145 research outputs found

    Qualitative interpretation and sampling validity of peer recognition study

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    In an examination of limitations to a previous study, it was found that there was no significant difference between respondents and non-respondents with regard to country or eminence of institution. Observations from non-respondents illustrate possible constraints on the interpretation of responses.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23847/1/0000086.pd

    VEGF, FGF1, FGF2 and EGF gene polymorphisms and psoriatic arthritis

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    BACKGROUND: Angiogenesis appears to be a first-order event in psoriatic arthritis (PsA). Among angiogenic factors, the cytokines vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and fibroblast growth factors 1 and 2 (FGF1 and FGF2) play a central role in the initiation of angiogenesis. Most of these cytokines have been shown to be upregulated in or associated with psoriasis, rheumatoid arthritis (RA) or ankylosing spondylitis (AS). As these diseases share common susceptibility associations with PsA, investigation of these angiogenic factors is warranted. METHODS: Two hundred and fifty-eight patients with PsA and 154 ethnically matched controls were genotyped using a Sequenom chip-based MALDI-TOF mass spectrometry platform. Four SNPs in the VEGF gene, three SNPs in the EGF gene and one SNP each in FGF1 and FGF2 genes were evaluated. Statistical analysis was performed using Fisher's exact test, and the Cochrane-Armitage trend test. Associations with haplotypes were estimated by using weighted logistic models, where the individual haplotype estimates were obtained using Phase v2.1. RESULTS: We have observed an increased frequency in the T allele of VEGF +936 (rs3025039) in control subjects when compared to our PsA patients [Fisher's exact p-value = 0.042; OR 0.653 (95% CI: 0.434, 0.982)]. Haplotyping of markers revealed no significant associations. CONCLUSION: The T allele of VEGF in +936 may act as a protective allele in the development of PsA. Further studies regarding the role of pro-angiogenic markers in PsA are warranted

    Developing classification criteria for skin-predominant dermatomyositis: the Delphi process

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    Background The European League Against Rheumatism/American College of Rheumatology classification criteria for inflammatory myopathies are able to classify patients with skin-predominant dermatomyositis (DM). However, approximately 25% of patients with skin-predominant DM do not meet two of the three hallmark skin signs and fail to meet the criteria. Objectives To develop a set of skin-focused classification criteria that will distinguish cutaneous DM from mimickers and allow a more inclusive definition of skin-predominant disease. Methods An extensive literature review was done to generate items for the Delphi process. Items were grouped into categories of distribution, morphology, symptoms, antibodies, histology and contextual factors. Using REDCap™, participants rated these items in terms of appropriateness and distinguishing ability from mimickers. The relevance score ranged from 1 to 100, and the median score determined a rank-ordered list. A prespecified median score cut-off was decided by the steering committee and the participants. There was a pre-Delphi and two rounds of actual Delphi. Results There were 50 participating dermatologists and rheumatologists from North America, South America, Europe and Asia. After a cut-off score of 70 during the first round, 37 of the initial 54 items were retained and carried over to the next round. The cut-off was raised to 80 during round two and a list of 25 items was generated. Conclusions This project is a key step in the development of prospectively validated classification criteria that will create a more inclusive population of patients with DM for clinical research

    Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools

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    Objective: Several questionnaires have been developed to screen for psoriatic arthritis (PsA), but head-to-head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments.<p></p> Methods: Data from the CONTEST study, a head-to-head comparison of 3 existing questionnaires, were used to identify items with a Youden index score of ≥0.1. These were combined using 4 approaches: CONTEST (simple additions of questions), CONTESTw (weighting using logistic regression), CONTESTjt (addition of a joint manikin), and CONTESTtree (additional questions identified by classification and regression tree [CART] analysis). These candidate questionnaires were tested in independent data sets.<p></p> Results: Twelve individual questions with a Youden index score of ≥0.1 were identified, but 4 of these were excluded due to duplication and redundancy. Weighting for 2 of these questions was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in 6 joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC curve analysis and discarded. The other 3 questionnaires were significant in all data sets, although CONTESTw was slightly inferior to the others in the validation data sets. Potential cut points for referral were also discussed.<p></p> Conclusion: Of 4 candidate questionnaires combining existing discriminatory items to identify PsA in people with psoriasis, 3 were found to be significant on ROC curve analysis. Testing in independent data sets identified 2 questionnaires (CONTEST and CONTESTjt) that should be pursued for further prospective testing

    Dermatite seborreica

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    Genome-wide association study in frontal fibrosing alopecia identifies four susceptibility loci including HLA-B*07:02

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    Frontal fibrosing alopecia (FFA) is a recently described inflammatory and scarring type of hair loss affecting almost exclusively women. Despite a dramatic recent increase in incidence the aetiopathogenesis of FFA remains unknown. We undertake genome-wide association studies in females from a UK cohort, comprising 844 cases and 3,760 controls, a Spanish cohort of 172 cases and 385 controls, and perform statistical meta-analysis. We observe genome-wide significant association with FFA at four genomic loci: 2p22.2, 6p21.1, 8q24.22 and 15q2.1. Within the 6p21.1 locus, fine-mapping indicates that the association is driven by the HLA-B*07:02 allele. At 2p22.1, we implicate a putative causal missense variant in CYP1B1, encoding the homonymous xenobiotic- and hormone-processing enzyme. Transcriptomic analysis of affected scalp tissue highlights overrepresentation of transcripts encoding components of innate and adaptive immune response pathways. These findings provide insight into disease pathogenesis and characterise FFA as a genetically predisposed immuno-inflammatory disorder driven by HLA-B*07:02

    Improvement of thermal performance and energy efficiency of lightweight solar housing for peri-urban villages

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    This study concerns an investigation into the thermal performance and energy efficiency of prefabricated lightweight houses for peri-urban villages in the Perth Metropolitan region of Western Australia. Several styles of residence were selected for comparison, taken from the first three “lifestyle villages” constructed by National Lifestyle Villages Pty Ltd (NLV). NLV is committed to quadruple bottom-line sustainability and the aim is, therefore, to provide indicators of how old and new dwellings compared under the same external conditions. The buildings themselves are prefabricated and brought to site in two halves, framed in steel, clad with fibre-cement boarding, roofed in zincalume sheeting, floored in flooring grade particle board with applied fibre-cement sheeting. Although the basic design was developed using the passive principles of solar design and other energy conservation measures, they possess little thermal mass to augment the thermal efficiency. Research has indicated several feasible and low-budget innovative improvements to incorporate into future designs, and how best to modify and retrofit existing dwellings. NLV aims to provide homes for over 40,000 people in 100 villages throughout Australia by the year 2025. Any improvement in residential thermal performance can be translated not only into energy savings and greenhouse gas reduction on a significant scale, but can enhance comfort levels for residents whilst reducing their energy costs. This paper will present the data and report on the results of the investigations. Recommendations will be made for housing in proposed future villages with regard to requirements for other improvements such as innovative means of increasing internal thermal mass
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