Giving in Illinois, 2015

Illinois is home to over 5,200 grantmaking foundations spanning all types—independent or family, corporate, community, and operating—sizes, and issue areas. The community includes many foundations that only give locally or within the state, as well as those that fund nationally and even internationally. The following analysis provides an overview of the scale and composition of the Illinois foundation community and an examination of how Illinois foundations have fared relative to U.S. foundations in general over the past decade

Assessment of nutritional status by dual X-Ray absorptiometry in women with rheumatoid arthritis: a case-control study

Rheumatoid arthritis (RA) has been related to an impairment of the nutritional status. Body mass index (BMI) has been used but questions arise about how to properly evaluate nutritional status in RA patients. Few studies have evaluated it by dual-energy X-ray absorptiometry.In women with RA, to analyze:Case-control study including 89 women with RA. The control group was composed by 100 patients affected by non-inflammatory rheumatic disorders. Study variables included age, RA duration, history, activity and disability, and in relation to nutritional status: BMI, serum albumin (ALB), whole body DXA assessment, and skeletal muscle index (SMI).Mean age of patients was 62 ± 8 years, mean duration of RA was 14 ± 9 years, mean disease activity score (DAS28) was 3.7 ± 1.4 and mean Health Assessment Questionnaire was 0.88 ± 0.77. BMI was 27.43 ± 5.16 Kg/m in patients and 27.78 ± 3.98 Kg/m in controls (P: ns). ALB was within normal range in all patients.By whole body DXA, RA patients presented a statistically significant lower lean mass in all locations and lower fat mass in limbs than controls. Patients had a redistribution of fat mass to trunk. Lean mass directly correlated with fat mass.Neither BMI nor ALB correlated with DXA parameters.BMI, appendicular lean mass and SMI correlated inversely with disease duration. Trunk lean mass correlated inversely, and fat mass directly, with RA disability parameters.RA patients fulfilled criteria of sarcopenia in 44% of cases versus 19% of controls (P <.001). In RA patients, regarding SMI, BMI showed a high specificity to detect sarcopenia (94% of the patients with low BMI had sarcopenia) but low sensitivity (47% of the patients with normal BMI or overweight had sarcopenia).RA patients have an impairment of nutritional status associated to disease duration that looks like sarcopenia and that is not predicted by BMI

Giving in Illinois 2016

Illinois is home to over 5,200 grantmaking foundations spanning all types—independent or family, corporate, community, and operating—sizes, and issue areas. The community includes many foundations that only give locally or within the state, as well as those that fund nationally and even internationally. The following analysis provides an overview of the scale and composition of the Illinois foundation community and an examination of how Illinois foundations have fared relative to U.S. foundations in general over the past decade

Increase of Circulating Monocyte–Platelet Conjugates in Rheumatoid Arthritis Responders to IL-6 Blockage

Monocytes; Rheumatoid arthritis; TocilizumabMonocitos; Artritis reumatoide; TocilizumabMonòcits; Artritis reumatoide; TocilizumabPlatelets (PLT) bind to a significant percentage of circulating monocytes and this immunomodulatory interaction is increased in several inflammatory and autoimmune conditions. The therapeutic blockage of IL-6 with Tocilizumab (TCZ) alters PLT and the phenotype and function of monocytes in rheumatoid arthritis (RA). However, the relationship between monocyte–PLT conjugates (CD14+PLT+) and clinical and immunological variables and the regulation of this interaction by IL-6 blockage are still unknown. Here, we compared the presence of monocyte–PLT conjugates (CD14+PLT+) and membrane CD162 expression using flow cytometry, and, by ELISA, the markers of PLT activation (sCD62P and sCD40L) in healthy donors (HD) and patients with long-standing RA before TCZ (baseline). We found higher percentages and absolute counts of CD14+PLT+, and higher plasmatic levels of sCD62P and sCD40L but lower CD162 expression on monocytes from RA patients than those from HD. Additionally, the levels of CD14+PLT+ inversely correlated with inflammatory parameters. Interestingly, 95% of patients with lower percentages of CD14+PLT+ and only 63% of patients with higher percentages of CD14+PLT+ achieved a EULAR-defined response at four weeks (p = 0.036). After TCZ, the percentage of CD14+PLT+ increased in 92% of RA patients who achieved 12 w-remission (p < 0.001). Our results suggest that the binding of PLTs has a modulatory effect, accentuated by the increased binding of PLTs to monocytes in response to the therapeutic blockage of IL-6.This study is supported by Instituto de Salud Carlos III and Fondos FEDER (PI17/00072 and PI20/00184)

Comparative effectiveness of Tocilizumab with either Methotrexate or Leflunomide in the treatment of rheumatoid arthritis

Objective: In agreement with EULAR recommendations, a DMARD in combination with a biotherapy is the reference treatment because of the superior long-term clinical and radiographic outcomes. Methotrexate (MTX) is the cornerstone of combination therapy but is in some cases contra-indicated or poorly tolerated. This observational study aimed to compare the effectiveness and safety of TCZ in combination with either MTX or leflunomide (LEF) in the treatment of patients with active rheumatoid arthritis (RA) and an inadequate response to one or more DMARDs and/or biological agents in a real-world setting. Methods: We performed an ambispective review of 91 patients with active RA who were routinely treated with TCZ plus MTX or LEF. A comparative study between the two combinations of treatment was performed at 6 months of follow-up considering 3 outcomes: improvement of RA disease activity, evolution of functional disability, and tolerability and side effect profile. Results: Of the 91 patients, 62 received TCZ with MTX and 29 received TCZ with LEF. Eighty-one patients were followed for 6 months, and the remaining 10 patients discontinued treatment due to serious adverse events. At baseline, there were no significant differences between the groups in terms of the main clinical and laboratory data or in the number of previous DMARDs and biological agents used. At 6 months, there were no significant differences between the combinations in terms of disease activity and functional disability. Serious adverse events occurred in 11% and 10% of the patients treated in combination with MTX and LEF, respectively. Conclusion: Our preliminary data support the argument that LEF is an effective and safe (equivalent) alternative to MTX for combination treatment with TCZ

Cognition and behavior in sheep repetitively inoculated with aluminum adjuvant-containing vaccines or aluminum adjuvant only

Sheep health management strategies often include the use of aluminum (Al)-containing vaccines. These products were associated with the appearance of the ovine autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome), which included an array of ethological changes in the affected animals. The aim of this pilot study was to investigate cognitive and behavioral changes in sheep subjected to a protocol of repetitive inoculation with Al-containing products. Twenty-one lambs were assigned to three groups (n = 7 each): Control, Adjuvant-only, and Vaccine. Vaccine group was inoculated with commercial Al- hydroxide containing vaccines; Adjuvant-only group received the equivalent dose of Al only (Alhydrogel®), and Control group received Phosphate-buffered saline. Sixteen inoculations were administered within a 349-day period. Ethological changes were studied in late summer (7 inoculations) and mid-winter (16 inoculations). Animals in Vaccine and Adjuvant-only groups exhibited individual and social behavioral changes. Affiliative interactions were significantly reduced, and aggressive interactions and stereotypies increased significantly. They also exhibited a significant increase in excitatory behavior and compulsive eating. There were increased levels of stress biomarkers in these two groups. In general, changes were more pronounced in the Vaccine group than they were in the Adjuvant-only group. Some changes were already significant in summer, after seven inoculations only. This study is the first to describe behavioral changes in sheep after having received repetitive injections of Al-containing products, and may explain some of the clinical signs observed in ovine ASIA syndrome

Luodaksemme töitä : työn diskurssien rakentuminen europuolueiden vaaliohjelmissa

Tutkielman aiheena ovat europuolueiden näkemykset työstä. Tutkimus kohdistuu kolmen europuolueen, Euroopan kansanpuolue (EPP), Euroopan sosiaalidemokraatit (PES) ja liberaalipuolue (ALDE-puolue), tapaan rakentaa työn diskursseja. Diskurssien rakentumista tarkastellaan europuolueiden vuoden 2014 eurovaaleja varten laatimissa vaaliohjelmissa. Tutkielmassa käytetään diskurssien tarkasteluun kansainvälisen politiikan feminististä teoriaa ja erityisesti feministisen tutkimuksen dikotomioiden analyysiä. Dikotomiat ovat feministisen tutkimuksen käyttämä käsite vastinpareille. Dikotomioita ovat esimerkiksi maskuliininen ja feminiininen, julkinen ja yksityinen sekä rationaalinen ja irrationaalinen. Julkinen ja rationaalinen ovat maskuliinisia käsitteitä, yksityinen ja irrationaalinen feminiinejä käsitteitä. Lisäksi tutkielmassa tarkastellaan sitä, mikä vaaliohjelmissa nähdään ongelmaksi ja mikä esitetään toiseudeksi. Tutkimusmenetelmänä tutkielmassa käytetään diskurssianalyysiä. Keskeisinä tutkimustuloksina tutkielmassa havaitaan se, että 1) europuolueiden työhön liittyviä käsitteitä on mahdollista jakaa maskuliinisiin ja feminiineihin, 2) puolueilla on erilaisia painotuksia maskuliinisen ja feminiinisen akselilla, 3) EPP ja ALDE-puolue maskuliinisista painotuksistaan johtuen pystyivät paremmin osallistumaan vuoden 2014 eurovaalien keskusteluun siitä, miten työpaikkoja luodaan, 4) ongelman esityksien tarkastelussa havaitaan, että EPP ja ALDE-puolue edistävät samoja tavoitteita eli työpaikkojen luontia eri tavoin kuin PES, 5) europuolueet nojautuvat toiseuden retoriikkaan määritellessään itseään ja 6) maskuliininen näkemys työstä tuottaa todellisuutta, jossa maskuliinisuus korostuu: rationaalisuus, kilpailukykyisyys ja objektiivisuus. Tällä on ainakin kaksi ulottuvuutta: a) työssä - työpaikalla, työelämässä ja työuralla - korostuu maskuliinisuus ja b) työstä puhuttaessa korostuu työn julkinen tuottava puoli. Tutkielman tulosten perusteella on mahdollista päätellä, että kansainvälisen politiikan feministinen teoria ja diskurssianalyysi sopivat europuolueiden vaaliohjelmien tarkasteluun ja voivat tarjota uusia näkökulmia siihen, millaisia diskursseja puolueet materiaalissaan tuottavat. Tulevan tarkastelun kohteena voisivat olla esimerkiksi muidenkin europuolueiden käsitykset työstä, kansallisten puolueiden käsitykset työstä, eri puolueiden käsitykset muista politiikan aloista: ulkopolitiikasta, sosiaali- ja terveyspolitiikasta tai tietystä politiikkaohjelmasta. Päätelmänä esitetään myös, politiikan tutkimus tuo esille asioita, joita on hyvä ottaa huomioon politiikan teossa

Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study

Altres ajuts: This work is conducted under the umbrella of the Rheumatology Society of Catalonia and supported by Merck Research Laboratories.Background: Recent data suggest that anti-TNF doses can be reduced in ankylosing spondylitis (AS) patients. Some authors even propose withdrawing treatment in patients in clinical remission; however, at present there is no evidence to support this. Objective: To assess how long AS patients with persistent clinical remission remained free of flares after anti-TNF withdrawal and to evaluate the effects of treatment reintroduction. We also analyze the characteristics of patients who did not present clinical relapse. Methods: Multicenter, prospective, observational study of a cohort of patients with active AS who had received infliximab as a first anti-TNF treatment and who presented persistent remission (more than 6 months). We recorded at baseline and every 6-8 weeks over the 12-month period the age, gender, disease duration, peripheral arthritis or enthesitis, HLA-B27 status, BASDAI, CRP, ESR, BASFI, and three visual analogue scales, spine global pain, spinal night time pain, and patient's global assessment. Results: Thirty-six out of 107 patients (34%) presented persistent remission and were included in our study. After treatment withdrawal, 21 of these 36 patients (58%) presented clinical relapse during follow-up. Infliximab therapy was reintroduced and only 52% achieved clinical remission, as they had before the discontinuation of infliximab; in an additional 10%, reintroduction of infliximab was ineffective, obliging us to change the anti-TNF therapy. No clinical or biological factors were associated with the occurrence of relapse during the follow-up. Conclusions: Two thirds of patients in clinical remission presented clinical relapse shortly after infliximab withdrawal. Although the reintroduction of infliximab treatment was safe, half of the patients did not present the same clinical response that they had achieved prior to treatment withdrawal

New insights in ovien Asia Syndrome: Clinicopathological changes in experimentally induced animals

Trabajo presentado en el 10th International Congress on Autoimmunity, celebrado en Leipzig (Alemania), del 6 al 10 de abril de 2016Ovine Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA syndrome) is a disease linked to the repetitive stimulation of the immune system by vaccines, especially those containing aluminium as adjuvant. The syndrome includes two clinical distinct phases: Acute, with severe neurological symptoms and chronic, with extreme cachexia leading to death. An experimental reproduction of the syndrome (286 dpi to 1 December 2015) is currently being performed in 84 three months old (at the beginning of the experiment) male sheep, that are divided into 3 groups (n=28), a: commercial vaccines containing aluminium adjuvant; b: aluminium adjuvant alone and c: PBS. Group “a” is being repetitively inoculated with commercial vaccines and group “b” receives the adjuvant alone in with the same amount/dose of Al3+. So far, a total of 13 inoculations have been applied and a total of 32.05 mg of Al3+ inoculated in groups “a” and “b”. Periodic complete clinic examination of all animals is being carried out. A cohort (n=7 lambs of each group) is being studied for behavior and social relationship by using 24 h recordings and open field and t-maze tests. Clinical studies do not show any significant difference among groups. However, a tendency in decreasing body weight is already observed in lambs from group a. In addition, lambs from group a and b show discrete behavioral changes, as compulsive wool biting and generalized restlessness. The experiment will be maintained for at least another 6 months and it will be completed with furthers clinic and behavioral tests and postmortem studies.Peer reviewe

Desarrollo Consulta de Enfermería Clínica en el manejo de las enfermedades reumáticas

Se presenta la actividad desarrollada por la Consulta Experta de Enfermería Reumatológica del Hospital Moisés Broggi.Incluye una revisión de los criterios de derivación desde las consultas clínicas de Reumatología así como recomendaciones prácticas sobre la actividad que en ella se desarrolla