BackgroundRheumatoid arthritis (RA) is a systemic chronic inflammatory disease characterised by joint destruction, deformity, lower functional status and decrease in life expectancy. The Porphyromonas gingivalis (P. gingivalis) has been reported to be significantly associated with RA. The adipokines are suggested to be a common link between periodontitis and RAObjectivesTo determine the association between serum adipokines levels and presence of P gingivalis in patients with early rheumatoid arthritis (eRA) compared to healthy individualsMethodsA cross sectional study was conducted. Patients with the diagnosis of (eRA) according to the ACR/EULAR 2010 criteria were studied in Bogota-Colombia. A complete medical history related to RA was obtained. Adiponectin levels measured by Luminex technology (MILLIPLEXMAP ), IL6 by chemiluminescence (Immulite 1000, Siemens) and leptin quantification by ELISA (Diasource, ), high-sensitivity CRP (hs-CRP) (Immulite 1000, Siemmens) and ESR (Test 1 THL Ali FAX), and the detection of periodontopathic bacteria was carried out by qPCR from subgingival plaque samples. Cancer, autoimmune disease, infection, antibiotic use, diabetes, orthodontics treatment were exclusion criteria. An association analysis was made to evaluate the relationship between adipokines levels and periodontal, rheumatologic conditions using X2 test, Mann Whitney test and logistic regression model was performed to confirm this associations. All the results were performed with a level of significance of 95%ResultsA total of 51 patients with eRA and 51 healthy individuals were matched by age and gender. The mean age in RA patients was 48,54±10,93 years, 80,39% were female, between RA patients, 17.64% were in high activity and 27.45% in remission by DAS 28-ESR. 45.1% had APCA>20 UE. 37.25% were overweight and 13.72% were obese. 82.35% of patients had treatment, of which 80.39% received treatment with conventional disease modifying therapy, being methotrexate the most frequent one in 86.8%. In turn, 64.7% and 51% had high leptin and adiponectin levels respectively. An association of high adiponectin levels was found with Body Mass Index-BMI <25 (p=0.017). The presence of P gingivalis in RA patients was 78.4% and in healthy individuals was 45,09% p=0001. The adiponectin levels>47755 pg/ml were found associated with the absence of P gingivalis (OR=0.078 95% CI 0.01–0.62) adjusted an ever smoking history of cigarette smoking, Body Mass Index>30 and high level of leptin and IL6.ConclusionsThe adiponectin plays an anti-inflammatory role in the pathophysiology of several chronic inflammatory diseases and it has been reported to inhibit LPS-induced NFκB nuclear translocation and to affect other LPS-triggered pathways. To promote the weight control in eRA could be to prevent the oral infectionReference[1] Le Sage F, et al. Mol Cell Endocrinol2017;446:102–110.Disclosure of InterestNone declared
Objetivos: Revisar/resumir indicaciones, resultados audiológicos y de calidad de vida del dispositivo totalmente implantable Carina®. Diseño: Revisión sistemática. Métodos: Se realizó una búsqueda sistemática de la literatura entre junio/2011 y enero/2012 en bases de datos: Medline, OVID, Embase, Pro Quest, Biblioteca Cochrane. También se revisó literatura gris (Sigle) en búsqueda de información no publicada. No hubo restricción de lenguaje o límite temporal, y se incluyeron estudios en humanos con mediciones antes/después de la intervención. Se excluyeron reportes de un caso y estudios con pacientes prelinguales. Se evaluó heterogeneidad estadística (prueba Der Simonian-Laird), y la ganancia funcional combinada (GFC) se estimó con un modelo de efectos aleatorios. Se evaluó sesgo de publicación (gráfica de embudo y prueba Eggs). Resultados: Se identificaron 155 publicaciones, 43 enfocadas en el tema de investigación; ocho cumplieron criterios de inclusión/exclusión, que reportan 110 pacientes. La GFC fue 27,24 dB [IC 95% = 21,66-32,83 dB], I2 = 85%. El reconocimiento de palabras (65 dB-SPL) se incrementó con Carina® entre 35 y 70%, y hubo mejoría en calidad de vida (escala Aphab). La complicación más frecuente fue extrusión (2,7%). Se encontró sesgo de publicación (Eggs = 0,0011). Conclusiones: Se encontró heterogeneidad clínica y bajo nivel de evidencia publicada. La GFC fue considerable con el implante.
Objetivo: Evaluar los resultados audiométricos y de seguridad preoperatorios y postoperatorios en niños con implante auditivo Carina®. Diseño: Estudio antes y después. Métodos: Se incluyeron niños con hipoacusia conductiva unilateral o bilateral, con atresia auricular congénita. Se llevaron a cabo medidas repetidas intrasujetos, para evaluar la ganancia funcional, y seguimiento detallado de complicaciones, con el fin de establecer la seguridad. Se usó la prueba T-Student para muestras relacionadas en el análisis estadístico. Resultados: Se incluyeron ocho pacientes (edad media de 14,5 ± 1,9), y 50% (N.º = 4) fueron hombres. No se observó diferencia significativa entre el promedio de tonos puros (PTP) de la vía ósea prequirúrgica y postquirúrgica (p > 0,05). La ganancia funcional media fue de 25,0 ± 6,9 dB; se encontró diferencia estadísticamente significativa entre el PTA sin ayuda auditiva (60,6 ± 9,4 dB) y el PTA con ella (35,6 ± 10,5 dB) (p < 0,0001). No se observaron complicaciones mayores. Conclusiones: Los resultados audiológicos y de seguridad son satisfactorios, y se soporta el uso confiable del dispositivo en niños; se requieren estudios adicionales, enfocados en la evaluación de la calidad de vida para cuantificar el beneficio al respecto
BackgroundRheumatoid arthritis (RA) is a systemic chronic inflammatory disease. Adipose tissue is regarded as an active endocrine organ producing adipokines such as leptin and adiponectin, and some proinflammatory cytokines which have proinflammatory properties that account for chronic low-grade systemic inflammationObjectivesTo investigate the levels of adipokines in eRA and establish their association with the state of rheumatic conditionMethodsCross sectional study was conducted. 51 patients with eRA according to the ACR/EULAR 2010 criteria and 51 healthy controls matched by age and gender, were included. A complete medical history was obtained. Adiponectin levels measured by Luminex technology, IL6 by chemiluminescence and lptin by Enzyme-linked immunosorbent assay. Serum markers of RA such as rheumatoid factor, erythrocyte sedimentation rate(ESR), C reactive protein(CRP), and anticitrullinated protein antibodies-APCA IgG/IgA. Disease activity was evaluated by DAS28CRP, DAS28ESR, CDAI, SDAI and RAPID3, the functional status using Multidimensional health assessment questionnaire(MDHAQ) and radiological status by Simple Erosion Narrowing Score(SENS). An association analysis was made to evaluate the relationship between adipokines levels and rheumatologic conditions using X2 test, Mann Whitney and logistic regression model was performed to confirm this associations. All the results were performed with a level of significance of 95%ResultsIn the eRA group, 80.39% were women, the mean age was 48.54±10.93 years. 37.25% had overweight and 13.72% had obesity Among the controls, 80.39% were women, with the mean age of 48.55±11.07 years. 27.45% had overweight and 5.88% had obesity.45,09% moderate activity and 17.64% high activity by DAS28ESR. High leptin levels were found in 64.7% vs 23.5% in healthy controls (p=0,001). High adiponectin levels was found associated to BMI<25(p=0.017) and high leptin level to BMI>25(p=0.038) and disease activity by RAPID3(p=0.039). The presence of joint space narrowing in hands was associated with low adiponectin levels(p=0.044). The association of leptin levels>1.67 ng/mL with the diagnosis of RA was maintained in the model adjusted for the presence of P gingivalis, DAS28-ESR, CRP >3 mg/L, economic status and BMI>30, OR=2.79 95% CI (1.54–5.07). The presence of high leptin and IL6 levels and low level adiponectin at the same time were more frequently found in the female gender(p=0.047), primary schooling(p=0.050), BMI>30(p=0.023), patients with radiological damage SENS>3 (p=0.047) and were found associated at the same time to MDHAQ>3, BMI>25 and RAPID3 >12 (OR 5.03 95% CI 1.05–24) adjusted to clinical variablesConclusionsThe role of adipokines as the leptin could be considered to be the bridge between immune tolerance, metabolic function and autoimmunity and suggests the possibility to use circulating levels of adipokines as potential biomarkers of disease activity and functional status in early stage of rheumatoid arthritisReference[1] Šenolt L. Expert Rev Clin Immunol2017;13:1–3.Disclos...
Objetivo: Describir la experiencia y comparar los resultados audiométricos ycambio en calidad de vida en pacientes con el dispositivo auditivo totalmente implantable Carina®.Diseño: Estudio antes y después.Métodos: El dispositivo Carina® fue implantado en pacientes con hipoacusiaconductiva, mixta o neurosensorial de moderada a severa. Como método deevaluación se realizaron medidas repetidas intra-sujetos para ganancia funcional y cambios en calidad de vida. Se usó la prueba T-Student para muestras relacionadas en el análisis estadístico.Resultados: Se incluyeron 27 pacientes (edad media = 28,2±15,8 años). No se observaron diferencias significativas entre el promedio de tonos puros (PTP) de la vía ósea prequirúrgica y posquirúrgica (p > 0,05). La ganancia funcional media fue = 24,0 ± 7,9 dB; se encontró una diferencia estadísticamente significativa entre el PTP sin Carina® (62,3 ± 12,4 dB) y con Carina® (38,3 ± 11,9 dB) (p < 0,0001). Hubo una mejoría significativa en la calidad de vida con el uso del dispositivo (p < 0,05). Se presentó una explantación como única complicación mayor (3,7%). Conclusiones: Los resultados audiológicos y de cambios en calidad de vida encontrados muestran a Carina® como una opción de rehabilitación auditiva eficiente.
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