41 research outputs found
Deletion of LCE3C and LCE3B genes at PSORS4 does not contribute to susceptibility to psoriatic arthritis in German patients
Cryo-EM structures reveal intricate Fe-S cluster arrangement and charging in Rhodobacter capsulatus formate dehydrogenase
Metal-containing formate dehydrogenases (FDH) catalyse the reversible oxidation of formate to carbon dioxide at their molybdenum or tungsten active site. They display a diverse subunit and cofactor composition, but structural information on these enzymes is limited. Here we report the cryo-electron microscopic structures of the soluble Rhodobacter capsulatus FDH (RcFDH) as isolated and in the presence of reduced nicotinamide adenine dinucleotide (NADH). RcFDH assembles into a 360 kDa dimer of heterotetramers revealing a putative interconnection of electron pathway chains. In the presence of NADH, the RcFDH structure shows charging of cofactors, indicative of an increased electron load
Tumor necrosis factor polymorphisms in psoriatic arthritis : association with the promoter polymorphism TNF-857 independent of the PSORS1 risk allele
Poster presentation Background Single nucleotide polymorphisms (SNPs) of the TNF gene at positions -238 and -308 have earlier been associated with psoriasis vulgaris and psoriatic arthritis (PsA). However, a strong linkage disequilibrium at the chromosomal region 6p21 renders the interpretation of these findings difficult since also other risk factors for psoriasis (PSORS1) than SNPs of the TNF gene have bee mapped to that particular region. Therefore, in this study several SNPs of the TNF gene and of its neighbouring lymphotoxin alpha (LTA) gene were analysed independently and dependently on carrying the PSORS1 risk allele. Methods SNPs in the promoter of the TNF gene (-238G/A, -308G/A, -857C/T, -1031T/C), and one SNP of the LTA gene (+252A/G), of the TNLFRSF1A gene (+36A/G) and of the TNLFRSF1B gene (+676T/G), respectively, were genotyped in 375 psoriasis patients, 375 PsA patients, and 376 controls. The tryptophan–tryptophan–cysteine–cysteine haplotype of the CCHCR1 gene (CCHCR1*WWCC) was used to estimate the genetic impact of the PSORS1 risk allele. Results Whereas an earlier-described association of allele TNF*-238A with psoriasis could be confirmed, our study revealed that this association was completely dependent on concomitant carriage of the PSORS1 risk allele. For PsA, but not psoriasis vulgaris without joint manifestations, strong association with the allele TNF*-857T was detected (OR = 1.956; P value corrected for multiple testing, Pcorr = 0.0025) also in patients negative for the PSORS1 risk allele. Conclusion Our results indicate genetic differences between psoriasis vulgaris patients with and without joint manifestation. While the previously reported association between TNF*-238A and psoriasis seems to primarily reflect linkage disequilibrium with PSORS1, TNF*-857T may represent a risk factor for PsA independent of PSORS1. A potential pathophysiologic relevance of the elucidated genetic association is further suggested by previously reported experimental evidence for a functional impact of the respective TNF polymorphism on TNFalpha expression levels
Inorganic fluorescent marker materials for identification of post-consumer plastic packaging
Current plastic packaging waste management practices in Europe, but also in other countries require improvement due to legal and societal requirements. To meet high recycling rates, significant changes among others in post-consumer packaging waste sorting become necessary. This waste stream is dominated by plastic packaging. Inorganic fluorescent tracer materials (oxide crystals doped with ytterbium Yb sensitizer ions and either erbium (Er), holmium (Ho) or thulium (Tm) activator ions) enable a sorting criterion which is independent of the properties of the packaging materials. The authors propose to use up-conversion fluorescence as a unique mean for polymer marking and product identification. To this end, PE-HD film samples, with 10, 100 and 1000 ppm of marker concentration in different polymer matrix colours (semi-transparent, yellow, green, and black) were irradiated with 980 nm diode laser radiation, with an excitation intensity up to 10 W/cm. The performance of three different marker types with their maximum emission in green, red, and NIR was measured and assessed both with and without polymer matrix. Moreover, PE-HD sample bottles with tracers were tested, and a tracer regime for specific code generation for improved polymer identification is proposed
The Value of an Automated Ultrasound System in the Detection of Synovitis
Background The detection of joint swelling caused by synovitis is important for the diagnosis of inflammatory arthritis. Ultrasound (US) and MRI have proven to be more sensitive and reliable than physical examination, but they are time-consuming and expensive. The automated breast volume scanner was developed to acquire serial B-mode pictures of the female breast and these can be analyzed in all three dimensions. Objectives To analyze the value of automated B-mode ultrasound employing the ABVS system in detecting synovitis of the finger joints compared to manual ultrasound (mUS) and physical examination, using MRI as the gold standard. Methods 19 consecutive patients suffering from active rheumatoid (n=15) or psoriatic (n=4) arthritis were included. Automated and mUS were conducted with a linear array (ACUSON S2000, 11MHz). Multiplanar reconstruction enabled examination of the images for the presence of synovitis. Results 90% of the hand joints were assessable by automated ultrasound. Automated US detected 12.0, mUS 14.2, MRI 13.4, and clinical examination 4.1 positive joints - i.e. joints with synovitis - on average per patient. The inter-observer reliability of both assessors for automated and mUS, MRI, and physical examination, was 66.9%, 72.7%, 95.1%, and 88.9%, respectively. 84.3% of the joints classified as positive on MRI were confirmed by automated ultrasound, 85.5% on mUS, and 36.0 on physical examination. This translated into a sensitivity of 83.5%, 85.5%, and 36.0% for the three methods, respectively. Conclusion: Automated ultrasound is a promising ultrasound method for assessing small joints in patients with inflammatory arthritis
Delegation ärztlicher Leistungen an rheumatologische Fachassistenten: Effekte auf Depression und Angst bei Patienten mit rheumatoider Arthritis
Background: At least 1 comorbidity occurs in 80% of patients with rheumatoid arthritis (RA). In addition to cardiovascular comorbidities psychological comorbid conditions are common. The prevalence of depression and anxiety is higher in patients than in the general population. Screening for comorbidities is crucial. A shortage of outpatient specialist care barely allows resources for this. The implementation of team-based care holds the potential to improve the standard of care while simultaneously working against the shortage of care. Objective: The aim of the study was to examine the effects of care on the course of depression and anxiety in patients with seropositive RA and active disease. Material and methods: A multicenter pragmatic randomized controlled trial was conducted over the course of 1 year with 224 patients. After baseline, five more visits followed. In the intervention group (IG), three were initially carried out by qualified rheumatological assistants. Depression, anxiety and patient satisfaction with outpatient care were looked at in detail. Results: In the IG the anxiety symptoms significantly improved over 12 months (p = 0.036). The proportions of patients with anxiety also significantly changed in the IG (p < 0.001), while there was no change in the control group between baseline and month 12. The values of the depression scale did not differ significantly (p = 0.866). In terms of the information dimension of the satisfaction questionnaire, patients in the IG felt significantly better informed after 6 months (p = 0.013) and 12 months (p = 0.003). Conclusion: A positive effect of team-based care on the course of depression and anxiety in patients with seropositive RA and active disease could be shown.Hintergrund: Bei 80 % der Patienten mit einer rheumatoiden Arthritis (RA) tritt mindestens eine Komorbidität auf. Neben kardiovaskulären Komorbiditäten sind psychische Erkrankungen häufig. Die Prävalenz von Depression und Angst ist bei Betroffenen höher als in der Allgemeinbevölkerung. Ein Screening auf Komorbidität ist hoch relevant. Die Unterversorgung im fachärztlichen Bereich lässt dies kaum zu. Die Implementierung einer Visite durch die rheumatologische Fachassistenz (RFA) bietet Potenzial, die Versorgung zu verbessern und der Unterversorgung zu begegnen. Fragestellung: Ziel ist, Auswirkungen einer teambasierten Versorgung auf den Verlauf von Depression und Angst bei Patienten mit einer seropositiven RA im Krankheitsschub zu untersuchen. Material und Methoden: Es handelt sich um eine multizentrische, pragmatische, randomisierte, kontrollierte Studie über 1 Jahr mit 224 Patienten. Nach Baseline folgen 5 Visiten. In der Interventionsgruppe (IG) fanden 3 zunächst bei der RFA statt. Depression, Angst und Behandlungszufriedenheit werden genauer betrachtet. Ergebnisse: In der IG hat sich die ängstliche Symptomatik über 12 Monate signifikant verbessert (p = 0,036). Auch die Anteile der Patienten mit Ängstlichkeit verändern sich signifikant in der Interventionsgruppe (p < 0,001), während es in der Kontrollgruppe im Vergleich zwischen Baseline und Monat 12 zu keiner Veränderung kam. Die Werte der Depressionsskala unterschieden sich nicht signifikant (p = 0,866). Bei der Dimension „Information“ des Zufriedenheitsfragebogens haben sich die Patienten in der IG nach 6 (p = 0,013) und 12 Monaten (p = 0,003) signifikant besser informiert gefühlt. Diskussion: Ein positiver Effekt der teambasierten Versorgung auf den Verlauf von Depression und Angst bei Patienten mit einer seropositiven RA im Krankheitsschub konnte gezeigt werden
New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis – Implications from the prospective multicenter VADERA II study
Objectives
To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease.
Methods
In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation.
Results
In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age 2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy.
Conclusions
Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.
Clinical trial registration number
This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483)
Tragfähigkeitsberechnung von Bauteilen mit Mehrfachkerben im Nennspannungskonzept
In der Praxis weisen Wellen und Achsen häufig komplex gestaltete oder überlagerte Kerbformen (Mehrfachkerben) auf, die von normativen Methoden zur Berechnung der Ermüdungsfestigkeit nicht erfasst sind. Die vorliegende Arbeit widmet sich daher der Zusammenführung von Kerbspannungsergebnissen einer Finite-Elemente-Analyse mit dem genormten Ermüdungsfestigkeitsnachweis nach DIN 743. Dazu erfolgt die Ableitung einer neuen, spannungsmechanisch begründeten Berechnungsmethode zur Integration von örtlich mehrachsigen Spannungszuständen in den nennspannungsbasierten Tragfähigkeitsnachweis. Die grundlegende Vorgehensweise der Norm wird nicht verändert. Sensitivitätsanalysen an einem Anwendungsbeispiel liefern zentrale Aussagen zur Relevanz verschiedener festigkeitsbeeinflussender Effekte bei Mehrfachkerben. Die Ergebnisse münden in einer anwendungsbereiten und ganzheitlichen Berechnungsanleitung für die Ermüdungsfestigkeitsberechnung von Bauteilen mit Mehrfachkerben in Anlehnung an DIN 743. Der zweite Teil der Arbeit wendet die erarbeitete Methode auf eine in der Konstruktionspraxis immer wiederkehrende Mehrfachkerbe, die Zahnwellenverbindung mit freiem Zahnauslauf, an. Als Ergebnis einer umfangreichen Parameterstudie liegen dem Anwender Berechnungsfaktoren zur Erfassung der Kerbwirkung für Zahnwellenverbindungen nach DIN 5480 in Abhängigkeit von zahlreichen geometrischen Einflussparametern vor. Abschließend werden die entwickelten Berechnungsmethode im Allgemeinen und die ermittelten normspezifischen Kennwerte für Zahnwellenverbindungen im Speziellen an vorhandenen experimentellen Stichversuchen aus der Literatur gespiegelt
Tragfähigkeitsberechnung von Bauteilen mit Mehrfachkerben im Nennspannungskonzept
In der Praxis weisen Wellen und Achsen häufig komplex gestaltete oder überlagerte Kerbformen (Mehrfachkerben) auf, die von normativen Methoden zur Berechnung der Ermüdungsfestigkeit nicht erfasst sind. Die vorliegende Arbeit widmet sich daher der Zusammenführung von Kerbspannungsergebnissen einer Finite-Elemente-Analyse mit dem genormten Ermüdungsfestigkeitsnachweis nach DIN 743. Dazu erfolgt die Ableitung einer neuen, spannungsmechanisch begründeten Berechnungsmethode zur Integration von örtlich mehrachsigen Spannungszuständen in den nennspannungsbasierten Tragfähigkeitsnachweis. Die grundlegende Vorgehensweise der Norm wird nicht verändert. Sensitivitätsanalysen an einem Anwendungsbeispiel liefern zentrale Aussagen zur Relevanz verschiedener festigkeitsbeeinflussender Effekte bei Mehrfachkerben. Die Ergebnisse münden in einer anwendungsbereiten und ganzheitlichen Berechnungsanleitung für die Ermüdungsfestigkeitsberechnung von Bauteilen mit Mehrfachkerben in Anlehnung an DIN 743. Der zweite Teil der Arbeit wendet die erarbeitete Methode auf eine in der Konstruktionspraxis immer wiederkehrende Mehrfachkerbe, die Zahnwellenverbindung mit freiem Zahnauslauf, an. Als Ergebnis einer umfangreichen Parameterstudie liegen dem Anwender Berechnungsfaktoren zur Erfassung der Kerbwirkung für Zahnwellenverbindungen nach DIN 5480 in Abhängigkeit von zahlreichen geometrischen Einflussparametern vor. Abschließend werden die entwickelten Berechnungsmethode im Allgemeinen und die ermittelten normspezifischen Kennwerte für Zahnwellenverbindungen im Speziellen an vorhandenen experimentellen Stichversuchen aus der Literatur gespiegelt