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BACKGROUND/AIMS: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). METHODS: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. RESULTS: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. CONCLUSION: Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

Asunto(s)

Abatacept , Antirreumáticos , Artritis Reumatoide , Enfermedades Pulmonares Intersticiales , Humanos , Abatacept/uso terapéutico , Abatacept/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/complicaciones , Femenino , Persona de Mediana Edad , Masculino , Estudios Retrospectivos , Enfermedades Pulmonares Intersticiales/tratamiento farmacológico , Enfermedades Pulmonares Intersticiales/etiología , Enfermedades Pulmonares Intersticiales/fisiopatología , Enfermedades Pulmonares Intersticiales/diagnóstico , Antirreumáticos/uso terapéutico , Antirreumáticos/efectos adversos , Anciano , Resultado del Tratamiento , Progresión de la Enfermedad , Factores de Tiempo , Pulmón/efectos de los fármacos , Pulmón/fisiopatología , Pulmón/diagnóstico por imagen , Factores de Riesgo , Adulto , República de Corea , Tomografía Computarizada por Rayos X

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To facilitate rapid monitoring of airborne viruses, they must be collected with high efficiency and concentrated in a small volume of a liquid sample. In addition, the development of low-cost miniaturized samplers is essential for multipoint monitoring. Thus, in an attempt to fulfill these requirements, this study developed a microfluidic condensation bioaerosol sampler (MCBS). The developed sampler comprised two parts: a virus growth section and a virus droplet-to-liquid sample conversion section, each of which was fabricated on a chip using microfluidic technology. The condensation nucleus growth technique used in the virus growth section grew nanometer-sized airborne viruses into micro-sized droplets, making it possible to collection of viruses easier and with high efficiency. In addition, the virus droplet-to-liquid sample conversion section controlled the transport of droplets based on electrowetting technology. This enabled the collected airborne viruses to be concentrated in tens of microliters of the liquid sample. To evaluate the performance of both the sections, the virus dropletization, virus collection efficiency, and virus droplet-to-liquid sample conversion efficiency were evaluated through quantitative experiments. H1N1 and HCOV-229E viruses were used to conduct quantitative experiments on MCBS. We could obtain virus liquid samples with at 72.8- and 89.9-times higher concentration through 1:1 evaluation with a commercial sampler. Thus, the developed sampler facilitated efficient collection and concentration of airborne viruses in a compact, cost-effective manner. This is expected to facilitate rapid and accurate multipoint monitoring of viral aerosols.

Asunto(s)

Aerosoles , Microbiología del Aire , Técnicas Biosensibles , Diseño de Equipo , Aerosoles/análisis , Técnicas Biosensibles/instrumentación , Humanos , Dispositivos Laboratorio en un Chip , Microfluídica/instrumentación , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Monitoreo del Ambiente/instrumentación , Monitoreo del Ambiente/métodos , Técnicas Analíticas Microfluídicas/instrumentación

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Optical Fourier surfaces (OFSs), characterized by sinusoidally profiled diffractive optical elements, can outperform traditional binary-type counterparts by minimizing optical noise through selectively driving diffraction at desired frequencies. While scanning probe lithography (SPL), gray-scale electron beam lithography (EBL), and holographic inscriptions are effective for fabricating OFSs, achieving full-color diffractions at fundamental efficiency limits is challenging. Here, an integrated manufacturing process is presented, validated theoretically and experimentally, for fully transparent OFSs reaching the fundamental limit of diffraction efficiency. Leveraging holographic inscriptions and soft nanoimprinting, this approach effectively addresses challenges in conventional OFS manufacturing, enabling scalable production of noise-free and maximally efficient OFSs with record-high throughput (1010-1012 µm2 h-1), surpassing SPL and EBL by 1010 times. Toward this end, a wafer-scale OFSs array is demonstrated consisting of full-color diffractive gratings, color graphics, and microlenses by the one-step nanoimprinting, which is readily compatible with rapid prototyping of OFSs even on curved panels, demanding for transformative optical devices such as augmented and virtual reality displays.

RESUMEN

Background and Objective: Rheumatoid arthritis (RA) is an autoimmune disease in which joints are gradually destroyed. Early diagnosis and treatment before joint deformation or destruction is important. The detection of novel RA biomarkers in saliva may facilitate early detection of RA before disease onset. This study aimed to evaluate salivary concentration of α1-antitrypsin (A1AT) in healthy patients and those with RA, and to assess the diagnostic value of salivary A1AT. Materials and Methods: In total, 80 participants were included: 20 healthy participants, and 60 patients with RA. Saliva and serum samples were obtained from all the patients. Levels of A1AT and cytokines, including interleukin-1 beta (IL-1ß), IL-6, and IL-10 in saliva and serum, were evaluated using an enzyme-linked immunosorbent assay kit and Luminex assay. Data were analyzed using SPSS for Windows. Results: There was a higher level of A1AT in the saliva of patients with RA (median: 2388.66 ng/mL) than that in healthy controls (1579.06 ng/mL). There was a positive mild-to-moderate accuracy (area under the curve: 0.57-0.85) of A1AT in saliva to diagnose RA. The cut-off level (ng/mL) of A1AT in saliva for detecting RA was 1689.0. Conclusions: The obtained data can promote the application of the measurements of A1AT in saliva to diagnose RA.

Asunto(s)

Artritis Reumatoide , Saliva , alfa 1-Antitripsina , Femenino , Humanos , Masculino , alfa 1-Antitripsina/análisis , alfa 1-Antitripsina/sangre , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/sangre , Biomarcadores/análisis , Biomarcadores/sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Interleucina-1beta/análisis , Interleucina-1beta/sangre , Proyectos Piloto , Saliva/química

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Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.

Asunto(s)

Artritis Reumatoide , Halitosis , Osteoartritis , Enfermedades Periodontales , Periodontitis , Xerostomía , Masculino , Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anticuerpos Antiproteína Citrulinada , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Osteoartritis/complicaciones , Osteoartritis/diagnóstico , Biomarcadores , Periodontitis/complicaciones , Periodontitis/diagnóstico , Periodontitis/epidemiología , Autoanticuerpos , Péptidos Cíclicos

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Hydrocarbon (HC)-based block copolymers have been recognized as promising candidates for proton exchange membranes (PEMs) due to their distinct hydrophilic-hydrophobic separation, which results in improved proton transport compared to that of random copolymers. However, most PEMs derived from HC-based ionomers, including block copolymers, encounter challenges related to durability in electrochemical cells due to their low mechanical and chemical properties. One method for reinforcing HC-based ionomers involves incorporating the ionomers into commercially available low surface tension PTFE porous substrates. Nevertheless, the high interfacial energy between the hydrocarbon-based ionomer solution and PTFE remains a challenge in this reinforcement process, which necessitates the application of surface energy treatment to PTFE. Here, multiblock sulfonated poly(arylene ether sulfone) (SPAES) ionomers are being reinforced using untreated PE on the surface, and this is compared to reinforcement using surface-treated porous PTFE. The PE support layer exhibits a lower surface energy barrier compared to the surface-treated PTFE layer for the infiltration of the multiblock SPAES solution. This is characterized by the absence of noticeable voids, high translucency, gas impermeability, and a physical and chemical stability. By utilizing a high surface tension PE support with a comparable value to the multiblock SPAES, effective reinforcement of the multiblock SPAES ionomers is achieved for a PEM, which is potentially applicable to various hydrogen energy-based electrochemical cells.

RESUMEN

Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.

Asunto(s)

Artritis Gotosa , Gota , Humanos , Gota/diagnóstico , Gota/tratamiento farmacológico , Pueblo Asiatico , Consenso , República de Corea

RESUMEN

Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.

RESUMEN

Although drugs such as acetaminophen, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs), are commonly used for pain management, the side effects of these drugs such as hepatotoxicity, nephrotoxicity, nausea, and vomiting, can not be neglected. Therefore, combinations of analgesics with different mechanisms raise the possibility of developing novel analgesics. Therefore, the aim of the present study was to evaluate whether DW-1021, the ionic complex of pelubiprofen (NSAID) and tramadol (opioid), has synergic antinociceptive and anti-inflammatory effects in nociceptive as well as inflammation-induced nociceptive models compared to pelubiprofen- or tramadol-only administration. Strong synergistic antinociceptive efficacy of DW-1021 was observed in the mouse writhing test and von Frey paw withdrawal threshold test in the carrageenan-induced rats. The hot plate test in mice and the Randall-Selitto mechanical paw pressure test in carrageenan-induced rats revealed that DW-1021 had a preferable effect on relieving pain to pelubiprofen, but not as much as tramadol. In the carrageenan-induced rats, DW-1021 had a more potent effect on reducing paw inflammation (paw volume, width, and thickness) via the suppression of PGE2 production than tramadol, but less than that of pelubiprofen. Taken together, our results suggest that the administration of DW-1021, a combination of pelubiprofen and tramadol, exerted a potent effect and can be used as a potential therapeutic agent for relieving pain and inflammation.

Asunto(s)

Tramadol , Ratas , Ratones , Animales , Tramadol/farmacología , Tramadol/uso terapéutico , Roedores , Carragenina/uso terapéutico , Dolor/tratamiento farmacológico , Dolor/inducido químicamente , Analgésicos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Analgésicos Opioides/uso terapéutico , Inflamación/tratamiento farmacológico

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This corrects the article on p. e95 in vol. 36, PMID: 33783147.

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The production of elemental sulfur from petroleum refining has created a technological opportunity to increase the valorization of elemental sulfur by the creation of high-performance sulfur based plastics with improved thermomechanical properties, elasticity and flame retardancy. We report on a synthetic polymerization methodology to prepare the first example of sulfur based segmented multi-block polyurethanes (SPUs) and thermoplastic elastomers that incorporate an appreciable amount of sulfur into the final target material. This approach applied both the inverse vulcanization of S8 with olefinic alcohols and dynamic covalent polymerizations with dienes to prepare sulfur polyols and terpolyols that were used in polymerizations with aromatic diisocyanates and short chain diols. Using these methods, a new class of high molecular weight, soluble block copolymer polyurethanes were prepared as confirmed by Size Exclusion Chromatography, NMR spectroscopy, thermal analysis, and microscopic imaging. These sulfur-based polyurethanes were readily solution processed into large area free standing films where both the tensile strength and elasticity of these materials were controlled by variation of the sulfur polyol composition. SPUs with both high tensile strength (13-24 MPa) and ductility (348 % strain at break) were prepared, along with SPU thermoplastic elastomers (578 % strain at break) which are comparable values to classical thermoplastic polyurethanes (TPUs). The incorporation of sulfur into these polyurethanes enhanced flame retardancy in comparison to classical TPUs, which points to the opportunity to impart new properties to polymeric materials as a consequence of using elemental sulfur.

RESUMEN

BACKGROUND: Patient-centered management is becoming increasingly important in gout, but there are limited studies exploring patients' perspectives and preferences. We aimed to investigate patients' perspectives and preferences regarding gout and gout management, and their impacts on adherence to urate lowering therapy (ULT). METHODS: A paper-based survey was performed in patients with gout seen at the rheumatology outpatient clinics of 16 tertiary hospitals. The survey included questions regarding demographics, comorbidities, gout attacks, current treatment and adherence, and patients' perspectives and preferences regarding gout and gout management. Multivariate regression analysis was performed to determine the factors associated with ULT adherence. RESULTS: Of 809 surveyed patients with gout, 755 (94.5%) were using ULT. Among those using ULT, 89.1% had ≥ 80% adherence to ULT. Majority of the patients knew management strategies to some extent (94.8%), perceived gout as a life-long disease (91.2%), and were making efforts toward practicing at least one lifestyle modification (89.2%). Most patients (71.9%) obtained information about gout management during their clinic visits. Approximately half of the patients (53.6%) preferred managing their disease with both ULT and lifestyle modification, 28.4% preferred ULT only, and 17.4% preferred lifestyle modification only. Adherence was better in patients with older age (odds ratio [OR], 1.03), those with better knowledge of gout management strategies (OR, 3.56), and those who had preference for ULT (OR, 2.07). CONCLUSION: Patients' perspectives and management preferences had high impacts on adherence to ULT in gout. Consideration of patients' perspectives and preferences is important for achieving the desired clinical outcome in gout.

Asunto(s)

Supresores de la Gota/uso terapéutico , Gota/tratamiento farmacológico , Conocimientos, Actitudes y Práctica en Salud , Prioridad del Paciente , Adulto , Anciano , Anciano de 80 o más Años , Manejo de la Enfermedad , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Atención Dirigida al Paciente , Encuestas y Cuestionarios

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The human oral microbiome refers to an ecological community of symbiotic and pathogenic microorganisms found in the oral cavity. The oral cavity is an environment that provides various biological niches, such as the teeth, tongue, and oral mucosa. The oral cavity is the gateway between the external environment and the human body, maintaining oral homeostasis, protecting the mouth, and preventing disease. On the flip side, the oral microbiome also plays an important role in the triggering, development, and progression of oral and systemic diseases. In recent years, disease diagnosis through the analysis of the human oral microbiome has been realized with the recent development of innovative detection technology and is overwhelmingly promising compared to the previous era. It has been found that patients with oral and systemic diseases have variations in their oral microbiome compared to normal subjects. This narrative review provides insight into the pathophysiological role that the oral microbiome plays in influencing oral and systemic diseases and furthers the knowledge related to the oral microbiome produced over the past 30 years. A wide range of updates were provided with the latest knowledge of the oral microbiome to help researchers and clinicians in both academic and clinical aspects. The microbial community information can be utilized in non-invasive diagnosis and can help to develop a new paradigm in precision medicine, which will benefit human health in the era of post-metagenomics.

RESUMEN

BACKGROUND: There is increasing interest in the quality of health care and considerable efforts are being made to improve it. Rheumatoid arthritis (RA) is a disease that can result in favorable outcomes when appropriate diagnosis and treatment are provided. However, several studies have shown that RA is often managed inappropriately. Therefore, the Korean College of Rheumatology aimed to develop quality indicators (QIs) to evaluate and improve the health care of patients with RA. METHODS: Preliminary QIs were derived based on the existing guidelines and QIs for RA. The final QIs were determined through two separate consensus meetings of experts. The consensus was achieved through a panel of experts who voted using the modified Delphi method. RESULTS: Fourteen final QIs were selected among 70 preliminary QIs. These included early referral to and regular follow-up with a rheumatologist, radiographs of the hands and feet, early initiation and maintenance of disease-modifying anti-rheumatic drug (DMARD) therapy, periodic assessment of disease activity, screening for drug safety and comorbidities, including viral hepatitis and tuberculosis before biologic DMARD therapy, periodic laboratory testing, supplementation with folic acid, assessment of the risk for cervical spine instability before general anesthesia, patient education, and specialized nurse. CONCLUSION: These QIs can be used to assess and improve the quality of health care for patients with RA.

Asunto(s)

Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Indicadores de Calidad de la Atención de Salud , Calidad de la Atención de Salud , Consenso , Manejo de la Enfermedad , Medicina Basada en la Evidencia , Adhesión a Directriz/normas , Humanos , Derivación y Consulta , República de Corea , Reumatología/normas

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OBJECTIVES: The diagnosis of ankylosing spondylitis (AS) is often delayed, which affects various clinical outcomes. This study examined the real-world situation of patients with AS during diagnosis and treatment. METHODS: Data were obtained from 26 tertiary care hospitals in Korea using a self-report questionnaire. The questionnaire assessed symptoms, pain, extra-articular manifestations, the initial pattern of pain before diagnosis, factors leading to delayed referral to rheumatology, time until receiving an AS diagnosis, comorbid diseases, treatment status, and disease education needs. RESULTS: Between September and October 2019, 1012 patients with AS completed the survey. Of these, 75.8% were men and 51.8% were in their 30s or 40s. Median disease duration was 76 months. The median time to diagnosis with AS was 12 months. When pain occurred, the medical departments most frequently visited first were orthopedic (61.5%) and rheumatology (18.7%) departments. The likelihood of the first visit being to the orthopedic department and the frequency of biologics use increased with the disease duration. The rates of uveitis, depressed mood, and comorbid diseases were higher in the group with delayed diagnosis. CONCLUSIONS: Physicians should be aware of subtypes of AS that take longer to diagnose and comorbid diseases in the real-world clinical setting.

Asunto(s)

Autoinforme , Espondilitis Anquilosante , Adulto , Femenino , Humanos , Masculino , República de Corea/epidemiología , Espondilitis Anquilosante/diagnóstico , Espondilitis Anquilosante/epidemiología , Encuestas y Cuestionarios

RESUMEN

INTRODUCTION AND OBJECTIVE: Ankylosing spondylitis (AS) has characteristics of spinal bone bridge and fusion. Although BMD reduction in AS may be presumed to be due to spinal inflammation, this study was designed to confirm whether immobilization of the spine due to syndesmophytes is related to BMD reduction, as immobilization itself is a risk factor for BMD reduction. METHODS: Among male patients diagnosed with AS according to the modified New York criteria, those who underwent bone density tests with quantitative computed tomography (QCT) were retrospectively analyzed through a chart review. The correlation between the presence or absence of bone bridges for each vertebral body level of the L spine confirmed with radiography and BMD confirmed with QCT was analyzed. RESULTS: A total of 47 male patients with AS were enrolled. The mean patient age was 46.8 ± 8.2 years, and the mean disease duration was 7.9 ± 6.4 years. The trabecular BMD of the lumbar spine (L1-L4) ranged from 23.1 to 158.45 mg/cm3 (mean 102.2 ± 37 mg/cm3), as measured with QCT. The lumbar BMD measurements showed that 30 patients (63.8%) had osteopenia or osteoporosis. Bone bridge formation showed a negative correlation with BMD. Low BMD was significantly correlated with bone bridge in the vertebral body (p < 0.05). Positive correlations were observed between bone bridge score and BASMI flexion score, whereas significant negative correlations were found between BMD and BASMI flexion score (p < 0.05). CONCLUSION: Decreased mobility of the vertebrae due to bone bridge formation affects the decrease in BMD in patients with AS.

Asunto(s)

Densidad Ósea , Enfermedades Óseas Metabólicas/patología , Placa de Crecimiento/patología , Vértebras Lumbares/patología , Fracturas de la Columna Vertebral/patología , Espondilitis Anquilosante/complicaciones , Tomografía Computarizada por Rayos X/métodos , Adulto , Enfermedades Óseas Metabólicas/diagnóstico por imagen , Enfermedades Óseas Metabólicas/etiología , Placa de Crecimiento/diagnóstico por imagen , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/lesiones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Fracturas de la Columna Vertebral/diagnóstico por imagen

RESUMEN

PURPOSE: To investigate correlations between myositis-specific autoantibodies (MSA) or myositis-associated antibodies (MAA) and clinical features, thereby demonstrating the utility of clinicoserologic classification in idiopathic inflammatory myopathies (IIM) patients. MATERIALS AND METHODS: We conducted a multicenter study of 108 adult patients (age ≥18 years) who were diagnosed with IIM by Peter and Bohan criteria or 2004 European Neuromuscular Centre (ENMC) criteria. Clinical data were obtained by medical record review. Immunoblot assay with Euroline strip (EUROIMMUN, Germany) was performed using the sera of dermatomyositis (DM, n=56), polymyositis (PM, n=45), amyopathic DM (n=5), DM sine dermatitis (n=1), and immune mediated necrotizing myopathy (n=1) patients. Patients were classified based on two classifications: 2017 EULAR/ACR and novel clinicoserologic classification. RESULTS: According to 2017 EULAR/ACR criteria, DM and PM were the most and the second most frequent entities. Overlap myositis was the major entity of IIM, and the frequency of PM was significantly lower when applying clinicoserologic classification criteria. Sixty-nine (63.9%) patients had one or more MSA, and 61 (56.5%) patients had one or more MAA. Interstitial lung disease was closely associated with anti-MDA5 and anti-ARS, and DM-specific skin lesions were frequently observed in patients with anti-TIF1γ, anti-SRP, and anti-MDA5. CONCLUSION: The clinicoserologic criteria based on MSA/MAA positivity could reflect more precise clinical features of IIM. Establishment of a laboratory system routinely available to screen for MSA/MAA status will be beneficial to provide precise diagnosis and proper management of IIM patients.

Asunto(s)

Enfermedades Autoinmunes , Miositis , Adolescente , Adulto , Autoanticuerpos , Humanos , Miositis/diagnóstico , República de Corea , Estudios Retrospectivos

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has caused more than 100 million infections and 2 million deaths worldwide. In up to 20% of cases, COVID-19 infection can take a severe, life-threatening course. Therefore, preventive measures such as mask-wearing, hand hygiene, and social distancing are important. COVID-19 vaccines that use novel vaccine technology can prevent up to 95% of infections. However, the uncertainty regarding the efficacy and safety of vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), who are immunocompromised due to underlying immune dysfunction and concomitant immunosuppressive treatment, warrants clear guidance. A task force of the Korean College of Rheumatology formulated a set of vaccination guidance based on the currently available data and expert consensus. The currently available COVID-19 vaccines are considered to be safe and effective. Every patient with AIIRD should receive one of the available COVID-19 vaccines unless contraindicated for medical reasons such as prior allergy/anaphylaxis to the COVID-19 vaccine or its components. Patients should continue immunosuppressive treatment for their underlying AIIRD, including biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Corticosteroids should be reduced to the lowest dose possible without aggravating the AIIRD. To improve the vaccine response, methotrexate can be withheld for 1-2 weeks after each vaccination, and the timing of rituximab and abatacept infusion should be adjusted if clinically acceptable. Rheumatologists should play a leading role in educating and vaccinating patients with AIIRD.

Asunto(s)

Enfermedades Autoinmunes/tratamiento farmacológico , Vacunas contra la COVID-19/inmunología , COVID-19/prevención & control , Guías de Práctica Clínica como Asunto , Enfermedades Reumáticas/tratamiento farmacológico , SARS-CoV-2/inmunología , Vacunación , Antirreumáticos/uso terapéutico , Enfermedades Autoinmunes/inmunología , Humanos , Inmunosupresores/uso terapéutico , Enfermedades Reumáticas/inmunología

RESUMEN

For a mechanically tough proton exchange membrane, a composite membrane incorporated with a porous polymer substrate is of great interest to suppress the ionomer swelling and to improve the dimensional stability and mechanical strength of the ionomers. For the composite membranes, good impregnation of substrate-incompatible ionomer solution into the substrate pores still remains one of the challenges to be solved. Here, we demonstrated a facile process (surface treatment with solvents compatible with both substrate and the ionomer solution) for the fabrication of the composite membranes using polytetrafluoroethylene (PTFE) as a porous substrate and poly(arylene ether sulfone) (SPAES) as a hydrocarbon-based (HC) ionomer. Appropriate solvents for the surface treatment were sought through the contact angle measurement, and it was found that alcohol solvents effectively tuned the surface property of PTFE pores to facilitate the penetration of the SPAES/N-methyl-2-pyrrolidone (NMP) solution into ∼300 nm pores of the substrate. Using this simple alcohol treatment, the SPAES/NMP contact angle was reduced in half, and we could fabricate the mechanically tough PTFE/HC composite membranes, which were apparently translucent and microscopically almost void-free composite membranes.