scholarly journals The relevance of ultrasound examination of the foot and ankle in patients with rheumatoid arthritis – a review of the literature

2019 ◽  
Vol 21 (2) ◽  
pp. 175 ◽  
Author(s):  
Oana Șerban ◽  
Maria Bădărînză ◽  
Daniela Fodor
Keyword(s):  
Rheumatoid Arthritis ◽  
Ultrasound Examination ◽  
Joint Damage ◽  
The Other ◽  
Foot And Ankle ◽  
Review Of The Literature ◽  
The Us ◽  
Ankle And Foot

Rheumatoid arthritis (RA) is an inflammatory disease characterized by symmetrical involvement of the joints and tendons, especially of the hands and wrists, but also of the feet and ankles from the very beginning of the disease. For the patient, the foot and ankle involvement is equally important as the other joints, since it affects the functionality of the feet and the quality of life of the patients. It is already known that subclinical involvement of the ankles and feet occurs even in patients that are considered in clinical remission, thus they do not need for changes of therapy, but still might benefit from it. In spite of this, theclinicians do not give enough care to the ankle and foot in RA patients, especially if asymptomatic, resulting future deformities, joint damage and feet disability. In order to show the importance of the feet and ankles in RA patients and to demonstrate the indispensable role of ultrasonography (US) for that purpose, at the same time displaying the US abnormalities that should draw our attention, we performed this review of the literature. 

Cancer survival: Which low molecular weight heparin (LMWH) is best?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19624-19624
Author(s):  
J. E. Spahr ◽  
W. Akerley ◽  
G. M. Rodgers
Keyword(s):  
Survival Benefit ◽  
Low Molecular Weight Heparin ◽  
Randomized Trials ◽  
Randomized Clinical Trials ◽  
Cancer Survival ◽  
The Other ◽  
Low Molecular Weight ◽  
Review Of The Literature ◽  
The Us

19624 Background: The role of LMWH in cancer survival is controversial. There have been 6 randomized trials specifically evaluating cancer survival with LMWH. The objective of this study was to determine which LMWH is best for cancer survival, based on literature data. Methods: We performed a review of the literature for studies published from 1990 - 2007. Results: We identified 14 studies that included data on cancer survival and the use of LMWH, even if the primary endpoint was not cancer survival. We found studies for 5 LMWH products (See Table ). Conclusions: Based on our analysis, dalteparin is the most well studied LMWH in cancer. The 4 best designed trials looking at cancer survival were performed using dalteparin with over 1190 patients. The magnitude of benefit appears to be greatest in patients with better up-front estimated survival, and absence of metastatic disease. The estimated survival benefit was 25%. The second best studied LMWH appears to be nadroparin, with 5 trials with over 480 patients, including the MALT trial, and the most recently published Icli trial. Unfortunately, nadroparin is currently not available in the US. The studies of the other LMWH lack evidence to draw significant conclusions. The results of this study must be interpreted with caution. As there have been no randomized clinical trials comparing one LMWH against another in cancer survival, the studies we compared were not always similar in design or LMWH dosing, and cannot be compared head-to-head. No significant financial relationships to disclose. [Table: see text]

PENGARUH KUALITAS PRODUK DAN RELIGIUSITAS TERHADAP KEPUTUSAN NASABAH PRODUK SIMPANAN PADA BSM CABANG PURWOKERTO

2017 ◽  
Vol 4 (1) ◽  
pp. 189-215
Author(s):  
Yoiz Shofwa Shafrani
Keyword(s):  
Regression Analysis ◽  
Product Quality ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Analytical Tool ◽  
The Other ◽  
Financial Assets ◽  
Islamic Bank

Perkembangan dunia perbankan syariah tidak lepas dari peran para nasabah yang memberikan kepercayaan terhadap pihak perbankan untuk penyimpanan asset keuangannya. Faktanya banyak kelompok nasabah yang memutuskan untuk menjadi nasabah di perbankan syariah karena faktor religiusitasnya. Faktor lain yang dapat ikut mempengaruhi keputusan nasabah adalah kualitas produk. Di mana kualitas produk merupakan karakteristik yang melekat dari suatu produk. Kemungkinan yang terjadi bahwa kebanyakan nasabah pada perbankan syariah juga masih merupakan nasabah perbankan konvensional.Tujuan yang ingin dicapai dalam penelitian ini adalah untuk mengetahui pengaruh kualitas produk dan tingkat religiusitas nasabah terhadap keputusan nasabah untuk menyimpan dananya atau tidak di BSM Cabang Purwokerto. Alat analisis yang digunakan adalah analisis regresi linier berganda, dengan jumlah sampel 100 nasabah. Diperoleh hasil Y = 5,046 + 0,101X1 + 0,218X2. Berdasarkan uji F yang sudah dilakukan maka dapat diketahui bahwa variabel kualitas produk dan religiusitas secara bersama – sama berpengaruh terhadap keputusan nasabah untuk menyimpan dananya di BSM Cabang Purwokerto. Berdasarkan uji t yang sudah dilakukan dapat diketahui bahwa secara partial baik variabel kualitas produk maupun variabel religiusitas berpengaruh terhadap keputusan nasabah untuk menyimpan dananya di BSM Cabang Purwokerto. The progress of the Islamic bank cannot be separated from the role of its customers who give trust to the bank to deposit their financial assets. It is a fact many groups of customers decide to be the customers of the Islamic bank because of their religiosity. The other influences factor of a customer’s decision is the quality of the product. The aim of this research was to determine the effect of product quality and level of customers’ religiosity towards customers’ decision whether to keep their funds in Syariah Mandiri Bank, Branch of Purwokerto, or not. The analytical tool used was multiple linear regression analysis, with a sample of 100 customers. The results indicate Y = 5,046 + 0,101X1 + 0,218X2. Based on F, it can be seen that both variables of product quality and religiosity simultanously affect the customers’ decision to keep theirfunds in BSM Branch of Purwokerto. Based on t test, it can be seen that independently, either variable of product quality or variables of religiosityinfluences the customers’ decision to keep their funds in BSM Branch of Purwokerto.

scholarly journals Prostacyclin-IP signaling and prostaglandin E2-EP2/EP4 signaling both mediate joint inflammation in mouse collagen-induced arthritis

2006 ◽  
Vol 203 (2) ◽  
pp. 325-335 ◽  
Author(s):  
Tetsuya Honda ◽  
Eri Segi-Nishida ◽  
Yoshiki Miyachi ◽  
Shuh Narumiya
Keyword(s):  
Rheumatoid Arthritis ◽  
Synovial Fluid ◽  
Joint Inflammation ◽  
Synovial Fibroblasts ◽  
The Other ◽  
Receptor Subtype ◽  
Significant Suppression ◽  
Wild Type ◽  
Collagen Induced Arthritis

Prostaglandin (PG)I2 (prostacyclin [PGI]) and PGE2 are abundantly present in the synovial fluid of rheumatoid arthritis (RA) patients. Although the role of PGE2 in RA has been well studied, how much PGI2 contributes to RA is little known. To examine this issue, we backcrossed mice lacking the PGI receptor (IP) to the DBA/1J strain and subjected them to collagen-induced arthritis (CIA). IP-deficient (IP−/−) mice exhibited significant reduction in arthritic scores compared with wild-type (WT) mice, despite anti-collagen antibody production and complement activation similar to WT mice. IP−/− mice also showed significant reduction in contents of proinflammatory cytokines, such as interleukin (IL)-6 in arthritic paws. Consistently, the addition of an IP agonist to cultured synovial fibroblasts significantly enhanced IL-6 production and induced expression of other arthritis-related genes. On the other hand, loss or inhibition of each PGE receptor subtype alone did not affect elicitation of inflammation in CIA. However, a partial but significant suppression of CIA was achieved by the combined inhibition of EP2 and EP4. Our results show significant roles of both PGI2-IP and PGE2-EP2/EP4 signaling in the development of CIA, and suggest that inhibition of PGE2 synthesis alone may not be sufficient for suppression of RA symptoms.

scholarly journals Role of Biological Response Modifiers in the Treatment of Rheumatoid Arthritis - A Review

1970 ◽  
Vol 18 (1) ◽  
pp. 60-65
Author(s):  
Md Azizul Haque ◽  
ARM Saifuddin Ekram ◽  
Quazi Tarikul Islam
Keyword(s):  
Rheumatoid Arthritis ◽  
Monoclonal Antibody ◽  
Chronic Disease ◽  
Receptor Antagonist ◽  
Disease Progression ◽  
Joint Damage ◽  
Biological Response ◽  
The Past ◽  
Conventional Dmards

Rheumatoid arthritis is a chronic disease with the potential to cause substantial joint damage and disability. During the past 10 years, improved understanding of the pathophysiology of rheumatoid arthritis has led to several key changes in the approach to therapy. Most important of that is the development of some biological agents interfering with the activity of several important cytokines. Infliximab, etanarcept, and adalimumab are TNF blockers, anakinra is IL-1 receptor antagonist, and rituximab is anti CD-20 monoclonal antibody. These newer agents proved to be useful for alleviating symptoms and slowing the disease progression in the patients with RA who have failed to respond to conventional DMARDs.   doi: 10.3329/taj.v18i1.3309 TAJ 2005; 18(1): 60-65

scholarly journals Why do we have to use new low flux dialysis machine for daily home dialysis

2018 ◽  
Vol 1 (2) ◽  
pp. 71-74
Author(s):  
Hafedh Fessi
Keyword(s):  
Recovery Time ◽  
Western Europe ◽  
Ultrafiltration Rate ◽  
Dialysis Dose ◽  
Good Opportunity ◽  
Home Dialysis ◽  
Session Management ◽  
The Us

After a decline at the end of 90’s, Home Hemodialysis recently found a second breath. This renewal doesn’t only concern France, but also the US and Western Europe (GB, Italy and Spain).Several studies confirm that low flux dialysat machines deliver adequate dialysis dose, based on high dialysat saturation and low daily ultrafiltration rate. Frequent sessions avoid long interdialytic interval. They also are easy to use, allow easier session management with more flexibility and mobility.Daily hemodialysis with low dialysat flux responds to new goals: improving quality of life reaching better cardiovascular parameters and reduce recovery time post dialysis.Better patient adhesion to the treatment with low flux dialysat machines allows a decrease in barriers to home memodialysis development.It gives a good opportunity today to improve dialysis quality. The role of patient care partner is determinant

scholarly journals Interaction of race and pathology for neuroendocrine tumors: Epidemiology, natural history, or racial disparity?

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 376-376
Author(s):  
Rachel M Lee ◽  
Danielle K DePalo ◽  
Alexandra G Lopez-Aguiar ◽  
Mohammad Yahya Zaidi ◽  
Flavio G. Rocha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neuroendocrine Tumors ◽  
Prognostic Value ◽  
Oncologic Outcomes ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Curative Intent ◽  
Black And White ◽  
The Us

376 Background: The prognostic value of pathologic variables is not consistent for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We previously demonstrated a limited prognostic role of lymph node (LN) positivity in small bowel NETs (SBNET) compared to pancreatic NETs (panNET). Although minority race is often associated with worse cancer outcomes, the interaction of race with pathologic and oncologic outcomes of pts with GEP-NETS is not known. Methods: Pts with GEP-NETs who underwent curative intent resection at eight institutions of the US NET Study Group from 2000-16 were included. Given few pts of other races, only Black and White race pts were analyzed. Results: Of 2,182 pts, 1,143 met inclusion criteria. Median age was 58 yrs, median follow up was 3 yrs, 48% were male, 14% (n = 157) were Black, and 86% (n = 986) were White. Black pts were more likely uninsured (7 vs 2%, p = 0.005), had symptomatic bleeding (13 vs 7%, p = 0.006), required emergency surgery (7 vs 3%, p = 0.003), and had LN positive disease (47 vs 36%, p = 0.016). Despite this, Black pts had improved 5 yr recurrence free survival (RFS) compared to White pts (90 vs 80%, p = 0.008). The quality of care received was comparable between both groups, demonstrated by similar LN yield at surgery, neg margin resection rate, post-op complications, and need for reoperation or readmission (all p > 0.05). Black pts were more likely to have SBNET (22 vs 13%) and less likely to have panNET (43 vs 68%) compared to White pts (p < 0.001). Consistent with prior data, pts with LN pos panNET had decreased 5yr RFS (67 vs 83%, p = 0.001); however, for SBNET, LN involvement was not prognostic (77 vs 96%, p = 0.08). The prognostic value of LN pos disease was similar between Black and White pts in both SBNET (p = 0.34) and panNET (p = 0.95). Conclusions: Black pts with GEP-NET present with more advanced disease, including higher LN positivity. Despite this, Black pts have improved RFS compared to White pts. Although there may be delays in seeking or reaching care, Black pts received similar quality of care compared to White pts. The improved RFS seen in Black pts may be attributed to the epidemiologic differences in the site of presentation of GEP-NETs and variable prognostic value of LN pos disease.

scholarly journals Peptides Bearing Multiple Post-Translational Modifications as Antigenic Targets for Severe Rheumatoid Arthritis Patients

2021 ◽  
Vol 22 (24) ◽  
pp. 13290
Author(s):  
Cristina García-Moreno ◽  
María J. Gómara ◽  
Raúl Castellanos-Moreira ◽  
Raimon Sanmartí ◽  
Isabel Haro
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Serum Antibody ◽  
Joint Damage ◽  
Erosive Disease ◽  
Post Translational Modifications ◽  
Diagnosis And Prognosis ◽  
Modified Peptides ◽  
Chimeric Peptides

Rheumatoid arthritis (RA) is characterized by the presence of autoantibodies that are of paramount importance for the diagnosis and prognosis of the disease and have been implicated in its pathogenesis. Proteins resulting from post-translational modifications (PTMs) are capable of triggering autoimmune responses important for the development of RA. In this work, we investigate serum antibody reactivity in patients with an established RA against a panel of chimeric peptides derived from fibrin and filaggrin proteins and bearing from one to three PTMs (citrullination, carbamylation and acetylation) by home-designed ELISA tests (anti-AMPA autoantibodies). The role of anti-AMPAs as biomarkers linked to the presence of a more severe RA phenotype (erosive disease with radiological structural damage) and to the presence of interstitial lung disease (ILD), a severe extra-articular manifestation in RA patients entailing a high mortality, was also analyzed. In general, the association with the clinical phenotype of RA was confirmed with the different autoantibodies, and especially for IgA and IgM isotypes. The prevalence of severe joint damage was only statistically significant for the IgG isotype when working with the peptide bearing three PTMs. Furthermore, the median titers were significantly higher in patients with RA-ILD, a finding not observed for the IgG isotype when working with the single- and double-modified peptides.

Role of joint damage, malalignment and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis and osteoarthritis

2021 ◽  
pp. annrheumdis-2020-218744
Author(s):  
Irina Gessl ◽  
Mihaela Popescu ◽  
Victoria Schimpl ◽  
Gabriela Supp ◽  
Thomas Deimel ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Power Doppler ◽  
Joint Damage ◽  
Joint Space ◽  
Early Arthritis ◽  
Damage Score ◽  
Established Disease ◽  
Active Inflammation

ObjectivesTo determine whether clinical tenderness can be considered a sign of inflammatory joint activity in patients with rheumatoid arthritis (RA), osteoarthritis (OA) or psoriatic arthritis (PsA) and to assess other possible factors associated with tenderness.MethodsPatients diagnosed with RA, PsA and OA underwent clinical and ultrasound examination of wrists and finger joints. Radiographs of the hands were scored for erosions, joint space narrowing (JSN), osteophytes and malalignment. A binary damage score (positive if ≥1 erosion, JSN and/or presence of malalignment) was calculated. Differences in grey scale signs of synovitis and power Doppler (PD) between tender non-swollen (TNS) versus non-tender non-swollen (NTNS) joints were calculated. Disease duration was assessed,<2 years was regarded as early and >5 years as long-standing arthritis.ResultsIn total, 34 patients (9 early and 14 long-standing) from patients with RA, 31 patients (7 early and 15 long-standing) with PsA and 30 with OA were included. We found equal frequencies of PD signal between TNS and NTNS joints in RA (p=0.18), PsA (p=0.59) or OA (p=0.96). However, PD had a significant association with tenderness in early arthritis both in RA (p=0.02) and in PsA (p=0.02). The radiographic damage score showed significant association with tenderness in RA (p<0.01), PsA (p<0.01) and OA (p=0.04).ConclusionTenderness might not always be a sign of active inflammation in RA, PsA and OA. While tenderness in early arthritis may be more related to inflammation, established disease is better explained by joint damage and malalignment.

Competition Law in Europe

2020 ◽  
pp. 103-114
Author(s):  
David J. Gerber
Keyword(s):  
Reference Point ◽  
Competition Law ◽  
Institutional Arrangements ◽  
The Other ◽  
Multiple Voices ◽  
The Us ◽  
National Boundaries ◽  
Substantive Law ◽  
European Competition Law

European competition law is the other central player in the competition law world, so an entire chapter is devoted to understanding how it works and how to deal with it. Virtually all firms operating beyond their own national boundaries need to pay attention to it, many regimes use it as a model and reference point, and its institutions have broad and often deep influence on many others. Some aspects of the substantive law are similar to US antitrust, but the similarities are sometimes misleading. For example, EU law uses economic analysis in ways that often differ from how it is used in the US. Procedural and institutional arrangements are often complicated. They represent multiple voices, as national and EU institutions function together to create, apply, and enforce competition law. The chapter reveals how this system functions and what factors guide decisions in it. It looks, in particular, at the institutional arrangements between the EU and its member states, including the role of the European Competition Network.

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