Anti citrullinated protein antibodies and mechanism of action of common disease modifying drugs--insights in pathomechanisms of autoimmunity.

The increasing understanding of autoimmune mechanisms continuously leads to new therapeutic targets and development of novel diagnostic tools in rheumatology. On the other hand, an improved comprehension of mechanisms of action of many drugs and the daily utilization in rheumatology leads to a better understanding of the underlying autoimmune processes. An example for the latter is Bcell depletion using anti-CD20 antibodies, which leads to the concept of B cells not only playing a role as antibody secreting cells but also as important cellular components of autoimmune processes, acting as antigen presenting and cytokine producing cells.

The EUROHIS-QOL 8-item index: comparative psychometric properties to its parent WHOQOL-BREF.

Objectives: To test the psychometric properties of the EUROHIS-QOL 8-item index, a shortened version of the World Health Organization Quality of Life Instrument-Abbreviated Version (WHOQOL-BREF).

Methods: The sample consisted of 2359 subjects identified from primary care settings, with 1193 having a confirmed diagnosis of depression. Data came from six countries (Australia, Brazil, Israel, Russia, Spain, and the United States) involved in a large international study, the Longitudinal Investigation of Depression Outcomes.

Quality of care, quality of life, and attitudes toward disabilities: perspectives from a qualitative focus group study in Porto Alegre, Brazil.

Objective: To explore the concepts of quality of life (QOL), quality of care (QOC), and attitudes toward disabilities in Porto Alegre, Brazil, from the perspective of people living with disabilities, including their relatives and caregivers.

Methods: This was a qualitative study that interviewed a total of 23 participants in five focus groups, during May-August 2006. After an open discussion about QOL, the WHOQOL-Bref, a generic questionnaire for the assessment of QOL, was presented to participants.

[Rheumatic patients in the intensive care unit].

The mortality of patients with rheumatic diseases in the intensive care unit is generally high despite their relatively young age. In these patients, it is often difficult to make the diagnosis of the underlying autoimmune disease or to differentiate between septic complications and an acute flare; likewise, the complexity of the specific antirheumatic therapy can also be accompanied by problems. The following article gives an overview of problems in the diagnosis and treatment of critically ill patients with autoimmune diseases in the intensive care unit.

Effective treatment of rheumatoid arthritis-associated interstitial lung disease by B-cell targeted therapy with rituximab.

Rheumatoid arthritis- (RA-) associated interstitial lung disease (RA-ILD) is the extra-articular complication with most adverse impact on the quality of life and survival in RA patients. However, treatment options are limited and controlled studies are lacking. Here, we present the case of a 66-year-old patient suffering from severe RA-ILD, which has been successfully treated with Rituximab (RTX).

Histamine-gated ion channels in mammals?

There is ample pharmacological and physiological evidence for yet unidentified histamine receptors in mammalian brain that are linked to a Cl(-) conductance. In invertebrates, two histamine-gated chloride channels (HisCl α1 and α2) are already well known. HisCl channels are members of the Cys-loop receptor superfamily of ligand-gated ion channels and are closely related to the mammalian GABA(A) and glycine receptors (GlyR).

Development and evaluation of a novel ultrasound score for large joints in rheumatoid arthritis: one year of experience in daily clinical practice.

Objective: To introduce and evaluate a new standardized ultrasound (US) score developed for large joints in patients with rheumatoid arthritis (RA).

Methods: A US score was designed to determine the degree of inflammation in the shoulder, the elbow, the hip, and the knee joint in patients with RA (Sonography of Large Joints in Rheumatology [SOLAR] score). Synovitis and synovial vascularity were scored semiquantitatively (grade 0-3) by gray-scale US (GSUS) and power Doppler US (PDUS).

Subjective perception of health in elderly inpatients.

There is evidence that subjective health is an important variable in general health outcomes. It can be an indicator of the individual's overall health status, creating a reliable and valid estimate about health. Quality of life (QoL) assessment can be associated with the individuals' subjective assessment of their own health status.

Contextual recognition memory deficits in major depression are suppressed by cognitive support at encoding.

Objectives: To investigate the effect of cognitive support (an associative orienting instruction at encoding) on contextual memory in depressed patients.

Methods: Seventeen patients (age 20-40 years, 14 women) diagnosed with major depressive disorder (MDD) and 22 healthy controls matched for age, gender and education completed a recognition memory task for item (object) and context (location), with or without an incidental binding cue at encoding. In addition, participants completed the vocabulary subtest of the Wechsler Adult Intelligence Scale (WAIS III) and the Wisconsin Card Sorting Test (WCST).

Current state of evidence on 'off-label' therapeutic options for systemic lupus erythematosus, including biological immunosuppressive agents, in Germany, Austria and Switzerland--a consensus report.

Systemic lupus erythematosus (SLE) can be a severe and potentially life-threatening disease that often represents a therapeutic challenge because of its heterogeneous organ manifestations. Only glucocorticoids, chloroquine and hydroxychloroquine, azathioprine, cyclophosphamide and very recently belimumab have been approved for SLE therapy in Germany, Austria and Switzerland. Dependence on glucocorticoids and resistance to the approved therapeutic agents, as well as substantial toxicity, are frequent.

Quality of life, diagnosis, and treatment of patients with major depression: a prospective cohort study in primary care.

Objective: To describe the demographic and clinical characteristics, adequacy of antidepressant treatment, and changes in quality of life of patients with major depression receiving follow-up care from primary care centers.

Method: A cohort study was performed in which major depression patients were followed-up over a nine-month period. Several evaluation instruments were used, including the World Health Organization Quality of Life and the Quality of Life-Depression, Centers for Epidemiologic Studies-Depression questionnaires.

Melancholia in Latin American studies: a distinct mood disorder for the ICD-11.

Objective: Melancholic depression is a lifetime diagnosis, typically with recurrent episodes. Melancholia, a syndrome with a long history and distinctive psychopathological features, is differentiated from major depression by the DSM-IV specifiers and partly described in the International Classification of Diseases - 10th edition. Within the present classification, it is frequently seen in severely ill patients with major depression and bipolar disorder.

Syntheses, crystal structures, reactivity, and photochemistry of gold(III) bromides bearing N-heterocyclic carbenes.

Gold(I) complexes bearing N-heterocyclic carbenes (NHC) of the type (NHC)AuBr (3a/3b) [NHC = 1-methyl-3-benzylimidazol-2-ylidene (= MeBnIm), and 1,3-dibenzylimidazol-2-ylidene (= Bn(2)Im)] are prepared by transmetallation reactions of (tht)AuBr (tht = tetrahydrothiophene) and (NHC)AgBr (2a/2b). The homoleptic, ionic complexes [(NHC)(2)Au]Br (6a/6b) are synthesized by the reaction with free carbene. Successive oxidation of 3a/3b and 6a/6b with bromine gave the respective (NHC)AuBr(3) (4a/4b) and [(NHC)(2)AuBr(2)]Br (7a/7b) in good overall yields as yellow powders.

Risk of infections in rheumatoid arthritis patients treated with tocilizumab.

Objectives: To investigate the occurrence and risk factors for infections in RA patients treated with tocilizumab.

Methods: A cohort of all RA patients (n = 112) starting tocilizumab therapy between October 2008 and March 2010 in Northern Bavaria was screened for infections. Mild/moderate and severe infections were recorded.

[Ultrasound-guided joint injections in patients with rheumatic diseases].

Joint and soft tissue injections are routinely performed in daily rheumatology practice to establish the diagnosis or as part of the treatment in patients suffering from rheumatic diseases. Consequently, joint injections have been included in the rheumatology further training curriculum. Despite numerous studies demonstrating a poor accuracy and outcome of joint injections guided only by clinical examination, most of the injection procedures are still performed in a "blind" fashion based on clinical judgment.

Estimating the SF-6D value set for a population-based sample of Brazilians.

Objectives: SF-6D is a preference-based measure of health developed to estimate utility values from the SF-36. The aim of this study was to estimate a weighting system for the SF-6D health states representing the preferences of a sample of the Southern Brazilian general population.

Methods: A sample of 248 health states defined by the SF-6D was valued by a sample of the southern Brazilian population using the standard gamble.

Cross-cultural evaluation of the WHOQOL-BREF domains in primary care depressed patients using Rasch analysis.

Background: The Rasch model prescribes procedures to ensure that a scale constructed from multiple items conforms to fundamental requirements of interval scales of measurement.

Objective: To test the Rasch properties of the domains of the World Health Organization Quality of Life Instrument-abbreviated version (WHOQOL-BREF) in depressed patients from primary care settings.

Design: Cross-sectional, cross-national study.

Rheumatoid arthritis recapitulates events relevant in blastocyst implantation and embryogenesis: a pathogenetic theory.

Objectives: Theoretical considerations support the hypothesis that functionally relevant genes were not positively selected for symptomatic chronic inflammatory diseases (CIDs) because of 3 major reasons: 1) high negative selection pressure with loss of reproducibility; 2) no selection pressure at all (many CIDs of today manifest in higher ages, and due to low life expectancy of our ancestors, they did not suffer from CIDs that we know today); 3) there was no time for natural selection (various CIDs did not exist long enough). Nevertheless, genes can be transferred before outbreak of a CID and can confer an increased risk. However, these genes were positively selected for fitness in reproduction and survival at younger ages independent of a symptomatic CID (antagonistic pleiotropy).

Ethanol alters calcium signaling in axonal growth cones.

Calcium (Ca2+) channels are sensitive to ethanol and Ca2+ signaling is a critical regulator of axonal growth and guidance. Effects of acute and chronic exposure to ethanol (22, 43, or 87 mM) on voltage-gated Ca2+ channels (VGCCs) in whole cells, and KCl-induced Ca2+ transients in axonal growth cones, were examined using dissociated hippocampal cultures. Whole-cell patch-clamp analysis in neurons with newly-formed axons (Stage 3) revealed that rapidly inactivating, low-voltage activated (LVA) and non-inactivating, high-voltage activated (HVA) currents were both inhibited in a dose-dependent manner by acute ethanol, with relatively greater inhibition of HVA currents.

On the infrared spectrum of L-lysinium(2+) sulfate.

It is argued that the infrared spectrum of L-lysine sulfate (L-Lys2+·SO4(2-)) published by Krishnakumar et al. [V. Krishnakumar, S.

Exercise and severe depression: preliminary results of an add-on study.

Background: Physical exercise has been extensively researched as a therapeutic option for treatment of major depression.

Methods: In a randomized controlled trial, we analyze the effects of aerobic physical exercise as an add-on strategy for treatment of severe depressed inpatients. The exercise has a "Dose" of 16.

Brittle fracture in viscoelastic materials as a pattern-formation process.

A continuum model of crack propagation in brittle viscoelastic materials is presented and discussed. Thereby, the phenomenon of fracture is understood as an elastically induced nonequilibrium interfacial pattern formation process. In this spirit, a full description of a propagating crack provides the determination of the entire time dependent shape of the crack surface, which is assumed to be extended over a finite and self-consistently selected length scale.

Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID).

Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting.

Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases.