Fat embolism of necrotic bone marrow could be a frequent cause of acute chest syndrome (ACS) in sickle cell syndromes (SC), as suggested by postmortem findings. To check this hypothesis in living patients, we evaluated the presence of fatty macrophages recovered by bronchoalveolar lavage (BAL) in ACS. We investigated 20 consecutive cases of ACS by BAL, and identification of alveolar cells containing fat droplets was performed using oil red O (ORO), a specific neutral fat stain. The specificity of the method was determined on control groups, including eight SC patients without acute chest syndrome and 15 non-SC patients. A cut-off of > 5% of alveolar macrophages containing fat droplets was determined from the control groups to assess the diagnosis of fat embolism. In 12 ACS episodes, BAL exhibited > 5% of fatty macrophages, ranging from 10% to 100% (median value 46.5%). In 11 cases, fat embolism was associated with proven (n = 8) or probable (n = 3) bone marrow infraction, which mostly predated ACS. Eight ACS episodes were associated with a low percentage (< or = 5%) of fatty alveolar macrophages and could be related to a cause other than fat embolism in six episodes, such as sepsis, in-situ thrombosis, or rib infarcts generating hypoventilation. This study supports the diagnostic yield of BAL for fat embolism, which can be incriminated in 60% of cases of ACS in this adult population.

Platelets, as nonnucleated blood components, are classically recognized for their pivotal role in hemostasis. In recent years, however, accumulating evidence points to a nonhemostatic role for platelets, as active participants in the inflammatory and immune responses to microbial organisms in infectious diseases. This stems from the ability of activated platelets to secrete a plethora of immunomodulatory cytokines and chemokines, as well as directly interplaying with viral receptors. While much attention has been given to the role of the cytokine storm in the severity of the coronavirus disease 2019 (COVID-19), less is known about the contribution of platelets to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we give a brief overview on the platelet contribution to antiviral immunity and response during SARS-CoV-2 infection.

Objectives: To evaluate oral hygiene status in Rheumatoid arthritis (RA) patients, to analyse possible related factors, and to investigate the role of the rheumatologist in information about importance of adequate oral hygiene status in RA patients. Methods: A cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 ± 11.7 years). For each patient, we recorded oral symptoms, oral hygiene status and role of rheumatologist in information on the oral hygiene status. Factors associated with regular brushing (≥2/day) were also analysed. Results: Median disease duration was 8 years (4;2). Dental pain was reported by 74% of patients and bleeding by 51% of them. Regular brushing was noted in 45% of patients. The use of a correct brushing method was noted in 14% of cases. Two patients reported visiting a dentist regularly. Information explaining that poor oral hygiene has a negative impact on RA was delivered by rheumatologist to 11 patients. Regular brushing of teeth was recommended by rheumatologist to 8 patients and 10 patients were advised by their rheumatologist to consult a dentist. Regular brushing was more important in women (48,3% vs 18,2%; p=0.05) and in the literate patients (57,6 vs 31,2%, p<0.01). No association was found between regular brushing, Disease Activity Score 28 (DAS28) and health Assessment Questionnaire (HAQ). Conclusion: This study illustrates bad oral hygiene status in RA patients, which seems more important in men and illiterate patients. It also highlights poor information given by the rheumatologist.

Background:The relationship between oral hygiene and rheumatoid arthritis has been demonstrated by several studies.Objectives:To evaluate oral hygiene status in rheumatoid arthritis (RA) patients.To inform about the therapeutic education given by the rheumatologist on the importance of adequate oral hygiene in the management of RAMethods:This is a cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 years, median disease duration of 8 years, mean specialized care duration of 3 years). A questionnaire evaluating oral hygiene status was administered. It focused on following items: the daily frequency of brushing, the modalities of brushing, the use of other means of oral hygiene, the regular follow-up at a dentist’s doctor and the place of the rheumatologist in therapeutic education on the oral dental hygiene status.Results: Table I illustrates the results of oral hygiene evaluation in RA patients. Table I : Evaluation of Oral Hygiene in RA patients Items N=100 Daily Brushing Frequency (%):- 0 times/day- once a day- 2 times/day- 3 times/day- After each meal18373483adequate brushing time (≥3min) (%) 31Correct brushing method (%) 14Use of other means of oral hygiene (%) 36Regular dentist visit (%) 2Never visit a dentist (%) 27 Table II illustrates the results of the place of oral hygiene information in rheumatologic management. Table II : Place of information on oral hygiene in rheumatologic care. Questions Yes (%) 1. does your rheumatologist ever examined your oral cavity?2. have you ever been informed by your rheumatologist that poor oral hygiene has a negative impact on your rheumatoid arthritis?6,011,03. Does your rheumatologist ever recommended regular brushing of your teeth?8,04. Does your rheumatologist already recommended to you to consult a dentist?10,0Conclusion:This study illustrates the high prevalence of oral hygiene insufficiency in patients followed for RA. It also highlights poor therapeutic education given by the rheumatologist on the importance of adequate oral hygiene in the management of RA.Disclosure of Interests:None declared

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