Factors promoting health-related quality of life in people with rheumatic diseases: a 12 month longitudinal study

<p>Abstract</p> <p>Background</p> <p>Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL). There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases.</p> <p>Methods</p> <p>A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions.</p> <p>Results</p> <p>Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC), emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure.</p> <p>Conclusions</p> <p>This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies.</p

Particulate-facilitated leaching of glyphosate and phosphorus from a marine clay soil via tile drains

Losses of commonly used chemical pesticides from agricultural land may cause serious problems in recipient waters in a similar way to phosphorus (P). Due to analytical challenges concerning determination of glyphosate (Gly), transport behaviour of this widely used herbicide is still not well-known. The objective of the present study was to quantify and evaluate leaching of Gly in parallel with P. Leaching losses of autumn-applied Gly (1.06 kg ha-1) via drainage water were examined by flow-proportional sampling of discharge from 20 drained plots in a field experiment in eastern Sweden. Samples were analysed for Gly in particulate-bound (PGly) and dissolved (DGly) form. The first 10 mm water discharge contained no detectable Gly, but the following 70 mm had total Gly (TotGly) concentrations of up to 6 µg L-1, with 62% occurring as PGly. On average, 0.7 g TotGly ha-1 was leached from conventionally ploughed plots, compared with 1.7 g TotGly ha-1 from shallow-tilled plots (cultivator to 12 cm working depth). Higher Gly losses occurred in snowmelt periods in spring, but then with the majority (60%) as DGly. All autumn concentrations of PGly in drainage water were significantly correlated (p&lt;0.001) to the concentrations of particulate-bound phosphorus (PP) lost from the different plots (Pearson correlation coefficient 0.84), while PP concentrations were in turn significantly correlated to water turbidity (Pearson correlation coefficient 0.81). Leaching losses of TotGly were significantly lower (by 1.3 g ha-1; p&lt;0.01) from plots that had been structure-limed three years previously and ploughed thereafter than from shallow-tilled plots. Turbidity and PP concentration also tended to be lowest in discharge from structure-limed plots and highest from shallow-tilled plots. This difference in TotGly leaching between soil management regimes could not be explained by differences in measured pH in drainage water or amount of discharge. However, previously structure-limed plots had significantly better aggregate stability, measured as readily dispersed clay (RDC), than unlimed plots. The effects of building up good soil structure, with strong soil aggregates and an appropriate pore system in the topsoil, on mitigating Gly and P losses in particulate and dissolved form should be further investigated

Phosphorus Availability in Soils Amended with Wheat Residue Char

Plant availability and risk for leaching and/or runoff losses of phosphorus (P) from soils depends among others on P concentration in the soil solution. Water soluble P in soil measures soil solution P concentration. The aim of this study was to understand the effect of wheat residue char (biochar) addition on water soluble P concentration in a wide range of biochar amended soils. Eleven agricultural fields representing dominant soil texture classes of Swedish agricultural lands were chosen. Concentrations of water soluble P in the soils and in biochar were measured prior to biochar incorporation to soils in the laboratory. Experiments with three dominant soil textures- silt loam, clay loam and an intermediate loam soil with different rates of biochar addition (i.e., 0.5, 1, 2 and 4%; w/w) showed that the highest concentration of water soluble P was achieved at an application rate of 1%. At higher application rates, P concentrations decreased which coincided with a pH increase of 0.3 - 0.7 units. When the eleven soils were amended with 1% (w/w) biochar, water soluble P concentrations increased in most of the soils ranging from 11 to 253%. However, much of the water soluble P added through the biochar was retained (33 - 100%). We concluded that - wheat residue char can act as a source of soluble P; and low and high additions of biochar can have different effects on soil solution P concentration due to possible reactions with Ca and Mg added with biochar

Impaired Antibody Response Is Associated with Histone-Release, Organ Dysfunction and Mortality in Critically Ill COVID-19 Patients

Purpose: the pathophysiologic mechanisms explaining differences in clinical outcomes following COVID-19 are not completely described. This study aims to investigate antibody responses in critically ill patients with COVID-19 in relation to inflammation, organ failure and 30-day survival. Methods: All patients with PCR-verified COVID-19 and gave consent, and who were admitted to a tertiary Intensive care unit (ICU) in Sweden during March-September 2020 were included. Demography, repeated blood samples and measures of organ function were collected. Analyses of anti-SARS-CoV-2 antibodies (IgM, IgA and IgG) in plasma were performed and correlated to patient outcome and biomarkers of inflammation and organ failure. Results: A total of 115 patients (median age 62 years, 77% male) were included prospectively. All patients developed severe respiratory dysfunction, and 59% were treated with invasive ventilation. Thirty-day mortality was 22.6% for all included patients. Patients negative for any anti-SARS-CoV-2 antibody in plasma during ICU admission had higher 30-day mortality compared to patients positive for antibodies. Patients positive for IgM had more ICU-, ventilator-, renal replacement therapy- and vasoactive medication-free days. IgA antibody concentrations correlated negatively with both SAPS3 and maximal SOFA-score and IgM-levels correlated negatively with SAPS3. Patients with antibody levels below the detection limit had higher plasma levels of extracellular histones on day 1 and elevated levels of kidney and cardiac biomarkers, but showed no signs of increased inflammation, complement activation or cytokine release. After adjusting for age, positive IgM and IgG antibodies were still associated with increased 30-day survival, with odds ratio (OR) 7.1 (1.5-34.4) and 4.2 (1.1-15.7), respectively. Conclusion: In patients with severe COVID-19 requiring intensive care, a poor antibody response is associated with organ failure, systemic histone release and increased 30-day mortality

Impaired Antibody Response Is Associated with Histone-Release, Organ Dysfunction and Mortality in Critically Ill COVID-19 Patients.

PURPOSE: the pathophysiologic mechanisms explaining differences in clinical outcomes following COVID-19 are not completely described. This study aims to investigate antibody responses in critically ill patients with COVID-19 in relation to inflammation, organ failure and 30-day survival. METHODS: All patients with PCR-verified COVID-19 and gave consent, and who were admitted to a tertiary Intensive care unit (ICU) in Sweden during March-September 2020 were included. Demography, repeated blood samples and measures of organ function were collected. Analyses of anti-SARS-CoV-2 antibodies (IgM, IgA and IgG) in plasma were performed and correlated to patient outcome and biomarkers of inflammation and organ failure. RESULTS: A total of 115 patients (median age 62 years, 77% male) were included prospectively. All patients developed severe respiratory dysfunction, and 59% were treated with invasive ventilation. Thirty-day mortality was 22.6% for all included patients. Patients negative for any anti-SARS-CoV-2 antibody in plasma during ICU admission had higher 30-day mortality compared to patients positive for antibodies. Patients positive for IgM had more ICU-, ventilator-, renal replacement therapy- and vasoactive medication-free days. IgA antibody concentrations correlated negatively with both SAPS3 and maximal SOFA-score and IgM-levels correlated negatively with SAPS3. Patients with antibody levels below the detection limit had higher plasma levels of extracellular histones on day 1 and elevated levels of kidney and cardiac biomarkers, but showed no signs of increased inflammation, complement activation or cytokine release. After adjusting for age, positive IgM and IgG antibodies were still associated with increased 30-day survival, with odds ratio (OR) 7.1 (1.5-34.4) and 4.2 (1.1-15.7), respectively. CONCLUSION: In patients with severe COVID-19 requiring intensive care, a poor antibody response is associated with organ failure, systemic histone release and increased 30-day mortality

Influence of soil phosphorus and manure on phosphorus leaching in Swedish topsoils

In Sweden, subsurface transport of phosphorus (P) from agricultural soils represents the primary pathway of concern for surface water quality. However, there are mixed findings linking P in leachate with soil P and limited understanding of the interactive effects of applied P sources and soil test P on P leaching potential. Identifying soils that are susceptible to P leaching when manure is applied is critical to management strategies that reduce P loadings to water bodies. Intact soil columns (20 cm deep) from five long-term fertilization trials across Sweden were used in leaching experiments with simulated rainfall to explore the interactive effects of dairy cow (Bos taurus L.) manure application, soil test P and cropping system. Strong relationships were observed between ammonium-lactate extractable P in soil and dissolved reactive P (DRP) concentrations in leachate, although regression slopes varied across soils. For three soils, application of manure (equal to 21-30 kg P ha-1) to the soil columns significantly increased DRP leaching losses. The increase in DRP concentration was correlated to soil test P, but with wide variations between the three soils. For two soils leachate P concentrations after manure addition were independent of soil P status. Despite variable trends in P leaching across the different soils, P concentrations in leachate were always moderate from soils at fertilization rates equivalent to P removal with harvest. Results clearly stress the importance of long-term P balance to limit P leaching losses from Swedish agricultural soils

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Radiological, Nuclear Medicine & Hybrid Imaging

Contrast-enhanced computed tomography (CT) of the neckthorax-abdomen and pelvis, including 3-phase examination of the liver, constitutes the basic imaging for primary neuroendocrine tumor (NET) diagnosis, staging, surveillance, and therapy monitoring. CT characterization of lymph nodes is difficult because of inadequate size criteria (short axis diameter), and bone metastases are often missed. Contrast-enhanced magnetic resonance imaging (MRI) including diffusion-weighted imaging is preferred for the examination of the liver, pancreas, brain and bone. MRI may miss small lung metastases. MRI is less well suited than CT for the examination of extended body areas because of the longer examination procedure. Ultrasonography (US) frequently provides the initial diagnosis of liver metastases and contrast-enhanced US is excellent to characterize liver lesions that remain equivocal on CT/MRI. US is the method of choice to guide the biopsy needle for the histopathological NET diagnosis. US cannot visualize thoracic NET lesions for which CTguided biopsy therefore is used. Endocopic US is the most sensitive method to diagnose pancreatic NETs, and additionally allows for biopsy. Intraoperative US facilitates lesion detection in the pancreas and liver. Somatostatin receptor imaging should be a part of the tumor staging, preoperative imaging and restaging, for which 68 Ga-DOTA-somatostatin analog PET/CT is recommended, which is vastly superior to somatostatin receptor scintigraphy, and facilitates the diagnosis of most types of NET lesions, for example lymph node metastases, bone metastases, liver metastases, peritoneal lesions, and primary small intestinal NETs. (18)FDG-PET/CT is better suited for G3 and high G2 NETs, which generally have higher glucose metabolism and less somatostatin receptor expression than low-grade NETs, and additionally provides prognostic information. (C) 2017 S. Karger AG, Base