Normal neonatal TREC and KREC levels in early onset juvenile idiopathic arthritis.

OBJECTIVE: Dysregulated central tolerance predisposes to autoimmune diseases. Reduced thymic output as well as compromised central B cell tolerance checkpoints have been proposed in the pathogenesis of juvenile idiopathic arthritis (JIA). The aim of this study was to investigate neonatal levels of T-cell receptor excision circles (TRECs) and kappa-deleting element excision circles (KRECs), as markers of T- and B-cell output at birth, in patients with early onset JIA. METHODS: TRECs and KRECs were quantitated by multiplex qPCR from dried blood spots (DBS), collected 2-5 days after birth, in 156 children with early onset JIA and in 312 matched controls. RESULTS: When analysed from neonatal dried blood spots, the median TREC level was 78 (IQR 55-113) in JIA cases and 88 (IQR 57-117) copies/well in controls. The median KREC level was 51 (IQR 35-69) and 53 (IQR 35-74) copies/well, in JIA cases and controls, respectively. Stratification by sex and age at disease onset did not reveal any difference in the levels of TRECs and KRECs. CONCLUSION: T- and B-cell output at birth, as measured by TREC and KREC levels in neonatal dried blood spots, does not differ in children with early onset JIA compared to controls.

Luce Irigaray's Philosophy of the Child and Philosophical Thinking for a New Era.

In her book To be Born (2017), Luce Irigaray offers a novel philosophy of the child. Instead of viewing the child as a bearer of rights and in need of adequate care as is common in contemporary philosophies of childhood, Irigaray presents the child as a metaphor of a new human being which represents natural belonging. The rearticulation of the human has been ongoing in Irigaray's philosophy from its beginnings with its efforts to give voice to the excluded, silenced, repressed feminine. Irigaray's phenomenological restructuring of subjectivity in her philosophy of sexuate difference is taken to a new level with her philosophy of the child. Her conception of the child is interpreted here in light of the experiential and affective turn within phenomenology and cognitive sciences about philosophical thinking as embodied and embedded thinking for a new era. Irigaray sheds light on the silencing and repressing of the child within us in an effort to enable us as adult beings to think from and with it. Philosophical thinking needs to be more consciously connected with the embodied sources of thought that are already present in early infancy and continue to be present in adult thinking as neglected or repressed experiential and affective layers of thought. Irigaray's philosophy of the child is a basis for a methodology of embodied philosophical thinking such as has been developed within Claire Petitmengin's microphenomenology and within Eugene Gendlin's methodology of philosophical thinking from the felt sense.

[Do opioids, sedatives and proton-pump inhibitors increase the risk of fractures?]

INTRODUCTION: A pharmacoepidemiological study was conducted to analyse the relationship between bone fracture and the use of certain drugs. MATERIAL/METHODS: The study includes patients 40 years and older, diagnosed with bone fractures in the Emergency Department of Landspitali University Hospital in Reykjavik, Iceland, during a 10-year period (2002-2011). Also were included those who picked up from a pharmacy 90 DDD or more per year of the drugs included in the study in the capital region of Iceland during same period. Opiates, benzodiazepines/hypnotics (sedatives) were compared with HMG-CoA reductase inhibitors (statins), non-steroid anti-inflammatory drugs (NSAID) and beta blockers. Proton-pump inhibitors (PPI) and histamine H2-antagonists were also examined. To examine the association between above drugs and fractures the data from electronic hospital database were matched to the prescription database run by the Directorate of Health. RESULTS: A total of 29,056 fractures in 22,891 individuals were identified. The females with fractures were significantly older and twice as many, compared to males. The odds ratio (OR) for fractures was not significantly different between the NSAID, statins and beta blockers. OR for opiates showed almost double increased risk of fractures, 40% increased risk for sedatives and 30% increased risk for PPIs compared to beta blockers. No increased fracture-risk was noted in patients taking H2 antagonists. CONCLUSION: This study shows a relationship between the use of opiates, sedatives and bone fractures. The incidence of fractures was also increased in patients taking PPIs which is interesting in the light of the wide-spread use of PPIs in the community. Key words: Opiates, sedatives, proton- pump inhibitors, fractures. Correspondence: Magnus Johannsson, magjoh@hi.is.