Development of low blood glucose readings in nine non-diabetic patients treated with tumor necrosis factor-alpha inhibitors: a case series

<p>Abstract</p> <p>Introduction</p> <p>Treatment with various biological agents in disease states such as rheumatoid arthritis has been associated with multiple side effects. Whereas many of these are frequently reported in the literature, hypoglycemia, a possible side effect of tumor necrosis factor-alpha inhibitors, may be underpublicized.</p> <p>Case presentation</p> <p>We report nine cases of non-diabetic Caucasian women who were between 29 and 68 years of age and who developed low glucose readings after treatment with tumor necrosis factor-alpha inhibitors. We provide a more detailed discussion of existing evidence of the role of tumor necrosis factor-alpha in the pathogenesis of inflammation and its impact on glycemic equilibrium.</p> <p>Conclusions</p> <p>Physicians using tumor necrosis factor-alpha inhibitors in the treatment of various rheumatic and other autoimmune diseases should be aware of the potential for the development of glycemic disturbance in these patients. A further role of tumor necrosis factor-alpha inhibitors in the glycemic equilibrium warrants larger controlled trials in patients with and those without a history of diabetes.</p

Lack of association of the CIITA -168A→G promoter SNP with myasthenia gravis and its role in autoimmunity

<p>Abstract</p> <p>Background</p> <p>The major histocompatibility complex class II transactivator (CIITA) regulates MHC class II gene expression. A promoter SNP -168A→G (rs3087456) has previously been shown to be associated with susceptibility to several immune mediated disorders, including rheumatoid arthritis (RA), multiple sclerosis (MS) and myocardial infarction (MI). Myasthenia gravis (MG) is an autoimmune disorder which has previously been shown to be associated with polymorphisms of several autoimmune predisposing genes, including <it>IL-1</it>, <it>PTPN22</it>, <it>TNF-α </it>and the <it>MHC</it>. In order to determine if allelic variants of rs3087456 increase predisposition to MG, we analyzed this SNP in our Swedish cohort of 446 MG patients and 1866 controls.</p> <p>Results</p> <p>No significant association of the SNP with MG was detected, neither in the patient group as a whole, nor in any clinical subgroup. The vast majority of previous replication studies have also not found an association of the SNP with autoimmune disorders.</p> <p>Conclusions</p> <p>We thus conclude that previous findings with regard to the role of the <it>CIITA </it>-168A→G SNP in autoimmunity may have to be reconsidered.</p

Antibodies against cyclic citrullinated peptide don’t decrease after 6 months of infliximab treatment in refractory rheumatoid arthritis

Anti-citrullinated peptide antibodies (ACPA) and the rheumatoid factor (RF) are well-established serological markers for rheumatoid arthritis (RA). ACPA are very useful in the diagnosis of RA, especially at the early stages of the disease when ACPA have a greater diagnostic value than RF. The aim of the study was to assess the influence of infliximab treatment on RF IgM and ACPA serum levels and RA activity during 6 months of treatment. Thirty-two patients with refractory RA were treated with infliximab during a 6-month period. At baseline, 3 and 6 months of treatment the patients were examined for the number swollen and tender joints out of 28 (SJC, TJC) and the visual analogue scale of arthritis activity according to the patient (VAS). Serum samples were tested for erythrocyte sedimentation rate (ESR), C-reactive protein level (CRP), ACPA and RF IgM. The disease activity score (DAS-28) parameter was also calculated at the same time. During the course of our study, we observed statistically significant improvement in ESR, CRP, TJC, SJC, VAS DAS-28, and RF IgM after 3 and 6 months of infliximab treatment when compared to the baseline, whereas the ACPA level remained unchanged after 3 and 6 months of treatment (P = 0.96 and P = 0.85). The changes in the ACPA level are not a factor for evaluation of successful infliximab treatment but the changes in RF IgM are. According to different behavior of these antibodies during infliximab treatment, we suggest that the roles of ACPA and RF in the pathogenesis of RA are different

Connecting Critical Hermeneutics with the Management and Organizational Studies: An Analysis of the Philosophy and Methods of its Implementation in Organizations

Critical hermeneutics is rooted in philosophy of knowledge, in general, and in the methodology of human sciences, in particular. This approach is methodologically considered as a qualitative study with the aim of achieving internal understanding in various fields such as linguistic, longitudinal and experimental sciences. Jürgen Habermas, one of the precursors of Frankfurt School, is the pioneer of this method. In 1981, he published one of his best works entitled “Communicative Interaction Theory”, and added the symbolic aspects of social interaction to Frankfurt critical theory. Thus, critical hermeneutics does not pursue a “unifying answer”; rather it seeks to portray the social phenomena that are derived through discourse. Discourse, as a means of obtaining data, is used in critical hermeneutics and as Habermas posited, the essential prerequisite for discourse is to provide space devoid of any trace of power. In this qualitative study, the researchers conducted in-depth interviews with individuals, and by transcribing the interviews, converted the phenomenon into text. These texts constitute the research data of the study. Then, the researchers interpreted the textual form of the phenomena and represented the obtained results in several limited themes, each of which is further split into certain limited categories. Since the main advantage of critical hermeneutics is developing and reorienting the existing interpretative approaches to the study of management, this paper attempts to examine this approach as a qualitative research method in organization and management studies, and represent its process and key features

Coumaroyl flavone glycosides and cinammic acid derivatives from the aerial parts of Phlomis bruguieri Desf.

Background and objectives: Phlomis bruguieri Desf. (Lamiaceae) is a perennial herbaceous plant distributed in Iran, Turkey and Iraq. Despite medicinal potentials of this species, the current knowledge on its phytochemical constituents is limited. The aim of the present study was to investigate the phytochemical constituents of the essential oil and various extracts of this species. Methods: Essential oils of the plant aerial parts were extracted by hydrodistillation and steam distillation methods and analysed using GC and GC/MS.Column chromatography with silica gel (normal and reversed phases) and Sephadex LH-20 were also used for the isolation of compounds from various extracts obtained from P. bruguieri aerial parts. The structures of isolated compounds were established by 1D and 2D NMR techniques. Results: By GC and GC/MS analysis, germacrene D (29.8%), apiole (20.7%) and myristicin (16.63%) were identified as the main compounds of hydrodistilled oil. Apiole (53.20%) and myristicin (34.87%) were also detected as the main compounds of the oil extracted by steam distillation method. Phytochemical analysis of the plant extracts resulted in the isolation and structural elucidation of  β-sitosterol (1), p-coumaric acid methyl ester (2), chrysoeriol 7-O-(3''-(E)-p-coumaroyl)-β-D-glucopyranoside (3), chrysoeriol 7-O-(3'',6''-di-O-(E)-p-coumaroyl)-β-D glucopyranoside (4), chrysoeriol 7-O-β-D-glucopyranoside (5), chlorogenic acid (6) and verbascoside (7). Conclusion: the results of the present study introduce steam distilled oil of P. bruguieri as a new source of apiole and myristicin. Moreover, identification of coumaroyl flavone glycosides and cinammic acid derivatives from the aerial parts of this species highlighted the species as a good candidate for further biological and pharmacological studies