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Background: During the post-World War II occupation of Austria, approximately 20,000-30,000 'children born of war' (CBOW), also called occupation children were born through intimate contacts between Austrian women and occupation soldiers. Research on other CBOW populations indicates that CBOW mostly grow up under difficult conditions, sometimes with strong long-term mental health consequences.Objective: To examine whether comparable psychosocial consequences can be found in Austrian occupation children (AOC), a first quantitative study was carried out.Method: Child maltreatment, post-traumatic stress disorder, depression and somatization, and general life satisfaction were assessed in a sample of 98 AOC using self-report instruments. Results were compared to a sample of German occupation children (GOC; N = 146).Results: High prevalence of above threshold full (10.2%) and partial (14.3%) PTSD, somatic (16.3%) and depressive (11.1%) symptomatology were found in AOC. They were at high risk of child maltreatment (e.g. emotional abuse: 53.6%), which was associated with current symptomatology. Notably, AOC tended to report high levels of general life satisfaction. No differences were found between GOC and AOC.Conclusions: Findings highlight the complex and long-term effects of developmental conditions and childhood maltreatment on mental health of CBOW, even decades later. Findings of high life satisfaction provide evidence of resilience and maturation processes across the lifespan.
Austrian occupation children show a notable vulnerability to childhood maltreatment and its long-term consequences, including a high prevalence of above threshold PTSD, somatic, and depressive symptomatology.Findings on the psychosocial consequences of growing up as occupation children in Austria after World War II are consistent with previous studies in similar populations and can be generalized as more or less typical common experiences of children born of war.Despite psychological distress, occupation children showed surprising levels of life satisfaction, suggesting potential resilience.
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Maltrato a los Niños , Depresión , Trastornos por Estrés Postraumático , Humanos , Austria , Femenino , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/epidemiología , Masculino , Niño , Depresión/psicología , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Segunda Guerra Mundial , Prevalencia , Personal Militar/psicología , Personal Militar/estadística & datos numéricos , Satisfacción Personal , AdolescenteRESUMEN
What are social niches, and how do they arise and change? Our first goal in the present article is to clarify the concept of an individualized social niche and to distinguish it from related concepts, such as a social environment and a social role. We argue that focal individuals are integral parts of individualized social niches and that social interactions with conspecifics are further core elements of social niches. Our second goal in the present article is to characterize three types of processes-social niche construction, conformance, and choice (social NC3 processes)-that explain how individualized social niches originate and change. Our approach brings together studies of behavior, ecology, and evolution and integrates social niches into the broader concept of an individualized ecological niche. We show how clarifying the concept of a social niche and recognizing the differences between the three social NC3 processes enhance and stimulate empirical research.
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The term 'environment' is not uniformly defined in the public health sciences, which causes crucial inconsistencies in research, health policy, and practice. As we shall indicate, this is somewhat entangled with diverging pathogenic and salutogenic perspectives (research and policy priorities) concerning environmental health. We emphasise two distinct concepts of environment in use by the World Health Organisation. One significant way these concepts differ concerns whether the social environment is included. Divergence on this matter has profound consequences for the understanding of health and disease, for measures derived from that understanding targeting health promotion and disease prevention, and consequently, for epistemic structures and concept development in scientific practice. We hope to improve the given situation in public health by uncovering these differences and by developing a fruitful way of thinking about environment. Firstly, we side with the salutogenic conception of environment as a health resource (as well as a source of health risks). Secondly, we subdivide the concept of environment into four health-oriented environmental categories (viz., natural, built-material, socio-cultural, and psychosocial) and we link these with other theoretical notions proposed in the health sciences literature. Thirdly, we propose that in public health 'environment' should be understood as consisting of all extrinsic factors that influence or are influenced by the health, well-being, and development of an individual. Consequently, none of the four categories should be excluded from the concept of environment. We point out the practical relevance and fruitfulness of the conception of environment as a health source and frame this in causal terms, representing individual health environments as causal networks. Throughout, we side with the view that for the design of human health-promoting settings, increased attention and consideration of environmental resources of salutogenic potential is particularly pressing.
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Salud Pública , Humanos , Medio Social , Ambiente , Salud Ambiental , Política de Salud , Promoción de la SaludRESUMEN
Organisms interact with their environments in various ways. We present a conceptual framework that distinguishes three mechanisms of organism-environment interaction. We call these NC3 mechanisms: niche construction, in which individuals make changes to the environment; niche choice, in which individuals select an environment; and niche conformance, in which individuals adjust their phenotypes in response to the environment. Each of these individual-level mechanisms affects an individual's phenotype-environment match, its fitness, and its individualized niche, defined in terms of the environmental conditions under which the individual can survive and reproduce. Our framework identifies how individuals alter the selective regimes that they and other organisms experience. It also places clear emphasis on individual differences and construes niche construction and other processes as evolved mechanisms. The NC3 mechanism framework therefore helps to integrate population-level and individual-level research.
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To improve the reliability of the quantitative scorings of the synovial biopsies, we evaluate whether diameter of arthroscopic forceps influences histological quality of synovial tissue and/or histological scores and we compare the intra- and inter-observer performances of the main histological scoring systems. Synovial biopsies were retrieved in the same part of the joint using 1, 2 and 4 mm diameters grasping forceps. After standard staining and immunohistochemistry with anti-CD68 antibody, slides were scored blindly by 2 independent experienced operators for tissue quality and with Krenn score, de Bois-Tak score and CD68 semi-quantitative score. Four samples did not pass quality control. No difference other than a higher number of vessels in the 4 mm versus 2 mm forceps (p = 0.01) was found among the 3 groups. CD68 score was significantly higher in the 2 versus 4 mm forceps (p = 0.009). So we concluded that only vessels quantification and CD68 semi-quantitative score seemed affected by the forceps size. The intra-reader agreement was variable across observers and features: 0.78 (0.66-0.87) for the Krenn scoring system, 0.89 (0.78-0.97) for the de Bois-Tak score and 0.93 (0.81-1.00) for the CD68 score. Interobserver reliabilities of Krenn score, de Bois-Tak score and CD68 scores were satisfactory: 0.95 (0.92-0.99) for Krenn, 0.98 (0.96-0.99) for de Bois-Tak and 0.80 (0.71-0.89) for CD68.
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Instrumentos Quirúrgicos , Membrana Sinovial , Biopsia , Recuento de Células , Humanos , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Membrana Sinovial/patologíaRESUMEN
INTRODUCTION: Apremilast is approved for the treatment of psoriasis and psoriatic arthritis (PsA). Real-world evidence on the efficacy and safety of apremilast in clinical practice is limited. We assessed the use of apremilast in patients with PsA in Belgium clinical practice. METHODS: The multicentre, observational, prospective APOLO study enrolled patients with active PsA initiating apremilast in Belgium between April 2017 and December 2018. Primary outcome was PsA Response Criteria (PsARC) after 6 months of apremilast treatment. Secondary outcomes included PsA Impact of Disease 12 (PsAID12) and Health Assessment Questionnaire Disability Index (HAQ-DI). Disease-specific outcomes and patient-reported outcomes (PROs) were analysed for patients who received apremilast within 30 days prior to their study inclusion and completed at least 150 days of treatment (reference set [REF]). RESULTS: Of 107 patients enrolled in the study, 106 received at least one dose of apremilast and 69 were included in the REF. PsARC response was achieved by 43.5% of patients (30/69) in the REF at month 6; mean global and composite scores including 68-joint count for pain/tenderness (68-TJC) and 66-joint count for swelling (66-SJC) improved, and 27% and 42% of patients with 68-TJC and 66-SJC > 0 at baseline had complete joint count resolution, respectively. Mean global and composite PsAID12 and HAQ-DI scores decreased at 6 months, indicating improved quality of life. Apremilast was well tolerated and the reported adverse events were in line with the known safety profile. CONCLUSION: Results from the APOLO study indicate that treatment with apremilast in Belgian clinical practice improves the signs and symptoms of PsA as well as patient quality of life. CLINICALTRIALS. GOV IDENTIFIER: NCT03096990.
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Artritis Psoriásica , Antiinflamatorios no Esteroideos/efectos adversos , Artritis Psoriásica/diagnóstico , Artritis Psoriásica/tratamiento farmacológico , Bélgica , Humanos , Estudios Prospectivos , Calidad de Vida , Talidomida/análogos & derivados , Resultado del TratamientoRESUMEN
An inflamed synovial membrane plays a major role in joint destruction and is characterized by immune cells infiltration and fibroblast proliferation. This proteomic study considers the inflammatory process at the molecular level by analyzing synovial biopsies presenting a histological inflammatory continuum throughout different arthritis joint diseases. Knee synovial biopsies were obtained from osteoarthritis (OA; n = 9), chronic pyrophosphate arthropathy (CPPA; n = 7) or rheumatoid arthritis (RA; n = 8) patients. The histological inflammatory score was determined using a semi-quantitative scale based on synovial hyperplasia, lymphocytes, plasmocytes, neutrophils and macrophages infiltration. Proteomic analysis was performed by liquid chromatography-mass spectrometry (LC-MS/MS). Differentially expressed proteins were confirmed by immunohistochemistry. Out of the 1871 proteins identified and quantified by LC-MS/MS, 10 proteins (LAP3, MANF, LCP1, CTSZ, PTPRC, DNAJB11, EML4, SCARA5, EIF3K, C1orf123) were differentially expressed in the synovial membrane of at least one of the three disease groups (RA, OA and CPPA). Significant increased expression of the seven first proteins was detected in RA and correlated to the histological inflammatory score. Proteomics is therefore a powerful tool that provides a molecular pattern to the classical histology usually applied for synovitis characterization. Except for LCP1, CTSZ and PTPRC, all proteins have never been described in human synovitis.
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Artritis/inmunología , Artritis/patología , Proteínas/metabolismo , Membrana Sinovial/inmunología , Membrana Sinovial/patología , Anciano , Artritis Reumatoide/inmunología , Artritis Reumatoide/patología , Biopsia , Condrocalcinosis , Femenino , Humanos , Inmunohistoquímica , Masculino , Espectrometría de Masas , Persona de Mediana Edad , ProteómicaRESUMEN
It is now well recognized that osteoarthritis (OA) synovial membrane presents inflammatory components. The aim of this work is to provide evidence that similar inflammatory mechanisms exist in synovial membrane (n = 24) obtained from three pathologies presenting altogether an inflammatory gradient: OA, chronic pyrophosphate arthropathy (CPPA) and rheumatoid arthritis (RA). Synovial biopsies were first characterized by a histological score based on synovial hyperplasia and infiltration of lymphocytes, plasma cells, polymorphonuclear and macrophages. All biopsies were also analyzed by 2D-nano-UPLC-ESI-Q-Orbitrap for protein identification and quantification. Protein levels were correlated with the histological score. Histological score was in the range of 3 to 8 for OA, 5 to 13 for CPPA and 12 to 17 for RA. Of the 4,336 proteins identified by mass spectrometry, 51 proteins were selected for their strong correlation (p < 0.001) with the histological score of which 11 proteins (DNAJB11, CALR, ERP29, GANAB, HSP90B1, HSPA1A, HSPA5, HYOU1, LMAN1, PDIA4, and TXNDC5) were involved in the endoplasmic reticulum (ER) stress. Protein levels of S100A8 and S100A9 were significantly higher in RA compared to OA (for both) or to CPPA (for S100A8 only) and also significantly correlated with the histological score. Eighteen complement component proteins were identified, but only C1QB and C1QBP were weakly correlated with the histological score. This study highlights the inflammatory gradient existing between OA, CPPA and RA synovitis either at the protein level or at the histological level. Inflamed synovitis was characterized by the overexpression of ER stress proteins.
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Artritis Reumatoide/patología , Condrocalcinosis/patología , Estrés del Retículo Endoplásmico , Mediadores de Inflamación/metabolismo , Osteoartritis/patología , Proteínas/metabolismo , Sinovitis/patología , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/inmunología , Artritis Reumatoide/metabolismo , Biomarcadores/análisis , Biomarcadores/metabolismo , Condrocalcinosis/inmunología , Condrocalcinosis/metabolismo , Difosfatos/metabolismo , Chaperón BiP del Retículo Endoplásmico , Femenino , Humanos , Inflamación/inmunología , Inflamación/metabolismo , Inflamación/patología , Masculino , Persona de Mediana Edad , Osteoartritis/inmunología , Osteoartritis/metabolismo , Proteínas/análisis , Proteoma/análisis , Proteoma/metabolismo , Estudios Retrospectivos , Sinovitis/inmunología , Sinovitis/metabolismoRESUMEN
This paper examines a specific kind of part-whole relations that exist in the molecular genetic domain. The central question is under which conditions a particular molecule, such as a DNA sequence, is a biological part of the human genome. I address this question by analyzing how biologists in fact partition the human genome into parts. This paper thus presents a case study in the metaphysics of biological practice. I develop a metaphysical account of genomic parthood by analyzing the investigative and reasoning practices in the ENCODE (ENCyclopedia Of DNA Elements) project. My account reveals two conditions that determine whether a molecule is a part of the human genome (i.e., a genomic part). First, genomic parts must possess a causal role function in the genome as a whole, that is, their functions must contribute to the genome directing the overall functioning of the cell. Second, genomic parts must have a specific chemical structure and be actual segments of the DNA sequence of the genome.
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Genoma Humano , Metafisica , Anotación de Secuencia Molecular , Transcripción Genética , Genómica , HumanosRESUMEN
BACKGROUND: 18F-FDG PET/CT has been proposed in the evaluation of the disease activity in rheumatoid arthritis (RA). The goals of this study were to evaluate the reproducibility of the technique, to compare metabolic parameters to clinical, biological and ultrasonographic parameters before and after treatment and to evaluate whether the early metabolic response was related to the outcome. 18F- FDG PET/CT of the hands, wrists and knees was obtained in 15 patients with anti-TNFα refractory RA, at baseline and 16 weeks after treatment with rituximab. The number of PET-positive joints (PET+ joints), the cumulative standard uptake value (cSUV) and the composite index (CI) were defined. The composite clinical index DAS28, CRP serum levels and the number of joints positive at ultrasonography (US+ joints) and the cumulative synovial thickness (CST) were also assessed at baseline and week 24. RESULTS: High interobserver agreement was observed, both at baseline and after treatment. The number of PET+ joints was not correlated with the number of joints tender or swollen. The 3 metabolic parameters were strongly correlated with US, CRP and DAS28 at baseline and with US and CRP (CSUV, CI) at week 16, but no longer with the DAS28 index. The metabolic response based on the change in the visual PET/CT joint analysis predicted the outcome with a high negative predictive value of 91%, with a 91% specificity, and an 86% accuracy. CONCLUSIONS: These preliminary data suggest that 18F- FDG PET/CT is a reproducible and accurate tool for evaluating disease activity in refractory rheumatoid arthritis and its non-response to rituximab. The correlation obtained with US joint assessment gives relevance to objective diseased joints through imaging techniques.
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BACKGROUND: Children born of war are a phenomenon of every conflict. At the end of World War II and thereafter, approximately 400,000 children were fathered by foreign soldiers and born to local women in Germany. Quantitative research on psychosocial consequences of growing up as German occupation child (GOC) has been missing so far. METHODS: This study examines adult attachment and its association with current depression in GOC (N = 146) using self-report instruments: Adult Attachment Scale, Patient Health Questionnaire. Data were compared to a birth-cohort-matched representative sample of the German population (BCMS; N = 786). RESULTS: GOC differ in both attachment dimensions (less comfortable with closeness/intimacy, lowered ability to depend on others) and adult attachment (more dismissive and fearful) compared to BCMS. Insecure adult attachment is associated with current depression. CONCLUSION: GOC grew up under difficult circumstances (e.g. poverty, adverse events, and stigmatization). Even decades later they display more insecure attachment in current relationships. Findings underline the complex and long-term impact of their developmental conditions on attachment and current mental health.
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Adultos Sobrevivientes de Eventos Adversos Infantiles/psicología , Depresión , Acontecimientos que Cambian la Vida , Apego a Objetos , Segunda Guerra Mundial , Adulto , Niño , Depresión/diagnóstico , Depresión/epidemiología , Depresión/psicología , Femenino , Alemania/epidemiología , Humanos , Masculino , Técnicas PsicológicasRESUMEN
BACKGROUND: Children born of war are a common phenomenon of conflict. In the aftermath of World War II, more than 200,000 German occupation children (GOC) were fathered by occupation soldiers and born to local women. GOC often grew up under difficult conditions and showed high prevalence rates of mental disorders even decades later. METHODS: Experiences of childhood maltreatment and their association with Posttraumatic Stress Disorder (PTSD), depression, and somatization in GOC (N = 146) are investigated and compared with a representative birth-cohort-matched sample (BCMS) from the German general population (N = 920). RESULTS: Outcomes show significantly higher prevalence rates of emotional abuse/neglect, physical, and sexual abuse in GOC compared to BCMS. All five subtypes of childhood maltreatment increase the risk of PTSD and somatoform syndrome; depressive syndromes are associated with emotional abuse/neglect and physical abuse. GOC were at high risk of childhood maltreatment. CONCLUSIONS: Findings underline the complex, long-term impact of developmental conditions and childhood maltreatment on mental disorders even decades later.
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Maltrato a los Niños/estadística & datos numéricos , Depresión/epidemiología , Trastornos Somatomorfos/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Segunda Guerra Mundial , Anciano , Niño , Maltrato a los Niños/psicología , Depresión/etiología , Femenino , Alemania/epidemiología , Encuestas Epidemiológicas , Historia del Siglo XX , Humanos , Modelos Lineales , Modelos Logísticos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Padres Solteros/psicología , Trastornos Somatomorfos/etiología , Estereotipo , Trastornos por Estrés Postraumático/etiología , Violencia/historia , Violencia/psicologíaRESUMEN
High levels of mental disorders, especially PTSD, are commonly known among groups of people forced to leave their homeland as a consequence of war-related experiences (e. g. armed conflict, torture or persecution). Depending on the cultural background the perceptions of illnesses vary, different symptom presentation and thereupon different coping strategies respectively expectations towards health care services exist. To minimize the danger of misdiagnosis by different experts working with refugees in the host countries, a culture-sensitive diagnostic approach is needed from the beginning. This article describes important aspects of culture-sensitive diagnostics by means of 2 commented case reports. Special focus is set on the aspect of linguistic and in a broader sense cultural comprehension between therapist, client and if necessary language mediator.
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Asistencia Sanitaria Culturalmente Competente , Cultura , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Refugiados/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Adulto , Barreras de Comunicación , Femenino , Alemania , Humanos , Acontecimientos que Cambian la Vida , Masculino , Trastornos Mentales/etnología , Relaciones Médico-Paciente , Prejuicio , Identificación Social , Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/etnología , Trastornos Somatomorfos/psicología , Trastornos por Estrés Postraumático/etnología , Ideación Suicida , TraducciónRESUMEN
At the end of World War II and during the first decade after the war, roughly 200,000 children were fathered in intimate contacts between German women and foreign soldiers. The experiences of these German occupation children (GOC) have been so far described in case reports and from historical perspective only. Research on psychosocial consequences of growing up as a GOC has been missing so far. This study examined traumatic experiences, posttraumatic stress disorder, somatization, and depression in GOC (N = 146) using self-report instruments: Posttraumatic Diagnostic Scale and Patient Health Questionnaire. Findings have then been compared with a representative birth cohort-matched sample from the German general population (N = 977). German occupation children showed significantly higher prevalence rates of most traumatic experiences, higher point prevalence rates of full and partial posttraumatic stress disorder, depression, and somatization than the control group. In summary, GOC often grew up under difficult conditions (e.g., poverty, single mothers, and stigmatization). Even decades later, they showed higher rates of different mental disorders and higher comorbidity. These findings underline the complex and long-term impact of their burdened social, financial, and familial conditions. The results underpin the importance of conceptualizing occupation children as a vulnerable group in postconflict settings.
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Depresión/epidemiología , Trastornos Somatomorfos/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Segunda Guerra Mundial , Depresión/etiología , Femenino , Alemania/epidemiología , Historia del Siglo XX , Humanos , Masculino , Persona de Mediana Edad , Pobreza/psicología , Pobreza/estadística & datos numéricos , Prevalencia , Escalas de Valoración Psiquiátrica , Padres Solteros/psicología , Padres Solteros/estadística & datos numéricos , Trastornos Somatomorfos/etiología , Estereotipo , Trastornos por Estrés Postraumático/etiología , Encuestas y Cuestionarios , Violencia/historia , Violencia/psicologíaRESUMEN
OBJECTIVE: The purpose of this study was to compare tomosynthesis with radiography for the detection of bone erosions of the foot in patients with established rheumatoid arthritis (RA) using MDCT as a reference standard. SUBJECTS AND METHODS: Eighteen consecutive patients with established RA were included. Each patient underwent radiography, tomosynthesis, and CT examinations of the feet on the same day. Two radiologists independently determined the number of bone erosions and the Sharp-van der Heijde score with each of the three imaging modalities. RESULTS: On a total of 216 joints from 18 patients, 216 bone erosions were detected on CT, 215 on tomosynthesis, and 181 with radiography. The mean (± SD) Sharp-van der Heijde score was equivalent for tomosynthesis (18.8 ± 16.8) and CT (19.8 ± 18.5) but was statistically lower for radiography (16.4 ± 18.0) (p = 0.030). The respective overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for tomosynthesis were 80%, 75%, 78%, 76%, and 80%, whereas the respective corresponding values for radiography were 66%, 81%, 74%, 77%, and 71%. The radiation burden of tomosynthesis was almost equivalent to that of radiography. CONCLUSION: Tomosynthesis has a higher sensitivity than radiography to detect bone erosions of the foot in patients with established RA and imparts an almost equivalent radiation burden.
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Artritis Reumatoide/complicaciones , Deformidades Adquiridas del Pie/diagnóstico por imagen , Intensificación de Imagen Radiográfica/métodos , Femenino , Deformidades Adquiridas del Pie/patología , Humanos , Masculino , Persona de Mediana Edad , Interpretación de Imagen Radiográfica Asistida por Computador , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
STUDY DESIGN: Clinical measurement. PURPOSE: The test-retest reliability of maximal grip strength measurements (MGSM) is examined in subjects for 12 weeks post-stroke together with maximal grip strength recovery and the maximal-grip and upper-extremity strength measurements' relationship with capacity and performance test scores. METHODS: A Jamar dynamometer and the Motricity Index (MI) were used for strength measurements. The Chedoke Arm and Hand Activity Inventory and ABILHAND questionnaire for evaluating capacities and performances. RESULTS: MGSM were reliable (Intraclass Correlation Coefficients = 0.97-0.99, Minimal Detectable Differences = 2.73-4.68 kg). Among the 34 participants, 47% did not have a measurable grip strength one week post-stroke but 50% of these recovered some strength within the first eight weeks. The MGSM and MI scores were correlated with scores of tests of capacity and performance (Spearman's Rank Correlation Coefficients = 0.69-0.94). CONCLUSIONS: MGSM are reliable in the first weeks after a stroke. LEVEL OF EVIDENCE: N/A.
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Fuerza de la Mano/fisiología , Recuperación de la Función/fisiología , Accidente Cerebrovascular/fisiopatología , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dinamómetro de Fuerza Muscular , Reproducibilidad de los Resultados , Rehabilitación de Accidente CerebrovascularRESUMEN
OBJECTIVES: To date the experiences of German occupation children (GOC) have been described solely in historical studies; empirical research on the psychosocial consequences growing up as German occupation children was missing. This paper provides an introduction to the background, methodological approaches and descriptive information on a sample for the first German-based empirical study on this topic. It also touches on methodical challenges and solution processes. METHODS: Children born of war resemble a target group that is difficult to reach (hidden population). Therefore, an investigation needs consultation of both people from the target group and scientific experts (participatory approach) as well as specific methodological approaches. The questionnaire utilized contains adaptations of established and psychometrically validated instruments as well as adapted self-developed items. N = 146 occupation children were surveyed (mean age 63.4, 63.0% women) via press release and contact to platforms of children born of war. SUMMARY: Despite methodological challenges an instrument to assess the target group was developed through participatory methods. The instrument shows high relevance for the target group and is highly accepted. High rates of American and French participants show the influence of networking in platforms on successful recruitment.
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Adaptación Psicológica , Sistemas Políticos , Terapia Psicoanalítica , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Sobrevivientes/psicología , Segunda Guerra Mundial , Adolescente , Adulto , Anciano , Niño , Preescolar , Investigación Participativa Basada en la Comunidad , Padre/psicología , Femenino , Alemania , Humanos , Ilegitimidad , Masculino , Persona de Mediana Edad , Personal Militar/psicología , Psicometría/estadística & datos numéricos , Estigma Social , Trastornos por Estrés Postraumático/terapia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Import of secretory proteins into the Endoplasmic Reticulum (ER) is an established function of the Sec61 channel. The contribution of the Sec61 channel to export of misfolded proteins from the ER for degradation by proteasomes is still controversial, but the proteasome 19S regulatory particle (RP) is necessary and sufficient for extraction of specific misfolded proteins from the ER, and binds directly to the Sec61 channel. In this work we have identified an import-competent sec61 mutant, S353C, carrying a point mutation in ER-lumenal loop 7 which reduces affinity of the cytoplasmic face of the Sec61 channel for the 19S RP. This indicates that the interaction between the 19S RP and the Sec61 channel is dependent on conformational changes in Sec61p hinging on loop 7. The sec61-S353C mutant had no measurable ER import defects and did not cause ER stress in intact cells, but reduced ER-export of a 19S RP-dependent misfolded protein when proteasomes were limiting in a cell-free assay. Our data suggest that the interaction between the 19S RP and the Sec61 channel is essential for the export of specific substrates from the ER to the cytosol for proteasomal degradation.
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Degradación Asociada con el Retículo Endoplásmico , Proteínas de Transporte de Membrana/metabolismo , Complejo de la Endopetidasa Proteasomal/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/metabolismo , Proteínas de Transporte de Membrana/análisis , Proteínas de Transporte de Membrana/genética , Mutación Puntual , Canales de Translocación SEC , Saccharomyces cerevisiae/citología , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/análisis , Proteínas de Saccharomyces cerevisiae/genéticaRESUMEN
OBJECTIVE: Our study reports the results of the MIRA (MabThera In Rheumatoid Arthritis) registry, set up to collect data about clinical usage, patient profile, and retention of rituximab (RTX) treatment in daily clinical practice in Belgium. METHODS: Patients with active rheumatoid arthritis (RA) who failed at least 1 anti-tumor necrosis factor (anti-TNF) treatment were included in our study between November 2006 and October 2011. At baseline, demographics, medication, disease history, disease activity, rheumatoid factor (RF), and anticyclic citrullinated peptide antibodies (anti-CCP) status were recorded. Evolution of the 28-joint Disease Activity Score (DAS28)-erythrocyte sedimentation rate, retreatments, and reasons for therapy stop were followed prospectively. RESULTS: The MIRA registry included 649 patients, with mean disease duration of 12.8 ± 0.4 years and DAS28 values at inclusion of 5.85 ± 0.48. Patients received on average 2.82 ± 0.07 (range 1-9) RTX treatments, over a mean followup period of 93.1 ± 2.6 weeks. At database lock, 433 patients (66.7%) were still under RTX treatment, 182 (28.0%) had stopped treatment, and 34 (5.2%) were lost to followup. Ineffectiveness (n = 108, 59%) and safety concerns (n = 39, 22%) were the most frequent reasons for discontinuing RTX therapy. From 2006 to 2011, RTX practice patterns clearly evolved toward RTX being started in patients with a lower number of previously failed anti-TNF drugs and lower baseline DAS28 values. A lower number of previous anti-TNF drugs, and positivity for RF and anti-CCP, predicted more successful longterm treatment. RTX treatment provided adequate longterm disease control. CONCLUSION: In our daily practice study, RTX provided good longterm disease control and treatment retention in refractory patients with RA. Over the years, rheumatologists tended to start this treatment in patients with fewer previous anti-TNF treatments and lower disease activity.
Asunto(s)
Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Retratamiento , Rituximab , Resultado del TratamientoRESUMEN
OBJECTIVES: Even 60 years after World War II, the German elderly population is significantly more often affected by posttraumatic symptomatology compared to the younger cohorts. This study is addressing prevalence rates of posttraumatic symptomatology and its comorbidity with depression and somatisation. METHODS: This study examines posttraumatic stress disorder (PTSD) according to DSM-IV, partial PTSD, depression and somatisation in a randomly selected sample of the German general population aged 60-85 years (N = 1.659) using self-rating instruments (Patient Health Questionnaire, PHQ; Post Traumatic Diagnostic Scale, PTDS). RESULTS: One-month prevalence rate was 4.0% for DSM-IV PTSD; another 12.2% fulfilled the criteria of partial PTSD. A significant increase across the age groups was found for partial PTSD. 11.5% of the persons affected by posttraumatic symptomatology fulfil the criteria of a somatoform syndrome, 8.6% fulfil the criteria of major depression and 10.4% fulfil the criteria of other depressive syndromes according to the PHQ. A current posttraumatic symptomatology is associated with increased prevalence rates of somatoform and depressive disorders. Moreover, traumatic experiences without a current PTSD are associated with increased rates of somatoform disorders. CONCLUSION: Posttraumatic symptomatology is a common phenomenon in the German elderly population. Especially, subsyndromal disorders are very common and increasing across the age groups. Posttraumatic symptomatology is associated with an increased risk of depressive and somatoform disorders. As posttraumatic symptoms are often neglected in geriatric health care, future effort should address the recognition and treatment of posttraumatic symptoms in elderly patients.