Italian consensus guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis

No abstract availabl

Prise en charge de l'infection par le virus de l'hépatite B chez les patients atteints de polyarthrite rhumatoïde: conférence de consensus italienne

No abstract availabl

Prise en charge de l’infection par le virus de l’hépatite B chez les patients atteints de polyarthrite rhumatoïde : conférence de consensus italienne

none33openSebastiani, Marco*; Atzeni, Fabiola; Milazzo, Laura; Quartuccio, Luca; Scirè, Carlo; Gaeta, Giovanni Battista; Lapadula, Giovanni; Armignacco, Orlando; Tavio, Marcello; Olivieri, Ignazio; Meroni, Pierluigi; Bazzichi, Laura; Grassi, Walter; Mathieu, Alessandro; Mastroianni, Claudio; Sagnelli, Evangelista; Santantonio, Teresa; Uberti Foppa, Caterina; Puoti, Massimo; Sarmati, Loredana; Airò, Paolo; Epis, Oscar Massimiliano; Scrivo, Rossana; Gargiulo, Miriam; Riva, Agostino; Manfredi, Andreina; Ciancio, Giovanni; Zehender, Gianguglielmo; Taliani, Gloria; Meroni, Luca; Sollima, Salvatore; Sarzi-Puttini, Piercarlo; Galli, MassimoSebastiani, Marco; Atzeni, Fabiola; Milazzo, Laura; Quartuccio, Luca; Scirè, Carlo; Gaeta, Giovanni Battista; Lapadula, Giovanni; Armignacco, Orlando; Tavio, Marcello; Olivieri, Ignazio; Meroni, Pierluigi; Bazzichi, Laura; Grassi, Walter; Mathieu, Alessandro; Mastroianni, Claudio; Sagnelli, Evangelista; Santantonio, Teresa; Uberti Foppa, Caterina; Puoti, Massimo; Sarmati, Loredana; Airò, Paolo; Epis, Oscar Massimiliano; Scrivo, Rossana; Gargiulo, Miriam; Riva, Agostino; Manfredi, Andreina; Ciancio, Giovanni; Zehender, Gianguglielmo; Taliani, Gloria; Meroni, Luca; Sollima, Salvatore; Sarzi-Puttini, Piercarlo; Galli, Massim

International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies

Anti-nuclear antibodies (ANA) are fundamental for the diagnosis of autoimmune diseases, and have been determined by indirect immunofluorescence assay (IIFA) for decades. As the demand for ANA testing increased, alternative techniques were developed challenging the classic IIFA. These alternative platforms differ in their antigen profiles, sensitivity and specificity, raising uncertainties regarding standardisation and interpretation of incongruent results. Therefore, an international group of experts has created recommendations for ANA testing by different methods. Two groups of experts participated in this initiative. The European autoimmunity standardization initiative representing 15 European countries and the International Union of Immunologic Societies/World Health Organization/Arthritis Foundation/Centers for Disease Control and Prevention autoantibody standardising committee. A three-step process followed by a Delphi exercise with closed voting was applied. Twenty-five recommendations for determining ANA (1-13), anti-double stranded DNA antibodies (14-18), specific antibodies (19-23) and validation of methods (24-25) were created. Significant differences between experts were observed regarding recommendations 24-25 (p<0.03). Here, we formulated recommendations for the assessment and interpretation of ANA and associated antibodies. Notably, the roles of IIFA as a reference method, and the importance of defining nuclear and cytoplasmic staining, were emphasised, while the need to incorporate alternative automated methods was acknowledged. Various approaches to overcome discrepancies between methods were suggested of which an improved bench-to-bedside communication is of the utmost importance. These recommendations are based on current knowledge and can enable harmonisation of local algorithms for testing and evaluation of ANA and related autoantibodies. Last but not least, new more appropriate terminologies have been suggested

The ATLAS fast tracker processor design

The extended use of tracking information at the trigger level in the LHC is crucial for the trigger and data acquisition (TDAQ) system to fulfill its task. Precise and fast tracking is important to identify specific decay products of the Higgs boson or new phenomena, as well as to distinguish the contributions coming from the many collisions that occur at every bunch crossing. However, track reconstruction is among the most demanding tasks performed by the TDAQ computing farm; in fact, complete reconstruction at full Level-1 trigger accept rate (100 kHz) is not possible. In order to overcome this limitation, the ATLAS experiment is planning the installation of a dedicated processor, the Fast Tracker (FTK), which is aimed at achieving this goal. The FTK is a pipeline of high performance electronics, based on custom and commercial devices, which is expected to reconstruct, with high resolution, the trajectories of charged-particle tracks with a transverse momentum above 1 GeV, using the ATLAS inner tracker information. Pattern recognition and the track parameter extraction are expected to be performed in roughly 100 m s, allowing all the high level trigger selections to use the tracks provided by FTK in order to build high quality and robust triggering

Smoking in Systemic Sclerosis: a Longitudinal European Scleroderma Trials and Research Group Study

Objective: Data on the role of tobacco exposure in systemic sclerosis (SSc; scleroderma) severity and progression are scarce. We aimed to assess the effects of smoking on the evolution of pulmonary and skin manifestations, based on the European Scleroderma Trials and Research group database. Methods: Adult SSc patients with data on smoking history and a 12\u201324-month follow-up visit were included. Associations of severity and progression of organ involvement with smoking history and the Comprehensive Smoking Index were assessed using multivariable regression analyses. Results: A total of 3,319 patients were included (mean age 57 years, 85% female); 66% were never smokers, 23% were ex-smokers, and 11% were current smokers. Current smokers had a lower percentage of antitopoisomerase autoantibodies than previous or never smokers (31% versus 40% and 45%, respectively). Never smokers had a higher baseline forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio than previous and current smokers (P &lt; 0.001). The FEV1/FVC ratio declined faster in current smokers than in never smokers (P = 0.05) or ex-smokers (P = 0.01). The baseline modified Rodnan skin thickness score (MRSS) and the MRSS decline were comparable across smoking groups. Although heavy smoking (&gt;25 pack-years) increased the odds of digital ulcers by almost 50%, there was no robust adverse association of smoking with digital ulcer development. Conclusion: The known adverse effect of smoking on bronchial airways and alveoli is also observed in SSc patients; however, robust adverse effects of smoking on the progression of SSc-specific pulmonary or cutaneous manifestations were not observed. \ua9 2018, American College of Rheumatolog

Joint and tendon involvement predict disease progression in systemic sclerosis: A EUSTAR prospective study

OBJECTIVE: To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. PATIENTS AND METHODS: We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration 643 years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one organ progression. RESULTS: Joint synovitis (HR: 1.26, 95% CI 1.01 to 1.59) and TFRs (HR: 1.32, 95% CI 1.03 to 1.70) were independently predictive of overall disease progression, as were also the diffuse cutaneous subset (HR: 1.30, 95% CI 1.05 to 1.61) and positive antitopoisomerase-I antibodies (HR: 1.25, 95% CI 1.02 to 1.53). Regarding skin progression, joint synovitis (HR: 1.67, 95% CI 1.06 to 2.64) and TFRs (HR: 1.69, 95% CI 1.02 to 2.77) were also independently predictive of worsening of the modified Rodnan skin score. For cardiovascular progression, joint synovitis was predictive of the occurrence of new digital ulcer(s) (HR: 1.45, 95% CI 1.08 to 1.96) and decreased left ventricular ejection fraction (HR: 2.20, 95% CI 1.06 to 4.57); TFRs were confirmed to be an independent predictor of scleroderma renal crisis (HR: 2.33, 95% CI 1.03 to 6.19). CONCLUSIONS: Joint synovitis and TFRs are independent predictive factors for disease progression in patients with early SSc. These easily detected clinical markers may be useful for the risk stratification of patients with SSc