Long-term risk of mortality and lymphoproliferative disease and predictive classification of primary Sjögren's syndrome

Objective. Primary Sjögren's syndrome (SS) may lead to lymphoproliferative disease (LPD) and death in certain patients. We sought to determine the incidence and predictors of adverse long-term outcomes to achieve a rational predictive classification of the syndrome. Methods. Predictive modeling was performed in a cohort of 723 consecutive patients with primary SS (587 newly diagnosed [incident] cases and 136 prevalent cases). Results. During 4,384 person-years of followup, we recorded 39 deaths (7 due to lymphoma) and 38 diagnoses of LPD. The standardized mortality ratio was 1.15 (95% confidence interval [95% CI] 0.86-1.73) compared with the general population of Greece. In incident cases, the probability of LPD was 2.6% at 5 years and 3.9% at 10 years. Mortality rates were significantly higher in patients with low C4 levels at the first study visit (hazard ratio [HR] 4.39, 95% CI 2.18-8.83). LPD was independently predicted by the presence of parotid enlargement (HR 5.21, 95% CI 1.76-15.4), palpable purpura (HR 4.16, 95% CI 1.65-10.5), and low C4 levels (HR 2.40, 95% CI 0.99-5.83) at the first study visit. All patients who eventually developed lymphoma resulting in death during the followup period had either low C4 levels or palpable purpura at the first study visit. Training-validation split-cohort modeling confirmed the predictive importance of low C4 levels and palpable purpura, both of which were present in 20.9% of patients at their first visit. Conclusions. In patients with primary SS, 1 in 5 deaths is attributable to lymphoma. The presence of palpable purpura and low C4 levels at the first visit adequately distinguishes high-risk patients (type I primary SS) from patients with an uncomplicated disease course (type II [low-risk] primary SS)

Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis

Objective To measure aortic stiffness and global left ventricular LV function in patients with ankylosing spondylitis AS and no clinical evidence of heart disease. Methods Fiftyseven consecutive patients with AS 54 males, three females, mean age 41.78±10.02 years without clinical evidence of cardiac involvement and 78 healthy subjects 73 males, five females, mean age 39.92±9.11 years underwent complete echocardiographic study. Aortic stiffness was determined noninvasively by aortic distensibility AoD and the global LV function was evaluated by the myocardial performance index the Tei index. Results AoD in patients with AS 2.21±0.24×10-6 cm2dyn-1 was decreased compared to controls 2.58±0.19 ×10-6 cm2dyn-1, p<0.01, confirming that aortic stiffness is increased in AS. The LV Tei index was significantly increased in the patient group compared to the control group 0.392±0.031 vs. 0.370±0.034, p<0.01. The ejection fraction EF did not differ between the two groups p>0.05. In multivariate linear regression analysis, AoD was significantly associated with the Bath Ankylosing Spondylitis Disease Activity Index BASDAI and LV isovolumic relaxation time IVRT whereas the LV Tei index was associated with BASDAI and the LV mass index. Conclusions Patients with AS and no clinical evidence of cardiac disease have increased stiffness of the aorta and decreased global myocardial performance and both of these abnormal measurements correlate with disease activity. The abnormal Tei index may reflect an early manifestation of cardiac dysfunction in these patients. © 2009 Taylor & Francis on license from Scandinavian Rheumatology Research Foundation. © 2009 Informa UK Ltd All rights reserved

Measurements of total production cross sections for π+\pi^{+}+C, π+\pi^{+}+Al, K+K^{+}+C, and K+K^{+}+Al at 60 GeV/c and π+\pi^{+}+C and π+\pi^{+}+Al at 31 GeV/c

International audienceThis paper presents several measurements of total production cross sections and total inelastic cross sections for the following reactions: π++C, π++Al, K++C, K++Al at 60  GeV/c, π++C and π++Al at 31  GeV/c. The measurements were made using the NA61/SPS Heavy Ion and Neutrino Experiment spectrometer at the CERN Super Proton Synchrotron (SPS). Comparisons with previous measurements are given and good agreement is seen. These interaction cross sections measurements are a key ingredient for neutrino flux prediction from the reinteractions of secondary hadrons in current and future accelerator-based long-baseline neutrino experiments

Search for the critical point of strongly-interacting matter in 40{}^{40}Ar + 45{}^{45}Sc collisions at 150A GeV/c using scaled factorial moments of protons

International audienceThe critical point of dense, strongly interacting matter is searched for at the CERN SPS in ${}^{40}$Ar + ${}^{45}$Sc collisions at 150A GeV/c. The dependence of second-order scaled factorial moments of proton multiplicity distribution on the number of subdivisions of transverse momentum space is measured. The intermittency analysis is performed using both transverse momentum and cumulative transverse momentum. For the first time, statistically independent data sets are used for each subdivision number. The obtained results do not indicate any statistically significant intermittency pattern. An upper limit on the fraction of critical proton pairs and the power of the correlation function is obtained based on a comparison with the Power-law Model developed for this purpose

ALICE Technical Design Report on Forward Detectors : FMD, T0 and V0

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ALICE Technical Design Report of the Computing

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