Enthesitis in a European registry-based cohort of patients with psoriatic arthritis treated with tumour necrosis factor inhibitors: clinical burden, patient-reported outcomes, and treatment response.

OBJECTIVE: To explore the registration of enthesitis among biologic-naïve patients with psoriatic arthritis (PsA) initiating tumour necrosis factor inhibitor (TNFi) treatment across 12 European registries, compare the disease burden and patient-reported outcomes (PROs) between patients with and without enthesitis, and assess the enthesitis treatment response. METHOD: Demographics, clinical characteristics, and PROs at first TNFi (TNFi-1) initiation (baseline) were assessed in patients with PsA, diagnosed by a rheumatologist, with versus without assessment of entheses and between those with versus without enthesitis. Enthesitis scores and resolution frequency were identified at follow-up. RESULTS: Of 10 547 patients in the European Spondyloarthritis (EuroSpA) Research Collaboration Network initiating TNFi, 1357 underwent evaluation for enthesitis. Eight registries included a validated scoring system for enthesitis. At baseline, 874 patients underwent entheses assessment [Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 485 patients, Spondyloarthritis Research Consortium of Canada (SPARCC) 389 patients]. Enthesitis was detected by MASES in 170/485 (35%, mean score ± sd 3.1 ± 2.4) and by SPARCC in 236/389 (61%, 4 ± 3.4). Achilles enthesitis was most frequent, by both MASES (unilateral/bilateral 28%/9%) and SPARCC (48%/18%). MASES/SPARCC baseline and follow-up scores for TNFi-1 were available for 100/105 patients. Of these, 63 patients (63%) (MASES) and 46 (43.8%) (SPARCC) achieved resolution of enthesitis. The site-specific enthesitis resolution was overall lower at SPARCC sites (peripheral; 63-80%) than at MASES sites (mainly axial; 82-100%) following TNFi-1. Disease activity and PROs were worse in patients with versus without enthesitis. CONCLUSION: Entheseal assessments are only registered in a minority of patients with PsA in routine care. When assessed, enthesitis was common, and a substantial proportion demonstrated resolution following treatment with TNFi-1.

Real time biodetection of individual pathogenic microorganisms in food and water.

The primary objective of this research is to examine the feasibility of using an innovative technique based on laser-induced fluorescence coupled with flow cytometry to detect pathogenic microorganisms in food or water in real time. Our initial application is the rapid detection of E. coli O157:H7 in ground beef. The research performed demonstrated conclusively that this approach is feasible, and that the technique has key advantages over current alternatives including: it is (1) able to totally examine a large volume of food or water in real time, (2) capable of detecting single microorganisms (alternative techniques require in excess of 10(4) microorganisms), (3) intrinsically automatic, and (4) sensitive only to the selected bacteria. We have demonstrated the feasibility of detecting individual E. coli bacteria with a breadboard system. The performance of this system allows for rapid detection of individual specific pathogenic microorganisms. Two of the most significant commercial applications of this technique are the detection of infectious microorganisms in contaminated food and water. Food-borne microbial pathogens account for approximately 7 million illnesses and 9,000 deaths in the U.S. annually, with an estimated economic loss of at least $6 billion [1]. In addition, this method has the potential for a broad range of other commercial applications, including the detection of small numbers of molecules, such as the ultrasensitive detection of explosives and groundwater contaminants.