Altered mean platelet volume in patients with polymyositis and its association with disease severity

Polymyositis (PM) is an autoimmune disease characterized by chronic inflammation in skeletal muscle. Mean platelet volume (MPV), a marker in the assessment of systemic inflammation, is easily measured by automatic blood count equipment. However, to our knowledge, there are no data in the literature with respect to MPV levels in PM patients. Therefore, in this study we aimed to investigate MPV levels in patients with PM. This study included 92 newly diagnosed PM patients and 100 healthy individuals. MPV levels were found to be significantly lower compared with healthy controls (10.3±1.23 vs 11.5±0.74 fL, P<0.001). Interestingly, MPV was found to be positively correlated with manual muscle test (MMT) score and negatively correlated with erythrocyte sedimentation rate (ESR) in patients with PM (r=0.239, P=0.022; r=−0.268, P=0.010, respectively). In addition, MPV was significantly lower in active PM patients compared with inactive PM patients (9.9±1.39 vs 10.6±0.92 fL, P=0.010). MPV was independently associated with PM in multivariate regression analyses, when controlling for hemoglobin and ESR (OR=0.312, P=0.031, 95%CI=0.108 to 0.899). The ROC curve analysis for MPV in estimating PM patients resulted in an area under the curve of 0.800, with sensitivity of 75.0% and specificity of 67.4%. Our results suggest that MPV is inversely correlated with disease activity in patients with PM. MPV might be a useful tool for rapid assessment of disease severity in PM patients.

Boulevard to broken dreams, Part 1: the Polonoroeste road project in the Brazilian Amazon, and the World Bank's environmental and indigenous peoples' norms

ABSTRACT Before the mid 1980s the World Bank conceived "nature" as something to be "conquered" and "environment" as a source of resources for "development". By the late 1980s the Bank incorporated norms of environmental sustainability and indigenous peoples' protection into its mandate, and other development-oriented IOs followed. This two-part paper describes how a fight over the Polonoroeste road project in the Brazilian Amazon - inside the Bank, between the Bank and NGOs supported by the US Congress, and between the Bank and the government of Brazil -helped to generate the far-reaching change of policy norms. The first part describes how the project was designed as an innovation in sustainable development in rainforests; and how it provoked a firestorm inside the Bank as it moved towards project approval.