1,721,005 research outputs found
HIGH INCIDENCE OF SERIOUS ADVERSE EVENTS AMONG ELDERLY RHEUMATOID PATIENTS RECEIVING MONOCLONAL ANTIBODIES ANTI-TNFALPHA
No full textObjectives: Approximately 10-33% of patients with rheumatoid arthritis (RA) are diagnosed after the age of 60. Treatment with anti-TNFalpha drugs in elderly might enhance the incidence of serious adverse events, particularly infections and cardiovascular disease. We retrospectively evaluated the safety of anti-TNFalpha therapy in elderly (age ≥ 65 yrs) and younger adult subjects (age < 65 yrs) with rheumatoid arthritis followed by a tertiary Rheumatology institution.
Methods: Data regarding the safety of anti-TNFalpha therapy (infliximab, etanercept, adalimumab) in 73 elderly rheumatoid arthritis patients were retrospectively evaluated and compared with those of 236 younger patients. All patients received anti-TNFalpha at the recommended dose. Safety and survival of anti-TNFalpha drugs were assessed at regularly scheduled visit. Differences between groups were analyzed by means of a chi-square test. P < 0.05 was taken as statistically significant.
Results: 1) Infliximab group. 19 pts (12 F/7 M, mean age 69,1±3,4, mean duration of disease 125,1±63,4 months) were ≥ 65 and 82 (64 F/18 M, mean age 50,1±9, mean duration of disease 139,4±81,3 months) were < 65 years of age. All patients received infliximab infusion at starting dose of 3 mg/kg along with a concomitant DMARD (methotrexate or leflunomide) and low-dose prednisone (5 mg/day). The infliximab dosage could be increased to 5 mg/kg or treatment interval shortened in case of inefficay. During the follow-up (median = 27,5 months), serious adverse events occurred in 68.4% (13/19) of pts ≥ 65 as opposed to 39% (32/82) of younger pts (p = 0,03). The rate of infliximab withdrawal due to serious adverse event was higher among elderly pts (57.8% vs 29.2%, p = 0,03). Among pts ≥ 65 yrs, cardiovascular disease (35.7%) resulted the main adverse events followed by infusion reaction (28.5%) and infections (21.4%).
2) Etanercept group. 29 pts (23 F/6 M, mean age 69,6±4,1, mean duration of disease 148,1±84,6 months) were ≥ 65 and 94 (78 F/16 M, mean age 48,1±11,8, mean duration of disease 105±81,8 months) were < 65 years of age. Concomitant DMARD therapy was similar between elderly and younger subjects (68.9% and 73.4%, p = ns). During the follow-up (median = 20,5 months), the rate of withdrawal due to serious adverse events did not differ between elderly and younger pts (10.3% vs 9.5%, p = ns). Furthermore, the rate of serious infection tended to be higher in younger than elderly pts (61.9% vs 20%, p = ns).
3) Adalimumab group. 25 pts (21 F/4 M, mean age 69,1±3,3, mean duration of disease 122,8±133 months) were ≥ 65 and 60 (51 F/9 M, mean age 48,1±11,1, mean duration of disease 105±84,9 months) were < 65 years of age. 88% in elderly group took a concomitant DMARD as opposed to 71.6% in younger subject (p = ns). During the follow-up (median = 12,1 months), more pts ≥ 65 yrs developed serious adverse than younger (48% vs 25%, p = 0,01). The rate of withdrawal due to serious adverse events was higher among elderly pts (36% vs 15%, p = 0,06). Infections (40%) and solid tumors (20%) were the main types of adverse events in elderly pts.
Conclusion: Among TNFalpha antagonists, only etanercept has a similar safety profile both in younger and elderly people with rheumatoid arthritis. On the basis of our observations monoclonal antibodies should be given with more caution in this population
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Full text link“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
Full text linkWe 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
Multiple sclerosis or Sjogren's syndrome: A clinical dilemma
No full textBackground: Multiple sclerosis (MS) like disease may be a feature of central nervous system (CNS) involvement in Sjogren''s syndrome prompting some difficulties in differential diagnosis with typical MS.
Objectives: To describe the clinical course, response to therapy and long term outcome of CNS Sjogren''s syndrome presenting as multiple sclerosis-like (MS) disease in a large series of primary Sjogren''s syndrome (pSS).
Methods: A cohort of 380 patients with pSS, consecutively observed at our unit from January 1990 to December 2002, was evaluated for CNS involvement with particular attention to MS-like disease. All the patients fulfilled the revised 2002 ECSG criteria for primary pSS. Clinical course, seroimmunological parameters and response to therapy of patients with MS-like clinical picture are described.
Results: Among 25 pts with CNS involvement, 4 pts (16%) had MS-like disease. All the pts were women, with a middle age of 41.5 years. In all cases, neurological symptoms preceded the diagnosis of pSS and occurred at a mean age of 33.5 years. Two patients had a monolateral visual loss due to retrobulbar optic neuritis. In two other cases there was also a spinal cord involvement, with a MRI imaging showing incomplete transverse myelitis. One patient developed brain stem involvement, with recurrent episodes of dizziness and sensorineural hearing loss. CSF analysis was performed in all patients showing mild lymphocytosis, raised IgG index and the presence of oligoclonal bands suggesting intyratechal immunological activation. In three pts brain MRI exhibited multiple areas of increased signal intensity on T2 weighted images, predominantly located in subcortical and periventricular white matter, with involvement of corpus callosum and cerebellum in one case. ANA were positive in 3 out 4 of pts, anti-Ro/SSA antibodies in 2 out of 4. Rheumatoid factor was positive in only one patient. No patient had anti-dsDNA or lupus anticoagulant. Only one patient presented a transient positivity for IgG anticardiolipin antibodies (low titer). All the patient had low levels of C4 (<15 mg/dl). Minor salivary glands biopsy was obtained in all patients showing a focal lymphocytic sialoadenytis with a focus score ≥ 1.
All the patient were treated with IV high doses of methylprednisolone during the acute phase of neurological manifestations; two patients received cyclosporine A 3 mg/kg/die, and one patient was treated with azathioprine 2 mg/kg/die. One patient with transverse myelitis had a good response to IV methylprednisolone and remained in remission with cyclosporine A, showing at instrumental follow-up evaluation a gradual disappearance of MRI lesions. Another patient suffered from a slowly primary progressive course with brainstem involvement following the first episode of optic neuritis. The remaining two pts had a relapsing-remitting course poorly influenced by immunosuppressive therapy (cyclosporine and azathioprine).
Conclusion: MS-like disease may be a rare but serious complication of pSS. Differential diagnosis from true MS is a troublesome challenge for the physician, expecially when the neurological syndrome represents the heralding picture as in the reported cases. Seroimmunological picture and salivary gland histopathology could be useful in the diagnostic interpretation permitting to avoid potentially dangerous immunomodulating therapies such as beta-IFN. In our opinion demyelinating disease should be considered in the CNS spectrum of pSS and should be carefully evaluated when dealing with MS disease with atypical presentation and/or in presence of warning signs of autoimmunity
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe 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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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