Primary biliary cirrhosis (PBC) is an uncommon and enigmatic autoimmune disease, characterized by female predominance, autoantibodies to mitochondrial antigens (AMA), destruction of small bile ducts, and ultimately cirrhosis and liver failure. 1,2 Although genetic factors appear to be important in determining susceptibility to autoimmune diseases such as PBC, studies of a variety of autoimmune diseases in monozygotic twins have revealed concordance rates of only 10% to 50%. 1,2 Thus, environmental factors may trigger disease in susceptible individuals. Among the factors that have been suggested to play a role in the etiology of PBC are infectious diseases, 3 other autoimmune diseases, 4 and lifestyle factors, such as smoking, 5 and a high-fat diet. 6,7 Although many mechanisms have been proposed 3,7-9 by which these various factors may be involved in PBC, little epidemiologic research in the United States has been conducted; most published research consists of case reports and laboratory studies. The lack of conclusive information about the etiology of PBC is due, in part, to the methodologic difficulties of studying the disease and also to its relative rarity. Previous studies have been hindered by small sample sizes, unrepresentative samples, lack of a standard case definition, and lack of inclusion of appropriate comparison groups. 10 This report is unique because of its size and its use of two sets of controls, including siblings. PATIENTS AND METHODSStudy Population. A total of 241 patients with PBC were identified from an electronic mail list server for an Internet support group for individuals with PBC. All people on the electronic mail list server were sent a questionnaire. Confirmation of the diagnosis of PBC was performed as described later. PBC cases who completed the survey were asked to provide names and addresses of their siblings to serve as a comparison group. The cases were later asked to provide the names and addresses of 3 friends who were the same sex, within 5 years of their age, and who did not have PBC to serve as a second comparison group. Siblings were sent the same packet of information as cases (see below), whereas friends were sent an abbreviated questionnaire, omitting the dietary questions. A total of 241 individuals with PBC, 261 siblings, and 225 friends were identified.Data Collection. The questionnaire for the study was developed using standardized questions drawn from the National Health and Nutrition Examination Survey (NHANES). 11 These questions have been tested for reliability and validity in a number of studies. 12 The initial survey instrument was pilot tested in approximately 25 individuals without PBC, after which appropriate modifications were made. The final survey included 209 questions, with many of them having several parts, for a total of 983 variables. The survey instrument included questions about demographics (age, education, gender, race/ethnicity), general medical history (including childhood illnesses, infectious illnesses, chronic diseases, surgeries, and m...

Objective-We conducted a retrospective cohort study to examine cancer risk in a large cohort of systemic lupus erythematosus (SLE) patients in California.Methods-The cohort consisted of individuals with SLE derived from statewide patient discharge data during the period 1991-2002. SLE patients were followed using cancer registry data to examine patterns of cancer development. Standardized incidence ratios (SlRs) and 95% CI were calculated to compare the observed to expected numbers of cancers based on age-, race-, and sex-specific incidence rates in the California population.Results-The 30,478 SLE patients were observed for 157,969 person-years. A total of 1,273 cancers occurred within the observation interval. Overall cancer risk was significantly elevated (SIR=1.14, 95% CI=1.07-1.20). SLE patients had higher risks of vagina/vulva (SIR=3.27, 95% CI=2.41-4.31) and liver cancers (SIR=2.70, 95% CI=1.54-4.24). Elevated risks of lung, kidney, and thyroid cancers and several hematopoietic malignancies were also observed. Individuals had significantly lower risks of several screenable cancers, including breast, cervix, and prostate.Conclusions-These data suggest that risks of several cancer types are elevated among SLE patients. Detailed studies of endogenous and exogenous factors that drive these associations are needed.The final publication is available at Sprinter via: http://dx

In the year preceding the diagnosis of cancer, the number of cases with unprovoked VTE was modestly higher than expected, and almost all of the unexpected VTE cases were associated with a diagnosis of metastatic-stage cancer within 4 months. Given the timing and advanced stage of the unexpected cases, it is unlikely that earlier diagnosis of these cancers would have significantly improved long-term survival.

The effects of addition order of the components for ethylene–glycidyl methacrylate (E‐GMA) copolymers and two types of organoclays (Cloisite® 15A and Cloisite® 30B) on morphology and mechanical properties of polyamide‐6/elastomer/organoclay ternary nanocomposites were investigated by x‐ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM) analyses, melt flow index (MFI) measurements, differential scanning calorimetry (DSC), and tensile and impact tests. Four different addition orders (All‐S, PI‐C, PC‐I, and IC‐P) were applied through melt blending in a twin‐screw extruder. All‐S indicates that the elastomer, the organoclay, and polyamide‐6 were compounded in the extruder simultaneously, and the resulting compound was extruded once more. The other symbols represent the components for the two extrusions. P, I, and C stand for polyamide‐6, elastomer, and organoclay, respectively. The first two ingredients were compounded in the first extrusion, and the resulting compound was mixed with the third component in the second extrusion run. For polyamide‐6/ Cloisite® 15A/E‐GMA nanocomposites processed by PI‐C and IC‐P addition orders, stacked silicate layers were observed in the TEM micrographs. On the contrary, the nanocomposites with Cloisite® 30B gave the best result in terms of intercalation/exfoliation in the IC‐P sequence. Generally, for Cloisite® 15A containing ternary nanocomposites, the All‐S addition order gave the highest impact strength, tensile strength, and Young's modulus owing to potential interactions between the functional groups of the three components. For polyamide‐6/Cloisite® 30B/E‐GMA ternary nanocomposites, the PC‐I mixing sequence produced the highest Young's modulus. For these nanocomposites, impact and tensile strengths and elongation at break were relatively insensitive to the mixing order. © 2012 Wiley Periodicals, Inc. Adv Polym Techn 32: E675–E691, 2013; View this article online at http://wileyonlinelibrary.com. DOI 10.1002/adv.21310

Objective The objective of this retrospective cohort study was to evaluate cancer risk among rheumatoid arthritis (RA) patients in California. Methods The study cohort derived from statewide patient discharge records was followed via linkage with cancer registry data over the period 1991–2002. Age and sex adjusted standardized incidence ratios (SIRs) and 95% confidence intervals were calculated to compare observed to expected numbers of cancers based on age, race, and sex specific incidence rates in the California population. Results Among the 84,475 RA patients, who were observed for 405,540 person-years, 5,533 incident cancers were diagnosed during the observation interval. The risk of developing lymphohematopoietic cancer was significantly higher in the cohort for both sexes. Males had significantly higher risks of lung, liver, and esophageal cancer, but a lower risk of prostate cancer. Females were at significantly decreased risk for several cancers including breast, ovary, uterus, cervix, and melanoma, with the risk reduction ranging from 15 to 57% lower than the general population. Hispanics had increased risks of leukemia, vagina/vulva, lung, and liver cancers. Conclusion Studies investigating the mechanisms that underlie the reported associations between RA and specific cancer types are needed.