THE WRIST AND THE METACARPAL ARCH IN RHEUMATOID ARTHRITIS: The Supination Collapse of the Hand

This paper first describes the usual sequence of the structural changes affecting the wrist and the matacarpal arch in rheumatoid arthritis. Acccording to this sequence, four different types of wrist deformities and two different types of metacarpal arch deformities are determined and their specific features are presented. Treatment options are mentioned for each type, and the author’s preferred treatment is discussed in more detail.

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The role of imaging in predicting the development of rheumatoid arthritis

Rheumatology and Immunology Research ◽

10.2478/rir-2021-0007 ◽

2021 ◽

Vol 2 (1) ◽

pp. 27-33

Author(s):

Ho So ◽

Isaac Cheng ◽

Lai-Shan Tam

Keyword(s):

Rheumatoid Arthritis ◽

Structural Changes ◽

Treatment Options ◽

Preclinical Phase ◽

Systemic Autoimmunity ◽

Quantitative Computer Tomography ◽

Magnetic Resonance Imaging Mri ◽

Circulating Autoantibodies ◽

Pro Inflammatory Cytokines

Abstract Rheumatoid arthritis (RA) remains a chronic debilitating disease with a significant negative societal impact, despite the expanding landscape of treatment options. This condition is often preceded by a phase of systemic autoimmunity with circulating autoantibodies, elevated pro-inflammatory cytokines, or subtle structural changes. The capability of identifying individuals in the preclinical phase of RA disease makes a “preventive window of opportunity” possible. Much recent work has focused on the role of imaging modalities including ultrasound (US), magnetic resonance imaging (MRI), and high-resolution peripheral quantitative computer tomography (HR-pQCT) in identifying at-risk individuals with or without early joint symptoms for the development of inflammatory arthritis. This article will review the evidence and discuss the challenges as well as opportunities of proactive risk assessment by imaging in RA.

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Studies on the Behavior Some Paints in Electro-insulating Fluid Based on Vegetable Esters

Revista de Chimie ◽

10.37358/rc.18.5.6276 ◽

2018 ◽

Vol 69 (5) ◽

pp. 1139-1144

Author(s):

Iosif Lingvay ◽

Adriana Mariana Bors ◽

Livia Carmen Ungureanu ◽

Valerica Stanoi ◽

Traian Rus

Keyword(s):

Structural Changes ◽

Oxidation Processes ◽

High Oleic ◽

Painting Materials ◽

Insulating Paper ◽

Different Types ◽

Mechanism And Kinetics ◽

Kinetics Of ◽

Natural Ester

For the purpose of using three different types of painting materials for the inner protection of the transformer vats, their behavior was studied under actual conditions of operation in the transformer (thermal stress in electro-insulating fluid based on the natural ester in contact with copper for electro-technical use and electro-insulating paper). By comparing determination of the content in furans products (HPLC technique) and gases formed (by gas-chromatography) in the electro-insulating fluid (natural ester with high oleic content) thermally aged at 130 �C to 1000 hours in closed glass vessels, it have been found that the presence the investigated painting materials lead to a change in the mechanism and kinetics of the thermo-oxidation processes. These changes are supported by oxygen dissolved in oil, what leads to decrease both to gases formation CO2, CO, H2, CH4, C2H4 and C2H6) and furans products (5-HMF, 2-FOL, 2 -FAL and 2-ACF). The painting materials investigated during the heat treatment applied did not suffer any remarkable structural changes affecting their functionality in the electro-insulating fluid based on vegetable esters.

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Pulmonary Manifestations in Rheumatoid Arthritis, Psoriatic Arthritis and Peripheral Spondyloarthritis Prevalence, Diagnostic Approach and Treatment Options

Current Rheumatology Reviews ◽

10.2174/1573397116666200905122757 ◽

2020 ◽

Vol 16 ◽

Author(s):

Daniel Dejcman ◽

Valentin Sebastian Schäfer ◽

Dirk Skowasch ◽

Carmen Pizarro ◽

Andreas Krause ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Psoriatic Arthritis ◽

Lung Disease ◽

Current Knowledge ◽

Treatment Options ◽

Pulmonary Diseases ◽

Chronic Obstructive ◽

Pulmonary Manifestations ◽

Major Cluster ◽

Peripheral Spondyloarthritis

: Interstitial lung disease (ILD) is the most common form of pulmonary impairment in patients with rheumatoid arthritis (RA). However, patients with RA or other arthritic diseases such as psoriatic arthritis (PsA) or peripheral spondyloarthritis (pSpA) may develop several other pulmonary diseases such as chronic obstructive lung disease (COPD) with a higher risk than patients without arthritis. The article at hand aims at summarizing the current knowledge on the prevalence of pulmonary diseases in the above-mentioned forms of arthritis, the challenges for prevalence studies and detecting pulmonary diseases in patients with arthritis as well as possible treatment options. Dyspnea, cough or other pulmonary symptoms or findings in arthritis patients should prompt gradual diagnostic procedures considering pulmonary manifestations as a major cluster of differential diagnosis. Considering its poor prognosis and morbidity burden, RA-ILD needs to be ruled out. Treatment of manifestations often lacks solid evidencebased guidelines and referrals to specialized centers are often necessary.

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Lessons Not Learned: Why is There Still a Crisis-Level Shortage of Accounting Ph.D.s?

Accounting Horizons ◽

10.2308/acch-50703 ◽

2014 ◽

Vol 28 (2) ◽

pp. 313-330 ◽

Cited By ~ 19

Author(s):

R. David Plumlee ◽

Philip M. J. Reckers

Keyword(s):

Student Perceptions ◽

Structural Changes ◽

Ad Hoc ◽

Doctoral Programs ◽

Cumulative Impact ◽

Program Administrators ◽

Accounting Faculty ◽

Present Information ◽

Different Types

SYNOPSIS: In 2005, an ad hoc committee appointed by the American Accounting Association (AAA) documented a crisis-level shortage of accounting Ph.D.s and recommended significant structural changes to doctoral programs (Kachelmeier, Madeo, Plumlee, Pratt, and Krull 2005). However, subsequent studies show that the shortage continues and the cumulative costs grow (e.g., Fogarty and Holder 2012; Brink, Glasscock, and Wier 2012). The Association to Advance Collegiate Schools of Business (AACSB) recently called for renewed attention to the problem (AACSB 2013b). We contribute to the literature by providing updated information regarding responses by doctoral programs and, from the eyes of potential candidates, of continuing impediments to solving the doctoral shortage. In this paper, we present information gathered through surveys of program administrators and master's and Accounting Doctoral Scholars Program (ADS) students. We explore (1) the cumulative impact of the Ph.D. shortage as of 2013, including its impact on accounting faculty composition, across different types of institutions, (2) negative student perceptions of Ph.D. programs and academic accounting careers, which discourage applicants from pursuing Ph.D. programs, and (3) impediments facing institutions in expanding doctoral programs.

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AB0243 CONSIDERING THE COMBINATION OF TWO BIOLOGICS IN CASE OF FAILURE OF THE MONOTHERAPY IN JUVENILE ONSET RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4058 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1147.1-1147

Author(s):

A. Haddouche ◽

K. Ait Bellabas ◽

W. F. Hamrani ◽

S. Sahraoui ◽

R. Fatma ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Alternative Therapy ◽

Biologic Therapies ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

Juvenile Onset ◽

Multiple Treatment ◽

Tnf Blocker ◽

Different Types ◽

First Time

Background:The management of rheumatoid arthritis refractory to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) is currently well codified and includes different types of biologics and even targeted sDMARDs. A rotation of biologic therapies is recommended in order to better control the disease.Methods:We report the case of a 20-year-old patient followed in our hospital for the management of a deforming and erosive seropositive rheumatoid arthritis (FR +, ACPA +) with a juvenile onset at the age of 8 years. The diagnosis of an immunopositive polyarticular form of JIA was retained in 2010 (9 years old); the patient was treated with methotrexate (MTX) at a dose of 10 mg per week and methylprednisolone at doses varying between 4 and 10 mg per day. Following the failure of MTX, etanercept was introduced for 6 months without success, followed by tocilizumab in 2012 at a dose of 8mg/kg/month for a year, without good response. In 2014, a course of rituximab (RTX) at a dose of 2 shots of 500mg, 2 weeks apart was prescribed followed 9 months later by etanercept at a dose of 50 mg a week for 3 years then by adalimumab (40mg/ week) because of the multiple treatment failures.In 2018, the repetition of RTX at a dose of 1g, renewed 15 days later, improved the patient for only 3 months. Then, a combination of two biologics, namely RTX (2 x 1g, 15 days apart) and adalimumab 1 month later (40mg / week) was received by the patient with a good response at 3 months. The latter was maintained for 7 months even after stopping the adalimumab following confinement for COVID-19. In September 2020, flares occurred and the adalimumab (ADA) has been delivered but without success during 3 months, stopped later for a benign form of COVID-19 (15 months after RTX). In January 2021, the association RTX + ADA was given again and we hope that it will be as effective as the first prescription.Results:The clinical and biological severity of our patient’s rheumatoid arthritis led us to give a combination of two biological treatments. Indeed, we do not have other therapeutic classes to deliver to her, that encouraged us to rotate between all the available biological therapies in our country. The combination of a CD20 inhibitor (RTX) with a TNF blocker (ADA) was safe and made possible, for the first time, the achievement of clinical and biological remission during 7 months, even after stopping the TNF blocker. Greenwald et al. reported the safety of the combination of RTX + TNF inhibitors in a randomized clinical trial in 51 patients. Its efficacy, a secondary goal of the study, was suggested at 24 weeks by the percentage of ACR 20 and ACR 50 responses that was greater than in the RTX placebo group.Conclusion:The combination of RTX with a TNF blocker can be a real alternative therapy in rheumatoid arthritis with failure to a biological monotherapy.Disclosure of Interests:None declared

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From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

International Journal of Molecular Sciences ◽

10.3390/ijms22020686 ◽

2021 ◽

Vol 22 (2) ◽

pp. 686

Author(s):

Chao-Yi Wu ◽

Huang-Yu Yang ◽

Shue-Fen Luo ◽

Jenn-Haung Lai

Keyword(s):

Rheumatoid Arthritis ◽

Treatment Options ◽

Clinical Manifestations ◽

Bone Destruction ◽

Response To Therapy ◽

Current Evidence ◽

Prognosis Prediction ◽

Diagnosis And Prognosis ◽

Systemic Inflammatory Disease ◽

Citrullinated Protein

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy.

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Enhanced thermal stability and lifetime of epoxy nanocomposites using covalently functionalized clay: experimental and modelling

New Journal of Chemistry ◽

10.1039/c4nj01768d ◽

2015 ◽

Vol 39 (3) ◽

pp. 2269-2278 ◽

Cited By ~ 31

Author(s):

Omid Zabihi ◽

Hamid Khayyam ◽

Bronwyn L. Fox ◽

Minoo Naebe

Keyword(s):

Thermal Stability ◽

Thermal Degradation ◽

Structural Changes ◽

Epoxy Nanocomposites ◽

Degradation Model ◽

Different Types

Relationship between thermal degradation model of epoxy nanocomposites containing different types of modified nanoclay and their structural changes is explained.

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Treatment Options for Rheumatoid Arthritis: Celecoxib, Leflunomide, Etanercept, and Infliximab

Annals of Pharmacotherapy ◽

10.1345/aph.19344 ◽

2000 ◽

Vol 34 (6) ◽

pp. 743-760 ◽

Cited By ~ 19

Author(s):

Brigitte T Luong ◽

Barbara S Chong ◽

Dionne M Lowder

Keyword(s):

Rheumatoid Arthritis ◽

English Language ◽

Data Extraction ◽

Treatment Options ◽

Nonsteroidal Antiinflammatory Drugs ◽

Antiinflammatory Drugs ◽

Safety And Efficacy ◽

Medline Search ◽

Pertinent Data

OBJECTIVE: To review new pharmacologic agents approved for use in the management of rheumatoid arthritis (RA). DATA SOURCES: A MEDLINE search (1966–January 2000) was conducted to identify English-language literature available on the pharmacotherapy of RA, focusing on celecoxib, leflunomide, etanercept, and infliximab. These articles, relevant abstracts, and data provided by the manufacturers were used to collect pertinent data. STUDY SELECTION: All controlled and uncontrolled trials were reviewed. DATA EXTRACTION: Agents were reviewed with regard to mechanism of action, efficacy, drug interactions, pharmacokinetics, dosing, precautions/contraindications, adverse effects, and cost. DATA SYNTHESIS: Traditional pharmacologic treatments for RA have been limited by toxicity, loss of efficacy, or both. Increasing discoveries into the mechanisms of inflammation in RA have led to the development of new agents in hopes of addressing these limitations. With the development of celecoxib, a selective cyclooxygenase-2 inhibitor, the potential exists to minimize the gastrotoxicity associated with nonsteroidal antiinflammatory drugs. Leflunomide has been shown to be equal to or less efficacious than methotrexate, and may be beneficial as a second-line disease-modifying antirheumatic drug (DMARD). The biologic response modifiers, etanercept and infliximab, are alternatives that have shown benefit alone or in combination with methotrexate. However, they should be reserved for patients who fail to respond to DMARD therapy. Further studies should be conducted to evaluate the long-term safety and efficacy of these agents as well as their role in combination therapy. CONCLUSIONS: Celecoxib, leflunomide, etanercept, and infliximab are the newest agents approved for RA. Clinical trials have shown that these agents are beneficial in the treatment of RA; however, long-term safety and efficacy data are lacking.

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Antimicrobial Properties of 8-Hydroxyserrulat-14-en-19-oic Acid for Treatment of Implant-Associated Infections

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01735-12 ◽

2012 ◽

Vol 57 (1) ◽

pp. 333-342 ◽

Cited By ~ 13

Author(s):

Justyna Nowakowska ◽

Hans J. Griesser ◽

Marcus Textor ◽

Regine Landmann ◽

Nina Khanna

Keyword(s):

Structural Changes ◽

Treatment Options ◽

Antimicrobial Properties ◽

Bactericidal Effect ◽

Mouse Tissue ◽

Logarithmic Phase ◽

Content Type ◽

Gram Positive Bacteria ◽

Time Kill

ABSTRACTTreatment options are limited for implant-associated infections (IAI) that are mainly caused by biofilm-forming staphylococci. We report here on the activity of the serrulatane compound 8-hydroxyserrulat-14-en-19-oic acid (EN4), a diterpene isolated from the Australian plantEremophila neglecta. EN4 elicited antimicrobial activity toward various Gram-positive bacteria but not to Gram-negative bacteria. It showed a similar bactericidal effect against logarithmic-phase, stationary-phase, and adherentStaphylococcus epidermidis, as well as against methicillin-susceptible and methicillin-resistantS. aureuswith MICs of 25 to 50 μg/ml and MBCs of 50 to 100 μg/ml. The bactericidal activity of EN4 was similar againstS. epidermidisand its Δicamutant, which is unable to produce polysaccharide intercellular adhesin-mediated biofilm. In time-kill studies, EN4 exhibited a rapid and concentration-dependent killing of staphylococci, reducing bacterial counts by >3 log10CFU/ml within 5 min at concentrations of >50 μg/ml. Investigation of the mode of action of EN4 revealed membranolytic properties and a general inhibition of macromolecular biosynthesis, suggesting a multitarget activity.In vitro-tested cytotoxicity on eukaryotic cells was time and concentration dependent in the range of the MBCs. EN4 was then tested in a mouse tissue cage model, where it showed neither bactericidal nor cytotoxic effects, indicating an inhibition of its activity. Inhibition assays revealed that this was caused by interactions with albumin. Overall, these findings suggest that, upon structural changes, EN4 might be a promising pharmacophore for the development of new antimicrobials to treat IAI.

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