Role of Anti-MCV in Arthritis

Role of Anti-MCV in Arthritis Introduction Rheumatoid arthritis (RA) is characterized by joint inflammation resulting in severe deformity, thus, early management is crucial. At a time, rheumatoid factor (RF) was considered the gold standard for diagnosis, however, more specific and sensitive auto-antibodies have been reported. Antibodies against citrullinated peptides, the peptides modified by the conversion of arginine to citrulline, have then been regarded as specific serological markers for RA (Klareskog et al., 2008; Engelmann et al., 2008). Citrullination is a process of protein unfolding, altering protein structure resulting in aberrant recognition in the immune system. They are thought to be triggered by genes that confer susceptibility to RA and by environmental agents (Klareskog et al., 2008). Anti-cyclic citrullinated peptide (anti-CCP) has been proposed as a good alternative to RF for diagnosis of RA owing to its higher specificity and sensitivity (Sauerland et al., 2005). However, debate exists regarding its specificity in hepatitis C virus (HCV) infection (Riccio et al., 2008; Liu et al., 2008). HCV infection is usually asymptomatic and may be detected incidentally; it induces immunological extrahepatic manifestations including arthralgia and arthritis which can mirror RA, and discrimination would be difficult without observing the erosions (Palazzi et al., 2008). In addition to anti-CCP, anti-mutated citrullinated vimentin (anti-MCV) has gained importance. Vimentin is a protein filament that is expressed by in the synovium. Modification of this protein occurs in macrophages experiencing apoptosis, thus, anti-vimentin antibodies may emerge if the apoptotic material is not adequately removed (Khalifa et al., 2013). Performance of anti-MCV antibodies has been studied mainly in connective tissue diseases (Mutlu et al., 2009; Wagner et al., 2009; Luime et al., 2010), however, no enough data exists regarding its role in discriminating RA from HCV associated arthritis. Research Question What is the role of anti-MCV in differentiating arthritis of rheumatoid origin from that associated with chronic HCV infection? Â  Rationale HCV related arthritis is one of the extrahepatic immunological manifestations of HCV infection and may resemble rheumatoid arthritis (RA). Thus, differentiating patients with HCV associated arthropathy from patients with RA represents diagnostic and therapeutic challenges. Hypothesis The potential role of anti-MCV in discriminating rheumatoid arthritis from HCV associated arthropathy will be assessed in this study. Aim of the Work The aim of this study is to investigate the diagnostic value of anti-MCV in differentiating rheumatoid arthritis (RA) from HCV associated arthropathy. Objectives To measure the level of anti-MCV in rheumatoid patients and chronic HCV patients. To assess the diagnostic performance of anti-MCV in differentiating arthritis of rheumatoid disease and chronic HCV infection. Subjects, Material, and Methods Ethics statement: All procedures will be conducted in accordance with the ethical principles expressed in the Declaration of Helsinki. Written informed consents will be obtained from all patients will be enrolled in the study. Administrative Design: Approval will be obtained from Zagazig University Institutional Review Board (IRB). Subjects: Inclusion criteria: The study will be conducted on 2 groups of patients recruited from Zagazig University Hospitals: Group I will include 30 patients with rheumatoid arthritis (RA) characterized according to the American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) new classification criteria for RA (Aletaha et al., 2010), and negative for anti-HCV antibodies. Group II will include 30 patients with chronic HCV-associated arthropathy positive for HCV antibody and RNA. Exclusion Criteria: Patients with any of the following criteria will be excluded: Positive for HBs-Ag Other connective tissue diseases Chronic infection/inflammation Malignancy Organ transplant Material and Methods: The laboratory section of this part of study will be carried out in the Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University. Clinical division: Demographic data and disease history will be taken from all patients (age, sex, disease duration). Disease activity score (DAS 28) will be calculated for RA patients as per Preevo et al. (1995). Laboratory division: Five ml blood samples will be aseptically collected from both groups. Centrifugation will be done followed by storage at -20Â °C until analysis. All samples will be investigated for anti-MCV and anti-CCP using indirect enzyme linked immunosorbent technique (ELISA). All gathered data will be then statistically analyzed using the appropriate statistical tests.

Creative Story: If At First You Dont Succeed :: essays research papers

Creative Story: If At First You Don't Succeed "Eureka!" Sam excitedly exclaimed. "I've done it! I'm set for life and my happiness is assured. With this new invention I'll be honored for my brilliance, and I might even win the nobel prize!" he chirped ecstatically. Sam was a chicken, the great great great grandson of the Not-So-Great Chixken Little, who, in case the reader is ignorant, was the chick who thought the sky was falling and got everyone eaten by a crafty old fox [SIC]. Sam was a well built chicken, quite muscular in fact, and extremely inventive, but, unfortunately, he had no brains when it came to reality. His motto was: " If at first you don't succeed, try, try again," and he would never give up even if there was no way he could win. To this very day he still has an annual football game against a childhood friend, Bono, who is a prize winning, full grown bull. (In case the reader hasn't discovered it, after every game, Sam has a visit to the hospital where he is an infamous character, continually joked about by the nurses and doctors who work there.) *** "You may see Mr. Monty now, sir," the secretary informed Sam. He nervously eyed the door in front of him. The big, bold lettering stated: MR. JP MONTY EXECUTIVE PRESIDENT Doubts about his ability to make a good impression entered his mind, but Sam immediatly gathered himself together, glanced back at the sheep secretary, and entered the room. THe stately pig sat behind a magnificently carved oak desk in the most luxurious office Sam had ever seen. A plush oriental rug covered the floor from wall to wall, and paintings, pictures, and diplomas adorned the brightly colored walls. Extremely expensive ornaments were conspicuously displayed, spreading a DO-Not-Touch atmosphere around the room. But the room was nothing compared to the pig lounged in the sleek, black, leather chair. He was not fat, he was immense, he had one of those stomachs that literally hung over his waistband. His four chins wiggled like Jell-O as he turned his chubby head to face Sam. "Yeees," Mr. JP Monty stated suggestively. " Sir, this is your lucky day! I am the esteemed architect of the greatest invention of all time, and I have picked you, to invest in it. This will certainly earn you enormous profits ince the public gets ahold of my wonderful creation. What do you say sir? Are you with me or not? I know that if you decide to endorse my idea, then you will be greatly rewarded in the future,

Free Speech Should Not be Restricted -- Argumentative Persuasive Argum

Free Speech Should Not be Restricted I have an idea!   How about we let everyone freely speak their minds about issues and ideas.   Some will be better than others will of course, but the outcome will be a compilation of everyone’s best thoughts.   Everyone that is, except you.   We, meaning the country, decided that whatever it is that you have to say isn’t all that important and it is recommended that you keep all your thoughts to yourself as it is hard not to be offensive to everyone at the same time.   By offensive I mean to displease someone.   In general, no one really likes what you have to say.   Therefore it has been decided that you and only you will be silenced. â€Å"If all mankind minus one, were of one opinion, and only one person were of the contrary opinion, mankind would be no more justified in silencing that one person, than he, if he had the power, would be justified in silencing mankind.†Ã‚   John Stuart Mill could not have been more correct in his statement, using the first paragraph as an example. Walking into any airport, post 9-11, a series security checks is nec...

Good communication skill are essential

The most comprehensive note taking system requires attention on your part to enhance understanding. Effective note taking is an important practice to master at university. When you think of written sources you need to keep in mind that not all of the text is relevant to you. You need to build your skill of thinking and organising ideas by using main ideas and supporting ideas.Note taking can be used in abbreviations and you can create your own abbreviation as long as you are the erson who knows what these abbreviations means as we use many strategies for listening note taking, we can also take notes while we are reading. The good way of note taking in reading is that you can write all the references of the text to make it easier for you when you are reviewing your information later on. One way of being an active reader is by using skimming and scanning. They force you to work with a text anticipating, shaping and predicting the text before and during your eading† (Grellier and Goerke, 2010, p. 14). Another way to improve your reading and extend your understanding by developing a systematic form of annotating that way make you to be more active as a reader also to help you find the information easily when you reviewing the text In order to understand and consider the early childhood current interests, development and learning you need to take notes.As teachers can use these notes to create a complete developmental picture of young children. It can also offer important information for parent/teacher conferences. By developing a system and keeping them objective.

Key Features of Utilitarianism Essay

The theory of Utilitarianism is based on the concept of utility, a theory of usefulness. Utilitarianism is a system of morality that generates us with what the most useful thing to do in different situations and outcomes. Different Utilitarian approaches to morality have emerged each with their own theory of good and community of concerning individuals. Featuring the main influential contributors to this theory are Jeremy Bentham and John Stuart Mill. There are two types of theories, teleological and deontological theories. Firstly for the teleological theory, you would consider the ends, or the outcomes of your decision. It considers whether it is right or wrong depending on the different outcomes it might cause and not concerned with the motive or intention for an action. This is the most common thing to all Utilitarian, the teleological outlook. In this theory, the means justifies the ends. Whereas the deontological theory concentrates on the moral rules that can’t be broken. For this theory, the most important ethical thing isn’t the result or the consequence of the action, but the action itself. If by nature that the action is wrong, then don’t do it. For example, a deontologist could day, ‘You should never steal, this means by the act itself of stealing is wrong. This theory suggests that the end never justifies the means. Introducing Jeremy Bentham, where his theory focuses on weighing up pleasure and pain. In 1789, in Principles of Morals and Legislation, he wrote: Nature has placed mankind under the governance of two sovereign masters, pain and pleasure. It is for them alone to point out what we ought to do as well as what we shall do. This is when the hedonic calculus came into the equation. Its purpose is to weigh up pain and pleasure generated by the available moral actions to find the best option. There are 7 factors that needs to be considered in this calculus before making the decision, starting with its intensity, considering how deep or superficial the happiness is, duration, how temporary or permanent the happiness is, certainty, how sure the happiness is, propinquity, how near or remote the happiness is, fecundity, how likely the happiness is to recur or lead to future happiness, purity, how free from pain the happiness is and extent, how far the happiness-giving effects of action will spread. This suggestion will only help the majority and no the minority. It doesn’t give any protection to the minority, for example the sadistic guards, where the guards gain pleasure from torturing and the helpless prisoner gets pain but there are a higher number of guards comparing to one prisoner. So is it correct to say that what the guards are doing is right? For the calculas, what if someone doesn’t have all the available information for every 7 factors? Will the calculus still be put to use? There’s absolutely no guarantee in predicting the future because everyone is different. Each person has different views even if it’s on the same subject. The calculus is obviously flawed. J. S. Mill on the other hand, felt that Bentham had made a mistake in his assessment of what human beings desired the most. Mill thought that what was more important was that happiness will be most affectively gained when individuals seek their own needs. Mill knows that Bentham’s theory is based on quantitative level and that’s where he saw upcoming errors where human behaviours react to different things change everything. So, instead of focusing on quantity, Mill focuses on the qualitative pleasures. He developed a system of higher and lower pleasures where the higher pleasure would be taken into consideration first before the lower ones. Mill stood up on the fact that pleasures of the mind were higher than those of the body. For example, Mill thought that pure bodily pleasure like food, drink, drugs and sex was not as high an objective as those on an intellectual level. There are two types of utilitarianism, act and rule. For act, the principle of utility is faced individually. All of the acts are decided by the resulting consequences even if it might break the law. It has the benefit of being flexible where the section of justification may vary. Meaning of this is that, one day it might be the right thing to do and another day it might be the wrong thing to do. It is said that the act states the most number of good for the most number of people is generally good. For example, it can be in a form of satisfaction, pleasure and happiness. Act utilitarianism is the application on a case by case basis. It states that, when faced with a choice, we must first consider the likely consequences of potential actions and from that choose to do what we believe will generate the most pleasure.   The problem with this is that we have to take every single thing into account. By every dilemma that we face, we’d have to go through it first then make a decision to act upon it. It is closely associated with Bentham’s theory. For rule utilitarianism, it focuses on general rules that everyone should follow to bring about the greatest good for that community. For example, the rules are pursued by the whole community giving them convenience and reasonable rules to live by which ultimately brings the best result overall. This theory leans closer to Mill’s theory. In any situation, an individual must obey the rule even if it doesn’t lead to the greatest pleasure. By obeying all these rules, it brings the greatest good when everyone acts in the same manner. Now, there are the weak and the strong where the weak utilitarianism doesn’t have to stick by the rules cause they chose not to abide by it therefore when it comes to certain situations, they have a free choice to either follow it or not. For example, although rules should be framed on previous examples that benefit society, it is possible, under specific circumstances, to do what produces the greatest happiness and break that rule. On the other hand, strong utilitarianism is where people never break the rules. So a strong rule utilitarian might say the â€Å"Do not steal† rule must never be broken and they would stick to it even though in some situations, it might be better if they did steal but to them, it’s the wrong thing to do no matter whether it brings them to a better condition. Lastly, there are other forms of Utilitarianism such as the â€Å"Best Interest Utilitarianism† by Peter Singer where he tries to solve the problem that some pleasures are bad for us. Preference Utilitarianism by R. M. Hare where he tries to solve the problem that people have different ideas of pleasure even if it’s something very small and specific, not everyone wants and thinks the same. Ending with Motive Utilitarianism by Sidgwick where he tries to solve the problem of the difficulty of predicting consequences where he elaborates on the inaccuracy of an individual’s chances of guessing what’s going to happen in the future.

Psychological Issue Summary Term Paper Example | Topics and Well Written Essays - 250 words

Psychological Issue Summary - Term Paper Example Irrational thoughts cause depression just as much as depression causes irrational thoughts. I would have a bipolar sufferer talk me through some of the things going through their heads and then suggest that they step into the role of devil's advocate for a moment and provide a counter view to what they perceive. I would use the four column approach to try to indicate to the patient that, no matter what the objective situation, they become depressed and suggest that it is their own thoughts and perceptions that are misleading them. I would then proceed to use behavioral therapy in that vein suggested by the work we did in the cognitive section. I would have them practice behaviors that they typically do when depressed, then work on making those behaviors extinct and replacing them with healthy behaviors. For example: I would have them walk through calling a friend to talk. Finally, it seems that most of the reasons people are depressed are interpersonal. Friends are distant or unfair or non-existent, one isn't dating or is having a bad relationship, one's boss is arbitrary, etc. Worse, there comes to be a cyclical pattern where someone who is depressed alienates people who are optimistic, making a wind tunnel effect and reducing their social circle.

IRAC Brief and Torts Scenario Coursework Example | Topics and Well Written Essays - 500 words

IRAC Brief and Torts Scenario - Coursework Example ly based on the flooding associated with Sandy.† (Butts, 2015) The rule used in deciding the case was from the Executive Order 165 and Order 163 while the insurance policy acted as the agreement document. The plaintiff’s insurance cover excluded the case of losses or damages that were caused indirectly or directly by the floods. It covered only the losses or damages that were caused â€Å"by order of a civil authority as a direct result of a Covered Cause of Loss to property in the immediate area.† (Butts, 2015) Bamundo, Zwal and Schermerhorn main cause of loss was Sandy storm which is a flooding condition. The evacuation was, therefore, not a cause of loss to the plaintiff’s but a precautionary act to avoid further loss. In case, the civil authority acted out of no natural forces to evacuate the plaintiff’s then the case’s verdict would have favored them. The major cause of the loss to the plaintiff is the floods conditions, therefore, the insurance company are not suppose to compensate the plaintiff. The civil authority evacuation order was a precautionary act that whose cause was the flooding condition. The judge’s ruling is right and the facts and arguments that are provided are reasonable and make sense. Personal property is a property that is movable contrary to real estate or real property. In common law it can be referred to as personalty or chattels while in civil law it is called movables or immovable property. It can be classified in the form of tangibles and intangibles, whereby, the tangibles include clothing, furniture and jewelry while intangibles include negotiable instruments and securities (Burke & Snoe, 2008). Real property is a kind of property attached to land directly and includes the land itself (Burke & Snoe, 2008). It includes buildings, other structures, interests and rights. The real property can be categorized as either residential or rental. Intellectual property is a broad group of intangibles that have a company as