but non-linear relationship between the accumulated activity of Ra-226 in fish body and the concentration of Ra-226 in fish food. The highest activity of Ra-226 accumulated in fish body was found from fish fed with 10,000 mBq/g Ra-226 food. This was calculated as 256.4 ± 49.1 mBq/g, p fish fed with food containing lower concentration of Ra-226 (up to 1000 mBq/g), the bioaccumulation of Ra-226 in the body saturated. The Ra-226 concentration factor (CF) for fish was inversely proportional to the Ra-226 activity in food, and the highest CF value was 2.489, obtained from the lowest dietary Ra-226 activity (10 mBq/g). In addition, condition factors (K) of fish in all Ra-226-treated groups were significantly lower than those of the controls. The results show that the bioaccumulation of Ra-226 in fish is not simply related to the dietary Ra-226 activity, and has a saturation value when the dietary activity is low. In addition, the environmental level of Ra-226 in the fish food has a small adverse effect on the growth and fitness of fathead

  5. Isolated right atrial appendage (RAA rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA wall thickness

    Directory of Open Access Journals (Sweden)

    Jatene Fabio B

    2007-02-01

    Full Text Available Abstract Background Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture of the right atrium appendage (RAA is very rare, with 8 cases reported in the reviewed literature. The thin wall of the RAA has been presumed to render this chamber more prone to rupture in blunt trauma. Objective To report a case of isolated RAA rupture in blunt trauma, and to compare right atrium (RA and RAA wall thickness in a necropsy study. Methods The thickness of RA and RAA wall of hearts from cadavers of fatal penetrating head trauma victims was measured. Our case of isolated RAA rupture is presented. The main findings of the 8 cases reported in the literature, and the findings of our case, were organized in a table. Result The comparison of the data showed that wall thickness of the RAA (0.53 ± 0.33 mm was significantly thinner than that of RA (1.11 ± 0.42 mm (p Comments In all these 9 cases of isolated RAA rupture, cardiac tamponade occurred, RAA rupture was diagnosed intraoperatively and sutured, and the patients survived. Main mechanisms hypothesized for heart chamber rupture include mechanical compression coincident with phases of cardiac cycle, leading to high hydrostatic pressure inside the chamber. Published series include numerous cases of RA rupture, and only a few cases of RAA rupture. Conclusion Thus, our data suggests that wall thickness is not a determinant factor for RA or RAA rupture in blunt trauma.

  6. 'Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients

    Science.gov (United States)

    2010-01-01

    Background Footwear has been accepted as a therapeutic intervention for the foot affected by rheumatoid arthritis (RA). Evidence relating to the objective assessment of footwear in patients with RA is limited. The aims of this study were to identify current footwear styles, footwear characteristics, and factors that influence footwear choice experienced by patients with RA. Methods Eighty patients with RA were recruited from rheumatology clinics during the summer months. Clinical characteristics, global function, and foot impairment and disability measures were recorded. Current footwear, footwear characteristics and the factors associated with choice of footwear were identified. Suitability of footwear was recorded using pre-determined criteria for assessing footwear type, based on a previous study of foot pain. Results The patients had longstanding RA with moderate-to severe disability and impairment. The foot and ankle assessment demonstrated a low-arch profile with both forefoot and rearfoot structural deformities. Over 50% of shoes worn by patients were open-type footwear. More than 70% of patients' footwear was defined as being poor. Poor footwear characteristics such as heel rigidity and sole hardness were observed. Patients reported comfort (17%) and fit (14%) as important factors in choosing their own footwear. Only five percent (5%) of patients wore therapeutic footwear. Conclusions The majority of patients with RA wear footwear that has been previously described as poor. Future work needs to aim to define and justify the specific features of footwear that may be of benefit to foot health for people with RA. PMID:20959016

  7. 'Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients

    Directory of Open Access Journals (Sweden)

    Dalbeth Nicola

    2010-10-01

    Full Text Available Abstract Background Footwear has been accepted as a therapeutic intervention for the foot affected by rheumatoid arthritis (RA. Evidence relating to the objective assessment of footwear in patients with RA is limited. The aims of this study were to identify current footwear styles, footwear characteristics, and factors that influence footwear choice experienced by patients with RA. Methods Eighty patients with RA were recruited from rheumatology clinics during the summer months. Clinical characteristics, global function, and foot impairment and disability measures were recorded. Current footwear, footwear characteristics and the factors associated with choice of footwear were identified. Suitability of footwear was recorded using pre-determined criteria for assessing footwear type, based on a previous study of foot pain. Results The patients had longstanding RA with moderate-to severe disability and impairment. The foot and ankle assessment demonstrated a low-arch profile with both forefoot and rearfoot structural deformities. Over 50% of shoes worn by patients were open-type footwear. More than 70% of patients' footwear was defined as being poor. Poor footwear characteristics such as heel rigidity and sole hardness were observed. Patients reported comfort (17% and fit (14% as important factors in choosing their own footwear. Only five percent (5% of patients wore therapeutic footwear. Conclusions The majority of patients with RA wear footwear that has been previously described as poor. Future work needs to aim to define and justify the specific features of footwear that may be of benefit to foot health for people with RA.

  8. Raça e lesão de órgãos-alvo da hipertensão arterial em pacientes atendidos em um ambulatório universitário de referência na cidade de Salvador Race and hypertensive target-organ damage in patients from an university-affiliated outpatient care referral clinic in the city of Salvador

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Beisl Noblat

    2004-02-01

    Full Text Available OBJETIVO: Avaliar se a raça do paciente estaria associada à presença de hipertrofia ventricular esquerda, acidente vascular cerebral e insuficiência renal crônica em hipertensos atendidos em ambulatório de referência em Salvador-BA. MÉTODOS: Analisados dados de 622 pacientes com o primeiro atendimento em ambulatório de hipertensão, entre 1982 e 1986, e identificados os com história prévia ou seqüela de acidente vascular cerebral, hipertrofia ventricular esquerda ou insuficiência renal (creatinina sérica > 1,4 mg/dL. Modelos de regressão logística foram utilizados para estimar odds ratio (OR da associação entre raça (mulatos ou negros vs brancos e lesão de órgãos-alvo de hipertensão, ajustadas para sexo e idade. RESULTADOS: A média de idade dos pacientes foi 53,8±14,3 anos, 74,1% mulheres. Quanto à raça, 15,1% eram brancos, 65,9% mulatos e 19,0% negros. Acidente vascular cerebral foi significantemente mais freqüente em negros ou mulatos do que em brancos (odds ratio ajustada (ORa=3,44; intervalo de confiança (IC 95%=1,23-9,67. Quanto às associações envolvendo raça com os eventos hipertrofia ventricular esquerda e insuficiência renal as ORa não foram estatisticamente significantes, mas foram consistentes com maior prevalência de hipertrofia ventricular esquerda e insuficiência renal em negros e mulatos. CONCLUSÃO: Negros e mulatos hipertensos têm maior risco de lesão de órgão alvo do que brancos, com diferença racial maior para acidente vascular cerebral não fatal. Deve ser avaliada se diferenças raciais em mortalidade relacionada a complicações da hipertensão influenciam as associações observadas entre raça e lesão de órgãos-alvo.OBJECTIVE: To assess whether a patient's race is associated with the presence of left ventricular hypertrophy, stroke, and renal failure in hypertensive patients from an outpatient care referral clinic in the city of Salvador in the state of Bahia. METHODS: We

  9. Methods to improve patient recruitment and retention in stroke trials

    DEFF Research Database (Denmark)

    Berge, Eivind; Stapf, Christian; Al-Shahi Salman, Rustam

    2016-01-01

    Background: The success of randomized-controlled stroke trials is dependent on the recruitment and retention of a sufficient number of patients, but fewer than half of all trials meet their target number of patients. Methods: We performed a search and review of the literature, and conducted...... a survey and workshop among 56 European stroke trialists, to identify barriers, suggest methods to improve recruitment and retention, and make a priority list of interventions that merit further evaluation. Results: The survey and workshop identified a number of barriers to patient recruitment...... and retention, from patients’ incapacity to consent, to handicaps that prevent patients from participation in trial-specific follow-up. Methods to improve recruitment and retention may include simple interventions with individual participants, funding of research networks, and reimbursement of new treatments...

  10. REHABILITATION OF PATIENTS WITH APHASIA USING MODIFIED RESTORATION METHODS

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    M. M. Shcherbakova

    2014-01-01

    Full Text Available Backgroud: There is a high prevalence of vascular diseases of the brain in adult population. One of the most severe complications of the cerebral vascular diseases is an aphasia leading to patient’s disability. An extremely severe and unreversible condition for further rehabilitation is noted in a group of patients which develops an impressive speech impairment as a dominant disturbance associated with aphasia. Aim: To identify the most effective rehabilitation method for patients with complications of cerebral circulation disturbances manifesting as speech impairment in a form of aphasia. Materials and methods: Theoretical aspect of rehabilitation in post-stroke aphasia patients with a dominant impressive speech impairment was studied. All patients underwent neurologic examination, dynamic logopedic observation, and magnetic resonance imaging. The patients of the chosen group underwent rehabilitation with a modified modality of speech restoration. Results: Introduction of the modified rehabilitation methods into the logopedics practice proved their high efficiency. Significant improvement was seen in 64% of patients with acoustic-amnestic aphasia, in 57% of patients with acoustic-gnostic aphasia, and in 60% of those with semantic aphasia. Conclusion: A key moment for achievement of the high rehabilitation outcome is a complex approach needed for rehabilitation of patients with the consequences of the acute impairments of cerebral circulation.

  11. The periodontium of periodontitis patients contains citrullinated proteins which may play a role in ACPA (anti-citrullinated protein antibody) formation

    NARCIS (Netherlands)

    Nesse, Willem; Westra, Johanna; van der Wal, Jacqueline E.; Abbas, Frank; Nicholas, Anthony P.; Vissink, Arjan; Brouwer, Elisabeth; Westra J., [No Value

    Aim To determine the presence and location (stroma versus epithelium) of citrullinated proteins in periodontitis tissue as compared to non-periodontitis tissue and synovial tissue of RA patients. Materials & Methods Periodontitis, healthy periodontal and RA-affected synovial tissue samples were

  12. Assay of Blood and Synovial Fluid of Patients With Rheumatoid Arthritis for Staphylococcus aureus Enterotoxin D: Absence of Bacteria But Presence of Its Toxin.

    Science.gov (United States)

    Ataee, Ramezan Ali; Kashefi, Reyhane; Alishiri, Gholam Hossein; Esmaieli, Davoud

    2015-12-01

    Rheumatoid arthritis (RA) is the most common chronic inflammatory disease. The staphylococcal superantigens are considered as the causative agent of RA disease. This study aimed to assess the presence of staphylococcal enterotoxin D in synovial fluid and blood of patients with RA. A total of 120 blood and SF samples of patients with RA were studied. Bacterial culture, primer pairs design, polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay (ELISA) methods have been used to assess of the staphylococcal enterotoxin D. The data were analyzed through descriptive statistics. During this study and after sequential subcultures, only 5 bacterial strains were isolated. The results of PCR showed the presence of staphylococcal enterotoxin D gene in almost 50% of SF and also in 48.4% of blood samples of patients with RA. Similarly, the ELISA method detected staphylococcal enterotoxin D in 36.16% of SF and in 33.33% of blood of patients with RA. The result of this study showed that a high percentage of patients with RA have shown staphylococcal enterotoxin D (superantigen D) or entD gene in SF and in blood. However, the origin of this superantigen was not clarified and no Staphylococcus aureus enterotoxin D producer was isolated. This finding indicates other role of this superantigen besides its intoxication. Therefore, staphylococcal enterotoxin D as a biomarker may provide a good model for the diagnosis and treatment of patients with RA.

  13. TRAIL Death Receptor-4, Decoy Receptor-1 and Decoy Receptor-2 Expression on CD8+ T Cells Correlate with the Disease Severity in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Bisgin Atil

    2010-08-01

    Full Text Available Abstract Background Rheumatoid Arthritis (RA is a chronic autoimmune inflammatory disorder. Although the pathogenesis of disease is unclear, it is well known that T cells play a major role in both development and perpetuation of RA through activating macrophages and B cells. Since the lack of TNF-Related Apoptosis Inducing Ligand (TRAIL expression resulted in defective thymocyte apoptosis leading to an autoimmune disease, we explored evidence for alterations in TRAIL/TRAIL receptor expression on peripheral T lymphocytes in the molecular mechanism of RA development. Methods The expression of TRAIL/TRAIL receptors on T cells in 20 RA patients and 12 control individuals were analyzed using flow cytometry. The correlation of TRAIL and its receptor expression profile was compared with clinical RA parameters (RA activity scored as per DAS28 using Spearman Rho Analysis. Results While no change was detected in the ratio of CD4+ to CD8+ T cells between controls and RA patient groups, upregulation of TRAIL and its receptors (both death and decoy was detected on both CD4+ and CD8+ T cells in RA patients compared to control individuals. Death Receptor-4 (DR4 and the decoy receptors DcR1 and DcR2 on CD8+ T cells, but not on CD4+ T cells, were positively correlated with patients' DAS scores. Conclusions Our data suggest that TRAIL/TRAIL receptor expression profiles on T cells might be important in revelation of RA pathogenesis.

  14. The experimental treatment of corneal graft rejection with the interleukin-1 receptor antagonist (IL-1ra gene.

    Directory of Open Access Journals (Sweden)

    Jin Yuan

    Full Text Available PURPOSE: To investigate the protective effects of interleukin-1 receptor antagonist (IL-1ra gene transfer in a rat model of corneal graft rejection. METHODS: We constructed a recombinant plasmid (pcDNA3.1-hIL-1ra with high IL-1ra expression in eukaryotic cells. Using a Wistar-SD rat model of corneal graft rejection, we examined the effects of IL-1ra in vivo after cationic polymer jetPEI-mediated nonviral gene delivery. Four groups were included: negative controls (group I, n = 20, pcDNA3.1-hIL-1ra corneal stromal injection (group II, n = 34, pcDNA3.1-hIL-1ra anterior chamber injection (group III, n = 34, and 500 µg/ml IL-1ra protein subconjunctiva injection (group IV, n = 20. IL-1ra expression after transfection was evaluated by real-time polymerase chain reaction (RT-PCR and western blotting. The rejection indices of corneal grafts were analysed in the different groups. The expression levels of transforming growth factor β1 (TGF-β1, inflammatory chemokines including RANTES, interleukin-1 (IL-1 and the numbers of CD4+ and CD8+ T cells in the grafts were determined by biochemical assays at different time points after corneal transplantation. RESULTS: Various degrees of inflammatory cell infiltration and graft neovascularisation were observed by histopathology. After injecting the pcDNA3.1-hIL-1ra plasmid into the cornea, IL-1ra mRNA and protein expression was detected in the corneal stroma and reached a peak on day 3. The graft survival curves indicated that the corneal transparency rates of grafts in the IL-1ra gene-treated group and the IL-1ra protein-treated group were higher compared with the untreated group (P<0.05. During the period of acute rejection, TGF-β1, RANTES, IL-1α and IL-1β levels in the grafts in the IL-1ra treatment groups were lower than the control group (P<0.05. CD4+ and CD8+ T cell counts were reduced significantly in the corneal grafts of groups II, III and IV compared with group I (P<0.05. CONCLUSION

  15. Raúl Pepe Verano Montesinos

    OpenAIRE

    José Luis Luque

    2013-01-01

    El 31 de enero de 2005 falleció en Lima el doctor Raúl Verano. Nacido el 12 de julio de 1940 en Cajatambo, realizó sus estudios superiores en la Universidad Nacional Mayor de San Marcos, graduándose en 1971 de bachiller en Educación y en 1972 obtuvo el grado de bachiller en Biología con la tesis Foraminíferos del litoral del departamento de Lima; optando la profesión de Biólogo en 1973. Empezó sus actividades docentes en 1965 como Ayudante de Prácticas en las cá- tedras de zoología y desde 19...

  16. Pregnancy in Rađevina customs

    Directory of Open Access Journals (Sweden)

    Petrović-Savić Mirjana

    2012-01-01

    Full Text Available The paper discusses the representation of pregnancy in the customs and beliefs of a region in Serbia known as Rađevina. The research was aimed at recording and preserving the customs and lexis regarding pregnancy in this part of Serbia. We obtained the lexis through topic guided conversations with the informants. The article is divided into several sections: on pregnancy before pregnancy, prohibitions during pregnancy and consequences if they are not observed, revealing the baby's gender, conclusion and glossary. Rađevina used to have a system of regulations that the pregnant woman had to adhere to. Special attention was paid to the behavior of the pregnant woman herself. It was in larger part regulated by means of numerous prohibitions and limitations. Most of those prohibitions were based on the assumption of a magical relation of the future mother and the fetus in her womb. It is interesting to note that some prohibitions were observed before pregnancy itself, during the wedding ritual. In this period, the community tended to facilitate the bride's conception of a fair, healthy male child. During pregnancy itself the pregnant woman used certain objects to protect herself from evil and negative influences of her surroundings. The largest number of prohibitions during pregnancy were implemented so that a healthy, but also fair child should be born. Apart from that, the prohibitions were intended to influence the child's longevity. The section on pregnancy before pregnancy lists the techniques applied in the wedding ritual which influenced the bride's fertility with imitative magic. We also shed some light on the traditional revealing of the future child's gender, and the paper is ends with a glossary.

  17. Significance of arthrosonography for knee joint damage diagnosis in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L V Sizova

    2008-01-01

    Full Text Available Objective. To assess significance of arthrosonography in diagnosis of in knee joint changes in patients with early rheumatoid arthritis (RA. Material and methods. 44 patients with early RA aged 19 to 73 years were examined. 29,5% of pts had early RA without primary osteoarthritis (OA, 70,5% had early RA with primary OA. Ultrasonography of knee joints was performed with Diasonics (USA, 1997 by the linear sensor with frequency of 7 MHz. The protocol of ultrasonic examination of knee joints was filled for each pt. Results. Clinical signs of of knee joint synovitis have been revealed in 61,5% of pts with early RA without primary OA, and in 80,6% of pts with early RA with primary OA, ultrasonic - in 100% of pts. Intraarticular knee joint effusion resulted in increase of suprapatellar bursa and lateral recesses size. Extraarticular inflammation was frequently shown by thickening of semymemranous muscles tendons, especially in pts with the early RA with primary OA (p<0,005. Degenerative changes in the group of pts with primary OA were more expressed in early RA and usually accompanied by non-uniform decrease of cartilage thickness and occurrence of osteophytes while cartilage in pts with early RA without primary OA had normal thickness or thickening because of swelling, and osteophytes were absent. Conclusion. Prevalence of knee joint intraarticular and extraarticular inflammatory changes over degenerate changes (symmetric thickening of the synovium, primary increase of the sizes of suprapatellar bursa and lateral recesses because of effusion, thickening of tendons of knee joints at the normal or increased thickness of cartilage because of inflammation can be considered sonographic sign of early RA. In pts with early RA coincided with primary OA these changes were usually found in combination with non-uniform decrease of cartilage thickness. In case of cartilage inflammatory edema, detection of osteophytes allows to confirm presence of OA in pts with

  18. The genetics of rheumatoid arthritis: risk and protection in different stages of the evolution of RA

    Science.gov (United States)

    Yarwood, Annie; Huizinga, Tom W. J.

    2016-01-01

    There is now a general consensus that RA has a spectrum of disease stages that can begin many years before the onset of clinical symptoms. It is widely thought that understanding the complex interplay between genetics and environment, and their role in pathogenesis, is essential in gaining further insight into the mechanisms that drive disease development and progression. More than 100 genetic susceptibility loci have now been identified for RA through studies that have focused on patients with established RA compared with healthy controls. Studying the early preclinical phases of disease will provide valuable insights into the biological events that precede disease and could potentially identify biomarkers to predict disease onset and future therapeutic targets. In this review we will cover recent advances in the knowledge of genetic and environmental risk factors and speculate on how these factors may influence the transition from one stage of disease to another. PMID:25239882

  19. Decreased expression of methylene tetrahydrofolate reductase (MTHFR) gene in patients with rheumatoid arthritis.

    Science.gov (United States)

    Remuzgo-Martínez, Sara; Genre, Fernanda; López-Mejías, Raquel; Ubilla, Begoña; Mijares, Veronica; Pina, Trinitario; Corrales, Alfonso; Blanco, Ricardo; Martín, Javier; Llorca, Javier; González-Gay, Miguel Á

    2016-01-01

    Impairment of methylene tetrahydrofolate reductase (MTHFR), a key enzyme in the folate metabolism, results in an elevated plasma level of homocysteine, considered an independent risk factor for cardiovascular (CV) disease. Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increased risk of CV death. Polymorphisms in the MTHFR gene increase the frequency of CV disease in RA. The aim of this study was to determine the expression of MTHFR gene in patients with RA, with and without ischaemic heart disease (IHD). Relative expression of MTHFR gene and beta-actin and GAPDH as housekeeping genes was quantified by quantitative real-time polymerase chain reaction. It was analysed by the comparative Ct (threshold cycle) method in peripheral blood from 26 Spanish patients with RA (12 with IHD and 14 without IHD) and 10 healthy controls. MTHFR expression level in RA patients was also assessed according to disease activity, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies status. MTHFR expression was significantly reduced in patients with RA compared to controls (fold change = 0.85, p=0.029). It was especially true for RA patients with IHD (fold change= 0.79, p=0.021). However, no statistically significant relationship between MTHFR expression level in patients with RA and DAS28 CRP, DAS28 ESR, RF and anti-CCP status was observed. Patients with RA, in particular those with IHD, show a decreased expression of the MTHFR gene. This may support a potential implication of the transcriptional regulation of MTHFR in the pathogenesis of RA.

  20. 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

  1. Nutritional assessment of hospitalized patients: agreement between different methods

    OpenAIRE

    Rafaella Maria Monteiro Sampaio; Francisco José Maia Pinto; Cláudia Machado Coelho Souza de Vasconcelos

    2012-01-01

    Objective: To evaluate the correlation between the nutritional diagnosis by subjective global nutritional assessment (SGA) and that obtained by anthropometric measurements in patients admitted to a public hospital in the city of Fortaleza-CE, Brazil. Methods: Assessment of nutritional status was conducted for all 50 patients who were hospitalized in the period from August to September 2008. Besides measurement of weight, height, arm circumference andtriceps skinfold thickness, SGA form was ap...

  2. Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

    Science.gov (United States)

    Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

    2012-07-01

    A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

  3. Examination of an Electronic Patient Record Display Method to Protect Patient Information Privacy.

    Science.gov (United States)

    Niimi, Yukari; Ota, Katsumasa

    2017-02-01

    Electronic patient records facilitate the provision of safe, high-quality medical care. However, because personnel can view almost all stored information, this study designed a display method using a mosaic blur (pixelation) to temporarily conceal information patients do not want shared. This study developed an electronic patient records display method for patient information that balanced the patient's desire for personal information protection against the need for information sharing among medical personnel. First, medical personnel were interviewed about the degree of information required for both individual duties and team-based care. Subsequently, they tested a mock display method that partially concealed information using a mosaic blur, and they were interviewed about the effectiveness of the display method that ensures patient privacy. Participants better understood patients' demand for confidentiality, suggesting increased awareness of patients' privacy protection. However, participants also indicated that temporary concealment of certain information was problematic. Other issues included the inconvenience of removing the mosaic blur to obtain required information and risk of insufficient information for medical care. Despite several issues with using a display method that temporarily conceals information according to patient privacy needs, medical personnel could accept this display method if information essential to medical safety remains accessible.

  4. Posledice kvantnega računalništva

    OpenAIRE

    Malenko, Kokan

    2017-01-01

    Kvantno računalništvo je novo obetavno področje, ki bi lahko prineslo velike izboljšave današnje tehnologije. Vendar pa bi lahko obenem tudi razorožilo nekatere priljubljene kriptografske algoritme. Čeprav uporabnih in stabilnih kvantnih računalnikov še ni, sta njihova potencialna moč in uporabnost spodbudili veliko zanimanje. V tem delu bomo pojasnili osnovne lastnosti kvantnega računalnika, tj. ra-ču-nal-ni-ka, ki izkorišča kvantnomehanske pojave, kot so superpozicija, intefe...

  5. Separation of Ra/Ca by ion exchange; Separacion de Ra/Ca por intercambio ionico

    Energy Technology Data Exchange (ETDEWEB)

    Iturbe, J.L.; Jimenez R, M.; Flores M, J

    1991-04-15

    The radium and the calcium belong to the same group in the periodic classification and as consequence both they present very similar chemical properties, that makes difficult its separation. Both elements are also frequently associate in the nature, the calcium is very abundant, the radium is not it and for that reason it is indispensable its separation to analyze to this last one. The alpha spectroscopy is very appropriate to analyze to the {sup 226} Ra, however to achieve a good resolution of the spectra, the samples should contain small quantities of calcium. The purposes of this work were to know the chromatographic behavior of the alkaline-earthy cations: calcium, barium and radium and to apply these knowledge to the separation of the {sup 226} Ra and its analysis by means of alpha spectroscopy. (Author)

  6. 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.

    Science.gov (United States)

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko; Deguchi, Tomohiko

    2016-01-01

    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. 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. 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%, and 40%, respectively, in the control

  7. The effect of an intensive smoking cessation intervention on disease activity in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Roelsgaard, Ida Kristiane; Thomsen, Thordis; Østergaard, Mikkel

    2017-01-01

    -intervention. Discussion: This trial will reveal whether intensive smoking cessation counselling helps smokers with RA to achieve continuous smoking cessation and whether, as a concomitant benefit, it will reduce their RA disease activity. The trial aims to generate high quality evidence for the feasibility of a health...... erosive joint destruction and a lower health-related quality of life (HR-QoL) than non-smokers. It remains to be determined whether these effects can be reduced by smoking cessation. This randomised controlled trial (RCT) in patients with RA aims to examine the effect of intensive smoking cessation...... in patients with RA. Methods: This will be a multicentre, open label, two arm, parallel group, RCT, including 150 daily smokers with RA, being in remission or having low-moderate disease activity (DAS28 ≤ 5.1). The intervention group (n = 75) will receive five counselling sessions with a trained smoking...

  8. The effect of an intensive smoking cessation intervention on disease activity in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Roelsgaard, Ida Kristiane; Thomsen, Thordis; Østergaard, Mikkel

    2017-01-01

    Background: Rheumatoid arthritis (RA) is a chronic, inflammatory rheumatic disease with the potential to induce significant disability. Patients with RA are at increased risk of cardiovascular diseases (CVD). Smokers with RA tend to experience more pain and fatigue, higher disease activity, more...... intervention (motivational counselling combined with tailored nicotine replacement therapy) versus standard care on smoking cessation, and consequently on disease activity. Secondary objectives are to explore the effect on flare, risk factors for CVD, lung function, physical function, HR-QoL, pain and fatigue...... in patients with RA. Methods: This will be a multicentre, open label, two arm, parallel group, RCT, including 150 daily smokers with RA, being in remission or having low-moderate disease activity (DAS28 ≤ 5.1). The intervention group (n = 75) will receive five counselling sessions with a trained smoking...

  9. IL-15 expression on RA synovial fibroblasts promotes B cell survival.

    Directory of Open Access Journals (Sweden)

    Marta Benito-Miguel

    Full Text Available INTRODUCTION: The purpose of this study was to examine the role of RA Synovial Fibroblast (RASFib IL-15 expression on B cell survival. METHODS: Magnetically sorted peripheral blood memory B cells from 15 healthy subjects were cocultured with RASFib. RESULTS: RASFib constitutively expressed membrane IL-15. Survival of isolated B cells cultured for 6 days, below 5%, was extended in coculture with RASFib to 52+/-8% (p<0.001. IL-15 neutralizing agents but not isotype controls, reduced this rate to 31+/-6% (p<0.05. Interestingly, rhIL-15 had no effect on isolated B cells but significantly increased their survival in coculture with RASFib. In parallel, B cell IL-15R chains were upregulated in cocultures. BAFF and VCAM-1, that are expressed on RASFib, were tested as potential candidates involved in upregulating B cell IL-15R. Culture of B cells in the presence of rhBAFF or rhVCAM-1 resulted in significantly increased survival, together with upregulation of all three IL-15R chains; in parallel, rhIL-15 potentiated the anti-apoptotic effect of BAFF and VCAM-1. Both BAFF and VCAM-1 neutralizing agents downmodulated the effect of RASFib on B cell survival and IL-15R expression. In parallel, rhIL-15 had a lower effect on the survival of B cells cocultured with RASFib in the presence of BAFF or VCAM-1 neutralizing agents. Peripheral blood B cells from 15 early RA patients demonstrated an upregulated IL-15R and increased survival in cocultures. CONCLUSION: IL-15 expression on RASFib significantly contributes to the anti-apoptotic effect of RASFib on B cells. IL-15 action is facilitated by BAFF and VCAM-1 expressed on RASFib, through an upregulation of IL-15R chains.

  10. Dosimetry of {sup 223}Ra-chloride: dose to normal organs and tissues

    Energy Technology Data Exchange (ETDEWEB)

    Lassmann, Michael [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Nosske, Dietmar [Federal Office for Radiation Protection (BfS), Department of Radiation and Health, Oberschleissheim (Germany)

    2013-02-15

    {sup 223}Ra-Chloride (also called Alpharadin {sup registered}) targets bone metastases with short range alpha particles. In recent years several clinical trials have been carried out showing, in particular, the safety and efficacy of palliation of painful bone metastases in patients with castration-resistant prostate cancer using {sup 223}Ra-chloride. The purpose of this work was to provide a comprehensive dosimetric calculation of organ doses after intravenous administration of {sup 223}Ra-chloride according to the present International Commission on Radiological Protection (ICRP) model for radium. Absorbed doses were calculated for 25 organs or tissues. Bone endosteum and red bone marrow show the highest dose coefficients followed by liver, colon and intestines. After a treatment schedule of six intravenous injections with 0.05 MBq/kg of {sup 223}Ra-chloride each, corresponding to 21 MBq for a 70 kg patient, the absorbed alpha dose to the bone endosteal cells is about 16 Gy and the corresponding absorbed dose to the red bone marrow is approximately 1.5 Gy. The comprehensive list of dose coefficients presented in this work will assist in comparing and evaluating organ doses from various therapy modalities used in nuclear medicine and will provide a base for further development of patient-specific dosimetry. (orig.)

  11. Reconstruction of blood propagation in three-dimensional rotational X-ray angiography (3D-RA).

    Science.gov (United States)

    Schmitt, Holger; Grass, Michael; Suurmond, Rolf; Köhler, Thomas; Rasche, Volker; Hähnel, Stefan; Heiland, Sabine

    2005-10-01

    This paper presents a framework of non-interactive algorithms for the mapping of blood flow information to vessels in 3D-RA images. With the presented method, mapping of flow information to 3D-RA images is done automatically without user interaction. So far, radiologists had to perform this task by extensive image comparisons and did not obtain visualizations of the results. In our approach, flow information is reconstructed by forward projection of vessel pieces in a 3D-RA image to a two-dimensional projection series capturing the propagation of a short additional contrast agent bolus. For accurate 2D-3D image registration, an efficient patient motion compensation technique is introduced. As an exemplary flow-related quantity, bolus arrival times are reconstructed for the vessel pieces by matching of intensity-time curves. A plausibility check framework was developed which handles projection ambiguities and corrects for noisy flow reconstruction results. It is based on a linear programming approach to model the feeding structure of the vessel. The flow reconstruction method was applied to 12 cases of cerebral stenoses, AVMs and aneurysms, and it proved to be feasible in the clinical environment. The propagation of the injected contrast agent was reconstructed and visualized in three-dimensional images. The flow reconstruction method was able to visualize different types of useful information. In cases of stenosis of the middle cerebral artery (MCA), flow reconstruction can reveal impeded blood flow depending on the severeness of the stenosis. With cases of AVMs, flow reconstruction can clarify the feeding structure. The presented methods handle the problems imposed by clinical demands such as non-interactive algorithms, patient motion compensation, short reconstruction times, and technical requirements such as correction of noisy bolus arrival times and handling of overlapping vessel pieces. Problems occurred mainly in the reconstruction and segmentation of 3D-RA

  12. Suicide risk and suicide method in patients with personality disorders.

    Science.gov (United States)

    Björkenstam, Charlotte; Ekselius, Lisa; Berlin, Marie; Gerdin, Bengt; Björkenstam, Emma

    2016-12-01

    The influence of psychopathology on suicide method has revealed different distributions among different psychiatric disorders. However, evidence is still scarce. We hypothesized that having a diagnosis of personality disorder (PD) affect the suicide method, and that different PD clusters would influence the suicide method in different ways. In addition, we hypothesized that the presence of psychiatric and somatic co-morbidity also affects the suicide method. We examined 25,217 individuals aged 15-64 who had been hospitalized in Sweden with a main diagnosis of PD the years 1987-2013 (N = 25,217). The patients were followed from the date of first discharge until death or until the end of the follow-up period, i.e. December 31, 2013, for a total of 323,508.8 person-years, with a mean follow up time of 11.7 years. The SMR, i.e. the ratio between the observed number of suicides and the expected number of suicides, was used as a measure of risk. Overall PD, different PD-clusters, and comorbidity influenced the suicide method. Hanging evidenced highest SMR in female PD patients (SMR 34.2 (95% CI: 29.3-39.8)), as compared to non-PD patients and jumping among male PD patients (SMR 24.8 (95% CI: 18.3-33.6)), as compared to non PD-patients. Furthermore, the elevated suicide risk was related to both psychiatric and somatic comorbidity. The increased suicide risk was unevenly distributed with respect to suicide method and type of PD. However, these differences were only moderate and greatly overshadowed by the overall excess suicide risk in having PD. Any attempt from society to decrease the suicide rate in persons with PD must take these characteristics into account. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Performance Comparisons of Improved Regular Repeat Accumulate (RA and Irregular Repeat Accumulate (IRA Turbo Decoding

    Directory of Open Access Journals (Sweden)

    Ahmed Abdulkadhim Hamad

    2017-08-01

    Full Text Available In this paper, different techniques are used to improve the turbo decoding of regular repeat accumulate (RA and irregular repeat accumulate (IRA codes. The adaptive scaling of a-posteriori information produced by Soft-output Viterbi decoder (SOVA is proposed. The encoded pilots are another scheme that applied for short length RA codes. This work also suggests a simple and a fast method to generate a random interleaver having a free 4 cycle Tanner graph. Progressive edge growth algorithm (PEG is also studied and simulated to create the Tanner graphs which have a great girth.

  14. Determination of {sup 226}Ra in urine samples by alpha spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Kehagia, K.; Potiriadis, C.; Bratakos, S.; Koukouliou, V.; Drikos, G. [Greek Atomic Energy Commission, PO Box 60092, Agia Paraskevi, Attiki 15310 (Greece)

    2007-07-01

    A radiation protection system to assess the internal contamination of workers during decontamination activities in an abounded fertilizer industry in the region of Attika, Greece, has been implemented. This system concerns, among other radionuclides, {sup 226}Ra. Because of the low {sup 226}Ra activities in urine, alpha spectrometry was used as the determination method after radiochemical separation. Radium was co precipitated with lead sulphate and purified using anion and cation exchange techniques. The source for the alpha spectrometric measurement was prepared by the electrodeposition of radium, from an aqueous/ethanol solution, onto stainless steel. The tracer used was {sup 229}Th. The chemical yield and the activity concentration were calculated via its daughter radionuclide {sup 217}At. Using the time-evolution formulas to calculate the {sup 217}At growth from its parent radionuclide {sup 225}Ra, a computer software was developed. This software was incorporated in a database, which automatically calculates and stores the results. (authors)

  15. Lasercooled RaF as a promising candidate to measure molecular parity violation

    CERN Document Server

    Isaev, T A; Berger, R

    2010-01-01

    The parameter $W_\\mathrm{a}$, which characterizes nuclear spin-dependent parity violation effects within the effective molecular spin-rotational Hamiltonian, was computed for the electronic ground state of radium fluoride (RaF) and found to be one of the largest absolute values predicted so far. These calculations were performed with the complex generalised Hartree-Fock method within a two-component (quasi-relativistic) zeroth-order regular approximation framework. Peculiarities of the molecular electronic structure of RaF lead to highly diagonal Franck-Condon matrices between vibrational states of the electronic ground and first excited states, which renders the molecule in principle suitable for direct laser cooling. As a trapped gas of cold molecules offers a superior coherence time, RaF can be considered a promising candidate for high-precision spectroscopic experiments aimed at the search of molecular parity-violation effects.

  16. Diatom species composition in the Raška river (Southwestern Serbia

    Directory of Open Access Journals (Sweden)

    Vidaković Danijela P.

    2015-01-01

    Full Text Available The paper presents data on the composition of epilithic diatoms in the Raška River. Samples were collected by scraping stone surfaces with a brush from 5 localities along the Raška River in April, June, August and November 2011 and March and May 2012. Diatom frustules were cleaned using cold acid method, and mounted on permanent slides. An investigation of the Raška River resulted in description of 106 diatom taxa. The most species rich genera are Navicula (10, Gomphonema (10 and Nitzschia (9, while other genera are presented with one or more species. Detailed floristic analysis of the benthic diatom flora in this river has not been conducted before. Therefore, this paper provides a groundwork for future researches. [Projekat Ministarstva nauke Republike Srbije, br. TR 037009

  17. Highest clinical effectiveness of rituximab in autoantibody-positive patients with rheumatoid arthritis and in those for whom no more than one previous TNF antagonist has failed : pooled data from 10 European registries

    NARCIS (Netherlands)

    Chatzidionysiou, Katerina; Lie, Elisabeth; Nasonov, Evgeny; Lukina, Galina; Hetland, Merete Lund; Tarp, Ulrik; Gabay, Cem; van Riel, Piet L. C. M.; Nordstrom, Dan C.; Gomez-Reino, Juan; Pavelka, Karel; Tomsic, Matija; Kvien, Tore K.; van Vollenhoven, Ronald F.

    Objective To assess the 6-month effectiveness of the first rituximab (RTX) course in rheumatoid arthritis (RA) and to identify possible predictors of response. Method 10 European registries submitted anonymised datasets (baseline, 3- and 6-month follow-up) from patients with RA who had started RTX,

  18. Highest clinical effectiveness of rituximab in autoantibody-positive patients with rheumatoid arthritis and in those for whom no more than one previous TNF antagonist has failed: pooled data from 10 European registries

    NARCIS (Netherlands)

    Chatzidionysiou, K.; Lie, E.; Nasonov, E.; Lukina, G.; Hetland, M.L.; Tarp, U.; Gabay, C.; Riel, P.L. van; Nordstrom, D.C.; Gomez-Reino, J.; Pavelka, K.; Tomsic, M.; Kvien, T.K.; Vollenhoven, R.F. van

    2011-01-01

    OBJECTIVE: To assess the 6-month effectiveness of the first rituximab (RTX) course in rheumatoid arthritis (RA) and to identify possible predictors of response. METHOD: 10 European registries submitted anonymised datasets (baseline, 3- and 6-month follow-up) from patients with RA who had started

  19. Measurement error in the assessment of radiographic progression in rheumatoid arthritis (RA) clinical trials: the smallest detectable change (SDC) revisited.

    Science.gov (United States)

    Navarro-Compán, V; van der Heijde, D; Ahmad, Harris A; Miller, Colin G; Wolterbeek, R; Landewé, R

    2014-06-01

    To evaluate if the mean smallest detectable change (SDC) of multiple time intervals using the Bland & Altman (B&A) levels of agreement (LoA) method is an appropriate surrogate for the generalisability analysis method for estimating the overall SDC of radiological progression in rheumatoid arthritis (RA) trials. Secondly, to compare the SDC based on 95% LoA with the SDC based on 80% LoA, and to investigate the association between SDC and baseline damage and progression. Fifteen datasets from randomised controlled trials in RA were scored by 13 experienced readers as pairs according to the modified Sharp/van der Heijde method. The SDC using the 95% and 80% LoA and the generalisability methods was calculated. 21 295 radiographic time points from 7643 patients were included. The mean (range) SDC for the LoA and the generalisability methods was 3.1 (2.3-4.3) and 3.2 (2.3-4.6) units, respectively. The mean ± SD difference between the two methods was -0.13 ± 0.28. The mean SDC including all intervals (n=31) was 3.0 ± 0.7 for 95% LoA and 2.0 ± 0.4 for 80% LoA. No relationship was observed between baseline damage and the SDC, whereas the SDC increased with increasing radiological progression. The mean of the interval SDCs obtained by the simple LoA method is a valid surrogate for the SDC obtained by complex generalisability methods. The SDC depends on the level of radiographic progression rather than on the level of absolute damage. In addition, the use of an SDC based on 80% rather than on 95% LoA is proposed.

  20. Pattern of Family Planning Methods used by Antenatal Patients in ...

    African Journals Online (AJOL)

    This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...

  1. NetRaVE: constructing dependency networks using sparse linear regression

    DEFF Research Database (Denmark)

    Phatak, A.; Kiiveri, H.; Clemmensen, Line Katrine Harder

    2010-01-01

    NetRaVE is a small suite of R functions for generating dependency networks using sparse regression methods. Such networks provide an alternative to interpreting 'top n lists' of genes arising out of an analysis of microarray data, and they provide a means of organizing and visualizing the resulting...... information in a manner that may suggest relationships between genes....

  2. Thyroid Gland in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    B T Turumhambetova

    2009-09-01

    Full Text Available The purpose of our study was to investigate the main parameters of thyroid status in patients with rheumatoid arthritis (RA, as well as particularities of course of this disease depending on of thyroid gland function disorder. Materials and methods. 52 women with RA were examined. The first group consisted of 11 women with subclinical and manifestive hypothyroidism the second one 41 women without thyroid gland function disorder. The group comparison was conducted on main indexes of thyroid gland condition the hormon level, AT-TPO, ultrasonic data, as well as clinical and laboratory RA data. Results. In women with hypothyroidism the systemic manifestations of RA were more often truely diagnosed; DAS28 indexes, ESR, the number ot swollen joints were higher. The high level ot AT-TPO was diagnosed in 54,55% – I group and in 31,7% – II group TTG level was really less in patients receiving synthetic glycocorticoids. Small thyroid gland volume was diagnosed in 23,07% of examined patients. The thyroid gland status indexes in them did not differ from patients with normal thyroid gland volume. Reliable increasing of the peripheral resistance index was revealed in lower thyroid artery according to the ultrasonic study data under the reduced thyroid gland size. Conclusions. High incidence of hypothyroidism and AT-TPO carriage in RA was revealed. Hypothyroidism development is accompanied by high clinic-laboratory RA activity. The reduction of the thyroid gland volumes in RA is possibly stipulated not only by autoimmunal pathology, but also chronic ischemia of the organ in the conditions of immune-complex vasculitis and early atherosclerosis. The TTG level in patients with RA is defined not only by pathology of the thyroid gland, but glycocorticoid therapy as well.

  3. (223)Ra-dichloride spectrometric characterization: Searching for the presence of long-lived isotopes with radiological protection implications.

    Science.gov (United States)

    Sánchez-Jiménez, J; López-Montes, A; Núñez-Martínez, L; Villa-Abaunza, A; Fraile, L M; Sánchez-Tembleque, V; Udías, J M

    2017-03-01

    (223)Ra-dichloride was approved with the commercial name of Xofigo in 2014 for treatment of metastatic castration-resistant prostate cancer. (223)Ra is obtained by neutron irradiation of (226)Ra yielding (227)Ac, which decays to (227)Th and (223)Fr, both decaying to (223)Ra. Since (223)Ra is predominantly (95.3%) an alpha emitter with a 11.42days long half-life, the radiopharmaceutical, its remnants, the patient, and waste material can be managed and disposed with low radiation protection requirements. (227)Ac is a long-lived (T1/2=21.77years) beta emitter that demands strong radiation protection measures. In particular waste disposal has to follow the International Atomic Energy Agency (IAEA) and European Commission (EC) regulations. Since (227)Ac is involved in the production of (223)Ra, an impurity analysis of each batch is required after production. Due to time restrictions, the manufacturer's detection limit (<0.001%) exceeds the one required to assure that (227)Ac concentrations are below direct disposal levels. To improve the detection limit, long-term accurate spectroscopy is required. Alpha and gamma spectroscopy measurements were carried out at the Complutense University Nuclear Physics Laboratory. After twelve months follow up of a sample, (227)Ac concentration was found to be smaller than 10(-9). This allows for direct waste disposal and no additional radiation protection restrictions than those required for (223)Ra. The presence of contamination by other radioisotopes was also ruled out by this experiment. Specifically (226)Ra, involved in (223)Ra production as the original parent and with a very long-lived (T1/2=1577years) alpha emitter, was also below the experimental detection limit. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Small intestinal bacterial overgrowth in patients with rheumatoid arthritis.

    Science.gov (United States)

    Henriksson, A E; Blomquist, L; Nord, C E; Midtvedt, T; Uribe, A

    1993-01-01

    OBJECTIVES--To examine the microflora of the upper small intestine in patients with seropositive rheumatoid arthritis (RA) using a combination of microbial cultivation and tests for microbial metabolic activity. METHODS--Twenty five patients with seropositive RA, 12 achlorhydric control subjects, and 11 control subjects with normal gastric acid secretion were investigated. Disease activity was evaluated in the patients with RA by three different indices. Eight (32%) of the patients with RA had hypochlorhydria or achlorhydria. The acid secretory capacity was determined with pentagastrin stimulation. A modified Crosby capsule was used to obtain biopsy specimens and samples of intestinal fluid from the proximal jejunum; aerobic and anaerobic microbial cultivation of mucosal specimens/intestinal fluid was carried out, and gas production and microflora associated characteristics in jejunal fluid were determined. Additionally, a bile acid deconjugation breath test was performed. RESULTS--Subjects with at least one of the following findings were considered to have bacterial overgrowth: positive bile acid deconjugation test; growth of Enterobacteriaceae; positive gas production; or low tryptic activity. By these criteria half of the patients with RA with hypochlorhydria or achlorhydria and half of the achlorhydric controls had bacterial overgrowth. Thirty five per cent of the patients with RA with normal gastric acid secretion had bacterial overgrowth compared with none of the normal controls. Disease activity indices and rheumatoid factor titres were significantly higher in patients with RA with bacterial overgrowth than in those without. CONCLUSIONS--A high frequency of small intestinal bacterial overgrowth was found in patients with RA; it was associated with a high disease activity and observed in patients with hypochlorhydria or achlorhydria and in those with normal acid secretion. PMID:8346978

  5. Raúl Pepe Verano Montesinos

    Directory of Open Access Journals (Sweden)

    José Luis Luque

    2013-05-01

    Full Text Available El 31 de enero de 2005 falleció en Lima el doctor Raúl Verano. Nacido el 12 de julio de 1940 en Cajatambo, realizó sus estudios superiores en la Universidad Nacional Mayor de San Marcos, graduándose en 1971 de bachiller en Educación y en 1972 obtuvo el grado de bachiller en Biología con la tesis Foraminíferos del litoral del departamento de Lima; optando la profesión de Biólogo en 1973. Empezó sus actividades docentes en 1965 como Ayudante de Prácticas en las cá- tedras de zoología y desde 1971 fue Jefe de Prácticas. Ascendiendo a Auxiliar en 1974, para luego ocupar diversos cargos en la administración universitaria, siendo los más destacados el de Director del Instituto de Investigaciones Antonio Raimondi entre 1981 y 1985 y Decano de la Facultad de Ciencias Biológicas de la Universidad Nacional Mayor de San Marcos en el período 1988 a 1991. Sus actividades de investigación estuvieron alrededor de la ictioparasitología, obteniendo el grado de Doctor en Ciencias Biológicas en 1987 con la tesis Kudoa peruviana Mateo, 1972, redescripción y ultraestructura; Kudoa sarmientae sp. n y Kudoa estela sp. n en peces de la costa peruana

  6. The NCI Patient Navigation Research Program Methods, Protocol and Measures

    Science.gov (United States)

    Freund, Karen M; Battaglia, Tracy A; Calhoun, Elizabeth; Dudley, Donald J.; Fiscella, Kevin; Paskett, Electra; Raich, Peter C.; Roetzheim, Richard G.

    2009-01-01

    Background Patient, provider, and systems barriers contribute to delays in cancer care, lower quality of care, and poorer outcomes in vulnerable populations, including low income, underinsured, and racial/ethnic minority populations. Patient navigation is emerging as an intervention to address this problem, but navigation requires a clear definition and a rigorous testing of its effectiveness. Pilot programs have provided some evidence of benefit, but have been limited by evaluation of single-site interventions and varying definitions of navigation. To overcome these limitations, a nine-site National Cancer Institute Patient Navigation Research Program (PNRP) was initiated. Methods The PNRP is charged with designing, implementing and evaluating a generalizable patient navigation program targeting vulnerable populations. Through a formal committee structure, the PNRP has developed a definition of patient navigation and metrics to assess the process and outcomes of patient navigation in diverse settings, compared with concurrent continuous control groups. Results The PNRP defines patient navigation as support and guidance offered to vulnerable persons with abnormal cancer screening or a cancer diagnosis, with the goal of overcoming barriers to timely, quality care. Primary outcomes of the PNRP are (1) time to diagnostic resolution, (2) time to initiation of cancer treatment, (3) patient satisfaction with care, and (4) cost effectiveness, for breast, cervical, colon/rectum, and/or prostate cancer. Conclusions The metrics to assess the processes and outcomes of patient navigation have been developed for the NCI-sponsored Patient Navigator Research Program. If the metrics are found to be valid and reliable, they may prove useful to other investigators. PMID:18951521

  7. Automated patient and medication payment method for clinical trials

    Directory of Open Access Journals (Sweden)

    Yawn BP

    2013-01-01

    Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

  8. Maintenance of physical activity in patients with rheumaoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Østergaard, Mikkel

    2012-01-01

    Background: Several exercise trials indicate that physical activity (PA) may improve physical function and quality of life, and reduce pain in patients with rheumatoid arthritis (RA) 1, 2. Few of these studies have included physical activity maintenance. Thus, it is still unknown how and why some...... patients with RA are able to maintain physical active. Objectives: The aim of this study was to describe the experience of physical activity maintenance in patients with RA. Methods: A qualitative salutogenetic-oriented study was conducted based on individual semi-structured interviews. Interviewee...... selection was carried out through purposeful sampling. On this basis, participants with self-reported regular physical activity were invited to participate in the study. In total, 16 individuals (12 women and four men; mean age 50), diagnosed with RA for an average of 21 years (range: 4 - 46 years...

  9. Rheumatoid Arthritis (RA) associated interstitial lung disease (ILD).

    LENUS (Irish Health Repository)

    O'Dwyer, David N

    2013-10-01

    Rheumatoid Arthritis (RA) is the most common Connective Tissue Disease (CTD) and represents an increasing burden on global health resources. Interstitial lung disease (ILD) has been recognised as a complication of RA but its potential for mortality and morbidity has arguably been under appreciated for decades. New studies have underscored a significant lifetime risk of ILD development in RA. Contemporary work has identified an increased risk of mortality associated with the Usual Interstitial Pneumonia (UIP) pattern which shares similarity with the most devastating of the interstitial pulmonary diseases, namely Idiopathic Pulmonary Fibrosis (IPF). In this paper, we discuss recent studies highlighting the associated increase in mortality in RA-UIP. We explore associations between radiological and histopathological features of RA-ILD and the prognostic implications of same. We emphasise the need for translational research in this area given the growing burden of RA-ILD. We highlight the importance of the respiratory physician as a key stakeholder in the multidisciplinary management of this disorder. RA-ILD focused research offers the opportunity to identify early asymptomatic disease and define the natural history of this extra articular manifestation. This may provide a unique opportunity to define key regulatory fibrotic events driving progressive disease. We also discuss some of the more challenging and novel aspects of therapy for RA-ILD.

  10. Activity concentrations of 224Ra, 226Ra, 228Ra and 40K radionuclides in refinery products and the additional radiation dose originated from oil residues in Turkey.

    Science.gov (United States)

    Parmaksiz, A; Agus, Y; Bulgurlu, F; Bulur, E; Yildiz, Ç; Öncü, T

    2013-10-01

    A total of 56 crude oil, refinery product, waste water, sludge and scale samples collected from three refineries were measured by gamma-ray spectrometry. Except for nine samples, all refinery product samples were found to have activity concentrations below the minimum detectable activity (MDA) values. The maximum (224)Ra, (226)Ra, (228)Ra and (40)K activity concentrations in crude oil and refinery product samples were measured as 11.7 ± 4.5, 14.9 ± 3.5, 11.6 ± 4.5, 248.5 ± 18.5 Bq kg(-1), respectively. The maximum (224)Ra, (226)Ra, (228)Ra and (40)K activity concentrations in scale, sludge and water samples were measured as 343.7 ± 11.8, 809.2 ± 29.0, 302.5 ± 21.6, 623.0 ± 80.9 Bq kg(-1), respectively. Radium equivalent activities of the residue samples were calculated up to 1241.8 ± 42.4 Bq kg(-1). The maximum activity concentration index and the alpha index were found to be 4.2 and 4.0, respectively. The annual effective doses of residue samples were calculated below the permitted dose rate for the public, i.e. 1 mSv y(-1).

  11. The potential of {sup 223}Ra and {sup 18}F-fluoride imaging to predict bone lesion response to treatment with {sup 223}Ra-dichloride in castration-resistant prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murray, Iain; Chittenden, Sarah J.; Denis-Bacelar, Ana M.; Flux, Glenn D. [Royal Marsden NHS Foundation Trust, Joint Department of Physics, Sutton, Surrey (United Kingdom); The Institute of Cancer Research, London (United Kingdom); Hindorf, Cecilia [Royal Marsden NHS Foundation Trust, Joint Department of Physics, Sutton, Surrey (United Kingdom); The Institute of Cancer Research, London (United Kingdom); Skaane University Hospital, Department of Radiation Physics, Lund (Sweden); Parker, Christopher C. [Royal Marsden NHS Foundation Trust, Department of Urology, Sutton (United Kingdom); Chua, Sue [Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine, Sutton (United Kingdom)

    2017-10-15

    The aims of this study were to calculate bone lesion absorbed doses resulting from a weight-based administration of {sup 223}Ra-dichloride, to assess the relationship between those doses and corresponding {sup 18}F-fluoride uptake and to assess the potential of quantitative {sup 18}F-fluoride imaging to predict response to treatment. Five patients received two intravenous injections of {sup 223}Ra-dichloride, 6 weeks apart, at 110 kBq/kg whole-body weight. The biodistribution of {sup 223}Ra in metastatic lesions as a function of time after administration as well as associated lesion dosimetry were determined from serial {sup 223}Ra scans. PET/CT imaging using {sup 18}F-fluoride was performed prior to the first treatment (baseline), and at week 6 immediately before the second treatment and at week 12 after baseline. Absorbed doses to metastatic bone lesions ranged from 0.6 Gy to 44.1 Gy. For individual patients, there was an average factor difference of 5.3 (range 2.5-11.0) between the maximum and minimum lesion dose. A relationship between lesion-absorbed doses and serial changes in {sup 18}F-fluoride uptake was demonstrated (r{sup 2} = 0.52). A log-linear relationship was demonstrated (r{sup 2} = 0.77) between baseline measurements of {sup 18}F-fluoride uptake prior to {sup 223}Ra-dichloride therapy and changes in uptake 12 weeks after the first cycle of therapy. Correlations were also observed between both {sup 223}Ra and {sup 18}F-fluoride uptake in lesions (r = 0.75) as well as between {sup 223}Ra absorbed dose and {sup 18}F-fluoride uptake (r = 0.96). There is both inter-patient and intra-patient heterogeneity of absorbed dose estimates to metastatic lesions. A relationship between {sup 223}Ra lesion absorbed dose and subsequent lesion response was observed. Analysis of this small group of patients suggests that baseline uptake of {sup 18}F-fluoride in bone metastases is significantly correlated with corresponding uptake of {sup 223}Ra, the associated {sup 223

  12. Detection of gene expression signatures related to underlying disease and treatment in rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Serikawa, Kyle A; Jacobsen, Søren; Lundsgaard, Dorthe

    2013-01-01

    OBJECTIVES: Gene expression signatures can provide an unbiased view into the molecular changes underlying biologically and medically interesting phenotypes. We therefore initiated this study to identify signatures that would be of utility in studying rheumatoid arthritis (RA). METHODS: We used...... in a subset of clinically active RA patients without C-reactive protein elevation. Furthermore, biologics-specific gene signatures in patients with RA indicate that looking for a biologic-specific response pattern may be a potential future tool for predicting individual patient response....... microarray profiling of peripheral blood mononuclear cells (PBMCs) in 30 RA patients to assess the effect of different biologic agent (biologics) treatments and to quantify the degree of a type-I interferon (IFN) signature in these patients. A numeric score was derived for the quantification step and applied...

  13. Clinical Pharmacogenetic Models of Treatment Response to Methotrexate Monotherapy in Slovenian and Serbian Rheumatoid Arthritis Patients: Differences in Patient's Management May Preclude Generalization of the Models

    Directory of Open Access Journals (Sweden)

    Barbara Jenko

    2018-01-01

    Full Text Available Objectives: Methotrexate (MTX is the first line treatment for rheumatoid arthritis (RA, but nevertheless 30% of patients experience MTX inefficacy. Our aim was to develop a clinical pharmacogenetic model to predict which RA patients will not respond to MTX monotherapy. We also assessed whether this model can be generalized to other populations by validating it on a group of Serbian RA patients.Methods: In 110 RA Slovenian patients, data on clinical factors and 34 polymorphisms in MTX pathway were analyzed by Least Absolute Shrinkage and Selection Operator (LASSO penalized regression to select variables associated with the disease activity as measured by Disease Activity Score (DAS28 score after 6 months of MTX monotherapy. A clinical pharmacogenetic index was constructed from penalized regression coefficients with absolute value above 0.05. This index was cross-validated and also independently validated on 133 Serbian RA patients.Results: A clinical pharmacogenetic index for prediction of DAS28 after 6 months of MTX monotherapy in Slovenian RA patients consisted of DAS28 score at diagnosis, presence of erosions, MTX dose, Solute Carrier Family 19 Member 1 (SLC19A1 rs1051266, Solute Carrier Organic Anion Transporter Family Member 1B1 (SLCO1B1 rs2306283, Thymidylate Synthase (TYMS, and Adenosine Monophosphate Deaminase 1 (AMPD1 rs17602729. It correctly classified 69% of Slovenian patients as responders or nonresponders and explained 30% of variability in DAS28 after 6 months of MTX monotherapy. Testing for validity in another population showed that it classified correctly only 22.5% of Serbian RA patients.Conclusions: We developed a clinical pharmacogenetic model for DAS28 after 6 months of MTX monotherapy in Slovenian RA patients by combining clinical and genetic variables. The clinical pharmacogenetic index developed for Slovenian patients did not perform well on Serbian patients, presumably due to the differences in patients' characteristics

  14. Patients' satisfaction with therapy methods of advanced chronic venous disease.

    Science.gov (United States)

    Chudek, Jerzy; Mikosiński, Jacek; Kobielski, Andrzej; Hering, Artur; Aleksiejew-Kleszczyński, Tomasz; Umiński, Jacek; Zubilewicz, Tomasz; Kobusiewicz, Wojciech; Iłżecki, Marek; Wojtak, Andrzej; Stec, Janusz; Urbanek, Tomasz

    2016-02-01

    To assess patients' satisfaction from the therapy of advanced chronic venous disorders (CVD) in everyday clinical practice in Poland, and to compare the efficacy of various venoactive drugs (VADs) in venous ulcers healing process. Seven hundred and eighty unselected adult patients with active (N.=441) or healed (N.=339) venous ulcers participated in the non-interventional observational 6-week study. Compression therapy and VADs were utilized by 81.5% and 89.2% of patients respectively: 31.2% of all patients underwent surgical procedures for vein incompetence, 61.3% were satisfied with surgical methods, 43% with compression therapy, and 32.6% with VADs ‑ with highest rate of satisfied patients in the group taking Ruscus aculeatus and HMC and ascorbic acid (51.4%). Of 377 patients with active venous ulcers smaller than 200 cm2, adherent to VADs, 18.0% have been cured, and 66.6% have improved during 6-week period of observation. Multiple logistic regression analysis revealed that the compression therapy (OR=2.74), the size of ulcer ≤10 cm2 (OR=2.70) were increasing the change of ulcer healing. No VADs was better than another in the healing process. 1) Compression therapy and VADs are highly utilized by patients with advanced CVD. 2) Patients are more satisfied with surgical than conservative treatment of advanced CVD. 3) More than half of the patients with the advanced stage CVD taking Ruscus aculeatus and HMC and ascorbic acid is satisfied with the obtained improvement. 4) Ruscus aculeatus and HMC and ascorbic acid is similarly effective as other frequently used VADs in venous ulcer healing. 5) Ruscus aculeatus and HMC and ascorbic acid exerting effects on veins, capillaries and lymphatic vessels may explain the positive results observed in this study.

  15. Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Osman Son

    2014-01-01

    Full Text Available Objective. The results from Diabetes Control and Complications Trial (DCCT have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM. During this study, we tried to inquire carbohydrate (Kh count method’s positive effects on the type 1 DM treatment’s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method.

  16. Interleukin-1Ra rs2234663 and Interleukin-4 rs79071878 Polymorphisms in Familial Mediterranean Fever.

    Science.gov (United States)

    Nursal, Ayse Feyda; Tekcan, Akin; Kaya, Suheyla Uzun; Sezer, Ozlem; Yigit, Serbulent

    2016-05-15

    Familial Mediterranean Fever (FMF) is an autosomal recessively inherited auto inflammatory disorder. MEFV gene, causing FMF, encodes pyrin that is associated with the interleukin-1 (IL-1) related inflammation cascade. The aim of this study was to investigate the relationship of interleukin-1 receptor antagonist (IL-1Ra) and interleukin-4 (IL-4) polymorphisms with the risk of FMF in the Turkish population. This study included 160 patients with FMF (74 men, 86 women) and 120 healthy controls (50 men, 70 women), respectively. Genotyping of IL-1Ra rs2234663 polymorphism was evaluated by gel electrophoresis after polymerase chain reaction (PCR). The IL-4 rs79071878 polymorphism was determined by PCR-based restriction fragment length polymorphism (PCR-RFLP) analysis. The results of analyses were evaluated for statistical significance. There was no significant difference in IL-1Ra genotype and allele distributions between FMF and the control groups (p>0.05). However, a significant association was observed between FMF patients and control groups according to IL-4 genotype distribution (p=0.016), but no association was found in the allelic frequency of IL-4 between FMF patients and the controls (p>0.05, OR: 1.131, CI 95%: 0.71-1.81). The IL-4 rs79071878 polymorphism, was associated whereas the IL-1Ra rs2234663 polymorphism was not associated with FMF risk in the Turkish population. Larger studies with different ethnicities are needed to determine the impact of IL-1Ra and IL-4 polymorphism on the risk of developing FMF. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. The IL-1Ra gene variable number tandem repeat variant is associated with susceptibility to temporomandibular disorders in Turkish population.

    Science.gov (United States)

    Tumer, Mehmet Kemal; Nursal, Ayse Feyda; Tekcan, Akin; Yerliyurt, Kaan; Geyko, Anastasia; Yigit, Serbulent

    2017-06-14

    Temporomandibular joint disorders (TMD) are a group of disorders involving temporomandibular joint and related structures. Interleukine-1 receptor antagonist (IL-1Ra) is an important anti-inflammatory molecule that competes with other interleukin-1 molecules. This study was designed to investigate the possible association of the IL-1Ra VNTR variant with the risk of TMD in the Turkish population. Peripheral blood samples were collected from 100 patients with TMD (23 males, 77 females) and 110 healthy individuals (35 males, 75 females). Genotyping of IL-1Ra 86 bp VNTR variant was evaluated by gel electrophoresis after polymerase chain reaction (PCR). Our results show that there is a statistically significant difference between TMD patients and control group with respect to IL-1Ra genotype distribution and allele frequencies. 1.2, 1.4, and 4.4 genotypes were more common in patients, while 2.2 and 3.3 genotypes were rarer (P<.000). Frequency of alleles 1 and 4 was higher in patient groups (P<.000), whereas alleles 2 and 3 had a lower frequency in patients with TMD (P<.000). This is the first correlation study that evaluates the association between IL-1Ra gene VNTR variant and TMD. The VNTR variant related to IL-1Ra gene showed a strong pattern of association with TMD that may have a potential impact on disease counseling and management. Larger studies with various ethnicities are needed to establish the impact of IL-1Ra VNTR variant on risk of developing TMD. © 2017 Wiley Periodicals, Inc.

  18. Fingerprints: A simple method for Screening Hemophilic Patients.

    Science.gov (United States)

    Jamalian, M; Mesri, M; Vishteh, H R K; Solhi, H; Salehpour, R

    2014-08-01

    The present study aims to compare hemophilic patients' fingerprint types with the normal people to help diagnose the disease, particularly new occurrences of the disease. This case-control study was conducted in 2012. Sixty two patients with hemophilia type A and 62 normal healthy people were selected. The type of fingerprint was determined by a forensic specialist who was kept unaware of the participants' group. Using advanced Henry method, the main types of fingerprints were classified as arch, loop, whorl, as well as other types. In the control group, loop type (65%) and in the case group the whorl type (34%) were the most frequent fingerprint type (p fingerprint in each finger between two groups. In addition, the average number of whorl type in the patients with mild disease was significantly higher and the average number of arch and other types of fingerprints was significantly lower than patients with moderate or severe disease. The findings of the present study indicated that not only are the fingerprints of normal and hemophilic people different, but also a difference was observed between hemophilic patients with the mild factor level and patients with moderate or severe one.

  19. Demographic Features of Patients with Rheumatoid Arthritis in Kosovo

    OpenAIRE

    Bajraktari, Ismet H.; Teuta, Backa-?i?o; Vjollca, Sahat?iu-Meka; Bajraktari, Halit; Saiti, Valton; Krasniqi, Blerim; Muslimi, Fikret

    2014-01-01

    Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory illness characterized by polyarthritis of small and large joints which in the course of time may progress to disability. Material and methods: In our prospective study were included 951 patients (females 730, and males 221 respectively) with an average age 51.3 year old, diagnosed with RA in accordance with ACR-EULAR/2010 criteria. The purpose of the paper is to investigate gender, age, group age by gender, level of ...

  20. IL2RA/CD25 Gene Polymorphisms: Uneven Association with Multiple Sclerosis (MS) and Type 1 Diabetes (T1D)

    Science.gov (United States)

    Alcina, Antonio; Fedetz, María; Ndagire, Dorothy; Fernández, Oscar; Leyva, Laura; Guerrero, Miguel; Abad-Grau, María M.; Arnal, Carmen; Delgado, Concepción; Lucas, Miguel; Izquierdo, Guillermo; Matesanz, Fuencisla

    2009-01-01

    Background IL-2 receptor (IL2R) alpha is the specific component of the high affinity IL2R system involved in the immune response and in the control of autoimmunity. Methods and Results Here we perform a replication and fine mapping of the IL2RA gene region analyzing 3 SNPs previously associated with multiple sclerosis (MS) and 5 SNPs associated with type 1 diabetes (T1D) in a collection of 798 MS patients and 927 matched Caucasian controls from the south of Spain. We observed association with MS in 6 of 8 SNPs. The rs1570538, at the 3′- UTR extreme of the gene, previously reported to have a weak association with MS, is replicated here (P = 0.032). The most associated T1D SNP (rs41295061) was not associated with MS in the present study. However, the rs35285258, belonging to another independent group of SNPs associated with T1D, showed the maximal association in this study but different risk allele. We replicated the association of only one (rs2104286) of the two IL2RA SNPs identified in the recently performed genome-wide association study of MS. Conclusions These findings confirm and extend the association of this gene with MS and reveal a genetic heterogeneity of the associated polymorphisms and risk alleles between MS and T1D suggesting different immunopathological roles of IL2RA in these two diseases. PMID:19125193

  1. Measurement of 224Ra and 226Ra activities in natural waters using a radon-in-air monitor

    Science.gov (United States)

    Kim, G.; Burnett, W.C.; Dulaiova, H.; Swarzenski, P.W.; Moore, W.S.

    2001-01-01

    We report a simple new technique for measuring low-level radium isotopes (224Ra and 226Ra) in natural waters. The radium present in natural waters is first preconcentrated onto MnO2-coated acrylic fiber (Mn fiber) in a column mode. The radon produced from the adsorbed radium is then circulated through a closed air-loop connected to a commercial radon-in-air monitor. The monitor counts alpha decays of radon daughters (polonium isotopes) which are electrostatically collected onto a silicon semiconductor detector. Count data are collected in energy-specific windows, which eliminate interference and maintain very low backgrounds. Radium-224 is measured immediately after sampling via 220Rn (216Po), and 226Ra is measured via 222Rn (218Po) after a few days of ingrowth of 222Rn. This technique is rapid, simple, and accurate for measurements of low-level 224Ra and 226Ra activities without requiring any wet chemistry. Rapid measurements of short-lived 222Rn and 224Ra, along with long-lived 226Ra, may thus be made in natural waters using a single portable system for environmental monitoring of radioactivity as well as tracing of various geochemical and geophysical processes. The technique could be especially useful for the on-site rapid determination of 224Ra which has recently been found to occur at elevated activities in some groundwater wells.

  2. [Methods of alternative medicine treatment assessed by patients with allergies and patients with chronic skin diseases].

    Science.gov (United States)

    Triebskorn, A; Drosner, M

    1989-06-15

    71 patients suffering from allergies and chronic skin diseases were questioned as to the so-called "alternative-medical" methods of treatment they had undergone. Two thirds of the patients judged the treatment as favorable or excellent, although the typical symptoms of only half of them, at the most, were actually improved. Part of the patients were able to reduce or do without their former medication. The vast majority of those patients who had already experienced a climatic therapy judged the success of such a treatment as good or excellent, when it was compared to a traditional or "alternative-medical" therapy alone. We discuss our results.

  3. Modeling the Energy Performance of LoRaWAN

    Directory of Open Access Journals (Sweden)

    Lluís Casals

    2017-10-01

    Full Text Available LoRaWAN is a flagship Low-Power Wide Area Network (LPWAN technology that has highly attracted much attention from the community in recent years. Many LoRaWAN end-devices, such as sensors or actuators, are expected not to be powered by the electricity grid; therefore, it is crucial to investigate the energy consumption of LoRaWAN. However, published works have only focused on this topic to a limited extent. In this paper, we present analytical models that allow the characterization of LoRaWAN end-device current consumption, lifetime and energy cost of data delivery. The models, which have been derived based on measurements on a currently prevalent LoRaWAN hardware platform, allow us to quantify the impact of relevant physical and Medium Access Control (MAC layer LoRaWAN parameters and mechanisms, as well as Bit Error Rate (BER and collisions, on energy performance. Among others, evaluation results show that an appropriately configured LoRaWAN end-device platform powered by a battery of 2400 mAh can achieve a 1-year lifetime while sending one message every 5 min, and an asymptotic theoretical lifetime of 6 years for infrequent communication.

  4. Modeling the Energy Performance of LoRaWAN.

    Science.gov (United States)

    Casals, Lluís; Mir, Bernat; Vidal, Rafael; Gomez, Carles

    2017-10-16

    LoRaWAN is a flagship Low-Power Wide Area Network (LPWAN) technology that has highly attracted much attention from the community in recent years. Many LoRaWAN end-devices, such as sensors or actuators, are expected not to be powered by the electricity grid; therefore, it is crucial to investigate the energy consumption of LoRaWAN. However, published works have only focused on this topic to a limited extent. In this paper, we present analytical models that allow the characterization of LoRaWAN end-device current consumption, lifetime and energy cost of data delivery. The models, which have been derived based on measurements on a currently prevalent LoRaWAN hardware platform, allow us to quantify the impact of relevant physical and Medium Access Control (MAC) layer LoRaWAN parameters and mechanisms, as well as Bit Error Rate (BER) and collisions, on energy performance. Among others, evaluation results show that an appropriately configured LoRaWAN end-device platform powered by a battery of 2400 mAh can achieve a 1-year lifetime while sending one message every 5 min, and an asymptotic theoretical lifetime of 6 years for infrequent communication.

  5. Lower incidence of acute GVHD is associated with the rapid recovery of CD4+CD25+CD45RA+regulatory T cells in patients who received haploidentical allografts from NIMA-mismatched donors: A retrospective (development) and prospective (validation) cohort-based study.

    Science.gov (United States)

    Wang, Yu; Zhao, Xiang-Yu; Xu, Lan-Ping; Zhang, Xiao-Hui; Han, Wei; Chen, Huan; Wang, Feng-Rong; Mo, Xiao-Dong; Zhang, Yuan-Yuan; Zhao, Xiao-Su; Y, Kong; Liua, Kai-Yan; Huang, Xiao-Jun; Yu, Xue-Zhong; Chang, Ying-Jun

    2016-01-01

    To investigate the effects of non-inherited maternal antigen (NIMA) on clinical outcomes and immune recovery, especially of regulatory T cells (Tregs), in patients who underwent unmanipulated haploidentical transplantation. A retrospective cohort (n = 57) and a prospective cohort (n = 88) were included. All patients received haploidentical allografts from sibling donors. Reconstitution of immune subsets, including Tregs, was determined using multicolor flow cytometry. In the retrospective cohort, the cumulative incidence of grades II-IV acute GVHD in patients with NIMA-mismatched donors was significantly lower than that of cases with NIPA-mismatched donors (14.8% vs. 43.30%, p = 0.018). Patients with higher percentages of CD4 + CD25 + CD45RA + T cells (naive Tregs) within CD4 + T cells recovered on day 30 (≥1.55%) experienced a significantly lower incidence of grades II-IV acute GVHD than that of cases with lower percentages of naive Tregs (NIMA mismatch and the percentages of naive Tregs were associated with the incidence of grades II-IV acute GVHD [ p = 0.050, and 0.031, respectively]. In the prospective cohort, the association of NIMA mismatch [HR = 0.365, 95% CI, 0.169-0.786, p = 0.010] or higher percentages of naive Tregs recovered on day 30 (≥1.55%) [HR = 0.114, 95% CI, 0.027-0.479, p = 0.003] with a lower cumulative incidence of grades II-IV acute GVHD was further demonstrated. No effects of NIMA mismatch on chronic GVHD, transplant-related mortality, relapse, disease-free survival, or overall survival were found. Our results confirmed the role of NIMA mismatch in acute GVHD and provided the first demonstration, based on clinical data, that recovered Tregs may be involved in the effects of NIMA on acute GVHD in a haploidentical transplant setting.

  6. Preferences of patients and health professionals for route and frequency of administration of biologic agents in the treatment of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Huynh, Tuan Khai; Ostergaard, Ann; Egsmose, Charlotte

    2014-01-01

    OBJECTIVES: To examine the preferences of rheumatoid arthritis (RA) patients and health professionals (HPs) for the route and frequency of administration of biologic drugs. METHODS: One hundred and seven RA patients treated with biological agents for intravenous or subcutaneous use, 35 biologic......-naïve RA patients treated with a disease-modifying antirheumatic drug and 30 rheumatology HPs (physicians and nurses) were recruited from two outpatient clinics in Copenhagen, Denmark. All subjects filled out a questionnaire interrogating their choice of preferred route and frequency of administration...

  7. Conditional anomaly detection methods for patient-management alert systems.

    Science.gov (United States)

    Valko, Michal; Cooper, Gregory; Seybert, Amy; Visweswaran, Shyam; Saul, Melissa; Hauskrecht, Milos

    2008-07-01

    Anomaly detection methods can be very useful in identifying unusual or interesting patterns in data. A recently proposed conditional anomaly detection framework extends anomaly detection to the problem of identifying anomalous patterns on a subset of attributes in the data. The anomaly always depends (is conditioned) on the value of remaining attributes. The work presented in this paper focuses on instance-based methods for detecting conditional anomalies. The methods rely on the distance metric to identify examples in the dataset that are most critical for detecting the anomaly. We investigate various metrics and metric learning methods to optimize the performance of the instance-based anomaly detection methods. We show the benefits of the instance-based methods on two real-world detection problems: detection of unusual admission decisions for patients with the community-acquired pneumonia and detection of unusual orders of an HPF4 test that is used to confirm Heparin induced thrombocytopenia - a life-threatening condition caused by the Heparin therapy.

  8. Comparison of two nutritional assessment methods in gastroenterology patients.

    Science.gov (United States)

    Filipović, Branka F; Gajić, Milan; Milinić, Nikola; Milovanović, Branislav; Filipović, Branislav R; Cvetković, Mirjana; Sibalić, Nela

    2010-04-28

    To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two methods: subjective global assessment (SGA) and nutritional risk index (NRI). The investigation was performed on 299 hospitalized patients, aged 18-84 years (average life span 55.57 +/- 12.84), with different gastrointestinal pathology, admitted to the Department of Gastroenterohepatology, Clinical and Hospital Center "Bezanijska Kosa" during a period of 180 d. All the patients, after being informed in detail about the study and signing a written consent, underwent nutritional status analysis, which included two different nutritional indices: SGA and NRI, anthropometric parameters, bioelectrical impedance analysis, and biochemical markers, within 24 h of admission. In our sample of 299 hospitalized patients, global malnutrition prevalence upon admission varied from 45.7% as assessed by the SGA to 63.9% by NRI. Two applied methods required different parameters for an adequate approach: glucose level (5.68 +/- 1.06 mmol/L vs 4.83 +/- 1.14 mmol/L, F = 10.63, P = 0.001); body mass index (26.03 +/- 4.53 kg/m(2) vs 18.17 +/- 1.52 kg/m(2), F = 58.36, P DFA) delineated the following parameters as important for prediction of nutritional status according to SGA assessment: concentration of albumins, level of proteins, SGA score and body weight. The DFA extracted MAMC, glucose level and NRI scores were variables of importance for the prediction of whether admitted patients would be classified as well or malnourished. SGA showed higher sensitivity to predictor factors. Assessment of nutritional status requires a multidimensional approach, which includes different clinical indices and various nutritional parameters.

  9. Ra: The Sun for Science and Humanity

    Science.gov (United States)

    1996-01-01

    To guide the development of the Ra Strategic Framework, we defined scientific and applications objectives. For our primary areas of scientific interest, we choose the corona, the solar wind, the Sun's effect on the Earth, and solar theory and model development. For secondary areas of scientific interest, we selected sunspots, the solar constant, the Sun's gravitational field, helioseismology and the galactic cosmic rays. We stress the importance of stereoscopic imaging, observations at high spatial, spectral, and temporal resolutions, as well as of long duration measurements. Further exploration of the Sun's polar regions is also important, as shown already by the Ulysses mission. From an applications perspective, we adopted three broad objectives that would derive complementary inputs for the Strategic Framework. These were to identify and investigate: possible application spin-offs from science missions, possible solar-terrestrial missions dedicated to a particular application, and possible future applications that require technology development. The Sun can be viewed as both a source of resources and of threats. Our principal applications focus was that of threat mitigation, by examining ways to improve solar threat monitoring and early warning systems. We compared these objectives to the mission objectives of past, current, and planned international solar missions. Past missions (1962-1980) seem to have been focused on improvement of scientific knowledge, using multiple instrument spacecraft. A ten year gap followed this period, during which the results from previous missions were analyzed and solar study programmes were prepared in international organizations. Current missions (1990-1996) focus on particular topics such as the corona, solar flares, and coronal mass ejections. In planned missions, Sun/Earth interactions and environmental effects of solar activity are becoming more important. The corona is the centre of interest of almost all planned missions

  10. Leaching of 226Ra from components of uranium mill tailings

    Science.gov (United States)

    Landa, E.R.

    1991-01-01

    A sequential extraction procedure was used to characterize the geochemical forms of 226Ra retained by mixtures of quartz sand and a variety of fine-grained rock and mineral species. These mixtures had previously been exposed to the sulfuric acid milling liquor of a simulated acid-leach uranium milling circuit. For most test cases, the major fraction of the 226Ra was extracted with 1 mol/1 NH4Cl and was deemed to be exchangeable. However, 226Ra retained by the barite-containing mixture was resistant to both 1 mol/1 NH4Cl and 1 mol/HCHCl extraction. ?? 1991.

  11. Forenzično računovodstvo u poljoprivredi

    OpenAIRE

    Blaženović, Ivan; Ranogajec, Ljubica

    2016-01-01

    Računovodstveni izvještaji predstavlju glavne izvore informacija o posjedovnoj strani i uspješnosti poduzeća. Manipulacije računovodstvenim informacijama rade se s ciljem prikrivanja stvarnog stanja u poduzeću. U procesu otkrivanja prijevara forenzičari se koriste računalnom opremom i posebno dizajniranim programima za pregled i usporedbu podataka poslovnih knjiga poduzeća koje je pod kontrolom. Ukoliko se uoče nepravilnosti, pokreće se istraga nad tim poduzećem s ciljem sprječavanja kriminal...

  12. Serum YKL-40 concentrations in patients with rheumatoid arthritis: relation to disease activity

    DEFF Research Database (Denmark)

    Johansen, J S; Stoltenberg, M; Hansen, M

    1999-01-01

    according to disease activity in RA, but provides in some respect information different from conventional markers. Our previous studies are consistent with a local release of YKL-40 in the arthritic joint followed by a secondary increase in serum YKL-40. YKL-40 may prove to be a new tool for the study......OBJECTIVE: YKL-40, also called human cartilage glycoprotein-39, is secreted by chondrocytes, synovial cells, macrophages and neutrophils. Studies have shown that YKL-40 is an autoantigen in rheumatoid arthritis (RA). We evaluated whether serum YKL-40 was related to disease activity in patients...... with RA. METHODS: Serum YKL-40 was determined by radioimmunoassay in 156 patients with RA during a 1 yr longitudinal study. RESULTS: Serum YKL-40 was increased in 54% of the patients with clinically active disease. Patients with clinically active disease initially who became inactive after 12 months had...

  13. IL-1 receptor antagonism and muscle gene expression in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Berchtold, L. A.; Larsen, C. M.; Vaag, A.

    2009-01-01

    Background. We have previously reported that systemic blockade of IL-1 beta in patients with type 2 diabetes with anakinra (a recombinant human interleukin-1-receptor antagonist, IL-1Ra), lowered glycated hemoglobin improved beta-cell function and reduced circulating levels of IL-6 and CRP (7......). To investigate the effects of IL-1Ra in insulin-sensitive tissue, gene expression levels in skeletal muscle from type 2 diabetic patients treated with IL-1Ra were analysed. Methods. Gene expression profiles in vastus lateralis muscle biopsies from five obese patients (BMI>27) were determined before and after 13......RT-PCR, were significantly altered when comparing the number of transcripts before and after treatment for each individual. Conclusion. Treatment with IL-1Ra did not significantly affect gene expression levels in skeletal muscle in this limited and selected sample of obese patients with type 2 diabetes. Larger...

  14. Clinical patient registry recruitment and retention: a survey of patients in two chronic disease registries

    Directory of Open Access Journals (Sweden)

    Daniel H. Solomon

    2017-04-01

    Full Text Available Abstract Background The collection of routine clinical data in the setting of research registries can serve an important role in understanding real world care. However, relatively little is known about the patient experience in registries, motivating us to survey patients enrolled in two chronic disease registries. Methods We conducted similar surveys in two disease-based registries based at one academic medical center in the US. One group of patients with rheumatoid arthritis (RA had been enrolled in a registry, and we focused on retention factors. In a second group of patients with inflammatory bowel disease (IBD recently enrolled or considering enrollment, we examined factors that would influence their enrollment and willingness to answer frequent questionnaires and give biospecimens. The surveys were analyzed using descriptive statistics and the two cohorts were compared using nonparametric and chi-square tests. Results We received 150 (50% completed surveys from RA and 169 (63% from IBD patients. Mean age of subjects was 62 years in RA and 43 in IBD with more women respondents with RA (83% than IBD (62%. The two groups described very similar factors as the top three motivations for participation: desire to help others, desire to improve care of own disease, and ease of volunteering. Preferred methods of surveying included mail, e-mail, but telephone was not favored; age was an important correlate of this preference. Respondents preferred surveys either every 1–3 months (28.7% RA and 55.0% IBD or every 4–6 months (50.7% RA and 29.0% IBD. They differed in the preference for payment for answering surveys with 68.0% with RA answering that no payment was necessary but only 36.1% with IBD felt similarly. Conclusions Patients engaged in clinical registries demonstrate a high level of commitment to improve care and many report a willingness to answer questions relatively frequently.

  15. Diffusion tensor imaging: the normal evolution of ADC, RA, FA, and eigenvalues studied in multiple anatomical regions of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Loebel, Ulrike [University Hospital Jena, Institute of Diagnostic and Interventional Radiology, Jena (Germany); St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Sedlacik, Jan [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); University Hospital Jena, Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Guellmar, Daniel [University Hospital Jena, Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena (Germany); University Hospital Jena, Biomagnetic Center, Department of Neurology, Jena (Germany); Kaiser, Werner A.; Mentzel, Hans-Joachim [University Hospital Jena, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Reichenbach, Juergen R. [University Hospital Jena, Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena (Germany)

    2009-04-15

    The aim of our work was to investigate the process of myelination in healthy patients using the diffusion parameters apparent diffusion coefficient (ADC), relative anisotropy (RA), fractional anisotropy (FA), and eigenvalues. Age-dependent changes were assessed using the slope m of the fit functions that best described the data. Seventy-two patients (3 weeks-19 years) without pathological magnetic resonance imaging findings were selected from all pediatric patients scanned with diffusion tensor imaging over a 5-year period at our institution. ADC, RA, FA, and eigenvalue maps were calculated and regions of interest were selected in anterior/posterior pons, genu/splenium of corpus callosum (CC), anterior/posterior limb of internal capsule (IC), and white matter (WM) regions (frontal, temporal, parietal, occipital WM). Statistical analysis was performed using Spearman correlation coefficient and regression analysis. Mean values ranged 71.6 x 10{sup -5} to 90.3 x 10{sup -5} mm{sup 2}/s (pons/parietal WM) for ADC, 0.32-0.94 (frontal WM/CC) for RA, and 0.36-0.81 (frontal WM/splenium) for FA. Logarithmic fit functions best described the data. Strong age influences were observed for CC, pons, and parietal/frontal WM and changes were significant for all three eigenvalues, most pronounced for perpendicular eigenvalues. Changes in RA and FA differed depending on the structure anisotropy. Changes observed for ADC, RA, FA, and eigenvalues with age were consistent with previous findings. Changes detected for RA and FA varied due to the different scaling of both parameters. We found that the use of the largely linear scaled RA adds more valuable information for the assessment of age-dependent structural changes as compared to FA. Additionally, we report normative values for the diffusion parameters studied. (orig.)

  16. Ordination of environmental data using principal component analysis: the case of the radium isotopes (Ra-226 and Ra-28) in surface waters in an area associated with NORM/TENORM mining

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Wagner de S.; Py Junior, Delcy de A.; Antunes, Marcos M., E-mail: wspereira@inb.gov.b, E-mail: delcy@inb.gov.b, E-mail: antunes@inb.gov.b [Industrias Nucleares do Brasil SA, Pocos de Caldas, MG (Brazil). Unidade de Tratamento de Minerios. Coordenacao de Protecao Radiologica; Kelecom, Alphonse, E-mail: kelecom@uol.com.b [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Inst. de Biologia. Curso de Pos-Graduacao em Biologia Marinha; Carmo, Roberto F., E-mail: rfcarmo@inb.gov.b [Industrias Nucleares do Brasil SA, Caetite, BA (Brazil). Unidade de Concentracao de Uranio. Coordenacao de Protecao Radiologica; Oliveira, Gabriela T. de [Centro Universitario de Sao Joao da Boa Vista (UNIFAE), SP (Brazil). Curso de Engenharia Quimica

    2009-07-01

    The radium isotopes Ra-226 and Ra-228 were analyzed in surface water at six points, during eighteen months, from June 2006 to December 2007, in the neighborhood of a mine of phosphate associated with uranium in the region of Santa Quiteria, state of Ceara, Brazil. The soluble fraction (which passes through filter of 0.45 micron) and the particulate fraction (which is retained on the 0.45 micron filter) were analyzed using the Principal Component Analysis, PCA, a method for ranking environmental data, and were analyzed also by F test for testing the difference between radionuclides and the difference between the two analyzed fractions. The PCA has identified four groups of samples. Results of Ra-226 in soluble fraction are grouped in the negative part of axis 1 (Factor 1) and axis 2 (Factor 2). Results of Ra-228 in particulate fraction are grouped in the positive part of axis 1 (Factor 1) and in the negative part of axis 2. Results of Ra-226 in soluble fraction are grouped along the positive part of axis 1 (Factor 1). Finally, results of Ra-228 in the particulate fraction are grouped in the positive part of axis 1 (Factor 1) and axis 2 (Factor 2). This last group has two discrepant points (01 and 06). There is no statistical difference between the two analyzed fractions but there are statistical differences between analyzed radionuclides. Therefore, three conclusions can be identified: The use of PCA with radionuclides and analyzed fractions as parameters permits the grouping of collecting data by their environmental similarities; the mean concentration of Ra-226 was statistically higher than that of Ra-228; and there is no statistical difference between soluble and particulate fractions. (author)

  17. Precision measurement of the RaE shape factor

    Energy Technology Data Exchange (ETDEWEB)

    Grau, C.A. [CIEMAT, Madrid (Spain). Direccion de Tecnologia; Grau, M.A. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas (CIEMAT), Madrid (Spain). Inst. de Investigacion Basica

    1996-01-01

    We apply to RaE a new method to determine the shape factor coefficients of pure beta transitions with energies over the Cherenkov threshold of water. This method is based on the precision measurement of one observable, the ft-value, and two quasi-observables, the Cherenkov counting efficiency and the position of the maximum point of the liquid-scintillation logarithmic pulse-height spectrum. We found for the revised shape factor function that the ground state wave function vertical stroke {sup 210}Bi, 1{sup -} right angle is the combination of the three wave functions vertical stroke 1h{sub 9/2}2g{sub 9/2} right angle, vertical stroke 1h{sub 9/2} 1i{sub 11/2} right angle and vertical stroke 1h{sub 9/2}2g{sub 7/2} right angle. This result is also confirmed by the excellent agreement we obtain with experiment for the longitudinal electron polarization. (orig.).

  18. RA diagnostics applying optical tomography in frequency domain

    Science.gov (United States)

    Klose, Alexander D.; Prapavat, Viravuth; Minet, Olaf; Beuthan, Juergen; Mueller, Gerhard J.

    1998-01-01

    Our aim is to reconstruct the optical parameters in a slice of a finger joint phantom for further investigations about rheumatoid arthritis (RA). Therefore, we have developed a flexible NIR scanning system in order to collect amplitude and phase delay of photon density waves in frequency-domain. A cylindrical finger joint phantom was embedded in a container of Intralipid solution due to the application of an inverse method for infinite geometry. The joint phantom was investigated by a laser beam obtaining several projections. The average optical parameters of each projection was calculated. Using different reconstruction techniques, e.g. ART and SIRT with a special projection operator, we reconstructed the optical parameters in a slice. The projection operator can be heuristically described by a photon path density function of a homogeneous media with infinite geometry. Applied to an object with an unknown distribution of optical parameters it calculates the expectation value of the investigated object. The potentials and limits of these fast reconstruction methods will be presented.

  19. Background Characterization for Thermal Ion Release Experiments with 224Ra

    Energy Technology Data Exchange (ETDEWEB)

    Kwong, H.; /Stanford U., Phys. Dept.; Rowson, P.; /SLAC

    2005-12-15

    The Enriched Xenon Observatory for neutrinoless double beta decay uses {sup 136}Ba identification as a means for verifying the decay's occurrence in {sup 136}Xe. A current challenge is the release of Ba ions from the Ba extraction probe, and one possible solution is to heat the probe to high temperatures to release the ions. The investigation of this method requires a characterization of the alpha decay background in our test apparatus, which uses a {sup 228}Th source that produces {sup 224}Ra daughters, the ionization energies of which are similar to those of Ba. For this purpose, we ran a background count with our apparatus maintained at a vacuum, and then three counts with the apparatus filled with Xe gas. We were able to match up our alpha spectrum in vacuum with the known decay scheme of {sup 228}Th, while the spectrum in xenon gas had too many unresolved ambiguities for an accurate characterization. We also found that the alpha decays occurred at a near-zero rate both in vacuum and in xenon gas, which indicates that the rate was determined by {sup 228}Th decays. With these background measurements, we can in the future make a more accurate measurement of the temperature dependency of the ratio of ions to neutral atoms released from the hot surface of the probe, which may lead to a successful method of Ba ion release.

  20. Evaluation of the Psychometric Properties of SOGS-RA in the Polish Version

    Directory of Open Access Journals (Sweden)

    Jolanta Jarczyńska

    2016-09-01

    Full Text Available Objective: The objective was to adapt the American pathological gambling screening tool /SOGS-RA The South Oaks Gambling Screen - Revised for Adolescent/ by K. Winters, R. Stinchfield and J. Fulkerson (1993 and to evaluate its psychometric properties. Method: The adapted tool was used in research on a randomly selected sample of 2,617 adolescents aged 13-20 years in the 2012/2013 school year. Results: On the SOGS-RA scale, 2.6% of the trial participants achieved a score indicating past year problem gambling before the survey, 4.1% were classified as problem gamblers, whereas 17.3% of adolescents engaged in social gambling that did not pose a problem gambling risk at the time. The SOGS-RA demonstrated satisfactory internal consistency (Cronbach's alpha = 0.78. Conclusions: The Polish adaptation of the SOGS-RA scale is reliable and accurate, which is why it is worth recommending it for use in further research on Polish adolescents.

  1. Comparison of methods of estimating creatinine clearance in pediatric patients.

    Science.gov (United States)

    Padgett, Danielle; Ostrenga, Andrew; Lepard, Lindsey

    2017-06-01

    A retrospective study was conducted to compare various methods of measuring serum creatinine (SCr) values for use in pediatric renal function assessments, including a method aligned with a recently implemented national SCr testing standard. Demographic, medication-use, and selected laboratory data were collected from the hospital records of a sample of pediatric patients (n = 91) who underwent 12- or 24-hour timed urine collection for determination of creatinine clearance (CLcr) over a 2-year period. Documented CLcr values measured via the timed urine collection method were compared with investigator-calculated estimates of CLcr or glomerular filtration rate (GFR) derived using 3 SCr-based methods: the Counahan-Barratt equation; the original Schwartz equation; and the "bedside IDMS-traceable Schwartz equation," a modified version of the Schwartz equation reflecting the recent shift toward isotope dilution mass spectrometry (IDMS) methods of SCr measurement, which have been found to yield SCr values 10-20% lower than those derived by older methods, potentially resulting in GFR overestimation if traditional formulas for estimating GFR are used. Comparisons of timed urine collection-derived CLcr values with CLcr values derived from the 3 comparator equations indicated significant levels of bias in all cases, with calculated correlation coefficients of 0.71 for the original Schwartz equation, 0.72 for the bedside IDMS-traceable Schwartz equation, and 0.72 for the Counahan-Barratt equation. Pediatric CLcr values calculated using the original Schwartz, bedside IDMS-traceable Schwartz, and Counahan-Barratt equations were well correlated, but none of the 3 equations yielded values that correlated well with CLcr values derived via the gold-standard method of timed urine collection. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  2. Giver lave Ra-værdier bedre hygiejne?

    DEFF Research Database (Denmark)

    Gram, Lone; Bagge-Ravn, Dorthe; Kold, John

    2004-01-01

    Ifølge vore undersøgelser er der ingen grund til at ændre på den generelle anbefaling om, at Ra bør være mindre end 0,8 µm. Muligvis kan man dog i særlige tilfælde opnå hygiejnemæssige gevinster ved at bruge meget fine poleringer, dvs. Ra mindre end 0,8 µm.......Ifølge vore undersøgelser er der ingen grund til at ændre på den generelle anbefaling om, at Ra bør være mindre end 0,8 µm. Muligvis kan man dog i særlige tilfælde opnå hygiejnemæssige gevinster ved at bruge meget fine poleringer, dvs. Ra mindre end 0,8 µm....

  3. Impossible cartographies: approaching Raúl Ruiz’s cinema

    National Research Council Canada - National Science Library

    Michael Goddard

    2013-01-01

    Raúl Ruiz (1931-2011), while considered one of the world’s most significant filmmakers by several film critics, is yet to be the subject of any thorough academic engagement with his work in English...

  4. LoRA: A Loudspeaker-Based Room Auralization System

    DEFF Research Database (Denmark)

    Favrot, Sylvain Emmanuel; Buchholz, Jörg

    2010-01-01

    that the involved signal processing preserves the temporal, spectral and spatial properties of the room impulse response captured by these parameters. This flexible research platform will be useful for studying auditory processing and perception in normal-hearing and hearing-impaired listeners in fully controlled......In order to study basic human perception in reverberant environments, a novel loudspeaker-based room auralization (LoRA) system is proposed in this paper. The LoRA system efficiently combines modern room acoustic models with high-order Ambisonic auralization. An objective evaluation has been...... carried out demonstrating the applicability of the LoRA system. Room acoustic parameters (reverberation time, clarity, speech transmission index and inter-aural cross correlation coefficients) of room impulse responses were compared at the input and the simulated output of the LoRA system. Results show...

  5. Prevalence of Periodontitis in Patients with Established Rheumatoid Arthritis: A Swedish Population Based Case-Control Study

    Science.gov (United States)

    Eriksson, Kaja; Nise, Lena; Kats, Anna; Luttropp, Elin; Catrina, Anca Irinel; Askling, Johan; Jansson, Leif; Alfredsson, Lars; Klareskog, Lars; Lundberg, Karin; Yucel-Lindberg, Tülay

    2016-01-01

    Introduction The possible hypothesis of a link between periodontitis and rheumatoid arthritis (RA), specifically anti-citrullinated protein antibody (ACPA) positive RA, prompted us to investigate the prevalence of periodontitis in the Swedish Epidemiological Investigation of RA (EIRA), a well-characterised population-based RA case-control cohort. Methods Periodontal status of 2,740 RA cases and 3,942 matched controls was retrieved through linking EIRA with the National Dental Health Registry (DHR), where dental diagnostic- and treatment codes on the adult Swedish population have been registered. Dental records from 100 cases and controls were reviewed to validate the periodontal diagnostic codes in DHR. Results The reviewed dental records confirmed 90% of the periodontitis diagnoses in DHR among RA cases, and 88% among controls. We found the positive predictive value of periodontitis diagnoses in the DHR to be 89% (95% CI 78 to 95%) with a sensitivity of 77% (95% CI: 65 to 86%). In total, 86% of EIRA participants were identified in DHR. The risk for periodontitis increased by age and current smoking status in both cases as well as controls. No significant differences in prevalence of periodontal disease in terms of gingivitis, periodontitis, peri-implantitis or increased risk for periodontitis or peri-implantitis were observed between RA cases and controls. In addition, there was no difference on the basis of seropositivity, ACPA or rheumatoid factor (RF), among patients with RA. Conclusions Our data verify that smoking and ageing are risk factors for periodontitis, both in RA and controls. We found no evidence of an increased prevalence of periodontitis in patients with established RA compared to healthy controls, and no differences based on ACPA or RF status among RA subjects. PMID:27203435

  6. Comparação de métodos alternativos para estimar a produção de leite de vacas da raça Gir Comparison of alternative methods to estimate the milk yield of cows from Gyr breed

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    Tarcísio de Moraes Gonçalves

    1999-01-01

    Full Text Available O objetivo deste trabalho foi comparar métodos alternativos para estimar a produção de leite de vacas da raça Gir. Um total de 3632 lactações de vacas da raça Gir, no período de 1986 a 1996, foi analisado. Os métodos foram: A - controle na ordenha da manhã realizado nos meses ímpares e o da ordenha da tarde nos meses pares - a produção da ordenha da manhã foi multiplicada pelo fator multiplicativo da manhã (FM, e a da tarde pelo fator multiplicativo da tarde (FT, B e D - controle realizado na ordenha da manhã (em B a produção da manhã foi multiplicada pelo FM e em D produção foi duplicada; C e E - controle realizado na ordenha da tarde (em C produção da tarde foi multiplicada pelo FT e em E foi duplicada. Todos os métodos foram comparados com a produção real (R. O método A mostrou-se mais preciso, sendo a precisão do método C intermediária entre os métodos B e D. Correlações de Pearson entre as produções estimadas pelos diferentes métodos e R, pela produção até 305 dias e pela produção total foram, respectivamente, 0,98; 0,95; e 0,96 para A, 0,97; 0,93; e 0,95 para B, 0,93; 0,90; e 0,89 para C, 0,97; 0,94; e 0,95 para D e 0,93; 0,89; e 0,89 para E. O método A mostrou-se o mais viável para estimar a produção de leite no dia do controle leiteiro, por sua praticidade e precisão, enquanto os metodos C e E foram os piores entre os metodos de controle avaliados.The objective of this work was to compare the alternative methods to estimate the milk yield of cows from Gyr breed. A total of 3,632 lactations from of Gyr breed cows, from 1986 to 1996, were analyzed. The methods were: A - the morning milking control was performed in the odd months and the afternoon milking control in the even months - the yield of the morning milking control was multiplied by the multiplicative factor of the morning (MF and that of evening by the multiplicative factor of the afternoon (AF, B and D - the control was performed in

  7. O pensamento desenvolvimentista de Raúl Prebisch Raúl Prebisch's thought on development

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    Joaquim Miguel Couto

    2007-04-01

    Full Text Available As idéias do economista argentino Raúl Prebisch (1901-1986 sempre estiveram voltadas para a ação. As dificuldades encontradas diante de problemas concretos (durante a crise dos anos 1930, tornaram Prebisch um homem prático. Assim, suas teorias sobre a substituição de importações, o sistema centro-periferia e a criação de um mercado comum latino-americano, possuíam um grande sentido de influenciar a realidade. A única exceção coube a sua "Teoria da Transformação", construída no último decênio de sua vida. Nesta, Prebisch se afasta da realidade e teoriza sobre a criação de um novo sistema econômico, através de uma síntese entre socialismo e liberalismo.The Argentinean economist Raúl Prebisch’s (1901-1986 ideas were always gone back to the action. Difficulties facing concrete problems made him a pragmatic man. Thus, his theories about import substitution, core-periphery system and the creation of a common Latin-American market, were embodied in a great purpose of influencing the reality. The only exception was the "Theory of Transformation", which was built in the last decade of this life. There, Prebisch moves off practical matters and speculates about the creation of a new economic system, through a synthesis of socialism and liberalism.

  8. Identifying Preliminary Domains to Detect and Measure Rheumatoid Arthritis Flares: Report of the OMERACT 10 RA Flare Workshop

    DEFF Research Database (Denmark)

    Bingham, Clifton O; Alten, Rieke; Bartlett, Susan J

    2011-01-01

    an international research project to understand the specific characteristics and impact of episodic disease worsening, or "flare," so that outcome measures can be developed or modified to reflect this uncommonly measured, but very real and sometimes disabling RA disease feature. Patient research partners provided......, a preliminary list of key domains has been identified to evaluate flare. RESULTS: At OMERACT 10, consensus was achieved identifying features of flare in addition to the existing core set for RA, including fatigue, stiffness, symptom persistence, systemic features, and participation. Patient self-report of flare...

  9. Feelings of guilt and shame in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    ten Klooster, Peter M.; Christenhusz, Lieke C.A.; Taal, Erik; Eggelmeijer, Frank; van Woerkom, Jan-Maarten; Rasker, Hans J.

    2014-01-01

    This study aims to determine whether patients with rheumatoid arthritis (RA) experience more general feelings of guilt and shame than their peers without RA and to examine possible correlates of guilt and shame in RA. In a cross-sectional survey study, 85 out-patients with RA (77 % female; median

  10. Evaluation of orthodontic treatment need by patient-based methods compared with normative method

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    Imaneh Asgari

    2013-01-01

    Full Text Available Background: A comprehensive system of assessing orthodontic need requires the integration of normative clinical measures with patient-based indicators. This study sought to discover weather an oral health-related quality of life measure or Aesthetic Component of Index of Orthodontic Treatment Need (AC-IOTN could be used as a predictor of orthodontic treatment need. Factors affecting the judgment of patient and dentist about this need are discussed. Materials and Methods: Oral examination on 597 Iranian students between 13 years and 18 years was done to reach the grade of Dental Health Component (DHC. The Child Oral Health Impact Profile (COHIP and AC-IOTN were recorded. The diagnostic values of subjective tests were assessed. Multiple logistic regressions were applied to investigate the role of variables in the persons′ perceptions. Results: Half of the 570 eligible students did not need orthodontic treatment either on professional or self-assessment; 60% of patients with definite need had a distinct impact on their quality of life. The specificity of AC to detect the healthy persons was excellent (0.99 but its sensitivity was low (0.08. COHIP score gave a better sensitivity but its specificity was 50%. Caries experience, quality of life, father′s education, and brushing habits were the factors relating to the same judgment of persons and dentists (P < 0.02. Conclusion: Regarding the discrepancies between two assessment methods, present instruments did not meet the predictor′s competencies. The patient-based methods could not substitute the professional assessment, but by identification, the persons with higher impacts would benefit the prioritization process.

  11. Significance of arthrosonography in the diagnosis of metatarsophalangeal joint injury in patients with rheumatoid arthritis

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    Rita Aleksandrovna Osipyants

    2013-01-01

    Full Text Available Objective: to estimate the contribution of arthrosonography to the diagnosis of metatarsophalangeal joint (MTPJ injury and to reveal predictors for functional impairments in patients with rheumatoid arthritis (RA. Subjects and methods. The investigation enrolled 50 patients with the RA diagnosis meeting to the American College of Rheumatology 1987 criteria. According to disease duration, the patients were divided into two groups: 1 9 patients with an early RA history of less than 2 years (ERA; 2 41 patients with a RA history of over 2 years (LRA. All the patients underwent clinical joint evaluation, laboratory and instrumental examination, including joint X-ray and ultrasonography (USG. Results. An inflammatory process in the foot joints is significantly more frequently detected on ultrasound than clinically (p < 0.0001. The detection rate of erosions, as evidenced by USG, was significantly higher than that by X-ray, in ERA in particular (p = 0.01. Comparison analysis of patients with low and high HAQ scores showed the relationship between functional status, age, pain degree, and inflammatory process in the fifth MTPJ, as shown by USG. There were no associations with disease duration, traditional clinical and laboratory parameters of RA activity, and erosive changes in the feet. Conclusion. Joint USG in daily clinical practice makes it possible to objectively evaluate pathological changes in the feet and the probability of work disability due to RA.

  12. Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis

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    Theodoridou Katerina

    2007-04-01

    Full Text Available Abstract Background Anti-cyclic citrullinated peptide (anti-CCP antibodies have been of diagnostic value in Northern European Caucasian patients with rheumatoid arthritis (RA. In these populations, anti-CCP antibodies are associated with the HLA-DRB1 shared epitope. We assessed the diagnostic value of anti-CCP antibodies in Greek patients with RA where the HLA shared epitope was reported in a minority of patients. Methods Using an enzyme-linked immunosorbent assay (ELISA (CCP2 kit, we tested anti-CCP antibodies in serum samples from 155 Greek patients with RA, 178 patients with other rheumatic diseases, and 100 blood donors. We also determined rheumatoid factor (RF and compared it to anti-CCP antibodies for area under the curve (AUC, sensitivity, specificity and likelihood ratios. Results Sensitivity of anti-CCP2 antibodies and RF for RA was 63.2% and 59.1%, and specificity was 95.0% and 91.2%, respectively. When considered simultaneously, the AUC for anti-CCP antibodies was 0.90 with 95% CI of 0.87 to 0.93 and the AUC for RF was 0.71 with 95% CI of 0.64 to 0.77. The presence of both antibodies increased specificity to 98.2%. Anti-CCP antibodies were positive in 34.9% of RF-negative RA patients. Anti-CCP antibodies showed a correlation with the radiographic joint damage. Anti-CCP-positive RA patients had increased the swollen joint count and serum CRP concentration compared to anti-CCP-negative RA patients (Mann-Whitney U test, p = 0.01, and p Conclusion In Greek patients with RA, anti-CCP2 antibodies exhibit a better diagnostic value than RF and a correlation with radiological joint damage and therefore are useful in everyday rheumatology practice.

  13. Assessing Medication Adherence in Patients with Rheumatoid Arthritis (RA)

    Science.gov (United States)

    2017-04-26

    DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) JOINT BASE SAN ANTONIO - LACKLAND TEXAS 26 APR 2017 MEMORANDUM FOR SGSP ATrN: MAJ SHAOPING MO...Shaoplng Mo Sumner, Maj , USAF, PharmD San Antonio Combined Military Postgraduate Year One Pharmacy Residency Program .......••Fort Sam Houston, TX

  14. Investigation of $\\alpha$-decay rates of $^{221}$Fr, $^{224}$Ra and $^{226}$Ra in different environments

    CERN Multimedia

    2007-01-01

    It has recently been suggested, and indicated experimentally, that $\\alpha$- decay half-lives are modified by solid state effects in the surrounding environment. We propose here to measure with high accuracy the $\\alpha$-decay half-life of $^{221}$Fr, $^{224}$Ra and $^{226}$Ra in insulators and metals. Furthermore we plan to investigate the temperature dependency of the half-life in these materials (room temperature, 4 K and 10 mK).

  15. Acute hepatitis in three patients with systemic juvenile idiopathic arthritis taking interleukin-1 receptor antagonist

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    Hollister J Roger

    2009-12-01

    Full Text Available Abstract Purpose We investigated the etiology of acute hepatitis in three children with systemic Juvenile Idiopathic Arthritis (sJIA taking Interleukin-1 receptor antagonist (IL1RA. Methods Laboratory and clinical data for three children with sJIA diagnosed at ages 13 months to 8 years who developed acute hepatitis during treatment with IL1RA were reviewed for evidence of sJIA flare, infection, macrophage activation syndrome (MAS, malignancy, and drug reaction. Results In all patients, hepatitis persisted despite cessation of known hepatotoxic drugs and in absence of known infectious triggers, until discontinuation of IL1RA. Liver biopsies had mixed inflammatory infiltrates with associated hepatocellular injury suggestive of an exogenous trigger. At the time of hepatitis, laboratory data and liver biopsies were not characteristic of MAS. In two patients, transaminitis resolved within one week of discontinuing IL1RA, the third improved dramatically in one month. Conclusions Although sJIA symptoms improved significantly on IL1RA, it appeared that IL1RA contributed to the development of acute hepatitis. Hepatitis possibly occurred as a result of an altered immune response to a typical childhood infection while on IL1RA. Alternatively, hepatitis could have represented an atypical presentation of MAS in patients with sJIA taking IL1RA. Further investigation is warranted to determine how anti-IL1 therapies alter immune responsiveness to exogenous triggers in patients with immune dysfunction such as sJIA. Our patients suggest that close monitoring for hepatic and other toxicities is indicated when treating with IL1RA.

  16. Clinical patient registry recruitment and retention: a survey of patients in two chronic disease registries.

    Science.gov (United States)

    Solomon, Daniel H; Shadick, Nancy A; Weinblatt, Michael E; Frits, Michelle; Iannaccone, Christine; Zak, Agnes; Korzenik, Joshua R

    2017-04-17

    The collection of routine clinical data in the setting of research registries can serve an important role in understanding real world care. However, relatively little is known about the patient experience in registries, motivating us to survey patients enrolled in two chronic disease registries. We conducted similar surveys in two disease-based registries based at one academic medical center in the US. One group of patients with rheumatoid arthritis (RA) had been enrolled in a registry, and we focused on retention factors. In a second group of patients with inflammatory bowel disease (IBD) recently enrolled or considering enrollment, we examined factors that would influence their enrollment and willingness to answer frequent questionnaires and give biospecimens. The surveys were analyzed using descriptive statistics and the two cohorts were compared using nonparametric and chi-square tests. We received 150 (50%) completed surveys from RA and 169 (63%) from IBD patients. Mean age of subjects was 62 years in RA and 43 in IBD with more women respondents with RA (83%) than IBD (62%). The two groups described very similar factors as the top three motivations for participation: desire to help others, desire to improve care of own disease, and ease of volunteering. Preferred methods of surveying included mail, e-mail, but telephone was not favored; age was an important correlate of this preference. Respondents preferred surveys either every 1-3 months (28.7% RA and 55.0% IBD) or every 4-6 months (50.7% RA and 29.0% IBD). They differed in the preference for payment for answering surveys with 68.0% with RA answering that no payment was necessary but only 36.1% with IBD felt similarly. Patients engaged in clinical registries demonstrate a high level of commitment to improve care and many report a willingness to answer questions relatively frequently.

  17. FLIR/INS/RA Integrated Landing Guidance for Landing on Aircraft Carrier

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    Zhenxing Ding

    2015-05-01

    Full Text Available This paper presents a FLIR/INS/RA integrated landing guidance method to provide information of aircraft states and carrier dynamics for fixed-wing aircraft landing on the aircraft carrier in low-visibility weather and high sea states. The method utilizes the Forward-Looking Infrared (FLIR system, the Inertial Navigation System (INS, and the Radio Altimeter (RA as sensors, to track infrared cooperated targets on the aircraft carrier. Several algorithms like the Newton iterative algorithm, the Kalman Filter (KF, and the Wavelet Transform (WT are employed to compute real-time and high-precision estimates of the aircraft states (runway-related position, attitude, and velocity and the carrier dynamics (pitch, roll, and heave. A simulation experiment is conducted and shows satisfactory results for the aircraft carrier landing guidance.

  18. Antibodies to Infliximab and Adalimumab in Patients with Rheumatoid Arthritis in Clinical Remission

    DEFF Research Database (Denmark)

    Eng, Grith P; Bendtzen, Klaus; Bliddal, Henning

    2015-01-01

    Objective. To investigate if antibodies towards biological TNF-α inhibitors (anti-TNFi Abs) are present in patients with rheumatoid arthritis (RA) in clinical remission and to relate any anti-TNFi Abs to circulating level of TNF-α inhibitor (TNFi). Methods. Patients with RA, treated with infliximab....../44 patients (18%) treated with infliximab and 1/49 patients (2%) treated with adalimumab (p = 0.012). In the former group, anti-TNFi Abs corresponded with low levels of TNFi (p = 0.048). Anti-TNFi Ab-positive patients had shorter disease duration at initiation of TNFi therapy (p = 0.023) but were similar...... for the rest of the compared parameters. Conclusions. In RA patients in clinical remission, anti-TNFi Abs occur frequently in patients treated with infliximab, while they occur rarely in patients treated with adalimumab. Presence of anti-infliximab Abs is accompanied by low or undetectable levels of infliximab...

  19. Radium isotopes ((226)Ra and (228)Ra) in Na-Cl type groundwaters from Tohoku District (Aomori, Akita and Yamagata Prefectures) in Japan.

    Science.gov (United States)

    Tomita, Jumpei; Zhang, Jing; Yamamoto, Masayoshi

    2014-11-01

    A total of 28 Na-Cl type groundwater samples were collected from Aomori, Akita and Yamagata Prefectures, in the Tohoku District of Japan, and their radium isotope ((226)Ra and (228)Ra) concentrations were measured along with their chemical components and stable isotope ratios (δ(2)H and δ(18)Os). The (226)Ra concentrations in groundwater samples varied widely, ranging from 8.8 to 1587 mBq kg(-1). These concentrations showed an increasing tendency with the increase of the total dissolved solid (TDS) contents. The (228)Ra/(226)Ra activity ratios were in the range from 0.3 to 4.2, with most data being around 0.5-2. These ratios were within those of (232)Th/(238)U found in granitic and related rocks and so on in Japan, indicating that Ra isotopes mainly ejected into the groundwater by the alpha-recoil process. The relationship between (226)Ra and other parameters suggested that Ra isotopes in groundwater samples in this study were mainly constrained by adsorption-desorption reactions depending on salinity with wide variation. Clear correlation between (226)Ra-Ca, (226)Ra-Sr, (226)Ra-Ba and (226)Ra-TDS observed in sulfate-free groundwater samples indicated that Ra isotopes of them were constrained by adsorption-desorption reactions depending on salinity under reducing condition. In contrast, relationship of (226)Ra-Ca, (226)Ra-Sr, (226)Ra-Ba and (226)Ra-TDS in sulfate-containing groundwater samples varied widely, and then, removal or enhanced mobility of Ra isotopes of them were observed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Patients with rheumatoid arthritis treated with methotrexate (MTX): concentrations of steady-state erythrocyte MTX correlate to plasma concentrations and clinical efficacy

    DEFF Research Database (Denmark)

    Hornung, N.; Ellingsen, T.; Attermann, J.

    2008-01-01

    OBJECTIVE: To investigate the accumulation of methotrexate (MTX) in circulating erythrocytes and the association with pharmacokinetic variables, weekly dose, and clinical efficacy in 2 cohorts of patients with chronic active rheumatoid arthritis (RA) undergoing MTX monotherapy. METHODS: Seventy......-six patients with RA were included in this open prospective study: 40 were included before initiation of MTX therapy. Laboratory analyses, intracellular MTX concentrations in erythrocytes (Ery-MTX), and clinical examinations including toxicity data were performed prospectively for 52 weeks. Plasma...

  1. Therapy palliative with {sup 2}23Ra without special radiation protection measures?; Palliative Therapie mit {sup 223}Ra ohne besondere Strahlenschutzmassnahmen?

    Energy Technology Data Exchange (ETDEWEB)

    Just, Guenther [Forschungsbuero Radonbalneologie (FRB), Grosspoesna (Germany); Petzold, Juergen

    2015-07-01

    For nearly 2 years now as a therapy of the castration resistant prostata carcinoma a nuclide therapy with {sup 223}Ra-Dichloride (trade-mark Xofigo) is applied. Xofigo is applied by a medical specialist for nuclear medicine altogether 6 times in a monthly distance. The activity used in each case is according to the body weight (50 kBq/kg BW). This therapy is licensed by the supervisory authorities of the German federal countries as an ambulant therapy. Special radiation protection measures are only required when exceeding a given number of 17 patients per year as incorparation measurements.

  2. Does PET reconstruction method affect Deauville scoring in lymphoma patients?

    Science.gov (United States)

    Enilorac, Blandine; Lasnon, Charline; Nganoa, Cathy; Fruchart, Christophe; Gac, Anne Claire; Damaj, Gandhi; Aide, Nicolas

    2017-12-14

    Background: When scoring 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) with the Deauville scale (DS), the quantification of tumor and reference organs limits the problem of optical misinterpretation. Compared to conventional reconstruction algorithms, point spread function (PSF) modeling significantly increases standardized uptake values (SUVs) in tumors but only moderately in the liver, which could affect the DS. We investigated whether the choice of the reconstruction algorithm affects the DS and whether discordances affect the capability of FDG PET to stratify lymphoma patients. Materials and Methods: Overall, 126 diffuse large B-cell Lymphoma (DLBCL) patients were included (56 females, 70 males, median (range) age: 65 (20-88) years). PET data were reconstructed with unfiltered PSF reconstruction. Additionally, a 6-mm filter was applied to PSF images to meet the European Association of Nuclear Medicine (EANM)/European Association Research Ltd (EARL) requirements (PSFEARL). One hundred interim PET (i-PET) and 95 end-of-treatment PET (EoT-PET) studies were analyzed. SUVmax in the liver and aorta were determined using automatic volumes of interest (VOIs) and compared to SUVmax of the residual mass with the highest FDG uptake. Results: For i-PET, using PSF and PSFEARL, patients were classified as responders and non-responders in 60 and 40 cases versus 63 and 37 cases, respectively. Five (5.0%) major discordances (i.e., changes from responder to non-responder) occurred. For Eot-PET, patients were classified using PSF and PSFEARL as responders and non-responders in 69 and 26 cases versus 72 and 23 cases, respectively. Three (3.2%) major discordances occurred. Concordance (Cohen's unweighted Kappa) between PSF and the PSFEARL Deauville scoring was 0.82 (95%CI: 0.73-0.91) for i-PET and 0.89 (95%CI: 0.81-0.96) for EoT-PET. The median follow-up periods were 28.4 and 27.4 months for i-PET and EoT-PET, respectively. Kaplan-Meier analysis showed

  3. Determinants of Brachial-Ankle Pulse Wave Velocity in Chinese Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Ping Li

    2013-01-01

    Full Text Available Objective. To investigate the relationship between Brachial-ankle pulse wave velocity (baPWV, and its associated risk factors in Chinese patients with RA. Methods. 138 Chinese RA patients and 150 healthy subjects were included. baPWV of all the participants was measured. RA related factors were determined, as well as traditional cardiovascular risk factors. Results. baPWV was significant higher in RA group (1705.44 ± 429.20 cm/s compared to the healthy control group (1386.23 ± 411.09 cm/s (P<0.001. Compared with low baPWV group, high baPWV group patients were significantly older (P = 0.008 and taller (P = 0.033. Serum cholesterol (P = 0.035, triglycerides (P = 0.004, and LDL level (P = 0.006 were significantly higher in high baPWV group patients compared with low baPWV group patients. The baPWV of RA patients was positively correlated with age (r = 0.439, P<0.001, and serum cholesterol level (r = 0.231, P = 0.035, serum triglycerides level (r = 0.293, P<0.001, serum LDL level (r = 0.323, P = 0.003. Meanwhile, baPWV negatively correlated with the height of RA patients (r = −0.253, P = 0.043. Multivariate regression analysis showed that baPWV of RA group was independently associated with age and serum triglycerides level. Conclusions. The old age and high level of serum triglycerides may be the major determinants of arterial stiffness in Chinese RA patients.

  4. Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan.

    Science.gov (United States)

    Jalil, Aisha; Zakar, Rubeena; Zakar, Muhammad Zakria; Fischer, Florian

    2017-02-21

    Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability. A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings. Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81

  5. COMPARATIVE EVALUATION OF HEMODYNAMIC CHARACTERISTICS IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Y. E. Teregulov

    2015-09-01

    Full Text Available Aim. To study the peculiarities of hemodynamic disorders in patients with rheumatoid arthritis (RA and arterial hypertension (HT, and in patients with hypertension but without RA using the integral indicators of arterial stiffness.Material and methods. The study included 106 RA patients (group 1, among them 83 (78% women and 23 (22% men, mean age 45.3±10.3 years. The group of comparison (group 2 included 63 patients (22 (35% women and 41 (65% men, mean age 47.9±12.8 years with HT stages 1-3. The control group (group 3 consisted of 32 healthy volunteers: 19 women and 13 men, mean age 24.7±5.34 years. All patients underwent ECG and echocardiography. The model of cardiovascular system was used to calculate the modulus of volume elasticity (MVE, mean arterial blood pressure (BP and total peripheral vascular resistance (TPR; stroke volume and cardiac output were measured using echocardiography.Results. Significant differences in the parameters of BP, arterial stiffness and TPR were identified in patients with RA and HT as compared with the patients of the control group. Arterial stiffness in RA patients with HT, as well as without it, was significantly higher and TPR was lower than in hypertensive patients. RA patients with HT were older and had significantly higher values of cardiac output than those without HT. In RA patients hyperkinetic type of hemodynamics was observed in 53.8% of the cases, eukinetic - in 34.9%, hypokinetic - in 11.3%. Hypertensive patients had same types of hemodynamics in 3.2%, 61.9%, and 34.9%, respectively. In healthy people hyperkinetic type was observed in 22.9% of the cases, eukinetic - in 65.6%, hypokinetic - in 12.5%.Conclusions. RA patients as compared with healthy people had significantly higher arterial stiffness indices regardless of BP. At that, hyperkinetic type of hemodynamics prevailed in RA patients, while in hypertensive patients and healthy people - the eukinetic one. Increased stroke volume and cardiac

  6. COMPARATIVE EVALUATION OF HEMODYNAMIC CHARACTERISTICS IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Y. E. Teregulov

    2015-01-01

    Full Text Available Aim. To study the peculiarities of hemodynamic disorders in patients with rheumatoid arthritis (RA and arterial hypertension (HT, and in patients with hypertension but without RA using the integral indicators of arterial stiffness.Material and methods. The study included 106 RA patients (group 1, among them 83 (78% women and 23 (22% men, mean age 45.3±10.3 years. The group of comparison (group 2 included 63 patients (22 (35% women and 41 (65% men, mean age 47.9±12.8 years with HT stages 1-3. The control group (group 3 consisted of 32 healthy volunteers: 19 women and 13 men, mean age 24.7±5.34 years. All patients underwent ECG and echocardiography. The model of cardiovascular system was used to calculate the modulus of volume elasticity (MVE, mean arterial blood pressure (BP and total peripheral vascular resistance (TPR; stroke volume and cardiac output were measured using echocardiography.Results. Significant differences in the parameters of BP, arterial stiffness and TPR were identified in patients with RA and HT as compared with the patients of the control group. Arterial stiffness in RA patients with HT, as well as without it, was significantly higher and TPR was lower than in hypertensive patients. RA patients with HT were older and had significantly higher values of cardiac output than those without HT. In RA patients hyperkinetic type of hemodynamics was observed in 53.8% of the cases, eukinetic - in 34.9%, hypokinetic - in 11.3%. Hypertensive patients had same types of hemodynamics in 3.2%, 61.9%, and 34.9%, respectively. In healthy people hyperkinetic type was observed in 22.9% of the cases, eukinetic - in 65.6%, hypokinetic - in 12.5%.Conclusions. RA patients as compared with healthy people had significantly higher arterial stiffness indices regardless of BP. At that, hyperkinetic type of hemodynamics prevailed in RA patients, while in hypertensive patients and healthy people - the eukinetic one. Increased stroke volume and cardiac

  7. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis--assessment of concurrent validity

    DEFF Research Database (Denmark)

    Ellegaard, K; Torp-Pedersen, S; Terslev, L

    2009-01-01

    investigated if the amount of CDU activity in a single joint can be used to quantify disease activity in RA. METHODS: A total of 109 patients with RA and affection of the wrist joint underwent a standardized CDU examination assessing three positions in their most affected wrist at start up in biological...... correlations were found. CONCLUSION: A standardized ultrasound examination of a single affected wrist joint in patients with RA may be used as a measure of disease activity. More studies are needed to identify the number of joints needed to examine by CDU to obtain the best validity of Doppler measurements...

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

    OpenAIRE

    Silvestre Donat, Francisco Javier; Silvestre Rangil, Javier; Bagán Debón, Leticia María; Bagán Sebastián, José Vicente

    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 effec...

  9. [Automatization of colorimetric serum zinc determination using the Bayer RA 1000 autoanalyzer].

    Science.gov (United States)

    Shum-Cheong-Sing, J; Arnaud, J; Favier, A

    1994-01-01

    A colorimetric method for the determination of zinc in serum was adapted for use with the Bayer RA 1000 autoanalyzer. Zinc is dissociated from proteins by guanidinium hydrochloride and complexed with 2-(5-bromo-2-pyridylazo)-5-(N-propyl-N- sulfopropylamino-)phenol (5-Br-PAPS). Precision (within-run CVs from 1.4 to 4.2%; between-run CVs from 3.5 to 8.1%), accuracy (93 to 103%) and detection limit (1.15 mumol/l) were sufficient for routine determinations. Moreover, results obtained with the proposed Bayer RA 1000 method were in good agreement with those obtained by flame atomic absorption spectrometry (FAAS) which could be considered the reference method. For 119 sera, the correlation coefficient r was found to be 0.958 and the regression line was as follows: serum zinc (RA 1000) = 0.96 serum zinc (FAAS) + 0.8 mumol/l. Moreover, 98% of the differences between colorimetry and FAAS were within the range Md +/- 1.96 SDd, where Md is the mean of the differences and SDd is the standard deviation of the differences.

  10. MSFIA-LOV system for {sup 226}Ra isolation and pre-concentration from water samples previous radiometric detection

    Energy Technology Data Exchange (ETDEWEB)

    Rodríguez, Rogelio [Environmental Radioactivity Laboratory (LaboRA), University of the Balearic Islands, Cra. Valldemossa km 7.5, 07122, Palma (Spain); Environment and Energy Department, Advanced Materials Research Center (CIMAV) S.C., Miguel de Cervantes 120, Chihuahua, Chih. 31136 (Mexico); Borràs, Antoni [Environmental Radioactivity Laboratory (LaboRA), University of the Balearic Islands, Cra. Valldemossa km 7.5, 07122, Palma (Spain); Leal, Luz [Environment and Energy Department, Advanced Materials Research Center (CIMAV) S.C., Miguel de Cervantes 120, Chihuahua, Chih. 31136 (Mexico); Cerdà, Víctor [Department of Chemistry, University of the Balearic Islands, Cra. Valldemossa km 7.5, 07122, Palma (Spain); Ferrer, Laura, E-mail: laura.ferrer@uib.es [Environmental Radioactivity Laboratory (LaboRA), University of the Balearic Islands, Cra. Valldemossa km 7.5, 07122, Palma (Spain)

    2016-03-10

    An automatic system based on multisyringe flow injection analysis (MSFIA) and lab-on-valve (LOV) flow techniques for separation and pre-concentration of {sup 226}Ra from drinking and natural water samples has been developed. The analytical protocol combines two different procedures: the Ra adsorption on MnO{sub 2} and the BaSO{sub 4} co-precipitation, achieving more selectivity especially in water samples with low radium levels. Radium is adsorbed on MnO{sub 2} deposited on macroporous of bead cellulose. Then, it is eluted with hydroxylamine to transform insoluble MnO{sub 2} to soluble Mn(II) thus freeing Ra, which is then coprecipitated with BaSO{sub 4}. The {sup 226}Ra can be directly detected in off-line mode using a low background proportional counter (LBPC) or through a liquid scintillation counter (LSC), after performing an on-line coprecipitate dissolution. Thus, the versatility of the proposed system allows the selection of the radiometric detection technique depending on the detector availability or the required response efficiency (sample number vs. response time and limit of detection). The MSFIA-LOV system improves the precision (1.7% RSD), and the extraction frequency (up to 3 h{sup −1}). Besides, it has been satisfactorily applied to different types of water matrices (tap, mineral, well and sea water). The {sup 226}Ra minimum detectable activities (LSC: 0.004 Bq L{sup −1}; LBPC: 0.02 Bq L{sup −1}) attained by this system allow to reach the guidance values proposed by the relevant international agencies e.g. WHO, EPA and EC. - Highlights: • Automatic, rapid and selective method for {sup 226}Ra extraction/pre-concentration from water. • MSFIA-LOV system performs a sample clean-up prior to {sup 226}Ra radiometric detection. • {sup 226}Ra sample preparation allows using two radiometric detectors (LBPC and LSC). • Environmental levels of {sup 226}Ra are easily quantified. • High sensitivity and selectivity are achieved, reaching the

  11. Cleanliness of Canal Walls following Gutta-Percha Removal with Hand Files, RaCe and RaCe plus XP-Endo Finisher Instruments: A Photographic in Vitro Analysis.

    Science.gov (United States)

    Karamifar, Kasra; Mehrasa, Neda; Pardis, Pouyan; Saghiri, Mohammad Ali

    2017-01-01

    Gutta-percha must be removed from the root canal space during retreatment to ensure a more favorable outcome. The aim of this study was to compare the efficacy of hand instruments, RaCe and RaCe plus XP-endo finisher instruments in removal of gutta-percha from root canal walls during retreatment. Thirty single-rooted premolars were prepared, obturated, and divided into three groups according to retreatment method; in group 1, retreatment was carried out by hand instruments, while in groups 2 and 3 retreatment was done using RaCe rotary files alone or accompanied by XP-endo finisher instruments, respectively. After retreatment, teeth were sectioned longitudinally and photographic images were taken. The amount of remaining gutta-percha in coronal, middle and apical thirds was quantified using Image J software. The two-way ANOVA and post hoc Tukey's tests were used to analyze data. The level of significance was set at 0.05. RaCe cleaned the apical third significantly better than hand instrumentation. In the coronal third, RaCe+XP-endo finisher was more effective than RaCe. RaCe+XP-endo finisher was more effective than hand instrumentation in the entire root canal. The amount of remaining gutta-percha was the least in the apical part and increased toward the coronal part with the use of XP-endo finisher (P<0.05). Rotary instrumentation was more effective in removing gutta-percha from the canal walls. Furthermore, use of XP-endo finisher file resulted in cleaner canal walls and was more effective in removing gutta-percha from the coronal toward the apical part of the canal.

  12. [Methods of heparin therapy in surgical patients with thrombohemorrhagic syndrome].

    Science.gov (United States)

    Gasanov, F D

    2012-01-01

    The results of comparative study of different heparin medications efficacy in patients with thrombohemorrhagic syndrome (THS) are presented. The study was conducted in 286 patients with THS as a result of peritonitis of various etiology (174 patients), massive hemorrhage, shock, microcirculation disorders (112 patients). Heparin therapy carried out in 249 patients (87.1%), 37 patients (12.9%) had no heparin therapy./ In "heparin" group 193 patients (77.5%) received low molecular weight heparin (LMWH), 56 patients (22.5%) took unfractionated heparin (UFH). LWMH demonstrated high efficiency with fewer hemorrhagic complications in comparison with UFH/.

  13. Spiritual well-being in patients with rheumatoid arthritis.

    Science.gov (United States)

    Lin, Wen-Chuan; Gau, Meei-Ling; Lin, Hui-Chen; Lin, Hung-Ru

    2011-03-01

    Rheumatoid arthritis (RA) is a chronic, long-term, and non-life-threatening disease. Individuals with RA face various daily pressures that include physical symptoms as well as feelings of helplessness, dependency, threats to self-respect, interference with social activities, disruptions of family ties, and difficulties in continuing to work. Quality of life reflects a patient's spiritual well-being and can be used as an important indicator of adaptation to RA. The aim of this study was to describe the status of spiritual well-being in RA patients. This study used meta-synthesis with Sandelowski and Barroso's qualitative meta-summary technique. A comprehensive search of Academic Search Complete, CINAHL, MEDLINE, PsycARTICA LES, and SocINDEX using relevant keywords identified primary research studies that have previously explored spiritual well-being in patients with RA. Each study was systematically evaluated on the basis of the following inclusion criteria: (a) clear descriptions of research purposes and qualitative research, sampling strategies and techniques used; (b) statement of sample size and sample variables; (c) description of data analysis methods used; and (d) quality of research finding presentation. A total of 675 articles, published between 1995 and 2009, were found. Ten met the inclusion criteria. The results revealed four consistent themes related to RA patients' spiritual well-being, namely, living with the disease, reclaiming control, reframing the situation, and bolstering courage. Multifaceted resources should be used to give patients spiritual support. These resources should include establishing cognition-based education programs that provide information about the disease and programs that offer strong support for patient groups. Curricula should address how to plan family education courses. Spiritual well-being as presented in this study should be integrated into quality-of-life evaluations of RA patients and provide an evaluation tool able to

  14. Pověra a kyberatropologie

    Directory of Open Access Journals (Sweden)

    Klára Nádaská

    2015-06-01

    Full Text Available The presented contribution is based onresearch materials of a defended master’s thesis.It deals with the issue of defining the term “superstition”and subsequently presents its own research,which is focused on the superstition thatwarns against buying a stroller before the birth ofa child. The research uses discussion forums fromfive countries – the Czech Republic, Slovakia,Poland, Austria and Germany. The theoreticalfoundation for the research methodology consistsof cyberanthropology, a scientific discipline whichinvestigates cyberculture. The method applied inthe analysis of the contents of the discussion forumentries is a formal analysis of the text.

  15. Ultra-traces of 226Ra in nylon used in the BOREXINO solar neutrino experiment

    Science.gov (United States)

    Zuzel, G.; Wójcik, M.; Buck, C.; Rau, W.; Heusser, G.

    2003-02-01

    BOREXINO is a large-scale liquid scintillator detector for solar neutrinos with a low expected event rate, therefore requiring an extremely low radioactive background. In this paper we present a method, which makes it possible to measure the surface and bulk activities of 226Ra in thin nylon foils for use in BOREXINO at unprecedented concentration levels, as low as 0.5 μBq/m 2 and 10 μBq/kg, respectively. It is based on high-sensitivity 222Rn emanation detection, taking advantage of the fact that the permeability of nylon for radon is strongly enhanced in the presence of water. A mathematical diffusion model is outlined to distinguish the surface and bulk activity of 226Ra from the 222Rn emanation rates of dry and wet film. The experimental method is described in connection with screening measurements of nylon foils of different origin. One foil could be identified with a low 226Ra contamination (corresponding to ˜10 -12 g/g 238U-equivalent) for application in BOREXINO. This film will be used for the construction of a liquid scintillator containment vessel as the central part of the BOREXINO solar neutrino detector.

  16. Do patient-reported outcome measures cover personal factors important to people with rheumatoid arthritis? A mixed methods design using the International Classification of Functioning, Disability and Health as frame of reference.

    Science.gov (United States)

    Dür, Mona; Coenen, Michaela; Stoffer, Michaela Alexandra; Fialka-Moser, Veronika; Kautzky-Willer, Alexandra; Kjeken, Ingvild; Drăgoi, Răzvan Gabriel; Mattsson, Malin; Boström, Carina; Smolen, Josef; Stamm, Tanja Alexandra

    2015-02-25

    Personal factors (PFs) are internal factors that determine functioning and the individuals' experience of disability. Their coverage by patient-reported outcome measures (PROMs) has not been examined in rheumatoid arthritis (RA) so far. The aims of this study were to identify PFs important in the life stories of people with RA and to determine their coverage by PROMs used in RA. The qualitative data of people with RA was explored to identify PFs. Additionally a systematic literature search was conducted to find PROMs used in RA. PROMs items were linked to the components, domains and categories of the International Classification of Functioning, Disability and Health (ICF) to determine the coverage of important PFs by PROMs. Twelve PFs were found to be important in the life stories of people with RA. The PFs coping and reflecting about one's life in an optimistic way were covered most frequently, each by 14 of the 42 explored PROMs, while job satisfaction was not covered at all. The London Coping with Rheumatoid Arthritis Questionnaire, General Self-Efficacy Scale, Arthritis Self-Efficacy Scale, Rheumatoid Arthritis Self-Efficacy Questionnaire and Revised Ways of Coping Inventory covered most PFs. Nineteen PROMs did not cover any of the PFs. Several PFs were identified as important in the life stories of people with RA, but only 55% of the PROMS covered some of these PFs. When evaluating PFs important to people with RA, health professionals should be alert on which PROMs can be used to assess which PFs.

  17. Smokers with CT detected emphysema and no airway obstruction have decreased plasma levels of EGF, IL-15, IL-8 and IL-1ra.

    Directory of Open Access Journals (Sweden)

    Juan P de-Torres

    Full Text Available RATIONALE: Low-grade inflammation and emphysema have been shown to be associated with an increased risk of lung cancer. However, the systemic inflammatory response in patients with emphysema is still unknown. OBJECTIVE: TO COMPARE THE PLASMA CYTOKINE PROFILES IN TWO GROUPS OF CURRENT OR FORMER SMOKERS WITHOUT AIRWAY OBSTRUCTION: a control group of individuals without computed tomography (CT detected emphysema vs. a study group of individuals with CT detected emphysema. METHODS: Subjects underwent a chest CT, spirometry, and determination of EGF, IL-15, IL-1ra, IL-8, MCP-1, MIP-1β, TGFα, TNFα, and VEGF levels in plasma. Cytokine levels in each group were compared adjusting for confounding factors. RESULTS: 160 current smokers and former smokers without airway obstruction participated in the study: 80 without emphysema and 80 subjects with emphysema. Adjusted group comparisons revealed significant reductions in EGF (-0.317, p = 0.01, IL-15 (-0.21, p = 0.01, IL-8 (-0.180, p = 0.02 and IL-1ra (-0.220, p = 0.03 in subjects with emphysema and normal spirometry. CONCLUSIONS: Current or former smokers expressing a well-defined disease characteristic such as emphysema, has a specific plasma cytokine profile. This includes a decrease of cytokines mainly implicated in activation of apoptosis or decrease of immunosurveillance. This information should be taken into account when evaluated patients with tobacco respiratory diseases.

  18. Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) Family Study: rationale and design for a randomized controlled trial evaluating rheumatoid arthritis risk education to first-degree relatives.

    Science.gov (United States)

    Sparks, Jeffrey A; Iversen, Maura D; Miller Kroouze, Rachel; Mahmoud, Taysir G; Triedman, Nellie A; Kalia, Sarah S; Atkinson, Michael L; Lu, Bing; Deane, Kevin D; Costenbader, Karen H; Green, Robert C; Karlson, Elizabeth W

    2014-09-01

    We present the rationale, design features, and protocol of the Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) Family Study (ClinicalTrials.gov NCT02046005). The PRE-RA Family Study is an NIH-funded prospective, randomized controlled trial designed to compare the willingness to change behaviors in first-degree relatives of rheumatoid arthritis (RA) patients without RA after exposure to RA risk educational programs. Consented subjects are randomized to receive education concerning their personalized RA risk based on demographics, RA-associated behaviors, genetics, and biomarkers or to receive standard RA information. Four behavioral factors associated with RA risk were identified from prior studies for inclusion in the risk estimate: cigarette smoking, excess body weight, poor oral health, and low fish intake. Personalized RA risk information is presented through an online tool that collects data on an individual's specific age, gender, family history, and risk-related behaviors; presents genetic and biomarker results; displays relative and absolute risk of RA; and provides personalized feedback and education. The trial outcomes will be changes in willingness to alter behaviors from baseline to 6 weeks, 6 months, and 12 months in the three intervention groups. The design and the execution of this trial that targets a special population at risk for RA, while incorporating varied risk factors into a single risk tool, offer distinct challenges. We provide the theoretical rationale for the PRE-RA Family Study and highlight particular design features of this trial that utilize personalized risk education as an intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. IL-17RA Signaling in Airway Inflammation and Bronchial Hyperreactivity in Allergic Asthma.

    Science.gov (United States)

    Willis, Cynthia R; Siegel, Lori; Leith, Anh; Mohn, Deanna; Escobar, Sabine; Wannberg, Sharon; Misura, Kira; Rickel, Erika; Rottman, James B; Comeau, Michael R; Sullivan, John K; Metz, Daniela P; Tocker, Joel; Budelsky, Alison L

    2015-12-01

    Asthma is a heterogeneous disease characterized by airway inflammation and hyperreactivity. IL-17 receptor A (IL-17RA) is a shared receptor subunit required for activity of IL-17 family cytokines, including IL-17A and IL-25. IL-17A and IL-25 induce different proinflammatory responses, and concentrations are elevated in subjects with asthma. However, the individual contributions of IL-17A and IL-25 to disease pathogenesis are unclear. We explored proinflammatory activities of the IL-17 pathway in models of pulmonary inflammation and assessed its effects on contractility of human bronchial airway smooth muscle. In two mouse models, IL-17RA, IL-17RB, or IL-25 blockade reduced airway inflammation and airway hyperreactivity. Individually, IL-17A and IL-25 enhanced contractility of human bronchial smooth muscle induced by methacholine or carbachol. IL-17A had more pronounced effects on methacholine-induced contractility in bronchial rings from donors with asthma compared with donors without asthma. Blocking the IL-17 pathway via IL-17RA may be a useful therapy for some patients with asthma by reducing pulmonary inflammation and airway hyperreactivity.

  20. No Correlation Exists between Disease Activity and the Expression of Killer-Cell Immunoglobulin-Like Receptors in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Toshiaki Kogure

    2007-01-01

    Full Text Available Objective. The genes for killer-cell immunoglobulin-like receptors (KIRs have been cloned and their functions and expression in patients with rheumatoid arthritis (RA have been partially clarified. However, the correlation between their expression and disease activity has not been analyzed in patients with RA. Thus, we measured KIR expression on lymphocytes in patients with RA, and assessed the correlation between KIR expression and disease activity. Patients and Methods. In the cross-sectional study, 15 patients (9 females and 6 males who fulfilled the diagnostic criteria for RA were assessed. In the longitudinal study, patients who were followed-up for 3 months were assessed. CD158a/b expression on peripheral blood mononuclear cells (PBMC of RA patients was analyzed using flow cytometry. Results. No significant correlation between KIR expression and CRP, ESR, or IgM-RF was observed. There was no remarkable change in the expression of KIRs between the baseline and after 3 months. Additionally, in the 5 patients whose expression of KIRs particularly changed, the time-related changes in the expression of KIRs were independent from those of inflammation parameters and IgM-RF. Conclusion. There was no correlation between KIR expression and disease activity; therefore, the clinical use of KIR expression should be limited, while unnatural KIR expression may be involved in the pathogenesis of RA, but not a recruitment of chronic inflammation to induce joint damage.

  1. Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Atsushi Hashimoto

    2017-01-01

    Full Text Available Objective. Rheumatoid arthritis (RA may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH including pneumocystis pneumonia (PCP in patients with RA. Methods. We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA. Multivariate logistic regression analysis was applied to calculate adjusted odds ratios (ORs for factors associated with the occurrence of IRH. Results. In a total of 9210 patient-years (2688 patients, there were 373 IRH (3.7/100 patient-years. Respiratory tract infections were most frequent (n=154, and additionally 16 PCP, followed by urinary tract infections (n=50. Significant factors for PCP included higher age (≥70 years; OR 3.5, male sex (6.6, underlying lung disease (3.0, use of corticosteroids (4.8, and use of biologics (5.4. Use of methotrexate (5.7 was positively associated with PCP but negatively with total infections (0.7. Additionally, functional disorders and higher RA disease activity were also related to total infections. Conclusions. Risk factors for infection should be taken into account when deciding treatment for the individual RA patient.

  2. RA – beskeden genetisk disposition - resultater fra nyt dansk tvillingstudie

    DEFF Research Database (Denmark)

    Svendsen, Anders Jørgen

    2010-01-01

    undersøgelse af RA hos danske tvillinger underbygger vores tidligere observationer, der indikerer, at den genetiske disposition til den gruppe af polyartritter, der samles under betegnelsen reumatoid arthrit, er beskeden. De senere års forskning tyder på, at sygdommen i klinisk, behandlingsmæssig, men også i...

  3. Nuclear structure of 216 Ra at high spin

    Indian Academy of Sciences (India)

    Bi(10B, 3n) reaction at an incident beam energy of 55 MeV and 209Bi(11B, 4n) reaction at incident beam energies ranging from 65 to 78 MeV. Based on coincidence data, the level scheme for 216Ra has been considerably extended up to ...

  4. Kui ei taha, ära õpi? / Peeter Kreitzberg

    Index Scriptorium Estoniae

    Kreitzberg, Peeter, 1948-2011

    2003-01-01

    Autor leiab, et viimase 10 aasta jooksul levinud arusaam - kui ei taha, ära õpi - on tegelikult väga negatiivsete tagajärgedega seisukoht. Haridus ei ole vaid individuaalne hüve ja selle puudumine individuaalne õnnetus, see on kogu ühiskonna probleem

  5. Respuesta a Raúl Martínez Santos

    Directory of Open Access Journals (Sweden)

    Natàlia Balagué Serre

    2014-12-01

    Full Text Available Las autoras del trabajo titulado “Unificar las cièncias del deporte” (núm. 114, julio-sep. 2013, responden a la réplica enviada por el Prof. Raúl Martínez Santos titulada “Reflexiones y condiciones para una unificación de las ciencias del deporte” .

  6. Differential effects of Th1 versus Th2 cytokines in combination with hypoxia on HIFs and angiogenesis in RA

    Science.gov (United States)

    2012-01-01

    Introduction Hypoxia and T-helper cell 1 (Th1) cytokine-driven inflammation are key features of rheumatoid arthritis (RA) and contribute to disease pathogenesis by promoting angiogenesis. The objective of our study was to characterise the angiogenic gene signature of RA fibroblast-like synoviocytes (FLS) in response to hypoxia, as well as Th1 and T-helper cell 2 (Th2) cytokines, and in particular to dissect out effects of combined hypoxia and cytokines on hypoxia inducible transcription factors (HIFs) and angiogenesis. Methods Human angiogenesis PCR arrays were used to screen cDNA from RA FLS exposed to hypoxia (1% oxygen) or dimethyloxalylglycine, which stabilises HIFs. The involvement of HIF isoforms in generating the angiogenic signature of RA FLS stimulated with hypoxia and/or cytokines was investigated using a DNA-binding assay and RNA interference. The angiogenic potential of conditioned media from hypoxia-treated and/or cytokine-treated RA FLS was measured using an in vitro endothelial-based assay. Results Expression of 12 angiogenic genes was significantly altered in RA FLS exposed to hypoxia, and seven of these were changed by dimethyloxalylglycine, including ephrin A3 (EFNA3), vascular endothelial growth factor (VEGF), adipokines angiopoietin-like (ANGPTL)-4 and leptin. These four proangiogenic genes were dependent on HIF-1 in hypoxia to various degrees: EFNA3 >ANGPTL-4 >VEGF >leptin. The Th1 cytokines TNFα and IL-1β induced HIF-1 but not HIF-2 transcription as well as activity, and this effect was additive with hypoxia. In contrast, Th2 cytokines had no effect on HIFs. IL-1β synergised with hypoxia to upregulate EFNA3 and VEGF in a HIF-1-dependent fashion but, despite strongly inducing HIF-1, TNFα suppressed adipokine expression and had minimal effect on EFNA3. Supernatants from RA FLS subjected to hypoxia and TNFα induced fewer endothelial tubules than those from FLS subjected to TNFα or hypoxia alone, despite high VEGF protein levels. The Th2

  7. Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

    DEFF Research Database (Denmark)

    Schrama, J. C.; Fenstad, A. M.; Dale, H.

    2015-01-01

    Background and purpose-Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year...... period, and compared it with that in THR patients with osteoarthritis (OA).Patients and methods-We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves......, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery.Results-RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision...

  8. Machine Vision System for Characterizing the Electric Field for the 225 Ra EDM Experiment

    Science.gov (United States)

    Sanchez, Andrew

    2017-09-01

    If an atom or fundamental particle possesses an electric dipole moment (EDM), that would imply time-reversal violation. At our current capability, if an EDM is detected in such a particle, that would suggest the discovery of beyond the standard model (BSM) physics. The unique structure of 225 Ra makes its atomic EDM favorable in the BSM search. An upgraded Ra-EDM apparatus will increase experimental sensitivity and the target electric field of 150 kV/cm will more than double the electric field used in previous experiments. To determine the electric field, the potential difference and electrode separation distance must be known. The optical method I have developed is a high-precision, non-invasive technique to measure electrode separation without making contact with the sensitive electrode surfaces. A digital camera utilizes a bi-telecentric lens to reduce parallax error and produce constant magnification throughout the optical system, regardless of object distance. A monochrome LED backlight enhances sharpness of the electrode profile, reducing uncertainty in edge determination and gap width. A program utilizing an edge detection algorithm allows precise, repeatable measurement of the gap width to within 1% and measurement of the relative angle of the electrodes. This work (SAM, Ra EDM) is supported by Michigan State University. This work (REU Program) is supported by U.S. National Science Foundation under Grant Number #1559866.

  9. A novel method for the detection of antibodies to adalimumab in the presence of drug reveals "hidden" immunogenicity in rheumatoid arthritis patients

    NARCIS (Netherlands)

    van Schouwenburg, Pauline A.; Bartelds, Geertje M.; Hart, Margreet H.; Aarden, Lucien; Wolbink, Gerrit Jan; Wouters, Diana

    2010-01-01

    Production of anti drug antibodies (ADA) in adalimumab treated RA patients is associated with reduced serum adalimumab levels and less clinical response. However, most current assays to measure ADA are unable to detect ADA in complex with adalimumab. Thus, ADA is only measured if antibody production

  10. Evaluation of central and peripheral corneal thicknesses in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Alime Gunes

    2015-08-01

    Full Text Available ABSTRACTPurpose:To evaluate central corneal thickness (CCT and peripheral corneal thickness (PCT in patients with rheumatoid arthritis (RA and to assess the relationships among the corneal parameters, dry eye disease, and clinical variables of RA.Methods:A total of 58 RA patients and 58 control subjects participated in this study. A detailed ophthalmological examination was performed on each subject. Dry eye evaluation was performed using Schirmer’s test, tear break-up time (TBUT, corneal fluorescein staining, and Ocular Surface Disease Index (OSDI. Corneal thickness at the apex point, the center of the pupil, the thinnest point, and PCT (3 mm from the apex to the superior, inferior, nasal, and temporal locations were evaluated using Scheimpflug imaging (Pentacam®. Additionally, the relative peripheral index (RPI was calculated by dividing the PCT by the CCT. The disease severity and quality of life were evaluated with DAS28 and HAQ, respectively. The laboratory evaluation comprised ESR and CRP.Results:The mean corneal thicknesses at the apex point, the center of the pupil, the thinnest point, and the superior, inferior, nasal, and temporal points were significantly thinner in RA patients than controls. Schirmer’s test scores and TBUT were significantly lower, and corneal staining and OSDI scores were significantly higher in RA patients. There were no significant correlations between the corneal parameters and the clinical variables of RA or dry eye tests.Conclusion:The CCT and PCT were thinner in RA patients compared to those in control subjects. However, there were no significant correlations between the corneal parameters and the clinical variables of RA or dry eye tests.

  11. A STUDY OF SOME PARAMETERS OF THE EXTERNAL RESPIRATORY FUNCTION AND THEIR RELATIONSHIP TO THE CLINICAL ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. V. Bestaev

    2014-01-01

    Full Text Available Pulmonary pathology is diagnosed in patients with rheumatoid arthritis (RA. The external respiratory function (ERF examination is widely used to assess the functional capacity of the lungs. Objective. To evaluate ERF in patients with RA. Material and methods. The study included 155 patients with RA. A MasterScreen Body plethysmograph (Erich Jaeger was used to determine the ERF parameters (diffusing lung capacity, DLC; forced inspiratory vital capacity, FIVC; forced expiratory volume in 1 second, FEV1; total lung capacity, TLC; the FEV1/FIVC ratio, and the modified Tiffeneau index. DLC was measured by the single-breath method. ERF parameters were represented as a percentage of the appropriate value for a given gender, age, and height of the patient. Results. Of the 155 examined patients with RA, a decrease in the DLC parameter was detected in 107 (69%, while in 87 (81% patients, the decrease was less than 10% of the proper values. An analysis of the state of the ERF parameters revealed a decrease in FEV1 in 48 (31% patients, FIVC in 41 (27% patients, and TLC in 36 (23% patients. The restrictive type of lung ventilation was determined in 27% of patients, bronchial obstruction in 31% of patients, an iso- lated decrease in DLC in 12% of patients with RA. In 31% of cases, no deviations of the ERF parameters from normal values were found. A statistically significant negative correlation between the clinical activity of RA and the DLC level (r = -0.59; p<0.05 was found. Conclusion. The study revealed a high frequency of variation in the ERF parameters in patients with RA. In most cases, the variation was demonstrated by DLC. The obstructive changes were prevalent among RA patients. The high percentage of smokers among RA patients with the obstructive type of ventilation may indicate the influence of smok- ing on the development of bronchial obstruction. Our work revealed the significant relationship between the degree of RA activity and the DLC value.

  12. RAPIDARC (RA) in the uterine cervical cancer; dosimetric gain vs 3D-Crt; RAPIDARC (RA) en el cancer de cervix uterino; ganancia dosimetrica vs 3D-CRT

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez, J.; Garcia, B.; Quispe, K.; Gonzales, A.; Marquina, J., E-mail: jose.ramirez@aliada.com.pe [Clinica Aliada, Oncologia Integral, Av. Jose Galvez Barrenechea 1044, San Isidro, Lima (Peru)

    2014-08-15

    This work aims to quantitatively assess RAPIDARC (RA) treatments versus three dimensional-Conformal Radiation Therapy with field to field technique (3D-Crt-Fin F). 11 patients with cervical cancer treated at our institution radically or adjuvant clinical stages I-III B were evaluated. The prescribed dose was 50 Gy (2 Gy / Fr). The RA plans consisted of two isocentric complete arcs and conformational plans of 4 isocentric fields (previous, subsequent, right side and left side) with 3D-Crt-Fin F technique; both cases carried out ??in the Eclipse version 10 planner with calculation algorithm analytical anisotropic algorithm (AAA) and volumetric optimization software (for VMAT plans). Homogeneity indices (Hi), conformity indices (CI) Sigma indices (S-Index), monitor units (MU) and the time required for each treatment were compared. The mean age was 52 years (32-65) of the 11 patients 9 were clinical stages I-II B. The Hi varied from 0.052 for RA to 0.163 for 3D-Crt-Fin F (p = 0.009), and the CI between 1.005 and 1.35 (p = 0.26), the S-index from 1.2 to 3.7 (p = 0.001) and the H-index of 1.08 to 1.15 (p = 0.24). All dose limits in risk organs were met with a significant difference in the RA plans versus 3D-Crt-Fin F. In patients with cervical cancer the treatment plans quality with the indices aforementioned seems to be better with the RA technique, being observed a significant reduction of radiation to surrounding organs. (author)

  13. Determination of {sup 226}Ra, {sup 228}Ra, and {sup 210}Pb in mushroom from a naturally high radioactive region

    Energy Technology Data Exchange (ETDEWEB)

    Rosa, Mychelle M.L.; Custodio, Luis Gustavo; Cheberle, Luan T.V.; Taddei, Maria Helena T., E-mail: mychelle@cnen.gov.br, E-mail: lgcustodio@hotmail.com, E-mail: lt.cheberle@bol.com.br, E-mail: mhtaddei@cnen.gov.br [Comissao Nacional de Energia Nuclear (LAPOC/CNEN-MG), Pocos de Caldas, MG (Brazil). Laboratorio de Pocos de Caldas; Maihara, Vera A., E-mail: vmaihara@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (CNEN/IPEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    Many studies have shown that mushrooms are organisms which efficiently accumulate radionuclides and can be used as indicators of environmental contamination and ecosystem quality. The Pocos de Caldas plateau, in Minas Gerais, is a region that has elevated natural radioactivity due to the presence of radiological anomalies of volcanic origin. Seventy areas of radioactive anomalies have been identified in this region. From the radiological point of view the determination of {sup 226}Ra, {sup 228}Ra, and {sup 210}Pb is relevant because they are decay products of the natural series of {sup 238}U and {sup 232}Th, mainly responsible for natural radioactive exposures of man. The present paper is part of a broader study conducted in the Pocos de Caldas plateau, in which the concentration activities of {sup 226}Ra, {sup 228}Ra, and {sup 210}Pb in mushroom samples were determined. The mushrooms were collected at different points of the plateau under the influence of radioactive anomalies and away from the influence of anomalies. From statistical studies a correlation between the accumulation of radionuclides in mushrooms and anomalies was established and it was possible to confirm the efficiency that the mushrooms present as environmental contamination indicators. (author)

  14. Inventory of {sup 226}Ra, {sup 228}Ra and {sup 210}Pb in marine sediments cores of Southwest Atlantic Ocean

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Alice M.R.; Oliveira, Joselene de, E-mail: alice.costa@usp.br, E-mail: jolivei@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Gerencia de Metrologia das Radiacoes. Lab. de Radiometria Ambiental; Figueira, Rubens C.L.; Mahiques, Michel M.; Sousa, Silvia H.M., E-mail: rfigueira@usp.br, E-mail: mahiques@usp.br, E-mail: smsousa@usp.br [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Instituto Oceanografico

    2015-07-01

    {sup 210}Pb (22.3 y) is a radioactive isotope successfully applied as tracer of sediment dating of the last 100-150 years. The application of {sup 226}Ra and {sup 228}Ra as paleoceanographic tracers (half-lives of 1,600 y and 5.7 y, respectively) also gives some information of ocean's role in past climate change. In this work, it was analyzed 2 sediment cores collect at Southwest Atlantic Ocean. The sediments samples were freeze-dried and acid digested in microwave. It was carried out a radiochemical separation of {sup 226}Ra, {sup 228}Ra and {sup 210}Pb and performed a gross alpha and gross beta measurement of both precipitates Ba(Ra)SO{sub 4} and PbCrO{sub 4} in a low background gas-flow proportional counter. Activity concentrations of {sup 226}Ra ranged from 45 Bq kg{sup -1} to 70 Bq kg{sup -1} in NAP-62 and from 57 Bq kg{sup -1} to 82 Bq kg{sup -1} in NAP-63 samples. The concentration of {sup 228}Ra varied between 37 Bq kg{sup -1} and 150 Bq kg{sup -1} in NAP-62 and between 23 Bq kg{sup -1} and 111 Bq kg{sup -1} in NAP-63 samples. The concentration of total {sup 210}Pb ranged from 126 Bq kg{sup -1} to 256 Bq kg{sup -1} in NAP-62 and from 63 Bq kg{sup -1} to 945 Bq kg{sup -1} in NAP-63 samples. Results of {sup 210}Pb{sub uns} varied from 68 Bq kg{sup -1} to 192 Bq kg{sup -1} for NAP-62, while varied from <4.9 Bq kg{sup -1} to 870 Bq kg{sup -1} in NAP-63 profile. Increased values of {sup 210}Pb{sub uns} were found on the top of both NAP-62 and NAP- 63 sediment profile. (author)

  15. Original paper Prevalence of selected organ-specific autoantibodies in rheumatoid arthritis and primary Sjögren’s syndrome patients

    Directory of Open Access Journals (Sweden)

    Arkadiusz Koszarny

    2015-05-01

    Full Text Available Objectives : The aim of the study was to investigate the prevalence of selected organ-specific autoantibodies in rheumatoid arthritis (RA and primary Sjögren’s syndrome (pSS patients, and discuss their clinical significance. Material and methods : The study included 121 RA and 30 pSS patients. Sera were tested for the presence of autoantibodies to thyroid peroxidase (anti-TPO, thyroglobulin (anti-TG, TSH receptor (TRAbs, mitochondrial antigen M2 (AMA-M2-3E and gliadin-analogous fusion peptides (anti-GAF(3X using the ELISA method. Non-organ-specific antibodies were determined: rheumatoid factor in IgM class, anti-citrullinated peptide antibodies and antinuclear antibodies. The occurrence of antibodies was also examined with regards to RA activity. Results : The following autoantibodies were detected in RA patients: anti-TPO – 13 (10.7%, anti-TG – 6 (5%, AMA-M2-3E – 3 (2.5%, anti-GAF(3X – 5 (4.1%. The respective levels of these autoantibodies in pSS patients were 3 (10%, 2 (6.7%, 4 (13.3% and 2 (6.7%. Polyautoimmunity was confirmed in 34 RA patients (including 20 cases of autoimmune thyroid disease [AITD] and in 6 pSS patients (6 cases of AITD. When RA patients were divided into anti-TPO positive and anti-TPO negative groups, we found a statistically significant relationship between groups regarding age and hemoglobin concentration. In pSS patients the anti-TPO positive group was less likely to use immunosuppressive drugs as compared with the anti-TPO negative group. Anti-TPO was significantly more frequently detected in RA + AITD vs. RA, RA + SS + AITD vs. RA and in pSS + AITD vs. pSS patients. Conclusions : Organ-specific autoantibodies are relatively frequently observed in patients with RA and pSS. Their presence is connected with the clinical picture of the diseases.

  16. Magnetic resonance imaging assessed inflammation in the wrist is associated with patient-reported physical impairment, global assessment of disease activity and pain in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Glinatsi, Daniel; Baker, Joshua F; Hetland, Merete L

    2017-01-01

    metacarpophalangeal joints in the analyses did not strengthen the associations between MRI pathology and PRO s. Conclusions MRI-assessed inflammation, but not damage, in early RA wrists is associated with patientreported physical impairment, global assessment of disease activity and pain and influences the physical......Objectives T o examine whether MRI assessed inflammation and damage in the wrist of patients with early rheumatoid arthritis (RA) are associated with patient-reported outcomes (PRO s). Methods Wrist and hand MRIs of 210 patients with early RA from two investigator-initiated, randomised controlled...... studies (CIMESTR A/OP ERA) were assessed according to the Outcome Measures in Rheumatology RA MRI score (RAMRIS) for synovitis, tenosynovitis, osteitis, bone erosions and joint space narrowing (JSN) at baseline, 1 and 5 years follow-up. These features, and changes therein, were assessed for associations...

  17. Near-normalization of glycaemic control with glucagon-like peptide-1 receptor agonist treatment combined with exercise in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Mensberg, Pernille; Nyby, Signe; Jørgensen, Peter Godsk

    2017-01-01

    AIMS: Exercise as well as glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment improves glycaemic control in patients with type 2 diabetes. We investigated the effects of exercise in combination with a GLP-1RA (liraglutide) or placebo for the treatment of type 2 diabetes. METHODS: Thirty......-three overweight, dysregulated and sedentary patients with type 2 diabetes were randomly allocated to 16 weeks of exercise and liraglutide or exercise and placebo. Both groups had three supervised 60-minute training sessions per week including spinning and resistance training. RESULTS: HbA1c levels dropped by 2...... the intervention. CONCLUSIONS: In obese patients with type 2 diabetes, exercise combined with GLP-1RA treatment near-normalised HbA1c levels and caused a robust weight loss when compared to placebo. These results suggest that a combination of exercise and GLP-1RA treatment is effective in type 2 diabetes....

  18. Relationship between patient-reported and objective measurements of hand function in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    S.M. Günay

    2016-12-01

    Full Text Available Rheumatoid arthritis (RA often results in impairments in upper extremities, especially in the small joints of hand. Involvement of hand brings limitations in activities of daily living. However, it is commonly observed that patient-reported functional status of hand does not always corresponds to their actual physical performance in the clinical setting. The aim of this pilot study is to investigate the relationship between patient self-reported and objectively measured hand functions in patients with RA. Twenty-six patients (51±13 years with RA diagnosis participated in the study. Hand grip and pinch (lateral, bipod, tripod strengths were measured and Jebsen Hand Function Test (JHFT was performed for objective functional performance. Duruöz Hand Index and Beck Depression Inventory - Turkish version were completed by patients. Grip and all three-pinch strength results significantly correlated with Duruöz Hand Index scores (p<0.05. JHFT results except the sentence writing also correlated with the Duruöz scores (p<0.05. Our results showed that self-reported outcome scales might be used for determining functional level of hand in patients with RA in rheumatology practice. Objective quantitative functional tests are the best methods in evaluating functional level of hand, but require valid and reliable equipment with accurate calibration. Therefore, in case of unavailability of objective assessment tools, patient-reported scales may also reflect the real status of hand functions.

  19. Clinical and subclinical neuropsychiatric abnormalities in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Eman M Khedr

    2015-01-01

    Conclusion Cognitive impairment, depression, anxiety and peripheral neuropathy are common in RA patients. Early diagnosis and management of neuropsychiatric disorders in RA patients may greatly improve the patients′ health-related quality of life.

  20. Multidisciplinary study: DCD method applied to patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Marina Conese

    2009-06-01

    Full Text Available Eating disorders are quite common in clinical practice and can include out-of-control behaviours and thoughts that powerfully reinforce unhealthy eating patterns. They include anorexia nervosa and bulimia nervosa and Binge Eating Disorder. We conducted a trial on 102 patients (89 females and 13 males to investigate the efficacy of “DCD method” (appropriate dietary education associated to New-Electrosculpture on patients with obesity and eating disorders. The study underlines the efficacy of “DCD method”, especially when supported by behavioural therapy, in obese and overweight patients.

  1. [Ultrasonic methods and semiotics in patients with vasculogenic erectile dysfunction].

    Science.gov (United States)

    Zhukov, O B; Zubarev, A R

    2001-01-01

    The authors have developed criteria for ultrasonic assessment of cavernous bodies, arterial and venous circulation in normal penile vessels and in erectile dysfunction in 125 patients; describe modern ultrasound modalities in differential diagnosis of various forms of vasculogenic erectile dysfunction basing on the experience with 92 patients; validate hydrodynamic role of the tunica albuginea in pathogenesis of venocorporal dysfunction and pathological venous drainage. Early ischemic signs of arterial insufficiency were revealed.

  2. Increased Responsiveness to Toll-Like Receptor 4 Stimulation in Peripheral Blood Mononuclear Cells from Patients with Recent Onset Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    M. L. Kowalski

    2008-01-01

    Full Text Available Background. Cell signaling via Toll-like receptors (TLRs leads to synovial inflammation in rheumatoid arthritis (RA. We aimed to assess effects of TLR2 and TLR4 stimulation on proinflammatory cytokine production by peripheral blood mononuclear cells (PBMCs from patients with recent-onset RA, osteoarthrosis (OA, and healthy control (HC. Methods. PBMCs were stimulated with LPS, biglycan and cytokine mix. Cytokines were analyzed in supernatants with ELISA. Expression of toll-like receptors mRNA in leukocytes was analyzed using real-time qPCR. Results. PBMCs from RA patients spontaneously produced less IL-6 and TNFα than cells from OA and HC subjects. LPS increased cytokines' production in all groups. In RA patients increase was dramatic (30 to 48-fold and 17 to 31-fold, for respective cytokines compared to moderate (2 to 8-fold in other groups. LPS induced 15-HETE generation in PBMCs from RA (mean 251% and OA patients (mean 43%, although only in OA group, the increase was significant. TLR2 and TLR4 gene expressions decreased in response to cytokine mix, while LPS enhanced TLR2 expression in HC and depressed TLR4 expression in OA patients. Conclusion. PBMCs from recent-onset RA patients are overresponsive to stimulation with bacterial lipopolysaccharide. TLR expression is differentially regulated in healthy and arthritic subjects.

  3. USE OF SUBCUTANEOUS METHOTREXATE FOR THE TREATMENT OF PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: THE REMARCA TRIAL

    Directory of Open Access Journals (Sweden)

    D. E. Karateev

    2016-01-01

    Full Text Available The early administration of methotrexate (MTX and the use of its high (by the rheumatology practice standards doses contribute to the enhanced efficiency of therapy and the reduced severity of rheumatoid arthritis (RA. One of the important merits of MTX in the treatment of RA is the possibility of adjusting its dose and choosing its (oral or subcutaneous administration routes, which makes it possible to individualize treatment. Particular emphasis has been recently placed just on a subcutaneous MTX formulation that creates prerequisites for substantially improving the efficiency of RA therapy. The paper gives the data of the REMARCA (Russian investigation of methotrexate and biologicals for early active arthritis trial assessing the results of RA treatment in the use of the subcutaneous MTX dosage form as a first-line drug and in the elaboration of management tactics for this disease.Subjects and methods. The investigation included 191 patients (34 men and 157 women with active RA; of whom 51.8% had very early RA (< 6 months' disease duration. 115 patients with RA completed a 24-month follow-up period; and their data were analyzed in more detail.Results and discussion. The findings may substantiate treatment policy based on the prescription of subcutaneous MTX (without previously administering its oral formulation in patients with early RA and high disease activity, starting the drug at 15 mg/week and rapidly escalating with the highest tolerable doses during 4-8 weeks, which allows remission (or low disease activity in the majority of patients without using glucocorticoids and biological agents.

  4. Increased HEV seroprevalence in patients with autoimmune hepatitis.

    Directory of Open Access Journals (Sweden)

    Sven Pischke

    Full Text Available BACKGROUND: Hepatitis E virus (HEV infection takes a clinically silent, self-limited course in the far majority of cases. Chronic hepatitis E has been reported in some cohorts of immunocompromised individuals. The role of HEV infections in patients with autoimmune hepatitis (AIH is unknown. METHODS: 969 individuals were tested for anti-HEV antibodies (MP-diagnostics including 208 patients with AIH, 537 healthy controls, 114 patients with another autoimmune disease, rheumatoid arthritis (RA, and 109 patients with chronic HCV- or HBV-infection (HBV/HCV. Patients with AIH, RA and HBV/HCV were tested for HEV RNA. HEV-specific proliferative T cell responses were investigated using CFSE staining and in vitro stimulation of PBMC with overlapping HEV peptides. RESULTS: HEV-antibodies tested more frequently positive in patients with AIH (n = 16; 7.7% than in healthy controls (n = 11; 2.0%; p = 0.0002, patients with RA (n = 4; 3.5%; p = 0.13 or patients with HBV/HCV infection (n = 2; 2.8%; p = 0.03. HEV-specific T cell responses could be detected in all anti-HEV-positive AIH patients. One AIH patient receiving immunosuppression with cyclosporin and prednisolone and elevated ALT levels had acute hepatitis E but HEV viremia resolved after reducing immunosuppressive medication. None of the RA or HBV/HCV patients tested HEV RNA positive. CONCLUSIONS: Patients with autoimmune hepatitis but not RA or HBV/HCV patients are more likely to test anti-HEV positive. HEV infection should been ruled out before the diagnosis of AIH is made. Testing for HEV RNA is also recommended in AIH patients not responding to immunosuppressive therapy.

  5. Sexual dimorphism of RA manifestations: genes, hormones and behavior.

    Science.gov (United States)

    Kovacs, William J; Olsen, Nancy J

    2011-05-01

    Women are more likely than men to develop rheumatoid arthritis (RA), and recent data suggest that they also suffer greater disability than men with this disease. The reasons for these sexually dimorphic patterns of disease incidence and progression are unknown, but investigations into the underlying mechanisms could provide useful insights into RA pathogenesis and may also suggest new treatment approaches. The processes of sexual differentiation involve genetic input, gonadal hormone signaling and responses from target cells and tissues. Layered upon these processes are behavioral characteristics of males and females acquired as a result of their social context. Differences in disease presentation between the sexes could be the result of complex combinations of all these factors. Recent research suggests that the developmental processes of sexual differentiation might render women more susceptible than men to similar levels of immune or inflammatory burden by virtue of sex-specific differences in body composition and structure.

  6. Association between periodontal disease temporomandibular disorders and rheumatoid arthritis among patients visiting rheumatology centers in Bengaluru City: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2017-01-01

    Full Text Available Introduction: Association between rheumatoid arthritis (RA, periodontitis and temporomandibular disorder (TMD can be an outcome of the existing inflammatory conditions or involvement of joints at a different level of severity. Aim: This study aims to find an association between periodontal disease and TMDs and RA among patients visiting various Rheumatology centers in Bengaluru city. Materials and Methods: A total of 100 RA patients and age- and gender-matched comparison group were recruited from various Rheumatology centers in Bengaluru city. Periodontal status and loss of attachment (LOA were measured from the World Health Organization (2013 criteria and TMDs and severity were assessed using Helkimo index (1987. Data were analyzed and comparisons were done using Chi-square test and independent t-test (P < 0.05. Correlation and association are measured through spearman's correlation and logistic regression analysis. Results: There was a significant difference regarding shallow and deep periodontal pocket depth among RA (4.62 ± 2.33, 1.48 ± 1.7 and comparison (3.48 ± 2.53, 0.83 ± 1.05 groups (P = 0.01. Impaired mobility (P = 0.012, altered function (P = 0.032, painful function (P = 0.023, muscle pain (P = 0.028, and temporomandibular joint pain (P = 0.048 differed significantly between RA group and comparison group. RA patients were more likely to suffer from TMD (OR = 4.88 and LOA (OR = 2.16 than the comparison group. Conclusion: Periodontitis and TMD are found to be associated with RA. A dental check-up for patients suffering from RA should be part of the routine RA assessment.

  7. Autoantibodies against citrullinated histone H3 in rheumatoid arthritis and periodontitis patients

    NARCIS (Netherlands)

    Janssen, Koen M. J.; de Smit, Menke J.; Withaar, Coenraad; Brouwer, Elisabeth; van Winkelhoff, Arie J.; Vissink, Arjan; Westra, Johanna

    Aim: To determine the presence of citrullinated histones in inflamed periodontal tissue and to determine the presence of anti-citrullinated histone autoantibodies in sera from patients with rheumatoid arthritis (RA) and periodontitis (PD) patients. Methods: The presence of citrullinated histone H3,

  8. Emotion regulation predicts change of perceived health in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    van Middendorp, H; Geenen, R; Sorbi, MJ; van Doornen, LJP; Bijlsma, JWJ

    Objectives: To examine whether emotion regulation predicts change of perceived health in patients with rheumatoid arthritis ( RA). Methods: Sixty six patients ( 44 female, 22 male; mean (SD) age 57.7 (11.6) years) participated in a prospective study. Hierarchical regression analysis was used to

  9. MRI assessment of suppression of structural damage in patients with rheumatoid arthritis receiving rituximab

    DEFF Research Database (Denmark)

    Peterfy, Charles; Emery, Paul; Tak, Paul P

    2016-01-01

    Objective. To evaluate changes in structural damage and joint inflammation assessed by MRI following rituximab treatment in a Phase 3 study of patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) who were naive to biological therapy. Methods. Patients were randomised to recei...

  10. Hemicraniectomy in Older Patients with Extensive Middle-Cerebral-Artery Stroke

    DEFF Research Database (Denmark)

    Jüttler, Eric; Unterberg, Andreas; Woitzik, Johannes

    2014-01-01

    BACKGROUND. Early decompressive hemicraniectomy reduces mortality without increasing the risk of very severe disability among patients 60 years of age or younger with complete or subtotal space-occupying middle-cerebral-artery infarction. Its benefit in older patients is uncertain. METHODS. We ra...

  11. Preparation of (212)Pb-labeled monoclonal antibody using a novel (224)Ra-based generator solution.

    Science.gov (United States)

    Westrøm, Sara; Generalov, Roman; Bønsdorff, Tina B; Larsen, Roy H

    2017-08-01

    Alpha-emitting radionuclides have gained considerable attention as payloads for cancer targeting molecules due to their high cytotoxicity. One attractive radionuclide for this purpose is (212)Pb, which by itself is a β-emitter, but acts as an in vivo generator for its short-lived α-emitting daughters. The standard method of preparing (212)Pb-labeled antibodies requires handling and evaporation of strong acids containing high radioactivity levels by the end user. An operationally easier and more rapid process could be useful since the 10.6h half-life of (212)Pb puts time constraints on the preparation protocol. In this study, an in situ procedure for antibody labeling with (212)Pb, using a solution of the generator nuclide (224)Ra, is proposed as an alternative protocol for preparing (212)Pb-radioimmunoconjugates. Radium-224, the generator radionuclide of (212)Pb, was extracted from its parent nuclide, (228)Th. Lead-212-labeling of the TCMC-chelator conjugated monoclonal antibody trastuzumab was carried out in a solution containing (224)Ra in equilibrium with progeny. Subsequently, the efficiency of separating the (212)Pb-radioimmunoconjugate from (224)Ra and other unconjugated daughter nuclides in the solution using either centrifugal separation or a PD-10 desalting size exclusion column was evaluated and compared. Radiolabeling with (212)Pb in (224)Ra-solutions was more than 90% efficient after only 30min reaction time at TCMC-trastuzumab concentrations from 0.15mg/mL and higher. Separation of (212)Pb-labeled trastuzumab from (224)Ra using a PD-10 column was clearly superior to centrifugal separation. This method allowed recovery of approximately 75% of the (212)Pb-antibody-conjugate in the eluate, and the remaining amount of (224)Ra was only 0.9±0.8% (n=7). The current work demonstrates a novel method of producing (212)Pb-based radioimmunoconjugates from a (224)Ra-solution, which may be simpler and less time-consuming for the end user compared with the method

  12. Cervical spine instability in the course of rheumatoid arthritis - imaging methods.

    Science.gov (United States)

    Mańczak, Małgorzata; Gasik, Robert

    2017-01-01

    Cervical spine is affected in more than a half of patients with rheumatoid arthritis (RA). Depending on the degree of damage to the individual joints and ligaments RA-related cervical spine instability takes the form of atlanto-axial subluxation, subaxial subluxation or cranial settling. In the advanced cases spinal stenosis can occur as well as spinal cord injuries with typical neurological symptoms. The identification of patients with cervical spine instability before the occurrence of neurological complications still constitutes a diagnostic challenge. The article presents the methods of cervical spine imaging with the use of plain radiographs, magnetic resonance imaging (MRI) and computed tomography (CT). We discuss the advantages and disadvantages associated with each method and the possibility of its application in the diagnosis of cervical spine instability in RA. The knowledge of the above mentioned issues is indispensable to select an appropriate time for surgical intervention.

  13. Cervical spine instability in the course of rheumatoid arthritis – imaging methods

    Directory of Open Access Journals (Sweden)

    Małgorzata Mańczak

    2017-08-01

    Full Text Available Cervical spine is affected in more than a half of patients with rheumatoid arthritis (RA. Depending on the degree of damage to the individual joints and ligaments RA-related cervical spine instability takes the form of atlanto-axial subluxation, subaxial subluxation or cranial settling. In the advanced cases spinal stenosis can occur as well as spinal cord injuries with typical neurological symptoms. The identification of patients with cervical spine instability before the occurrence of neurological complications still constitutes a diagnostic challenge. The article presents the methods of cervical spine imaging with the use of plain radiographs, magnetic resonance imaging (MRI and computed tomography (CT. We discuss the advantages and disadvantages associated with each method and the possibility of its application in the diagnosis of cervical spine instability in RA. The knowledge of the above mentioned issues is indispensable to select an appropriate time for surgical intervention.

  14. Trapping of short lived Ra{sup +} ions

    Energy Technology Data Exchange (ETDEWEB)

    Bekker, H.; Nunes Portela, M.; Seelen, D.; Dermois, O.; Jungmann, K.; Onderwater, C.J.G.; Timmermans, R.G.E.; Willmann, L.; Wilschut, H.W. [KVI, University of Groningen, NL (Germany)

    2012-07-01

    A precision measurement of atomic parity violation in order to determine electroweak mixing angle at low energy scale is underway at the KVI, University of Groningen. The experiment exploits the large sensitivity of a single trapped Ra{sup +} ion. It requires the trapping of short lived radium ions in a Paul trap. Our first laser spectroscopy on an ensemble of trapped short-lived {sup 209-214}Ra{sup +} isotopes employed buffer gas cooled ions in a linear Paul trap. It provided hyperfine structure of the 6d {sup 2}D{sub 3/2} states and isotope shift of the 6d {sup 2}D{sub 3/2}-7p {sup 2}P{sub 1/2} transition. In a next step the buffer gas cooled Ra ions are extracted from the trap and transported in an electrostatic transport system towards a small Paul trap in an UHV environment. Here the ion can be cooled and subsequently microwave transitions between hyperfine states in the 6d {sup 2}D{sub 3/2} manifold can be driven in order to yield high precision results on the hyperfine constants. These results provide input for the ongoing precision atomic structure calculations.

  15. Octupole collectivity in $^{220}$Rn and $^{224}$Ra

    CERN Document Server

    Gaffney, Liam Paul

    Collective properties of the radioactive nuclei $^{220}$Rn and $^{224}$Ra have been studied via Coulomb excitation of a 2.8$\\,$A.MeV radioactive ion beam (RIB) incident upon $^{60}$Ni, $^{112,114}$Cd and $^{120}$Sn targets. The experiments took place at the REX-ISOLDE RIB facility, CERN. De-excitation $\\gamma$-ray yields following multiple-step Coulomb excitation were detected in coincidence with recoiling target nuclei in the Miniball spectrometer. For the first time, B(E3;3$^+ \\rightarrow 0^+$) values have been directly measured with a radioactive ion beam. In the process, $^{224}$Ra becomes the heaviest post-accelerated RIB to date at ISOLDE (with the possible exception of the quasi-stable $^{238}$U). The measurements presented in this thesis represent a tripling of the number of nuclei around Z$\\simeq88$ and N$\\simeq134$, for which direct measurements of the octupole collectivity have been performed. The only previous measurements being for the relatively long-lived $^{226}$Ra. The $\\gamma$-ray yields, in...

  16. Raízes e estruturas da sociedade brasileira

    Directory of Open Access Journals (Sweden)

    Leonor Natividade de Campos Medeiros

    2014-05-01

    Full Text Available Este estudo teve como objetivo conhecer e refletir as raízes e estruturas da sociedade brasileira, na visão de dois grandes pensadores: Sérgio Buarque de Holanda com Raízes do Brasil e Gilberto Freyre com Casa-Grande & Senzala. Holanda dividiu o Brasil em duas fases a primeira da colonização portuguesa e a segunda uma critica ao Estado Novo. Freyre mostra a organização social, política e econômica da época da colonização e desenvolve seus estudos ao final da década de 1920, época em que o ambiente intelectual brasileiro está sob a força do modernismo. Conclui-se que o pensamento de Holanda e Freyre se assemelha em alguns aspectos e diverge em outros.   Sociologia de Freyre; Sociologia de Holanda; Raízes da sociedade brasileira

  17. Risk factors for fractures in patients with rheumatoid arthritis (preliminary results of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment»

    Directory of Open Access Journals (Sweden)

    Marina Mikhailovna Podvorotova

    2013-01-01

    Full Text Available In patients with rheumatoid arthritis (RA, bone fractures occur 1.5-2 times more frequently than in the population. They often lead to reduced quality of life, to disability and death in the patients. It should be noted that risk factors (RFs for fractures have not been studied on a sufficient sample in Russia; there are no recommendations on the prevention of fractures in this category of patients. Objective: to compare groups of RA patients with and without a history of fractures to further identify possible RFs for fractures. Subjects and methods. The trial included 254 patients aged 18 to 85 years, diagnosed with RA, from the database of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment», who had been followed up in 2010 to 2011. The patients were divided into two groups: 1 101 (39.8% patients with a history of low-trauma fractures and 2 153 (60.2% patients without a history of fractures. In Group 1, the patients were older than in Group 2 (mean age 59.8 and 56.1 years, respectively. Menopause was recorded in 88.1 and 77.8% of cases, respectively. The groups differed in the duration of RA an average of 15.5 and 11.5 years, respectively Results. The fractures in the history were associated with the use of glucocorticoids (GC, their higher cumulative dose and use duration. In Group 1 patients, the bone mineral density (BMD was lower in all study skeleton portions and more frequently corresponded to osteoporosis. RA complications, such as amyloidosis and osteonecrosis, were more common in the patients with a history of fractures. Conclusion. In RA patients, the most likely RFs of fractures are age, the long-term intake of large-dose GC, low BMD, the severe course of RA, and the presence of its complications.

  18. Content validity across methods of malnutrition assessment in patients with cancer is limited

    NARCIS (Netherlands)

    Sealy, Martine J.; Nijholt, Willemke; Stuiver, Martijn M.; van der Berg, Marit M.; Roodenburg, Jan L. N.; Schans, van der Cees P.; Ottery, Faith D.; Jager-Wittenaar, Harriet

    Objective: To identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition. Study Design and Setting: Systematic review of studies in cancer patients that operationalized malnutrition as a variable,

  19. [Patients on the move: validated methods to quantify physical activity].

    Science.gov (United States)

    Bakker, Esmée A; Eijsvogels, Thijs M H; de Vegt, Femmie; Busser, Guus S F; Hopman, Maria T E; Verbeek, André L M

    2015-01-01

    Physical activity is an important component in the maintenance and improvement of general health; physical inactivity is, however, an increasing problem in the Netherlands. Requests for advice on physical activity are increasing within the healthcare. Assessment of an individual's physical activity pattern is required to provide tailored advice. There are a number of methods for measuring physical activity; these are divided into subjective and objective methods. Subjective measures include physical activity questionnaires and diaries. Objective measures include indirect calorimetry, measurement with doubly labelled water, heart-rate monitoring and the use of an accelerometer or pedometer. The choice of method depends predominantly on the aim of the measurement, and the availability of personnel, time and financial resources. In clinical practice a validated questionnaire is usually the preferred method, but when measuring effects this should be combined with an objective measurement instrument.

  20. [Treatment of patella fractures of 164 patients with 5 methods].

    Science.gov (United States)

    Xie, Feng; Fang, Guo-Hua; Zhou, Yi

    2010-12-01

    To investigate the effects of different treatments for different patella fractures, and analyze the clinical outcome. One hundred and sixty-four patients with patella fracture were treated between July 2005 and December 2009, 113 males and 51 females with an average age of 38.5 years old, ranging from 21 to 72 years. There were 21 cases of linear fracture or separation of the patella patella separation > 0.5 cm and for the pure horizontal type or vertical-type fractures, 34 cases were separated into three block, 46 cases were separated into four and above. Of 164 cases, 21 patients accepted traditional treatment, 39 patients were fixed with cerclage wire and tension band wire, 43 with cannulated screws and tension band wire fixation, 29 with cannulated screws for the minimally invasive treatment, 32 patients with fixation of NT-PC RESULTS: One hundred and sixty-four cases were followed up with a mean period of 14 months (3 to 36 months). By Lysholm knee score criteria: 19 cases in traditional treatment were excellent and good, 36 cases in cerclage wire and tension band wire technique cases were excellent and good, 40 cases in cannulated screws and tension band wire fixation, 27 cases in cannulated screws for the minimally invasive treatment were excellent and good, 30 cases in NT-PC were excellent and good. The surgery should be avoided if the patients can be treated with manipulation and fixation. Those who need surgical treatment should be based on the type of fracture to select a different surgical operation. Percutaneous reduction can be fixed, and try to minimally invasive surgery. Whether traditional treatment or internal fixation, the appropriate functional exercise need to make as early as possible.

  1. The absolute recommendation of chamber Neubauer method for platelets counting instead of indirect methods in severe thrombocytopenic patients

    Directory of Open Access Journals (Sweden)

    Oliveira Raimundo Antônio Gomes

    2003-01-01

    Full Text Available Accurate and precise platelet counting is crucial for recommending platelets transfusion for thrombocytopenic patients, principally when platelet counts are bellow 30,000/µl. As most laboratories still use the indirect methods for confirming low automated platelet counts, this work compared two indirect methods used in practice (Fonio and Nosanchunk et al. with the International Committee for Standardization in Hematology recommended direct method (Brecher and Cronkite. The obtained data show that the indirect methods present low precision and accuracy, and that the direct method should always be employed in severe thrombocytopenic samples thanks to its high precision.

  2. Cell therapy centered on IL-1Ra is neuroprotective in experimental stroke

    DEFF Research Database (Denmark)

    Clausen, Bettina Hjelm; Lambertsen, Kate Lykke; Dagnæs-Hansen, Frederik

    2016-01-01

    irradiated mice with IL-1Ra-producing bone marrow cells is associated with neuroprotection and recruitment of IL-1Ra-producing leukocytes after stroke. Neuroprotection is also achieved by therapeutic injection of IL-1Ra-producing bone marrow cells 30 min after stroke onset, additionally improving...... production of IL-1Ra and IL-1α/β identifies microglia, not infiltrating leukocytes, as the major sources of IL-1Ra after experimental stroke, and shows IL-1Ra and IL-1β to be produced by segregated subsets of microglia with a small proportion of these cells co-expressing IL-1α. Reconstitution of whole body...... by demonstration of IL-1Ra-producing cells in the human cortex early after ischemic stroke. Taken together, our results attribute distinct neuroprotective or neurotoxic functions to segregated subsets of microglia and suggest that treatment strategies increasing the production of IL-1Ra by infiltrating leukocytes...

  3. Radiant Ceiling Panels Combined with Localized Methods for Improved Thermal Comfort of Both Patient and Medical Staff in Patient Room

    DEFF Research Database (Denmark)

    Mori, Sakura; Barova, Mariya; Bolashikov, Zhecho Dimitrov

    2012-01-01

    The objectives were to identify whether ceiling installed radiant heating panels can provide thermal comfort to the occupants in a patient room, and to determine a method for optimal thermal environment to both patient and medical staff simultaneously. The experiments were performed in a climate...... chamber resembling a single-bed patient room under convective air conditioning alone or combined with the ceiling installed radiant heating panels. Two thermal manikins simulated a patient lying in the bed and a doctor standing next to the patient. Conventional cotton blanket, electric blanket, electric...... mattress were used to provide local heating for the patient. The effects of the methods were identified by comparing the manikin based equivalent temperatures. The optimal thermal comfort level for both patient and medical staff would obtained when two conventional cotton blankets were used with extra...

  4. High-Linear Energy Transfer Irradiation Targeted to Skeletal Metastases by the Alpha Emitter Ra-223: Adjuvant or Alternative to Conventional Modalities?

    Energy Technology Data Exchange (ETDEWEB)

    Bruland, Oyvind S.; Nilsson, Sten; Fisher, Darrell R.; Larsen, Roy H.

    2006-10-15

    The bone-seeking, alpha-particle emitting radiopharmaceutical Alpharadin, 223RaCl2 (t1/2 = 11.4 days) is under clinical development as a novel treatment for skeletal metastases from breast and prostate cancer. This paper summarizes the current status of preclinical and clinical research on 223RaCl2. Potential advantages of 223Ra to that of external beam irradiation or registered beta-emitting bone-seekers are discussed. Published data of 223Ra dosimetry in mice and a therapeutic study in a skeletal metastases model in nude rats have indicated significant therapeutic potential of bone-seeking alpha-emitters. This paper provides short-term and long-term results from the first clinical single dosage trial. We present data from a repeated dosage study of five consecutive injections of 50 kBq/kg bodyweight, once every third week, or two injections of 125 kBq/kg bodyweight, six weeks apart. Furthermore, preliminary results are given for a randomized phase II trial involving 64 patients with hormone-refractory prostate cancer and painful skeletal metastases who received four monthly injections of 223Ra or saline as an adjuvant to external beam radiotherapy. Also presented are preliminary dose estimates for 223Ra in humans. Results indicate that repeated dosing is feasible and that opportunities are available for combined treatment strategies.

  5. U-Th-Ra disequilibria at the Masaya (Nicaragua); Desequilibres U-Th-Ra au Masaya (Nicaragua)

    Energy Technology Data Exchange (ETDEWEB)

    Sigmarsson, O.; Condomines, M. [Centre de Recherches Volcanologiques, CNRS URA-10, 63 - Clermont Ferrand (France)

    1996-12-31

    {sup 238}U-{sup 230}Th-{sup 226}Ra radioactive disequilibria were measured in several basalt samples of the post-caldera flows of the Masaya volcano (Nicaragua). {sup 230}Th/{sup 232}Th ratios are from the highest known in the world (about 2.53) with {sup 230}Th/{sup 238}U ratios close to 1. These exceptionally high isotopic thorium ratios from the Masaya and other neighboring volcanoes (Conception, Cerro Negro, Momotombo) are followed by very high {sup 10}Be/{sup 9}Be ratios (60 10{sup -11} for the 1722 flow). These geochemical characteristics with {delta}{sup 18}O of typical mantle origin (5.55) suggest an influence of the subducted sediments fluids in the magma source. The age of the metasomatism ranges from 10 to 0.3 Ma. Initial {sup 226}Ra/{sup 230}Th ratios measured in four historical flows vary from 1.3 to 1.4 and are anti-correlated with the Th content. These variations are probably linked to the fractionated crystallisation of plagioclase minerals. The initial {sup 226}Ra/Ba ratio remains constant and suggests the existence of a huge stationary magmatic reservoir. This hypothesis is also confirmed by the disproportion between the SO{sub 2} quantity emitted by the volcano and by the degassing of lavas on the ground. The {sup 226}Ra excess observed in the Masaya lavas can be the result of a second stage of metasomatism which occurred less than 8000 years B.P. during partial fusion. Abstract only. (J.S.).

  6. An evaluation of ²²⁶Ra and ²²⁸Ra in drinking water in several counties in Texas, USA.

    Science.gov (United States)

    Landsberger, S G; George, G

    2013-11-01

    Naturally Occurring Radioactive Material (NORM) or Technology Enhanced Naturally Occurring Radioactive Material (TENORM) can be a potential health risk. It is now well known that the underlying geology in many parts of Texas has given rise to levels of (226)Ra and (228)Ra that often exceed the limits set by the US Environmental Protection Agency. A detailed literature search was undertaken to assess the levels of (226)Ra and (228)Ra in all of the Texas counties. Several statistical evaluations of the data were performed. The Hickory aquifer in the Llano Uplift region of Texas has consistently had the highest number of (226)Ra and (228)Ra concentrations above the legal limit. As well many of the affected rural communities may not have the financial resources to rectify the problem. Copyright © 2013. Published by Elsevier Ltd.

  7. COMPARATIVE EVALUATION OF THE EFFICACY AND SAFETY OF ABATACEPT IN PATIENTS WITH DIFFERENT DURATION OF RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. A. Borisova

    2016-01-01

    Full Text Available Objective: to compare the efficacy and safety of abatacept (ABC in patients with different duration of rheumatoid arthritis (RA.Subjects and methods. The investigation enrolled 86 patients with previous inefficiency or intolerability of therapy with synthetic disease-modifying antirheumatic drugs (DMARDs, mainly with methotrexate, and/or biological agents (BAs, such as adalimumab, etanercept, rituximab, infliximab, certolizumab pegol, and tocilizumab. The patients were divided into 2 groups. Group 1 included 29 (34% patients with early RA (< 2 years' disease duration; Group 2 consisted of 57 (66% patients with long-term RA (> 2 years' disease duration. The patients' mean age was 49±13.4 years; most of them were women who had a high RA activity (the mean DAS28 value was 5.2±1.15, were seropositive for rheumatoid factor and anti-cyclic citrullinated peptide antibodies. All the patients underwent standard clinical and laboratory examinations. ABC was injected intravenously at a dose of 10 mg/kg according to the standard regimen. Every 3 months, disease activity was assessed with DAS28; functional status was evaluated with the Health Assessment Questionnaire (HAQ.Results and discussion. In the early and advanced RA patients, the mean DAS28 at baseline was 5.2±0.9 and 5.2±1.3, respectively. After 3 months of ABC treatment, it significantly decreased in both groups (p < 0.05. An improvement according to the criteria of the European League Against Rheumatism (EULAR occurred in 76% of the early RA patients and in 74.5% of the advanced RA ones. Following 3 and 6 months of therapy, there were no significant differences between the two groups in the rate of a good response: the latter was obtained in 31 and 42% of early RA cases and in 25.5 and 40% of advanced RA cases, respectively. After 3 and 6 months, both groups showed a comparable number of those who did not respond to treatment (24 and 12.5% in the early RA group and 25.5 and 25% in

  8. Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Hansen, M; Stoltenberg, M

    1999-01-01

    OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease-modifying a......OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease......-Pratt analysis). The rate of erosive progression on MRI was highly correlated with baseline scores and, particularly, with area under the curve (AUC) values of synovial membrane volume (Spearman's sigma = 0.69, P

  9. An efficient steganography method for hiding patient confidential information.

    Science.gov (United States)

    Al-Dmour, Hayat; Al-Ani, Ahmed; Nguyen, Hung

    2014-01-01

    This paper deals with the important issue of security and confidentiality of patient information when exchanging or storing medical images. Steganography has recently been viewed as an alternative or complement to cryptography, as existing cryptographic systems are not perfect due to their vulnerability to certain types of attack. We propose in this paper a new steganography algorithm for hiding patient confidential information. It utilizes Pixel Value Differencing (PVD) to identify contrast regions in the image and a Hamming code that embeds 3 secret message bits into 4 bits of the cover image. In order to preserve the content of the region of interest (ROI), the embedding is only performed using the Region of Non-Interest (RONI).

  10. En Route Patient Safety: A Mixed-Methods Study

    Science.gov (United States)

    2014-03-01

    and CASF member’s rear repeatedly bumped pts legs during litter carry to acft [aircraft] causing pt obvious pain as displayed by facial grimace...mislabeled medications were common issues that could place a patient’s safety in jeopardy. Patients arrive to plane, many needed pain medications...Your endorphins are working. You push through a lot of stuff that you would generally go to sleep. But we know this mission is that important

  11. Sleep Disturbances in Patients with Rheumatoid Arthritis | Abbasi ...

    African Journals Online (AJOL)

    BACKGROUND: Sleep problems are frequent in chronic diseases like rheumatoid arthritis (RA). The present study was conducted to determine frequency of sleep disturbances and their relations with disease severity. METHODS: The present case-control study was performed on 100 rheumatoid patients who were referred ...

  12. Classification of Patients Treated for Infertility Using the IVF Method

    Directory of Open Access Journals (Sweden)

    Malinowski Paweł

    2015-12-01

    Full Text Available One of the most effective methods of infertility treatment is in vitro fertilization (IVF. Effectiveness of the treatment, as well as classification of the data obtained from it, is still an ongoing issue. Classifiers obtained so far are powerful, but even the best ones do not exhibit equal quality concerning possible treatment outcome predictions. Usually, lack of pregnancy is predicted far too often. This creates a constant need for further exploration of this issue. Careful use of different classification methods can, however, help to achieve that goal.

  13. Radiochemical determination and separation or total radium, 226Ra and 224Ra; Analisis Radioquimico de Radio total, Radio-226 y Radio-224

    Energy Technology Data Exchange (ETDEWEB)

    Suarez, J. A.; Gonzalez, J. A.; Pablo, M. A. de

    1987-07-01

    Radiochemical purification and separation of radium has been carried out and the determination of total radium solubilized in aqueous samples has been studied assuming that all the alpha emitters of the sample have their origin in the 226Ra and elements of its desintegration chain. Also, the activities of 22Ra and 226 Ra have been evaluated separately doing a measurement after the chemical separation of the radium and another one 10 days after. (Author) 9 refs.

  14. Simultaneous determination of Ra-226, natural uranium and natural thorium by gamma-ray spectrometry INa(Ti), in solid samples.; Determinacion de U (Natural), Th (Natural) y Ra-226 en diversos materiales, mediante espectrometria con INa (TI)

    Energy Technology Data Exchange (ETDEWEB)

    Salvador, S.; Navarro, T.; Alvarez, A.

    1991-07-01

    A method has been developed to determine activities of Ra-226, natural uranium and natural thorium by gamma-ray spectrometry. The measurement system has been calibrated using standards specially prepared at the laboratory. It is necessary to assume secular equilibrium in the samples, between Ra-226 and Th-232 and its daughters nuclides, and between U-238 and its immediate daughter Th-234, as the photo peaks measured are those of the daughters. The results obtained indicate that this method can of ter replace the radiochemical techniques used to measure activities in this type of sample. The method has been successfully used to determine these natural isotopes in samples from uranium mills. (Author) 9 refs.

  15. Radiographic absorptiometry for pre-screening of osteoporosis in patients with low energy fractures

    DEFF Research Database (Denmark)

    Buch, Inge; Oturai, Peter S; Jensen, Lars T

    2010-01-01

    .001). Using a RA cut-off value (T-score ...Dual energy X-ray absorptiometry (DEXA) is the most accurate method and thus the method of choice for diagnosing osteoporosis. Due to the limited access to DEXA-scanners, screening of patients with low energy fractures (LEF) for osteoporosis is not routinely performed in Denmark. Pre...

  16. Ra+ ion trapping : toward an atomic parity violation measurement and an optical clock

    NARCIS (Netherlands)

    Portela, M. Nunez; Dijck, E. A.; Mohanty, A.; Bekker, H.; van den Berg, Joost E.; Giri, G. S.; Hoekstra, S.; Onderwater, C. J. G.; Schlesser, S.; Timmermans, R.G.E.; Versolato, O. O.; Willmann, L.; Wilschut, H. W.; Jungmann, K.

    2014-01-01

    A single Ra+ ion stored in a Paul radio frequency ion trap has excellent potential for a precision measurement of the electroweak mixing angle at low momentum transfer and as the most stable optical clock. The effective transport and cooling of singly charged ions of the isotopes Ra-209 to Ra-214 in

  17. Selective extraction of naturally occurring radioactive Ra2+ from aqueous waste streams

    NARCIS (Netherlands)

    van Leeuwen, F.W.B.

    2005-01-01

    This thesis describes the design and selectivity of new Ra2+ extractants. The results presented provide insight in both the requirements needed to give Ra2+ selectivity and in the achievable Ra2+/Mn+ (Mn+ = alkali(ne earth) cation) separations.

  18. Novel bed integrated ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Kokora, Monika

    2014-01-01

    This study presents a novel method for advanced ventilation of hospital wards leading to improved air quality at reduced ventilation rate. The idea is to evacuate the bio-effluents generated from patients’ body by local exhaustion before being spread in the room. This concept was realized by usin...

  19. Beneficial effects of spa treatment on functional status and quality of life of patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mustur Dušan

    2008-01-01

    Full Text Available INTRODUCTION Rheumatoid arthritis (RA is a chronic constantly deteriorating disease of unpredictable clinical course, with exacerbations, remissions and damaged joints. It leads to the loss of self-sufficiency, independence in performing many daily activities, decrease of working ability and invalidity. Beside physical factors, which are regarded as most responsible for the poorer quality of life of RA patients, psychological changes are also significant, such as the feeling of helplessness, hopelessness and depression. The goal of the treatment of patients with RA is to decrease illness symptoms, slow down the development of illness progression, improvement of physical functioning and provision of expert help to the RA patients to adapt to life. OBJECTIVE The aim of the study was to assess the influence of spa therapy on the functional condition and life quality of RA patients. METHODS The study involved 69 patients with RA (51 female and 18 male, on average aged 55.2±11.4 years, with illness duration 12.5±7.5 years, and were a part of a cohort from Norway, suffering of inflammatory rheumatism. All the patients came for four-week rehabilitation at the Institute for Physical Medicine, Rehabilitation and Rheumatology "Dr. Simo Milošević" in Igalo, Montenegro. The RA patients underwent treatment with mud compresses, mud, mineral and pearl baths, as well as with underwater shower massage (balneotherapy kinesitherapy and certain forms of electrotherapy with analgesic effects. The evaluation was done on admission and after completed physical therapy when we assessed RA patients' functional condition and quality of life. The functional condition was determined using the Modified Health Assessment Questionnaire (MHAQ, and the quality of life using the Medical Outcomes Study Short Form 36-item Questionnaire (SF-36, which encompassed eight life domains. RESULTS After completion of 28-dayspa therapy, RA patients showed a significant improvement in

  20. Investigation of Caucasian rheumatoid arthritis susceptibility loci in African patients with the same disease

    Science.gov (United States)

    2012-01-01

    Introduction The largest genetic risk to develop rheumatoid arthritis (RA) arises from a group of alleles of the HLA DRB1 locus ('shared epitope', SE). Over 30 non-HLA single nucleotide polymorphisms (SNPs) predisposing to disease have been identified in Caucasians, but they have never been investigated in West/Central Africa. We previously reported a lower prevalence of the SE in RA patients in Cameroon compared to European patients and aimed in the present study to investigate the contribution of Caucasian non-HLA RA SNPs to disease susceptibility in Black Africans. Methods RA cases and controls from Cameroon were genotyped for Caucasian RA susceptibility SNPs using Sequenom MassArray technology. Genotype data were also available for 5024 UK cases and 4281 UK controls and for 119 Yoruba individuals in Ibadan, Nigeria (YRI, HapMap). A Caucasian aggregate genetic-risk score (GRS) was calculated as the sum of the weighted risk-allele counts. Results After genotyping quality control procedures were performed, data on 28 Caucasian non-HLA susceptibility SNPs were available in 43 Cameroonian RA cases and 44 controls. The minor allele frequencies (MAF) were tightly correlated between Cameroonian controls and YRI individuals (correlation coefficient 93.8%, p = 1.7E-13), and they were pooled together. There was no correlation between MAF of UK and African controls; 13 markers differed by more than 20%. The MAF for markers at PTPN22, IL2RA, FCGR2A and IL2/IL21 was below 2% in Africans. The GRS showed a strong association with RA in the UK. However, the GRS did not predict RA in Africans (OR = 0.71, 95% CI 0.29 - 1.74, p = 0.456). Random sampling from the UK cohort showed that this difference in association is unlikely to be explained by small sample size or chance, but is statistically significant with p<0.001. Conclusions The MAFs of non-HLA Caucasian RA susceptibility SNPs are different between Caucasians and Africans, and several polymorphisms are barely detectable in

  1. Heat-washout - an objective method for diagnosing neuropathy and atherosclerosis in diabetic patients

    DEFF Research Database (Denmark)

    Midttun, M; Snorgaard, O

    2013-01-01

    The heat-washout method is an objective method that measures cutaneous blood flow rate (BFR) in ml (100 g. min)(-1), previously found useful for measuring toe BFR in non-diabetic patients with claudication.......The heat-washout method is an objective method that measures cutaneous blood flow rate (BFR) in ml (100 g. min)(-1), previously found useful for measuring toe BFR in non-diabetic patients with claudication....

  2. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

    2008-01-01

    OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5...... and lowest remission rates was >/=15% in 10 countries, 5-14% in 7 countries, and generally low remission rates [definition of remission, male sex, higher education, shorter disease duration, smaller number of comorbidities, and regular......,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR...

  3. Familial pulmonary alveolar proteinosis caused by mutations in CSF2RA.

    Science.gov (United States)

    Suzuki, Takuji; Sakagami, Takuro; Rubin, Bruce K; Nogee, Lawrence M; Wood, Robert E; Zimmerman, Sarah L; Smolarek, Teresa; Dishop, Megan K; Wert, Susan E; Whitsett, Jeffrey A; Grabowski, Gregory; Carey, Brenna C; Stevens, Carrie; van der Loo, Johannes C M; Trapnell, Bruce C

    2008-11-24

    Primary pulmonary alveolar proteinosis (PAP) is a rare syndrome characterized by accumulation of surfactant in the lungs that is presumed to be mediated by disruption of granulocyte/macrophage colony-stimulating factor (GM-CSF) signaling based on studies in genetically modified mice. The effects of GM-CSF are mediated by heterologous receptors composed of GM-CSF binding (GM-CSF-Ralpha) and nonbinding affinity-enhancing (GM-CSF-Rbeta) subunits. We describe PAP, failure to thrive, and increased GM-CSF levels in two sisters aged 6 and 8 yr with abnormalities of both GM-CSF-Ralpha-encoding alleles (CSF2RA). One was a 1.6-Mb deletion in the pseudoautosomal region of one maternal X chromosome encompassing CSF2RA. The other, a point mutation in the paternal X chromosome allele encoding a G174R substitution, altered an N-linked glycosylation site within the cytokine binding domain and glycosylation of GM-CSF-Ralpha, severely reducing GM-CSF binding, receptor signaling, and GM-CSF-dependent functions in primary myeloid cells. Transfection of cloned cDNAs faithfully reproduced the signaling defect at physiological GM-CSF concentrations. Interestingly, at high GM-CSF concentrations similar to those observed in the index patient, signaling was partially rescued, thereby providing a molecular explanation for the slow progression of disease in these children. These results establish that GM-CSF signaling is critical for surfactant homeostasis in humans and demonstrate that mutations in CSF2RA cause familial PAP.

  4. Relative efficacy for radiation reducing methods in scoliotic patients

    Energy Technology Data Exchange (ETDEWEB)

    Aikenhead, J.; Triano, J.; Baker, J. (National College of Chiropractic, Lombard, IL (USA))

    1989-08-01

    Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies, various protection techniques have been used including various lead and aluminum filtration systems, altered patient positioning and varied tube-film distances. The purpose of this study was to evaluate the efficiency for radiation dosage reduction of three filtration systems used frequently in the chiropractic profession. The systems tested were the Nolan Multiple X-ray Filters, the Clear-Pb system and the Sportelli Wedge system. These systems were tested in seven configurations varying breast shielding, distance and patient positioning. All systems tested demonstrated significant radiation reductions to organs, especially breast tissue. The Clear-Pb system appeared to be the most effective for all organs except the breast, and the Sportelli Wedge system demonstrated the greatest reduction to breast tissue.

  5. RADIOGRAPHIC PROGRESSION ON RADIOGRAPHS OF HANDS AND FEET DURING THE FIRST 3 YEARS OF RHEUMATOID-ARTHRITIS MEASURED ACCORDING TO SHARP METHOD (VANDERHEIJDE MODIFICATION)

    NARCIS (Netherlands)

    VANDERHEIJDE, DMFM; VANLEEUWEN, MA; VANRIEL, PLCM; VANDEPUTTE, LBA

    Objective. To determine the development rate of erosions and joint space narrowing in a cohort of patients during the first 3 years of rheumatoid arthritis (RA). Methods. All consecutive patients fulfilling the American Rheumatism Association criteria and seen within the 1st year of the disease were

  6. Multicentre evaluation of a novel vaginal dose reporting method in 153 cervical cancer patients

    NARCIS (Netherlands)

    Westerveld, Henrike; de Leeuw, Astrid; Kirchheiner, Kathrin; Dankulchai, Pittaya; Oosterveld, Bernard; Oinam, Arun; Hudej, Robert; Swamidas, Jamema; Lindegaard, Jacob; Tanderup, Kari; Pötter, Richard; Kirisits, Christian

    2016-01-01

    Recently, a vaginal dose reporting method for combined EBRT and BT in cervical cancer patients was proposed. The current study was to evaluate vaginal doses with this method in a multicentre setting, wherein different applicators, dose rates and protocols were used. In a subset of patients from the

  7. Translation, cultural adaptation and validation of the English "Short form SF 12v2" into Bengali in rheumatoid arthritis patients

    NARCIS (Netherlands)

    Islam, Nazrul; Khan, Ikramul Hasan; Ferdous, Nira; Rasker, Johannes J.

    2017-01-01

    Background: To develop a culturally adapted and validated Bengali Short Form SF 12v2 among Rheumatoid arthritis (RA) patients. Methods: The English SF 12v2 was translated, adapted and back translated into and from Bengali, pre-tested by 60 patients. The Bengali SF 12v2 was administered twice with 14

  8. Monitoring rheumatoid arthritis using an algorithm based on patient-reported outcome measures: a first step towards personalised healthcare

    NARCIS (Netherlands)

    Hendrikx, J.; Fransen, J.; Riel, P.L.C.M. van

    2015-01-01

    OBJECTIVES: The objective of this proof of concept study was to evaluate alerts generated by a patient-reported outcome measure (PROM)-based algorithm for monitoring patients with rheumatoid arthritis (RA). METHODS: The algorithm was constructed using an example PROM score of an equally weighted

  9. Plasma levels of retinoids, carotenoids and tocopherols in patients with mild obstructive sleep apnoea

    Science.gov (United States)

    Day, Regina M.; Matus, Ismael A.; Suzuki, Yuichiro J.; Yeum, Kyung-Jin; Qin, Jian; Park, Ah-Mee; Jain, Vivek; Kuru, Tunay; Tang, Guangwen

    2009-01-01

    Background and objective OSA is associated with increased incidence of cardiovascular diseases. Pathogenic mechanisms of vascular diseases include thickened vascular walls due to the increased number of smooth muscle cells (SMC). Retinoic acid (RA) suppresses the growth of SMC, and reduced retinoid levels are associated with vascular diseases. Oxidant signalling promotes SMC growth, thus antioxidant levels may also influence the development of cardiovascular diseases. The present study tested the hypothesis that plasmas from OSA patients contain altered levels of retinoids, carotenoids and tocopherols. Methods Plasma samples were taken before and after sleep from patients with OSA (mostly mild) without known cardiovascular diseases and from control subjects. Levels of retinoids, carotenoids and tocopherols were measured using sensitive gas chromatograph-mass spectrometry and high pressure liquid chromatography methods and total antioxidant capacity was assessed fluorometrically. Results Results showed that plasmas from patients with OSA had significantly lower retinyl palmitate and 9-cis RA compared with control subjects, while levels of retinol, all-trans RA and 13-cis RA were indifferent. All-trans β-carotene and 9-cis β-carotene were also lower in OSA patients. Levels of all-trans RA and 13-cis RA in OSA patients were reduced after sleep compared with before sleep. OSA patients showed significantly higher δ-tocopherol compared with controls. Treatment of cultured human vascular SMC with post-sleep OSA patient plasmas promoted cell growth, but not in controls. Conclusions Mild OSA exhibits altered levels of specific retinoids, carotenoids and tocopherols, which may be markers and/or mediators for the increased susceptibility of patients to vascular diseases. PMID:19761534

  10. Methods to reduce prescribing errors in elderly patients with multimorbidity

    Directory of Open Access Journals (Sweden)

    Lavan AH

    2016-06-01

    Full Text Available Amanda H Lavan, Paul F Gallagher, Denis O’Mahony Department of Geriatric Medicine, Cork University Hospital, University College Cork, Cork, Ireland Abstract: The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers’ lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission. This review examines the various ways of minimizing prescribing errors in multimorbid older people. The role of education in physician prescribers and clinical pharmacists, the use of implicit and explicit prescribing criteria designed to improve medication appropriateness in older people, and the application of information and communication-technology systems to minimize errors are discussed in detail. Although evidence to support any single intervention to prevent prescribing errors in multimorbid elderly people is inconclusive or lacking, published data support focused prescriber education in geriatric pharmacotherapy, routine application of STOPP/START (screening tool of older people’s prescriptions/screening tool to alert to right treatment criteria for potentially inappropriate prescribing, electronic prescribing, and close liaison between clinical pharmacists and physicians in relation to structured medication review and reconciliation. Carrying out a structured medication review aimed at optimizing pharmacotherapy in this vulnerable patient population presents a major challenge. Another

  11. The patient radiation protection in external radiotherapy: specificity and methods; La radioprotection du patient en radiotherapie externe: specificites et methodes

    Energy Technology Data Exchange (ETDEWEB)

    Beauvais March, H. [Hopital Val de Grace, 75 - Paris (France)

    1999-07-01

    The daily use of high level radiation doses to fight against carcinomas has often led to consider radiation protection as a marginal problem, in this area. But the therapeutic advances, by increasing the life time and life quality have made the side effects unacceptable and revealed the appearance of radioinduced carcinomas. So, it is necessary to practice a patient radiation protection. The general principles of radiation protection are applicable to radiotherapy. (justification, optimization and dose limit, planning of the treatment, quality control of installations). (N.C.)

  12. Pharmacokinetics and pharmacogenetics of 13-cis retinoic acid in Indian high-risk neuroblastoma patients.

    Science.gov (United States)

    Gota, Vikram; Chinnaswamy, Girish; Vora, Tushar; Rath, Sanhita; Yadav, Akanksha; Gurjar, Murari; Veal, Gareth; Kurkure, Purna

    2016-10-01

    To compare the pharmacokinetics of 13-cis retinoic acid (13-cisRA) between Indian and UK neuroblastoma patients receiving comparable treatment, alongside measures of toxicity and response. 13-cisRA (160 mg/m(2)/day) was administered to 36 patients ≤16 years in two divided doses. Plasma 13-cisRA concentrations were determined on days 1 and 14 of cycles 1 and 4 of treatment. Area under the plasma concentration-time curve (AUC0-6h) was estimated using non-compartment modelling. Patients were genotyped for UGT2B7, CYP3A5*3, CYP3A7*2 and *2, *3 and *4 variants of CYP2C8. Marked inter-patient variability in 13-cisRA pharmacokinetics was observed. There was a trend towards a higher AUC0-6h on day 1 versus day 14 for both treatment cycles studied. Children who swallowed 13-cisRA capsules (n = 18) achieved higher AUC0-6h values compared to those who could not (n = 16) (Mean AUC 21.53 vs. 9.35 µM h, P < 0.05). Patients who were event free at 1 year tended to have higher AUC0-6h on C1D1 compared to those patients who progressed, although this did not reach significance with the number of patients studied (P = 0.08). Similarly, patients who achieved a 13-cisRA C max of ≥2 µM on C1D1 tended to have higher median EFS compared to those who did not (17.0 vs. 8.1 months). UGT2B7, CYP2C8*2/*3/*4 or CYP3A5*3 genotype did not have any effect on 13-cisRA pharmacokinetics. Method of administration markedly affects 13-cisRA pharmacokinetics in Indian neuroblastoma patients, supporting similar findings in UK patients. An appropriate oral liquid formulation of 13-cisRA that can be administered to all children with neuroblastoma is urgently needed on an international level.

  13. Laboratory-Based Investigation of Denture Sonication Method in Patients with Candida-Associated Denture Stomatitis.

    Science.gov (United States)

    Perić, Mirjana; Radunović, Milena; Pekmezović, Marina; Marinković, Jelena; Živković, Rade; Arsić Arsenijević, Valentina

    2017-09-05

    Denture stomatitis (DS) is a disease characterized by inflammation and erythema of the oral mucosa areas covered by the denture. Multifactorial etiological factors contribute to DS, but it seems that Candida plays the key role. The aim of the study was to evaluate the denture sonication method to: (i) increase the possibility of diagnosing patients with Candida-associated DS; (ii) detect and identify the mixed Candida spp., and (iii) determine the Candida colony forming units (CFU) and its possible relationship with DS severity, based on Newton's classification. The cross-sectional study conducted at the Clinic for Dental Prosthetics, Belgrade (Serbia) from June 2013 to December 2014 enrolled edentulous patients with dentures (n = 250). Patients without DS (n = 20) were the control group (CG). The patients' data were collected, and patients with DS (study group/SG) were selected and divided into SG Candida+ and SG Candida-. Based on severity of DS, the SG patients were classified in 3 groups (Newton's classification). Four sampling methods were applied to detect patients with Candida-associated DS: mucosa swab, denture swab, oral rinse, and denture sonication method. The sensitivity and specificity of denture sonication method were shown using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). In 97 (38.8%), out of 250 clinically examined patients, DS was diagnosed. In 82 (84.5%), out of 97 mycologically examined patients, Candida-associated DS was detected when denture sonication method was applied. Additionally, using the denture sonication method we observed: (i) the largest number of Candida positive patients compared to other sampling methods (p method is easy, accurate, and sensitive, and increases the possibility of diagnosing patients with Candida-associated DS. Additionally, yeast quantification, mixed Candida spp., and non-albicans Candida were detectable when cultivation on Candida CHROMagar was performed. It was not

  14. Calculation of P,T-odd interaction effect in ^{225}RaO

    CERN Document Server

    Kudashov, A D; Skripnikov, L V; Mosyagin, N S; Titov, A V

    2012-01-01

    The 10-electron generalized relativistic effective core potential and the corresponding correlation spin-orbital basis sets are generated for the Ra atom and the relativistic coupled cluster calculations for the RaO molecule are performed. The main goal of the study is to evaluate the P,T-odd parameter X characterized by the molecular electronic structure and corresponding to a "volume effect" in the interaction of the ^{225}Ra nucleus Schiff moment with electronic shells of RaO. Our final result for X(^{225}RaO) is -7532 which is surprisingly close to that in ^{205}TlF but has different sign. The obtained results are discussed and the quality of the calculations is analyzed. The value is of interest for a proposed experiment on RaO [PRA 77, 024501 (2008)] due to a very large expected Schiff moment of the ^{225}Ra nucleus.

  15. Rapid Reagentless Detection of M. tuberculosis H37Ra in Respiratory Effluents

    Energy Technology Data Exchange (ETDEWEB)

    Adams, K L; Steele, P T; Bogan, M J; Sadler, N M; Martin, S; Martin, A N; Frank, M

    2008-01-29

    Two similar mycobacteria, Mycobacteria tuberculosis H37Ra and Mycobacteria smegmatis are rapidly detected and identified within samples containing a complex background of respiratory effluents using Single Particle Aerosol Mass Spectrometry (SPAMS). M. tuberculosis H37Ra (TBa), an avirulent strain, is used as a surrogate for virulent tuberculosis (TBv); M. smegmatis (MSm) is utilized as a near neighbor confounder for TBa. Bovine lung surfactant and human exhaled breath condensate are used as first-order surrogates for infected human lung expirations from patients with pulmonary tuberculosis. This simulated background sputum is mixed with TBa or MSm and nebulized to produce conglomerate aerosol particles, single particles that contain a bacterium embedded within a background respiratory matrix. Mass spectra of single conglomerate particles exhibit ions associated with both respiratory effluents and mycobacteria. Spectral features distinguishing TBa from MSm in pure and conglomerate particles are shown. SPAMS pattern matching alarm algorithms are able to distinguish TBa containing particles from background matrix and MSm for >50% of the test particles, which is sufficient to enable a high probability of detection and a low false alarm rate if an adequate number of such particles are present. These results indicate the potential usefulness of SPAMS for rapid, reagentless tuberculosis screening.

  16. Assessment of the usefulness of skin autofluorescence as an indicator of disease activity and of the risk of developing diabetes in patients suffering from rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Paweł Żuchowski

    2015-12-01

    Full Text Available Objectives : Diabetes develops much more often in patients suffering from rheumatoid arthritis (RA than in healthy population. One of the parameters which allow to evaluate the risk of developing diabetes and cardiovascular diseases (CVD is the level of advanced glycation end products (AGE in the skin. In patients suffering from RA, an increase in AGE level may be also linked with the course of the underlying disease. The aim of the study was to evaluate the correlation between the AGE level and the course of RA as well as other risk factors for the development of diabetes and CVD. Material and methods: The study included 148 patients divided into three groups: group I – patients with RA (n = 102, 79 F/23 M, group II – patients with RA and diabetes (n = 21, 14 F/7 M, group III – healthy individuals (n = 25, 16 F/9 M. Each patient underwent a skin autofluorescence signal (SAF examination with an AGE Reader, which allows the assessment of AGE level, as well as being subjected to the laboratory tests panel. Additionally, patients from group I and II have had their DAS28 (ESR indicator calculated. Results: In groups I, II, and III, the respective mean SAF values, expressed in arbitrary units [au], were to 2.54, 2.74, and 1.96 au. Between-group differences in terms of mean SAF values were statistically significant (p < 0.05. Conclusions : Significantly higher mean SAF values in groups I and II as compared to group III suggest that the increase in the AGE level in patients with RA is linked with the underlying disease and does not have to correspond with the real risk of diabetes and CVD. In conclusion, despite the known limitations of the technique, measuring AGE levels allows for closer monitoring of RA patients who are at a higher risk of developing diabetes.

  17. The investigation of association between IL-1Ra and ACE I/D polymorphisms in carpal tunnel syndrome.

    Science.gov (United States)

    Cevik, Betul; Tekcan, Akin; Inanir, Ahmet; Kurt, Semiha Gulsum; Yigit, Serbulent

    2017-03-29

    Carpal tunnel syndrome (CTS) is a common neurologic impairment caused by injury on the median nerve in the wrist, characterized by pain and loss of sensory. CTS usually occurs through three factors, such as a mechanical pressure on median nerve, immunologic changes, and oxidative stress. The aim of this study was to evaluate the influence of interleukin-1 receptor antagonist (IL-1Ra) and angiotensin-converting enzyme (ACE) I/D polymorphisms on the susceptibility of patients to the CTS. One hundred fifty-eight patients with CTS and 151 healthy controls were enrolled in this study. Each patient was analyzed according to diseases symptoms, such as gender, a positive Tinel's sign, a positive Phalen maneuver, disease sides, EMG findings, and clinical stage. We applied the polymerase chain reaction (PCR) to determine the polymorphisms of IL-1Ra and ACE I/D. The statistically significant relation was not found between IL-1Ra, ACE I/D polymorphisms and CTS (respectively, P>.05; P>.05, OR: 1.51, CI: 0.82-1.61). Additionally, in the result of the statistical analysis compared with gene polymorphisms and clinical characteristics, we did not find any correlation (P>.05). Our findings showed that there are no associations of IL-1Ra and ACE I/D polymorphisms with susceptibility of a person for the development of CTS. So, it means that these polymorphisms do not create a risk for the development of CTS. Further studies with larger populations will be required to confirm these findings in different study populations. © 2017 Wiley Periodicals, Inc.

  18. Translation, cultural adaptation and validation of the English ?Short form SF 12v2? into Bengali in rheumatoid arthritis patients

    OpenAIRE

    Islam, Nazrul; Khan, Ikramul Hasan; Ferdous, Nira; Rasker, Johannes J.

    2017-01-01

    Background To develop a culturally adapted and validated Bengali Short Form SF 12v2 among Rheumatoid arthritis (RA) patients. Methods The English SF 12v2 was translated, adapted and back translated into and from Bengali, pre-tested by 60 patients. The Bengali SF 12v2 was administered twice with 14 days interval to 130 Bangladeshi RA patients. The psychometric properties of the Bengali SF 12v2 were assessed. Test-retest reliability was assessed by intra-class correlation coefficient (ICC) and ...

  19. Osteoporosis diagnostics in patients with rheumatoid arthritis

    OpenAIRE

    Małgorzata Węgierska; Marta Dura; Einat Blumfield; Paweł Żuchowski; Marzena Waszczak; Sławomir Jeka

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease. The development of comorbidities often occurs in the course of RA. One of them is osteoporosis, which has serious social and economic effects and may contribute to the increase in the degree of disability and premature death of the patient. Due to the young age in which RA disease occurs, densitometry (DXA) of the lumbar spine is the basic examination in osteoporosis diagnostics. In the course of RA, much more frequent...

  20. Raúl Castro a la hora de las decisiones

    Directory of Open Access Journals (Sweden)

    Janette HABEL

    2010-01-01

    Full Text Available Este artículo trata sobre el nuevo rol político de Raúl Castro en Cuba. Su misión no es fácil. Debe redefinir un proyecto de desarrollo viable en condiciones históricas y geopolíticas nuevas; garantizar la estabilidad del país; organizar el relevo entre los antiguos dirigentes históricos y las nuevas generaciones; y, además, iniciar negociaciones con la administración Obama. ¿Se podrá hablar en adelante de un «raulismo» o se seguirá imponiendo el «fidelismo»? Asimismo, ¿cómo salvaguardar la soberanía e independencia, junto a las principales conquistas sociales desde hace cincuenta años, mientras al mismo tiempo se llevan a cabo las reformas «estructurales » y se intenta normalizar relaciones con el continente, específicamente con Estados Unidos? Esa respuesta, que no es obvia, la debe dar Raúl Castro.

  1. Computerized electrocardiography in American pit bull terrier dogsEletrocardiografia computadorizada em cães da raça American pit bull terrier

    Directory of Open Access Journals (Sweden)

    Mauro José Lahm Cardoso

    2013-10-01

    Full Text Available Electrocardiography (ECG is an essential examination for evaluation of patient with heart disease is great importance the diagnosis of arrhythmias. The examination can determine source f rhythm and frequency depolarization heart, providing information in clinical status myocardium, since deflections P-QRS-T tracing can be altered by disease or physiological factor. With advancement of computer technology, computerized electrocardiography has been used in human medicine as auxiliary diagnostic method and currently is being increasingly used in veterinary medicine. The objectives this study were to study e computerized electrocardiographic parameters in dogs breed American Pit Bull Terrier, comparing them with patterns species. In present study, we evaluated electrocardiographic examinations 42 dogs the breed American Pit Bull clinically healthy, 22 males and 20 females, aged between 1 and 6 years. Sinus rhythm was observed in 57% of dogs showed sinus rhythm and only 26% were wandering pacemaker. The electrocardiographic values obtained from these dogs computerized ECG were within the normal range of species, except the duration of the P wave which had longer than 0.04 seconds in 24% of dogs. We conclude that the dogs of the breed American Pit Bull Terrier have the same electrocardiographic values obtained in other breeds by the computerized method, except for the increase in P-wave duration. A eletrocardiografia (ECG é um exame essencial para avaliação do paciente com doença cardíaca, sendo de grande importância para o diagnóstico das arritmias. O exame pode determinar a origem do ritmo e a freqüência de despolarização do coração, fornecendo informações do estado clínico do miocárdio, uma vez que as deflexões P-QRS-T do traçado podem ser alteradas por uma enfermidade ou fator fisiológico. Com o avanço da informática, a eletrocardiografia computadorizada tem sido utilizada na medicina humana e veterinária como método de

  2. Physical therapy methods in the treatment and rehabilitation of cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kucherova, T. Ya., E-mail: nii@oncology.tomsk.ru; Choinzonov, E. L., E-mail: nii@oncology.tomsk.ru; Tuzikov, S. A., E-mail: TuzikovSA@oncology.tomsk.ru; Vusik, M. V., E-mail: vusik@oncology.tomsk.ru; Doroshenko, A. V., E-mail: doroshenko@sibmail.com [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Velikaya, V. V., E-mail: viktoria.v.v@inbox.ru; Gribova, O. V., E-mail: gribova79@mail.ru; Startseva, Zh. A., E-mail: zhanna.alex@rambler.ru [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); National Research Tomsk Polytechnic University, Lenina Avenue 30, Tomsk, 634050 (Russian Federation)

    2016-08-02

    The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

  3. Physical therapy methods in the treatment and rehabilitation of cancer patients

    Science.gov (United States)

    Kucherova, T. Ya.; Velikaya, V. V.; Gribova, O. V.; Startseva, Zh. A.; Choinzonov, E. L.; Tuzikov, S. A.; Vusik, M. V.; Doroshenko, A. V.

    2016-08-01

    The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

  4. Temporomandibular Joint Disorders in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Yi-Chun Lin

    2007-12-01

    Conclusion: There was a high prevalence of TMD in RA patients. The severity of TMD variably correlated with RA severity. Clinically, a high score of hand-joint space narrowing may serve as an early indicator of RA patients at risk of severe TMD. This may facilitate early management and prevent the functional impairment of the temporomandibular joint.

  5. Pleuropulmonary manifestation in patients with rheumatoid arthritis in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Omer S. B. Alamoudi

    2017-01-01

    Conclusions: Pneumonia, bronchiectasis, and interstitial lung disease were the most common abnormalities seen in RA patients. The presence of comorbidity, male gender, and ExRA was significantly associated with lung involvement.

  6. Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients.

    Science.gov (United States)

    Osera, Shozo; Yano, Tomonori; Odagaki, Tomoyuki; Oono, Yasuhiro; Ikematsu, Hiroaki; Ohtsu, Atsushi; Kaneko, Kazuhiro

    2015-10-01

    Percutaneous endoscopic gastrostomy (PEG) using the direct method is generally indicated for cancer patients. However, there are little available data about peritonitis related to this method. The aim of this retrospective analysis was to assess peritonitis related to PEG using the direct method in patients with cancer. We assessed the prevalence of peritonitis and the relationship between peritonitis and patients' backgrounds, as well as the clinical course after peritonitis. Between December 2008 and December 2011, peritonitis was found in 9 (2.1 %) of 421 patients. Of the 9 patients with peritonitis, 4 had received PEG prior to chemoradiotherapy. Emergency surgical drainage was required in 1 patient, and the remaining 8 recovered with conservative treatment. Peritonitis occurred within 8 days of PEG for 8 of the 9 patients and occurred within 2 days of suture removal for 4 of the 9 patients. Peritonitis related to PEG using the direct method was less frequent for cancer patients. Peritonitis tended to occur within a few days after removal of securing suture and in patients with palliative stage.

  7. 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

    OBJECTIVES: The aim of this paper is to investigate sensitivity to change (SRM), predictive validity and discriminative ability of a quantitative (QS) and a semi-quantitative (SQS) Doppler ultrasound scoring systems in patients with rheumatoid arthritis (RA) treated with anti-TNF-α therapy. METHODS......: RA patients with wrist joint affection treated with TNF-α inhibitor were followed for one year. The wrist was examined with Doppler before initiating therapy and after one year. DAS28 was determined at both visits. One person trained in the SQS system and one in the QS system evaluated the anonymised...... 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...

  8. 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

    Inventory (MFI), Short Form SF-12v2, Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) as well as demographic data and clinical data (comorbid condition, disease duration, disease activity). Results The response rate was 89%. All participants were between 22 and 88 years old (mean age......Background Sleep disturbances and fatigue are frequently experienced (40-70 %) in patients with rheumatoid arthritis (RA) and contribute to decreased quality of life and adverse health and behaviour consequences. However, little is known about the prevalence of poor sleep and its association...... 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...

  9. 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

    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......Background Sleep disturbances and fatigue are frequently experienced (40-70 %) in patients with rheumatoid arthritis (RA) and contribute to decreased quality of life and adverse health and behaviour consequences. However, little is known about the prevalence of poor sleep and its association...... Inventory (MFI), Short Form SF-12v2, Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) as well as demographic data and clinical data (comorbid condition, disease duration, disease activity). Results The response rate was 89%. All participants were between 22 and 88 years old (mean age...

  10. Effectiveness and drug adherence of biologic monotherapy in routine care of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Jorgensen, Tanja Schjodt; Kristensen, Lars Erik; Christensen, Robin

    2015-01-01

    DMARD) treatment as monotherapy without concomitant conventional synthetic DMARDs (csDMARDs) during the study period 1 May, 2011 through 30 April 2013 were eligible for inclusion. All patient files were checked to ensure that they were in accordance with the treatment registration in DANBIO. Descriptive statistics......OBJECTIVES: To estimate the prevalence of Danish RA patients currently on biologic monotherapy and compare the effectiveness and drug adherence of biologic therapies applied as monotherapy. METHODS: All RA patients registered in the Danish biologics database (DANBIO) as receiving biologic DMARD (b......DMARDs, with the exception of infliximab, which had significantly poorer drug adherence (P RA was prescribed in Denmark as monotherapy, of which 70% were...

  11. Patients' views on changes in doctor-patient communication between 1982 and 2001: a mixed-methods study.

    Science.gov (United States)

    Butalid, Ligaya; Verhaak, Peter F M; Boeije, Hennie R; Bensing, Jozien M

    2012-08-08

    Doctor-patient communication has been influenced over time by factors such as the rise of evidence-based medicine and a growing emphasis on patient-centred care. Despite disputes in the literature on the tension between evidence-based medicine and patient-centered medicine, patients' views on what constitutes high quality of doctor-patient communication are seldom an explicit topic for research. The aim of this study is to examine whether analogue patients (lay people judging videotaped consultations) perceive shifts in the quality of doctor-patient communication over a twenty-year period. Analogue patients (N = 108) assessed 189 videotaped general practice consultations from two periods (1982-1984 and 2000-2001). They provided ratings on three dimensions (scale 1-10) and gave written feedback. With a mixed-methods research design, we examined these assessments quantitatively (in relation to observed communication coded with RIAS) and qualitatively. 1) The quantitative analyses showed that biomedical communication and rapport building were positively associated with the quality assessments of videotaped consultations from the first period, but not from the second. Psychosocial communication and personal remarks were related to positive quality assessments of both periods; 2) the qualitative analyses showed that in both periods, participants provided the same balance between positive and negative comments. Listening, giving support, and showing respect were considered equally important in both periods. We identified shifts in the participants' observations on how GPs explained things to the patient, the division of roles and responsibilities, and the emphasis on problem-focused communication (first period) versus solution-focused communication (last period). Analogue patients recognize shifts in the quality of doctor-patient communication from two different periods, including a shift from problem-focused communication to solution-focused communication, and they

  12. Lack of Association for Reported Endocrine Pancreatic Cancer Risk Loci in the PANDoRA Consortium.

    Science.gov (United States)

    Campa, Daniele; Obazee, Ofure; Pastore, Manuela; Panzuto, Francesco; Liço, Valbona; Greenhalf, William; Katzke, Verena; Tavano, Francesca; Costello, Eithne; Corbo, Vincenzo; Talar-Wojnarowska, Renata; Strobel, Oliver; Zambon, Carlo Federico; Neoptolemos, John P; Zerboni, Giulia; Kaaks, Rudolf; Key, Timothy J; Lombardo, Carlo; Jamroziak, Krzysztof; Gioffreda, Domenica; Hackert, Thilo; Khaw, Kay-Tee; Landi, Stefano; Milanetto, Anna Caterina; Landoni, Luca; Lawlor, Rita T; Bambi, Franco; Pirozzi, Felice; Basso, Daniela; Pasquali, Claudio; Capurso, Gabriele; Canzian, Federico

    2017-08-01

    Background: Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms for which very little is known about either environmental or genetic risk factors. Only a handful of association studies have been performed so far, suggesting a small number of risk loci.Methods: To replicate the best findings, we have selected 16 SNPs suggested in previous studies to be relevant in PNET etiogenesis. We genotyped the selected SNPs (rs16944, rs1052536, rs1059293, rs1136410, rs1143634, rs2069762, rs2236302, rs2387632, rs3212961, rs3734299, rs3803258, rs4962081, rs7234941, rs7243091, rs12957119, and rs1800629) in 344 PNET sporadic cases and 2,721 controls in the context of the PANcreatic Disease ReseArch (PANDoRA) consortium.Results: After correction for multiple testing, we did not observe any statistically significant association between the SNPs and PNET risk. We also used three online bioinformatic tools (HaploReg, RegulomeDB, and GTEx) to predict a possible functional role of the SNPs, but we did not observe any clear indication.Conclusions: None of the selected SNPs were convincingly associated with PNET risk in the PANDoRA consortium.Impact: We can exclude a major role of the selected polymorphisms in PNET etiology, and this highlights the need for replication of epidemiologic findings in independent populations, especially in rare diseases such as PNETs. Cancer Epidemiol Biomarkers Prev; 26(8); 1349-51. ©2017 AACR. ©2017 American Association for Cancer Research.

  13. [Research advances in indices and methods for nutritional status evaluation in patients with liver cirrhosis].

    Science.gov (United States)

    Li, H; Zhang, L

    2017-03-20

    In recent years, malnutrition in patients with liver cirrhosis has been taken more and more seriously in clinical physicians, and patients' nutritional status is closely associated with prognosis. At present, there are many methods for the evaluation of nutritional status in patients with liver cirrhosis, but there are still no unified standards. This article reviews the common evaluation indices and methods used in clinical practice in China and foreign countries, in order to provide a basis for accurately evaluating nutritional status and guiding nutritional therapy in patients with liver cirrhosis.

  14. Ab initio full charge-density study of the atomic volume of α-phase Fr, Ra, Ac, Th, Pa, U, Np, and Pu

    DEFF Research Database (Denmark)

    Vitos, Levente; Kollár, J.; Skriver, Hans Lomholt

    1997-01-01

    We have used a full charge-density technique based on the linear muffin-tin orbitals method in first-principles calculations of the atomic volumes of the light actinides including Fr, Ra, and Ac in their low-temperature crystallographic phases. The good agreement between the theoretical and exper......We have used a full charge-density technique based on the linear muffin-tin orbitals method in first-principles calculations of the atomic volumes of the light actinides including Fr, Ra, and Ac in their low-temperature crystallographic phases. The good agreement between the theoretical...

  15. Cor/raça no Estudo Pró-Saúde: resultados comparativos de dois métodos de autoclassificação no Rio de Janeiro, Brasil Ethnicity/race in the Pró-Saúde Study: comparative results of two methods of self-classification in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Marcos Chor Maio

    2005-02-01

    Full Text Available Variações nos sistemas de classificação da cor/raça e a dependência contextual de sua aplicação são alguns dos desafios para a realização de estudos de saúde com recorte étnico/racial no Brasil. As respostas a duas abordagens distintas para autoclassificação de raça - questão fechada (IBGE e questão aberta - foram comparadas em um estudo de coorte dos funcionários de uma universidade no Rio de Janeiro. De acordo com a pergunta fechada, 54,0% dos 3.717 participantes classificaram-se como brancos, 30,0% como pardos e 16,0% como pretos. Segundo a pergunta aberta, essas proporções foram 53,0%, 25,0% e 22,0%, respectivamente, agrupando-se os termos moreno, mestiço e mulato na categoria parda. Apesar da concordância elevada (kappa = 0,80; IC95%: 0,78-0,82, proporções não desprezíveis de participantes negros ou pardos (pergunta aberta escolheram categorias mais "claras" entre as opções do IBGE. A utilização do recorte étnico/racial nos estudos de saúde pode não apenas revelar dados sobre as desigualdades sociais no Brasil, mas também contribuir para a formulação de políticas na área da saúde pública informadas pelas especificidades da sociedade brasileira.Variations in classification systems related to color/race and the contextual dependence of their utilization are two challenges for researchers conducting health studies within an ethnic/racial framework. A comparison was made between the results obtained by two distinct approaches to racial self-classification - a closed question (using categories from the IBGE, or National Census Bureau and an open-ended question - in a cohort study of employees at a university in Rio de Janeiro. According to the closed question, 54.0% of the 3,717 respondents classified themselves as white, 30.0% as brown (or mixed-race, and 16.0% as black. According to answers to the open-ended question, the proportions were 53.0%, 25.0%, and 22.0%, respectively, when the terms "moreno

  16. Digestibilidade dos nutrientes e parâmetros ruminais de bovinos de corte alimentados com rações contendo bagaço de cana-de-açúcar obtido pelo método de extração por difusão ou por moagem convencional Digestibility of nutrients and ruminal characteristics in beef cattle fed rations containing sugarcane bagasse obtained by diffusion or conventional milling extraction method

    Directory of Open Access Journals (Sweden)

    Mário Márcio Arakaki Rabelo

    2008-09-01

    Full Text Available Objetivou-se com este trabalho avaliar o efeito da utilização do bagaço de cana-de-açúcar in natura (BIN, obtido pelo método de extração do açúcar por difusão (BINdif ou moagem convencional (BINmoa como fonte de fibra íntegra, associado ao bagaço tratado sob pressão e vapor (BTPV sobre a digestibilidade dos nutrientes e os parâmetros ruminais de bovinos de corte. Quatro machos da raça Nelore, não-castrados, com fístulas ruminais e peso vivo médio inicial de 380 kg, foram distribuídos em delineamento experimental quadrado latino 4 × 4. Os tratamentos foram compostos das combinações dos bagaços: 5% BINmoa + 45% BTPV; 5% BINdif + 45% BTPV; 10% BINdif + 40% BTPV; 15% BINdif + 35% BTPV. A utilização do BIN obtido por difusão, mesmo no nível mais elevado, não teve efeito sobre a digestibilidade dos nutrientes (MS, MO, PB, FDN, FDA e EE da dieta. Entretanto, o fornecimento do bagaço obtido por difusão provocou redução nos consumos de MS, MO, PB e FDN em relação ao bagaço obtido por moagem. A produção total de ácidos graxos voláteis no rúmen, a porcentagem molar dos ácidos acético, propiônico e butírico, a relação acético/propiônico, o pH ruminal e a concentração ruminal de nirogênio amoniacal não diferiram entre os bagaços fornecidos. A utilização do bagaço obtido pelo processo de difusão ou de moagem convencional como fonte de fibra íntegra associado ao bagaço tratado sob pressão e vapor não prejudicou a digestibilidade dos nutrientes e os parâmetros ruminais de bovinos de corte alimentados com rações contendo 50% de concentrado.The objective of this study was to evaluate the effects of feeding sugarcane bagasse, obtained by extraction of sugar using diffusion (BINdif or conventional milling (BINmoa method, as a fiber source associated with bagasse treated under pressure and steam (BTPV on nutrient digestibility and ruminal characteristics in beef cattle. Four Nellore young bulls (380 kg

  17. Gender and age effects on the continuous reaction times method in volunteers and patients with cirrhosis

    DEFF Research Database (Denmark)

    Lauridsen, Mette Enok Munk; Grønbæk, Henning; Næser, Esben

    2012-01-01

    Abstract Minimal hepatic encephalopathy (MHE) is a metabolic brain disorder occurring in patients with liver cirrhosis. MHE lessens a patient's quality of life, but is treatable when identified. The continuous reaction times (CRT) method is used in screening for MHE. Gender and age effects......, identifies brain dysfunction rather than effects of gender and age....... on the CRT method are unknown and may confound the results. The aim of this study was to standardise the CRT method outcomes for age and gender effects. We studied 121 volunteers without known disease and 181 patients with cirrhosis by a CRT test. Reaction time to an auditory signal was measured 100 times...

  18. Volumetric modulated arc therapy is superior to conventional intensity modulated radiotherapy - a comparison among prostate cancer patients treated in an Australian centre

    Directory of Open Access Journals (Sweden)

    Haydu Lauren E

    2011-09-01

    Full Text Available Abstract Background Radiotherapy technology is expanding rapidly. Volumetric Modulated Arc Therapy (VMAT technologies such as RapidArc® (RA may be a more efficient way of delivering intensity-modulated radiotherapy-like (IM treatments. This study is an audit of the RA experience in an Australian department with a planning and economic comparison to IM. Methods 30 consecutive prostate cancer patients treated radically with RA were analyzed. Eight RA patients treated definitively were then completely re-planned with 3D conformal radiotherapy (3D; and a conventional sliding window IM technique; and a new RA plan. The acceptable plans and their treatment times were compared and analyzed for any significant difference. Differences in staff costs of treatment were computed and analyzed. Results Thirty patients had been treated to date with eight being treated definitely to at least 74 Gy, nine post high dose brachytherapy (HDR to 50.4Gy and 13 post prostatectomy to at least 64Gy. All radiotherapy courses were completed with no breaks. Acute rectal toxicity by the RTOG criteria was acceptable with 22 having no toxicity, seven with grade 1 and one had grade 2. Of the eight re-planned patients, none of the 3D (three-dimensional conformal radiotherapy plans were acceptable based on local guidelines for dose to organs at risk. There was no statistically significant difference in planning times between IM and RA (p = 0.792. IM had significantly greater MUs per fraction (1813.9 vs 590.2 p Conclusions 3D was incapable of covering a modern radiotherapy volume for the radical treatment of prostate cancer. These volumes can be treated via conventional IM and RA. RA was significantly more efficient, safe and cost effective than IM. VMAT technologies are a superior way of delivering IM-like treatments.

  19. [Exploration of risk factors on the occurrence of osteoporotic vertebral fracture in patients with rheumatoid arthritis].

    Science.gov (United States)

    Liu, Wen; Xu, Shengqian; Ma, Xixi; Hu, Linwei; Peng, Liping; Xu, Jianhua

    2014-11-01

    To explore the prevalence of osteoporosis (OP) and vertebral osteoporotic fracture (OPF) and related risk factors in patients with rheumatoid arthritis (RA). A total of 644 patients with RA from Jan. 2010 to Oct. 2013 were recruited, anteroposterior and lateral X-rays examination of vertebral column (T5-L5) were conducted, and semi-quantity method were used as the standard for judging vertebral OPF. Meanwhile, patients' clinical and laboratory data including daily dosage of glucocorticoid, duration of glucocorticoid usage, cumulative amount dosage of glucocorticoid were recorded in details. 158 normal subjects were selected as control group. (1)The prevalence of vertebral OPF in patients with RA was 16.6%. Bone mineral density (BMD) of all measured lumbar vertebra in RA group were markedly decreased [(0.97 ± 0.22) g/cm(2)]. The total prevalence of OP at lumbar vertebra in RA was 17.9% (81/452), which was significantly higher than that of control group (4.4%, 7/158) (P OPF was significantly higher than that in patients without OPF [40.6% (41/101) vs 11.4% (40/351); P OPF were of older age, longer use of glucocorticoid, more cumulative amount dosage of glucocorticoid, longer disease duration, higher scores of health assessment questionnaires (HAQ) and increased ESR (P OPF in RA patients. Logistic regression analysis also showed that RA was the risk factor of OPF (OR = 4.716, 95% CI 1.987-11.192, P OPF has found that age-OPF and daily dosage of glucocorticoid-OPF AUCROC were 0.689 and 0.636 respectively. The cut-off value in ROC curve of age and daily dose or treatment course of glucocorticoid-OPF were 54.5 years and 6.25 mg (P OPF AUCROC was 0.685, with cut-off value in ROC of age-OPF 135 days (P OPF in patients with RA increases remarkably. Old age and OP at spine are risk factors related to the development of OPF in patients with RA.

  20. Anti-TNFa treatment in patients with rheumatoid arthritis and anti-Ro/SSA antibodies

    Directory of Open Access Journals (Sweden)

    P. Airò

    2011-09-01

    Full Text Available Objective: To analyse clinical efficacy, onset of new autoantibodies or symptoms of autoimmune disease in patients affected by rheumatoid arthritis with anti-Ro/SSA treated with anti-TNFa agents. Methods: Six anti-Ro/SSA positive subjects with RA were studied every six months until 24th month of treatment in order to detect ANA titer (IFI, anti-dsDNA (Farr, anti-cardiolipin and anti-beta2glycoprotein I (ELISA, anti-ENA (CIE. The titre of anti-Ro/SSA were analysed by ELISA. Four patients were diagnosed as overlap RA/SS. Results: Six female patients (mean age 58ys, SD 9.8ys, with long-standing RA (mean 7ys, range 5-22 ys were treated with anti-TNFa agents for a mean of 31 months (SD: 20.4 m: 4 with Infliximab and 2 with Etanercept. All the patients showed a significant reduction of DAS until 24th month (p<0.006 with stability of sicca symptoms. The titer of ANA and anti-Ro/SSA was stable, while 4 subjects developed anti-dsDNA at low titer within 6-12 months. One patient withdrawn the treatment, because of lupus-like features; another one, with HCV hepatitis, interrupted Etanercept because of elevation of liver enzymes. No anticardiolipin or antibeta2GPI antibodies were detected. One subject with RA-SS also presented a primary biliary cirrhosis: clinical and histological features of cholangitis remained stable during Etanercept treatment. Conclusions: Anti-TNFa treatment showed good efficacy and safety in anti-Ro/SSA positive patients with RA. Anti-ds- DNA antibodies at low titer appeared in most patients while the onset of lupus-like disease could be considered a rare event also in RA patients with a rich autoimmune repertoire.

  1. "When I first started going I was going in on my knees, but I came out and I was skipping": exploring rheumatoid arthritis patients' perceptions of receiving treatment with acupuncture.

    Science.gov (United States)

    Hughes, J G

    2009-01-01

    To outline rheumatoid arthritis (RA) patients' experiences of receiving treatment with acupuncture, exploring the impact of practitioner affiliation to a traditional or western theoretical base. Qualitative study utilising grounded theory method. Convenience sample of thirteen patients with RA. Data collection, organisation and analysis performed concurrently. In-depth semi-structured interviews were tape-recorded and transcribed. Field notes were also taken. Open, axial and selective coding performed. Emergent categories and themes identified and informed the topics to be discussed in subsequent interviews. Patients perceived acupuncture as alleviating a number of RA symptoms including the relief of rheumatic pain and improvements in mobility. Acupuncture was additionally perceived as alleviating a number of consequential secondary symptoms of RA, such as fatigue, depression and sleeplessness. These effects allowed patients to feel normal again and regain their lives, and resulted in improvements in patients' lifestyle, emotional well-being and self-image. Acupuncturist affiliation impacts on both patient experience and perception of effects. Acupuncture elicits a range of effects which contribute to improvements in RA patients' quality of life. Varied levels of congruence were identified between the intended therapeutic effect of acupuncture [Hughes JG, Goldbart J, Fairhurst E, Knowles K. Exploring acupuncturists' perceptions of treating patients with rheumatoid arthritis. Complementary Therapies in Medicine 2007;15:101-8] and patients' perceptions of effects. Acupuncturist affiliation has demonstrable implications for the practice and research of acupuncture.

  2. [Assessment of nutritional status of patients candidates for lung resection by 2 methods].

    Science.gov (United States)

    Carnero Gregorio, M; Obeso Carillo, G A; Durán Toconas, J C; Villaverde Taboada, C; García-Mayor García, R V; Cañizares Carretero, M A; Pérez Méndez, L F

    2012-01-01

    It is important to determine the nutritional status of an individual that may be submitted to a surgical intervention since it has been shown a relationship between nutritional status impairments and the incidence of complications. We present the data from a study comparing two nutritional assessment methods. To study the rate of hyponutrition in patients candidates to lung resection in southern Galicia, and to determine if there were significant differences in the use of 2 different nutritional assessment methods. 200 patients participated in this study: 144 males (aged 29-83 years) and 56 females (aged 20-80 years). All of them were assessed for their nutritional status according to Chang's method and we also performed a patient-generated global subjective assessment (PG-GSA) according to the SENBA working group protocol. There is agreement between the 2 methods in assessing 122 patients as having "good nutritional status". There are two cases with agreement between both methods in the diagnosis of "moderate hyponutrition or risk for hyponutrition". No case of "severe hyponutrition" is diagnosed by the Chang's method. We found statistically significant differences between the observations obtained with the two methods. The Chang's method performed more accurately than the PG-GSA, so that we believe it should be the first choice method for the preoperative nutritional assessment of patients candidate to a lung resection.

  3. Imbalance between HAT and HDAC activities in the PBMCs of patients with ankylosing spondylitis or rheumatoid arthritis and influence of HDAC inhibitors on TNF alpha production.

    Directory of Open Access Journals (Sweden)

    Eric Toussirot

    Full Text Available OBJECTIVE: Acetylation or deacetylation of histone proteins may modulate cytokine gene transcription such as TNF alpha (TNF. We evaluated the balance between histone deacetytlase (HDAC and histone acetyltransferase (HAT in patients with rheumatoid arthritis (RA or ankylosing spondylitis (AS compared to healthy controls (HC and determined the influence of HDAC inhibitors (trichostatin A -TSA- or Sirtinol -Sirt- on these enzymatic activities and on the PBMC production of TNF. METHODS: 52 patients with RA, 21 with AS and 38 HC were evaluated. HAT and HDAC activities were measured on nuclear extracts from PBMC using colorimetric assays. Enzymatic activities were determined prior to and after ex vivo treatment of PBMC by TSA or Sirt. TNF levels were evaluated in PBMC culture supernatants in the absence or presence of TSA or Sirt. RESULTS: HAT and HDAC activities were significantly reduced in AS, while these activities reached similar levels in RA and HC. Ex vivo treatment of PBMC by HDACi tended to decrease HDAC expression in HC, but Sirt significantly reduced HAT in RA. TNF production by PBMC was significantly down-regulated by Sirt in HC and AS patients. CONCLUSION: HAT and HDAC were disturbed in AS while no major changes were found in RA. HDACi may modulate HDAC and HAT PBMC expression, especially Sirt in RA. Sirtinol was able to down regulate TNF production by PBMC in HC and AS. An imbalance between HAT and HDAC activities might provide the rationale for the development of HDACi in the therapeutic approach to inflammatory rheumatic diseases.

  4. [The effectiveness of physical therapy methods (Bobath and motor relearning program) in rehabilitation of stroke patients].

    Science.gov (United States)

    Krutulyte, Grazina; Kimtys, Algimantas; Krisciūnas, Aleksandras

    2003-01-01

    The purpose of this study was to examine whether two different physiotherapy regimes caused any differences in outcome in the rehabilitation after stroke. We examined 240 patients with stroke. Examination was carried out at the Rehabilitation Center of Kaunas Second Clinical Hospital. Patients were divided into 2 groups: Bobath method was applied to the first (I) group (n=147), motor relearning program (MRP) method was applied to the second (II) group (n=93). In every group of patients we established samples according to sex, age, hospitalization to rehab unit as occurrence of CVA degree of disorder (hemiplegia, hemiparesis). The mobility of patients was evaluated according to European Federation for Research in Rehabilitation (EFRR) scale. Activities of daily living were evaluated by Barthel index. Analyzed groups were evaluated before physical therapy. When preliminary analysis was carried out it proved no statically reliable differences between analyzed groups (reliability 95%). The same statistical analysis was carried out after physical therapy. The results of differences between patient groups were compared using chi(2) method. Bobath method was applied working with the first group of patients. The aim of the method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While applying this method at work, physical therapist guides patient's body on key-points, stimulating normal postural reactions, and training normal movement pattern. MRP method was used while working with the second group patients. This method is based on movement science, biomechanics and training of functional movement. Program is based on idea that movement pattern shouldn't be trained; it must be relearned. CONCLUSION. This study indicates that physiotherapy with task-oriented strategies represented by MRP, is preferable to physiotherapy with facilitation/inhibition strategies, such the Bobath programme, in the

  5. STUDI PEMBELAJARAN RUMAH QURANI DALAM MENINGKATKAN KEMAMPUAN BERBAHASA ANAK USIA DINI DI RA ASSAKINAH SEJAHTERA KAB. BANDUNG BARAT

    Directory of Open Access Journals (Sweden)

    Heryanto Heryanto

    2018-01-01

    Full Text Available This research was motivated by the problems in early childhood language skills in RA Assakinah Sejahtera, namely the tendency of interest in learning language skills, especially speaking skills are still relatively low and there is still the teacher’s ability or competence is not optimal. So, we need a model of learning that is more effective in the learning process. The approach used in this study is a qualitative descriptive approach using the techniques of observation data collection, interviews, documentary studies, and literature studies.This study aimed to describe: 1 the learning objective of quranic home conditions in RA Assakinah Sejahtera, 2 implementation of the quranic home method in RA Assakinah Sejahtera in order to improve language skills, 3 the results achieved from the use of the quranic home method, and 4 using barriers of quranic home method. The theoretical basis of this study, researchers refer to several concepts: 1 learning theory, Law 20 of 2003 on National Education System chapter 1, verse 2002, 2 The concept of Quranic home learning, pusdiklatrumahqurani 2012, 3 The concept of early childhood education, curriculum 2004 of kindergarten and Raudlatul Afhtal (Depdiknas, 2004: 2, and 4 Language Concepts, Strategies Mastery Speak, Suwarna 2002.The results of this study indicate that in improving language skills for early childhood needed teacher guidance and parents collaboration. Guidance by the teacher implemented is designed to be more flexible in the sense of a child can learn with class organization that vary in individual activities, classical, and groups. Cooperation with the parents conducted to establish communication through the development of children's ability liaison books are competitors by providing stimulation reward as maintaining cooperative school with his parents. Conclusions from this research is the Quranic home learning can improve language skills in early childhood in RA Assakinah Sejahtera and in

  6. Depression in patients with rheumatoid arthritis: description, causes and mechanisms

    OpenAIRE

    Margaretten, Mary; Julian, Laura; Katz, Patricia; YELIN, EDWARD

    2011-01-01

    Two sets of contributory factors to depression among patients with rheumatoid arthritis (RA) are generally examined – the social context of the individual and the biologic disease state of that person’s RA. This article will review the evidence for both. RA affects patients both physically and psychologically. Comorbid depression is common with RA and leads to worse health outcomes. Low socioeconomic status, gender, age, race/ethnicity, functional limitation, pain and poor clinical status hav...

  7. Lack of effect of doxycycline on disease activity and joint damage in patients with rheumatoid arthritis. A double blind, placebo controlled trial

    NARCIS (Netherlands)

    Laan, W. van der; Molenaar, E.; Ronday, K.; Verheijen, J.; Breedveld, F.; Greenwald, R.; Dijkmans, B.; Tekoppele, J.

    2001-01-01

    Objective. To investigate the effects of doxycycline on disease activity and joint destruction in patients with rheumatoid arthritis (RA). Methods. A 36 week double blind, placebo controlled crossover trial was conducted. Patients (n = 66) received 50 mg doxycycline or placebo twice a day during 12,

  8. Anti-infliximab antibodies are already detectable in most patients with rheumatoid arthritis halfway through an infusioncycle: an open-label pharmacokinetic cohort study

    NARCIS (Netherlands)

    Bemt, B.J.F van den; Broeder, A. den; Wolbink, G.J.; Hekster, Y.A.; Riel, P.L. van; Benraad, B.; Hoogen, F.H. Van den

    2011-01-01

    BACKGROUND: This study in patients with rheumatoid arthritis (RA) treated with infliximab describes prospectively the course of (anti)infliximab levels within an infusioncycle to assess at what moment patients develop low/no infliximab trough levels and/or detectable anti-infliximab levels. METHODS:

  9. Dosimetry of bone metastases in targeted radionuclide therapy with alpha-emitting {sup 223}Ra-dichloride

    Energy Technology Data Exchange (ETDEWEB)

    Pacilio, Massimiliano [Azienda Ospealiera San Camillo Forlianini, Rome (Italy). Dept. of Medical Physics; Ventroni, Guido; Mango, Lucio [Azienda Ospealiera San Camillo Forlianini, Rome (Italy). Dept. of Nuclear Medicin; De Vincentis, Giuseppe; Di Castro, Elisabetta; Frantellizzi, Viviana; Follacchio, Giulia Anna; Garkavaya, Tatiana [Rome Univ. (Italy). Dept. of Radiological, Oncological and Anatomo Pathological Sciences; Cassano, Bartolomeo; Lorenzon, Leda [Rome Univ. (Italy). Postgraduate School of Medical Physics; Pellegrini, Rosanna; Pani, Roberto [Rome Univ. (Italy). Dept. of Molecular Medicine; Ialongo, Pasquale [Azienda Ospealiera San Camillo Forlianini, Rome (Italy). Dept. of Radiology

    2016-01-15

    Ra-dichloride is an alpha-emitting radiopharmaceutical used in the treatment of bone metastases from castration-resistant prostate cancer. Image-based dosimetric studies remain challenging because the emitted photons are few. The aim of this study was to implement a methodology for in-vivo quantitative planar imaging, and to assess the absorbed dose to lesions using the MIRD approach. The study included nine Caucasian patients with 24 lesions (6 humeral head lesions, 4 iliac wing lesions, 2 scapular lesions, 5 trochanter lesions, 3 vertebral lesions, 3 glenoid lesions, 1 coxofemoral lesion). The treatment consisted of six injections (one every 4 weeks) of 50 kBq per kg body weight. Gamma-camera calibrations for {sup 223}Ra included measurements of sensitivity and transmission curves. Patients were statically imaged for 30 min, using an MEGP collimator, double-peak acquisition, and filtering to improve the image quality. Lesions were delineated on {sup 99m}Tc-MDP whole-body images, and the ROIs superimposed on the {sup 223}Ra images after image coregistration. The activity was quantified with background, attenuation, and scatter correction. Absorbed doses were assessed deriving the S values from the S factors for soft-tissue spheres of OLINDA/EXM, evaluating the lesion volumes by delineation on the CT images. In 12 lesions with a wash-in phase the biokinetics were assumed to be biexponential, and to be monoexponential in the remainder. The optimal timing for serial acquisitions was between 1 and 5 h, between 18 and 24 h, between 48 and 60 h, and between 7 and 15 days. The error in cumulated activity neglecting the wash-in phase was between 2 % and 12 %. The mean effective half-life (T{sub 1/2eff}) of {sup 223}Ra was 8.2 days (range 5.5-11.4 days). The absorbed dose (D) after the first injection was 0.7 Gy (range 0.2-1.9 Gy). Considering the relative biological effectiveness (RBE) of alpha particles (RBE = 5), D{sub RBE} = 899 mGy/MBq (range 340-2,450 mGy/MBq). The

  10. An implanted $^{228}$Ra source for response characterization of bolometers

    CERN Multimedia

    TeO$_{2}$ crystals are used as bolometers in experiments searching for Double $\\beta$ Decay without emission of neutrinos. One of the most important issues in this extremely delicate kind of experiments is the discrimination of the background from the real signal. A deep knowledge of the bolometric response to $\\alpha$-particles is therefore needed to recognize and discard them, since it has been proven that $\\alpha$ surface contamination could be a major contribution in our background budget. We would like to use ISOLDE’s capability of implanting $^{228}$Ra to make a long-lived source feeding several monochromatic $\\alpha$- and recoiling nuclei, with little or no $\\alpha$-peak broadening due to the source itself, for tests of our detectors in Milano and Gran Sasso INFN National Lab.

  11. Loe-ära-loe! Eesti lastekirjandus 2007 / Jaanika Palm

    Index Scriptorium Estoniae

    Palm, Jaanika, 1973-

    2008-01-01

    Hainsalu, Lehte. Rõõmuratas (TEA Kirjastus) ; Vilep, Heiki. Katus sõidab (Vilep & Vallik) ; Vaiksoo, Jaanus. Onu Heino eksis ära (Koolibri) ; Vallik, Aidi. Tirtsti ja turtsti (TEA Kirjastus) ; Trull, Ilmar. Järvevaht ja joogivesi (Eesti Ekspressi Kirjastus) ; Kassel, Riina. Kalliralli (Ilo) ; Kumberg, Krista. Autopõnn Anto lemmiktoit (Koolibri) ; Ojar, Triinu. Suur must koer = Suur must pini (Päike ja Pilv) ; Pervik, Aino. Suleline, Puhuja ja must Munk (Tänapäev) ; Tomusk, Ilmar. Tere, Volli! (Tänapäev) ; Ausman, Piia. Tähtsad asjad (Haus Galerii) ; Ulman, Mihkel. Võlur taskust (Elmatar) ; Tangsoo, Jaan. Kotermann Juko imeline reis läbi Eestimaa (Varrak) ; Made, Reet. Tuhin tiibades (Koolibri) ; Vallik, Aidi. Mis sinuga juhtus, Ann? (Tänapäev)

  12. The Paran\\'a Ra'anga expedition

    CERN Document Server

    Gangui, Alejandro; Vena, Pablo

    2013-01-01

    Paran\\'a Ra'anga (the image of Paran\\'a, in Guaran\\'i) is the name of a cultural and scientific expedition that traveled the rivers: R\\'io de la Plata, Paran\\'a and Paraguay, from Buenos Aires to Asunci\\'on, during March 2010. The project brought together some forty scientists and artists from three countries in a slow and enriching cruise, putting in active contact actors from different backgrounds and disciplines -which usually run separately- in the framework of an unusual space-time experience. The project recovers the historical tradition of the trip as an instrument of knowledge and collaboration between the arts and sciences, necessary to build new ways of seeing and understanding the river and its banks. This article reports on the motivations of this project and its projection.

  13. Annual intakes of (226)Ra, (228)Ra and (40)K in staple foodstuffs from a high background radiation area in the southwest region of Cameroon.

    Science.gov (United States)

    Ele Abiama, P; Ben-Bolie, G H; Amechmachi, N; Najib, F; El Khoukhi, T; Owono Ateba, P

    2012-08-01

    Concentrations of naturally occurring radionuclides (226)Ra, (228)Ra and (40)K were determined in five most consumed vegetables in a high-level background radiation area (HLBRA) in the southwest region of Cameroon. A total of 25 foodstuff samples collected from Akongo, Ngombas, Awanda, Bikoué and Lolodorf rural districts were analyzed by gamma spectrometry. The average activity concentration values of (226)Ra, (228)Ra and (40)K were respectively 2.30, 1.50 and 140.40 Bq kg(-1) fresh-weights. The effective dose for individual consumption of the investigated foodstuff types was calculated on an estimated annual intake of such diets in the study area. The estimated total daily effective doses from the ingestion of the investigated foodstuffs for each studied long-life natural radionuclide were respectively 0.41 μSv for (226)Ra, 0.84 μSv for (228)Ra and 0.71 μSv for (40)K. The total annual effective dose was estimated at 0.70 mSv y(-1). (228)Ra (44%) and (40)K (36%) were found to be the main sources for internal irradiation which is very likely due to the specific uptake of these radionuclides by the studied plants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Impact of adherence to biological agents on health care resource utilization for patients over the age of 65 years with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Lathia U

    2017-07-01

    Full Text Available Urja Lathia, Emmanuel M Ewara, Francois Nantel Janssen Inc., Toronto, ON, Canada Objective: Poor adherence to therapy increases the patient and societal burden and complexity of chronic diseases such as rheumatoid arthritis (RA. In the past 15 years, biologic disease-modifying anti-rheumatic drugs (DMARDs have revolutionized the treatment of RA. However, little data are available on the impact of adherence to biologics on health care resources. The objective of the study was to determine the long-term health care resource utilization patterns of RA patients who were adherent to biologic DMARD therapy compared to RA patients who were non-adherent to biologic DMARD therapy in an Ontario population and to determine factors influencing adherence. Methods: Patients were identified from the Ontario RA Database that contains all RA patients in Ontario, Canada, identified since 1991. The study population included RA patients, aged 65+ years, with a prescription for a biologic DMARD between 2003 and 2013. Exclusion criteria included diagnosis of inflammatory bowel disease, psoriatic arthritis or psoriasis in the 5 years prior to the index date and discontinuation of biologic DMARD, defined as no subsequent prescription during the 12 months after the index date. Adherence was defined as a medication possession ratio of ≥0.8 measured as the proportion of days for which a patient had biologic treatment(s over a defined follow-up period. Adherent patients were matched to non-adherent patients by propensity score matching. Results: A total of 4,666 RA patients were identified, of whom 2,749 were deemed adherent and 1,917 non-adherent. The age (standard deviation was 69.9 (5.46 years and 75% were female. Relative rates for resource use (physician visits, emergency visits, hospitalization, home care and rehabilitation for the matched cohort were significantly lower (P<0.0001 in adherent patients. Non-adherent patients’ use of oral prednisone (67% was

  15. Magic wavelengths for the 7s1/2-6d3/2,5/2 transitions in Ra+

    Science.gov (United States)

    Wu, Xiao-Mei; Li, Cheng-Bin; Tang, Yong-Bo; Shi, Ting-Yun

    2016-09-01

    The dynamic polarizabilities of the 7s and 6d states of Ra+ are calculated using a relativistic core polarization potential method. The magic wavelengths of the 7s1/2-6d3/2,5/2 transitions are identified. Comparing to the common radio-frequency (RF) ion traps, using the laser field at the magic wavelength to trap the ion could suppress the frequency uncertainty caused by the micromotion of the ion, and would not affect the transition frequency measurements. The heating rates of the ion and the powers of the laser for the ion trapping are estimated, which would benefit the possible precision measurements based on all-optical trapped Ra+. Project supported by the National Basic Research Program of China (Grant No. 2012CB821305) and the National Natural Science Foundation of China (Grant Nos. 91336211 and 11504094).

  16. Field analyses of (238)U and (226)Ra in two uranium mill tailings piles from Niger using portable HPGe detector.

    Science.gov (United States)

    Déjeant, Adrien; Bourva, Ludovic; Sia, Radia; Galoisy, Laurence; Calas, Georges; Phrommavanh, Vannapha; Descostes, Michael

    2014-11-01

    The radioactivities of (238)U and (226)Ra in mill tailings from the U mines of COMINAK and SOMAÏR in Niger were measured and quantified using a portable High-Purity Germanium (HPGe) detector. The (238)U and (226)Ra activities were measured under field conditions on drilling cores with 600s measurements and without any sample preparation. Field results were compared with those obtained by Inductive Coupled Plasma Atomic Emission Spectroscopy (ICP-AES) and emanometry techniques. This comparison indicates that gamma-ray absorption by such geological samples does not cause significant deviations. This work shows the feasibility of using portable HPGe detector in the field as a preliminary method to observe variations of radionuclides concentration with the aim of identifying samples of interest. The HPGe is particularly useful for samples with strong secular disequilibrium such as mill tailings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Using methods of stretching lower extremities amongst patients with vertebrogenic algic syndrome

    OpenAIRE

    Kocsis, Ágnes

    2016-01-01

    Name: Ágnes Kocsis Supervisor: Bc. Monika Tichá Title: Using methods of stretching lower extremities amongst patients with vertebrogenic algic syndrome Abstract: The subject of this work is to evaluate the effect of stretching lower extremities amongst patients with back pain. The theoretical part deals with different kinds of stretching, guidelines and new methods of stretching. I focused on the stretching of the fascial structures and influencing shortened muscles using yoga exercises. I su...

  18. A window of opportunity for abatacept in RA: is disease duration an independent predictor of low disease activity/remission in clinical practice?

    Science.gov (United States)

    Harrold, Leslie R; Litman, Heather J; Connolly, Sean E; Kelly, Sheila; Hua, Winnie; Alemao, Evo; Rosenblatt, Lisa; Rebello, Sabrina; Kremer, Joel M

    2017-06-01

    The objective of the study was to examine whether disease duration independently predicts treatment response among biologic-naïve patients with rheumatoid arthritis (RA) initiating abatacept in clinical practice. Using the Corrona RA registry (February 2006-January 2015), biologic-naïve patients with RA initiating abatacept with 12-month (±3 months) follow-up and assessment of disease activity (Clinical Disease Activity Index [CDAI]) at initiation and at 12 months were identified. The primary outcome was mean change in CDAI (ΔCDAI) from baseline to 12 months. Secondary outcomes at 12 months included achievement of low disease activity (LDA; CDAI ≤10 in patients with moderate/high disease activity at initiation) and remission (CDAI ≤2.8 in patients with low, moderate or high disease activity at initiation). Linear and logistic regression analyses were performed to examine the relationship between disease duration and response to abatacept. There were 281 biologic-naïve patients with RA initiating abatacept (disease duration 0-2 years, n = 107; 3-5 years, n = 45; 6-10 years, n = 50; >10 years, n = 79). Increased disease duration was associated with older age (p = 0.047), and the median number of prior conventional disease-modifying antirheumatic drugs used was lowest in the 0- to 2-year duration group (p 10 years. In adjusted analyses, shorter disease duration was significantly associated with greater mean ΔCDAI (p = 0.015) and greater likelihood of achieving LDA (p = 0.048). In biologic-naïve patients with RA initiating abatacept, earlier disease (shorter disease duration) was associated with greater ΔCDAI and likelihood of achieving LDA.

  19. Keitel Functional Test for patients with rheumatoid arthritis: translation, reliability, validity, and responsiveness

    DEFF Research Database (Denmark)

    Holm, Bente; Jacobsen, S.; Skjodt, H.

    2008-01-01

    ) 15 patients with long-lasting (median=6 years) active RA, tested before and after 2, 6, and 14 weeks of anti-tumor necrosis factor alpha (TNF-alpha) inhibitor therapy, and (2) 35 patients with early (median=0.25 year) RA, tested at years 0, 0.5, 1, and 2. Twenty-three patients in the early RA group...

  20. Voice Improvement in Patients with Functional Dysphonia Treated with the Proprioceptive-Elastic (PROEL) Method.

    Science.gov (United States)

    Lucchini, E; Ricci Maccarini, A; Bissoni, E; Borragan, M; Agudo, M; González, M J; Romizi, V; Schindler, A; Behlau, M; Murry, T; Borragan, A

    2017-07-18

    The objective of the study was to analyze the outcome of the proprioceptive-elastic (PROEL) voice therapy method in patients with functional dysphonia (FD). Fifty-two patients with FD were involved in the study; they were composed of three subgroups of patients with (1) FD without glottal insufficiency (n = 28), (2) FD and glottal insufficiency (n = 9), and (3) FD, glottal insufficiency, and vocal nodules (n = 15). A multidimensional assessment protocol including videolaryngostroboscopy; maximum phonation time; perceptual evaluation of dysphonia with the Grade, Instability, Roughness, Breathiness, Asthenia, and Strain (GIRBAS) scale; and 10-item version of the Voice Handicap Index was conducted before and after 15 sessions of voice therapy. All voice therapy sessions were conducted by the same speech-language pathologist. The comparison between voice assessment before and after voice therapy with the PROEL method in patients with FD, in all the three subgroups, revealed a statistically significant improvement in periodicity and the mucosal wave in the laryngostroboscopy, maximum phonation time, GIRBAS scale scores, and VHI-10. Voice of patients with FD improved after treatment with the PROEL method. Further studies are needed to analyze the efficacy of the PROEL method with randomized double-blind clinical trials using different methods for voice therapy. At present, the PROEL method represents an alternative tool for the speech pathologist to improve voice in patients with FD. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. 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...

  2. Using Computational Approaches to Improve Risk-Stratified Patient Management: Rationale and Methods

    Science.gov (United States)

    Stone, Bryan L; Sakaguchi, Farrant; Sheng, Xiaoming; Murtaugh, Maureen A

    2015-01-01

    Background Chronic diseases affect 52% of Americans and consume 86% of health care costs. A small portion of patients consume most health care resources and costs. More intensive patient management strategies, such as case management, are usually more effective at improving health outcomes, but are also more expensive. To use limited resources efficiently, risk stratification is commonly used in managing patients with chronic diseases, such as asthma, chronic obstructive pulmonary disease, diabetes, and heart disease. Patients are stratified based on predicted risk with patients at higher risk given more intensive care. The current risk-stratified patient management approach has 3 limitations resulting in many patients not receiving the most appropriate care, unnecessarily increased costs, and suboptimal health outcomes. First, using predictive models for health outcomes and costs is currently the best method for forecasting individual patient’s risk. Yet, accuracy of predictive models remains poor causing many patients to be misstratified. If an existing model were used to identify candidate patients for case management, enrollment would miss more than half of those who would benefit most, but include others unlikely to benefit, wasting limited resources. Existing models have been developed under the assumption that patient characteristics primarily influence outcomes and costs, leaving physician characteristics out of the models. In reality, both characteristics have an impact. Second, existing models usually give neither an explanation why a particular patient is predicted to be at high risk nor suggestions on interventions tailored to the patient’s specific case. As a result, many high-risk patients miss some suitable interventions. Third, thresholds for risk strata are suboptimal and determined heuristically with no quality guarantee. Objective The purpose of this study is to improve risk-stratified patient management so that more patients will receive the

  3. DISEASE COPING STYLES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE OR RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Y. K. Galetskayte

    2013-01-01

    Full Text Available Objective: to study the types of response to illness in patients with chronic obstructive pulmonary disease (COPD or rheumatoid arthritis (RA.Subjects and methods. The sample consisted of 100 patients (mean age 59.2 ± 14.4 years from University Clinical Hospital One, I.M. Seche nov First Moscow State Medical University, 57 of whom were treated for RA and 43 were for COPD. All the patients were examined by a psychiatrist, a psychologist, and a therapist. The Beck Depression Inventory, SF-36 quality of life questionnaire, and projective psychological tests were also used.Results. Three main types of response to illness were identified. The features of aberrant hypochondria were most common in the patientswith COPD (53.3 % (23/43. In RA, hypochondriacal development as a confrontation with illness was intrinsic to a considerable proportion of patients (42.1 % (24/57. The common response was hypochondriacal neurosis (health anxiety, organ neurotic and omatoautonomic disorders that was encountered in 27 % (27/100 in the patients with COPD or RA and more common in those with RA (29.8 % (17/57. The examination revealed nosogenic depressive reactions in 19.2 % (11/57 of the patients with RA and in 9.3 % (4/43 of those with COPD.Conclusion. The main types of response to somatic illness in the two chronic diseases similar in their impact on quality of life have been investigated, which may be further used to manage this category of patients.

  4. DISEASE COPING STYLES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE OR RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Y. K. Galetskayte

    2014-07-01

    Full Text Available Objective: to study the types of response to illness in patients with chronic obstructive pulmonary disease (COPD or rheumatoid arthritis (RA.Subjects and methods. The sample consisted of 100 patients (mean age 59.2 ± 14.4 years from University Clinical Hospital One, I.M. Seche nov First Moscow State Medical University, 57 of whom were treated for RA and 43 were for COPD. All the patients were examined by a psychiatrist, a psychologist, and a therapist. The Beck Depression Inventory, SF-36 quality of life questionnaire, and projective psychological tests were also used.Results. Three main types of response to illness were identified. The features of aberrant hypochondria were most common in the patientswith COPD (53.3 % (23/43. In RA, hypochondriacal development as a confrontation with illness was intrinsic to a considerable proportion of patients (42.1 % (24/57. The common response was hypochondriacal neurosis (health anxiety, organ neurotic and omatoautonomic disorders that was encountered in 27 % (27/100 in the patients with COPD or RA and more common in those with RA (29.8 % (17/57. The examination revealed nosogenic depressive reactions in 19.2 % (11/57 of the patients with RA and in 9.3 % (4/43 of those with COPD.Conclusion. The main types of response to somatic illness in the two chronic diseases similar in their impact on quality of life have been investigated, which may be further used to manage this category of patients.

  5. Using Computational Approaches to Improve Risk-Stratified Patient Management: Rationale and Methods.

    Science.gov (United States)

    Luo, Gang; Stone, Bryan L; Sakaguchi, Farrant; Sheng, Xiaoming; Murtaugh, Maureen A

    2015-10-26

    Chronic diseases affect 52% of Americans and consume 86% of health care costs. A small portion of patients consume most health care resources and costs. More intensive patient management strategies, such as case management, are usually more effective at improving health outcomes, but are also more expensive. To use limited resources efficiently, risk stratification is commonly used in managing patients with chronic diseases, such as asthma, chronic obstructive pulmonary disease, diabetes, and heart disease. Patients are stratified based on predicted risk with patients at higher risk given more intensive care. The current risk-stratified patient management approach has 3 limitations resulting in many patients not receiving the most appropriate care, unnecessarily increased costs, and suboptimal health outcomes. First, using predictive models for health outcomes and costs is currently the best method for forecasting individual patient's risk. Yet, accuracy of predictive models remains poor causing many patients to be misstratified. If an existing model were used to identify candidate patients for case management, enrollment would miss more than half of those who would benefit most, but include others unlikely to benefit, wasting limited resources. Existing models have been developed under the assumption that patient characteristics primarily influence outcomes and costs, leaving physician characteristics out of the models. In reality, both characteristics have an impact. Second, existing models usually give neither an explanation why a particular patient is predicted to be at high risk nor suggestions on interventions tailored to the patient's specific case. As a result, many high-risk patients miss some suitable interventions. Third, thresholds for risk strata are suboptimal and determined heuristically with no quality guarantee. The purpose of this study is to improve risk-stratified patient management so that more patients will receive the most appropriate care

  6. The portfolio method as management support for patients with major depression.

    Science.gov (United States)

    Nunstedt, Håkan; Nilsson, Kerstin; Skärsäter, Ingela

    2014-06-01

    To describe how patients with major depression in psychiatric outpatient care use the portfolio method and whether the method helps the patients to understand their depression. Major depressive disorder is an increasing problem in society. Learning about one's depression has been demonstrated to be important for recovery. If the goal is better understanding and management of depression, learning must proceed on the patient's own terms, based on the patient's previous understanding of their depression. Learning must be aligned with patient needs if it is to result in meaningful and useful understanding. Each patient's portfolio consisted of a binder. Inside the binder, there was a register with predetermined flaps and questions. The patients were asked to work with the questions in the sections that built the content in the portfolio. Individual interviews with patients (n = 5) suffering from major depression according to Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) (American Psychiatric Association 1994) were repeatedly conducted between April 2008 and August 2009 in two psychiatric outpatient clinics in western Sweden. Data were analysed using latent content analysis. The results showed that the portfolio was used by patients as a management strategy for processing and analysis of their situation and that a portfolio's structure affects its usability. The patients use the portfolio for reflection on and confirmation of their progress, to create structure in their situation, as a management strategy for remembering situations and providing reminders of upcoming activities. Using a clearly structured care portfolio can enable participation and patient learning and help patients understand their depression. The portfolio method could provide a tool in psychiatric nursing that may facilitate patient understanding and increase self-efficacy. © 2013 John Wiley & Sons Ltd.

  7. Changes in hand and generalised bone mineral density in patients with recent-onset rheumatoid arthritis

    NARCIS (Netherlands)

    Guler-Yuksel, M.; Allaart, C.F.; Goekoop-Ruiterman, Y.P.; Bouwstra, J.K.; Groenendael, J.H.L.M.; Mallee, C.; Bois, de M.H.W.; Breedveld, F.C.; Dijkmans, B.A.C.; Lems, W.F.

    2009-01-01

    Objectives: To evaluate changes in bone mineral density (BMD) in the hands, hip and spine after 1 and 2 years of follow-up, in relation to antirheumatic and antiresorptive therapies and disease and demographic variables in patients with recent-onset rheumatoid arthritis ( RA). Methods: Changes in

  8. Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Brouwer, S.J.M. de; Kraaimaat, F.W.; Sweep, F.C.; Donders, A.R.T.; Eijsbouts, A.; Koulil, S. van; Riel, P.L.C.M. van; Evers, A.W.M.

    2011-01-01

    BACKGROUND: Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA). METHODS: Seventy-four

  9. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Sørensen, Jan; Hetland, Merete Lund

    2015-01-01

    ) and ankylosing spondylitis (AS) changed from year 2000 to 2011. METHODS: Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13,721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset...

  10. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Sørensen, Jan; Hetland, Merete Lund

    2014-01-01

    ) and ankylosing spondylitis (AS) changed from year 2000 to 2011. METHODS: Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13 721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset...

  11. Treatment of pregnant and non-pregnant rheumatic patients : a survey among Dutch rheumatologists

    NARCIS (Netherlands)

    Vroom, F.; van de Laar, M. A. J. F.; van Roon, E. N.; Brouwers, J. R. B. J.; den Berg, L. T. W. de Jong-van

    2008-01-01

    Background: The aim of this study was to explore, among Dutch rheumatologists, aspects such as attitude towards guidelines, pharmacotherapy and information needs in the treatment of pregnant as well as non-pregnant rheumatoid arthritis (RA) patients. Methods: Fifteen rheumatologists from nine

  12. Treatment of pregnant and non-pregnant rheumatic patients: a survey among Dutch rheumatologists

    NARCIS (Netherlands)

    Vroom, F.; van de Laar, Mart A F J; van Roon, E.N.; Brouwers, J.R.B.J.; de Jong-van den Berg, L.T.W.

    2008-01-01

    Background: The aim of this study was to explore, among Dutch rheumatologists, aspects such as attitude towards guidelines, pharmacotherapy and information needs in the treatment of pregnant as well as non-pregnant rheumatoid arthritis (RA) patients. - Methods: Fifteen rheumatologists from nine

  13. A 588-gene microarray analysis of the peripheral blood mononuclear cells of spondyloarthropathy patients

    NARCIS (Netherlands)

    Gu, J.; Märker-Hermann, E.; Baeten, D.; Tsai, W. C.; Gladman, D.; Xiong, M.; Deister, H.; Kuipers, J. G.; Huang, F.; Song, Y. W.; Maksymowych, W.; Kalsi, J.; Bannai, M.; Seta, N.; Rihl, M.; Crofford, L. J.; Veys, E.; de Keyser, F.; Yu, D. T. Y.

    2002-01-01

    OBJECTIVES: To identify genes which are more highly expressed in the peripheral blood mononuclear cells (PBMC) of patients with spondyloarthropathy (SpA), rheumatoid arthritis (RA) and psoriatic arthritis (PsA), in comparison to normal subjects. METHODS: A 588-gene microarray was used as a screening

  14. Relevance of the new pre-cachexia and cachexia definitions for patients with rheumatoid arthritis

    NARCIS (Netherlands)

    van Bokhorst-de van der Schueren, M.A.E.; Konijn, N.P.C.; Bultink, I.E.M.; Lems, W.F.; Earthman, C.P.; van Tuyl, H.D.

    2012-01-01

    Background & aims: The recently proposed definitions of 'pre-cachexia' and 'cachexia' might offer new possibilities for the detection of malnutrition in patients with rheumatoid arthritis (RA). Methods: The prevalence of different components of nutritional status and the compiled definitions of

  15. Forefoot disease activity in rheumatoid arthritis patients in remission: results of a cohort study

    NARCIS (Netherlands)

    van der Leeden, M.; Steultjens, M.P.M.; van Schaardenburg, D.; Dekker, J.

    2010-01-01

    Introduction: The aim of our study was to investigate the presence of disease activity in the metatarsophalangeal (MTP) joints of the forefoot in rheumatoid arthritis (RA) patients in remission according to the Disease Activity Score based on 28 joints (DAS28) remission criterion.Methods: A total of

  16. Impact of foliage on LoRa 433MHz propagation in tropical environment

    Science.gov (United States)

    Ahmad, Khairol Amali; Salleh, Mohd Sharil; Segaran, Jivitraa Devi; Hashim, Fakroul Ridzuan

    2018-02-01

    LoRa is being considered as one of the promising system for Low-Power-Wide-Area-Network (LPWAN) to support the growth of Internet of Things (IoT) applications. Designed to operate in the industrial, scientific and medical (ISM) bands, LoRa had been tested and evaluated mainly in Europe and US in the 868 MHz and 915 MHz modulation bands. Using chirp spread spectrum technology, LoRa is expected to be robust against degredation. This paper provides some early results in the performance of LoRa signal propagation of 433 MHz modulation in tropical foliage environments.

  17. Tracking suspended particle transport via radium isotopes ((226)Ra and (228)Ra) through the Apalachicola-Chattahoochee-Flint River system.

    Science.gov (United States)

    Peterson, Richard N; Burnett, William C; Opsahl, Stephen P; Santos, Isaac R; Misra, Sambuddha; Froelich, Philip N

    2013-02-01

    Suspended particles in rivers can carry metals, nutrients, and pollutants downstream which can become bioactive in estuaries and coastal marine waters. In river systems with multiple sources of both suspended particles and contamination sources, it is important to assess the hydrologic conditions under which contaminated particles can be delivered to downstream ecosystems. The Apalachicola-Chattahoochee-Flint (ACF) River system in the southeastern United States represents an ideal system to study these hydrologic impacts on particle transport through a heavily-impacted river (the Chattahoochee River) and one much less impacted by anthropogenic activities (the Flint River). We demonstrate here the utility of natural radioisotopes as tracers of suspended particles through the ACF system, where particles contaminated with arsenic (As) and antimony (Sb) have been shown to be contributed from coal-fired power plants along the Chattahoochee River, and have elevated concentrations in the surficial sediments of the Apalachicola Bay Delta. Radium isotopes ((228)Ra and (226)Ra) on suspended particles should vary throughout the different geologic provinces of this river system, allowing differentiation of the relative contributions of the Chattahoochee and Flint Rivers to the suspended load delivered to Lake Seminole, the Apalachicola River, and ultimately to Apalachicola Bay. We also use various geochemical proxies ((40)K, organic carbon, and calcium) to assess the relative composition of suspended particles (lithogenic, organic, and carbonate fractions, respectively) under a range of hydrologic conditions. During low (base) flow conditions, the Flint River contributed 70% of the suspended particle load to both the Apalachicola River and the bay, whereas the Chattahoochee River became the dominant source during higher discharge, contributing 80% of the suspended load to the Apalachicola River and 62% of the particles entering the estuary. Neither of these hydrologic

  18. [The choice of the method for body temperature measurement in intensive care patients: a literature review].

    Science.gov (United States)

    Peron, Paolo

    2010-01-01

    Measuring body temperature in intensive care patients is a routine nursing task, but there is no common practice regarding the site of measurement. to identify which method is most suitable and therefore advisable in critical patients the available databases were consulted and the pertinent literature was reviewed. many studies have been performed regarding the different methods, more or less invasive, of body temperature monitoring and their accuracy, reliability and patient tolerability . in the literature , it is agreed that the gold standard site for body temperature measurement is the pulmonary, femoral or brachial artery but that further studies are necessary in this field.

  19. Determining emergency physicians' and nurses' views concerning older patients: a mixed-method study.

    Science.gov (United States)

    Bulut, Hulya; Yazici, Gulay; Demircan, Ahmet; Keles, Ayfer; Guler Demir, Sevil

    2015-04-01

    The number of elderly patients presenting to emergency services is gradually increasing. Given that the needs of older patients differ from those of other patients, the quality of emergency care for this patient group also varies. This mixed-method study aimed to reveal the views of emergency service staff concerning ageing and elderly patients. Participants were 19 physicians and 17 nurses employed by the adult emergency service of a university hospital. Data were gathered using questionnaires and focus group interviews. Frequency and percentages were used to evaluate quantitative data. Open-ended questions used to gather quantitative data were analysed using thematic analysis and four themes (including understanding older patients' situations, good nursing care and medical treatment, affecting good nursing care and medical treatment, emotions experienced) were determined. Emergency department staff identified older patients as dependent individuals requiring health care. Nurses indicated that good care for older patients included ensuring that their physical, social, and psychological needs were met; whereas, physicians identified good treatment as improving the quality of life. Impediments to the care and treatment of older patients were identified as staff shortages, emergency service crowding, and lack of proper training for emergency department staff. Emergency department staff also indicated that they experienced weariness and exhaustion while providing health care for older patients. Emergency nurses and physicians were aware of older patients and their needs but experienced difficulties regarding patient density, physical settings, staff shortages, and a lack of training. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Mannose binding lectin and susceptibility to rheumatoid arthritis in Brazilian patients and their relatives.

    Directory of Open Access Journals (Sweden)

    Isabela Goeldner

    Full Text Available INTRODUCTION: Rheumatoid arthritis (RA is a commonly occurring systemic inflammatory auto immune disease and is believed to be associated with genetic factors. The innate immune complement protein Mannose binding lectin (MBL and their MBL2 genetic variants are associated with different infectious and autoimmune diseases. METHODS: In a Brazilian cohort, we aim to associate the functional role of circulating MBL serum levels and MBL2 variants in clinically classified patients (n = 196 with rheumatoid arthritis including their relatives (n = 200 and ethnicity matched healthy controls (n = 200. MBL serum levels were measured by ELISA and functional MBL2 variants were genotyped by direct sequencing. RESULTS: The exon1+54 MBL2*B variant was significantly associated with an increased risk and the reconstructed haplotype MBL2*LYPB was associated with RA susceptibility. Circulating serum MBL levels were observed significantly lower in RA patients compared to their relatives and controls. No significant contribution of MBL levels were observed with respect to functional class, age at disease onset, disease duration and/or other clinical parameters such as nodules, secondary Sjögren syndrome, anti-CCP and rheumatoid factor. Differential distribution of serum MBL levels with functional MBL2 variants was observed in respective RA patients and their relatives. CONCLUSIONS: Our results suggest MBL levels as a possible marker for RA susceptibility in a Brazilian population.

  1. Nutritional assessment in surgical oncology patients: a comparative analysis between methods.

    Science.gov (United States)

    Cunha, Carla de Magalhães; Sampaio, Ethiane de Jesus; Varjão, Maria Lúcia; Factum, Clarissa Simon; Ramos, Lilian Barbosa; Barreto-Medeiros, Jairza Maria

    2014-11-01

    The malnutrition found in oncology patients is the main responsible for the increase in morbimortality and worsening of their quality of life. Currently, the assessment of malnutrition is performed by subjective and objective methods, or the combination of them. Although these methods are routinely applied and their association is very common in clinical practice, there are few studies on the agreement between them. Thereby, this study aims to compare different methods for nutritional status assessment in surgical oncology patients. 173 oncology patients, admitted for surgery, were submitted to an anthropometric evaluation and answered a SGA, PG-SGA and NRS-2002. Kappa test was used to evaluated the level of concordance between the methods. Poor concordance were observed between BMI and NRS-2002 (K=0,286), SGA (K=0,372) and PGSGA (K=0,173). Among the subjective methods, the best results were found for SGA and PG-SGA (K=0,690), and the lowest between NRS-2002 and both others (SGA: K=0,345; PG-SGA: K=0,322). The poor concordance found between objective and subjective methods reinforces the importance of associating indicators in the nutritional assessment of this population Despite of the poor concordance found between the nutritional status assessment methods investigated in this study, patients who had greater depletion of body stores were also diagnosed with a higher degree of malnutrition by subjective methods. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  2. Multicentre evaluation of a novel vaginal dose reporting method in 153 cervical cancer patients

    DEFF Research Database (Denmark)

    Westerveld, Henrike; de Leeuw, Astrid; Kirchheiner, Kathrin

    2016-01-01

    Background and purpose Recently, a vaginal dose reporting method for combined EBRT and BT in cervical cancer patients was proposed. The current study was to evaluate vaginal doses with this method in a multicentre setting, wherein different applicators, dose rates and protocols were used. Materia...

  3. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing

    NARCIS (Netherlands)

    Ramamurthy, S.; D'Orsi, C.J.; Sechopoulos, I.

    2016-01-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360 degrees with a

  4. An exploratory study of microbial diversity in sinus infections of cystic fibrosis patients by molecular methods

    DEFF Research Database (Denmark)

    Rudkjøbing, Vibeke Børsholt; Aanaes, Kasper; Wolff, Tine Yding

    2014-01-01

    BACKGROUND: For the first time microorganisms in CF sinuses are investigated by molecular methods in response to an absence of anaerobes in CF sinus samples during a two-year period at the Copenhagen CF center. METHODS: Endoscopic sinus surgery was performed in 19 CF patients. DNA from intact...

  5. Measurement by liquid scintillation of {sup 226} Ra coprecipitated in BaSO{sub 4}; Medicion por centelleo liquido de {sup 226} Ra coprecipitado en BaSO{sub 4}

    Energy Technology Data Exchange (ETDEWEB)

    Lopez del Rio, H.; Davila R, J.I.; Badillo A, V.E.; Mireles G, F.; Quirino T, L.; Lugo R, J.F.; Pinedo V, J.L.; Rios M, C. [UAEN-UAZ, A.P. 579C, Cipres 10, Fracc. La Penuela, 98068 Zacatecas (Mexico)]. e-mail: idavila@cantera.reduaz.mx

    2003-07-01

    The {sup 226} Ra is one of the more radio toxic nuclides since when entering to the organism it continues metabolically to the calcium, accumulating mainly in the bone tissue where it becomes in an internal radiation source. For the analysis of radium in water the methods of radon emanation are generally applied and coprecipitation with barium sulfate. This last is quick and efficient, and the radium in the precipitate can be measured by alpha or gamma spectrometry, or liquid scintillation dissolving the precipitate one with EDTA. In this work it is proposed a procedure for the radium measurement in water based on the coprecipitation with barium sulfate and in the detection by liquid scintillation. The precipitate of Ba(Ra)SO{sub 4} it is carried with water and blended with the liquid scintillator OptiPhase Hi Safe 3, avoiding the dissolution with EDTA. A 92{+-} 1.4% of radium it was recovered and it was reached a minimum activity detectable of 4.2 {+-} 0.9 mBq{sup -1}. The procedure was essayed with natural mineral water with a knew activity in concentration of {sup 226} Ra. The analytic result it coincided with the reported value with a relative error of 9%. (Author)

  6. Determination of {sup 226}Ra by gamma spectrometry: study of packaging vial of sample for analysis; Determinacao de {sup 226}Ra por espectrometria gama: estudo do recipiente de acondicionamento de amostra para analise

    Energy Technology Data Exchange (ETDEWEB)

    Carneiro, Andre Cavalcanti

    2015-07-01

    Determination of radioactivity levels of {sup 226}Ra by gamma spectrometry in a sample is based on measurements of {sup 214}Pb and {sup 214}Bi, daughters of {sup 222}Rn. Because radon is a gas, it can leak from the sample vial or accumulate on the upper empty it. If the vial has any crack, there will be loss of gas, which will cause error in determining the {sup 226}Ra concentration. One possible cause of cracks in the vials, that houses standards and samples, is the radiolysis action in the vial material, usually a polymer. As the demand {sup 226}Ra analysis in different matrices (geological samples, food, plants, etc.) is increasing, it was decided to study some polymer vials available on the market, to verify the feasibility to be used when is applied the analysis method using gamma spectrometry. Four types of polymer vials have been studied. The radiation doses in walls of the vials caused by natural radionuclides present in the sample were simulated using gamma irradiation. Tests, such as compressive strength test and tightness, were applied to the irradiated and non-irradiated vials. First, to verify the effect of radiolysis on the vial material and also if there was {sup 222}Rn diffusion in their walls. These preliminary results pointed out that the acrylic vials are the best option of packaging samples for analysis. This study should be repeated in a larger number of samples for a better evaluation. (author)

  7. Ultrasound colour Doppler is associated with synovial pathology in biopsies from hand joints in rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Andersen, Martin; Ellegaard, Karen; Hebsgaard, Josephine B

    2014-01-01

    OBJECTIVES: Little is known regarding the association between ultrasound-determined pathological synovial blood flow and synovial pathology in rheumatoid arthritis (RA). We therefore examined the association between colour Doppler ultrasound imaging and synovitis assessed by histopathology...... and specific cell markers by immunohistochemistry in patients with RA. METHODS: 81 synovial sites from wrist and finger joints from 29 RA patients were evaluated by ultrasound colour Doppler and subsequently biopsied by needle arthroscopy. The association between ultrasound colour fraction and an overall......-3). Data were clustered within patients, thus a linear mixed model was applied for the statistical tests. Parsimony in the statistical models was achieved omitting covariates from the model in the case of what was judged no statistical significance (p>0.1). RESULTS: Doppler colour fraction showed...

  8. Prognostic value of anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis.

    Science.gov (United States)

    Kuru, Omer; Bilgici, Ayhan; Birinci, Asuman; Ulusoy, Hasan; Durupinar, Belma

    2009-01-01

    To determine the predictive value for radiological damage of anti-cyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) in patients with rheumatoid arthritis (RA). Ninety patients with RA were enrolled in this study. All patients had symptom duration of at least one year. Anti-CCP and IgM-RF were evaluated with enzyme linked immunosorbent assay and nephelometry methods, respectively. Radiological damage was assessed by Larsen score. In forward stepwise logistic regression analysis, anti-CCP positivity and RF positivity were seen as significant independent predictors of the radiological outcomes (p = 0.01, p treatment in RA (Tab. 4, Ref. 37). Full Text (Free, PDF) www.bmj.sk.

  9. Longitud de las raíces cervicales en resonancia magnética: relación con la parálisis postoperatoria de la quinta raíz cervical Medida do comprimento das raízes cervicais pela ressonância magnética: relação com a paralisia pós-operatória e a quinta raiz cervical Cervical nerve root length in magnetic resonance imaging: its relationship with postoperative fifth root palsy

    Directory of Open Access Journals (Sweden)

    Juan José Mezzadri

    2010-03-01

    Full Text Available OBJETIVO: determinar la longitud de la raíz C5. MÉTODOS: se estudiaron con resonancia magnética (Signa 1,5 T, cortes axiales de 5 mm de espesura, TR=850, TE=26, FOV=200 las columnas cervicales de 50 pacientes (29 hombres - 21 mujeres entre 26 y 68 años. Se incluyeron solo casos con cervicalgia y/o cervicobraquialgia. Se midió (en mm la longitud de las raíces cervicales tercera a séptima, derechas e izquierdas. La comparación de los promedios se realizó a través del análisis de varianza, para un nivel de significación α=0,05 con IC de 95%. Las comparaciones post-hoc se hicieron empleando el test de Bonferroni. RESULTADOS: se observó que el lado (derecho o izquierdo y el sexo (varón o mujer no tuvieron incidencia estadísticamente significativa en el valor de la longitud de las raíces (p>0,05. La raíz C5 tuvo un tamaño significativamente diferente (pOBJETIVO: determinar o comprimento da raiz C5. MÉTODOS: as colunas cervicais de 50 pacientes (29 homens - 21 mulheres, com idades entre 26 e 68 anos foram analisadas com ressonância magnética (Signa 1,5 T, cortes axiais de 5 mm de espessura, TR=850, TE=26, FOV=200. Foram incluídos casos com dor cervical e/ou cervicobraquial. O comprimento das raízes C3 a C7, à direita e esquerda, foi medido. A comparação das médias foi realizada com uma análise de variância para um nível de significação α = 0,05 com IC de 95%. As comparações post-hoc foram feitas com o teste de Bonferroni. RESULTADOS: foi observado que o lado (direito ou esquerdo e o sexo (homem ou mulher não tiveram incidência estatística significante em relação ao valor do comprimento das raízes. A raiz C5 evidenciou um tamanho significativamente diferente (pOBJECTIVE: to determine the length of the C5 root. METHODS: the cervical spines of 50 patients (29 male and 21 female, between 26 and 68 years old, were studied with magnetic resonance imaging (Signa 1.5 T, axial images with 5 mm thickness, TR=850, TE=26

  10. Engaging patients with heart failure into the design of health system interventions: Impact on research methods.

    Science.gov (United States)

    Newhouse, Robin P; Johantgen, Meg; Thomas, Sue A; Trocky, Nina M; Dennison-Himmelfarb, Cheryl; Cheon, Jooyoung; Miller, Wanda; Gray, Tracy; Pruitt, Robin

    The purpose of this study was to engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. A qualitative structured interview was conducted with eight patients with a diagnosis of HF admitted to two rural hospitals. Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Results validated that the intervention, methods and outcomes for the planned study were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of research is essential to guide patient-centered studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Monitoring patients treated with anti-TNF-alpha biopharmaceuticals: assessing serum infliximab and anti-infliximab antibodies

    DEFF Research Database (Denmark)

    Svenson, M; Geborek, P; Saxne, T

    2007-01-01

    Infliximab is an anti-tumour necrosis factor-alpha (TNF-alpha) mouse-human IgG1/kappa antibody used to treat patients with rheumatoid arthritis (RA) and other inflammatory diseases. Unfortunately, response failure and side-effects due to immunogenicity of the drug are not rare. In this study, we...... have compared different methods of assessing drug levels and anti-infliximab antibodies (Abs) and analysed the character of these Abs in sera of RA patients treated with infliximab for 1.5-18 months....

  12. Genetic Variation in the TLR5 Locus Is Associated with Anti-TNF Response Among Rheumatoid Arthritis Patients

    DEFF Research Database (Denmark)

    Sode, Jacob

    2014-01-01

    Background/Purpose: In a recent study (paper in press) of Danish rheumatoid arthritis (RA) patients we found single nucleotide polymorphisms (SNPs) in the NLRP3 and interferon-γ genes to be associated with response to tumor necrosis factor a inhibitors (anti-TNF). The aim of this study...... was to extend and corroborate these associations by analyzing a new set of functional polymorphisms in the NLRP3-inflammasome and interferon-γ pathways in RA patients treated with anti-TNF. Methods: Twenty-three functional single nucleotide polymorphisms (SNPs) in 14 genes involved in the inflammasome...

  13. A computer program integrating a multichannel analyzer with gamma analysis for the estimation of {sup 226} Ra concentration in soil samples

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, J. E.

    1992-08-01

    A new hardware/software system has been implemented using the existing three-regions-of-interest method for determining the concentration of {sup 226}Ra in soil samples for the Pollutant Assessment Group of the Oak Ridge National Laboratory. Consisting of a personal computer containing a multichannel analyzer, the system utilizes a new program combining the multichannel analyzer with a program analyzing gamma-radiation spectra for {sup 226}Ra concentrations. This program uses a menu interface to minimize and simplify the tasks of system operation.

  14. A computer program integrating a multichannel analyzer with gamma analysis for the estimation of sup 226 Ra concentration in soil samples

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, J. E.

    1992-08-01

    A new hardware/software system has been implemented using the existing three-regions-of-interest method for determining the concentration of {sup 226}Ra in soil samples for the Pollutant Assessment Group of the Oak Ridge National Laboratory. Consisting of a personal computer containing a multichannel analyzer, the system utilizes a new program combining the multichannel analyzer with a program analyzing gamma-radiation spectra for {sup 226}Ra concentrations. This program uses a menu interface to minimize and simplify the tasks of system operation.

  15. Coping methods to stress among patients on hemodialysis and peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Kobra Parvan

    2015-01-01

    Full Text Available Dialysis patients need to deal and cope with various aspects of their disease. Identifying the adaptation methods provides valuable information for planning specific treatment and medical care delivery and improving the performance of medical teams. The present study aims to evaluate the coping strategies to stress among patients undergoing hemodialysis (HD and peritoneal dialysis (PD at the Imam Reza Educational-Medical Hospital, Tabriz, West Azarbaijan, Iran. This descriptive and analytical study was conducted on 70 patients in the year 2012. The subjects were selected through census method and simple random sampling method. Data were collected using a customized questionnaire and consisted of demographic information and the Jalowiec Coping Scale (JCS through a structured interview. Descriptive and inferential statistics were used to analyze the data in SPSS (version 13. The mean score of frequency of use of the coping strategy as "sometimes used" for the HD patients was 70.94 ± 18.91 and also for PD patients as "seldom used" was 58.70 ± 12.66. The mean score of helpfulness of coping strategies in the HD group was 49.57 ± 19.42 as "slightly helpful", whereas in the PD group it was 37.21 ± 14.38 as "slightly helpful" Furthermore, both groups used the emotion-oriented coping styles more frequently than the problem-oriented methods. HD patients used coping methods more frequently than the PD patients. The majority of patients used emotion-oriented coping strategies to deal with stress factors. Use of educational, counseling and supportive programs to assist in coping techniques can facilitate the coping process with stress factors in dialysis patients.

  16. Coping methods to stress among patients on hemodialysis and peritoneal dialysis.

    Science.gov (United States)

    Parvan, Kobra; Ahangar, Ronak; Hosseini, Fahimeh Alsadat; Abdollahzadeh, Farahnaz; Ghojazadeh, Morteza; Jasemi, Madineh

    2015-03-01

    Dialysis patients need to deal and cope with various aspects of their disease. Identifying the adaptation methods provides valuable information for planning specific treatment and medical care delivery and improving the performance of medical teams. The present study aims to evaluate the coping strategies to stress among patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) at the Imam Reza Educational-Medical Hospital, Tabriz, West Azarbaijan, Iran. This descriptive and analytical study was conducted on 70 patients in the year 2012. The subjects were selected through census method and simple random sampling method. Data were collected using a customized questionnaire and consisted of demographic information and the Jalowiec Coping Scale (JCS) through a structured interview. Descriptive and inferential statistics were used to analyze the data in SPSS (version 13). The mean score of frequency of use of the coping strategy as "sometimes used" for the HD patients was 70.94 ± 18.91 and also for PD patients as "seldom used" was 58.70 ± 12.66. The mean score of helpfulness of coping strategies in the HD group was 49.57 ± 19.42 as "slightly helpful", whereas in the PD group it was 37.21 ± 14.38 as "slightly helpful" Furthermore, both groups used the emotion-oriented coping styles more frequently than the problem-oriented methods. HD patients used coping methods more frequently than the PD patients. The majority of patients used emotion-oriented coping strategies to deal with stress factors. Use of educational, counseling and supportive programs to assist in coping techniques can facilitate the coping process with stress factors in dialysis patients.

  17. Validating Rheumatoid Arthritis Remission Using the Patients' Perspective

    DEFF Research Database (Denmark)

    Rasch, Linda A; Boers, Maarten; Hill, Catherine L

    2017-01-01

    presented. Selected instruments significantly correlated with the Disease Activity Score in 28 joints (construct validity) and all instruments except 1 discriminated between patients in and patients not in remission. The subsequent discussion mainly focused around 3 points: (1) the formulation of patient......OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) working group on the patients' perspective on remission in rheumatoid arthritis (RA) has been working on this topic since 2010. At OMERACT 2016, progress and preliminary data on validity of measurement instruments for pain, fatigue......, and independence in remission in RA were presented, and future directions were explored. METHODS: A special interest group was organized, in which the current data on the patients' perspective on remission were presented. The ongoing study that aimed to validate measurement instruments for pain, fatigue...

  18. The development of a method for assessing the quality of life of cancer patients.

    Science.gov (United States)

    Selby, P. J.; Chapman, J. A.; Etazadi-Amoli, J.; Dalley, D.; Boyd, N. F.

    1984-01-01

    Although the need for a method of measuring the quality of life of patients undergoing therapy for cancer has been widely recognised, no adequately evaluated or feasible method has been established. We describe a method in which 31 items were assessed by patient self report using linear analogue scales. Eighteen items inquiring about general health problems were derived from the Sickness Impact Profile, an established method of assessing the effect of health upon behaviour and function. Thirteen items inquiring about major problems associated with breast cancer were derived from clinical experience and the opinions of patients with this disease. Each item of the measurement method (instrument) has been evaluated for content, feasibility, reliability and validity by methods that are widely used in psychometry but less familiar in medicine. It appeared easy to use, acceptable and reliable in these assessment. Validity was evaluated indirectly since no standard measurements of quality of life exist for comparison. Most items appeared valid when compared to alternative measurement methods including the Sickness Impact Profile and evaluation by a physician in a structured interview. The correlations between items in the instrument were analysed by factor analysis and seemed to fit with the clinical features of breast cancer. The method distinguished between clinically distinct groups of patients and detected changes with time. The study illustrates the possible approaches to the scientific evaluation of methods for measuring subjective features of patients lives. This method appears suitable for some purposes to measure quality of life in breast cancer and is intended to be flexible enough to be modified for other diseases. However, further evaluation, development and refinement will be needed before routine clinical application can be recommended. PMID:6743512

  19. Volume adjustment of lung density by computed tomography scans in patients with emphysema

    DEFF Research Database (Denmark)

    Shaker, S B; Dirksen, A; Laursen, Lars Christian

    2004-01-01

    PURPOSE: To determine how to adjust lung density measurements for the volume of the lung calculated from computed tomography (CT) scans in patients with emphysema. MATERIAL AND METHODS: Fifty patients with emphysema underwent 3 CT scans at 2-week intervals. The scans were analyzed with a software...... package that detected the lung in contiguous images and subsequently generated a histogram of the pixel attenuation values. The total lung volume (TLV), lung weight, percentile density (PD), and relative area of emphysema (RA) were calculated from this histogram. RA and PD are commonly applied measures...... of pulmonary emphysema derived from CT scans. These parameters are markedly influenced by changes in the level of inspiration. The variability of lung density due to within-subject variation in TLV was explored by plotting TLV against PD and RA. RESULTS: The coefficients for volume adjustment for PD were...

  20. Preserved skeletal muscle protein anabolic response to acute exercise and protein intake in well-treated rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Mikkelsen, Ulla Ramer; Dideriksen, Kasper; Andersen, Mads Bisgaard

    2015-01-01

    and anabolic signaling response in patients with RA compared to healthy controls. METHODS: Thirteen RA patients (age range 34-84 years; diagnosed for 1-32 years, median 8 years) were individually matched with 13 healthy controls for gender, age, BMI and activity level (CON). Plasma levels of C-reactive protein...... of genes related to inflammatory signaling, myogenesis and muscle growth/atrophy were analyzed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: CRP was significantly higher in the RA patients (2.25 (0.50) mg/l) than in controls (1.07 (0.25) mg/l; p = 0.038) and so was TNF......-α (RA 1.18 (0.30) pg/ml vs. CON 0.64 (0.07) pg/ml; p = 0.008). Muscle myofibrillar protein synthesis in both RA patients and CON increased in response to PROT and PROT + EX, and even more with PROT + EX (p 0.05). The gene expression response was largely...

  1. Serum levels of IL-17, IL-4, and INFγ in Serbian patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Voja Pavlovic

    2014-01-01

    Full Text Available Background: Rheumatoid arthritis (RA is a chronic, systemic, inflammatory disease with autoimmune etiology, characterized by synovial inflammation and destruction of joint cartilage and bone. There are controversial data about the profile of interleukin-17 (IL-17A, interleukin-4 (IL-4, and interferon-gamma (INFγ, indicating in some studies the key role of IL-17, while in others the Th1 cytokines. Materials and Methods: Serum samples of 31 early RA patients were evaluated for erythrocytes sedimentation rate (ESR, rheumatoid factor (RF, C-reactive protein (CRP, anti-cyclic citrullinated peptide antibodies (anti-CCP, and for the tested cytokines (IL-17A, IL-4, and INFγ. Disease activity score (DAS28 calculation was done for all patients. Control serum samples were obtained from 29 healthy volunteers. Results: The levels of tested cytokines were significantly higher (IL-17A, p < 0.001; INFγ, p < 0.001; IL-4, p < 0.01 in patients with early RA, compared to the healthy controls. In early RA patients, a strong correlation of serum IL-17A was found with DAS28, ESR, and CRP. Also, significant negative correlation was found between serum INFγ levels and the DAS28 score, indicating that INFγ may play a key role in maintaining immune homeostasis in patients with RA. Conclusion: The mean serum IL-17A levels in patients with early RA, corresponded with the disease activity and severity. This might highlight the usefulness of the serum IL-17A level in defining the activity and predictive patterns, for aggressive disease therapy, and it might express specific therapeutically targets.

  2. Effectiveness of Different Pain Control Methods in Patients with Knee Osteoarthritis after Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Jin-Lain Ming

    2017-01-01

    Full Text Available The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n=120 and patient-controlled analgesia (PCA Group 2 (n=57 according to the treatment methods they received. All patients experience the highest pain level on the day of their surgery; women complained of higher pain levels than men did, while the PCA group had lower postoperative pain. Meanwhile, patients with general anesthesia experienced more pain than those with spinal anesthesia in postoperative period. Patients with a higher postoperative pain index have a smaller optimal knee flexion angle. The PCA group had lower postoperative pain; all patients experienced the highest pain level on the day of their surgery. The results of this study could serve as a reference for nurses where PCA ensures a better postoperative pain control and therefore facilitates recovery and improves the quality of nursing.

  3. Patient Safety Incidents Involving Sick Children in Primary Care in England and Wales: A Mixed Methods Analysis

    National Research Council Canada - National Science Library

    Rees, Philippa; Edwards, Adrian; Powell, Colin; Hibbert, Peter; Williams, Huw; Makeham, Meredith; Carter, Ben; Luff, Donna; Parry, Gareth; Avery, Anthony; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew

    2017-01-01

    .... Methods and Findings We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning...

  4. Adipose-derived mesenchymal stem cells from infrapatellar fat pad of patients with rheumatoid arthritis and osteoarthritis have comparable immunomodulatory properties.

    Science.gov (United States)

    Skalska, Urszula; Kontny, Ewa

    2016-01-01

    Adipose-derived mesenchymal stem cells (ASCs) possess immunosuppressive properties, but their activity is dependent on stimuli provided by local environment. It is possible that proinflammatory milieu of rheumatoid joint affects ASCs function. To verify this hypothesis, rheumatoid ASCs (RA-ASCs) and osteoarthritic ASCs (OA-ASCs) derived from infrapatellar fat pad (IPFP) of the knee joint have been compared. RA- and OA-ASCs isolated from patients were cultured in vitro. Their secretory and proliferative activity was measured. Peripheral blood mononuclear cells (PBMCs) from healthy donors were co-cultured with ASCs. Then, PBMCs proliferation was measured by (3)H-thymidine incorporation method, cytokines secretion by immunoassays, T cells activation and regulatory T cells (Tregs) percentage - by flow cytometry. RA- and OA-ASCs properties in vitro were comparable, however, some differences in secretory activity occurred. RA- and OA-ASCs inhibited PBMCs proliferation and induced interleukin 10 production but up-regulated interleukin 17 A secretion and failed to limit release of other proinflammatory mediators (tumor necrosis factor [TNF], interferon γ [IFNγ], CCL5) by PBMCs. RA- and OA-ASCs did not suppress activation markers expression on T cells and did not trigger Tregs expansion. The present study shows that IPFP-ASCs from RA and OA patients have comparable functions in vitro. Their immunosuppressive activity seems to be impaired comparing to available data.

  5. Clinical audit of foot problems in patients with rheumatoid arthritis treated at Counties Manukau District Health Board, Auckland, New Zealand

    Directory of Open Access Journals (Sweden)

    Dalbeth Nicola

    2009-05-01

    Full Text Available Abstract Background At diagnosis, 16% of rheumatoid arthritis (RA patients may have foot joint involvement, increasing to 90% as disease duration increases. This can lead to joint instability, difficulties in walking and limitation in functional ability that restricts activities of daily living. The podiatrist plays an important role in the multidisciplinary team approach to the management of foot problems. The aim of this study was to undertake a clinical audit of foot problems in patients with RA treated at Counties Manukau District Health Board. Methods Patients with RA were identified through rheumatological clinics run within CMDHB. 100 patients were eligible for inclusion. Specific foot outcome tools were used to evaluate pain, disability and function. Observation on foot lesions were noted and previous history of foot assessment, footwear/insoles and foot surgery were evaluated. Results The median age of the cohort was 60 (IQR: 51–64 years old with median disease duration of 15 (IQR: 7.3–25 years. Over 85% presented with foot lesions that included corns and callus over the forefoot region and lesser toe deformities. Moderate to high disability was noted. High levels of forefoot structural damage were observed. 76% had not seen a podiatrist and 77% reported no previous formal foot assessment. 40% had been seen at the orthotic centre for specialised footwear and insoles. 27% of RA patients reported previous foot surgery. A large proportion of patients wore inappropriate footwear. Conclusion This clinical audit suggests that the majority of RA patients suffer from foot problems. Future recommendations include the provision of a podiatrist within the current CMDHB multidisciplinary rheumatology team to ensure better services for RA patients with foot problems.

  6. Prevalence of Food Supplements used in Patients with Rheumatoid Arthritis Referred to Government Hospitals in Yazd

    Directory of Open Access Journals (Sweden)

    A Noshi

    2016-09-01

    Full Text Available Introduction: Rheumatoid Arthritis (RA is an autoimmune disease where immune system mistakenly assumes different elements of joints as exogenous and attacks it. Based on scientific findings, a wide range of complementary and alternative therapies (including herbal and food supplements are useful for RA. Methods: This Cross-sectional study was carried out on 120 patients suffered from RA whom were referred to public health centers of Yazd in 2014. Using a questionnaire, demographic characteristics and the type and rate of supplementation were evaluated in these patients. Results: out of 120 patients, 118 individuals used at least one of the questioned supplements. Patients ranged from 19 to 76 years that 71.6 percent ≥ 40 years, 85% female, 92% married, 55% earned between 1 and 2 million Tomans per month and 51.7% had high school diploma or higher education. The most prevalent consumed supplement was calcium-Vitamin D (90.7% and Folic acid (%80.5, vitamin D (%73.7, and omega-3 (%55.9 came afterward. Interestingly, majority of patients (96.5% were taking supplements under the supervision of rheumatologist. Conclusion: Based on present data obtained in patients suffering from RA, most frequently used supplement was calcium-vitamin D. Most patients were satisfied of positive effects of these supplements.

  7. Effects of auditing patient safety in hospital care: design of a mixed-method evaluation

    Science.gov (United States)

    2013-01-01

    Background Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects. Methods and design Our study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011–July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects. Discussion We report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to

  8. The impact of using musculoskeletal ultrasound imaging and other influencing factors on medication adherence in patients with rheumatoid arthritis: a qualitative study

    Directory of Open Access Journals (Sweden)

    Kumar K

    2016-06-01

    Full Text Available Kanta Kumar,1,2 Karim Raza,3,4 Paramjit Gill,1 Sheila Greenfield1 1Primary Care Clinical Sciences, University of Birmingham, Birmingham, 2Faculty of Medical and Human Sciences, University of Manchester, Manchester, 3Institute of Inflammation and Ageing, University of Birmingham, 4Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK Background: Medication can ease symptoms and limit disease progression in rheumatoid arthritis (RA. Despite this, nonadherence to medication is common in RA. We explored the determinants of high and low adherence to disease-modifying antirheumatic drugs (DMARDs in patients with RA and provide suggestions on approaches to improving adherence to DMARDs.Methods: Patients with RA were identified from those who had previously participated in a questionnaire measuring levels of medication adherence. Twenty patients participated (ten high and ten low adherers, as determined by responses to the Medication Adherence Report Scale. In-depth individual semistructured interviews were undertaken until data saturation was reached. Interviews were transcribed and analyzed using a constant comparative method.Results: Four main themes related to adherence were identified: 1 symptom severity; 2 illness perception; 3 perceived benefits and risks of DMARDs; and 4 the quality and quantity of information about RA and DMARDs. In addition, patients’ suggestions about strategies to optimize adherence to DMARDs were captured and they fell within the following themes: 1 musculoskeletal ultrasound to explain the disease process and to provide objective feedback about the extent to which their disease activity is being effectively controlled; 2 better explanations of the consequences of poorly controlled RA; and 3 a good relationship with the health professional.Conclusion: Patients’ beliefs about medicines, perceptions about RA, and level of satisfaction with information about DMARDs influenced their adherence to DMARDs. The use

  9. Effects of treatment with a fully human anti-tumour necrosis factor alpha monoclonal antibody on the local and systemic homeostasis of interleukin 1 and TNFalpha in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Barrera Rico, P.; Joosten, L.A.B.; Broeder, A. den; Putte, L.B.A. van de; Riel, P.L.C.M. van; Berg, W.B. van den

    2001-01-01

    OBJECTIVES: To study the short term effects of a single dose of D2E7, a fully human anti-tumour necrosis factor (TNFalpha) monoclonal antibody (mAb), on the local and systemic homeostasis of interleukin 1beta (IL1beta) and TNFalpha in patients with rheumatoid arthritis (RA). METHODS: All patients

  10. MLN3897 plus methotrexate in patients with rheumatoid arthritis: Safety, efficacy, pharmacokinetics, and pharmacodynamics of an oral CCR1 antagonist in a phase IIa, double-blind, placebo-controlled, randomized, proof-of-concept study

    NARCIS (Netherlands)

    Vergunst, Clarissa E.; Gerlag, Danielle M.; von Moltke, Lisa; Karol, Michael; Wyant, Tim; Chi, Xuedong; Matzkin, Ellen; Leach, Timothy; Tak, Paul P.

    2009-01-01

    OBJECTIVE: To assess the efficacy, safety, pharmacokinetics, and pharmacodynamics of the CC chemokine receptor CCR1 antagonist MLN3897 in patients with rheumatoid arthritis (RA) receiving methotrexate (MTX). METHODS: In this phase IIa, proof-of-concept study, patients meeting the American College of

  11. Golimumab in patients with active rheumatoid arthritis after treatment with tumor necrosis factor a inhibitors: findings with up to five years of treatment in the multicenter, randomized, double-blind, placebo-controlled, phase 3 GO-AFTER study

    NARCIS (Netherlands)

    Smolen, Josef S.; Kay, Jonathan; Doyle, Mittie; Landewé, Robert; Matteson, Eric L.; Gaylis, Norman; Wollenhaupt, Jürgen; Murphy, Frederick T.; Xu, Stephen; Zhou, Yiying; Hsia, Elizabeth C.

    2015-01-01

    Introduction: The aim of this study was to assess long-term golimumab therapy in rheumatoid arthritis (RA) patients who discontinued previous tumor necrosis factor-alpha (TNF)-inhibitor(s). Methods: Patients enrolled into this multicenter, randomized, double-blind, placebo-controlled study of active

  12. Combined anti-tumor necrosis factor-α therapy and DMARD therapy in rheumatoid arthritis patients reduces inflammatory gene expression in whole blood compared to DMARD therapy alone

    Directory of Open Access Journals (Sweden)

    Carl K Edwards

    2012-12-01

    Full Text Available Periodic assessment of gene expression for diagnosis and monitoring in rheumatoid arthritis (RA may provide a readily available and useful method to detect subclinical disease progression and follow responses to therapy with disease modifying anti-rheumatic agents (DMARDs or anti-TNF-α therapy. We used quantitative real-time PCR to compare peripheral blood gene expression profiles in active ("unstable" RA patients on DMARDs, stable RA patients on DMARDs, and stable RA patients treated with a combination of a DMARD and an anti-TNF-α agent (infliximab or etanercept to healthy human controls. The expression of 48 inflammatory genes were compared between healthy controls (N=122, unstable DMARD patients (N=18, stable DMARD patients (N=26, and stable patients on combination therapy (N=20. Expression of 13 genes was very low or undetectable in all study groups. Compared to healthy controls, patients with unstable RA on DMARDs exhibited increased expression of 25 genes, stable DMARD patients exhibited increased expression of 14 genes and decreased expression of five genes, and combined therapy patients exhibited increased expression of six genes and decreased expression of 10 genes. These findings demonstrate that active RA is associated with increased expression of circulating inflammatory markers whereas increases in inflammatory gene expression are diminished in patients with stable disease on either DMARD or anti-TNF-α therapy. Furthermore, combination DMARD and anti-TNF-α therapy is associated with greater reductions in circulating inflammatory gene expression compared to DMARD therapy alone. These results suggest that assessment of peripheral blood gene expression may prove useful to monitor disease progression and response to therapy.

  13. The Patient Centered Assessment Method (PCAM: integrating the social dimensions of health into primary care

    Directory of Open Access Journals (Sweden)

    Rebekah Pratt

    2015-07-01

    Full Text Available Background: Social dimensions of health are known to contribute to what is often termed “patient complexity”, which is particularly common among patients with multimorbidity. Health-care professionals require tools to help them identify and manage these aspects of patient needs. Objectives: To examine: (i the Patient Centered Assessment Method (PCAM, a tool for assessing patient complexity in ways that are sensitive to the biopsychosocial dimensions of health, in primary care settings in Scotland; (ii the impact of the PCAM on referral patterns and its perceived value; and (iii the PCAM’s perceived applicability for use in a complex patient population. Design: Two studies are described: (i a mixed-methods prospective cohort study of the implementation of the PCAM in primary care clinics; and (ii a qualitative exploratory study that evaluated the value of the PCAM in a complex patient population. Results: Use of the PCAM did not impact patient satisfaction or perception of practitioners’ empathy, but it did increase both the number of onward referrals per referred patient (9–12% and the proportion of referrals to non-medical services addressing psychological, social, and lifestyle needs. Nurses valued the PCAM, particularly its ability to help them address psychological and social domains of patients’ lives, and found it to be highly relevant for use in populations with known high complexity. Conclusions: The PCAM represents a feasible approach for assessing patient needs with consideration to the social dimensions of health, and allows practitioners to refer patients to a broader range of services to address patient complexity.

  14. Sedentary behaviour in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Thomsen, Tanja; Beyer, Nina; Aadahl, Mette

    2015-01-01

    BACKGROUND: Despite increasing interest in investigating sedentary behaviour (SB) in the general population and in patients with rheumatoid arthritis (RA), there is little documentation of the subjective experiences of SB in patients with RA. This study aimed to examine how patients with RA...... modification of physical activity level causing increase in SB, especially during periods of disease flare. Prioritizing and planning of SB also functioned as part of self-management strategies. 3) It has nothing to do with my arthritis; for some patients, SB was not related to RA, but simply reflected a way...

  15. Impossible cartographies: approaching Raúl Ruiz’s cinema

    Directory of Open Access Journals (Sweden)

    Michael Goddard

    2013-06-01

    Full Text Available Raúl Ruiz (1931-2011, while considered one of the world’s most significant filmmakers by several film critics, is yet to be the subject of any thorough academic engagement with his work in English. My book Impossible Cartographies sets out on this task by mapping, as fully as possible, Ruiz’s cinematic trajectory across more than five decades of prolific work ranging from his earliest work in Chile to high budget ‘European’ costume dramas culminating in the recent Mysteries of Lisbon (2010. It does this by treating Ruiz’s work, with its surrealist, magic realist, popular cultural and neo-Baroque sources, as a type of ‘impossible’ cinematic cartography, mapping real, imaginary and virtual spaces, and crossing between different cultural contexts, aesthetic strategies, and technical media. In argues that across the different phases of Ruiz’s work identified, there are key continuities such as the invention of singular cinematic images and the interrogation of their possible and impossible combinations. This article will present some of the key themes of Ruiz’s cinema and use ideas of virtual cartography, tableaux vivants and the neo-baroque to illuminate a range of Ruiz’s films from the Hypothesis of the Stolen Painting (1978 to Mysteries of Lisbon, his last major project.

  16. [A new method of gastric shunting for treatment of patients with morbid obesity].

    Science.gov (United States)

    Grubnik, V V; Golliak, V P; Kresiun, M S

    2013-01-01

    The gastric shunting (GSH) method, permitting to control the patients body mass more effectively and promoting complete remission of diabetes mellitus type II, was elaborated. In 2008 - 2009 yrs 29 patients (9 men, 20 women) were operated on for morbid obesity, using shunting interventions. In 21 patients (the first group) a standard GSH was performed, in 8 (second group)--a modified operation. In 18-24 mo the excessive patient's body mass in patients of the first group have reduced by 62.8%, of the second group--by 89.3%. Complete compensation of diabetes mellitus type II with rejection from insulin and other antidiabetic preparations was achieved in 4 patients of the first group and in all--in the second group. Resistence for insulin have had lowered in patients of both groups, including in the first group--in 1,4 times, in the second group--in 3.2 times. Thus, preliminary results accurately demonstrate, that application of a modified GSH method is more effective, concerning the patients body mass reduction and achievement of complete compensation of diabetes mellitus type II.

  17. Association of Variants in IL2RA With Progression of Joint Destruction in Rheumatoid Arthritis

    NARCIS (Netherlands)

    Knevel, R.; de Rooy, D. P. C.; Zhernakova, A.; Grondal, G.; Krabben, A.; Steinsson, K.; Wijmenga, C.; Cavet, G.; Toes, R. E. M.; Huizinga, T. W. J.; Gregersen, P. K.; van der Helm-van Mil, A. H. M.

    ObjectiveHeritability studies have suggested an important role of genetic predisposition in the progression of joint destruction in rheumatoid arthritis (RA); the heritability is estimated at 45-58%. Several single-nucleotide polymorphisms (SNPs) have been identified as being associated with RA

  18. Demand Side Management Using the Internet of Energy Based on LoRaWAN Technology

    DEFF Research Database (Denmark)

    Shahryari, Kolsoom; Anvari-Moghaddam, Amjad; Shahryari, Shadi

    2017-01-01

    into cloud because of a long range, low power, wide area and low bit rate wireless telecommunication system which is called LoRaWAN. All devices in fog domain are connected by long range wide area network (LoRa) into a smart gateway. The gateway which bridges fog domain and cloud, is introduced...

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

    DEFF Research Database (Denmark)

    Jawaheer, D; Olsen, J; Lahiff, M

    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.......To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner....

  20. Selective 226Ra2+ ionophores provided by self-assembly of guanosine and isoguanosine derivatives.

    Science.gov (United States)

    van Leeuwen, Fijs W B; Verboom, Willem; Shi, Xiaodong; Davis, Jeffery T; Reinhoudt, David N

    2004-12-22

    The self-assembled guanosine (G 1)-based hexadecamers and isoguanosine (isoG 2)-based decamers are excellent 226Ra2+ selective ionophores even in the presence of excess alkali (Na+, K+, Rb+, and Cs+) and alkaline earth (Mg2+, Ca2+, Sr2+, and Ba2+) cations over the pH range 3-11. G 1 requires additional picrate anions to provide a neutral assembly, whereas the isoG 2 assembly extracts 226Ra2+ cations without any such additives. Both G 1-picrate and isoG 2 assemblies show 226Ra2+ extraction even at a 0.35 x 10(6) fold excess of Na+, K+, Rb+, Cs+, Mg2+, or Ca2+ (10(-2) M) to 226Ra2+ (2.9 x 10(-8) M) and at a 100-fold salt to ionophore excess. In the case of the G 1-picrate assembly, more competition was observed from Sr2+ and Ba2+, as extraction of 226Ra2+ ceased at an M2+/226Ra2+ ratio of 10(6) and 10(4), respectively. With the isoG 2 assembly, 226Ra2+ extraction also occurred at a Sr2+/226Ra2+ ratio of 10(6) but ceased at a 10(6) excess of Ba2+. The results clearly demonstrate the power of molecular self-assembly for the construction of highly selective ionophores.

  1. The influence of lifestyle habits on quality of life in patients with established rheumatoid arthritis—A constant balancing between ideality and reality

    Directory of Open Access Journals (Sweden)

    Karina Malm

    2016-05-01

    Full Text Available Introduction: Rheumatoid arthritis (RA is a chronic, inflammatory, and systemic disease with symptoms that limit activities and affect quality of life. RA is associated with an increased risk of developing comorbidities, some of which are also known to be associated with lifestyle habits such as physical activity, diet, smoking, and alcohol. There has been an augmented focus on the implementation and maintenance of healthy lifestyle habits even for patients with RA in the past decade, but little is known about the link between patients’ experiences of lifestyle habits and quality of life. The aim of the study was thus to describe and explore how patients with established RA experience the influence of lifestyle habits on quality of life. Methods: The study had a descriptive and explorative design, based on qualitative content analysis. Strategic sampling was used in order to achieve variations in experiences. Twenty-two patients with RA (14 women and 8 men from 30 to 84 years old, with a disease duration ranging from 8 to 23 years, were interviewed. Results: The analysis of the influence of lifestyle habits on quality of life resulted in the theme balancing between ideality and reality. Three categories emerged about how lifestyle habits influenced quality of life by limitations (including insufficiency and adaptation, self-regulation (including guilt and motivation, and companionship (including belonging and pleasure. Conclusions: Quality of life for patients with established RA was influenced by the balance between ideality and reality in the lifestyle habits: physical activity, diet, smoking, and alcohol. This is important new knowledge for health professionals when discussing lifestyle habits with RA patients.

  2. {sup 226}Ra measurement by thermal ionisation mass spectrometry: Use of {sup 226}Ra and {sup 14}C for groundwater dating

    Energy Technology Data Exchange (ETDEWEB)

    Dever, L. [Universite Paris-SUD, Orsay, (France). Lab d`Hydrologie et Geochemie Isotopique; Hillaire-Marcel, C. [Geotop, Universite du Quebec a Montreal, Montreal (Canada)

    1997-10-01

    Recent developments in thermal ionisation mass spectrometry (TIMS) and in chemical separation Ra and Ba allow to analyse {sup 226}Ra on smaller water samples (<200 ml) than with conventional counting techniques (10{sup 3} litres). The sampling has been realised on the Chalk aquifer of the Paris basin. The water samples have been collected in the unsaturated zone using in situ filtering devices and in the unconfined and confined parts of the aquifer in the boreholes used for public water supply. {sup 226}Ra contents vary from 0.064{+-}0.02 dpm/kg (n=6) in the unsaturated zone to 0.119{+-}0.069 dpm/kg (n=7) in the unconfined aquifer and 0.319{+-}0.057 dpm/kg (n=9) in the confined aquifer. For all the samples the {sup 226}Ra/{sup 238}U activity ratios are much lower than the secular equilibrium. This points out that the two isotopes have different input function in the water during the mineralisation of the solution. The good correlation (r{sup 2}=0.9) between the {sup 226}Ra and Sr indicates that dissolution of Chalk is the dominant mechanism of mineralisation in {sup 226}Ra of the solution. In the Chalk the mineralisation of the water occurs in the first metres of the unsaturated zone, during the water percolation the water rock interaction takes place through dissolution and precipitation of calcite in a non steady state. According to his distribution coefficient Sr is then a better tracer of dissolution/precipitation process than Ba. Using a geochemical model based on {sup 226}Ra/Sr and Sr/Ca ratios an `age` of the water could be determined. With {sup 226}Ra half life of 1620 years we obtain `ages` varying from 150 years to 1950 years in the unconfined aquifer. For the confined part of the aquifer where the redox condition is different it is necessary to use a geochemical model based on the U concentration in the water, the {sup 226}Ra gives in such case ages varying from 1.8ka to 12.8ka. The radiocarbon ages obtained through usual chemical and/or isotopic models