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Abstract Background Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular (CV) events and CV mortality. Subclinical carotid atherosclerosis is independently associated with rates of incident CV events among patients with RA. The complement system has been related to both the etiopathogenesis of RA and CV disease. In this study, we aimed to evaluate the association between a comprehensive assessment of the complement system and carotid intima media thickness and carotid plaque in patients with RA. Methods 430 patients with RA were recruited. Functional assays of the three pathways of the complement system, utilizing new-generation techniques, were assessed. Additionally, serum levels of individual components of the complement system belonging to the three pathways were measured: C1q (classical), lectin (lectin), C2, C4, and C4b (classical and lectin), factor D and properdin (alternative), C3 and C3a (common), C5, C5a, and C9 (terminal), as well as regulators factor I and C1-inhibitor. Subclinical carotid atherosclerosis was evaluated by ultrasonography. Multivariable linear regression analysis was conducted to investigate the association between the complement system and carotid intima media thickness and carotid plaque. Results After multivariable adjustment, which included traditional CV risk factors and disease-related data, C3a and C5a exhibited significant positive correlations with carotid intima media thickness. Additionally, higher values of C1-inhibitor, properdin, C3, C5, and C5a were independently associated with the presence of carotid plaque. Conclusion The complement system and subclinical carotid atherosclerosis are linked in patients with RA.

BackgroundThe complement system has been linked to the etiopathogenesis of rheumatoid arthritis (RA). Patients with RA exhibit a dysregulated profile of lipid molecules, which has been attributed to the inflammation present in the disease. In this study, we aimed to evaluate the association between a comprehensive assessment of the complement system and the lipid profile of patients with RA.Methods430 patients with RA were recruited. New-generation techniques were employed to conduct functional assays of the three pathways of the complement system. Serum levels of various complement components such as C1q, factor D, properdin, lectin, C1-inhibitor, C2, C4, C4b, C3, C3a, C5, C5a, and C9 were assessed. Furthermore, a complete pattern of lipid molecules was measured including high (HDL), low-density lipoproteins (LDL), and lipoprotein (a). Multivariable linear regression analysis was conducted to investigate the association between the complement system and lipid profile in RA patients.ResultsAfter multivariable analysis, several noteworthy associations emerged between the complement system and lipid molecules. Notably, complement components most strongly linked to the lipid profile were C1q and properdin, representing the upstream classical and alternative pathways, along with C3 from the common cascade. These associations demonstrated significance and positivity concerning total cholesterol, LDL, atherogenic index, apolipoprotein B, and lipoprotein(a), suggesting a connection with an unfavorable lipid profile. Interestingly, complement functional assays of the three pathways and activated products such as C3a and C5a showed no correlation with the lipid pattern.ConclusionThe correlation between the complement system and lipid molecule patterns is pronounced in patients with RA. This relationship is predominantly positive and primarily associated with upstream complement components rather than activated ones.

Objective To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients.Methods Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3).Results Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p

Polymyalgia rheumatica (PMR) is an inflammatory disease common in people aged 50 years and older. This condition is characterized by the presence of pain and stiffness involving mainly the shoulder and pelvic girdle. Besides the frequent association with giant cell arteritis (GCA), several conditions may mimic PMR or present with PMR features. Since the diagnosis is basically clinical, an adequate diagnosis of this condition is usually required. Positron emission tomography/computed tomography (PET-CT) has proved to be a useful tool for the diagnosis of PMR. The use of 18F-FDG-PET imaging appears promising as it provides detailed information on inflammatory activity that may not be evident with traditional methods. However, since PET-CT is not strictly necessary for the diagnosis of PMR, clinicians should consider several situations in which this imaging technique can be used in patients with suspected PMR.

The objective is to evaluate the sleep characteristics of the staff working in a pediatric intensive care unit (PICU). They were asked to complete an anonymous survey concerning the characteristics and quality of their sleep, as well as the impact of sleep disturbances on their work and social life, assessed by Functional Outcomes of Sleep Questionnaire (FOSQ)-10 questionnaire. The response rate was 84.6% (85% females): 17% were doctors, 57% nurses, 23% nursing assistants, and 3% porters. 83.8% of them worked on fix shifts and 16.2% did 24-h shifts. 39.8% of workers considered that they had a good sleep quality and 39.8% considered it to be poor or bad. The score was good in 18.2% of the staff and bad in 81.8%. Night shift workers showed significantly worse sleep quality on both the objective and subjective evaluation. There was a weak concordance (kappa 0.267; p = 0.004) between the perceived quality of sleep and the FOSQ-10 evaluation. Sleep disorders affected their emotional state (30.2% of workers) and relationships or social life (22.6%). In conclusion, this study finds that a high percentage of health professionals from PICU suffer from sleep disorders that affect their personal and social life. This negative impact is significantly higher in night shift workers. Many health workers are not aware of their bad sleep quality.

Con la publicación de los Grabados rupestres postpaleolíticos del Alto Duero (IVluseo Numantino, Soria, 1992) dábamos por concluido uno de los capítulos más importante del estudio del arte rupestre del extremo oriental de la meseta castellano-leonesa. El trabajo —Tesis Doctoral de uno de nosotros dirigida por el Prof. Dr. D. E. Ripoll— recogía más de 2.769 figuras grabadas en 73 abrigos rocosos y, a juicio del recensionista de International Newsletter on Rock Art (\hlORA núm. 5, 1993, p. 31), venía a constituir un trabajo de base para el conocimiento de este tipo de manifestaciones en la Península Ibérica. La investigación, sin embargo, no se estancó y la casualidad ha querido que, pasado un tiempo, fuéramos advertidos de la existencia, en San Esteban de Gormaz (Soria), de una cueva que disponía en sus paredes y techumbre de un amplio, y enigmático, conjunto de grabados rupestres. ¿Enigmáticos? Sí. La cueva «Las Salinas» —como fue bautizada por los niños que la descubrieron— presenta un corpus grabado próximo, por su técnica, estilo y temática, al mundo «esquemático» peninsular si bien la existencia entre sus motivos de, al menos, dos proboscidios provoca en nosotros la duda no sólo ya sobre su adscripción estilístico-cultural sino, y sobre todo, sobre su autenticidad. Precisamente estas dudas son las que —además del consejo de nuestro maestro el Prof. E. Ripoll— motivan las páginas que siguen, en espera de que la experiencia de otros colegas nos pueda dar alguna luz que las disipe o matice.

Aim of the study: to compare the metabolic status using chemical blood test markers for periodontal disease-diagnosed patients suffering or not from systemic conditions (diabetes mellitus and chronic viral hepatitis). Material and Methods. 195 patients diagnosed with various stages of chronic periodontal disease (PD) were divided into four groups: PD + diabetes mellitus (n=60), PD + hepatitis B (n=16), PD + hepatitis C (n=10) and PD only (n=109). The patients’ blood samples were analyzed for: biochemical parameters (blood sugar – glucose, total cholesterol, hepatic enzymes – transaminase ALT and AST, triglycerides) and cellular parameters (full blood count, erythrocyte sedimentation rate, prothrombin time and international normalized ratio). Data collection and statistical analysis t-test were performed for comparison, p < 0.05 for statistical significance. Results. Our retrospective study shows elevated levels of hepatic enzymes (both AST and ALT) for the periodontal patients diagnosed with chronic HCV/HBV infection than for systemic-healthy periodontal patients. The total cholesterol mean values expressed no statistically significant difference between the four group of patients. Triglycerides mean levels were lower than the physiological reference value for periodontal patients with no co-morbidities but expressed higher average values for systemic-diseased ones. Glucose levels were the highest for the periodontal patients with diabetes. Conclusion. Metabolic parameters in periodontal patients suffer alterations caused by diabetes and HBV/HCV infection.

Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects’ immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients’ saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients’ inflammatory status.

In the search of alternatives for controlling Aethina tumida Murray, we recently proposed the BAA trap which uses boric acid and an attractant which mimics the process of fermentation caused by Kodamaea ohmeri in the hive. This yeast is excreted in the feces of A. tumida causing the fermentation of pollen and honey of infested hives and releasing compounds that function as aggregation pheromones to A. tumida. Since the boron is the toxic element in boric acid, the aim of this article is to assess the amount of boron residues in honey and beeswax from hives treated with the BAA trap. For this aim, the amount of bioaccumulated boron in products of untreated hives was first determined and then compared with the amount of boron of products from hives treated with the BAA trap in two distinct climatic and soil conditions. The study was conducted in the cities of Padilla, Tamaulipas, and Valladolid, Yucatan (Mexico) from August 2014 to March 2015. The quantity of boron in honey was significantly less in Yucatan than in Tamaulipas; this agrees with the boron deficiency among Luvisol and Leptosol soils found in Yucatan compared to the Vertisol soil found in Tamaulipas. In fact, the honey from Yucatan has lower boron levels than those reported in the literature. The BAA treatment was applied for four months, results show that the BAA trap does not have any residual effect in either honey or wax; i.e., there is no significant difference in boron content before and after treatment. On the other hand, the organophosphate pesticide coumaphos was found in 100% of wax samples and in 64% of honey samples collected from Yucatan. The concentration of coumaphos in honey ranges from 0.005 to 0.040 mg/kg, which are below Maximum Residue Limit (MRL) allowed in the European Union (0.1 mg/kg) but 7.14% of samples exceeded the MRL allowed in Canada (0.02 mg/kg).