Remission in psoriatic arthritis: is it possible and how can it be predicted?

Introduction

Since remission is now possible in psoriatic arthritis (PsA) we wished to examine remission rates in PsA patients following anti tumour necrosis factor alpha (TNFα) therapy and to examine possible predictors of response.

Methods

Analysis of a prospective patient cohort attending a biologic clinic, between November 2004 and March 2008, was performed prior to commencing therapy and at regular intervals. Baseline clinical characteristics including demographics, previous disease-modifying antirheumatic drug (DMARD) response, tender and swollen joint counts, early morning stiffness, pain visual analogue score, patient global assessment, C reactive protein (CRP) and health assessment questionnaire (HAQ) were collected.

Results

A total of 473 patients (152 PsA; 321 rheumatoid arthritis (RA)) were analyzed. At 12 months remission, defined according to the disease activity score using 28 joint count and CRP (DAS28-CRP), was achieved in 58% of PsA patients compared to 44% of RA patients, significant improvement in outcome measures were noted in both groups (P < 0.05). Analysis of a subgroup of PsA and RA patients matched for DAS28-CRP at baseline also showed higher numbers of PsA patients achieving remission. Linear regression analysis identified the HAQ at baseline as the best predictor of remission in PsA patients (P < 0.001).

Conclusions

DAS28 remission is possible in PsA patients at one year following anti-TNF therapy, at higher rates than in RA patients and is predicted by baseline HAQ.     

Bias and Sampling Error of the Estimated Proportion of Genotypic Variance Explained by Quantitative Trait Loci Determined From Experimental Data in Maize Using Cross Validation and Validation With Independent Samples.

Cross validation (CV) was used to analyze the effects of different environments and different genotypic samples on estimates of the proportion of genotypic variance explained by QTL (p). Testcrosses of 344 F(3) maize lines grown in four environments were evaluated for a number of agronomic traits. In each of 200 replicated CV runs, this data set was subdivided into an estimation set (ES) and various test sets (TS). ES were used to map QTL and estimate p for each run (p(ES)) and its median (p(ES)) across all runs. The bias of these estimates was assessed by comparison with the median (p(TS.ES)) obtained from TS. We also used two independent validation samples derived from the same cross for further comparison. The median p(ES) showed a large upward bias compared to p(TS.ES). Environmental sampling generally had a smaller effect on the bias of p(ES) than genotypic sampling or both factors simultaneously. In independent validation, p(TS.ES) was on average only 50% of p(ES). A wide range among p(ES) reflected a large sampling error of these estimates. QTL frequency distributions and comparison of estimated QTL effects indicated a low precision of QTL localization and an upward bias in the absolute values of estimated QTL effects from ES. CV with data from three QTL studies reported in the literature yielded similar results as those obtained with maize testcrosses. We therefore recommend CV for obtaining asymptotically unbiased estimates of p and consequently a realistic assessment of the prospects of MAS.     

Über die karyometrische Untersuchung der Spermatogenese bei Albinoratten

Zusammenfassung Die Veränderungen des Kernvolumens aller Hodenzellen während der Spermatogenese sind charakteristisch und können genau gemessen werden. Wird das Kernvolumen der in verschiedenen Reifephasen befindlichen Zellen mit den Kernvolumenwerten der Zellen der vorangehenden und folgenden Reifephase verglichen, so sind regelmäßige und sich zyklisch wiederholende Kurven zu gewinnen. Aus den Veränderungen dieser Kurven kann auf die Veränderung an während der permatogenese gefolgert werden.Bei Untersuchungen an Albinoratten wurden die charakteristischen und geringgradigen Veränderungen der Kernvolumina in den verschiedenen Phasen der meiotischen Teilung von Spermatogonien (A-, B-, bzw. intermediären Typs), Spermatozyten ('junge und 'alte I. Typs), Spermatiden, Sertolischen und Leydigschen Zellen bestimmt.

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Summary Volumetric changes of the nuclei occuring in the course of spermatogenesis are characteristic and well measurable. Comparing the nuclear volume of the cells in the different stages of maturation with that of the cells prior and following to it, regular and cyclically recurring curves may be observed. Deviation of the latter reveal changes in the spermatogenesis. Authors examined spermatogonia in white rats (types A, transitional and B), the spermatocytes (type I. young and old), the spermatids, the cells of Sertoli- and Leydig and determined in these the characteristic changes of the nuclear volume occuring in the different stages of meiotic division.

     

Cytogenetic effects of diazepam in peripheral lymphocytes of self-poisoned persons.

The frequencies of chromosomal aberrations and of micronuclei were determined in lymphocyte cultures of 25 patients who attempted suicide with diazepam, 6-12 h, 72 h and 30 days after self-poisoning. These data were compared with those of healthy controls. The frequencies of numerical aberrations showed a significant increase immediately after self-poisoning. However, this effect could not be detected on the 3rd and 30th days after self-poisoning.     

Lack of effect of self-poisoning on subsequent reproductive outcome

Reproductive outcome as assessed by personal interview was studied after severe self-poisoning in 1399 index patients below the age of 30 years and 881 control cases. Rates of delayed conception, infertility, spontaneous abortion, ectopic pregnancy and stillbirth were no higher in the study sample after self-poisoning than in the control sample. Among livebirths of index and control cases, there were no significant differences with respect to the sex ratio, mean birth weight, distribution of birth weight groups, percentage with low birth weight, twin occurrence, birth prevalence and distribution of congenital anomalies verified medically, rates of early death and some kinds of postnatal diseases. Consequently, there is no evidence that semilethal drug intoxication produces epidemiologically detectable germinal mutations in a sample involving 2503 pregnancies.     

Genetic-epidemiologic study of haemophilia A and B in Hungary

All known surviving haemophiliacs A and B and their relatives were reexamined by laboratory and clinical methods and evaluated by a genetic-epidemiologic approach in 4 north-western countries of Hungary. The prevalence of haemophilia A and B patients born in the fifties was 2.73 and 0.25 per 10,000 persons, respectively. The reproductive fitness was found to be 0.3 in haemophilia A, and 0.8 in haemophilia B patients. The mutation rates calculated by the indirect method were 6.3 x 10(-5) for haemophilia A and 0.2 x 10(-5) for haemophilia B.     

International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 10. A new approach to germinal mutation surveillance: pair-wise evaluation of component elements in unidentified multiple congenital abnormalities

In the Hungarian population-based surveillance of germinal mutations, 3 indicator conditions of offspring are being followed, namely 15 sentinel anomalies, Down syndrome and unidentified multiple congenital abnormality. The latter is discussed here as a possible indicator of germinal dominant gene and chromosomal mutations. The component congenital abnormalities of unidentified multiple congenital abnormalities are classified into 45 groups. The component congenital abnormalities were reduced to pairs. A pair is a set of 2 independent component congenital abnormalities in index patients with 2 or more congenital abnormalities. Baseline figures of all component congenital abnormality pairs in 3722 unidentified multiple congenital abnormalities were determined in the study period 1973-1982. The observed data for 1983 were compared with expected occurrences based on baseline figures. This pair-wise evaluation of component elements within unidentified multiple congenital abnormalities seems to be an adequate surveillance method to detect any time cluster of congenital abnormality pairs due to environmental factors including germinal mutagens.     

Maternal factors in the origin of isolated oesophageal atresia: A population‐based case–control study

Background: In most patients affected by isolated oesophageal atresia (IOA) the etiology is largely unknown. Thus, the aim of this study was to analyze potential risk factors in mothers. Methods: The study samples included 221 cases with IOA, 356 matched and 38,151 population controls without any defect in the population‐based dataset of the Hungarian Case–Control Surveillance of Congenital Abnormalities, 1980 to 1996. Only those exposures were evaluated that were medically recorded in prenatal maternity logbooks during the critical period of IOA. Results: The findings of this case–control study suggested that the mothers of cases with IOA had a higher proportion of first delivery and lower socioeconomic status. Acute respiratory diseases (odds ratio [OR] 95% confidence interval [CI], 3.8, 1.8–8.1) and essential hypertension treated with nifedipine (OR 95% CI, 3.8, 1.7–8.7) in the mothers of cases associated with a higher risk for IOA in their children. Conclusion: First delivery, lower socioeconomic status, acute respiratory diseases and essential hypertension treated with nifedipine in the mothers may associate with a higher risk for IOA in their children. Birth Defects Research (Part A) 103:804–813, 2015. © 2015 Wiley Periodicals, Inc.