Fingertip rapid point-of-care test in adult case-finding in coeliac disease

Background Coeliac disease (CD), due to its protean clinical manifestation, is still very under diagnosed in adults and delays in diagnosis may take years and even decades. Simple tools to find cases in primary care may help to identify patients for further diagnostic tests. We have evaluated the usefulness of an on site rapid fingertip whole blood point-of-care test (POCT) for such a purpose. Methods As CD is known to run within families, we tested 148 healthy relatives of 70 Romanian index cases with biopsy-proven CD (87% of all first-degree family members, median age 36 years) for the presence of circulating autoantibodies. In addition to performing the POCT (which measures blood erythrocyte self-TG2-autoantibody complexes) on site, blood was drawn for later evaluations of serum IgA-class endomysial antibodies (EMA). EMA-positive sera were further tested for transglutaminase 2 antibodies (TG2-IgA). All serological parameters were analyzed blindly in a centralized laboratory that had no knowledge of the on site POCT result. Endoscopic small intestinal biopsies was recommended for all POCT- or EMA-test positive subjects. Results In on site testing the POCT was positive in 12/148 first-degree relatives (8%) and all these subjects were also serum EMA-positive. A positive EMA test was found only in one other subject. All remaining 135 healthy first-degree relatives were negative for both POCT and EMA. Four subjects positive for both POCT and EMA were negative for TG2-IgA. Ten out of thirteen of the antibody-positive subjects agreed to undergo endoscopy. The POCT was found to be positive in 8/9 first-degree relatives having coeliac-type mucosal lesions of grade Marsh 2 (n = 3) or Marsh 3 (n = 6). The three POCT-positive subjects not agreeing to undergo endoscopy were also both EMA- and TG2-IgA-positive. Conclusion The fingertip whole blood rapid POCT might fulfill the unmet need for a simple and cheap case-finding biomarker for early detection and presumptive diagnosis of CD. Confirmatory studies are warranted in adult case-finding in specialized outpatient clinics and in primary care.BioMed Central open acces

Odin and Zeus : a comparative study on the supreme gods of two mythologies

Odin and Zeus. A comparative study on the supreme gods of two mythologies. is a comparative analysis of Odin and Zeus and of the mythologies they belong to. The study follows Georges Dumézil s theory of tripartite ideology according to which the Indo-European societies were divided in three classes represented by priests, soldiers and peasants. These could also be found on a mythological level, so that the society of gods can also be said to be driven by the same principles. Following the Nose model described by Dumézil in Gods of the Ancient Northmen (1959), according to which Odin and Tyr represent the first mythological class (function), Thor the second, and Njord, Frey and Freya represent the third function, the study aims at describing a similar division in the Greek world. The analysis follows the three functions described by Dumézil. The thesis describes Odin and Zeus in parallel along the tree functions in order to see what features they expose. In conclusion it can be seen that Odin is the sovreign god in the Norse mythology; he has war-like features, but cannot be considered a god of war; he has no third function features. Zeus, on the other hand, is the strongest and the mightiest of all Greek gods, and can be taken to represent all three functions, as long as we consider also that he can be helped in his representation of the second and third function by other specialised gods

Amplifiers in English and Norwegian : absolutely, completely, entirely, perfectly, and totally and their Norwegian correspondences : a study based on the English-Norwegian parallel corpus

The thesis consists of two parts, a theoretical and an analysis part. Part 1 discusses the idea of intensification, focusing on five English amplifiers: absolutely, completely, entirely, perfectly, and totally. A few ideas on translation and a short chapter on intensification in Norwegian are also included in this part. Part 2 discusses the five English amplifiers mentioned before in texts from the ENPC (English-Norwegian Parallel Corpus). The search in the ENPC was made in both directions (English and Norwegian) on absolutely, completely, entirely, perfectly, and totally; it came up with 462 cases of amplifiers, which made up the database of this study. The results of this search show that completely is the most frequently used of the five amplifiers, and that it is followed in number of frequency by entirely, perfectly, absolutely, and totally. In analysing the amplifiers I started from the premise that the modified words must trigger the use of the different Norwegian correspondences of our amplifiers. Consequently I considered the grammatical category of the words they modify and some semantical traits of these collocations. Some conclusions we may draw are: o Perfectly modifies most adjectives and adverbs of our amplifiers, and entirely modifies most verbs; o Absolutely is the only one of the maximizers discussed which modifies indefinite pronouns; o The five amplifiers discussed are more frequently used in translated English texts than in original ones. They are rendered either by a paraphrase or a zero correspondence in the original Norwegian texts; o The most frequently used Norwegian correspondences of our amplifiers are helt and fullstendig except for absolutely, whose most frequent correspondence is absolutt; o Whenever our amplifiers modify adjectives, their Norwegian correspondence would be either helt or no correspondence. Since most of the cases of zero correspondence occur in translated English texts, we may conclude that the necessity of intensifying in English is mostly triggered by the modified adjectives; o From a semantic point of view, the adjectives modified by our amplifiers are mainly adjectives of relevance. However some amplifiers may distinguish themselves by modifying other adjective types. The verbs modified by our amplifiers are mainly dynamic. However perfectly modifies almost as many stative as dynamic verbs. The modified verbs often also have a [+NEGATIVE] semantic feature, especially the ones that collocate with absolutely, completely, and entirely

Real-World Clinical Outcomes and Adverse Events in Patients with Chronic Lymphocytic Leukemia Treated with Ibrutinib: A Single-Center Retrospective Study

Background and Objectives: The treatment of chronic lymphocytic leukemia (CLL) has acquired new targeted therapies. In clinical trials, ibrutinib improved outcomes safely. Real-world data called for a reappraisal of ibrutinib strategies. We report on a single center’s experience with ibrutinib monotherapy, aiming to explore the outcomes, tolerability, and prognosis of CLL patients in routine clinical practice. Materials and Methods: Data were collected from all CLL patients treated with ibrutinib at Fundeni Clinical Institute, Bucharest, Romania, between January 2016 and June 2021. Results: A total of one hundred twenty-three CLL adult patients were treated with ibrutinib. Of the patients, 87% had relapsed/refractory CLL. The median age at ibrutinib initiation was 65 years; 44.7% of patients were staged Rai III/IV. At 32-month median follow-up, the median progression-free survival (PFS) was 50 months, the overall survival (OS) was not reached, and the overall response rate (ORR) was 86.2%. The age or number of previous therapies did not impact outcomes or tolerability. An Eastern Cooperative Oncology Group performance status (ECOG PS) score ≥ 2 and shorter time from initiation of last therapy (TILT) before ibrutinib predicted inferior PFS. Baseline characteristics had no impact on the OS except for TILT in R/R CLL patients. Drug-related adverse events (AEs) of any grade and grade ≥ 3 AEs were reported in 82.1% and 30.9% of the patients, respectively. Infections were the most common AEs (29.3%). Drug discontinuation was permanent in 43.9% of patients, mainly due to disease progression (17.1%) and toxicity (8.9%). Patients with a Cumulative Illness Rating Scale (CIRS) score ≥ 6 had a higher risk for toxicity-related discontinuation. An ECOG PS ≥ 2 predicted an increased rate of permanent discontinuation and grade ≥ 3 AEs. Conclusions: The outcomes of this study align with the results from ibrutinib clinical trials. Our study demonstrated that poor patient fitness, early relapse before ibrutinib, and permanent ibrutinib discontinuation are essential outcome determinants. Patient comorbidity burden and fitness were significant predictors for ibrutinib intolerance