ABSTRACT
OBJECTIVES: Reconstitution of B-cells after their therapeutic depletion with rituximab mimics the ontogeny of the B-cell linage in patients with rheumatoid arthritis. However, little is known about the effects of multiple cycles of treatment on the repletion kinetics and their long-lasting effects on the B-cell compartment. We therefore compared the recovery capacity of the B cell subpopulations between patients who experienced their first cycle of rituximab and those who experienced successive cycles. METHODS: The distribution of the different B-cell subsets was characterised by multiparametric flow cytometry in the peripheral blood of 29 patients in the first rituximab course (naïve cycles) and 40 patients in successive cycles. Samples were obtained at baseline and at 3, 6, and 8 months of each cycle. RESULTS: The baseline percentage of B-cell subsets was similar among successive cycles. Therefore, successive cycles were grouped for comparison with naïve cycles. Patients in naïve cycles had higher percentages at baseline of both total and memory B-cells. However, the recovery of the different B-cell subsets was similar between naïve and successive cycles. In naïve patients the percentage of transitional B-cells significantly correlated with disease activity at baseline. CONCLUSIONS: Rituximab induces a long-term reshape of the B-cell compartment while multiple cycles of rituximab do not induce cumulative effects on B-cell subpopulations. Transitional B-cells seem to be associated with higher disease activity, although further studies are needed to determine if they can be used as a biomarker to predict the need for rituximab retreatment.
Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid , Rituximab/therapeutic use , Antibodies, Monoclonal, Murine-Derived , Arthritis, Rheumatoid/immunology , B-Lymphocytes , HumansABSTRACT
This study investigated videos about Attention Deficit Hyperactivity Disorder (ADHD) on YouTube in terms of issues, sources, and episodic-thematic aspects. A total of 685 videos uploaded onto YouTube between 2006 and 2014 were content analyzed. Results demonstrated that the top three key issues about ADHD were symptom, child, and treatment. Doctor, patient, and supporter were the three most interviewed sources. Videos from the public sector including the government, company representative, and public organizations were relatively rare compared to other sources suggesting the potential for a greater role for the government and public sector contributions to YouTube to provide credible information relevant to public awareness, campaigns, and policy announcements. Meanwhile, many personal videos in the episodic frame advocated social solutions. This result implies that YouTube videos about health information from the private sectors have the potential to affect change at the social level.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Consumer Health Information , Internet , Social Media , Humans , Information Dissemination , Private Sector , Public SectorABSTRACT
Objetivo: Analizar el efecto de la estructura del afecto en las siguientes herramientas de evaluación de la artritis reumatoide: escala visual analógica (EVA) de dolor, HAQ y DAS28. Pacientes y métodos: Se estudiaron 86 pacientes con artritis reumatoide de reciente comienzo, de los que el 75,7% eran mujeres, con una mediana de edad al inicio de la enfermedad de 55 años. A todos los pacientes se les aplicó la versión adaptada a población española del cuestionario PANAS que evalúa las componentes de afecto positivo (AP) y negativo (AN). Los pacientes pertenecían al registro de artritis de reciente comienzo de nuestro centro por lo que se disponía de información clínica de los enfermos en 282 visitas. Para determinar el efecto de AP y AN en cada una de nuestras variables dependientes se estimaron 3 modelos de regresión lineal multivariable mediante modelos lineales generalizados usando el comando glm del programa Stata 10.1. Resultados: El promedio de la puntuación de AP y AN en nuestros pacientes fue similar al descrito para la población española sana. Las puntuaciones elevadas en la subescala de AN se asociaron a peores puntuaciones, tanto en la EVA de dolor, como en el HAQ. Por el contrario, puntuaciones elevadas en AP se asociaron con una mejor evolución de la actividad de la enfermedad medida por el DAS28. Conclusión: La estructura del afecto puede influir en las herramientas que utilizamos para la evaluación de los pacientes con artritis reumatoide, por lo que podría ser recomendable incluir la realización del PANAS como parte de dicha evaluación (AU)
Objective: To analyze the effect of the structure of mood over the following assessment tools for rheumatoid arthritis: visual analog scale (VAS) for pain, HAQ and DAS28. Patients and methods: We studied 86 patients with recent onset rheumatoid arthritis, of which 75.7% were female, with a mean age at disease onset of 55 years. All patients were administered the Spanish version of the PANAS questionnaire that evaluates the components of positive (PA) and negative mood (AN). Patients belonged to the registry of new-onset arthritis in our center so clinical information was available for 282 patients visits. To determine the effect of PA and AN on each of the dependent variables we performed three multivariate linear regression models using generalized linear models through the Stata glm command 10.1. Results: The mean score for PA and AN in our patients was similar to that described for the healthy Spanish population. The high scores on the subscale of AN were associated with worse scores in both the VAS for pain and the HAQ. By contrast, high scores on PA were associated with better outcomes of disease activity measured by DAS28. Conclusion: The structure of mood may influence the tools we use for evaluating patients with rheumatoid arthritis, so it might be advisable to include the PANAS questionnaire as part of that assessment (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Arthritis, Rheumatoid/diagnosis , /instrumentation , /methods , /standards , Surveys and Questionnaires/standards , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To analyze the effect of the structure of mood over the following assessment tools for rheumatoid arthritis: visual analog scale (VAS) for pain, HAQ and DAS28. PATIENTS AND METHODS: We studied 86 patients with recent onset rheumatoid arthritis, of which 75.7% were female, with a mean age at disease onset of 55 years. All patients were administered the Spanish version of the PANAS questionnaire that evaluates the components of positive (PA) and negative mood (AN). Patients belonged to the registry of new-onset arthritis in our center so clinical information was available for 282 patients visits. To determine the effect of PA and AN on each of the dependent variables we performed three multivariate linear regression models using generalized linear models through the Stata glm command 10.1. RESULTS: The mean score for PA and AN in our patients was similar to that described for the healthy Spanish population. The high scores on the subscale of AN were associated with worse scores in both the VAS for pain and the HAQ. By contrast, high scores on PA were associated with better outcomes of disease activity measured by DAS28. CONCLUSION: The structure of mood may influence the tools we use for evaluating patients with rheumatoid arthritis, so it might be advisable to include the PANAS questionnaire as part of that assessment.
Subject(s)
Affect , Arthritis, Rheumatoid/psychology , Adult , Aged , Arthritis, Rheumatoid/diagnosis , Female , Humans , Linear Models , Male , Middle Aged , Multivariate Analysis , Pain Measurement , Pain Perception , Psychological Tests , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
El objetivo de esta investigación se realiza con la finalidad de implementar un protocolo de atención se realiza con la finalidad de implementar un protocolo de atención en enfermeria dirigido al manejo del paciente intoxicado con organofosforados en el servicio de emergencias del hospital Militar para de esya manera unificar criterios de los profesionales de enfermeria que trabajan en la institucion y asi brindar cuidados optimos y oportunos al cliente esta investigacion pretende saber en que medida la implementacion de un protocolo de atencion de enfermeria mejorara la oportunidad y la calidad de la atencion a pacientes intoxicados con organofosforados el diseño de la investigación es de caracter descriptivo transversal la población estudiada esta constituida por el total de enfermeras que trabajan en COSSMIL la muestra fue seleccionada por conveniencia a todas las licenciadas que trabajan en el servicio de emergencias y terapia intensiva del Hospital Militar tomando en cuenta que estos pacientes no pueden ser transferidos a otros servicios, por el manejo hemodinamico que requieren para la ejecucion del estudio se elaboro un instrumento tipo cuestionario conformado esta construccion de la propuesta consta de 6 fases, las mismas que seran elaboradas, diseñadas y aplicadas previa presentación discusión analisis y aprobación ante el comite de evaluación una vez aprobado este protocolo se procedera a su ejecución y conocimiento al personal profesional de enfermeria dentro de los servicios de Emergencias y terapia Intensiva para su manejo adecuado de este tipo de pacientes
Subject(s)
Health Services Accessibility/standards , Health Services Accessibility/organization & administration , Health , Guidelines as Topic/nursingABSTRACT
The within-chromosome distribution of gametic disequilibrium (GD) between protein loci, and the underlying evolutionary factors of this distribution, are still largely unknown. Here, we report a detailed study of GD between a large number of protein loci (15) spanning 87% of the total length of the third chromosome of Drosophila melanogaster in a large sample of haplotypes (600) drawn from a single natural population. We used a sign-based GD estimation method recently developed for multiallelic systems, which considerably increases both the statistical power and the accuracy of estimation of the intensity of GD. We found that strong GD between pairs of protein loci was widespread throughout the chromosome. In total, 22% of both the pairs of alleles and pairs of loci were in significant GD, with mean intensities (as measured by D' coefficients) of 0.43 and 0.31, respectively. In addition, strong GD often occurs between loci that are far apart. By way of illustration, 32% of the allele pairs in significant GD occurred within pairs of loci separated by effective frequencies of recombination (EFRs) of 15-20 cM, the mean D' value being 0.49. These observations are in sharp contrast with previous studies showing that GD between protein loci is rarely found in natural populations of outcrossing species, even between very closely linked loci. Interestingly, we found that most instances of significant interallelic GD (68%) involved functionally related protein loci. Specifically, GD was markedly more frequent between protein loci related by the functions of hormonal control, molybdenum control, antioxidant defense system, and reproduction than between loci without known functional relationship, which is indicative of epistatic selection. Furthermore, long-distance GD between functionally related loci (mean EFR 9 cM) suggests that epistatic interactions must be very strong along the chromosome. This evidence is hardly compatible with the neutral theory and has far-reaching implications for understanding the multilocus architecture of the functional genome. Our findings also suggest that GD may be a useful tool for discovering networks of functionally interacting proteins.
Subject(s)
Chromosome Mapping , Drosophila melanogaster/genetics , Germ Cells , Linkage Disequilibrium , Animals , Genetic VariationABSTRACT
A restriçäo protéico-calórica em ratas adultas, durante 21 dias, acarretou queda significante nos pesos corporal e pulmonar desses animais, sem alterar significantemente o conteúdo de água e de DNA de seus pulmöes. A desnutriçäo protéico-calórica provocou, ainda, reduçäo significante no conteúdo pulmonar de RNA, proteína total e das relaçöes RNA/DNA e proteína total/DNA, indicando uma possível diminuiçäo da sintese protéica e do tamanho das células pulmonares respectivamente. As concentraçöes de RNA e proteína total foram semelhantes enquanto a de DNA foi signifivantemente superior nas ratas desnutridas. A desnutriçäo protéico-calórica näo afetou o conteúdo de hidroxiprolina do pulmäo enquanto ocasionou uma elevaçäo significante nas concentraçöes desse aminoácido, sugerindo a ocorrência de maior deposiçäo de colágeno ou a lentidäo de seu "turnover" em relaçäo aos das demais proteínas desse órgäo
