215 research outputs found
Predictors of DAPSA28 remission in patients with psoriatic arthritis initiating a first TNF-inhibitor: results from 13 European registries.
Get PDFOBJECTIVES
In bio-naïve patients with Psoriatic arthritis (PsA) initiating a Tumour Necrosis Factor inhibitor (TNFi), we aimed to identify baseline predictors of Disease Activity index for PsA in 28 joints (DAPSA28) remission (primary objective) and DAPSA28 moderate response at 6 months, as well as drug retention at 12 months across 13 European registries.
METHODS
Baseline demographic and clinical characteristics were retrieved and the three outcomes investigated per registry and in pooled data, using logistic regression analyses on multiply imputed data. In the pooled cohort, selected predictors that were either consistently positive or negative across all three outcomes, were defined as common predictors.
RESULTS
In the pooled cohort (n = 13 369), six-month proportions of remission, moderate response and 12-month drug retention were 25%, 34% and 63% in patients with available data (n = 6,954, n = 5,275 and n = 13 369, respectively). Baseline predictors of remission, moderate response and 12-month drug retention were identified, five common across all three outcomes. Odds ratios (95% confidence interval) for DAPSA28 remission were: age, per year: 0.97 (0.96-0.98); disease duration, years (10 vs ≤ 10 mg/l: 1.52 (1.22-1.89) and one mm increase in patient fatigue score: 0.99 (0.98-0.99).
CONCLUSION
Baseline predictors of remission, response and adherence to TNFi were identified, of which five were common for all three outcomes, indicating that the predictors emerging from our pooled cohort may be considered generalisable from the country- to disease-level
Malignancies in Wegener's granulomatosis: incidence and relation to cyclophosphamide therapy in a cohort of 293 patients
No full textOBJECTIVE: To describe the incidence of malignancies in a cohort of Danish patients with Wegener's granulomatosis (WG) and to investigate the cancer risk associated with cyclophosphamide (CYC) -therapy in WG. METHODS: In total, 293 patients diagnosed with WG between 1973 and 1999 were studied. Cancer incidence in the cohort was assessed through 2003 by linkage to the Danish Cancer Registry and compared to that of the general population by calculation of standardized incidence ratios (SIR). Analyses were stratified according to treatment with low cumulative CYC doses (< or = 36 g) and high doses (> 36 g, corresponding to treatment with 100 mg CYC/day for > 1 year). RESULTS: Fifty cancers occurred during 2121 person-years of followup (SIR of cancer of 2.1, 95% CI 1.5-2.7). Significantly increased SIR were observed for acute myeloid leukemia (AML; SIR 19.6, 95% CI 4.0-57), bladder cancer (SIR 3.6, 95% CI 1.2-8.3), and non-melanoma skin cancers (SIR 4.7, 95% CI 2.8-7.3). Leukemias and bladder cancers were diagnosed 6.9-18.5 years after initiation of CYC therapy. The risk of these malignancies was not increased for patients who never received CYC or for patients treated with cumulative CYC doses < or = 36 g. In contrast, high risks of AML (SIR 59.0, 95% CI 12-172) and bladder cancer (SIR 9.5, 95% CI 2.6-24) were observed for patients treated with cumulative CYC doses > 36 g. CONCLUSION: Treatment with high cumulative CYC doses implies a substantial risk of late-occurring, serious malignancies in WG. Patients with WG should be monitored for development of cancer for several decades after cessation of CYC therapy. These findings emphasize the need for development of new treatment regimens in WG Udgivelsesdato: 2008/1To describe the incidence of malignancies in a cohort of Danish patients with Wegener's granulomatosis (WG) and to investigate the cancer risk associated with cyclophosphamide (CYC) -therapy in WG
Differences in topographical location of sacroiliac joint MRI lesions in patients with early axial spondyloarthritis and mechanical back pain
Get PDFBackground: Early diagnostics of axial spondyloarthritis (axSpA) remains a challenge. Traditional imaging one-plane sacroiliac joint (SIJ) MRI assessment is used. By introducing a two-plane assessment system, the objective was to analyse the differences in SIJ MRI changes in early axSpA compared with changes in patients with mechanical back pain (MBP) by exploring the differences in volume and location. Methods: MRIs in the early diagnostic state of 25 axSpA patients (mean age 31.3 years) and 59 MBP patients (mean age 32.3 years) were included. The MRIs were assessed by two readers regarding the distribution of bone marrow edema (BME) in 14 joint portions and structural changes in six joint portions in addition to SIJ anatomical variations and lumbar spine disc degeneration. Results: AxSpA patients had a significantly higher overall BME sumscore (volume) of 25.1 compared to MBP patients 6.8, p < 0.005. The MBP group had the highest prevalence (66%) and sumscore (5.7) in the middle anterior sacrum. The axSpA group had significantly higher prevalence and sumscores in all joint portions except the three cartilaginous anterior sacral joint portions, including the ligamentous compartments (prevalence 40–60% compared to 8–15%, p both < 0.005). The axSpA group had also a significantly higher prevalence of erosions and fatty marrow disposition, but there were no differences in the prevalence of anatomical variations except the bipartite iliac bony plate. Conclusions: AxSpA patients demonstrated a widespread distribution of both inflammatory and structural changes, including high BME occurrence in the ligamentous joint portions whereas patients with MBP had the highest occurrence of BME in the middle anterior sacrum. These findings may help differentiate axSpA patients from other back pain conditions in the early diagnostic phase.</p
Molecular Biology of Infectius Agents in the Early Diagnosis of Spondyloarthritis (MICSA)
No full textShort‐term treatment with growth hormone stimulates osteoblastic and osteoclastic activity in osteopenic postmenopausal women: A dose response study
No full textAlpha‐fetoprotein and acetylcholinesterase activity in first‐and early second‐trimester amniotic fluid
No full textMolecular Biology of Infectius Agents in the Early Diagnosis of Spondyloarthritis (MICSA)
No full textObtuse, Flitting by, and Nevertheless There – Image Archives in Practice
No full textOver the past thirty years, the status of the archive as well as the state of what we call “documentary” have dominated discussions in and around photography. Although it is now commonplace to presume the objectifying gesture of documentary photography, the complex question of how, as a working artist/photographer, to approach the archive has not yet been adequately addressed. The purpose of this research is to raise questions about how, after the critique of the documentary image, the artist/photographer addresses, indeed, finds the archive. I am starting with the assumption that the archive is not only a place of storage but also a place of production, where our relation to the past is materialised and where our present writes itself into the future; thus, accordingly, I understand the archive as a place of negotiation and writing.
After the problems of the archive have been identified theoretically, the practice in the archive still encounters challenges and contradictions. This project explores those difficulties that remain within the practice in and around the archive, even after the critique has been stated. It is not about simply extending the critique, but finding an archive and the practice with it.
I am approaching these questions as a practitioner. As an artist and photographer, I am concerned with two practices in relation to archives: working with existing archives, and making work that will itself be archived. The point raised by those two activities is not to find or create another institutional archive per se, but to develop an archival practice in which the set of problems that the archives produce is in fact part of the process one engages in. Hence the work is a theoretical and practical set of experiments that may never be complete and conclusive
Validity and completeness of rheumatoid arthritis diagnoses in the nationwide DANBIO clinical register and the Danish National Patient Registry
No full textElse Helene Ibfelt,1 Jan Sørensen,2,3 Dorte V Jensen,4,5 Lene Dreyer,5,6 Berit Schiøttz‑Christensen,7 Pia H Thygesen,8 Ada Colic,9 Johnny L Raun,10 Natalia Manilo,11 Anne Rødgaard,4 Uta E Poulsen,12 Claus Rasmussen,13 Torben Hansen,14 Babara Unger,15 Randi Pelck,16 Anita Kincses,17 Henrik Nordin,18 Tove Lorenzen,19 Ali Theibich,20 Inger Marie Jensen Hansen,21 Jakob Espesen,22 Jolanta Grydehøj,23 Mette Holland-Fischer,24 Anne Gitte Loft,25 Merete Lund Hetland4,26 1Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet – Glostrup, Denmark; 2Centre of Health Economics Research, Institute of Public health, University of Southern Denmark, Odense, Denmark; 3Healthcare Outcome Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland; 4DANBiO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet – Glostrup, Glostrup, 5Center for Rheumatology and Spine Diseases, Gentofte University Hospital, Hellerup, 6The Parker Institute, Frederiksberg and Bispebjerg Hospital, Frederiksberg, 7Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, 8Department of Rheumatology, Odense University Hospital, Odense, 9Department of Rheumatology, Sydvestjysk Sygehus, Esbjerg/Grintsted, 10Department of Internal Medicine and Rheumatology, SLB – Fredericia Hospital, Fredericia, 11Department of Rheumatology, Frederiksberg Hospital, Copenhagen, 12Department of Rheumatology, Gigthospital Gråsten, Gråsten, 13Clinic of Internal Medicine, Rheumatology, Regionshospital Nordjylland, Hjørring, 14Department of Rheumatology, Holbæk sygehus, Holbæk, 15Department of Internal Medicine/Rheumatology, Hospitalsenheden Horsens, Horsens, 16Department of Rheumatology, Zealand University Hospital, Køge, 17Department of Rheumatology, Nordsjællands Hospitaler, Hillerød, 18Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, 19Department of Rheumatology, Silkeborg Regional Hospital and University Clinic, Silkeborg, 20Department of Rheumatology, Slagelse Hospital, Slagelse, 21Department of Rheumatology and University of Southern Denmark, Svendborg Hospital, Odense, 22Department of Internal Medicine, Vejle Hospital, Vejle, 23Department of Rheumatology, Regional Hospital, West Jutland, Herning, 24Department of Rheumatology, Aalborg University Hospital, Ålborg, 25Department of Rheumatology, Aarhus University Hospital, Aarhus, 26Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Objectives: In Denmark, patients with rheumatoid arthritis (RA) are registered in the nationwide clinical DANBIO quality register and the Danish National Patient Registry (DNPR). The aim was to study the validity of the RA diagnosis and to estimate the completeness of relevant RA cases in each registry.Study design and setting: Patients registered for the first time in 2011 with a diagnosis of RA were identified in DANBIO and DNPR in January 2013. For DNPR, filters were applied to reduce false-positive cases. The diagnosis was verified by a review of patient records. We calculated the positive predictive values (PPVs) of the RA diagnosis registrations in DANBIO and DNPR, and estimated the registry completeness of relevant RA cases for both DANBIO and DNPR. Updated data from 2011 to 2015 from DANBIO were retrieved to identify patients with delayed registration, and the registry completeness and PPV was recalculated.Results: We identified 1,678 unique patients in DANBIO or in DNPR. The PPV (2013 dataset) was 92% in DANBIO and 79% in DNPR. PPV for DANBIO on the 2015 update was 96%. The registry completeness of relevant RA cases was 43% in DANBIO, increasing to 91% in the 2015 update and 90% in DNPR.Conclusion: DANBIO held a high proportion of true RA cases (96%) and was found to be superior to the DNPR (79%) with regard to the validity of the diagnosis. Both registries were estimated to have a high completeness of RA cases treated in hospital care (~90%). Keywords: rheumatoid arthritis, validity, incidence, clinical registry, Denmar
Cartilage collagen type II seromarker patterns in axial spondyloarthritis and psoriatic arthritis:associations with disease activity, smoking and HLA-B27
No full textThe aim of the study was to assess the possible association between type II collagen turnover seromarkers and disease profile in patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA). Outpatients with axial SpA (n = 110) or PsA (n = 101) underwent clinical examination including disease activity measures and HLA-B27 typing. The procollagen IIA N-terminal peptide (PIIANP) and a matrix metalloproteinase-generated type II collagen fragment (C2M) were quantified in serum by ELISA. C2M was higher in SpA than in controls, 0.41 versus 0.36 ng/ml (p = 0.004), while PIIANP did not differ between patients and healthy subjects, 2252 versus 2142 ng/ml (p = 0.13). However, DMARD-naïve SpA patients had higher PIIANP, 2461 ng/ml (p = 0.01) and C2M, 0.44 ng/ml (p = 0.0007) levels than controls, and PIIANP correlated with CRP (ρ = 0.34). C2M was lower in SpA smokers, 0.36 ng/ml versus non-smokers, 0.43 ng/ml (p = 0.02), while PIIANP was higher in HLA-B27 positive, 2312 ng/ml versus negative patients, 2021 ng/ml (p = 0.03). In PsA, PIIANP and C2M did not differ between patients and controls, but PIIANP was elevated in patients not receiving DMARDs, 2726 ng/ml. In PsA, PIIANP and C2M did not differ according to smoking and HLA-B27. Cartilage degradation assessed by C2M is increased in SpA irrespective of treatment but not in PsA. Cartilage synthesis reflected by PIIANP is increased in untreated SpA and PsA. PIIANP correlates with CRP in SpA while not in PsA. In DMARD-naïve SpA but not in PsA, HLA-B27 positivity and smoking are associated with a chondro-proliferative metabolic pattern.</p
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