Treatment Patterns in Polyarticular Juvenile Idiopathic Arthritis: A Retrospective Observational Health Claims Data Study.

(1) Background: Achieving inactive disease decreases long-term joint damage in patients with polyarticular juvenile idiopathic arthritis (polyJIA). The aim of our study was to describe average time to treatment and medication changes over time. (2) Methods: Incident polyJIA patients were retrospectively identified in the InGef and WIG2 longitudinal health claims databases.

Etanercept in Axial Spondyloarthritis, Psoriatic Arthritis, and Plaque Psoriasis: Real-World Outcome Data from German Non-interventional Study ADEQUATE.

Introduction: For chronic diseases such as axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and plaque psoriasis (PsO), treatment goals include remission or at least low disease activity (LDA) by 12 weeks. Improvements in symptoms such as pain and fatigue should also be treatment goals.

Methods: ADEQUATE was a German, prospective, non-interventional study to evaluate the proportion of patients with rheumatoid arthritis, PsA, axSpA, or PsO who, in routine clinical practice, benefit from the continuation of treatment with etanercept (ETN) beyond 12 weeks, even when their treatment goals have not yet been reached.

Incidence, prevalence, and comorbidities of juvenile idiopathic arthritis in Germany: a retrospective observational cohort health claims database study.

Background: Juvenile idiopathic arthritis (JIA) describes heterogenous categories of chronic inflammatory rheumatic conditions of unknown origin in children and adolescents. Epidemiological data in the literature vary, depending on geographic location, ethnicity and the case definition used. We evaluated epidemiology, especially that of the categories defined by the International League of Associations for Rheumatology (ILAR).

Effectiveness of Etanercept in Rheumatoid Arthritis: Real-World Data from the German Non-interventional Study ADEQUATE with Focus on Treat-to-Target and Patient-Reported Outcomes.

Background: For rheumatoid arthritis (RA), the treat-to-target concept suggests attaining remission or at least low disease activity (LDA) after 12 weeks.

Objectives: This German, prospective, multicenter, non-interventional study aimed to determine the proportion of patients with RA who achieved their treat-to-target aim after 12 and 24 weeks of etanercept (ETN) treatment in a real-life setting, as opposed to patients achieving their therapeutic target at a later timepoint (week 36 or 52).

Methods: A total of 824 adults with a confirmed diagnosis of RA without prior ETN treatment were included.

Early psychological interventions for prevention and treatment of post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms in post-partum women: A systematic review and meta-analysis.

Background: Pre-term or full-term childbirth can be experienced as physically or psychologically traumatic. Cumulative and trans-generational effects of traumatic stress on both psychological and physical health indicate the ethical requirement to investigate appropriate preventative treatment for stress symptoms in women following a routine traumatic experience such as childbirth.

Objective: The objective of this review was to investigate the effectiveness of early psychological interventions in reducing or preventing post-traumatic stress symptoms and post-traumatic stress disorder in post-partum women within twelve weeks of a traumatic birth.

Hydroxychloroquine in patients with inflammatory and erosive osteoarthritis of the hands: results of the OA-TREAT study-a randomised, double-blind, placebo-controlled, multicentre, investigator-initiated trial.

Objectives: Hand osteoarthritis (OA) is a condition characterised by cartilage degradation and frequently erosive changes. Analgesics and non-steroidal anti-inflammatory drugs are used for symptomatic relief but are often poorly tolerated or contraindicated. Previous publications suggest hydroxychloroquine (HCQ) as a possible treatment for hand OA.

Case Report: Healing a Traumatic Birth.

One needs to recognize that the perinatal period is a vulnerable time where negative attitudes, words and actions can have an emotionally damaging effect on birthing women, who are especially sensitive to how they are treated, because of their high oxytocin levels. This case report depicts a traumatic birth in which the mother was needlessly separated from her baby and also harshly treated by the personnel, which had an emotionally devastating impact on the mother/baby relationship. This case report will demonstrate how psychotherapy was used to heal this distress.

Proficiency testing of 78 international laboratories measuring tritium in environmental waters by decay counting and mass spectrometry for age dating and water resources assessment.

Rationale: Tritium ( H) is an important hydrological tracer that has been commonly used for over 60 years to evaluate water residence times and water dynamics in shallow/recent groundwaters, streams, lakes and the ocean. We tested the analytical performance of 78 international laboratories engaged in low-level H assays for water age dating and monitoring of environmental waters.

Methods: Seven test waters were distributed by the IAEA to 78 international tritium laboratories.

A low-cost, autonomous mobile platform for limnological investigations, supported by high-resolution mesoscale airborne imagery.

Two complementary measurement systems-built upon an autonomous floating craft and a tethered balloon-for lake research and monitoring are presented. The autonomous vehicle was assembled on a catamaran for stability, and is capable of handling a variety of instrumentation for in situ and near-surface measurements. The catamaran hulls, each equipped with a small electric motor, support rigid decks for arranging equipment.

A laboratory information management system for the analysis of tritium (H) in environmental waters.

Accurate and precise measurements of low levels of tritium (H) in environmental waters are difficult to attain due to complex steps of sample preparation, electrolytic enrichment, liquid scintillation decay counting, and extensive data processing. We present a Microsoft Access™ relational database application, TRIMS (Tritium Information Management System) to assist with sample and data processing of tritium analysis by managing the processes from sample registration and analysis to reporting and archiving. A complete uncertainty propagation algorithm ensures tritium results are reported with robust uncertainty metrics.

A compact tritium enrichment unit for large sample volumes with automated re-filling and higher enrichment factor.

Tritium (H) in natural waters is a powerful tracer of hydrological processes, but its low concentrations require electrolytic enrichment before precise measurements can be made with a liquid scintillation counter. Here, we describe a newly developed, compact tritium enrichment unit which can be used to enrich up to 2L of a water sample. This allows a high enrichment factor (>100) for measuring low H contents of <0.

Sustained Increase of 25-Hydroxyvitamin D Levels in Healthy Young Women during Wintertime after Three Suberythemal UV Irradiations-The MUVY Pilot Study.

Objectives: Vitamin D (VitD) deficiency is a health problem prevalent not only in the elderly but also in young adults. The primary objective of our observational pilot study "MUVY" (Mood, UVR, Vitamin D in Young women) was to test both the short-term and long-term effects of a series of three suberythemal UV radiation (UVR) exposures on the VitD status and well-being of young healthy women during winter in a repeat measure design.

Methods: 20 healthy young women (Fitzpatrick skin types I-III, aged 21-25 years) received three full body broad band UVR exposures with an escalating erythemally weighted dose schedule during one week in winter, and completed self-report questionnaires monitoring symptoms of depression (Beck Depression Inventory, BDI) and affective state/well-being (Profile of Mood States, POMS) at baseline and three days after the last UVR exposure.

Effects of treatment with etanercept versus methotrexate on sleep quality, fatigue and selected immune parameters in patients with active rheumatoid arthritis.

Objectives: To compare sleep quality, disease activity and patient-reported outcomes such as fatigue and immune parameters in patients with rheumatoid arthritis treated with etanercept (ETA) or methotrexate (MTX).

Methods: Of 36 patients (28-joint Disease Activity Score, DAS28CRP≥3.2) in this 16-week (w), open, prospective study, 19 (11 women) received MTX 12.

Biologic monotherapy in the treatment of rheumatoid arthritis.

Biologics, possibly in combination with a conventional disease-modifying antirheumatic drug (DMARD) - preferably methotrexate (MTX), are used in accordance with the recommendations of the international rheumatological societies. However, in clinical practice, this recommendation is often problematic, as many rheumatologists know from personal experience. The quality of life of the patient is affected mainly by drug-induced intolerances (eg, MTX).

Low-dose Anti-thymocyte Globulin Inhibits Human B-cell Differentiation into Antibody-Secreting Cells.

Anti-thymocyte globulin (ATG) is used in the treatment of acute organ rejection. We studied in vitro the effect of low-dose ATG on B-cell activation and differentiation to antibody-secreting cells, as this may have an effect on B cell-driven autoimmune diseases, such as pemphigus vulgaris. Immunoglobulin production was analysed in the supernatants of peripheral blood mononuclear cells (PBMC) and CD19+ B cells from healthy donors and from patients with different autoimmune diseases.

Hydroxychloroquine in patients with inflammatory and erosive osteoarthritis of the hands (OA TREAT): study protocol for a randomized controlled trial.

Background: Osteoarthritis (OA) is a heterogeneous group of conditions with disturbed integrity of articular cartilage and changes in the underlying bone. The pathogenesis of OA is multifactorial and not just a disease of older people. Hydroxychloroquine (HCQ) is a disease-modifying anti-rheumatic drug (DMARD) typically used for the treatment of various rheumatic and dermatologic diseases.

[Inflammatory osteoarthritis of the hands - challenges in diagnosis and therapy].

Symptomatic osteoarthritis of the hand occurs in 5-20 % of the population ≥ 40 years. The diagnosis is made based on the clinical appearance, e. g.

Tritium in Japanese precipitation following the March 2011 Fukushima Daiichi Nuclear Plant accident.

Tritium concentrations in Japanese precipitation samples collected after the March 2011 accident at the Fukushima Dai-ichi Nuclear Power Plant (FNPP1) were measured. Values exceeding the pre-accident background were detected at three out of seven localities (Tsukuba, Kashiwa and Hongo) southwest of the FNPP1 at distances varying between 170 and 220 km from the source. The highest tritium content was found in the first rainfall in Tsukuba after the accident; however concentrations were 500 times less than the regulatory limit for tritium in drinking water.

The impact of childhood sexual abuse on childbearing and breastfeeding: the role of maternity caregivers.

This article is not a research study but rather a review of current understanding of the effects of childhood sexual abuse on the childbearing woman. Approximately one in four women has experienced early sexual abuse. Such a history can affect a woman's relationships with loved ones and care providers, contribute to her fears of labor and birth, and affect her ability to attach to her baby.

Academy of breastfeeding medicine founder's lecture 2009: Maternity care re-evaluated.

Abstract In the 1990s a rising tide of medical, surgical, and instrumental interventions served to make childbirth almost treated like a disease. This report supports a different approach to childbirth. A case and discussions of induction are presented.

The influence of viewpoint and object detail in blind people when matching pictures to complex objects.

We examined haptic viewpoint effects in blindfolded-sighted (BS) and visually impaired subjects: early blind (EB), late blind (LB), and very low vision (VLV). Participants felt complex objects and matched tangible pictures to them. In experiment 1, the EB and BS subjects had similar overall performance.