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.

Religious Allegory in “Lord of the Flies” Essay

In the novel â€Å"Lord of the Flies† we are given an example of what happens when a group of individuals that are proper, well behaved and orderly, are put into an environment where rules and regulations or the ability to enforce them are absent. Although the boys start out with the best of intensions to organize themselves to get off the island, they soon veer off course on to a path of self-survival, disregard for others and finally total savagery. The reasons for this breakdown are varied. Fear, individualism and the lack of impartial rules and their enforcement are some of the main contributing factors to the social breakdown on the island. Early in the novel one of the littl’uns sees an animal and describes it as a beast. This instills fear in everyone. The fear escalates and the boys find themselves neglecting important duties that would help them get rescued. This fear also leads to a further disintegration of the group as they argue over how to deal with this p erceived threat, the beast. â€Å"In a moment the platform was full of arguing, gesticulating shadows. To Ralph, seated, this seemed the breaking up on sanity. Fear, beast, no general agreement that the fire was all important: and when one tried to get the thing straight the argument sheered off, bringing up fresh, unpleasant matter.†(Golding 95). Beyond the fear of this wild perceived beast, the fear grows, and develops into a fear of each other. â€Å"Maybe† he said hesitantly, â€Å"maybe there is a beast†. â€Å"What I mean is†¦maybe it’s only us.†(Golding 96) The growing sense of individualism over community is another factor contributing to the breakdown on the island. Rather then acting for the good of the group, certain individuals such as Jack begin to act for their own pleasure. The island offers a lot of berries and different fruits. But Jack insists on hunting for fun and to fulfill his bloodlust. He did so at the expense of other duties such as maintaining the fire, and building shelters. Where as Ralph is more concerned with keeping everyone safe and eventually getting rescued. Jack only cares about fulfilling his own desires. â€Å"The best thing we can do is get ourselves rescued† Jack had to think for a moment before he could remember what rescue was. â€Å"Rescue? Yes, of course! All the same, I’d like to catch a pig first.†(Golding 54). The same mentality was also adopted by Jacks followers. To them it was more fun to hunt for wild pig then to build shelter or maintain the SOS fire. Another main factor is the lack of rules. This author William Golding chose English school kids because they come from a very  civilized society. Here on the island where there is the absence of law and the enforcement of any laws, certain characters begin to abuse the situation and act less civilized. Jacks illogical need to hunt the pig is an example of this, as is the wild dance that jack and his followers performed to celebrate the killing of the pig. This shows how civility is fading and being replaced by savagery. As I stated before, fear, individualism and the absence of law and order are the primary reason for the social meltdown that takes place on the island. Without a governing body whose main concern is to provide safety for the group as a whole, the possibility of individuals acting out their own selfish desires becomes likelihood.

CARL ROGER’S19 propositions Essay

CARL ROGER’S 19 PROPOSITIONS PROPOSITION 1: HUMAN EXPERIENCE AT ACONCIOUS AND UNCONCIOUS LEVEL Every individual exists in a continually changing world of experience of which he is the centre. PROPOSITION 2: HUMAN PERCEPTION The organism reacts to the field as it is experienced and perceived. This perceptual; field is, for the individual, reality. PROPOSITION 3: WHOLENESS The organism reacts as a whole to this phenomenal field. PROPOSITION 4: SELF-DETREMENATION The organism has one basic tendency and striving – to actualize, maintain, and enhance the experiencing organism. PROPOSITION 5: NEEDS AND BEHAVIOUR Behaviour is basically the goal-directed attempt of the organism to satisfy its needs as experience, in the field as perceived. PROPOSITION 6: EMOTIONS Emotion accompanies and in general facilitates such goal directed behaviour, the kind of emotion being related to the socking versus the consummatory aspects of the behaviour, and the intensity of the emotion being related to the perceived significance of the behaviour for the maintenance and enhancement of the organism. PROPOSITION 7: FRAME OF REFERENCE The best vantage point for understanding behaviour is from the internal frame of reference for the individual himself. PROPOSITION 8: THE SELF A portion of the total perceptual field gradually becomes differentiated as the self. PROPOSITION 9: THE SELF AND SIGNIFICANT OTHERS As a result of interaction with the environment, and particularly as a result of evaluational interaction with others, the structure of self is formed – an organized, fluid, but consistent conceptual pattern of perceptions of characteristics and relationships of the â€Å"I† or the â€Å"me† together with values attached to these concepts. PROPOSITION 10: VALUES:OWN AND ADOPTED FROM OTHERS The values attach themselves to experiences, and the values which are a part of the self structure, in some instances are values experienced directly by the organism, and in some instances are values introjected or taken over from others, but perceived in distorted fashion, as if they had been experienced directly. PROPOSITION 11: DEALING WITH EXPERIENCES AT CONCIOUS AND UNCONCIOUS LEVEL As experiences occur in the life of the individual, they are either (a) symbolised, perceived, and organized into some relationship to the self, (b) ignored because there is no perceived relationship to the self – structure, ( c ) denied symbolisation or given a distorted symbolization because the experience is inconsistent with the structure of the self. PROPOSITION 12: SELF AND BEHAVIOUR Most of the ways of behaving which are adopted by the organism are those which are inconsistent with the concept of self. PROPOSITION 13: BEHAVIOUR AND UNCONCIOUS EXPERIENCES Behaviour may, in some instances, be brought about by organic experiences and needs which have not been symbolized. Such behaviour may be inconsistent with the structure of the self, but in such instances the behaviour is not â€Å"owned† by the individual. PROPOSITION 14: PSYCHOLOGICAL TENSION Psychological maladjustment exists when the organism denies to awareness significant sensory and visceral experiences, which consequently are not symbolised and organized into the gestalt of the self-structure. When this situation exists, there is a basic or potential psychological tension. PROPOSITION 15: RECONSTRUCTION OF SELF Psychological adjustment exists when the concept of the self is such that all the sensory and visceral experiences of the organism are, or may be, assimilated on a symbolic level into a consistent relationship with the concept of self. PROPOSITION 16: DEFENCE OF SELF Any experience which is inconsistent with the organization or structure of self may be perceived as a threat and the more of these perceptions there are, the more rigidly the self-structure is organized to maintain itself. PROPOSITION 17: CONDITIONS FOR CHANGE Under certain conditions, involving primarily complete absence of any threat to the self structure, experiences which are inconsistent with it may be perceived, and examined, and the structure of self revised to assimilate and include such experiences. PROPOSITION 18: ACCEPTANCE OF SELF When the individual perceives and accepts into one consistent and integrated system all his sensory and visceral experiences, then he is necessarily more understanding of others and is more accepting of others as separate individuals. PROPOSITION 19: DEVELOPING YOUR OWN VALUING PROCESS As the individual perceives and accepts into his self-structure more of his organic experiences, he finds that he is replacing his present value system – based so largely upon introjections which have been distortedly symbolized – with a continuing organismic valuing process.

Wilson vs. Roosevelt Essay - 724 Words

Wilson vs. Roosevelt In the first two decades of the twentieth century the national political scene reflected a growing American belief in the ideas of the Progressive movement. This movement was concerned with fundamental social and economic reforms and gained in popularity under two presidents. Yet Theodore Roosevelt and Woodrow Wilson espoused two different approaches to progressive reform. And each one was able to prevail upon congress to pass legislation in keeping with his own version of the progressive dream. These two people, although they had different principles in mind, had one goal: to make changes to the nation for the better of the people and the country. Setting out to reach this goal, Roosevelt came to be a president†¦show more content†¦New Freedom and New Nationalism differed primarily, then, in their views of federal governmental power. Roosevelt wanted to use it while Wilson did not. Roosevelt became the president of the common man, gaining immense popularity and appeal from the citizens. This was because many of the actions that he has taken toward progressivism were for the common people, which included factory workers, laborers, children, and women. Under his presidency, He passed laws to ensure the safety of food and drugs sold in the American marketplace. He placed millions of acres of land under federal protection, preserving Americas natural resources. He regulated interstate commerce and helped laborers to get a fair chance at the negotiating table. In his New Nationalism platform, he called for womens suffrage, an end to child labor, pensions for the elderly, unemployment insurance, and increased regulation of the trusts. However, Wilson was less of a people’s man because he was a strong proponent of states rights and felt that such issues as womens suffrage and child labor laws were issues for the state. Wilson rejected a stronger role of governm ent in human affairs. Wilson’s approach to progressivism was aimed more at commerce rather than with the people. As soon as he became president, he set to tackle the â€Å"triple wall of privilege†: bank, tariff, and the trusts. He demanded that all trusts must be broken up in order for smallShow MoreRelatedRoosevelt vs. Wilson Essay514 Words   |  3 PagesRoosevelt vs. Wilson Two great men, two great presidents, led our nations to excellency and great success. Theodore Roosevelt and Woodrow Wilson were hard working, intelligent men who were very familiar, but were also different in many aspects. Through their dedication to our country and their passion of politics they have made our country better. There were many similarities between Theodore Roosevelt and Woodrow Wilson. The special relationship with their fathers was a quality thatRead MoreTheodore Roosevelt vs Woodrow Wilson Essay880 Words   |  4 PagesCompare and contrast the foreign policies of Theodore Roosevelt and Woodrow Wilson. Which do you think was a more effective president? Why? In foreign affairs, the white mans burden helped to justify Roosevelts New Imperialism in foreign policy. Uncivilized nations would gain eventual independence once they had conformed to the American model of government and democracy. Roosevelts corollary to the Monroe Doctrine set up the U.S. as policeman in the western hemisphere. Under TR, theRead MoreWilson vs. Roosevelt: the Better Progressive President? Essay747 Words   |  3 Pagespresidents. Yet Theodore Roosevelt and Woodrow Wilson espoused two different approaches to progressive reform. And each one was able to prevail upon congress to pass legislation in keeping with his own version of the progressive dream. 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Even though Wilsons plan and Roosevelts plan would differ in several waysRead MoreProgressive Era vs New Deal Essay examples981 Words   |  4 PagesNew Deal vs. Progressive Era During both the Progressive era and the New Deal era, policies as well as programs were being created in an effort to assist the American public, specifically those living in poverty. Throughout the early 1900’s Roosevelt had strayed away from the typical laissez-faire policy and decided that the people would need to be guided by the government. â€Å"Wilsonian Progressivism† had also aimed at assisting the public with his â€Å"New Freedom Program† which consisted of antitrustRead MoreApush Chapter 29 Study Guide1186 Words   |  5 Pagescase by case basis to determine if a company was being just. 2. Educational and political career of Woodrow Wilson (chronology) and origins- Once his father became a minister of the First Presbyterian Church, the family moved to Augusta, Georgia. 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This is also related to the election talked about in class when Woodrow Wilson won. Woodrow Wilson won the election because the Republican Party split their votes between Theodore Roosevelt and William Taft. This shows how politicians were nasty toward each other because Taft and Roosevelt respected each other that all changed when Taft beat out Roosevelt for the Republican Party representatives. After this Roosevelt begins to talk bad about Taft every chance he got. Finally, education is a themeRead MoreThe Between 1877 And 1920 Essay1519 Words   |  7 Pagesthe other hand, used the strategy of â€Å"vertical integration† which came about with Andrew Carnegie in 1873. 2. How did American Imperialism near the turn of the 20th century represent a new Manifest Destiny? How did Theodore Roosevelt, William Howard Taft, and Woodrow Wilson bring the progressive movement to their respective foreign policy initiatives? American Imperialism represented a new Manifest Destiny in several ways. 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