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Hypertrophic osteoarthropathy: classification, diagnostic features, and treatment options
No full textIntroduction: Hypertrophic osteoarthropathy (HOA) is an orphan disease characterized by digital clubbing, periostitis of tubular bones and arthralgia/arthritis. The disease may be classified as primary or secondary. Pulmonary and other intra-thoracic diseases are the cause of more than 90% of the secondary forms. Areas covered: The diagnosis is generally based on the presence of a triad of symptoms including digital clubbing, periostitis of the distal end of the tubular bones and painful swelling of the limbs, associated with bilateral and symmetrical arthritis in the large joints. Radiographic evaluation is the assessment reference for the diagnosis. Vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) seem to be the key mediators in the pathogenesis of this disorder. Treatment and prognosis depend on the HOA underlying cause. In some cases, treatment of associated malignancy can solve or improve clubbing. Bisphosphonates may have a role for the symptomatic treatment of HOA. Expert opinion: In clinical practice primary HOA is rare while secondary form is relatively frequent and may mimic other rheumatologic conditions. Notably HOA should be considered in the differential diagnosis of painful arthritis with periosteal bone involvement and if clubbing or periostitis become evident in a previously healthy individual a comprehensive search for an underlying illness should be undertaken
The dimeric form of HLA-G molecule is associated with the response of early rheumatoid arthritis (ERA) patients to methotrexate
No full textA growing body of evidence indicates a possible involvement of HLA (human leukocyte antigen)-G antigens in rheumatoid arthritis (RA), mainly in the HLA-G dimeric isoform, the most active HLA-G form with the strongest immunosuppression, that showed an excellent anti-inflammatory effect in collagen-induced arthritis model mice. However, the relevance of HLA-G dimers in RA response to methotrexate (MTX) treatment is still unknown. We analyzed the HLA-G dimers’ amount in plasma samples from early rheumatoid arthritis (ERA) patients before MTX therapy and evaluated the role of these molecules as biomarker of the different response to the treatment. Plasma sHLA-G levels were detected by ELISA, and HLA-G dimeric and monomeric forms were revealed by Western blot in 12 MTX responder (reaching DAS28 remission <2.6) and 8 MTX non-responder (DAS28 ≥5.1) patients before the therapy. The response to MTX was evaluated after 6 months of treatment. All ERA patients reaching remission showed higher plasma sHLA-G levels and the 78 kDa HLA-G dimeric form. Unresponsive ERA patients were characterized by lower plasma sHLA-G levels, and only one patient presented the 78 kDa HLA-G dimeric form (DAS28 5.1). Our preliminary results support the hypothesis that in ERA patients, sHLA-G and, in particular, the presence of the dimeric form in plasma samples before MTX therapy could be an a priori biomarker for the response to MTX treatment
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
HLA-G may predict the disease course in patients with early arthritis
No full textThe current management of early arthritis (EA) with negative
prognostic factors is to start an intensive treatment. To avoid
under/overtreatment, it is important to identify EA evolution
biomarkers. Several factors have been suggested but their predictive
value is still limited. Human leukocyte antigen-G (HLA-G)
molecules are expressed as membrane bound and soluble isoforms
(mHLA-G and sHLA-G) that act as ligand for immune-inhibitory
receptors (ILT2, ILT4 and KIR2DL4). Expression of HLAG is
influenced by a 14-bp insertion/deletion polymorphism in exon
8 of the gene, where the deletion is associated with mRNA stability.
sHLA-G levels are positively correlated with RA disease
activity and treatment response. We suggest a role both in disease
immunopathology and as a biomarker of disease course
and treatment response. We analyzed 14 EA patients during a
12 months follow-up pharmacological treatment. We evaluated
sHLA-G levels in plasma samples by enzyme-linked immunosorbent
assay, mHLA-G and IL-T2 expression on peripheral blood
cells by flow cytometry and typed HLA-G 14-bp polymorphism
by real-time polymerase chain reaction. Disease status parameters
(DAS28) and laboratory data were checked. The sHLA-G
levels, mHLA-G and IL-T2 expression inversely correlated with
DAS28 parameter during the 12 months follow-up (P < 0.0001).
The distribution of HLA-G polymorphism tends to a correlation
between the homozygosity for the deletion, the high producer
genotype and a lower DAS28 (P = 0.069). On the basis of these
preliminary results, HLA-G may be a candidate biomarker to
evaluate early prognosis and disease activity in EA patients
Therapeutic strategies in severe neuropsychiatric systemic lupus erythematosus: experience from a tertiary referral centre
Get PDFThe management of neuropsychiatric systemic lupus erythematosus (NPSLE) still remains empirical and based on clinical experience due to the lack of randomized controlled trials. Objective: to report the experience accumulated in a single tertiary referral centre about treatment of severe cases of NPSLE patients and to discuss therapeutic strategies on the background of EULAR recommendations. Methods: retrospective analysis of all consecutive cases of severe NPSLE treated in our centre since 1990 to 2010, satisfying the 1999 ACR criteria. Results: among 633 SLE patients who consecutively attended our centre, 231 (36%) displayed at least one neuropsychiatric (NP) manifestation for a total of 408 events attributable to SLE. Thirty-one patients (4.8%), 27 females and 4 males, experienced 35 major NP events requiring immunosuppressive therapy (including 3 relapses and 1 new event). An aggressive immunosuppressive strategy was applied to those patients with an immune mediated inflammatory NP event and to those patients with an increased disease activity as judged by ECLAM and SLEDAI scores. Overall at the end of the therapy 74% of the patients reached clinical remission or significant improvement of their symptoms measured by mean SLEDAI (from 10.09±1.09 to 2.04±0.52, PConclusions: the prevalence of NP involvement, described in our case series, is similar to those reported in literature as well as the treatment strategies applied. Nowadays, it is not possible to establish a standardized approach for each single NPSLE manifestation, and different therapeutic strategies must be tailored taking into account the most probable pathogenic mechanism involved, the general disease activity background, the co-morbidities, the type and the stage of the systemic involvement
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