262,472 research outputs found
Comparing ultraviolet light A photo(chemo)therapy with Methotrexate protocol in childhood localized scleroderma : evidence from systematic review and meta-analysis approach
No full textOBJECTIVE:
Localized scleroderma is a skin fibrosing disorder that, if untreated, may result in severe disability. The purpose of this systematic review is to compare the present evidence concerning the effectiveness of Methotrexate versus phototherapy, alone or associated with Psoralen, in childhood localized scleroderma.
METHOD:
A systematic search between January 1996 and May 2017 was performed to identify studies investigating the efficacy of Methotrexate (MTX) or phototherapy (UVA) for treating localized scleroderma with onset ≤18 years. Due to a lack of validated clinical criteria, four clinical response criteria were used to assess the treatment efficacy as primary outcome. We determined a combined estimate of the proportion of children responding to MTX and UVA.
RESULTS:
A total of 19 studies was included (8 MTX; 11 UVA). In the methotrexate group, 193 children were included in the analysis; in the phototherapy group, a total of 48 treated children. For both groups age, disease subtype, glucocorticoids (GCs) use, and side effects of treatment were also analyzed. The meta-analysis suggested that UVA and MTX protocols have both a favorable effect in active lesions of childhood localized scleroderma. However, MTX resulted significantly superior to UVA, with or without Psoralen.
CONCLUSION:
Our study supports the combination of MTX and GCs in patients with a high risk of complication. Phototherapy with UVA1 could represent a therapeutic option in patients with limited scleroderma, where lesions do not cross joints and they do not lead to potential cosmetic changes
A comparison between nailfold capillaroscopy patterns in adulthood in juvenile and adult-onset systemic sclerosis: A EUSTAR exploratory study
No full textOBJECTIVE Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database.
METHODS Data collected between June 2004 and April 2013 were examined with focus on capillaroscopy. In this retrospective exploratory study, series of patients with juvenile-onset SSc were matched with series of adult-onset SSc having the same gender and autoantibody profile.
RESULTS 30 of 123 patients with juvenile-onset and 2108 of 7133 with adult-onset SSc had data on capillaroscopy. Juvenile-onset SSc showed scleroderma pattern more frequently than adult-onset SSc (93.3% and 88%). The OR was 2.44 and 95% CI 0.57-10.41. An active scleroderma pattern was present in 58% of juvenile- and 61% of adult-onset SSc. The OR was 0.91 and 95% CI 0.28-2.93. The late scleroderma pattern was present in 61% of juvenile- and 55.5% of adult-onset SSc. The OR was 1.06 and 95% CI 0.34-3.56.
CONCLUSION This is the first exploratory study on the comparison of capillaroscopy between juvenile- and adult-onset SSc in adulthood. Juvenile-onset SSc had an increase prevalence of scleroderma pattern, but a similar distribution of the three patterns was suggested. Further studies are needed to define this issue
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Nailfold Capillaroscopy Patterns in Adulthood are Similar in Patients with Juvenile and Adult-Onset Systemic Sclerosis : A Eustar Case-Control Study : OP0221
No full textBackground: Nailfold capillaroscopy is a useful investigation to identify patients with Raynaud's phenomenon secondary to systemic sclerosis (SSc) because typical capillary changes can be clearly demonstrated in adults as well as in children. However, in juvenile-onset SSc the overall capillaroscopic pattern is called “scleroderma pattern”, the classification in “early”, “active” and “late” pattern (1) has never been applied, and differences in microvascular abnormalities between juvenile- and adult-onset SSc have never been explored.
Objectives: Microvascular abnormalities described as qualitative overall patterns by nailfold capillaroscopy in patients with juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database.
Methods: Data collected between June 2004 and April 2013 in the EUSTAR registry were examined with focus on capillaroscopy. In this case-control study, adult patients with juvenile-onset SSc with available data on capillaroscopy were matched with corresponding patients with adult-onset SSc having the same gender and autoantibody profile. Patients aged ≥65 year-old at disease onset were excluded.
Results: 30 adult patients with juvenile-onset SSc and 2108 patients with adult-onset SSc were included in the analysis. The mean age at the visit of patients with adult- and juvenile-onset SSc was 52.91±12.6 and 29.56±10.71 year-old respectively. Mean age at the onset of Raynaud's phenomenon was 38.60±12.23 year-old in adult-onset and 11.36±5.12 year-old in juvenile-onset SSc. Similar distribution of modified Rodnan skin score between adult- and juvenile-onset SSc was observed (8.85±7.88 and 10.25±9.74 respectively). The majority of patients had a scleroderma pattern and it was equally distributed among early, active and late pattern in juvenile-onset SSc and adult-onset SSc. Results of univariate analysis showed that in patients with juvenile-onset SSc showed the presence of scleroderma pattern more frequently than adult-onset SSc (OR=2.44, p=0.17), even if not significant. No difference was observed in the distribution of early, active and late pattern between the two groups (OR estimates are near 1.0). Juvenile-onset SSc and adult-onset SSc shared similar capillaroscopy patterns and organ involvement, except for a slightly decreased frequency of oesophageal involvement (46.66% vs 66.22%) and increased lung fibrosis assessed by HRCT (18.13% vs 42.85%) in juvenile-onset SSc (OR=0.46 p=0.04 and OR 2.97, p=0.009 respectively).
Conclusions: This study is the largest series of adult patients with juvenile-onset SSc in which capillaroscopy has been performed and classified using the three qualitative patterns usually applied in adult-onset SSc. We showed that the microvascular involvement documented by nailfold capillaroscopy patterns in adulthood was similar in patients with juvenile- and adult-onset SSc. The possibility to use the same classification in three patterns applied in adults may be useful to standardise this examination.
References:
Cutolo M, Pizzorni C, Tuccio M, Burroni A, Craviotto C, Basso M, et al. Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology (Oxford). 2004;43(6):719-26
Occurrenceof arthritis is in 37%of the patients without overlying skin involvementinjuvenile localized scleroderma. Summary of the extracutaneous involvement in a monocentric cohort
No full textProtecting Animals 36: Author Witi Ihimaera
No full textIn this very special episode of Knowing Animals I am joined by beloved New Zealand author Witi Ihimaera. Witi has written many books featuring nonhuman animals. He offers us a non-colonial lens through which to think about the human/nonhuman relationship
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
A cross-sectional, international survey on non-invasive techniques to assess the microcirculation in patients with Raynaud's phenomenon (Sunshine Survey)
No full textBackground: Microcirculatory impairment in patients with Raynaud's phenomenon (RP) may be assessed by different techniques, but real-life data concerning their roles and current usage are not available.
Objectives: To obtain an overview of the specific techniques which may be used for the assessment of adult patients with RP in clinical and research settings: nailfold videocapillaroscopy (NVC), dermoscopy, stereomicroscopy, and digital USB microscopy, laser Doppler flowmetry, imaging, and anemometry/velocimetry, laser Speckle Contrast Analysis (LASCA), thermographic imaging, upper limb arterial Doppler ultrasound.
Methods: This survey was conducted online between October and December 2015 on behalf of EULAR study group on Microcirculation in Rheumatic Diseases (SG_MC/RD). Emails with a link to the survey were sent to physicians from the European Scleroderma Trials and Research group (EUSTAR) and SG_MC/RD mailing lists. Of those e-mailed, 418 were physicians looking after adult patients, and this group was considered in the following descriptive analysis.
Results: Of the 418 eligible physicians, 107 completed the survey, giving an overall response rate of 25.6%. Among the respondents 89 (83.2%) were rheumatologists, 74 (69.2%) European; 87 (81.3%) were practising for more than 10 years and 50% looked after between 31 and 60 patients per year with primary and/or secondary RP. The most routinely performed technique was NVC (63/107, 58.9%) both by rheumatologists and non-rheumatologists (54/89, 60.7% and 9/18, 50.0%). NVC was reported as the most available technique (93/107, 86.9%), and available in the place of work in 78/107 (72.9%) among both rheumatologists and non-rheumatologists. Nailfold capillaroscopy was the most frequently performed by the physician him/herself by using different types of equipment relating to availability: NVC 64/94 (68.0%), dermoscopy 38/63 (60.3%), stereomicroscopy 31/42 (73.8%), and digital USB microscopy 34/39 (87.1%). Most rheumatologists reported high levels of “appropriateness” for NVC in both clinical and research settings for global assessment (86/88, 97.7% clinical setting, 87/88, 98.9% research setting), and differential diagnosis of primary and secondary RP (clinical and research setting both 84/87 96.5%). In clinical setting NVC showed the highest percentage of appropriateness for monitoring primary RP (84/88, 95.4%), RP secondary to connective tissue diseases other than systemic sclerosis (82/87, 94.2%) and to systemic sclerosis (87/87, 100%). All techniques other than capillaroscopy reached a consensus lower than 2/3 of respondents based on their knowledge/experience. In research setting, all techniques were judged as potentially useful with a consensus more than 2/3 of respondents.
Conclusions: Of all the different techniques upon which opinion was sought, nailfold capillaroscopy was the one most used by physicians looking after adult patients in both clinical and research settings, the majority of whom use NVC in their everyday practice. The low proportion of clinicians using other techniques suggests that these are currently confined to specialist centres
Author in Essay by I. A. Goncharov “Pepiniere”
No full textFeatures of the embodiment of the author’s position in the essay by I. A. Goncharov “Pepiniere” are considered. The relevance of the study is due to the poorly studied poetics of this work. A review of the scientific literature on relevant topics is performed. Methodological and theoretical definitions are given. The scientific novelty of the article is in the fact that for the first time attention is paid to artistic techniques that allow to identify the author's position in the specified literary text. The author of the article grounds her opinion from the fact that, despite the dominance of the subjective point of view, other characters’ views stand out in the work. It is concluded in the study that the text of the work represents a biographical author and author-creator. It was established that the position of the author-creator is expressed through the title, epigraphs, which are quotes, as well as through different points of view, including the author-character, the author-narrator, the characters of the work. The author of the article dwells in detail on different ways of expressing the points of view of the author-character and the author-narrator. It is proved that the point of view of the author-character and the author-narrator can intersect, they are interchanged. The author's development of the term comic “point of view” is presented in the article
Espai i identitat en l'obra de Jordi Pere Cerdà. Una geografia literària cerdaniana
No full textL'obra de l'autor nord-català Jordi Pere Cerdà (1920-2011) teixeix una cartografia literària que abasta tota dimensió espacial -real, imaginada i ficcional. Les prospeccions que assagen els seus texts es fonen en el medi natural i rural, canten a l'amor, als veïns i als éssers fantàstics del folklore català, es comprometen amb els refugiats encarant-se a tota frontera i, també, a tot abisme interior i exterior que oprimesca l'ésser. El mapatge cognitiu i literari que crea Cerdà sobrepassa qualsevol obstacle per construir espais oberts i possibles, en comunió amb l'altre. Partint d'una aproximació teòrica geocrítica, aquest treball d'investigació aprofundeix en diverses nocions sobre l'espacialitat lligades a un context convuls, ple de transformacions a nivell socioeconòmic, polític, cultural i lingüístic, el qual determinarà la vida d'un autor i d'un territori transfronterer com el de la Cerdanya i la Catalunya del Nord. En definitiva, la rica experiència vital de Jordi Pere Cerdà ens permet reflexionar sobre les relacions que vulguem establir entre els individus i amb el nostre hàbitat natural i cultural, a fi d'esdevenir membres actius que participen de la transformació dels espais que configuren les nostres identitats.The work of the North Catalan author Jordi Pere Cerdà (1920-2011) weaves a literary cartography which reaches all spatial dimensions -real, imagined and fictional. The prospections proved by their texts merge with the natural and rural environment, sing to love, neighbours and the fantastic beings of the Catalan folklore. Such prospections also commit themselves with the refugees facing every frontier and, also, facing all interior and exterior abyss that oppresses the being. The cognitive and literary mapping created by Cerdà overcomes any obstacle to construct opened and possible spaces, in communion with the other. Based on the theoretical approach called geocriticism, this research study delves into various notions about spatiality linked to a convulsive context, full of transformations at a socioeconomic, political, cultural and linguistic level; these transformations will determine the life of an author and a cross-border territory such as Cerdagne and Northern Catalonia. In short, the rich experience of Jordi Pere Cerdà allows us to reflect on the relationships we want to establish between individuals, as well as between human groups and our natural and cultural habitat, in order to become active members that participate in the transformation of the spaces that make up our identities.Programa de Doctorat en Llengües Aplicades, Literatura i Traducci
- …
