Revised criteria for the classification of rheumatoid arthritis

The Bulletin on the Rheumatic Diseases has published all of the classification criteria for the rheumatic diseases to date. These new revised classification criteria for rheumatoid arthritis are very important as they should provide understanding of the possibly changing face of rheumatoid arthritis.     

Genome scan of glomerular filtration rate and albuminuria: the HyperGEN study.

BACKGROUND: Albuminuria and reduced glomerular filtration rate (GFR) are markers of renal dysfunction associated with hypertension. We performed genome-wide scans to detect loci impacting these parameters in 1251 African American (AAs) and 1129 European American (EAs) hypertensive siblings from the Hypertension Genetic Epidemiology Network study. METHODS: GFR, estimated by the Modification of Diet in Renal Disease equation, and albuminuria, measured as albumin to creatinine ratio (ACR), were adjusted for gender, age, centre, mean blood pressure, anti-hypertensive medication class and diabetes status using SOLAR. Since albuminuria and abnormal GFR often coexist, we conducted bivariate linkage analyses to investigate the presence of pleiotropy. RESULTS: The phenotypic correlation between ACR and GFR was not significant in EAs (r = 0.04) and significantly negative in AAs (r = -0.17). Univariate analyses of ACR showed suggestive evidence of linkage on chromosomes 8, 16 and 17 (LOD: 2-2.8) in AAs, on chromosomes 18 and 19 (LOD = 2) in EAs, and on chromosome 19 (LOD = 2.6) when combining AAs and EAs. For GFR, suggestive linkage was found on chromosomes 7, 14 and 19 (LOD: 2.2-2.9) in AAs and on chromosomes 14, 15 and 16 (LOD: 2.1-3.3) in the combined group. Also, bivariate analyses showed a LOD score of 3.4 at 133 cM on chromosome 7 in AAs. CONCLUSIONS: Suggestive evidence for linkage to GFR and ACR was observed at many loci. The findings are consistent with previous studies. Also, indication of a pleiotropic locus was detected in chromosome 7 in AAs.     

Prioritization of patients on scheduled waiting lists: validation of a scoring system for hip and knee arthroplasty.

INTRODUCTION: The hip and knee replacement priority criteria tool (HKPT) is 1 of 5 tools developed by the Western Canada Waiting List Project for setting priorities among patients awaiting elective procedures. We set out to assess the validity of the HKPT priority criteria score (PCS) and map the maximum acceptable waiting times (MAWTs) for patients to levels of urgency. METHODS: Two studies were used to assess convergent and discriminant validity. In study 1, consecutive patients on a waiting list for hip or knee arthroplasty were assessed by orthopedic surgeons from the 4 provinces in Western Canada, using the HKPT and data on patient age, gender, joint site, type of surgery (primary or revision), 2 measures of surgeon-rated patient urgency, and diagnosis. In study 2, 6 patients were videotaped during a consultation interview with the surgeon and were assessed by a group of experts. We measured function with the PCS and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS: In study 1, we assessed 394 patients, and in study 2, 19 raters assessed the 6 patients. Correlations between the PCS and other measures of physician-rated urgency were strong, ranging from 0.78 to 0.89. For a subgroup of 60 patients, correlation between the PCS and function as measured with the WOMAC was 0.48, and correlation was greater (0.45-0.56) between items measuring similar constructs (e.g., pain at rest) than those measuring different constructs (0.21-0.40). In study 2, median MAWTs ranged from 4 to 24 weeks for 5 levels of urgency based on PCS percentiles. CONCLUSIONS: Results from this study support the validity of the PCS as a measure of surgeon-rated urgency for hip or knee arthroplasty. Evaluative studies are needed to assess the validity and acceptability of the tools and the establishment of MAWTs in clinical practice.     

β-锗代-α-氨基酸衍生物的合成及抗肿瘤活性

自六十年代初期发现羧乙基锗倍半氧化物(Ge—132)广泛的生物活性以来,已有许多相应的有机锗化合物被发现,在抗肿瘤活性方面,因有毒性较低、抗瘤谱广等一系列优点而引起人们广泛的兴趣,但由于活性较低影响了应用及发展,据文献报道,有机锗倍半氧     

Primary Sj?gren's syndrome in men. Clinical, serologic, and immunogenetic features

Although primary Sj?gren's syndrome is a common rheumatic disorder in women, it is not well recognized in men. This study represents the first report of the clinical, serologic, and immunogenetic features of a group of 36 men with primary Sj?gren's syndrome, which are contrasted with those of a group of 69 women with primary Sj?gren's syndrome. The majority of male patients had extraglandular involvement including articular (78 percent), neurologic (39 percent), inflammatory vascular (25 percent), and lymphoproliferative disorders (17 percent). Although men were at the same risk for the development of extraglandular complications, there were significant serologic and immunogenetic differences. In sharp contrast to women with Sj?gren's syndrome, men with Sj?gren's syndrome were seronegative with respect to the presence of serum rheumatoid factor (p = 0.008) and antibodies to Ro(SS-A) (p = 0.016). The supertypic specificity, MT2 (DRw52), as in women, was strongly associated with primary Sj?gren's syndrome in men when compared with race-matched control subjects (p = 0.0015). In men, however, the frequency of HLA-B8 and HLA-DR3, the most common DR locus specificity observed in women, was not statistically different from that observed in the normal control group.