There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality.

Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

I and i

Prospective Cohort Study

ALAT
: alanine aminotransferase
ASAT
: aspartate aminotransferase
APAH
: associated pulmonary arterial hypertension
BAS
: balloon atrial septostomy
BMPR2
: bone morphogenetic protein receptor 2
BNP
: brain natriuretic peptide
BPA
: balloon pulmonary angioplasty
BREATHE
: Bosentan

/pdf/2015-esc-ers-guidelines-for-the-diagnosis-and-treatment-of-y26yabnnom.pdf

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).

In this article, the 2010 European League against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological disease-modifying antirheumatic drugs (sDMARDs and bDMARDs, respectively) have been updated. The 2013 update has been developed by an international task force, which based its decisions mostly on evidence from three systematic literature reviews (one each on sDMARDs, including glucocorticoids, bDMARDs and safety aspects of DMARD therapy); treatment strategies were also covered by the searches. The evidence presented was discussed and summarised by the experts in the course of a consensus finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) were determined. Fourteen recommendations were developed (instead of 15 in 2010). Some of the 2010 recommendations were deleted, and others were amended or split. The recommendations cover general aspects, such as attainment of remission or low disease activity using a treat-to-target approach, and the need for shared decision-making between rheumatologists and patients. The more specific items relate to starting DMARD therapy using a conventional sDMARD (csDMARD) strategy in combination with glucocorticoids, followed by the addition of a bDMARD or another csDMARD strategy (after stratification by presence or absence of adverse risk factors) if the treatment target is not reached within 6 months (or improvement not seen at

/pdf/eular-recommendations-for-the-management-of-rheumatoid-4fujp4paik.pdf

EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update

Updated clinical classification of pulmonary hypertension.

Stellenwert sportlicher Betätigung zur Prävention und Therapie der Osteoporose - eine aktuelle Übersicht

Lange Zeit schienen die meisten Infektionen beherrschbar geworden zu sein. Hierzu haben besonders auch Impfungen beigetragen. In den letzten Jahren gefahrden neu aufgetretene bakterielle Infektionen durch multiresistente Erreger und Virusinfektionen wie das Chikungunya-Virus, Influenzaepidemien oder aktuell auch COVID-19 die Weltbevolkerung. Dies gilt in besonderer Weise fur von rheumatologischen Erkrankungen Betroffene, die oft zusatzlich einer immunsuppressiven Therapie bedurfen und damit besonders durch Infektionen gefahrdet sind. Impfungen konnen die Betroffenen sowohl individuell wie auch durch die Erzeugung einer Herdenimmunitat schutzen und stellen somit ein wichtiges Instrument dar, um die Morbiditat und Mortalitat durch Infektionen zu vermindern. Die Kenntnis uber Indikation und Anwendung der einzelnen Impfungen ist fur eine konsequente Umsetzung der aktuellen Empfehlungen besonders wichtig.

/pdf/most-important-vaccinations-in-patients-with-rheumatological-3gew2xc833.pdf

Most important vaccinations in patients with rheumatological diseases and why

Background In mammals tissue destruction often results in fibrotic scar tissue formation, which significantly impairs organ function. In contrast, many urodele amphibians have a remarkable regenerative capacity: Damaged tissues or even lost extremities are almost perfectly regenerated, both in function and size. We established the red-spotted newt Notophthalmus viridescens as a model organism to study endogenous knee joint regeneration in adult vertebrates. In this model, osteoarthritis (OA)-like symptoms can be induced by intra-articular injection of collagenase or surgical removal of articular cartilage. Treated animals primarily display joint instability and luxation, but joint functionality is completely restored after approximately 3 months. Objectives To identify key players involved in the underlying mechanisms driving knee joint regeneration using a high resolution gene analysis approach. Methods A cDNA array was performed after surgically and collagenase-induced knee damage in newts, and dysregulated candidate genes were selected. Microarray results were verified on the mRNA level by real-time PCR. Protein expression levels of the dysregulated candidates were analysed by immunohistochemistry (IHC). Additionally, in vitro experiments in newt-derived cell lines and primary newt cells (chondrocytes/fibroblasts) with tenascin-C (TN-C) knockdown were performed. Results Several matricellular proteins including TN-C were found to be upregulated during the regenerative process (at day 10 TN-C vs. control 22.4-fold in collagenase-induced OA model, 15.6-fold in surgically induced OA model). IHC revealed high TN-C expression in the periosteum in untreated newt legs. During the early phase of regeneration (at day 10) additional expression at the injury site (surgically induced OA) was observed. At later stages (20 and 40 days after injury) TN-C expression was detectable in regenerating tissues including articular cartilage. In adhesion experiments using the newt-derived cell line B1H1 TN-C coating had anti-adhesive properties (TN-C vs. control: 42% reduction). However, TN-C knock-down in newt cell lines and primary newt cells did not alter cellular adhesive behaviour. Conclusions TN-C plays an important role during knee joint regeneration. Further detailed studies will facilitate to identify additional molecular pathways guiding these regenerative processes unique for the newt and might allow the transfer to the development of new treatment options for human OA. Disclosure of Interest None declared

https://ard.bmj.com/content/annrheumdis/74/Suppl_2/366.3.full.pdf

THU0460 Tenascin-C in Joint Regeneration After Induced Osteoarthritis in the Newt Notophthalmus Viridescens

German Pregnancy Register "Rhekiss".

In October of 2007, a group of true experts in diverse areas relevant to scleroderma were invited to Florence, Italy for a 2-day symposium on ‘Controversies in Scleroderma’. As the organizing committee for this activity, we selected the topics and speakers and the format of the meeting which focused on brief cutting-edge presentations followed by intensive group discussions. This Supplement to Rheumatology seemed inescapably important to realize as a summary of the conference and as a compendium for the student of scleroderma everywhere. Each author was asked to write a concise treatise on their individual area of expertise and to follow a uniform format for understandability and accessibility. Full answers are not yet in to critically important questions in scleroderma but progress is considerable. We work in an era of excitement, collaboration and anticipation. The biological platform for considering interventions has never been stronger. We have several plausible molecular targets and the intellectual framework via which we can stratify our approach. As our understanding of the vascular, immunological and fibrotic features of disease evolves, new hypotheses will emerge and hopefully be efficiently and appropriately tested in controlled clinical trials. However, these trials will not be robust unless there is progress in the clinical sciences of trial design and outcome measures. Scleroderma is a remarkably heterogeneous disorder. It is likely that progress in therapy will be focused on both specific features of disease and on overarching approaches to the commonalities of disease pathogenesis that are expressed in all patients. Lung disease remains the leading cause of death with parenchymal and vascular pathologies being of near equal importance. This conference paid particular attention to new knowledge in both areas that will permit efficient study of well-documented cohorts of clinically and pathophysiologically similar patients. There is a lot here but also a lot of work ahead! We have better science and a sophisticated approach to clinical management and trial design. Effective treatments seem within reach. Acknowledgements

https://www.zora.uzh.ch/id/eprint/154781/1/ZORA_NL_154781.pdf

Ulf Müller-Ladner

Papers

Stellenwert sportlicher Betätigung zur Prävention und Therapie der Osteoporose - eine aktuelle Übersicht

Most important vaccinations in patients with rheumatological diseases and why

THU0460 Tenascin-C in Joint Regeneration After Induced Osteoarthritis in the Newt Notophthalmus Viridescens

German Pregnancy Register "Rhekiss".

A path to the future in scleroderma