523 research outputs found
13.0.0.0.0: una fecha maya carente de significado astronómico. 30. Arqueología
No full textBernal, Ignacio
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1905. “Maya Dates”, American Anthropologist,
vol. 7, pp. 642-647.Jenkins, John Major
2002. “Center and source: the Galactic Center in
Maya concepts”, Institute of Maya Studies Newsletter (An Afiliate of Miami Museum of Science), vol. 31(10), pp. 4-5.Malmstrom, Vincent H.
1978. “A Reconstruction of the Chronology of
Mesoamerican Calendarical Systems”, Journal for
the History of Astronomy, vol. 9, pp. 105-116.1997. Cycles of the Sun, Mysteries of the Moon: The
Calendar in Mesoamerican Civilization, Austin,
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mesoamericano”, Arqueología, núm. 21,
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Cardiovascular risk factors in patients with rheumatoid arthritis prescribed disease modifying anti-rheumatic drugs.
No full textIntroduction: Rheumatoid arthritis (RA) is associated with a heightened risk of cardiovascular disease (CVD), with both traditional CV risk factors and inflammation contributing to this risk.
Areas covered: This review highlights the burden of CVD in RA and associated traditional CV risk factors, including the complexity of dyslipidemia in RA and the so-called ‘lipid paradox.’ Furthermore, the recognized RA-disease-specific factors associated with higher risk of CVD and the role of systemic inflammation in the pathogenesis of CVD in RA will be addressed. With the advent of biologic and targeted synthetic therapies in the treatment of RA, the effect of conventional and newer generation disease modifying anti-rheumatic therapies (DMARDs) on CV risk and associated risk factors will also be discussed.
Expert opinion: Identifying the RA phenotype at greatest risk of CVD, understanding the interplay of increased traditional risk factors, common inflammatory processes and RA-specific factors, and personalized use of DMARDs according to disease phenotype and comorbidity to reduce this risk are key areas for future research
Sub-Analysis of ELF Score Biomarkers Components Indicates a Specific Correlation with Different Organ Involvement in Systemic Sclerosis.
No full textBackground/Purpose: A recent large multicenter study has identified an
algorithm, known as Enhanced Liver Fibrosis (ELF), by combining the serum
concentrations of amino-terminal propeptide of procollagen type III (PIIINP),
tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and hyaluronic acid
(HA) in a weighted average developed to match liver fibrosis pathology
scoring The algorithm has been shown to predict liver related outcomes in
patients with chronic liver diseases and recently it has been shown to correlate
with several measures of fibrosis in SSc including modified Rodnan SkinScore, presence of ILD, DLCO as well as age, disease activity and different
aspects of disease severity. The aim of this study was to compare the
performance of ELF with its single components in correlating with the
different clinical and instrumental variables in SSc, to determine whether any
of the three biomarkers could have a specific predictive value as surrogate
outcome measure in SSc.
Methods: The serum concentrations of the three biomarkers were
analysed in 129 SSc patients employing the same platform used to calculate
the ELF score (siemens, advia centaur). All patients were investigated for
clinical and serological subset, disease duration, skin and internal organ
involvement, HAQ-DI, disease severity and activity. Correlations were
calculated using Spearman correlation test. Mann-Whitney test was used to
perform comparison between groups. Statistical analysis was performed using
GraphPrism software.
Results: Median, correlation coefficient and statistical significance of
ELF and its single analytes are summarised in table 1. All three components
of ELF showed a similar strong correlation with mRSS and HAQ-DI,
confirming a strong predictive value on skin involvement. Interestingly, the
concentration of HA was the only parameter correlating with Age, muscle
severity and Heart severity, whereas it did not correlate with DLCO% or lung
severity. In this regard the biomarker with better performance on Lung
involvement was TIMP-1, which showed a strong correlation with DLCO and
lung Severity. Furthermore SSc patients with interstitial lung disease (ILD)
showed significant higher levels of TIMP-1 (P0.0136) and TIMP-1 was the
only biomarker to correlate with the EScSG-Activity Index. On the contrary,
PIIINP was the only one to correlate with Joint and kidney severity.
Coefficient correlation (rho) between ELF score and single serum markers with
clinical parameters in 129 SSc patients
ELF score PIIINP (ng/mL) TIMP-1 (ng/mL) HA (ng/mL)
Serum values
(median, range)
8.84, 6.49–.10.84
rho
6.25, 2.63–.33.06
rho
215.3, 88.5–.531.2
rho
41.53, 4.69–.236.4
rho
Age 0.34*** 0.05 0.11 0.42***
mRSS 0.26** 0.30*** 0.33*** 0.19*
DLCO, absolute value 0.26** 0.1 0.28** 0.20*
DLCO % 0.06 0.05 0.20* 0.02
Skin_sev 0.34*** 0.34*** 0.37*** 0.20*
Join/tendon_sev 0.26** 0.25** 0.13 0.11
Muscle_sev 0.34*** 0.17 0.08 0.26**
GI_sev 0.17* 0.15 0.03 0.09
Lung_sev 0.01 0.01 0.18* 0.11
Heart_sev 0.16 0.08 0.09 0.21*
Kidney_sev 0.16 0.23** 0.001 0.05
EScSG-AI 0.15 0.09 0.20* 0.08
HAQ-DI 0.32*** 0.25** 0.31*** 0.22*
*P0.05; **P0.01; ***P0.001
Conclusion: Subanalysis of the single serum markers included in the ELF
score algorithm suggests that the different biomarkers may function as
surrogate outcome measure of specific organ involvement in SSc. In this
regard, longitudinal studies confirming the predictive value and sensitivity to
change over time of the single biomarkers may pave the way to develop
specific algorithms tailored to carry the maximum predictive value on specific organ involvement in SSc
ELF Score: A Validated Serum Test Strongly Predictive of Fibrosis in Systemic Sclerosis.
No full textBackground/Purpose: The absence of a serum test predictive of
activity or severity in Scleroderma (SSc) is a major burden both for
clinical intervention studies and for clinical management. Recently, a
large multicenter study has identified an algorithm of three serum
biomarkers as predictive of severity and clinical outcome in Chronic Liver
Disease.The algorithm,known as Enhanced Liver Fibrosis (ELF), includes
the measurement of serum concentrations of hyaluronic acid, TIMP-1 and
aminoterminal propeptide of procollagen type III. Objectives: To evaluate
the predictive value of ELF test as surrogate outcome measure of fibrosis
in SSc.
Methods: 210 patients with SSc, all satisfying the ACR criteria for the
classification of the disease, were enrolled in the study. 260 sera were
analysed of which 90 were longitudinal samples from 40 patients. All
patients were investigated for clinical and serological subset, disease
duration, vascular, skin, joint, tendon, muscle, esophago-gastrointestinal,
lung, heart and kidney involvement, disease severity, disease activity
and HAQ-DI. ELF score was determined blindly by an independent
commercial service (iQur, London, UK). Correlations were calculated
using Spearman’s correlation test and an unpaired two-tailed T-test
was used to perform comparison between groups. All the variables found
to be correlated in univariate analysis were subsequently assessed by
step-wise regression analysis. Data were analysed employing SPSS18
software.
Results: The mean ELF score in SSc patients sera was 8.751.05
(normal range 5.97). ELF score correlated with many clinical and
instrumental measures assessing fibrotic involvement including: mRSS (r
0.32;p 0.0001),DLCO (r0.29; p 0.0001), FVC % (r0.21; p
0.038), Ejection Fraction (r0.21; p0.0009). The other variables found to
be correlated with ELF in univariate analysis were Age, ESR, CRP and FVC.
Step-wise regression analysis indicated that the single measures independently
associated with ELF score were mRSS, DLCO, EF and age whereas
ESR, CRP and FVC were not. When compared to complex clinical indexes
ELF score was also found to be correlated with EScSG-Activity Index (r
0.20; p 0.0015), total Medger’s disease severity score (r0.35;p0.0001)
and total HAQ-DI (r0.32;p0.0001).Most interestingly, in the longitudinal
samples ELF test showed a strong sensitivity to change, keeping the
correlation with mRSS ( r0.34 p 0.0009), DLCO (r0.029; p0.029
). In the same cohort of longitudinal samples ELF test was again correlated
with total Severity (r0.49; p 0.0001), EScSG-Activity index ( r
0.21;p0.046), and HAQ-DI (r 0.42;p0.0001).
Conclusion: The ELF test is a simple serum test that strongly
correlates with several measures of fibrosis in SSc. It has a clear face
validity for measuring the concentration of molecules involved in extracellular
matrix turnover and strongly correlates with fibrotic severity and
activity in SSc. The profound sensitivity to change with changes in mRSS,
severity, activity and lung function indicate a clear discriminant validity
of ELF as biomarker in SSc fibrotic involvement. ELF test should be
included in the algorithm of activity index in Scleroderma and considered
as outcome in clinical tri
To switch or not to switch after a poor response to a TNFα blocker? It is not only a matter of ACR20 OR ACR50
No full textThe introduction in the therapeutic armamentarium of TNF inhibitors (TNFi) has greatly advanced the chance of obtaining a control of clinical manifestations and of structural damage progression in an important proportion of patients with rheumatoid arthritis (RA) Methotrexate (MTX)-poor responders. However not more than 50% of TNFi treated patients can reach relevant clinical benefits. Therefore the unmet medical question is: should we continue the therapeutic approach with a second or a third TNFi, or should we use other drugs, and change the mode of action of the second drug? These are practical issues that still do not have a definite answer. The real problem is that up to this moment no real biomarker is available to make the appropriate choice. The only clear-cut biomarker is represented by the positivity of rheumatoid factor (RF) or anti citrullinated peptide autoantibodies (ACPA). Seropositive patients seem to respond better than seronegative ones to B cell depletion therapy (Rituximab). This paper discusses the pros and cons of switching or swapping in RA patients poorly responder to the first TNFi
Response to 'Correspondence to viewpoint 'Defining refractory rheumatoid arthritis' by Buch' by Roodenrijs et al
No full textStrong Positions and Laryngeal Features in Yukatek Maya
No full textYukatek Maya has two phonological phenomena, allophonic aspiration and [h]-epenthesis, which insert the feature [spread glottis] at the right edge of the prosodic word and phonological phrase respectively. Providing an OT analysis, then, requires constraints which privilege [s.g.] in certain `weak' positions. This sort of constraint, however, conflicts with many theories of positional privilege since it prefers a marked form in a ‘weak' position. Despite this, we show that a limited class of such constraints are necessary to account for aspiration and [h]-epenthesis in Yukatek Maya. Furthermore, these processes are argued to instantiate a cross-linguistic pattern favoring certain laryngeal features at the right edge of larger prosodic constituents. This pressure, which we term Final Laryngeal Strengthening, is argued to be the phonologization of a gradient phonetic pressure: the articulatory effort required to maintain persistent voicing throughout longer prosodic units.The definitive version of this paper is published in NELS 39: Proceedings of the 39th Annual Meeting of the North East Linguistic Society (2011) and is available at https://www.createspace.com/3756873.AnderBois, S. (2011). Strong Positions and Laryngeal Features in Yukatek Maya. In S. Lima, K. Mullin, & B. Smith (Eds.), Proceedings of the 39th Meeting of the North East Linguistic Society (NELS 39). Amherst, MA: GLSA.ISBN-13: 978-1468132878 (published proceedings
Efficacy, tolerability and safety of biologic therapy in rheumatoid disease: patient considerations
No full textSarah Horton1, Maya H Buch2, Paul Emery21Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, 2NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UKAbstract: Rheumatoid arthritis (RA) is a systemic inflammatory disease in which chronic inflammation leads to joint destruction and extra-articular complications. Early and effective inhibition of inflammation is critical in order to prevent the progressive joint damage that occurs rapidly after onset of the disease. In the past, treatment for this purpose was limited to conventional disease-modifying antirheumatic drugs (DMARDs), which were often suboptimal. Within the last decade however, the development of biologic therapies, targeted against cytokines and cells involved in the inflammatory process, has revolutionized the management of RA. Disease remission is now an achievable goal in newly diagnosed patients. Since the advent of the first tumor necrosis factor-α inhibitor in 1999, other biologics have proved necessary as individuals respond to varying degrees with different therapies. Several are now available for the treatment of patients with RA that remains active despite DMARD treatment. This article reviews the evidence, over the last decade, of the efficacy and safety of biologic therapies used in this context, and the recent clinical data supporting the use of biologic therapy earlier in the disease process as first-line therapy.Keywords: rheumatoid arthritis, biologic therapy, tumor necrosis factor, abatacept, rituximab, tocilizumab, safet
Entre hablantes y señantes: la documentación del maya yucateco y la lengua de señas maya yucateca. 2 Año 1 (2014) abril-junio. Rutas de Campo. Documentación lingüística
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sj-pdf-1-jso-10.1177_23971983241235708 – Supplemental material for Attitudes and barriers to pulmonary arterial hypertension screening in systemic sclerosis patients: A survey of UK-based rheumatologists
No full textSupplemental material, sj-pdf-1-jso-10.1177_23971983241235708 for Attitudes and barriers to pulmonary arterial hypertension screening in systemic sclerosis patients: A survey of UK-based rheumatologists by María Paula Álvarez-Hernández, Yannick Allanore, Ivo Andrade, Maya H Buch, Gerry Coghlan, Francesco Del Galdo, Christopher P Denton, Dinesh Khanna, David G Kiely, John D Pauling, Sheila Ramjug and Michael Hughes in Journal of Scleroderma and Related Disorders</p
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