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Iimura S, Rosenbusch M, Takamine A, Tsunoda Y, Wada M, Chen S, Hou DS, Xian W, Ishiyama H, Yan S, Schury P, Crawford H, Doornenbal P, Hirayama Y, Ito Y, Kimura S, Koiwai T, Kojima TM, Koura H, Lee J, Liu J, Michimasa S, Miyatake H, Moon JY, Naimi S, Nishimura S, Niwase T, Odahara A, Otsuka T, Paschalis S, Petri M, Shimizu N, Sonoda T, Suzuki D, Watanabe YX, Wimmer K, Wollnik H. Study of the N=32 and N=34 Shell Gap for Ti and V by the First High-Precision Multireflection Time-of-Flight Mass Measurements at BigRIPS-SLOWRI. Phys Rev Lett 2023; 130:012501. [PMID: 36669221 DOI: 10.1103/physrevlett.130.012501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
The atomic masses of ^{55}Sc, ^{56,58}Ti, and ^{56-59}V have been determined using the high-precision multireflection time-of-flight technique. The radioisotopes have been produced at RIKEN's Radioactive Isotope Beam Factory (RIBF) and delivered to the novel designed gas cell and multireflection system, which has been recently commissioned downstream of the ZeroDegree spectrometer following the BigRIPS separator. For ^{56,58}Ti and ^{56-59}V, the mass uncertainties have been reduced down to the order of 10 keV, shedding new light on the N=34 shell effect in Ti and V isotopes by the first high-precision mass measurements of the critical species ^{58}Ti and ^{59}V. With the new precision achieved, we reveal the nonexistence of the N=34 empirical two-neutron shell gaps for Ti and V, and the enhanced energy gap above the occupied νp_{3/2} orbit is identified as a feature unique to Ca. We perform new Monte Carlo shell model calculations including the νd_{5/2} and νg_{9/2} orbits and compare the results with conventional shell model calculations, which exclude the νg_{9/2} and the νd_{5/2} orbits. The comparison indicates that the shell gap reduction in Ti is related to a partial occupation of the higher orbitals for the outer two valence neutrons at N=34.
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Affiliation(s)
- S Iimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Department of Physics, College of Science, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Tokyo 171-8501, Japan
| | - M Rosenbusch
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - A Takamine
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Tsunoda
- Center for Computational Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - M Wada
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - S Chen
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - D S Hou
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - W Xian
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - H Ishiyama
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - S Yan
- Institute of Mass Spectrometry and Atmospheric Environment, Jinan University, Guangzhou 510632, China
| | - P Schury
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - H Crawford
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94523, USA
| | - P Doornenbal
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Hirayama
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - Y Ito
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
| | - S Kimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Koiwai
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T M Kojima
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Koura
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - J Liu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - S Michimasa
- Center of Nuclear Study (CNS), The University of Tokyo, Bunkyo 113-0033, Japan
| | - H Miyatake
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - J Y Moon
- Institute for Basic Science, 70, Yuseong-daero 1689-gil, Yusung-gu, Daejeon 305-811, Korea
| | - S Naimi
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - S Nishimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Niwase
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Kyushu University, Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan
| | - A Odahara
- Department of Physics, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - T Otsuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - S Paschalis
- School of Physics, Engineering, and Technology, University of York, York YO10 5DD, United Kingdom
| | - M Petri
- School of Physics, Engineering, and Technology, University of York, York YO10 5DD, United Kingdom
| | - N Shimizu
- Center for Computational Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - T Sonoda
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - D Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y X Watanabe
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - K Wimmer
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - H Wollnik
- New Mexico State University, Las Cruces, New Mexico 88001, USA
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Kallas R, LI J, Petri M. FRI0173 IDENTIFICATION OF RISK FACTORS FOR DEVELOPMENT OF OSTEONECROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Patient with Systemic Lupus Erythematosus (SLE), particularly those who received corticosteroids are at a high risk of osteonecrosis (ON).Objectives:In this analysis, we aimed at determining the predictors of ON in a longitudinal lupus cohort in which Caucasian and African-American ethnicities are well represented.Methods:The data were reviewed from the initiation of the cohort in 1987 until October 2019. 2428 patients were included in the analysis based on 224295 person-months of follow-up. ON was recorded using the Systemic Lupus Erythematosus International Collaborating Clinics/ American College of Rheumatology (SLICC/ACR) Damage Index. To calculate the rate of ON in each demographic and clinical subgroup, we calculated the number of ON events divided by the number of person-months at risk and converted this rate to rates per person-year. To assess the relationship between risk factors and rates of ON events, we used the pooled logistic regression. Rate ratios were adjusted for age. After identifying a set of variables related to ON incidence, we fit a final multivariable model to identify the most important risk factors for incident ON.Results:287 ON cases were identified, giving a point prevalence of 11%. ON cases that occurred before cohort entry were excluded. 122 incident events of ON occurred after cohort entry and were included in the final analysis. In the multivariable analysis, African-Americans were at twice the risk for ON compared to Caucasians. Male gender and smokers had about 80% and 50% increased risk of ON compared to females and non-smokers respectively. For every 10 year increase in the age there was a 20% reduced risk for ON. Patients diagnosed after the 1990’s had a 50% reduced risk of ON compared to those diagnosed before 1990’s. A highest daily dose of prednisone of 40 mg or higher, even when administered for a month or less, increased significantly the risk of ON. Use of pulse steroid was not associated with an increased risk of ON.Conclusion:Ethnicity remains an important determinant in the risk of ON. African-American SLE patients are at double the risk of ON compared to Caucasians. APOL1 risk variants confer an increased risk of ON in this high-risk ethnic group. Oral prednisone more than 40 mg daily administered for a month or less, at any point in the disease course, remains the most important predictor of ON. Prednisone-free or prednisone-limited regimens should be reinforced in SLE trials.Table 1.Associations between ON rates and corticosteroids dose and duration based on a multivariable modelPredictorRR (95% CI)p-valueMax prednisone and duration0- 40 mg/day for <=1 month1.00 (Ref)0- 40 mg/day for >1 month1.49 (0.68, 3.26)0.316240-60 mg/day for <=1 month2.76 (1.18, 6.39)0.018240-60 mg/day for >1 month3.87 (1.73, 8.62)0.0009>=60 mg/day for <=1 month6.6 (3.37, 12.93)<0.0001>=60 mg/day for >1 month5.15 (2.55, 10.4)<0.0001SexMale (vs. Female)1.79 (1.04, 3.10)0.0373EthnicityAfrican American (vs. Caucasian)1.94 (1.32, 2.83)0.0007Year of SLE diagnosis1990 and after (vs. before 1990)0.53 (0.36, 0.77)0.0008AgePer 10 year increase0.77 (0.66, 0.89)0.0006SmokingEver (vs. never)1.51 (1.04, 2.19)0.0293Table 2.Associations between ON rates and pulse steroid stratified by max prednisoneSubgroupNo. of ONsPerson yearsRate per 1000 person yearsAge-adjusted RR (95% CI)Age-adjusted p-valuePulse among those with maximum prednisone dose of <40 mgNo216752.13.111.00 (Ref)Yes2387.85.161.69 (0.40, 7.20)0.4801Pulse among those with maximum prednisone dose of >=40 mgNo887202.312.21.00 (Ref)Yes8959.28.30.71 (0.35, 1.48)0.3618Pulse among those with maximum prednisone dose of >=60 mgNo644329.93.111.00 (Ref)Yes7622.45.160.79 (0.36, 1.72)0.5477Acknowledgments:The Hopkins Lupus Cohort was funded by NIH Grant R01-AR069572Disclosure of Interests:None declared
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Vaquero V, Jungclaus A, Aumann T, Tscheuschner J, Litvinova EV, Tostevin JA, Baba H, Ahn DS, Avigo R, Boretzky K, Bracco A, Caesar C, Camera F, Chen S, Derya V, Doornenbal P, Endres J, Fukuda N, Garg U, Giaz A, Harakeh MN, Heil M, Horvat A, Ieki K, Imai N, Inabe N, Kalantar-Nayestanaki N, Kobayashi N, Kondo Y, Koyama S, Kubo T, Martel I, Matsushita M, Million B, Motobayashi T, Nakamura T, Nakatsuka N, Nishimura M, Nishimura S, Ota S, Otsu H, Ozaki T, Petri M, Reifarth R, Rodríguez-Sánchez JL, Rossi D, Saito AT, Sakurai H, Savran D, Scheit H, Schindler F, Schrock P, Semmler D, Shiga Y, Shikata M, Shimizu Y, Simon H, Steppenbeck D, Suzuki H, Sumikama T, Symochko D, Syndikus I, Takeda H, Takeuchi S, Taniuchi R, Togano Y, Tsubota J, Wang H, Wieland O, Yoneda K, Zenihiro J, Zilges A. Fragmentation of Single-Particle Strength around the Doubly Magic Nucleus ^{132}Sn and the Position of the 0f_{5/2} Proton-Hole State in ^{131}In. Phys Rev Lett 2020; 124:022501. [PMID: 32004026 DOI: 10.1103/physrevlett.124.022501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/29/2019] [Indexed: 06/10/2023]
Abstract
Spectroscopic factors of neutron-hole and proton-hole states in ^{131}Sn and ^{131}In, respectively, were measured using one-nucleon removal reactions from doubly magic ^{132}Sn at relativistic energies. For ^{131}In, a 2910(50)-keV γ ray was observed for the first time and tentatively assigned to a decay from a 5/2^{-} state at 3275(50) keV to the known 1/2^{-} level at 365 keV. The spectroscopic factors determined for this new excited state and three other single-hole states provide first evidence for a strong fragmentation of single-hole strength in ^{131}Sn and ^{131}In. The experimental results are compared to theoretical calculations based on the relativistic particle-vibration coupling model and to experimental information for single-hole states in the stable doubly magic nucleus ^{208}Pb.
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Affiliation(s)
- V Vaquero
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - J Tscheuschner
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - E V Litvinova
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008-5252, USA
| | - J A Tostevin
- Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - D S Ahn
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - R Avigo
- Dipartimento di Fisica dell'Università degli Studi di Milano, I-20133 Milano, Italy
- INFN, Sezione di Milano, I-20133 Milano, Italy
| | - K Boretzky
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - A Bracco
- Dipartimento di Fisica dell'Università degli Studi di Milano, I-20133 Milano, Italy
- INFN, Sezione di Milano, I-20133 Milano, Italy
| | - C Caesar
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - F Camera
- Dipartimento di Fisica dell'Università degli Studi di Milano, I-20133 Milano, Italy
- INFN, Sezione di Milano, I-20133 Milano, Italy
| | - S Chen
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, China
| | - V Derya
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - J Endres
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - N Fukuda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - U Garg
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - A Giaz
- Dipartimento di Fisica dell'Università degli Studi di Milano, I-20133 Milano, Italy
| | - M N Harakeh
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
- KVI-CART, Zernikelaan 25, NL-9747 AA Groningen, The Netherlands
| | - M Heil
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - A Horvat
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - K Ieki
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - N Imai
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - N Inabe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | | | - N Kobayashi
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - S Koyama
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Kubo
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - I Martel
- Departamento de Fsica Aplicada, Universidad de Huelva, E-21071 Huelva, Spain
| | - M Matsushita
- Center for Nuclear Study, The University of Tokyo, Tokyo 113-0033, Japan
| | - B Million
- INFN, Sezione di Milano, I-20133 Milano, Italy
| | - T Motobayashi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - N Nakatsuka
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - M Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - S Ota
- Center for Nuclear Study, The University of Tokyo, Tokyo 113-0033, Japan
| | - H Otsu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - T Ozaki
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Petri
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - R Reifarth
- Institut für Kernphysik, Goethe University Frankfurt, D-60438 Frankfurt, Germany
| | - J L Rodríguez-Sánchez
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
- Universidad de Santiago de Compostela, E-15782 Santiago de Compostela, Spain
| | - D Rossi
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - A T Saito
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - H Sakurai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - D Savran
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - H Scheit
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - F Schindler
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - P Schrock
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - D Semmler
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - Y Shiga
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - M Shikata
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - Y Shimizu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - H Simon
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - D Steppenbeck
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - H Suzuki
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - T Sumikama
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - D Symochko
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - I Syndikus
- Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - H Takeda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - S Takeuchi
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - R Taniuchi
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - Y Togano
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - J Tsubota
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - H Wang
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - O Wieland
- INFN, Sezione di Milano, I-20133 Milano, Italy
| | - K Yoneda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - J Zenihiro
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, 351-0198 Saitama, Japan
| | - A Zilges
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
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Abstract
AIM The Lupus Low Disease Activity State (LLDAS) is a potential treat to target goal in systemic lupus erythematosus (SLE). SLE patients in LLDAS for more than half of the observation time have about a 50% lower risk of new organ damage and have reduced mortality. We identified predictors of being in LLDAS ≥50% of the observation time. METHODS A total of 2228 SLE patients who had at least three clinical visits were included. Percentage of time in LLDAS was calculated based on the proportion of days under observation. LLDAS-50 was defined as being in LLDAS for ≥50% of the observation time. We used the stepwise selection procedure in logistic regression to identify predictors of LLDAS-50. RESULTS A total of 1169 (52.5%) SLE patients, but only 37.6% of African Americans, achieved LLDAS-50. In the multivariable model, African American ethnicity, hypocomplementemia, serositis, renal activity, arthritis, anti-RNP, anti-dsDNA, vasculitis, malar rash, discoid rash, thrombocytopenia, and immunosuppressive use were negative predictors of LLDAS-50. Older age at diagnosis, longer disease duration, higher education level, and greater percentage of time taking hydroxychloroquine remained positive predictors of LLDAS-50. CONCLUSION In this large cohort, only 52.5% achieved LLDAS-50. This proportion was even less in African Americans. A higher percentage of time taking hydroxychloroquine was a modifiable positive predictor of LLDAS-50. Anti-RNP, anti-dsDNA, and low complement were negatively associated with LLDAS-50. Our findings further emphasize the importance of inclusion of African Americans in clinical trials and hydroxychloroquine adherence in both clinical practice and clinical trials.
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Affiliation(s)
- H Babaoglu
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Division of Rheumatology, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - J Li
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - D Goldman
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - L S Magder
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USA
| | - M Petri
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
Hydroxychloroquine is used by 35% of SLE patients enrolled in the Baltimore Lupus Cohort. Eighty per cent of patients who took hydroxychloroquine at cohort entry remain on it six years later. In addition to its role for disease manifestations of lupus, hydroxychloroquine may be indicated for the prevention of disease or treatment-induced complications, including hyperlipidemia, diabetes mellitus, liver function test elevation and thrombosis.
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Affiliation(s)
- M Petri
- Division of Molecular and Clinical Rheumatology, Johns Hopkins University School of Medicine, Suite 7500, 1830 E. Monument Street, Baltimore, MD 21205, USA
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Crawford HL, Fallon P, Macchiavelli AO, Doornenbal P, Aoi N, Browne F, Campbell CM, Chen S, Clark RM, Cortés ML, Cromaz M, Ideguchi E, Jones MD, Kanungo R, MacCormick M, Momiyama S, Murray I, Niikura M, Paschalis S, Petri M, Sakurai H, Salathe M, Schrock P, Steppenbeck D, Takeuchi S, Tanaka YK, Taniuchi R, Wang H, Wimmer K. First Spectroscopy of the Near Drip-line Nucleus ^{40}Mg. Phys Rev Lett 2019; 122:052501. [PMID: 30822018 DOI: 10.1103/physrevlett.122.052501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Indexed: 06/09/2023]
Abstract
One of the most exotic light neutron-rich nuclei currently accessible for experimental study is ^{40}Mg, which lies at the intersection of the nucleon magic number N=28 and the neutron drip line. Low-lying excited states of ^{40}Mg have been studied for the first time following a one-proton removal reaction from ^{41}Al, performed at the Radioactive Isotope Beam Factory of RIKEN Nishina Center with the DALI2 γ-ray array and the ZeroDegree spectrometer. Two γ-ray transitions were observed, suggesting an excitation spectrum that shows unexpected properties as compared to both the systematics along the Z=12, N≥20 Mg isotopes and available state-of-the-art theoretical model predictions. A possible explanation for the observed structure involves weak-binding effects in the low-lying excitation spectrum.
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Affiliation(s)
- H L Crawford
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - P Fallon
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A O Macchiavelli
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - P Doornenbal
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - N Aoi
- Research Center for Nuclear Physics (RCNP), Osaka University, Mihogakoa, Ibaraki, Osaka 567-0047, Japan
| | - F Browne
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - C M Campbell
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Chen
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - R M Clark
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M L Cortés
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - M Cromaz
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - E Ideguchi
- Research Center for Nuclear Physics (RCNP), Osaka University, Mihogakoa, Ibaraki, Osaka 567-0047, Japan
| | - M D Jones
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R Kanungo
- Astronomy and Physics Department, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M MacCormick
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay Cedex 91406, France
| | - S Momiyama
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - I Murray
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay Cedex 91406, France
| | - M Niikura
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - S Paschalis
- Department of Physics, University of York, Heslington, York, England YO10 5DD, United Kingdom
| | - M Petri
- Department of Physics, University of York, Heslington, York, England YO10 5DD, United Kingdom
| | - H Sakurai
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - M Salathe
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - P Schrock
- Center for Nuclear Study, University of Tokyo, RIKEN Campus, Wako, Saitama 351-0198, Japan
| | - D Steppenbeck
- Center for Nuclear Study, University of Tokyo, RIKEN Campus, Wako, Saitama 351-0198, Japan
| | - S Takeuchi
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - Y K Tanaka
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany
| | - R Taniuchi
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - H Wang
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - K Wimmer
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
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Loelius C, Kobayashi N, Iwasaki H, Bazin D, Belarge J, Bender PC, Brown BA, Elder R, Elman B, Gade A, Grinder M, Heil S, Hufnagel A, Longfellow B, Lunderberg E, Mathy M, Otsuka T, Petri M, Syndikus I, Tsunoda N, Weisshaar D, Whitmore K. Enhanced Electric Dipole Strength for the Weakly Bound States in ^{27}Ne. Phys Rev Lett 2018; 121:262501. [PMID: 30636164 DOI: 10.1103/physrevlett.121.262501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/07/2018] [Indexed: 06/09/2023]
Abstract
An enhanced low-energy electric dipole (E1) strength is identified for the weakly bound excited states of the neutron-rich isotope ^{27}Ne. The Doppler-shift lifetime measurements employing a combination of the γ-ray tracking array GRETINA, the plunger device, and the S800 spectrograph determine the lower limit of 0.030 e^{2} fm^{2} or 0.052 W.u. for the 1/2^{+}→3/2^{-} E1 transition in ^{27}Ne, representing one of the strongest E1 strengths observed among the bound discrete states in this mass region. This value is at least 30 times larger than that measured for the 3/2^{-} decay to the 3/2_{gs}^{+} ground state. A comparison of the present results to large-scale shell-model calculations points to an important role of core excitations and deformation in the observed E1 enhancement, suggesting a novel example of the electric dipole modes manifested in weakly bound deformed systems.
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Affiliation(s)
- C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Kobayashi
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Iwasaki
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Belarge
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - P C Bender
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Elder
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Elman
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Grinder
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Heil
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - A Hufnagel
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - B Longfellow
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Lunderberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Mathy
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - T Otsuka
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Center for Nuclear Study, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku Tokyo, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku Tokyo, Japan
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - M Petri
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - I Syndikus
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - N Tsunoda
- Center for Nuclear Study, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku Tokyo, Japan
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Whitmore
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
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de Jesús GR, Sciascia S, Andrade D, Barbhaiya M, Tektonidou M, Banzato A, Pengo V, Ji L, Meroni PL, Ugarte A, Cohen H, Branch DW, Andreoli L, Belmont HM, Fortin PR, Petri M, Rodriguez E, Cervera R, Knight JS, Atsumi T, Willis R, Nascimento IS, Rosa R, Erkan D, Levy RA. Factors associated with first thrombosis in patients presenting with obstetric antiphospholipid syndrome (APS) in the APS Alliance for Clinical Trials and International Networking Clinical Database and Repository: a retrospective study. BJOG 2018; 126:656-661. [PMID: 30222236 DOI: 10.1111/1471-0528.15469] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the subsequent rate of thrombosis among women with obstetric antiphospholipid syndrome (Ob-APS) in a multicentre database of antiphospholipid antibody (aPL)-positive patients, and the clinical utility of the adjusted Global Antiphospholipid Syndrome Score (aGAPSS), a validated tool to assess the likelihood of developing new thrombosis, in this group of patients. DESIGN Retrospective study. SETTING The Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking Clinical Database and Repository. POPULATION Women with Ob-APS. METHODS Comparison of clinical and laboratory characteristics and measurement of aGAPSS in women with Ob-APS, with or without thrombosis, after initial pregnancy morbidity (PM). MAIN OUTCOME MEASURES Risk factors for thrombosis and aGAPSS. RESULTS Of 550 patients, 126 had Ob-APS; 74/126 (59%) presented with thrombosis, and 47 (63%) of these women developed thrombosis after initial PM, in a mean time of 7.6 ± 8.2 years (4.9/100 patient years). Younger age at diagnosis of Ob-APS, additional cardiovascular risk factors, superficial vein thrombosis, heart valve disease, and multiple aPL positivity increased the risk of first thrombosis after PM. Women with thrombosis after PM had a higher aGAPSS compared with women with Ob-APS alone [median 11.5 (4-16) versus 9 (4-13); P = 0.0089]. CONCLUSION Based on a retrospective analysis of our multicentre aPL database, 63% of women with Ob-APS developed thrombosis after initial obstetric morbidity; additional thrombosis risk factors, selected clinical manifestations, and high-risk aPL profile increased the risk. Women with subsequent thrombosis after Ob-APS had a higher aGAPSS at entry to the registry. We believe that aGAPSS is a valid tool to improve risk stratification in aPL-positive women. TWEETABLE ABSTRACT More than 60% of women with obstetric antiphospholipid syndrome had thrombosis after initial pregnancy morbidity.
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Affiliation(s)
- G R de Jesús
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - S Sciascia
- Department of Clinical and Biological Sciences, Centre of Research of Immunopathology and Rare Diseases, University of Turin, Turin, Italy
| | - D Andrade
- Departament of Rheumatology, Universidade de São Paulo, São Paulo, Brazil
| | - M Barbhaiya
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA
| | - M Tektonidou
- Rheumatology Unit, First Department of Propaedeutic Internal Medicine, University of Athens, Athens, Greece
| | - A Banzato
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padova, Italy
| | - V Pengo
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padova, Italy
| | - L Ji
- Rheumatology and Immunology Department, Peking University, First Hospital, Beijing, China
| | - P L Meroni
- Department of Rheumatology, University of Milan, Milan, Italy
| | - A Ugarte
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Hospital Universitario Cruces, Barakaldo, Spain
| | - H Cohen
- Department of Haematology, University College London, London, UK
| | - D W Branch
- Department of Obstetrics and Gynecology, University of Utah Health Sciences and Intermountain Healthcare, Salt Lake City, UT, USA
| | - L Andreoli
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - H M Belmont
- Division of Rheumatology, NYU School of Medicine, New York, NY, USA
| | - P R Fortin
- Division of Rheumatology, Centre Hospitalier de l'Université Laval, Québec, QC, Canada
| | - M Petri
- Division of Rheumatology, John Hopkins University, Baltimore, MD, USA
| | - E Rodriguez
- Rheumatology Department, Hospital 12 de Octubre, Madrid, Spain
| | - R Cervera
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
| | - J S Knight
- Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA
| | - T Atsumi
- Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - R Willis
- Antiphospholipid Standardization Laboratory, Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - I S Nascimento
- Departament of Rheumatology, Universidade de São Paulo, São Paulo, Brazil
| | - R Rosa
- Departament of Rheumatology, Universidade de São Paulo, São Paulo, Brazil
| | - D Erkan
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA
| | - R A Levy
- Department of Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,GlaxoSmithKline Immunology and Inflammation, Upper Providence, PA, USA
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Ettinger M, Karkosch R, Horstmann H, Savov P, Calliess T, Smith T, Petri M. Biomechanical properties of adjustable extracortical graft fixations in ACL reconstruction. J Exp Orthop 2018; 5:41. [PMID: 30269194 PMCID: PMC6163122 DOI: 10.1186/s40634-018-0154-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/13/2018] [Indexed: 11/16/2022] Open
Abstract
Background Reliable biomechanical data about the strength of different tibial extracortical graft fixation devices is sparse. This biomechanical study compares the properties of tibial graft fixation in ACL reconstruction with either the ACL Tight Rope™ or the Rigid Loop Adjustable™ device. The hypothesis was that both fixation devices would provide comparable results concerning gap formation during cyclic loading and ultimate failure load. Methods Sixteen sawbone tibiae (Sawbones™) underwent extracortical fixation of porcine flexor digitorum profundus grafts for ACL reconstruction. Either the ACL Tight Rope™ (Arthrex) or the Rigid Loop Adjustable™ (DePuy Mitek) fixation device were used, resulting in 2 groups with 8 specimens per group. Biomechanical analysis included pretensioning the constructs 10 times with 0.75 Hz, then cyclic loading of 1,000 position-controlled cycles and 1,000 force-controlled cycles applied with a servohydraulic testing machine. Elongation during cyclic loading was recorded. After this, ultimate failure load and failure mode analysis were performed. Results No statistically significant difference could be noted between the groups regarding gap formation during cyclic loading (4.6 ± 2.6 mm for the Rigid Loop Adjustable™ vs. 6.6 ± 1.5 mm for the ACL Tight Rope™ (p > 0.05)), and ultimate failure loads (980 ± 101.9 N for the Rigid Loop Adjustable™ vs. 861 ± 115 N ACL Tight Rope™ (p > 0.05)). Conclusion ACL Tight Rope™ and the Rigid Loop Adjustable™ fixation devices yield comparable biomechanical results for tibial extracortical graft fixation in ACL reconstruction. These findings may be of relevance for the future surgical decision-making in ACL reconstruction. Randomized controlled clinical trials comparing both fixation devices are desirable for the future.
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Affiliation(s)
- M Ettinger
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany.
| | - R Karkosch
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany
| | - H Horstmann
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany
| | - P Savov
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany
| | - T Calliess
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany
| | - T Smith
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany
| | - M Petri
- Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, D-30625, Hannover, Germany
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Petri M, Lu P, Omar M, Ettinger M, Krettek C, Neunaber C, Jagodzinski M. In vivo heterotopic culturing of prefabricated tendon grafts with mechanical stimulation in a sheep model. Knee 2018; 25:381-391. [PMID: 29655901 DOI: 10.1016/j.knee.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 01/21/2018] [Accepted: 02/19/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The goal of this study is to investigate the biomechanical and histological properties of in vivo heterotopically prefabricated cruciate ligament replacement grafts with and without mechanical stimulation. The clinical goal is to heterotopically prefabricate a bone-tendon-bone graft for anterior cruciate ligament reconstruction, which allows rapid ingrowth and early full weight bearing. METHODS In a sheep model, eight quadriceps tendon grafts were harvested and introduced into culture chambers at their proximal and distal ends. In group S, four tendon-chamber constructs were mechanically stimulated by direct attachment to the quadriceps tendon and patella. In group NS, the same constructs were cultured without proximal attachment. All sheep were sacrificed six weeks postoperatively and the constructs were examined biomechanically and histologically. The healthy contralateral ACL and quadriceps tendon were used as controls. RESULTS Macroscopically, no obvious ossification could be observed at the ends of the tendon-chamber constructs six weeks postoperatively. Histologically, the tendon tissue from the mechanically stimulated constructs revealed higher counts of cells and capillaries. However, there was less regular cell distribution and collagen fiber orientation compared to the control group. In addition, osteoblasts and osteogenesis were observed in the prefabricated constructs both with and without mechanical stimulation. Biomechanically, there were no significant differences in stiffness, elongation and ultimate failure load between the groups. CONCLUSION In vivo heterotopic culture of prefabricated tendon grafts may have the potential to stimulate osteoblasts and induce osteogenesis. Future studies with longer follow-up and modifications of the surgical technique and culture conditions are desirable.
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Affiliation(s)
- M Petri
- Trauma Department, Hannover Medical School (MHH), D-30625 Hannover, Germany.
| | - P Lu
- Trauma Department, Hannover Medical School (MHH), D-30625 Hannover, Germany
| | - M Omar
- Trauma Department, Hannover Medical School (MHH), D-30625 Hannover, Germany
| | - M Ettinger
- Department of Orthopedic Surgery, Hannover Medical School (MHH), Hannover, Germany
| | - C Krettek
- Trauma Department, Hannover Medical School (MHH), D-30625 Hannover, Germany
| | - C Neunaber
- Trauma Department, Hannover Medical School (MHH), D-30625 Hannover, Germany
| | - M Jagodzinski
- Department of Orthopedic Trauma, Agaplesion Ev. Hospital Bethel, Bückeburg, Germany
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Tang X, Teng S, Petri M, Krettek C, Liu C, Jagodzinski M. The effect of anti-inflammatory and antifibrotic agents on fibroblasts obtained from arthrofibrotic tissue: An in vitro and in vivo study. Bone Joint Res 2018; 7:213-222. [PMID: 29922438 PMCID: PMC5987688 DOI: 10.1302/2046-3758.73.bjr-2017-0219.r2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives The aims of this study were to determine whether the administration of anti-inflammatory and antifibrotic agents affect the proliferation, viability, and expression of markers involved in the fibrotic development of the fibroblasts obtained from arthrofibrotic tissue in vitro, and to evaluate the effect of the agents on arthrofibrosis prevention in vivo. Methods Dexamethasone, diclofenac, and decorin, in different concentrations, were employed to treat fibroblasts from arthrofibrotic tissue (AFib). Cell proliferation was measured by DNA quantitation, and viability was analyzed by Live/Dead staining. The levels of procollagen type I N-terminal propeptide (PINP) and procollagen type III N-terminal propeptide (PIIINP) were evaluated with enzyme-linked immunosorbent assay (ELISA) kits. In addition, the expressions of fibrotic markers were detected by real-time polymerase chain reaction (PCR). Fibroblasts isolated from healthy tissue (Fib) served as control. Further, a rabbit model of joint contracture was used to evaluate the antifibrotic effect of the three different agents. Results Dexamethasone maintained the viability and promoted the proliferation of AFib. Diclofenac decreased the viability and inhibited the cell proliferation during the first week of cultivation. However, decorin inhibited AFib proliferation and downregulated the expressions of fibrotic markers. Additionally, decorin could improve the flexion contracture angle and inhibit the deposition of interstitial matrix components in the rabbit joint model. Conclusion Decorin decreased the expression of myofibroblast markers in AFib, inhibited the proliferation of AFib, and prevented the initial procedure of arthrofibrosis in vivo, suggesting that decorin could be a promising treatment to inhibit the development of arthrofibrosis.Cite this article: X. Tang, S. Teng, M. Petri, C. Krettek, C. Liu, M. Jagodzinski. The effect of anti-inflammatory and antifibrotic agents on fibroblasts obtained from arthrofibrotic tissue: An in vitro and in vivo study. Bone Joint Res 2018;7:213-222. DOI: 10.1302/2046-3758.73.BJR-2017-0219.R2.
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Affiliation(s)
- X Tang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - S Teng
- Department of Orthopedic Trauma, Hannover Medical School (MH), Hannover, Germany
| | - M Petri
- Department of Orthopedic Trauma, Hannover Medical School (MH), Hannover, Germany
| | - C Krettek
- Department of Orthopedic Trauma, Hannover Medical School (MH), Hannover, Germany
| | - C Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - M Jagodzinski
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Revel A, Marqués FM, Sorlin O, Aumann T, Caesar C, Holl M, Panin V, Vandebrouck M, Wamers F, Alvarez-Pol H, Atar L, Avdeichikov V, Beceiro-Novo S, Bemmerer D, Benlliure J, Bertulani CA, Boillos JM, Boretzky K, Borge MJG, Caamaño M, Casarejos E, Catford WN, Cederkäll J, Chartier M, Chulkov L, Cortina-Gil D, Cravo E, Crespo R, Datta Pramanik U, Díaz Fernández P, Dillmann I, Elekes Z, Enders J, Ershova O, Estradé A, Farinon F, Fraile LM, Freer M, Galaviz D, Geissel H, Gernhäuser R, Golubev P, Göbel K, Hagdahl J, Heftrich T, Heil M, Heine M, Heinz A, Henriques A, Ignatov A, Johansson HT, Jonson B, Kahlbow J, Kalantar-Nayestanaki N, Kanungo R, Kelic-Heil A, Knyazev A, Kröll T, Kurz N, Labiche M, Langer C, Le Bleis T, Lemmon R, Lindberg S, Machado J, Marganiec J, Movsesyan A, Nacher E, Najafi M, Nilsson T, Nociforo C, Paschalis S, Perea A, Petri M, Pietri S, Plag R, Reifarth R, Ribeiro G, Rigollet C, Röder M, Rossi D, Savran D, Scheit H, Simon H, Syndikus I, Taylor JT, Tengblad O, Thies R, Togano Y, Velho P, Volkov V, Wagner A, Weick H, Wheldon C, Wilson G, Winfield JS, Woods P, Yakorev D, Zhukov M, Zilges A, Zuber K. Strong Neutron Pairing in core+4n Nuclei. Phys Rev Lett 2018; 120:152504. [PMID: 29756867 DOI: 10.1103/physrevlett.120.152504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/17/2018] [Indexed: 06/08/2023]
Abstract
The emission of neutron pairs from the neutron-rich N=12 isotones ^{18}C and ^{20}O has been studied by high-energy nucleon knockout from ^{19}N and ^{21}O secondary beams, populating unbound states of the two isotones up to 15 MeV above their two-neutron emission thresholds. The analysis of triple fragment-n-n correlations shows that the decay ^{19}N(-1p)^{18}C^{*}→^{16}C+n+n is clearly dominated by direct pair emission. The two-neutron correlation strength, the largest ever observed, suggests the predominance of a ^{14}C core surrounded by four valence neutrons arranged in strongly correlated pairs. On the other hand, a significant competition of a sequential branch is found in the decay ^{21}O(-1n)^{20}O^{*}→^{18}O+n+n, attributed to its formation through the knockout of a deeply bound neutron that breaks the ^{16}O core and reduces the number of pairs.
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Affiliation(s)
- A Revel
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Bvd Henri Becquerel, 14076 Caen, France
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 CAEN Cedex, France
| | - F M Marqués
- LPC Caen, ENSICAEN, Université de Caen, CNRS/IN2P3, F-14050 CAEN Cedex, France
| | - O Sorlin
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Bvd Henri Becquerel, 14076 Caen, France
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - C Caesar
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - M Holl
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - V Panin
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - M Vandebrouck
- Irfu, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - F Wamers
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - H Alvarez-Pol
- IGFAE, Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - L Atar
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - V Avdeichikov
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - S Beceiro-Novo
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bemmerer
- Helmholtz-Zentrum Dresden-Rossendorf, 01328, Dresden, Germany
| | - J Benlliure
- IGFAE, Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - C A Bertulani
- Department of Physics and Astronomy, Texas A&M University-Commerce, Commerce, Texas 75429, USA
| | - J M Boillos
- IGFAE, Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - K Boretzky
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - M J G Borge
- Instituto de Estructura de la Materia, CSIC, Serrano 113 bis, 28006 Madrid, Spain
| | - M Caamaño
- IGFAE, Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | | | - W N Catford
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - J Cederkäll
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - M Chartier
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - L Chulkov
- NRC Kurchatov Institute, Ru-123182 Moscow, Russia
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - D Cortina-Gil
- IGFAE, Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - E Cravo
- Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - R Crespo
- Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - U Datta Pramanik
- Saha Institute of Nuclear Physics, 1/AF Bidhan Nagar, Kolkata 700064, India
| | - P Díaz Fernández
- IGFAE, Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - I Dillmann
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
- II. Physikalisches Institut, Universität Gieß en, 35392 Gießen, Germany
| | - Z Elekes
- MTA Atomki, 4001 Debrecen, Hungary
| | - J Enders
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - O Ershova
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - A Estradé
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3JZ, United Kingdom
| | - F Farinon
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - L M Fraile
- Grupo de Física Nuclear y UPARCOS, Universidad Complutense de Madrid, CEI Moncloa, 28040 Madrid, Spain
| | - M Freer
- School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - D Galaviz
- Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP, 1000-149 Lisbon, Portugal
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - R Gernhäuser
- Physik Department E12, Technische Universität München, 85748 Garching, Germany
| | - P Golubev
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - K Göbel
- Goethe-Universität Frankfurt am Main, 60438 Frankfurt am Main, Germany
| | - J Hagdahl
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - T Heftrich
- Goethe-Universität Frankfurt am Main, 60438 Frankfurt am Main, Germany
| | - M Heil
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - M Heine
- IPHC-CNRS/Université de Strasbourg, 67037 Strasbourg, France
| | - A Heinz
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - A Henriques
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP, 1000-149 Lisbon, Portugal
| | - A Ignatov
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - H T Johansson
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - B Jonson
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - J Kahlbow
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | | | - R Kanungo
- Astronomy and Physics Department, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - A Kelic-Heil
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - A Knyazev
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - T Kröll
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - N Kurz
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - M Labiche
- STFC Daresbury Laboratory, WA4 4AD Warrington, United Kingdom
| | - C Langer
- Goethe-Universität Frankfurt am Main, 60438 Frankfurt am Main, Germany
| | - T Le Bleis
- Physik Department E12, Technische Universität München, 85748 Garching, Germany
| | - R Lemmon
- STFC Daresbury Laboratory, WA4 4AD Warrington, United Kingdom
| | - S Lindberg
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - J Machado
- Laboratório de Instrumentação, Engenharia Biomédica e Física da Radiação (LIBPhysUNL), Departamento de Física, Faculdade de Ciências e Tecnologias, Universidade Nova de Lisboa, 2829-516 Monte da Caparica, Portugal
| | - J Marganiec
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - A Movsesyan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - E Nacher
- Instituto de Estructura de la Materia, CSIC, Serrano 113 bis, 28006 Madrid, Spain
| | - M Najafi
- KVI-CART, University of Groningen, Zernikelaan 25, 9747 AA Groningen, The Netherlands
| | - T Nilsson
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - C Nociforo
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - S Paschalis
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - A Perea
- Instituto de Estructura de la Materia, CSIC, Serrano 113 bis, 28006 Madrid, Spain
| | - M Petri
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - S Pietri
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - R Plag
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - R Reifarth
- Goethe-Universität Frankfurt am Main, 60438 Frankfurt am Main, Germany
| | - G Ribeiro
- Instituto de Estructura de la Materia, CSIC, Serrano 113 bis, 28006 Madrid, Spain
| | - C Rigollet
- KVI-CART, University of Groningen, Zernikelaan 25, 9747 AA Groningen, The Netherlands
| | - M Röder
- Helmholtz-Zentrum Dresden-Rossendorf, 01328, Dresden, Germany
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, 01069 Dresden, Germany
| | - D Rossi
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - D Savran
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - H Scheit
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - H Simon
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - I Syndikus
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - J T Taylor
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - O Tengblad
- Instituto de Estructura de la Materia, CSIC, Serrano 113 bis, 28006 Madrid, Spain
| | - R Thies
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - Y Togano
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - P Velho
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP, 1000-149 Lisbon, Portugal
| | - V Volkov
- NRC Kurchatov Institute, Ru-123182 Moscow, Russia
| | - A Wagner
- Helmholtz-Zentrum Dresden-Rossendorf, 01328, Dresden, Germany
| | - H Weick
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - C Wheldon
- School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - G Wilson
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - J S Winfield
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - P Woods
- School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3JZ, United Kingdom
| | - D Yakorev
- Helmholtz-Zentrum Dresden-Rossendorf, 01328, Dresden, Germany
| | - M Zhukov
- Institutionen för Fysik, Chalmers Tekniska Högskola, 412 96 Göteborg, Sweden
| | - A Zilges
- Institut für Kernphysik, Universität zu Köln, 50937 Köln, Germany
| | - K Zuber
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, 01069 Dresden, Germany
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13
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Atar L, Paschalis S, Barbieri C, Bertulani CA, Díaz Fernández P, Holl M, Najafi MA, Panin V, Alvarez-Pol H, Aumann T, Avdeichikov V, Beceiro-Novo S, Bemmerer D, Benlliure J, Boillos JM, Boretzky K, Borge MJG, Caamaño M, Caesar C, Casarejos E, Catford W, Cederkall J, Chartier M, Chulkov L, Cortina-Gil D, Cravo E, Crespo R, Dillmann I, Elekes Z, Enders J, Ershova O, Estrade A, Farinon F, Fraile LM, Freer M, Galaviz Redondo D, Geissel H, Gernhäuser R, Golubev P, Göbel K, Hagdahl J, Heftrich T, Heil M, Heine M, Heinz A, Henriques A, Hufnagel A, Ignatov A, Johansson HT, Jonson B, Kahlbow J, Kalantar-Nayestanaki N, Kanungo R, Kelic-Heil A, Knyazev A, Kröll T, Kurz N, Labiche M, Langer C, Le Bleis T, Lemmon R, Lindberg S, Machado J, Marganiec-Gałązka J, Movsesyan A, Nacher E, Nikolskii EY, Nilsson T, Nociforo C, Perea A, Petri M, Pietri S, Plag R, Reifarth R, Ribeiro G, Rigollet C, Rossi DM, Röder M, Savran D, Scheit H, Simon H, Sorlin O, Syndikus I, Taylor JT, Tengblad O, Thies R, Togano Y, Vandebrouck M, Velho P, Volkov V, Wagner A, Wamers F, Weick H, Wheldon C, Wilson GL, Winfield JS, Woods P, Yakorev D, Zhukov M, Zilges A, Zuber K. Quasifree (p, 2p) Reactions on Oxygen Isotopes: Observation of Isospin Independence of the Reduced Single-Particle Strength. Phys Rev Lett 2018; 120:052501. [PMID: 29481189 DOI: 10.1103/physrevlett.120.052501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/08/2017] [Indexed: 06/08/2023]
Abstract
Quasifree one-proton knockout reactions have been employed in inverse kinematics for a systematic study of the structure of stable and exotic oxygen isotopes at the R^{3}B/LAND setup with incident beam energies in the range of 300-450 MeV/u. The oxygen isotopic chain offers a large variation of separation energies that allows for a quantitative understanding of single-particle strength with changing isospin asymmetry. Quasifree knockout reactions provide a complementary approach to intermediate-energy one-nucleon removal reactions. Inclusive cross sections for quasifree knockout reactions of the type ^{A}O(p,2p)^{A-1}N have been determined and compared to calculations based on the eikonal reaction theory. The reduction factors for the single-particle strength with respect to the independent-particle model were obtained and compared to state-of-the-art ab initio predictions. The results do not show any significant dependence on proton-neutron asymmetry.
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Affiliation(s)
- L Atar
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - S Paschalis
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - C Barbieri
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - C A Bertulani
- Texas A&M University-Commerce, 75428 Commerce, Texas, United States of America
| | - P Díaz Fernández
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - M Holl
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - M A Najafi
- KVI-CART, University of Groningen, Zernikelaan 25, 9747 AA Groningen, Netherlands
| | - V Panin
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- RIKEN, Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, 351-0198 Wako, Saitama, Japan
| | - H Alvarez-Pol
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - T Aumann
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - V Avdeichikov
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - S Beceiro-Novo
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - D Bemmerer
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, P.O.B. 510119, 01314 Dresden, Germany
| | - J Benlliure
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - J M Boillos
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - K Boretzky
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - M J G Borge
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - M Caamaño
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - C Caesar
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | | | - W Catford
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - J Cederkall
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - M Chartier
- University of Liverpool, L69 3BX Liverpool, United Kingdom
| | - L Chulkov
- NRC Kurchatov Institute, place Akademika Kurchatova, Moscow 123182, Russia
| | - D Cortina-Gil
- Departamento de Física de Partículas, Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - E Cravo
- Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - R Crespo
- Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - I Dillmann
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
- Justus-Liebig-Universität Gießen, 35392 Gießen, Germany
| | - Z Elekes
- ATOMKI Debrecen, Bem tér 18/c, 4026 Debrecen, Hungary
| | - J Enders
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - O Ershova
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - A Estrade
- University of Edinburgh, EH8 9YL Edinburgh, United Kingdom
| | - F Farinon
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - L M Fraile
- Grupo de Física Nuclear & IPARCOS, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - M Freer
- University of Birmingham, B15 2TT Birmingham, United Kingdom
| | - D Galaviz Redondo
- Nuclear Physics Center, University of Lisbon, 1649-003 Lisboa, Portugal
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
- Justus-Liebig-Universität Gießen, 35392 Gießen, Germany
| | - R Gernhäuser
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
| | - P Golubev
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - K Göbel
- Goethe-Universität Frankfurt, Max-von-Laue Straße 1, 60438 Frankfurt am Main, Germany
| | - J Hagdahl
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - T Heftrich
- Goethe-Universität Frankfurt, Max-von-Laue Straße 1, 60438 Frankfurt am Main, Germany
| | - M Heil
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - M Heine
- IPHC-CNRS/Université de Strasbourg, 67037 Strasbourg, France
| | - A Heinz
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - A Henriques
- Nuclear Physics Center, University of Lisbon, 1649-003 Lisboa, Portugal
| | - A Hufnagel
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - A Ignatov
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - H T Johansson
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - B Jonson
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - J Kahlbow
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | | | - R Kanungo
- Saint Mary's University, 923 Robie Street, B3H 3C3 Halifax, Nova Scotia, Canada
| | - A Kelic-Heil
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - A Knyazev
- Department of Physics, Lund University, 22100 Lund, Sweden
| | - T Kröll
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - N Kurz
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - M Labiche
- Science and Technology Facilities Council-Daresbury Laboratory, WA4 4AD Warrington, United Kingdom
| | - C Langer
- Goethe-Universität Frankfurt, Max-von-Laue Straße 1, 60438 Frankfurt am Main, Germany
| | - T Le Bleis
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
| | - R Lemmon
- Science and Technology Facilities Council-Daresbury Laboratory, WA4 4AD Warrington, United Kingdom
| | - S Lindberg
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - J Machado
- Nuclear Physics Center, University of Lisbon, 1649-003 Lisboa, Portugal
| | - J Marganiec-Gałązka
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
- Extreme Matter Institute, GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - A Movsesyan
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - E Nacher
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - E Y Nikolskii
- NRC Kurchatov Institute, place Akademika Kurchatova, Moscow 123182, Russia
| | - T Nilsson
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - C Nociforo
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - A Perea
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - M Petri
- Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - S Pietri
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - R Plag
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - R Reifarth
- Goethe-Universität Frankfurt, Max-von-Laue Straße 1, 60438 Frankfurt am Main, Germany
| | - G Ribeiro
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - C Rigollet
- KVI-CART, University of Groningen, Zernikelaan 25, 9747 AA Groningen, Netherlands
| | - D M Rossi
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - M Röder
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, P.O.B. 510119, 01314 Dresden, Germany
- Technische Universität Dresden, Institut für Kern- und Teilchenphysik, Zellescher Weg 19, 01069 Dresden, Germany
| | - D Savran
- Extreme Matter Institute, GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - H Scheit
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - H Simon
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - O Sorlin
- GANIL, Boulevard Henri Becquerel, 14076 Caen, France
| | - I Syndikus
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - J T Taylor
- University of Liverpool, L69 3BX Liverpool, United Kingdom
| | - O Tengblad
- Instituto de Estructura de la Materia, CSIC, E-28006 Madrid, Spain
| | - R Thies
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - Y Togano
- RIKEN, Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, 351-0198 Wako, Saitama, Japan
| | - M Vandebrouck
- GANIL, Boulevard Henri Becquerel, 14076 Caen, France
| | - P Velho
- Nuclear Physics Center, University of Lisbon, 1649-003 Lisboa, Portugal
| | - V Volkov
- NRC Kurchatov Institute, place Akademika Kurchatova, Moscow 123182, Russia
| | - A Wagner
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, P.O.B. 510119, 01314 Dresden, Germany
| | - F Wamers
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - H Weick
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - C Wheldon
- University of Birmingham, B15 2TT Birmingham, United Kingdom
| | - G L Wilson
- University of Surrey, GU2 7XH Surrey, United Kingdom
| | - J S Winfield
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
- Justus-Liebig-Universität Gießen, 35392 Gießen, Germany
| | - P Woods
- University of Edinburgh, EH8 9YL Edinburgh, United Kingdom
| | - D Yakorev
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, P.O.B. 510119, 01314 Dresden, Germany
| | - M Zhukov
- Chalmers University of Technology, Kemivägen 9, 412 96 Göteborg, Sweden
| | - A Zilges
- Universität zu Köln, Institut für Kernphysik, Zülpicher Straße 77, 50937 Köln, Germany
| | - K Zuber
- Technische Universität Dresden, Institut für Kern- und Teilchenphysik, Zellescher Weg 19, 01069 Dresden, Germany
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14
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Isenberg D, Sturgess J, Allen E, Aranow C, Askanase A, Sang-Cheol B, Bernatsky S, Bruce I, Buyon J, Cervera R, Clarke A, Dooley MA, Fortin P, Ginzler E, Gladman D, Hanly J, Inanc M, Jacobsen S, Kamen D, Khamashta M, Lim S, Manzi S, Nived O, Peschken C, Petri M, Kalunian K, Rahman A, Ramsey-Goldman R, Romero-Diaz J, Ruiz-Irastorza G, Sanchez-Guerrero J, Steinsson K, Sturfelt G, Urowitz M, van Vollenhoven R, Wallace DJ, Zoma A, Merrill J, Gordon C. Study of Flare Assessment in Systemic Lupus Erythematosus Based on Paper Patients. Arthritis Care Res (Hoboken) 2017; 70:98-103. [PMID: 28388813 PMCID: PMC5767751 DOI: 10.1002/acr.23252] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 04/04/2017] [Indexed: 12/22/2022]
Abstract
Objective To determine the level of agreement of disease flare severity (distinguishing severe, moderate, and mild flare and persistent disease activity) in a large paper‐patient exercise involving 988 individual cases of systemic lupus erythematosus. Methods A total of 988 individual lupus case histories were assessed by 3 individual physicians. Complete agreement about the degree of flare (or persistent disease activity) was obtained in 451 cases (46%), and these provided the reference standard for the second part of the study. This component used 3 flare activity instruments (the British Isles Lupus Assessment Group [BILAG] 2004, Safety of Estrogens in Lupus Erythematosus National Assessment [SELENA] flare index [SFI] and the revised SELENA flare index [rSFI]). The 451 patient case histories were distributed to 18 pairs of physicians, carefully randomized in a manner designed to ensure a fair case mix and equal distribution of flare according to severity. Results The 3‐physician assessment of flare matched the level of flare using the 3 indices, with 67% for BILAG 2004, 72% for SFI, and 70% for rSFI. The corresponding weighted kappa coefficients for each instrument were 0.82, 0.59, and 0.74, respectively. We undertook a detailed analysis of the discrepant cases and several factors emerged, including a tendency to score moderate flares as severe and persistent activity as flare, especially when the SFI and rSFI instruments were used. Overscoring was also driven by scoring treatment change as flare, even if there were no new or worsening clinical features. Conclusion Given the complexity of assessing lupus flare, we were encouraged by the overall results reported. However, the problem of capturing lupus flare accurately is not completely solved.
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Affiliation(s)
| | - J Sturgess
- The Hospital For Tropical Diseases, London, UK
| | - E Allen
- The Hospital For Tropical Diseases, London, UK
| | - C Aranow
- Feinstein Institute for Medical Research, Manhasset, New York
| | | | - B Sang-Cheol
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | | | - I Bruce
- The University of Manchester, Central Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Science Centre, Manchester, UK
| | - J Buyon
- New York School of Medicine, New York
| | - R Cervera
- Universitat de Barcelona, Barcelona, Spain
| | - A Clarke
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - P Fortin
- Université Laval, Quebec City, Québec, Canada
| | - E Ginzler
- Downstate Medical Center Rheumatology, Brooklyn, New York
| | - D Gladman
- Krembil Research Institute, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - J Hanly
- Nova Scotia Rehabiliation Center, Halifax, Nova Scotia, Canada
| | - M Inanc
- Istanbul University, Istanbul, Turkey
| | | | - D Kamen
- Medical University of South Carolina, Charleston, UK
| | | | - S Lim
- Emory University, Atlanta, Georgia
| | - S Manzi
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | - O Nived
- Lund University, Lund, Sweden
| | - C Peschken
- University of Manitoba, Winnipeg, Manitoba, Canada
| | - M Petri
- Johns Hopkins University, Baltimore, Maryland
| | - K Kalunian
- University of California at San Diego, Chicago, Illinois
| | - A Rahman
- University College London, London, UK
| | - R Ramsey-Goldman
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - J Romero-Diaz
- Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico
| | - G Ruiz-Irastorza
- Hospital Universitario Cruces and University of the Basque Country, Barakaldo, Spain
| | - J Sanchez-Guerrero
- Mount Sinai Hospital and University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - K Steinsson
- Landspitali University Hospital, Reykjavik, Iceland
| | | | - M Urowitz
- Krembil Research Institute, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - D J Wallace
- University of California at Los Angeles, Scotland, UK
| | - A Zoma
- Hairmyres Hospital, East Kilbride, Scotland, UK
| | - J Merrill
- Oklahoma Medical Research Foundation, Oklahoma City, UK
| | - C Gordon
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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15
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Ng X, dosReis S, Beardsley R, Magder L, Mullins CD, Petri M. Understanding systemic lupus erythematosus patients' desired outcomes and their perceptions of the risks and benefits of using corticosteroids. Lupus 2017; 27:475-483. [PMID: 28857718 DOI: 10.1177/0961203317726375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction The use of corticosteroids in systemic lupus erythematosus (SLE) patients requires difficult trade-offs between efficacy and risk of toxicity. This qualitative study examined SLE patients' most desired outcomes and their concerns with corticosteroid use in SLE treatment. Methods SLE patients with current/past experience with using corticosteroids were recruited from the clinics at the Johns Hopkins Lupus Center and the University of Maryland Medical Center. Five in-depth interviews ( N = 5) and four focus groups ( N = 15) were conducted during which discussions were transcribed and analyzed based on a grounded theory approach. Results We identified five major themes describing SLE patients' most desired outcomes: reduction in flares, maintenance of normal activities, minimization of treatment side effects, prevention of future organ damage, and finding a cure. Further, SLE patients reported these primary concerns with the adverse effects of corticosteroids: weight gain, organ damage (particularly bone-related damage), mood swings/irritability, sleep disturbances, and dental issues. Patients appeared to be more concerned with adverse effects that immediately affected their day-to-day lives. Conclusion Knowledge gained during this study better informs how patients view the benefits and risks of corticosteroids. This can facilitate discussions between physicians and patients as they work together to determine the appropriate use of corticosteroids.
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Affiliation(s)
- X Ng
- 1 Department of Pharmaceutical Health Services Research, 12265 University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - S dosReis
- 1 Department of Pharmaceutical Health Services Research, 12265 University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - R Beardsley
- 1 Department of Pharmaceutical Health Services Research, 12265 University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - L Magder
- 2 Department of Epidemiology and Public Health, 12265 University of Maryland School of Medicine, Baltimore, MD, USA
| | - C D Mullins
- 1 Department of Pharmaceutical Health Services Research, 12265 University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - M Petri
- 3 Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
PURPOSE OF REVIEW Glucocorticoids have been the mainstay of treatment in systemic lupus erythematosus for more than half a century. Despite advancements in knowledge concerning the pathophysiology of systemic lupus, the genomic/non-genomic actions of glucocorticoids, and the use of novel therapeutic agents in SLE, the burden of toxicity from glucocorticoid use remains unchanged. RECENT FINDINGS SLE patients receiving long-term prednisone therapy are at significant risk of morbidity due to permanent organ damage and prednisone daily dosages above 6 mg have been shown to increase the risk of future organ damage by 50%. Glucocorticoid use carries a higher risk of opportunistic infections, iatrogenic osteoporosis and avascular necrosis, an increase in risk of cardiovascular events, cataracts and glaucoma, as well as psychiatric adverse effects like psychosis and manic episodes. There are limited data regarding the relative efficacy of the different glucocorticoid formulations or dosing regimens. SUMMARY The use and dosing of glucocorticoids in SLE remains more art than science, although our knowledge regarding their complex genomic and non-genomic effects, as well as the resultant adverse effects, has greatly expanded over the past half a century.
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Affiliation(s)
- G Stojan
- Division of Rheumatology, Johns Hopkins University School of Medicine, Key Indexing Terms: systemic lupus erythematosus, glucocorticoid
| | - M Petri
- Division of Rheumatology, Johns Hopkins University School of Medicine, Key Indexing Terms: systemic lupus erythematosus, glucocorticoid
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17
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Chan K, Clarke AE, Ramsey-Goldman R, Foulkes W, Tessier Cloutier B, Urowitz MB, Gladman D, Nived O, Romero-Diaz J, Petri M, Ginzler E, Fortin PR, Bae SC, Wallace DJ, Yelin EH, Bernatsky S. Breast cancer in systemic lupus erythematosus (SLE): receptor status and treatment. Lupus 2017; 27:120-123. [PMID: 28595511 DOI: 10.1177/0961203317713146] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective There is a decreased risk of breast cancer in systemic lupus erythematosus (SLE) versus the general population; little is known regarding the receptor status of breast cancers in SLE, or treatment. Methods Breast cancer cases occurring after SLE diagnosis were ascertained through linkage with tumor registries. We determined breast cancer positivity for estrogen receptors (ER), progesterone receptors (PR), and/or Human Epidermal Growth Factor Receptor 2 (HER2), as well as cancer treatment. Results We obtained information on ER, PR, and/or HER2 status for 63 SLE patients with breast cancer. Fifty-three had information on ER and/or PR status; 36 of these (69%) were ER positive. Thirty-six of the 63 had information on HER2 status; of these, 26 had complete information on all three receptors. Twenty-one of these 26 (81%) were HER2 negative; seven of 26(27%) were triple negative. All but one patient underwent surgery; 11.5% received both non-tamoxifen chemotherapy and radiotherapy, 16.4% radiotherapy without non-tamoxifen chemotherapy, and 14.7% received non-tamoxifen chemotherapy without radiotherapy. Conclusion ER positivity was similar to historical general population figures, with a trend toward a higher proportion of triple-negative breast cancers in SLE (possibly reflecting the relatively young age of our SLE patients).
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Affiliation(s)
- K Chan
- 1 Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - A E Clarke
- 2 Division of Rheumatology, University of Calgary, AB, Canada
| | - R Ramsey-Goldman
- 3 Northwestern University and Feinberg School of Medicine, Chicago, IL, USA
| | - W Foulkes
- 4 Department of Human Genetics, McGill University, Montreal, QC, Canada
| | | | - M B Urowitz
- 6 Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto, ON, Canada
| | - D Gladman
- 6 Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto, ON, Canada
| | - O Nived
- 7 Department of Rheumatology, University Hospital Lund, Lund, Sweden
| | - J Romero-Diaz
- 8 Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico
| | - M Petri
- 9 Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E Ginzler
- 10 Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - P R Fortin
- 11 Division of Rheumatology, Centre Hospitalier Universitaire de Québec et Université Laval, Quebec City, QC, Canada
| | - S C Bae
- 12 Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - D J Wallace
- 13 Cedars-Sinai/David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - E H Yelin
- 14 Department of Medicine and Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - S Bernatsky
- 15 Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada
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18
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Pejchinovski M, Siwy J, Mullen W, Mischak H, Petri MA, Burkly LC, Wei R. Urine peptidomic biomarkers for diagnosis of patients with systematic lupus erythematosus. Lupus 2017; 27:6-16. [PMID: 28474961 DOI: 10.1177/0961203317707827] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Systematic lupus erythematosus (SLE) is characterized with various complications which can cause serious organ damage in the human body. Despite the significant improvements in disease management of SLE patients, the non-invasive diagnosis is entirely missing. In this study, we used urinary peptidomic biomarkers for early diagnosis of disease onset to improve patient risk stratification, vital for effective drug treatment. Methods Urine samples from patients with SLE, lupus nephritis (LN) and healthy controls (HCs) were analyzed using capillary electrophoresis coupled to mass spectrometry (CE-MS) for state-of-the-art biomarker discovery. Results A biomarker panel made up of 65 urinary peptides was developed that accurately discriminated SLE without renal involvement from HC patients. The performance of the SLE-specific panel was validated in a multicentric independent cohort consisting of patients without SLE but with different renal disease and LN. This resulted in an area under the receiver operating characteristic (ROC) curve (AUC) of 0.80 ( p < 0.0001, 95% confidence interval (CI) 0.65-0.90) corresponding to a sensitivity and a specificity of 83% and 73%, respectively. Based on the end terminal amino acid sequences of the biomarker peptides, an in silico methodology was used to identify the proteases that were up or down-regulated. This identified matrix metalloproteinases (MMPs) as being mainly responsible for the peptides fragmentation. Conclusions A laboratory-based urine test was successfully established for early diagnosis of SLE patients. Our approach determined the activity of several proteases and provided novel molecular information that could potentially influence treatment efficacy.
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Affiliation(s)
| | - J Siwy
- 1 Mosaiques Diagnostics GmbH, Hannover, Germany
| | - W Mullen
- 2 BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - H Mischak
- 1 Mosaiques Diagnostics GmbH, Hannover, Germany.,2 BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - M A Petri
- 3 Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L C Burkly
- 4 Biogen Inc, Cambridge, Cambridge, MA, USA
| | - R Wei
- 4 Biogen Inc, Cambridge, Cambridge, MA, USA
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19
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Willis R, Smikle M, DeCeulaer K, Romay-Penabad Z, Papalardo E, Jajoria P, Harper B, Murthy V, Petri M, Gonzalez EB. Clinical associations of proinflammatory cytokines, oxidative biomarkers and vitamin D levels in systemic lupus erythematosus. Lupus 2017; 26:1517-1527. [PMID: 28467291 DOI: 10.1177/0961203317706557] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background The abnormal biological activity of cytokines plays an important role in the pathophysiology of both systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Several studies have highlighted the association of vitamin D and certain pro-inflammatory cytokines with disease activity in SLE. However, there are limited data on the association of vitamin D and antiphospholipid antibodies (aPL) with various proinflammatory biomarkers in these patients and their relative impact on clinical outcomes. Methods The serum levels of several aPL, 25-hydroxy-vitamin D, pro-inflammatory cytokines including IFNα, IL-1β, IL-6, IL-8, IP10, sCD40L, TNFα and VEGF were measured in 312 SLE patients from the Jamaican ( n = 45) and Hopkins ( n = 267) lupus cohorts using commercial Milliplex and ELISA assays. Oxidized LDL/β2glycoprotein antigenic complexes (oxLβ2Ag) and their associated antibodies were also measured in the Jamaican cohort. Healthy controls for oxidative marker and cytokine testing were used. Results Abnormally low vitamin D levels were present in 61.4% and 73.3% of Hopkins and Jamaican SLE patients, respectively. Median concentrations of IP10, TNFα, sCD40L and VEGF were elevated in both cohorts, oxLβ2Ag and IL-6 were elevated in the Jamaican cohort, and IFNα, IL-1β and IL-8 were the same or lower in both cohorts compared to controls. IP10 and VEGF were independent predictors of disease activity, aPL, IP10 and IL-6 were independent predictors of thrombosis and IL-8, and low vitamin D were independent predictors of pregnancy morbidity despite there being no association of vitamin D with pro-inflammatory cytokines. Conclusions Our results indicate that aPL-mediated pro-inflammatory cytokine production is likely a major mechanism of thrombus development in SLE patients. We provide presumptive evidence of the role IL-8 and hypovitaminosis D play in obstetric pathology in SLE but further studies are required to characterize the subtle complexities of vitamin D's relationship with cytokine production and disease activity in these patients.
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Affiliation(s)
- R Willis
- 1 University of Texas Medical Branch, Galveston, TX, USA
| | - M Smikle
- 2 University of the West Indies, Mona Campus, Kingston, Jamaica
| | - K DeCeulaer
- 2 University of the West Indies, Mona Campus, Kingston, Jamaica
| | | | - E Papalardo
- 1 University of Texas Medical Branch, Galveston, TX, USA
| | - P Jajoria
- 1 University of Texas Medical Branch, Galveston, TX, USA.,3 Pinnacle Health Rheumatology, Lemoyne, PA, USA
| | - B Harper
- 1 University of Texas Medical Branch, Galveston, TX, USA.,4 Austin Diagnostic Clinic, Austin, TX, USA
| | - V Murthy
- 1 University of Texas Medical Branch, Galveston, TX, USA
| | - M Petri
- 5 John Hopkins University School of Medicine, Baltimore, MD, USA
| | - E B Gonzalez
- 1 University of Texas Medical Branch, Galveston, TX, USA
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20
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Abstract
Systemic lupus erythematosus (SLE) continues to have important morbidity and accelerated mortality despite therapeutic advances. Targeted therapies offer the possibility of improved efficacy with fewer side effects. Current management strategies rely heavily on nonspecific immunosuppressive agents. Prednisone, in particular, is responsible for a considerable burden of later organ damage. There are a multitude of diverse mechanisms of disease activity, immunogenic abnormalities and clinical manifestations to take into consideration in SLE. Many targeted agents with robust mechanistic preclinical data and promising early phase studies have ultimately been disappointing in phase III, randomized, controlled studies. Recent efforts have focused on B-cell therapies, in particular given the success of belimumab in clinical trials, with limited success. We remain optimistic regarding other specific therapies being evaluated, including interferon-alpha blockade. It is likely that in SLE, given the heterogeneity of the population involved, precision medicine is needed, rather than expecting that any single biologic will be universally effective.
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Affiliation(s)
- L Durcan
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | - M Petri
- Division of Rheumatology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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21
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Abstract
C1q is the first component of the classical complement pathway. Both clinically validated in-house ELISA assays as well as commercial ELISA kits are used for detection of anti-C1q antibodies. Anti-C1q autoantibodies can be detected in a wide range of autoimmune diseases and are highly sensitive for hypocomplementemic uticarial vasculitis. In SLE, anti-C1q are strongly associated with proliferative lupus nephritis, and their absence carries a negative predictive value for development of lupus nephritis of close to 100%. Anti-C1q in combination with anti-dsDNA and low complement has the strongest serological association with renal involvement. The anti-C1q titers correlate with global disease activity scores in patients with renal involvement, and higher titers seem to precede renal flares. After the successful treatment of a renal flare, anti-C1q has the tendency to decrease or even become undetectable. The main obstacle to the inclusion of anti-C1q in the classification criteria and clinical management of SLE is the lack of standardized laboratory assays.
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Affiliation(s)
- G Stojan
- Division of Rheumatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - M Petri
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
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22
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Omar M, Gathen M, Liodakis E, Suero EM, Krettek C, Zeckey C, Petri M. A comparative study of negative pressure wound therapy with and without instillation of saline on wound healing. J Wound Care 2017; 25:475-8. [PMID: 27523660 DOI: 10.12968/jowc.2016.25.8.475] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Negative pressure wound therapy (NPWT) has become an established treatment of traumatic and infected wounds. Negative pressure wound therapy with instillation (NPWTi) is a further development that combines the conventional NPWT with instillation of different fluids which continuously administer therapeutic reagents to the wound. The aim of this study was to compare the impact of additional saline instillation in NPWTi to NPWT alone. METHOD Between January and July 2014, consecutive patients with acute wounds of the lower limb were treated with NPWTi with saline instillation. The number of revision surgeries, length of hospital stay, and duration of treatment until final healing were recorded and compared with matched patients undergoing NPWT without instillation. RESULTS There were 10 patients recruited with 10 matched controls examined restrospectivley. Patients who received NPWTi were found to have decreased time of hospitalisation (21.5 versus 26.5 days, p=0.43), and accelerated wound healing (9.0 versus 12.5 days, p=0.36) than patients who received NPWT. However, the difference in the outcomes of the patients who received NPWTi and patients who received NPWT was not found to be statisticallly significant. CONCLUSION NPWTi with instillation of saline is a promising method and its effectiveness needs to be tested in a randomised controlled trial compared with NPWT alone. DECLARATION OF INTEREST This study obtained support by KCI (Wiebsaden, Germany) for the surgical material.
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Affiliation(s)
- M Omar
- Hannover Medical School, Trauma Department
| | - M Gathen
- Hannover Medical School, Trauma Department
| | - E Liodakis
- Hannover Medical School, Trauma Department
| | - E M Suero
- Hannover Medical School, Trauma Department
| | - C Krettek
- Hannover Medical School, Trauma Department
| | - C Zeckey
- Hannover Medical School, Trauma Department
| | - M Petri
- Hannover Medical School, Trauma Department
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23
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Euler SA, Kastenberger T, Attal R, Rieger M, Blauth M, Petri M. Do we still need autopsy in times of modern multislice computed tomography?-Missed diagnoses in the emergency room. Arch Orthop Trauma Surg 2017; 137:43-47. [PMID: 27826651 PMCID: PMC5216103 DOI: 10.1007/s00402-016-2588-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Indexed: 10/30/2022]
Abstract
INTRODUCTION In spite of increasing quality of emergency room (ER) assessment in trauma patients and improved accuracy of modern multislice computed tomography (MSCT), the number of potentially missed diagnoses is still controversial. The aim of this study was to compare the initial findings of ER assessment and MSCT to the findings during autopsy in trauma patients not surviving the first 48 h after admission. We hypothesized that autopsy was more accurate than MSCT in diagnosing potentially fatal diagnoses. PATIENTS AND METHODS Between January 2004 and September 2007, all trauma patients undergoing ER treatment in our institution who deceased within 48 h after admission were analyzed regarding diagnoses from initial ER assessment, including MSCT, and diagnoses from autopsy. Data were prospectively collected and retrospectively analyzed. Autopsy reports were compared to diagnoses of ER assessment and MSCT. Missed diagnoses (MD) and missed potentially fatal diagnoses (MPFD) were analyzed. RESULTS Seventy-three patients with a mean age of 53.2 years were included into the study. Sixty-three percent were male. Autopsy revealed at least one missed diagnosis in 25% of the patients, with the thoracic area accounting for 67% of these. At least one MPFD was found in 4.1% of the patients, all of them being located in the thorax. Total numbers of MD and MPFD were significantly lower for the newer CT generation (64 MSCT, N = 11), compared to older one (4 MSCT, N = 26). CONCLUSIONS As determined by autopsy, modern multislice computed tomography is an accurate method to diagnose injuries. However, 25% of all diagnoses, and 4.1% of potentially fatal diagnoses are still missed in trauma patients, who deceased within the first 48 h after admission. Therefore, autopsy seems to be necessary to determine potentially missed diagnoses for both academic and medicolegal reasons as well as for quality control.
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Affiliation(s)
- S. A. Euler
- Department of Trauma Surgery, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - T. Kastenberger
- Department of Trauma Surgery, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - R. Attal
- Department of Trauma Surgery, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - M. Rieger
- Department of Diagnostic & Interventional Radiology, Hall Regional Hospital, Milserstr. 10, 6060 Hall in Tirol, Austria
| | - M. Blauth
- Department of Trauma Surgery, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - M. Petri
- Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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24
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Kiani AN, Aukrust P, Ueland T, Hollan I, Barr E, Magder LS, Petri M. Serum osteoprotegrin (OPG) in subclinical atherosclerosis in systemic lupus erythematosus. Lupus 2016; 26:865-870. [PMID: 27927880 DOI: 10.1177/0961203316682101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction Osteoprotegerin (OPG) is a member of the tumor necrosis factor (TNF) receptor family. It has recently been demonstrated that OPG is produced by a variety of tissues, including the cardiovascular system (heart, arteries, veins), lung, kidney, immune tissues, and bone. The OPG-RANKL signaling pathway is strongly related to vascular calcification. We determined the association of this biomarker with subclinical atherosclerosis in systemic lupus erythematous (SLE). Methods We measured OPG and markers of subclinical atherosclerosis (coronary artery calcium (CAC), carotid intima-media thickness (cIMT) carotid plaque) in 166 SLE patients (91% female, 64% Caucasian, 31% African American, 5% others, mean age 45 years). Subgroups of patients with different levels of OPG level were compared with respect to average levels of CAC, cIMT, and with respect to presence of carotid plaque. Age was adjusted for using multiple regression. Results OPG was highly correlated with age ( p < 0.0001). Individuals with higher levels of OPG tended to have higher measures of CAC, cIMT, and more carotid plaque. However, after adjustment for age, these associations, while still positive, were no longer statistically significant. Conclusion In our study much of the association observed was due to confounding by age, and after adjusting for age, our findings do not rule out the possibility of a null association.
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Affiliation(s)
- A N Kiani
- 1 Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD, USA
| | - P Aukrust
- 2 Oslo University Hospital, Oslo, Norway
| | - T Ueland
- 2 Oslo University Hospital, Oslo, Norway
| | - I Hollan
- 3 Lillehammer Hospital of Rheumatic Diseases, Oslo, Norway
| | - E Barr
- 4 University of Maryland, Baltimore, MD, USA
| | - L S Magder
- 4 University of Maryland, Baltimore, MD, USA
| | - M Petri
- 1 Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD, USA
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Zuo Y, Willis R, Papalardo E, Petri M, Harris EN, Schleh A, DeCeulaer K, Smikle M, Vilá LM, Reveille JD, Alarcón GS, Gonzalez EB. A unique antiphospholipid assay recognizing phospholipid mixture compared with criteria antiphospholipid immunoassays in lupus patients. Lupus 2016; 26:606-615. [PMID: 27753626 DOI: 10.1177/0961203316671812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background While essential for the classification of antiphospholipid syndrome (APS), anticardiolipin (aCL) assays lack specificity and anti-β2glycoproteinI (anti-β2GPI) assays lack sensitivity in this regard. Our aim was to perform a comparative analysis of the APhL ELISA assay (IgG/IgM) and criteria antiphospholipid (aPL) immunoassays in identifying APS-related clinical manifestations in a large group of patients with systemic lupus erythematosus (SLE). Methods Serum samples from 1178 patients from the Hopkins ( n = 543), LUMINA ( n = 588) and Jamaican SLE cohorts ( n = 47) were examined for IgG/IgM positivity in aCL (in-house), anti-β2GPI (two commercial kits) and APhL (Louisville APL) ELISA assays. Correlation of assay positivity with clinical manifestations and sensitivity, specificity, positive and negative predictive values and likelihood ratios were evaluated. A case series analysis was also performed in patients for whom there was isolated positivity in the specific aPL assays. Results The prevalence of aCL positivity was 34.9%, anti-β2GPI kit A was 22.6%, APhL was 11.5% and anti-β2GPI kit B was 7.6% in the study population. Anti-β2GPI kit B, aCL and APhL assays were correlated with venous thrombosis, while only APhL was significantly correlated with arterial thrombosis and consistently correlated with pregnancy-related morbidity. No significant correlations were noted for anti-β2GPI kit A. Sensitivity was greatest for aCL assays followed by anti-β2GPI kit A, APhL and anti-β2GPI kit B, while specificity was greatest and equal for anti-β2GPI kit B and APhL assays. Conclusions Overall, APhL antibodies, especially IgG, represent a promising biomarker for the classification of APS patients in the context of autoimmunity and in risk assessment with regards to pregnancy morbidity and thrombotic manifestations.
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Affiliation(s)
- Y Zuo
- 1 University of Texas Southwestern Medical Center, Texas, USA
| | - R Willis
- 2 University of Texas Medical Branch, Galveston, Texas, USA
| | - E Papalardo
- 2 University of Texas Medical Branch, Galveston, Texas, USA
| | - M Petri
- 3 John Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - E N Harris
- 4 University of the West Indies, Mona Campus, Kingston, Jamaica
| | - A Schleh
- 2 University of Texas Medical Branch, Galveston, Texas, USA
| | - K DeCeulaer
- 4 University of the West Indies, Mona Campus, Kingston, Jamaica
| | - M Smikle
- 4 University of the West Indies, Mona Campus, Kingston, Jamaica
| | - L M Vilá
- 5 Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - J D Reveille
- 6 University of Texas School of Medicine at Houston, Texas, USA
| | - G S Alarcón
- 7 University of Alabama at Birmingham, Alabama, USA
| | - E B Gonzalez
- 2 University of Texas Medical Branch, Galveston, Texas, USA
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Hawi N, Schmiddem U, Omar M, Stuebig T, Krettek C, Petri M, Meller R. Arthroscopic Debridement for Irreparable Rotator Cuff Tears. Open Orthop J 2016; 10:324-329. [PMID: 27708734 PMCID: PMC5041203 DOI: 10.2174/1874325001610010324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 05/16/2015] [Accepted: 02/01/2016] [Indexed: 11/24/2022] Open
Abstract
Background: Arthroscopic debridement represents a salvage procedure for irreparable rotator cuff tears. It is important to accurately diagnose the patient for irreparable rotator cuff tears. The diagnosis and the therapeutic options must be explained to the patient. It is mandatory that the patient understands the primary goal of the arthroscopic debridement being reduction of pain, not improving strength or function. Methods: The procedure consists of 7 distinct steps to debride the soft tissues and alleviate pain. Results: Even though there is a lack of evidence that this procedure is superior to other therapeutic options, it has shown good results in patients with the main complaint of pain. Conclusion: The results reported in some studies should, however, be interpreted with caution, taking into consideration the substantial structural damage in irreparable defects.
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Affiliation(s)
- N Hawi
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - U Schmiddem
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - M Omar
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - T Stuebig
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - C Krettek
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - M Petri
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - R Meller
- Trauma Department, Hannover Medical School, Hannover, Germany
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Petri M, Greenspoon JA, Moulton SG, Millett PJ. Patch-Augmented Rotator Cuff Repair and Superior Capsule Reconstruction. Open Orthop J 2016; 10:315-323. [PMID: 27708733 PMCID: PMC5039955 DOI: 10.2174/1874325001610010315] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 06/28/2015] [Accepted: 02/01/2016] [Indexed: 11/22/2022] Open
Abstract
Background: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. Methods: A selective literature search was performed and personal surgical experiences are reported. Results: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients. Therefore, patch-augmented rotator cuff repair or superior capsule reconstruction (SCR) have been recently developed as arthroscopically applicable treatment options, with promising biomechanical and early clinical results. Conclusion: For younger patients with irreparable rotator cuff tears wishing to avoid tendon transfers or reverse total shoulder arthroplasty, both patch-augmentation and SCR represent treatment options that may delay the need for more invasive surgery.
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Affiliation(s)
- M Petri
- Steadman Philippon Research Institute 181 West Meadow Drive suite 1000 Vail, CO, 81657, USA; The Steadman Clinic 181 West Meadow Drive Vail, CO, 81657, USA
| | - J A Greenspoon
- Steadman Philippon Research Institute 181 West Meadow Drive suite 1000 Vail, CO, 81657, USA
| | - S G Moulton
- Steadman Philippon Research Institute 181 West Meadow Drive suite 1000 Vail, CO, 81657, USA
| | - P J Millett
- Steadman Philippon Research Institute 181 West Meadow Drive suite 1000 Vail, CO, 81657, USA; The Steadman Clinic 181 West Meadow Drive Vail, CO, 81657, USA
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Abstract
Objective The objective of this study was to estimate the proportion of pregnant women with systemic lupus erythematosus meeting Institute of Medicine guidelines for gestational weight gain and determine correlates of adherence to guidelines. Methods Singleton, live births in the Hopkins Lupus Pregnancy Cohort 1987-2015 were included. Pre-pregnancy weight was the weight recorded 12 months prior to pregnancy/first trimester. Final weight was the last weight recorded in the third trimester. Adherence to Institute of Medicine guidelines (inadequate, adequate, or excessive) was based on pre-pregnancy body mass index. Fisher's exact test and analysis of variance determined factors associated with not meeting guidelines. Stepwise selection estimated predictors of gestational weight gain. Results Of the 211 pregnancies, 34%, 24% and 42% had inadequate, adequate and excessive gestational weight gain, respectively. In exploratory analyses, differences in Institute of Medicine adherence were observed by pre-pregnancy body mass index, race, elevated creatinine during pregnancy and pre-pregnancy blood pressure. Odds of inadequate and excessive gestational weight gain increased 12% with each 1 kg/m2 increase in pre-pregnancy body mass index. Lower maternal education was associated with increased odds of inadequate and excessive gestational weight gain. Conclusions As in the general population, most women with systemic lupus erythematosus did not meet Institute of Medicine guidelines. Our results identified predictors of gestational weight gain to aid in targeted interventions to improve guideline adherence in this population.
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Affiliation(s)
- A M Eudy
- 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - A M Siega-Riz
- 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - S M Engel
- 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - N Franceschini
- 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - A G Howard
- 2 Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - M E B Clowse
- 3 Division of Rheumatology & Immunology, Duke University Medical Center, Durham, USA
| | - M Petri
- 4 Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, USA
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29
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Bernatsky S, Ramsey-Goldman R, Petri M, Urowitz MB, Gladman DD, Fortin PR, Ginzler E, Romero-Diaz J, Peschken C, Jacobsen S, Hanly JG, Gordon C, Nived O, Yelin EH, Isenberg D, Rahman A, Bae SC, Joseph L, Witte T, Ruiz-Irastorza G, Aranow C, Kamen D, Sturfeldt G, Foulkes WD, Hansen JE, St Pierre Y, Raymer PC, Tessier-Cloutier B, Clarke AE. Breast cancer in systemic lupus. Lupus 2016; 26:311-315. [PMID: 27687028 DOI: 10.1177/0961203316664595] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective There is a decreased breast cancer risk in systemic lupus erythematosus (SLE) versus the general population. We assessed a large sample of SLE patients, evaluating demographic and clinical characteristics and breast cancer risk. Methods We performed case-cohort analyses within a multi-center international SLE sample. We calculated the breast cancer hazard ratio (HR) in female SLE patients, relative to demographics, reproductive history, family history of breast cancer, and time-dependent measures of anti-dsDNA positivity, cumulative disease activity, and drugs, adjusted for SLE duration. Results There were 86 SLE breast cancers and 4498 female SLE cancer-free controls. Patients were followed on average for 7.6 years. Versus controls, SLE breast cancer cases tended to be white and older. Breast cancer cases were similar to controls regarding anti-dsDNA positivity, disease activity, and most drug exposures over time. In univariate and multivariate models, the principal factor associated with breast cancers was older age at cohort entry. Conclusions There was little evidence that breast cancer risk in this SLE sample was strongly driven by any of the clinical factors that we studied. Further search for factors that determine the lower risk of breast cancer in SLE may be warranted.
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Affiliation(s)
- S Bernatsky
- 1 Faculty of Medicine, McGill University, Montreal, Canada.,2 Division of Clinical Epidemiology, Research Institute of the McGill University Health Center, Montreal, Canada
| | - R Ramsey-Goldman
- 3 Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - M Petri
- 4 Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - M B Urowitz
- 5 Center for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto, Toronto, Canada
| | - D D Gladman
- 5 Center for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto, Toronto, Canada
| | - P R Fortin
- 6 Division of Rheumatology, Centre de recherche du CHU de Québec-Université Laval, Quebec City, Canada
| | - E Ginzler
- 7 State University of New York-Downstate Medical Center, New York, USA
| | - J Romero-Diaz
- 8 Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico
| | - C Peschken
- 9 University of Manitoba, Winnipeg, Canada
| | - S Jacobsen
- 10 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J G Hanly
- 11 Division of Rheumatology, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada
| | - C Gordon
- 12 Rheumatology Research Group, Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham: Rheumatology department, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust and NIHR/Wellcome Trust Clinical Research Facility, Queen Elizabeth Hospital Birmingham; University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - O Nived
- 13 Department of Rheumatology, Institution of Clinical Sciences, Lund University Hospital, Lund, Sweden
| | - E H Yelin
- 14 Department of Medicine, University of California, San Francisco, USA
| | - D Isenberg
- 15 Centre for Rheumatology Research, University College London, London, UK
| | - A Rahman
- 15 Centre for Rheumatology Research, University College London, London, UK
| | - S-C Bae
- 16 The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
| | - L Joseph
- 1 Faculty of Medicine, McGill University, Montreal, Canada.,2 Division of Clinical Epidemiology, Research Institute of the McGill University Health Center, Montreal, Canada
| | - T Witte
- 17 Department of Clinical Immunology, Hannover Medical School, Hannover, Germany
| | - G Ruiz-Irastorza
- 18 Autoimmune Diseases Research Unit, Department Of Internal Medicine, Hospital Universitario Cruces, University Of The Basque Country, Bizkaia, Spain
| | - C Aranow
- 19 Feinstein Institute for Medical Research, New York, USA
| | - D Kamen
- 20 Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, USA
| | - G Sturfeldt
- 13 Department of Rheumatology, Institution of Clinical Sciences, Lund University Hospital, Lund, Sweden
| | - W D Foulkes
- 21 Departments of Oncology, Human Genetics and Medicine, McGill University, Montreal, Canada
| | - J E Hansen
- 22 Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
| | - Y St Pierre
- 2 Division of Clinical Epidemiology, Research Institute of the McGill University Health Center, Montreal, Canada
| | - P Chrétien Raymer
- 2 Division of Clinical Epidemiology, Research Institute of the McGill University Health Center, Montreal, Canada
| | - B Tessier-Cloutier
- 23 Department of Anatomical Pathology, University of British Colombia, Vancouver, Canada
| | - A E Clarke
- 24 Division of Rheumatology, University of Calgary, Calgary, Canada
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Gladstone DE, Petri M, Bolaños-Meade J, Dezern AE, Jones RJ, Fine D, Brodsky RA. Long-term systemic lupus erythematosus disease control after allogeneic bone marrow transplantation. Lupus 2016; 26:773-776. [PMID: 27687020 DOI: 10.1177/0961203316669242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus (SLE), a disorder of the immune system, is potentially curable by allogeneic bone marrow transplantation (alloBMT). Until recently, alloBMT was limited by donor availability and toxicity. Reduced intensity conditioning (RIC) combined with post-transplantation cyclophosphamide (PTCy) has improved the availability and safety of alloBMT permitting its exploration in severe-refractory autoimmune illnesses. We report the six-year follow-up of a young female whose refractory SLE-associated nephrosis resolved after RIC alloBMT with PTCy.
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Affiliation(s)
- D E Gladstone
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
| | - M Petri
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
| | - J Bolaños-Meade
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
| | - A E Dezern
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
| | - R J Jones
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
| | - D Fine
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
| | - R A Brodsky
- Johns Hopkins Hospital and Health System, Baltimore, MD, USA
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Wallace DJ, Hobbs K, Clowse MEB, Petri M, Strand V, Pike M, Merrill JT, Leszczyński P, Neuwelt CM, Jeka S, Houssiau F, Keiserman M, Ordi-Ros J, Bongardt S, Kilgallen B, Galateanu C, Kalunian K, Furie R, Gordon C. Long-Term Safety and Efficacy of Epratuzumab in the Treatment of Moderate-to- Severe Systemic Lupus Erythematosus: Results From an Open-Label Extension Study. Arthritis Care Res (Hoboken) 2016; 68:534-43. [PMID: 26316325 DOI: 10.1002/acr.22694] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/17/2015] [Accepted: 08/11/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The primary objective was to assess the long-term safety of repeated courses of epratuzumab therapy in patients with moderate-to-severe systemic lupus erythematosus. Secondary objectives were to assess long-term efficacy and health-related quality of life (HRQOL). METHODS Eligible patients from the 12-week, phase IIb, randomized, placebo-controlled EMBLEM study enrolled into the open-label extension (OLE) study, SL0008. In the SL0008 study, patients received 1,200 mg epratuzumab infusions at weeks 0 and 2 of repeating 12-week cycles, plus standard of care. Safety measures included treatment-emergent adverse events (TEAEs) and serious TEAEs. Efficacy measures included combined treatment response, the British Isles Lupus Assessment Group score, the Systemic Lupus Erythematosus Disease Activity Index score, and the physician's and patient's global assessment of disease activity. Total daily corticosteroid dose and HRQOL (by the Short Form 36 health survey) were also assessed. RESULTS A total of 113 of the 203 patients (55.7%) who entered the SL0008 study continued epratuzumab therapy until study closure (total cumulative exposure: 381.3 patient-years, median exposure: 845 days, and maximum exposure: 1,185 days/approximately 3.2 years). TEAEs were reported in 192 patients (94.6%); most common were infections and infestations (68.0%, 138 patients). Serious TEAEs were reported in 51 patients (25.1%), and 14 patients (6.9%) had serious infections. In patients treated for 108 weeks (n = 116), the median corticosteroid dose was reduced from 10.0 mg/day at OLE screening to 5.0 mg/day at week 108. Improvements in efficacy and HRQOL measures in EMBLEM were maintained in the OLE, while placebo patients exhibited similar improvements in disease activity upon a switch to epratuzumab. CONCLUSION Open-label epratuzumab treatment was well tolerated for up to 3.2 years, and associated with sustained improvements in disease activity and HRQOL, while steroids were reduced.
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Affiliation(s)
- D J Wallace
- Cedars-Sinai Medical Center, Los Angeles, California
| | - K Hobbs
- Denver Arthritis Clinic, Denver, Colorado
| | - M E B Clowse
- Duke University Medical Center, Durham, North Carolina
| | - M Petri
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - V Strand
- Biopharmaceutical Consultant, Portola Valley, California
| | - M Pike
- MedPharm Consulting, Inc., Cambridge, Massachusetts
| | - J T Merrill
- Oklahoma Medical Research Foundation, University of Oklahoma Health Sciences Center, Oklahoma City
| | - P Leszczyński
- Poznan University of Medical Sciences, Poznan, Poland
| | - C M Neuwelt
- Alameda County Health System, Oakland, California
| | - S Jeka
- Clinic of Rheumatology and Connective Tissue Diseases, 2nd University Hospital, CM UMK, Bydgoszcz, Poland
| | - F Houssiau
- Clinique Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - M Keiserman
- Pontifical Catholic University, School of Medicine, Porto Alegre, Brazil
| | - J Ordi-Ros
- Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | | | - K Kalunian
- University of California San Diego School of Medicine, La Jolla
| | - R Furie
- North Shore-Long Island Jewish Health System, New York, New York
| | - C Gordon
- School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, and NIHR/Wellcome Trust Clinical Research Facility, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
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Petri M, Ettinger M, Brand S, Stuebig T, Krettek C, Omar M. Non-Operative Management of Rotator Cuff Tears. Open Orthop J 2016; 10:349-356. [PMID: 27708737 PMCID: PMC5041208 DOI: 10.2174/1874325001610010349] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/06/2015] [Accepted: 02/01/2016] [Indexed: 01/28/2023] Open
Abstract
Background: The role of nonoperative management for rotator cuff tears remains a matter of debate. Clinical results reported in the literature mainly consist of level IV studies, oftentimes combining a mixed bag of tear sizes and configurations, and are contradictory to some extent. Methods: A selective literature search was performed and personal surgical experiences are reported. Results: Most studies show an overall success rate of around 75% for nonoperative treatment. However, the majority of studies also present a progression of tear size and fatty muscle infiltration over time, with however debatable clinical relevance for the patient. Suggested factors associated with progression of a rotator cuff tear are an age of 60 years or older, full-thickness tears, and fatty infiltration of the rotator cuff muscles at the time of initial diagnosis. Conclusion: Non-operative management is indicated for patients with lower functional demands and moderate symptoms, and/or of course for those refusing to have surgery.
Close routinely monitoring regarding development of tear size should be performed, especially in patients that remain symptomatic during nonoperative treatment.
To ensure judicious patient counseling, it has to be taken into account that 1) tears that are initially graded as reparable may become irreparable over time, and 2) results after secondary surgical therapy after failed nonoperative treatment are usually reported to be inferior to those who underwent primary tendon repair.
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Affiliation(s)
- M Petri
- Trauma Department Hannover Medical School (MHH) Carl-Neuberg-Straße 1 D-30625 Hannover, Germany
| | - M Ettinger
- Orthopaedic Surgery Department Hannover Medical School (MHH) Anna-von-Borries-Str. 1-7 D-30625 Hannover, Germany
| | - S Brand
- Trauma Department Hannover Medical School (MHH) Carl-Neuberg-Straße 1 D-30625 Hannover, Germany
| | - T Stuebig
- Trauma Department Hannover Medical School (MHH) Carl-Neuberg-Straße 1 D-30625 Hannover, Germany
| | - C Krettek
- Trauma Department Hannover Medical School (MHH) Carl-Neuberg-Straße 1 D-30625 Hannover, Germany
| | - M Omar
- Trauma Department Hannover Medical School (MHH) Carl-Neuberg-Straße 1 D-30625 Hannover, Germany
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34
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Abstract
The Hopkins Lupus Cohort is supported by RO1 AR 43727 and by the Outpatient General Clinical Research Center M01-RR00052. Received 6 June 2005; accepted 23 June 2005 The Hopkins Lupus Cohort is a prospective longitudinal study of lupus activity, organ damage, and quality of life in SLE patients. It is balanced between Caucasian and African-American SLE patients. This review highlights major findings from the cohort with implications for clinical care.
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Affiliation(s)
- M Petri
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Abstract
Pericarditis is the most common cardiac abnormality in systemic lupus erythematosus (SLE) patients, but lesions of the valves, myocardium and coronary vessels may all occur. In the past, cardiac manifestations were severe and life threatening, often leading to death. Therefore, they were frequently found in post-mortem examinations. Nowadays cardiac manifestations are often mild and asymptomatic. However, they can be frequently recognized by echocardiography and other noninvasive tests. Echocardiography is a sensitive and specific technique in detecting cardiac abnormalities, particularly mild pericarditis, valvular lesions and myocardial dysfunction. Therefore, echocardiography should be performed periodically in SLE patients. Vascular occlusion, including coronary arteries, may develop due to vasculitis, premature atherosclerosis or antiphospholipid antibodies associated with SLE. Premature atherosclerosis is the most frequent cause of coronary artery disease (CAD) in SLE patients. Efforts should be made to control traditional risk factors as well as all other factors which could contribute to atherosclerotic plaque development.
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Affiliation(s)
- A Doria
- Division of Rheumatology, University of Padua, Padua, Italy.
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Kasitanon N, Fine DM, Haas M, Magder LS, Petri M. Hydroxychloroquine use predicts complete renal remission within 12 months among patients treated with mycophenolate mofetil therapy for membranous lupus nephritis. Lupus 2016; 15:366-70. [PMID: 16830883 DOI: 10.1191/0961203306lu2313oa] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The objective of this study was to identify clinical predictors of response to initial mycophenolate mofetil (MMF) therapy for membranous lupus nephritis (MLN). We observed the clinical outcomes of patients in the Hopkins Lupus Cohort within the first year of initiation of treatment with MMF therapy for newly diagnosed MLN, classified according to the new International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 classification. Complete renal remission was defined as proteinuria less than 500 mg/24 hours. Demographic, clinical, treatment and laboratory data were examined for their association with renal remission. Twenty-nine MLN patients treated with MMF were identified. Eleven (38%) patients achieved complete renal remission by 12 months. Of those taking hydroxychloroquine, 7/11 (64%) were in remission within 12 months compared to only 4/18 (22%) of those not on hyroxychloroquine ( P 0.036 based on a log-rank test). This association persisted after controlling for the presence of anti-ds-DNA ( P 0.026). Our results provide evidence that hydroxychloroquine has a benefit for renal remission when MMF is used as the initial therapy for MLN. Although hydroxychloroquine is frequently stopped in patients with lupus nephritis, this study suggests it should be started or maintained.
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Affiliation(s)
- N Kasitanon
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, USA
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Urowitz MB, Gladman D, Ibañez D, Fortin P, Sanchez-Guerrero J, Bae S, Clarke A, Bernatsky S, Gordon C, Hanly J, Wallace D, Isenberg D, Ginzler E, Merrill J, Alarcon G, Steinsson K, Petri M, Dooley MA, Bruce I, Manzi S, Khamashta M, Ramsey-Goldman R, Zoma A, Sturfelt G, Nived O, Maddison P, Font J, van Vollenhoven R, Aranow C, Kalunian K, Stoll T, Buyon J. Clinical manifestations and coronary artery disease risk factors at diagnosis of systemic lupus erythematosus: data from an international inception cohort. Lupus 2016; 16:731-5. [PMID: 17728367 DOI: 10.1177/0961203307081113] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Systemic Lupus International Collaborating Clinics (SLICC) comprises 27 centres from 11 countries. An inception cohort of 918 SLE patients has been assembled according to a standardized protocol between 2000 and 2006. Clinical features, classic coronary artery disease (CAD) risk factors, as well as other potential risk factors were collected. Of the 918 patients 89% were females, and of multi racial origin. Less than half the patients were living in a permanent relationship, 58% had post secondary education and 51% were employed. Eight percent had family history of SLE. At enrolment, with at mean age of diagnosis of 34.5 years, a significant number of patients already had CAD risk factors, such as hypertension (33%) and hypercholesterolemia (36%). Only 15% of the patients were postmenopausal, 16% were current smokers and 3.6% had diabetes at entry to the SLICC-RAS (Registry for Atherosclerosis). A number of patients in this multi-racial, multi-ethnic inception cohort of lupus patients have classic CAD risk factors within a mean of 5.4 months from diagnosis. This cohort will be increased to 1500 patients to be followed yearly for 10 years. This will provide a unique opportunity to evaluate risk factors for accelerated atherosclerosis in SLE. Lupus (2007) 16, 731—735.
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Affiliation(s)
- M B Urowitz
- SLICC Registry for Atherosclerosis Coordinating Centre, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario, Canada
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Abstract
Our understanding of the biological pathogenesis of systemic lupus erythematosus (SLE) is rapidly expanding. Although biologic research is vital, studies that address the importance of socioeconomic factors that contribute to the causation of the outcome of SLE are necessary to understand the full scope of the disease.Studies of social factors in SLE usually include ethnicity, gender and socioeconomic status (SES) as categorical variables. One hypothesis is that these variables exert their effect through a biologic or genetic factor. However, there is growing evidence to suggest a more direct psychological or sociological impact of these variables on disease. Although in research studies it may be difficult to tease out the biological and sociological impacts of these variables, the eventual understanding of these diverse roles will help in the design of eventual therapeutic interventions.
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Affiliation(s)
- S Sule
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Abstract
Aortic valve calcification is associated with atherosclerosis in the general population. We investigated the prevalence of and associates of aortic valve calcification in systemic lupus erythematosus (SLE). One-hundred and ninety-nine SLE patients enrolled in a clinical trial had aortic valve calcification assessed by helical CT. The patients had a mean age of 44.3 = 11.4 years and were 92% female, 61% Caucasian, 34% African-American, 2% Asian and 2% Hispanic. Aortic valve calcification was present in 1.5%, whereas coronary calcium was found in 43% and carotid plaque in 17%. Among cardiovascular risk factors, hs-CRP ( P = 0.0592), fibrinogen ( P = 0.0507), and lipoprotein(a) ( P = 0.0250), were associated with aortic valve calcification. Prednisone use ( P = 0.049) and use of methotrexate ( P = 0.0174) were also associated with aortic valve calcification. Aortic valve calcification was associated with antiphospholipid antibody positivity (0.0287) (lupus anticoagulant, by dilute Russell viper venom time). It was not associated with coronary calcium or carotid plaque. Aortic valve calcification, although rare in SLE, was associated with some novel cardiovascular risk factors and with a marker of hypercoagulability (lupus anticoagulant). In contrast to the general population, aortic valve calcification in SLE is not associated with subclinical measures of atherosclerosis, such as coronary calcium or carotid plaque.
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Affiliation(s)
- A N Kiani
- Division of Rheumatology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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Durcan L, Petri M. Immunomodulators in SLE: Clinical evidence and immunologic actions. J Autoimmun 2016; 74:73-84. [PMID: 27371107 DOI: 10.1016/j.jaut.2016.06.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 06/16/2016] [Accepted: 06/21/2016] [Indexed: 01/08/2023]
Abstract
Systemic lupus erythematosus (SLE) is a potentially fatal autoimmune disease. Current treatment strategies rely heavily on corticosteroids, which are in turn responsible for a significant burden of morbidity, and immunosuppressives which are limited by suboptimal efficacy, increased infections and malignancies. There are significant deficiencies in our immunosuppressive armamentarium, making immunomodulatory therapies crucial, offering the opportunity to prevent disease flare and the subsequent accrual of damage. Currently available immunomodulators include prasterone (synthetic dehydroeipandrosterone), vitamin D, hydroxychloroquine and belimumab. These therapies, acting via numerous cellular and cytokine pathways, have been shown to modify the aberrant immune responses associated with SLE without overt immunosuppression. Vitamin D is important in SLE and supplementation appears to have a positive impact on disease activity particularly proteinuria. Belimumab has specific immunomodulatory properties and is an effective therapy in those with specific serological and clinical characteristics predictive of response. Hydroxychloroquine is a crucial background medication in SLE with actions in many molecular pathways. It has disease specific effects in reducing flare, treating cutaneous disease and inflammatory arthralgias in addition to other effects such as reduced thrombosis, increased longevity, improved lipids, better glycemic control and blood pressure. Dehydroeipandrosterone is also an immunomodulator in SLE which can have positive effects on disease activity and has bone protective properties. This review outlines the immunologic actions of these drugs and the clinical evidence supporting their use.
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Affiliation(s)
- L Durcan
- Division of Rheumatology, University of Washington, Seattle, USA.
| | - M Petri
- Division of Rheumatology, Johns Hopkins University, School of Medicine, Baltimore, USA
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Petri MA, Martin RS, Scheinberg MA, Furie RA. Assessments of fatigue and disease activity in patients with systemic lupus erythematosus enrolled in the Phase 2 clinical trial with blisibimod. Lupus 2016; 26:27-37. [PMID: 27353505 DOI: 10.1177/0961203316654767] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/20/2016] [Indexed: 11/15/2022]
Abstract
This report evaluates the effects of blisibimod (A-623, AMG 623), a potent and selective inhibitor of B-cell activating factor (BAFF), on patient-reported fatigue and disease activity in the Phase 2b PEARL-SC clinical trial in patients with systemic lupus erythematosus (SLE). A total of 547 individuals who met the American College of Rheumatology (ACR) classification criteria for SLE, were positive for anti-double-stranded DNA or antinuclear antibodies, and had a Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score ≥6 at baseline, were randomized to receive placebo or blisibimod for at least 24 weeks. Patient self-reported fatigue was evaluated using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale, and disease activity was evaluated using Physician's Global Assessment, SELENA-SLEDAI, and British Isles Lupus Assessment Group Score. Statistically significant improvements in FACIT-Fatigue score were observed among individuals randomized to blisibimod, especially in the 200 mg QW group where favorable effects on disease activity with blisibimod compared to placebo were observed as early as Week 8. The mean improvement from baseline of 6.9 points at Week 24, compared with 4.4 points with placebo, met the criteria for minimal clinically important improvement difference defined for patients with SLE. Despite concomitant improvements in FACIT-Fatigue, SLE Responder Index (SRI) and SLE biomarkers (reported previously), FACIT-Fatigue score correlated only weakly with disease activity. While poor correlation between fatigue and disease activity is not new, the observation that correlation remains poor despite concurrent population improvements in disease and fatigue brings a new facet to our understanding of SLE.
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Affiliation(s)
- M A Petri
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R S Martin
- Medical Sciences, Anthera Pharmaceuticals Inc, Hayward, CA, USA
| | - M A Scheinberg
- Clinical Research Center, Hospital Abreu Sodré-AACD, São Paulo, Brazil
| | - R A Furie
- Division of Rheumatology and Allergy-Clinical Immunology, North Shore-Long Island Jewish Health System, Great Neck, NY, USA
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Durcan L, Fu W, Petri M. FRI0336 Hypocomplementemia in Systemic Lupus Erythematosus; Establishing The Importance of Low C3 and C4 in A Longitudinal Cohort: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Leung Y, Sullivan K, Shi L, Maurer K, Song L, Petri M. AB0159 Prolactin Induces Interferon Regulatory Factor 1 Activation and Histone H4 Hyperacetylation in Primary Monocytes Comparable To Changes Seen in Monocytes from Systemic Lupus Erythematosus Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Magder L, Duarte-Garcia A, Barr E, Petri M. FRI0312 Predictors of Incident Episodes of Proteinuria among Patients with Systemic Lupus Erythematosus. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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45
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Durcan L, Arbab-Zadeh A, Connelly M, Otvos J, Magder L, Petri M. THU0339 Non-Calcified Coronary Artery Plaque Associates with Adverse Lipoprotein Profiles in Systemic Lupus Erythematosus:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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46
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Sanjuan M, Henault J, Riggs J, Karnell J, Liarski V, Shirinian L, Xu L, Casey K, Smith M, Khatry D, Clarke L, Herbst R, Ettinger R, Petri M, Clark M, Mustelin T, Kolbeck R. AB0146 Self-Reactive IGE Exacerbates Interferon Responses Associated with Autoimmunity. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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47
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Fu W, Petri M. FRI0353 A Longitudinal Analysis of Change in Lupus Disease Activity Pattern in Hopkins Lupus Cohort Using A Multistate Markov Model Approach: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kwatra S, Fu W, Petri M. SAT0325 Smoking Is Associated with Future Lupus Cutaneous Activity in Prospective Analyses. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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49
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Durcan L, Fu W, Petri M. OP0183 Hypocomplementemia Associates with Thrombosis in SLE Patients with Antiphospholipid Antibodies: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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50
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Costedoat-Chalumeau N, Houssiau F, Izmirly P, Le Guern V, Navarra S, Jolly M, Ruiz-Irastorza G, Hachulla E, Agmon-Levin N, Shoenfeld Y, Dall'Ara F, Buyon J, Deligny C, Cervera R, Lazaro E, Bezanahary H, Leroux G, Morel N, Viallard JF, Pineau C, Galicier L, Van Vollenhoven R, Tincani A, Nguyen H, Gondran G, Zahr N, Pouchot J, Piette JC, Petri M, Isenberg D. THU0304 Adherence To Hydroxychloroquine as Assessed by Measurements of Drug and Metabolite Blood Levels in An International Prospective Study of Sle Patients in Flare. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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