Exposure to animals and risk of oligoarticular juvenile idiopathic arthritis: a multicenter case-control study

<p>Abstract</p> <p>Background</p> <p>An inverse association between early contact with microbial compounds and respiratory allergies is well established. The protective effect of infant contact with animals was also shown for inflammatory bowel disease (IBD) and systemic lupus erythematosus (SLE). We aimed to test the association between animal contact in infancy and oligoarticular juvenile idiopathic arthritis (OA JIA).</p> <p>Methods</p> <p>Parents of children with OA JIA registered at the Hospital for Pediatric Rheumatology in Garmisch-Partenkirchen were asked to complete a questionnaire. Children who underwent strabismus surgery at six referral centers for ophthalmology served as controls. Children age 6 to 18 years born in Germany without malformations were included (238 cases; response 89% and 832 controls; response 86%). Data were analyzed using logistic regression models after adjusting for potential confounders.</p> <p>Results</p> <p>Neither place of living (urban vs. rural area), living on a farm, nor regular farm animal (adjusted odds ratio 0.79; 95% confidence interval 0.42-1.47) or pet contact (0.79; 0.55-1.14) during infancy were clearly related to case status. Allergic rhinitis was inversely related to OA JIA (0.57; 0.34-0.95).</p> <p>Neither place of living (urban vs. rural area), living on a farm, nor regular farm animal (adjusted odds ratio 0.79; 95% confidence interval 0.42-1.47) or pet contact (0.79; 0.55-1.14) during infancy were related to case status. Allergic rhinitis was inversely related to OA JIA (0.57; 0.34-0.95).</p> <p>Conclusions</p> <p>Contact with farm environments in infancy might not be associated with OA JIA. This finding is consistent with previous findings for diabetes mellitus type 1 but contradicts results for IBD and SLE.</p

Social difference, community -building, and material social practice: Solidarity and diversity at the Ludlow tent colony, 1913-1914

In 1913, coal miners in southern Colorado initiated a strike under the auspices of the United Mine Workers of America (UMWA). The strike was brutally suppressed and the violence reached a crescendo during the little-known Ludlow Massacre of 20 April 1914. This struggle united workers of at least thirty-two ethnic, national, racial, and linguistic groups under the union's banner, and has become an exemplar of multi-ethnic working-class solidarity. Drawing on oral histories of survivors of the strike, and archaeological data from excavations at the site of the strikers' community known as the Ludlow tent colony, I explore the interplay of cultural diversity and solidarity. Social difference played a critical role in structuring daily social life within the exclusively working-class community at the Ludlow, Colorado, tent colony. The study reveals the complexity of processes of social differentiation and community-building among strikers, and probes the extent and limits of solidarity within the community. Evidence of a high degree of unity among miners, who also expressed a strong investment in (and awareness of) ethnic distinctions, underscores the complex relationship between social difference and community. This "dialectic of difference" (in the sense of Laclau 1996) was manifest in social contexts of inter-ethnic interaction that incorporated ethnically-distinctive practices. These contexts simultaneously marked social difference and, in some cases, promoted shared experiences and community-building among the diverse strike colony population. The research also critically examines the narrative of inter-ethnic unity that has become associated with the 1913-14 strike; the “we all got along” narrative. Close readings of first-person accounts of the life in the coal camps and tent colonies of southern Colorado reveal subtle forms of exclusion that held certain ethnic and racial groups at a distance from the general community of strikers. The nominally white European/Euro-American miners who made up the majority of oral history informants on the strike period deployed a shifting “circle of we” (in the sense of Di Leonardo 1998) that obscured lines of division within the coal mining community. The dynamics of difference and community among coal miners was also cross-cut by gender identities. Finally, the project reveals the ambivalent attitudes to diversity held by Colorado's coal mining companies and the UMWA. Despite fundamental ideological differences, both organizations adopted surprisingly similar outlooks regarding ethnic/racial difference. The study examines continuities and contradictions in company- and union-sponsored Americanization programs, and their unintended effects on miners' solidarity

Autoantibodies are major predictors of arthritis development in patients with anti-citrullinated protein antibodies and musculoskeletal pain

Objectives: Predictors of arthritis development are highly warranted among patients with anti-citrullinated protein antibodies (ACPAs) and musculoskeletal symptoms to optimize clinical management. We aimed to identify clinical and laboratory predictors of arthritis development, including biochemically assessed alcohol consumption, among ACPA-positive patients with musculoskeletal pain. Method: 82 ACPA-positive individuals with musculoskeletal pain but no clinical arthritis were followed for a median of 72 months (interquartile range 57–81 months). We evaluated the prognostic value of baseline clinical and laboratory factors including smoking, symptom duration, age, gender, shared epitope, rheumatoid factor (RF), anti-carbamylated protein antibodies, ACPA levels, erythrocyte sedimentation rate, C-reactive protein levels, tender joint count, patient-reported general well-being, 28-joint Disease Activity Score, and alcohol consumption as measured by phosphatidyl ethanol (PEth) levels in whole blood. Results: During follow-up, 48% developed at least one arthritis. Multivariable analysis revealed an increased risk of arthritis development with RF positivity [hazard ratio (HR) = 2.3, 95% confidence interval (CI) 1.1–4.8, p = 0.028] and higher ACPA levels (HR = 1.0, 95% CI 1.000–1.001, p = 0.002). High levels of RF (HR = 4.4, 95% CI 1.7–11) entailed the highest HR in this ACPA-positive population. Neither clinical characteristics nor alcohol consumption measured by PEth conferred significant prognostic value. Conclusions: ACPA levels and concurrent presence of RF are independent predictors of arthritis development among ACPA-positive patients with musculoskeletal pain. The results are compatible with a dose–response relationship between RA-related autoantibodies and risk of arthritis development. Funding Agencies|Swedish Society of Medicine [SLS-682741]; King Gustaf Vs 80-year foundation [FAI-2017-0420]; Swedish Rheumatism Association [R-754141]; Ostergotland County Council [LIO-700501]</p