| 1. |
- Kaptoge, S., et al.
(författare)
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Whom to treat? The contribution of vertebral X-rays to risk-based algorithms for fracture prediction. Results from the European Prospective Osteoporosis Study
- 2006
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 17:9, s. 1369-1381
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Vertebral fracture is a strong risk factor for future spine and hip fractures; yet recent data suggest that only 5-20% of subjects with a spine fracture are identified in primary care. We aimed to develop easily applicable algorithms predicting a high risk of future spine fracture in men and women over 50 years of age. Methods: Data was analysed from 5,561 men and women aged 50+ years participating in the European Prospective Osteoporosis Study (EPOS). Lateral thoracic and lumbar spine radiographs were taken at baseline and at an average of 3.8 years later. These were evaluated by an experienced radiologist. The risk of a new (incident) vertebral fracture was modelled as a function of age, number of prevalent vertebral fractures, height loss, sex and other fracture history reported by the subject, including limb fractures occurring between X-rays. Receiver Operating Characteristic (ROC) curves were used to compare the predictive ability of models. Results: In a negative binomial regression model without baseline X-ray data, the risk of incident vertebral fracture significantly increased with age [RR 1.74, 95% CI (1.44, 2.10) per decade], height loss [1.08 (1.04, 1.12) per cm decrease], female sex [1.48 (1.05, 2.09)], and recalled fracture history; [1.65 (1.15, 2.38) to 3.03 (1.66, 5.54)] according to fracture site. Baseline radiological assessment of prevalent vertebral fracture significantly improved the areas subtended by ROC curves from 0.71 (0.67, 0.74) to 0.74 (0.70, 0.77) P=0.013 for predicting 1+ incident fracture; and from 0.74 (0.67, 0.81) to 0.83 (0.76, 0.90) P=0.001 for 2+ incident fractures. Age, sex and height loss remained independently predictive. The relative risk of a new vertebral fracture increased with the number of prevalent vertebral fractures present from 3.08 (2.10, 4.52) for 1 fracture to 9.36 (5.72, 15.32) for 3+. At a specificity of 90%, the model including X-ray data improved the sensitivity for predicting 2+ and 1+ incident fractures by 6 and 4 fold respectively compared with random guessing. At 75% specificity the improvements were 3.2 and 2.4 fold respectively. With the modelling restricted to the subjects who had BMD measurements (n=2,409), the AUC for predicting 1+ vs. 0 incident vertebral fractures improved from 0.72 (0.66, 0.79) to 0.76 (0.71, 0.82) upon adding femoral neck BMD (P=0.010). Conclusion: We conclude that for those with existing vertebral fractures, an accurately read spine X-ray will form a central component in future algorithms for targeting treatment, especially to the most vulnerable. The sensitivity of this approach to identifying vertebral fracture cases requiring anti-osteoporosis treatment, even when X-rays are ordered highly selectively, exceeds by a large margin the current standard of practice as recorded anywhere in the world.
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| 2. |
- Anderson, Per, et al.
(författare)
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IL-2 overcomes the unresponsiveness but fails to reverse the regulatory function of antigen-induced T regulatory cells
- 2005
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Ingår i: Journal of Immunology. - 1550-6606. ; 174:1, s. 310-319
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Tidskriftsartikel (refereegranskat)abstract
- Intranasal administration of peptide Acl-9[4Y], based on the N-terminal epitope of myelin basic protein, can induce CD4(+) T cell tolerance, and suppress experimental autoimmune encephalomyelitis induction. The peptide-induced regulatory T (PI-T-Reg) cells failed to produce IL-2, but expressed IL-10 in response to Ag and could suppress naive T cell responses in vitro. Analysis of Jak-STAT signaling pathways revealed that the activation of Jak1, STAT3, and STAT5 were induced in tolerant T cells after Ag stimulation in vivo. In addition, the expression of suppressor of cytokine signaling 3 was induced in tolerant T cells, suggesting that cytokines regulate the tolerant state of the PI-T-Reg cells. Stimulation of PI-T-Reg cells in vitro with IL-10 induced Jak1 and STAT3 activation, but not STAT5, suggesting that IL-10 is important, but not the only cytokine involved in the development of T cell tolerance. Although IL-2 expression was deficient, stimulation with IL-2 in vitro induced Jak1 and STAT5 activation in PI-T-Reg cells, restored their proliferative response to antigenic stimulation, and abrogated PI-T-Reg-mediated suppression in vitro. However, the addition of IL-2 could not suppress IL-10 expression, and the IL-2 gene remained inactive. After withdrawal of IL-2, the PI-T-Reg cells regained their nonproliferative state and suppressive ability. These results underline the ability of the immune system to maintain tolerance to autoantigens, but at the same time having the ability to overcome the suppressive phenotype of tolerant T cells by cytokines, such as IL-2, during the protective immune response to infection.
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| 3. |
- Tenenbaum, E.D., et al.
(författare)
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The 1 mm spectrum of VY Canis Majoris: Chemistry in an O-rich envelope
- 2008
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Ingår i: in Proceedings of "Organic Matter in Space", Hong Kong Feb. 18-22, 2008, IAU symposium 251, eds. S. Kwok, S. Sandfjord, Cambridge University Press. - 9780521889827 ; , s. 171-172
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We present preliminary results of an unbiased spectral survey at 1 mm of the oxygen-rich supergiant, VY CMa. A number of exotic molecules have been detected, including NaC1 and PO, and a relatively rich organic chemistry is observed. Results of the survey will be compared with carbon-rich stars.
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| 4. |
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The Year in Osteoporosis v.2
- 2006
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Osteoporosis has been the subject of a rapid growth in research over the past twenty years. Papers describing recent advances are published in a wide range of journals, reflecting the diversity of clinical and research specialties that are concerned with this disease. The editors of this volume have brought together a multi-disciplinary team to select and critically appraise the important publications of the past eighteen months. Many journals have been scanned to provide the collection of key papers which are evaluated and linked in this book, giving the interested clinician a single volume to browse, and challenge, if necessary. Chapters are grouped around four key topics: epidemiology and pathophysiology, bone mass and measurement, management and prevention, and therapeutic issues. These groupings reflect the editors' evaluation of the areas of greatest publication activity in the period covered. "The Year in Osteoporosis Volume 2" provides an overview of latest advances that will help ensure best practice in the prevention and management of this increasingly prevalent and costly disorder.
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| 5. |
- Walsh, Nicolas E., et al.
(författare)
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Standards of care for acute and chronic musculoskeletal pain: The bone and joint decade (2000-2010)
- 2008
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993. ; 89:9, s. 1830-1845
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Tidskriftsartikel (refereegranskat)abstract
- Musculoskeletal conditions often manifest with the onset of pain and the resulting physical limitations. Musculoskeletal pain is almost inevitable in in individual's lifetime. It is one of the most common reasons for self-medication and entry into the health care system. Musculoskeletal pain affects in 4 adults and is the Most commons Source of serious long-term pain and physical disability. The Monumental impact Of musculoskeletal conditions is now recognized by the United Nations, the World Health Organization, World Bank, and numerous governments throughout the World through Support of the Bone and Joint Decade 2000 to 2010 initiative. Individuals With musculoskeletal pain concerns are regularly ignored. their complaints often Misunderstood by health care providers, and accordingly they do not receive timely or effective treatment. The standards of care in this document are designed to provide generic guidelines for appropriate care of people with acute or chronic musculoskeletal pain, This document was developed over a 4-year period using Multiple international meetings and a Task Force of the Bone and Joint Decade for developing international standards for the care of acute and chronic musculoskeletal pain. The final document is a product of the World Health Organization Collaborating Centre for Evidence-Based Health Care ill Musculoskeletal Disorders.
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| 6. |
- Woolf, A D, et al.
(författare)
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The patient with osteoporosis
- 2006
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Ingår i: Osteoporosis and the osteoporosis of rheumatid disease. - 9780323034371 - 0323034373 ; , s. 55-55
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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