Steroid-sparing agents in giant cell arteritis

Background: Giant cell arteritis is the commonest form of medium-to-large vessel vasculitis, requiring long-term corticosteroid therapy. The short- and long-term side effects of corticosteroids are many, including weight gain, psychological effects, osteoporosis, cardiometabolic complications, and infections. Materials and Methods: Various agents used in place of or in combination with corticosteroids to reduce corticosteroid-related side effects were reviewed. However, considerable variation in practice was identified giving unclear guidance. This review included the most recent evidence on methotrexate, mycophenolate mofetil, azathioprine, cyclophosphamide, abatacept, and tocilizumab Results and Discussion: Also discussed are encouraging results with tocilizumab in GCA patients. Amongst the agents available for steroid-sparing effects, tocilizumab demonstrated the most robust data and is consequently recommended as the agent of choice for steroid-sparing, for remission induction, remission maintenance, and treating relapsing and refractory cases of GCA.Published versio

Just in time management for world class manufacturing: the Japanesse way/ Chitale

186 hal.: ill.; 21,5 cm

Just in time management for world class manufacturing: the Japanesse way/ Chitale

186 hal.: ill.; 21,5 cm

New vegetation type map of India prepared using satellite remote sensing: Comparison with global vegetation maps and utilities

International audienceA seamless vegetation type map of India (scale 1: 50,000) prepared using medium-resolution IRS LISS-III images is presented. The map was created using an on-screen visual interpretation technique and has an accuracy of 90%, as assessed using 15,565 ground control points. India has hitherto been using potential vegetation/forest type map prepared by Champion and Seth in 1968. We characterized and mapped further the vegetation type distribution in the country in terms of occurrence and distribution, area occupancy, percentage of protected area (PA) covered by each vegetation type, range of elevation, mean annual temperature and precipitation over the past 100 years. A remote sensing-amenable hierarchical classification scheme that accommodates natural and semi-natural systems was conceptualized, and the natural vegetation was classified into forests, scrub/shrub lands and grasslands on the basis of extent of vegetation cover. We discuss the distribution and potential utility of the vegetation type map in a broad range of ecological, climatic and conservation applications from global, national and local perspectives. We used 15,565 ground control points to assess the accuracy of products available globally (i.e., GlobCover, Holdridge’s life zone map and potential natural vegetation (PNV) maps). Hence we recommend that the map prepared herein be used widely. This vegetation type map is the most comprehensive one developed for India so far. It was prepared using 23.5 m seasonal satellite remote sensing data, field samples and information relating to the biogeography, climate and soil. The digital map is now available through a web portal (http://bis.iirs.gov.in)