Objective: To investigate whether patients with rheumatoid arthritis (RA) have immunological or clinical evidence of gluten hypersensitivity.
Methods: Antigliadin antibodies (AGA) and antireticulin antibodies (ARA) were determined in two groups of RA patients and in a control group of patients with spondylarthropathies. In the first group of 42 patients with recent-onset RA, AGA and ARA were studied longitudinally during a one-year follow up period. In the second group of 36 patients with advanced RA and various abdominal symptoms examined by upper gastrointestinal endoscopy, AGA and ARA were determined cross-sectionally.
Results: Increased AGA (IgA or IgG) levels were found in 37% (29/78) of all RA patients compared to 12% (3/25) of controls. ARA positivity (IgG) was found in 4% (3/78) of RA patients and in none of the controls. AGA positivity was increased in patients with early RA compared to patients with advanced disease (48% vs. 25%) but the difference was not statistically significant. However, no true gluten hypersensitivity with positive AGA and ARA together with villous atrophy was observed.
Conclusion: Despite the increased AGA positivity found distinctively in patients with recent-onset RA, none of the RA patients showed clear evidence of coeliac disease. AGA positivity in early RA may indicate a role of the gut immune system in the initiation of RA.
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The purpose of this study was to identify whether NHS Trusts where discrimination in the delivery of care to patients from the South Asian community had been demonstrated had taken any actions to address the issue over the subsequent year. Freedom of information requests were sent to three trusts which had provided evidence of disparate provision of biologic therapy to patients with Crohn's disease, their associated Clinical Commissioning Groups and Healthwatch organisations to seek evidence whether they had remedied the situation. Requests were also sent to the Care Quality Commission, NHS Improvement and the Equality and Human Rights Commission seeking examples where they had responded to inequitable delivery of care related to ethnicity.
View Article and Find Full Text PDFTasers, a form of police weaponry causing neuromuscular incapacitation and extreme pain, were confirmed in 2010 to be used in New Zealand inpatient mental health units. Their use on patients, or tāngata whai ora (persons seeking wellbeing), raises ethical concerns about harm prevention, moral duties, and human rights in healthcare. The New Zealand healthcare system, grounded in principles and rights, regulates procedures to uphold fundamental rights.
View Article and Find Full Text PDFJ Law Med
November 2024
Associate Professor, Monash University Faculty of Law; Deputy Director, Castan Centre for Human Rights Law.
This article analyses qualitative empirical research conducted by this author to gain a deeper understanding of the rationale behind conscientious objection (CO) to voluntary assisted dying (VAD) and its impact on the operation of VAD in Victoria, Australia. It begins by providing an overview of the Australian legal approach to CO in the context of VAD. It then discusses the spectrum of attitudes that exist towards VAD, illuminating some of the nuance and complexity of the individual and institutional approaches.
View Article and Find Full Text PDFJ Law Med
November 2024
Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
The framing of patients making decisions about their medical treatment and care as traditional legal decisions, thresholds and formalities is a means to avoid legal liabilities through a rationalisation of decision-making, autonomy and choice. A credible account for the actual place of patients posits the sovereign power (founded in the works of Carl Schmitt and Giorgio Agamben) of the health care professional deciding the state of exception - a discrete legal space where the authority of health care professionals is both lawful and beyond the law. This reveals that dealing with broadly conceived consent issues with more law, more process and procedure but without addressing the inherent legality assumptions that empower health care professionals will always be flawed.
View Article and Find Full Text PDFPsychooncology
January 2025
Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China.
Objective: Influenced by their life stage and socio-cultural background, young and middle-aged cancer patients in China may experience unique psychological distress. Therefore, this study investigated the severity, problems, and associated factors of psychological distress among young and middle-aged cancer patients.
Methods: We conducted a cross-sectional study on young and middle-aged cancer patients aged 18-59 who were treated at a radiotherapy center from February 2022 to September 2023.
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