Early variation of ultrasound halo sign with treatment and relation with clinical features in patients with giant cell arteritis

Objectives To compare the ultrasound characteristics with clinical features, final diagnosis and outcome; and to evaluate the halo size following glucocorticoid treatment in patients with newly diagnosed GCA. Methods Patients with suspected GCA, recruited from an international cohort, had an ultrasound of temporal (TA) and axillary (AX) arteries performed within 7 days of commencing glucocorticoids. We compared differences in clinical features at disease presentation, after 2 weeks and after 6 months, according to the presence or absence of halo sign. We undertook a cross-sectional analysis of the differences in halo thickness using Pearson’s correlation coefficient (r) and Analysis of Variance (ANOVA). Results A total of 345 patients with 6 months follow-up data were included; 226 (65.5%) had a diagnosis of GCA. Jaw claudication and visual symptoms were more frequent in patients with halo sign (P =0.018 and P =0.003, respectively). Physical examination abnormalities were significantly associated with the presence of ipsilateral halo (P 0.05). However, the presence of halo at baseline failed to predict future ischaemic events occurring during follow-up. Conclusion In newly diagnosed GCA, TA halo is associated with the presence of ischaemic features and its size decreases following glucocorticoid treatment, supporting its early use as a marker of disease activity, in addition to its diagnostic role

Genome-wide association study of eosinophilic granulomatosis with polyangiitis reveals genomic loci stratified by ANCA status

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare inflammatory disease of unknown cause. 30% of patients have anti-neutrophil cytoplasmic antibodies (ANCA) specific for myeloperoxidase (MPO). Here, we describe a genome-wide association study in 676 EGPA cases and 6,809 controls, that identifies 4 EGPA-associated loci through conventional case-control analysis, and 4 additional associations through a conditional false discovery rate approach. Many variants are also associated with asthma and six are associated with eosinophil count in the general population. Through Mendelian randomisation, we show that a primary tendency to eosinophilia contributes to EGPA susceptibility. Stratification by ANCA reveals that EGPA comprises two genetically and clinically distinct syndromes. MPO+ ANCA EGPA is an eosinophilic autoimmune disease sharing certain clinical features and an HLA-DQ association with MPO+ ANCA-associated vasculitis, while ANCA-negative EGPA may instead have a mucosal/barrier dysfunction origin. Four candidate genes are targets of therapies in development, supporting their exploration in EGPA

Facebookin hyödyntäminen koripalloseurojen viestinnässä

Tässä opinnäytetyössä selvitetään Facebookin roolia koripalloseurojen viestinnässä. Facebook ja koripallo ovat molemmat tällä hetkellä ajankohtaisia aiheita. Työssä perehdytään myös sosiaalisen median hyötyihin yritykselle sekä asiakkaalle. Opinnäytetyö tehtiin syksyn 2011 ja kevään 2012 välisenä aikana. Työn tarkoitus on tutkia käyttävätkö seurat Facebookia ja millä tavoin ne ovat yhteydessä kuluttajiin. Lisäksi selvitetään käyttävätkö koripalloseurat koko Facebookin kapasiteettia markkinoimiseen ja mitkä ovat seurojen tavoitteet Facebookin käytöstä tulevaisuudessa. Tutkimus rajattiin suomalaisiin koripalloseuroihin. Opinnäytetyö tehtiin kvalitatiivisena tutkimuksena ja siihen sisältyy teoria osuus sekä empiirinen osuus. Teoriaosuus koostuu kolmesta eri aihealueesta: digitaalisesta markkinoinnista, sosiaalisesta mediasta sekä Facebookista. Empiirisessä osuudessa esitellään tulokset eri teemoissa sekä pohditaan tuloksia. Teemat ovat Facebookin käytön syyt, käyttötavat, käytön aktiivisuus, sivujen vastuuhenkilöt sekä Facebookin käytön tulevaisuus seuroissa. Tutkimus toteutettiin haastattelulla sekä sähköpostikyselyillä. Osallistuneet seurat ovat juniorijoukkueita ja naisten sekä miesten pääsarja- ja divisioonajoukkueita. Tutkimuksessa haastateltiin yhtä seuraa ja seitsemän seuraa vastasi sähköpostikyselyihin. Tutkimustulokset osoittivat, että koripalloseurat käyttävät Facebookia apuna viestinnässään, mutta eivät läheskään koko sen kapasiteettia. Seurojen edustajat ymmärsivät kuitenkin Facebookin tärkeän merkityksen tulevaisuudessa.The study examines Facebook’s role in public relations of basketball clubs. Facebook and basketball are both current subjects at the moment. The study also orientates with benefits of social media for the company and the consumer. The thesis was written during the autumn 2011 and the spring 2012. The aim of the thesis was to study if basketball clubs use Facebook and how they connect with consumers by using it. In addition, the aim was to find out if basketball clubs use the whole capacity of Facebook in marketing and what their plans are for using Facebook in the future. The study was restricted to the Finnish basketball clubs. The method is qualitative and it consist of a theory section and an empirical section. The theory section consist of three different areas: digital marketing, social media and Facebook. The results of the empirical section are introduced in different themes and discussions. The themes are reasons, methods and frequency of using Facebook, the people responsible for the club’s Facebook-pages and the club’s plans of using Facebook in the future. The study was carried out using interviews and e-mail inquiries. The clubs who attended to the study were junior clubs, women’s and men’s top league and division clubs. One club was interviewed and seven clubs answered to the e-mail inquiry. The results of the study showed that basketball clubs use Facebook as a help in marketing, but not even nearly the whole capacity. Representatives of the clubs, however, understood the importance of Facebook in the future

The role of biologic therapies in the management of systemic vasculitis

The recent development of biologic therapies capable of selectively targeting components of the immune system has revolutionised the treatment of inflammatory arthritides. The steady increase in use of biologic agents coupled with the expansion in the knowledge of the pathogenesis of vascular inflammation has led to their application in the treatment of primary systemic vasculitis. These agents may have a role in addition to or in place of conventional immunosuppression and also be effective when the latter fails to induce remission. The use of biologics as targeted therapies has also, in reverse, improved our understanding of the pathophysiology of vascular inflammation. While the advent of biologics heralds a new era in the management of the systemic vasculitis, evidence for their efficacy is still in its infancy and has yet to match that of conventional immunosuppressants. In this review, we examine the up-to-date evidence for the use of biologics in systemic vasculitis, including TNF-α inhibitors, and highlight the challenges facing their use. We examine the rationale for using biologics based on the pathophysiology of vasculitis. Issues of toxicity and pharmacovigilance with the use of biologics are also discussed. Finally, future directions and predictions are presented

The OMERACT Core Set of Outcome Measures for Use in Clinical Trials of ANCA-associated Vasculitis

There has been a marked increase in the past 15 years in the number and quality of clinical trials in the idiopathic inflammatory vasculitides, especially the small-vessel vasculitides known as antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis [AAV; granulomatosis, with polyangiitis (Wegener's)]. These trials have been conducted by multicenter, international groups in Europe and the United States with financial support provided by government agencies and biopharmaceutical companies. This increased clinical trial activity in vasculitis has been accompanied by the development and validation of new outcome measures--a challenging process for these complex, multiorgan system diseases. The international OMERACT Vasculitis Working Group has developed and implemented an iterative research agenda that has utilized accumulated experience and datasets from several multicenter clinical trials and large cohort studies. This work has led to the development, evaluation, validation, and endorsement, through the OMERACT consensus and validation processes, of a "core set" of outcome measurements for use in clinical trials of AAV. The core set includes domains of disease activity, damage assessment, patient-reported outcomes, and mortality; there is at least one validated outcome measurement instrument available for each domain. This report reviews the domains of illness in AAV included in the OMERACT core set, describes the instruments validated to measure these domains, and presents the approved core set