SUMMARYA taxonomic revision is made of the Neotropical genera Bocageopsis, Onychopetalum, and Unonopsis (Annonaceae). The closeness of these three genera was expressed by Fries when he placed them in his (informal) Unonopsis group (Fries, 1959), and the close relationship is supported by more recent phylogenetic research as well. Four species are recognized in Bocageopsis and two species in Onychopetalum. Unonopsis is by far the largest of the three genera with close to 50 species, of which no less than 23 species are here described as new. One species (Unonopsis umbilicata) had to be shelved as insufficiently known for lack of data, and another, obviously new, species from Colombia is too incomplete and is described provisionally as Unonopsis spec. A.Several keys are provided, one for the genera and one each for the species of Bocageopsis and Onychopetalum. For the species of Unonopsis a key to all species and, in addition, a key to the species of Mexico and Central America are provided. The species treatments include full descriptions, geographical and ecological notes, distribution maps, synonymy, taxonomic notes, and vernacular names. A complete list of exsiccatae is appended.Parallel to the taxonomic revision, a leaf anatomical survey was made by E.-J. van Marle, and is included here.
ObjectiveRecently the Diagnostic and Classification Criteria in Vasculitis Study group developed and published new American College of Rheumatology/EULAR classification criteria for giant cell arteritis (GCA). To test robustness in a different clinical setting and inform clinicians on performance in clinical practice, we aim to externally validate them in patients with a suspicion of GCA referred to our GCA fast-track clinic.MethodsPatients with suspected GCA from the Hospital Group Twente Early GCA in Twente prospective cohort were included. The clinical diagnosis of GCA verified after 6 months of follow-up made by the treating rheumatologist was used as a reference standard. A cut-off score of ≥6 was tested as described in the original article. Area under the receiver operating characteristics curve, sensitivity and specificity were calculated.ResultsIn total, 133 patients with suspected GCA were included, of whom 53 were diagnosed with GCA and 80 patients were not diagnosed with GCA. The area under the curve (AUC) was 0.96 (95% CI 0.92 to 0.98). Using the proposed cut-off score of≥6, we found that sensitivity was 98.0% (95% CI 89.9% to 100%) and specificity was 57.5% (95% CI 45.9% to 68.5%). The majority of misclassified patients without GCA had classification scores of 6 and 7 as clinical and/or laboratory criteria were often present in our non-GCA population.ConclusionOur results showed an excellent AUC and sensitivity with a moderate specificity for classification of GCA patients. Considering our relevant study population, we found that the new classification criteria might also be useful for diagnostic purposes, albeit with careful interpretation.
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