342 research outputs found
Transition to adult care in Finnish adolescents with juvenile idiopathic arthritis
Objective The symptoms of juvenile idiopathic arthritis (JIA) and the necessity for continuous treatment may persist in adulthood. Therefore, patients with JIA need to be appropriately transferred to adult care. We aimed to analyse the timing of the patients' transition to adult care, and patients' self-management skills with the process and the quality of the transition. Method This study included 161 Finnish participants of the population-based Nordic JIA cohort who attended a 17 year follow-up appointment. Special attention was paid to the three groups: those referred by the paediatric rheumatology outpatient clinic to primary healthcare (PHC), those who were directly transferred to adult rheumatology care, and those who were later referred. Results A total of 136 patients (84%) were eligible to participate in the study, and 40% of them were directly transferred to an adult rheumatology clinic. Of the patients, 72% eventually ended up being referred to an adult rheumatology outpatient clinic. However, 16% of the patients in the PHC group had active disease during the study appointment and were referred to adult services after the study visit. Conclusion This study reveals the need to improve the transition process from paediatric care to adult care and to find the variables that can indicate the need for immediate transition. Although challenging, it is important to avoid treatment delay in adult patients with JIA who may have active disease but who do not have appropriate access to an adult rheumatological outpatient clinic.Peer reviewe
Restricted upper airway dimensions in patients with dentofacial deformity from juvenile idiopathic arthritis
BACKGROUND: This retrospective, cross-sectional study aimed to assess the pharyngeal airway dimensions of patients with juvenile idiopathic arthritis (JIA) and moderate/severe JIA-related dentofacial deformity (mandibular retrognathia/micrognathia), and compare the results with JIA patients with a normal mandibular appearance and a group of non-JIA patients. METHODS: Seventy-eight patients were retrospectively included in a 1:1:1 manner as specified below. All patients had previously been treated at the Section of Orthodontics, Aarhus University, Denmark. All had a pretreatment cone beam computed tomography (CBCT). Group 1 (JIA+); 26 JIA patients with severe arthritis-related dentofacial deformity and mandibular retrognathia/micrognathia. Group 2 (JIA-); 26 JIA patients with normal mandibular morphology/position. Group 3 (Controls); 26 non-JIA subjects. Dentofacial morphology and upper airway dimensions, excluding the nasal cavity, were assessed in a validated three-dimensional (3D) fashion. Assessment of dentofacial deformity comprised six morphometric measures. Assessment of airway dimensions comprised nine measures. RESULTS: Five morphometric measures of dentofacial deformity were significantly deviating in the JIA+ group compared with the JIA- and control groups: Posterior mandibular height, anterior facial height, mandibular inclination, mandibular occlusal inclination, and mandibular sagittal position. Five of the airway measurements showed significant inter-group differences: JIA+ had a significantly smaller nasopharyngeal airway dimension (ad2-PNS), a smaller velopharyngeal volume, a smaller minimal cross-sectional area and a smaller minimal hydraulic diameter than JIA- and controls. No significant differences in upper airway dimensions were seen between JIA- and controls. CONCLUSION: JIA patients with severe arthritis-related dentofacial deformity and mandibular micrognathia had significantly restricted upper airway dimensions compared with JIA patients without dentofacial deformity and controls. The restrictions of upper airway dimension seen in the JIA+ group herein were previously associated with sleep-disordered breathing in the non-JIA background population. Further studies are needed to elucidate the role of dentofacial deformity and restricted airways in the development of sleep-disordered breathing in JIA
A retrospective observational study to determine baseline characteristics and early prescribing patterns for patients receiving Alirocumab in UK clinical practice
Background Alirocumab is a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9) and has been previously shown, in the phase III ODYSSEY clinical trial program, to provide significant lowering of lowdensity lipoprotein cholesterol (LDL-C) and reduction in risk of major adverse cardiovascular events. However, real-world evidence to date is limited. Objective The primary objective was to describe baseline characteristics, clinical history, and prior lipid-lowering therapy (LLT) use of patients initiated on alirocumab in UK clinical practice following publication of health technology appraisal (HTA) body recommendations. Secondary objectives included description of alirocumab use and lipid parameter outcomes over a 4-month follow-up period.
Methods In this retrospective, single-arm, observational, multicenter study, data were collected for 150 patients initiated on alirocumab.
Results Mean (standard deviation; SD) age of patients was 61.4 (10.5) years and baseline median (interquartile range; IQR) LDL-C level was 4.8 (4.2–5.8) mmol/l. Alirocumab use occurred predominantly in patients with heterozygous familial hypercholesterolemia (HeFH) (n = 100/150, 66%) and those with statin intolerance (n = 123/150, 82%). Most patients started on alirocumab 75 mg (n = 108/150 [72%]) and 35 (23.3%) were up-titrated to 150 mg. Clinically significant reductions in atherogenic lipid parameters were observed with alirocumab, including LDL-C (median [IQR] change from baseline, − 53.6% [− 62.9 to − 34.9], P < 0.001). Conclusion This study highlights the unmet need for additional LLT in patients with uncontrolled hyperlipidemia and demonstrates the clinical utility of alirocumab in early real-world practice, where dosing flexibility is an important attribute of this therapeutic option
Neutrophil extracellular traps in ulcerative colitis:A proteome analysis of intestinal biopsies
High field level crossing studies on spin dimers in the low dimensional quantum spin system NaT(CO)(HO) with T=Ni,Co,Fe,Mn
In this paper we demonstrate the application of high magnetic fields to study
the magnetic properties of low dimensional spin systems. We present a case
study on the series of 2-leg spin-ladder compounds
NaT(CO)(HO) with T = Ni, Co, Fe and Mn. In all
compounds the transition metal is in the high spin configuation. The
localized spin varies from S=1 to 3/2, 2 and 5/2 within this series. The
magnetic properties were examined experimentally by magnetic susceptibility,
pulsed high field magnetization and specific heat measurements. The data are
analysed using a spin hamiltonian description. Although the transition metal
ions form structurally a 2-leg ladder, an isolated dimer model consistently
describes the observations very well. This behaviour can be understood in terms
of the different coordination and superexchange angles of the oxalate ligands
along the rungs and legs of the 2-leg spin ladder. All compounds exhibit
magnetic field driven ground state changes which at very low temperatures lead
to a multistep behaviour in the magnetization curves. In the Co and Fe
compounds a strong axial anisotropy induced by the orbital magnetism leads to a
nearly degenerate ground state and a strongly reduced critical field. We find a
monotonous decrease of the intradimer magnetic exchange if the spin quantum
number is increased
Nitrogen doping of metallic single-walled carbon nanotubes: n-type conduction and dipole scattering
The charge transport properties of individual, metallic nitrogen doped,
single-walled carbon nanotubes are investigated. It is demonstrated that n-type
conduction can be achieved by nitrogen doping. Evidence was obtained by
appealing to electric-field effect measurements at ambient condition. The
observed temperature dependencies of the zero-bias conductance indicate a
disordered electron system with electric-dipole scattering, caused mainly by
the pyridine-type nitrogen atoms in the honeycomb lattice. These results
illustrate the possibility of creating all-metallic molecular devices, in which
the charge carrier type can be controlled.Comment: 16 page
BN domains included into carbon nanotubes: role of interface
We present a density functional theory study on the shape and arrangement of
small BN domains embedded into single-walled carbon nanotubes. We show a strong
tendency for the BN hexagons formation at the simultaneous inclusion of B and N
atoms within the walls of carbon nanotubes. The work emphasizes the importance
of a correct description of the BN-C frontier. We suggest that BN-C interface
will be formed preferentially with the participation of N-C bonds. Thus, we
propose a new way of stabilizing the small BN inclusions through the formation
of nitrogen terminated borders. The comparison between the obtained results and
the available experimental data on formation of BN plackets within the single
walled carbon nanotubes is presented. The mirror situation of inclusion of
carbon plackets within single walled BN nanotubes is considered within the
proposed formalism. Finally, we show that the inclusion of small BN plackets
inside the CNTs strongly affects the electronic character of the initial
systems, opening a band gap. The nitrogen excess in the BN plackets introduces
donor states in the band gap and it might thus result in a promising way for
n-doping single walled carbon nanotubes
SorLA Controls Neurotrophic Activity by Sorting of GDNF and Its Receptors GFR alpha 1 and RET
Peer reviewe
Atomic Configuration of Nitrogen Doped Single-Walled Carbon Nanotubes
Having access to the chemical environment at the atomic level of a dopant in
a nanostructure is crucial for the understanding of its properties. We have
performed atomically-resolved electron energy-loss spectroscopy to detect
individual nitrogen dopants in single-walled carbon nanotubes and compared with
first principles calculations. We demonstrate that nitrogen doping occurs as
single atoms in different bonding configurations: graphitic-like and
pyrrolic-like substitutional nitrogen neighbouring local lattice distortion
such as Stone-Thrower-Wales defects. The stability under the electron beam of
these nanotubes has been studied in two extreme cases of nitrogen incorporation
content and configuration. These findings provide key information for the
applications of these nanostructures.Comment: 25 pages, 13 figure
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