Treatment resistance of rheumatoid arthritis relates to infection of periodontal pathogenic bacteria: a case-control cross-sectional study

Recent studies have shown that periodontitis is associated with rheumatoid arthritis (RA) and periodontal bacteria, such as Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) are involved in the pathogenesis of RA via citrullinated proteins. Smoking has also been shown to be involved in the pathogenesis of RA; however, the extent of this involvement is still poorly understood. In addition, RA and polymyalgia rheumatica (PMR) are sometimes difficult to differentiate; however, the relationship between PMR and the factors from smoking and periodontal bacteria is unclear. The aim of this study was to clarify the relationship between periodontal pathogenic bacterial infections and smoking in patients with RA or PMR. This case-control study included 142 patients with untreated RA or PMR. This study evaluated the serum antibody titers against periodontal pathogenic bacterial antigens and an anti-citrullinated peptide antibody (ACPA). In patients with RA, the relationship between antibody titers and disease activity of RA and response after 3 months of treatment was also investigated. Additionally, the effects of smoking were evaluated. Although there was no significant difference in serum antibody titer against periodontal pathogenic bacteria between the ACPA-positive RA group and the ACPA-negative PMR group, we found an association between the elevated antibody titer against Pg and the degree of ACPA value, especially between negative group and high-value positive group (>= 100 U/mL). The antibody titers against Aa and Pg did not differ depending on disease activity score 28 (DAS28) at baseline; however, patients with high antibody titers had poor RA therapeutic response as judged by DAS28 after 3 months. We could not find any association between smoking and any of these parameters. Periodontal pathogenic bacteria, especially Pg, are associated with elevated ACPA levels. Our findings suggest that Pg and Aa infections interfere with the therapeutic response of RA

Dynamical pinning of domain wall in magnetic nanowire induced by Walker breakdown

Transmission probability of a domain wall through a magnetic nanowire is investigated as a function of the external magnetic field. Very intriguing phenomenon is found that the transmission probability shows a significant drop after exceeding the threshold driving field, which contradicts our intuition that a domain wall is more mobile in the higher magnetic field. The micromagnetics simulation reveals that the domain wall motion in the wire with finite roughness causes the dynamical pinning due to the Walker breakdown, which semi-quantitatively explains our experimental results.Comment: 17 pages, 4 figure

ソーシャルワークの機能と役割に関する一考察 : 児童養護施設の実践事例をもとにして

本研究の目的はソーシャルワークの機能と役割に焦点をあて,実践事例を分析することでソーシャルワークのあり方に関して検討することである。そのため実践事例として児童養護施設での実践事例を分析・検討した。 その結果,ソーシャルワークの機能と役割の重要性と同時に,ソーシャルワークの機能と役割はソーシャルワークの原理原則に律されたものでなければ機能不全を起こしてしまいかねないという結論に至った。This study examines a number of examples of social work in practice in order to clarify some of the functions and roles of social work, and consider an ideal method of social work. Data were drawn from examples of practice at a child nursing home, then analyzed and discussed. As a result, it is suggested that the failure to make the functions and roles of social work subordinate to the overriding principles of social work cause the breakdown of entire system

ソーシャルワークの機能・役割に関する 実践的考察と検討 : 児童養護施設での実践事例をもとにして-

本稿の目的は,児童養護施設におけるソーシャルワーク実践事例を用いてソーシャルワークの機能・役割を明確にしていくことである。本研究の社会的意義は,ソーシャルワーク実践事例を検討・考察することによりソーシャルワーク実践理論,特にソーシャルワークの機能・役割に対して実践的積み上げに貢献できる点にある。その結果,本実践事例においては,子どもの生活を支えるうえで多くのソーシャルワークの機能・役割が活用されており,特に生活支援と言った場合,多くの機関や専門職が連携し,その組織化をおこなっていた。そしてそれらは本稿の中で見た子どもの生活の応答性を高めていくものとなっていた。一方,本実践事例の子どもの言動や行動には,脆弱性も見られた。そのため日々の関わりの中での直接援助機能や仲介機能,ケースマネージャー機能などは,子どもの脆弱性をケアする役割を発揮し,よりよい生活・社会環境を整えるという点で重要なソーシャルワークの機能・役割であった。This paper reviews an example of social work practices in a foster home, which clarifies thefunctions and roles of social workers in such homes. The significance of this study for society is that an analytical review of social work practices such as the one described here can contribute to the accumulation of data for the development of social practice theory. This study revealed that social work functions and roles were employed in every aspect to support children\u27s lives. For support of children\u27s lives, there was professional cooperation and organization in many institutions. The role of social workers was intended to enhance the quality of the children lives. On the other hand, the children were often observed as beingvulnerable. Therefore, in order to care for children\u27s well-being, it was critical that attention was paid to residential care and specific case management. Social worker functions and roles are important in ensuringthat a child adjusts to its new living and social environment

ソーシャルワークの機能に関する実践的考察: 児童養護施設での実践事例をもとにして

本稿の目的は児童養護施設におけるソーシャルワーク実践事例を用いて,ソーシャルワークの機能を明確にしていくことである。その意義は実践事例の分析と検討からソーシャルワーク実践理論の研究的積み上げに多少なりとも貢献できるからである。 その結果,ソーシャルワーク機能は子どもの生活援助・支援においては随所に活用されていた。直接的援助機能やケースマネージャー機能,保護機能などが実践では多く活用され,子どもの成長と発達によってソーシャルワーク機能は広範囲にわたり活用されることなどが明らかになった。This paper reviews an example of social work practices at a foster home to clarify the social work functions at such homes. The objective is that an analytical review of social work practices such as the one described here can more or less contribute to the accumulation of the data for the social work practice theory. The review of the example revealed that social work functions were employed in every aspect to support children\u27s lives. In particular, functions such as residential care, case management, and protection were employed frequently, demonstrating that social work functions are employed more widely as children become older

Immunohistochemical Detection of Propionibacterium acnes in Granulomas for Differentiating Sarcoidosis from Other Granulomatous Diseases Utilizing an Automated System with a Commercially Available PAB Antibody

Propionibacterium acnes is implicated in the pathogenesis of sarcoidosis. We investigated the usefulness of immunohistochemistry (IHC) with a commercially available P. acnes-specific monoclonal antibody (PAB antibody) for differentiating sarcoidosis from other granulomatous diseases. Formalin-fixed paraffin-embedded tissue samples from 94 sarcoidosis patients and 30 control patients with other granulomatous diseases were examined by the original manual IHC method. We also compared the detection frequency of P. acnes in sarcoid granulomas between manual and automated IHC methods. P. acnes was detected in sarcoid granulomas of samples obtained by transbronchial lung biopsy (64%), video-associated thoracic surgery (67%), endobronchial-ultrasound-guided transbronchial-needle aspiration (32%), lymph node biopsy (80%), and skin biopsy (80%) from sarcoidosis patients, but not in any non-sarcoid granulomas of the samples obtained from control patients. P. acnes outside granulomas, however, was frequently detected in both groups. The detection status of P. acnes in granulomas did not correlate with the clinical characteristics of sarcoidosis patients. The automated Leica system exhibited the best detection sensitivity (72%) and almost an identical localization for P. acnes in sarcoid granulomas compared with the manual method. IHC with a PAB antibody is useful for differentiating sarcoidosis from other granulomatous diseases by detecting P. acnes in granulomas. An automated method by the Leica system can be used in pathology laboratories for differential diagnosis of granulomas by IHC with the PAB antibody

Control of Domain Wall Position by Electrical Current in Structured Co/Ni Wire with Perpendicular Magnetic Anisotropy

We report the direct observation of the current-driven domain wall (DW) motion by magnetic force microscopy in a structured Co/Ni wire with perpendicular magnetic anisotropy. The wire has notches to define the DW position. It is demonstrated that single current pulses can precisely control the DW position from notch to notch with high DW velocity of 40 m/s.Comment: 12 pages, 3 figure

Hospital and clinic cooperation for the treatment of rheumatoid arthritis in Okayama Prefecture, Japan

Objective: To survey the current status and problems of cooperation between clinics and hospitals in Okayama Prefecture, Japan for the treatment of rheumatoid arthritis (RA). 　Methods: We distributed a questionnaire to 300 of the 983 Okayama Prefecture clinics that had either an internal medicine or orthopedic surgery department, from December 2013 to February 2014. The questionnaire covered practice pattern for RA treatment in clinics, current status of the hospital and clinic cooperation, and acceptance of the biologic therapy. 　Results: One hundred clinics responded to the questionnaire. Seventy percent of the clinics reported making referrals to rheumatologists before the initiation of RA treatment, and half of the other 30% of the clinics administered methotrexate as the first-line treatment for RA by their own decision. Sixty-six clinics cooperated with flagship hospitals, conducting medical and laboratory examinations, providing prescriptions, and treating common diseases of patients. These clinics expected the cooperating rheumatologists to follow-up patients every 3 to 6 months and to make the diagnosis, make decisions regarding RA treatment changes, and perform surgery. Seventy-one percent of the clinics responded that cooperation with a hospital is possible even for patients who are administered biologics. As reasons for no cooperation with the flagship hospitals, clinics noted the lack of information about rheumatologists in the area and recent trends in the management of RA. 　Conclusion: The current study reported, for the first time, the actual conditions of management of RA in clinics, as well as future problems of hospital and clinic cooperation in Okayama Prefecture

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe