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Recent international recommendations have included exposure to natural radiation as one of the sources to monitor in certain occupationally exposed groups. Among those mentioned are workers in thermal spas, who may be exposed to high radiation doses due to the high concentration of radon in the indoor air of the spa. This paper presents the methodology and the results of an evaluation of radiation doses to the staff in different thermal spas in Spain. Different series of samples were collected and measurements made for the radon concentrations in water in 54 spas and in air in 20 spas. In six of the latter group, the air radon concentration was studied in different working areas occupied by the employees. The radon concentrations in water were between <2 and 775 x 10(3) Bq m(-3). The radon concentrations in air were between <10 and 5,200 Bq m(-3). The latter were used to estimate the dose received by each occupational group in the spa by taking into account the radon concentration in their main working area. By means of an exposure-dose conversion factor of 1.43 Sv per J h m(-3), the estimated effective doses were found to lie between 1 and 44 mSv y(-1). This upper limit is higher than the recommended annual limit of 20 mSv y(-1) for an occupational dose.

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1Seville, Seville, SpainBackgroundAssessment of pain improvement during treatment for Rheumatoid Arthritis (RA) may be useful to clinical decision between providers and their patients (pts).Baricitinib (BARI) once daily, an oral, selective Janus Kinase (JAK)1/JAK2 inhibitor, reduced disease activity levels in Rheumatoid Arthritis (RA) patients (pts) with an inadequate response (IR) to methotrexate (MTX).ObjectivesTo Evaluate the likelihood of achieving different levels of pain control with BARI 2 mg or 4 mg in patients with RA with inadequate response to traditional DMARDs or biological DMARDs.MethodsProspective observational registry of pts with RA who start treatment with BARI, in a third level Spanish Hospital (October 2017- June 2018). BARI 2 mg is started in patients with inadequate response to traditional DMARDs and BARI 4 mg in patients with inadequate response to biological DMARDs. The pts were assessment of pain was assessed with 0-100 mm visual analog scale (VAS) at each study visit. The likelihood of achieving >=25%, >=50% and >=70% pain VAS improvement through week 12 and analyze if there are significant differences between the group of patients with BARI 2 mg and BARI 4 mg (Mann-Whitney test). The statistical study was carried out with the SPSS15 computer package.ResultsWe included 38 pts (28 women), mean age 52 ± 12 years. Pain VAS improvement for all patients, baseline pain and weeks 12. The frequency is the percentage of improvement with respect to the baseline. In BARI 2 mg group, 58% of pts (p75) have experienced a decrease greater than pain VAS improvement than baseline and in BARI 4 mg group, 55% of pts (p75) have experienced a decrease greater than pain VAS improvement than baseline.No statistically significant differences were found in the two treatment groups (BARI 2 mg and BARI 4 mg) (p 0.847).ConclusionOur results, in general, agree with what is published in the literature (RA treated with BARI reported greater improvements in pain control when compared to adalimumab or placebo, a post-hoc analysis of the Phase 3 RA-BEAM study). BARI treated pts reported significantly greater and more rapid reductions in pain severity as measured by the pain VAS, improvements were sustained 12 weeks, without finding differences in pts receiving BARI 2 mg or BARI 4 mg.Disclosure of InterestsNone declared

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune, multiorgan disease characterised by periods of activity and remission. In lupus, one of the fields that has most helped his knowledge is the study of lymphocyte subpopulations through flow cytometry. Specifically, in the SLE some alterations have been detected at the level of B lymphocytes as the increase of B-cells subsets such as plasmablasts, plasma cells, transitional cells. There are no studies to date that have analysed the behaviour of B cells subsets in first -degree relatives of patients affected by lupusObjectivesTo analyse if there quantitative difference in the B-cells subsets of the first-degree relatives of SLE with respect to the control population (healthy) and the lupus populationMethodsTransversal descriptive study. We included 13 patients diagnosed with SLE according to the criteria of the American College of Rheumatology (ACR) with positivity for antinuclear antibodies (ANA) and anti-DNA, 34 first-degree relatives and 50 healthy controls between the months of May 2016 and March 2017. None of the subjects evaluated received treatment with rituximab or belimumab. We analysed B-cells subsets (negative double, naïve B-cells, unswitched memory B-cells, switched memory B-cells) in all the subjects included in our study. The 95% confidence intervals were obtained for both the means and the percentage difference. The level of statistical significance was established at p<0.05. The data was analysed with IBM SPSS software Statistics 19 and EPIDAT 4.1.Results47 subjects were analysed between relatives and patients, of which 33 (70.20%) were women. 13 subjects (27.70%) were diagnosed with lupus. 100% of those diagnosed with lupus were women. The mean (X) and confidence intervals (95% CI) for the different subgroups (healthy subjects, subjects diagnosed with SLE, relatives of the first degree) is shown in table 1. In none of the subpopulations analysed in patients diagnosed with SLE in front of relatives of 1 st grade it has reached statistical significance. When analysing B cells subsets of the three groups of subjects, we did find statistically significant differences between unswitched memory B cells of healthy subjects and 1 st degree relatives (being lower in the group of healthy subjects) This finding has not been described in any previous study, although it should be noted that the sample before us is small.Abstract OP0178 – Table 1B-CELLS SUBSETSHEALTHYSLERELATIVES Naïve (%)Mean (CI95%)70,4 (95% CI: 68,2 to 72,7)69,3 (95% CI: 62,2 to 76,3)65,8 (95% CI: 60,4 to 71,2) Doubles Negative (DN) (%)Mean (CI95%)4,1 (95% CI: 3,5 to 4,6)6,2 (95% CI: 4,8 to 7,6)2,9 (95% CI: 1,9 to 4,0)Unswitched (%)Mean (CI95%)9,6 (95% CI: 8,2 to 11,1)13,0 (95% CI: 7,4 to 18,7)17,2 (95% CI: 13,4 to 21,1)Switched (%)Mean (CI95%)11,4 (CI95%=10,1–12,7)11,5 (95% CI: 6,3 to 16,7)14,0 (95% CI: 11,2 to 16,8)ConclusionsThere are quantitative differences between unswitched memory B-cells of healthy subjects and relatives of 1 st grade of SLE. More studies with a larger samp...

BackgroundIn patients with haemophilia, the development of inhibitors to factor VIII/IX (Haemophilia A and B, HA/HB), prevents adequate replacement therapy and results in increased risk of serious bleeding episodes, poor control of joint bleeding, and progressive, debilitating joint disease.ObjectivesTo describe, according to the Arnold-Hilgartner scale (AHRS), the radiological findings in a cohort of hemophilic arthropathy (HArth) patients and to analyse the relationship that may exist between the degree of joint involvement and HA/HB, severity, age and presence or absence of inhibitor.MethodsThis is a retrospective study, carried out in the Haemophilia Unit of our hospital, in patients with HArth (2007–2017). Severity of haemophilia: percentage of coagulation factor (CF) activity, moderate (1%–5%) and severe <1%. The AHRS includes 5 levels.For the study of the association of the type and degree of haemophilia; and the presence of inhibitor, with the level in the AHRS, a linear model was used. The significance in this regard of the linear contrasts of interest was studied using F tests, defining the first species error at 0.05.ResultsWe included 88 patients. Characteristics of the patients in the attached chart. No significant association was detected between the type and severity of haemophilia with the development of inhibitor.The results of the linear model only showed association (p=0.01) between the severity of haemophilia and AHRS, patients with moderate haemophilia presented a least square mean for the AHRS of 2.6 (0.3), whereas the serious ones had a value of 3.4 (0.2). The least squared means for patients with HA and HB were 2.9 (0.2) and 3.1 (0.4) respectively, the contrast did not reach statistical significance (p>0.1), and the same occurred between patients who had generated or not inhibitor 2.8 (0.2) Vs 3.1 (0.3). Apart from the severity of haemophilia, the other factor that showed a significant and significant effect (p<0.001) on the AHRS values was age. The estimated value for the regression coefficient of age on the radiological status was 0.05 (0.009).Abstract AB1134 – Table 1Type of Haemophilia Haemophilia A n (%)73 (82%)Haemophilia B n (%)14 (15%)Severity of HaemophiliaHaemophilia A severe n (%)50 (56%)Haemophilia A moderate n (%)23 (26%)Haemophilia B severe n (%)13 (14%)Haemophilia B moderate n (%)1 (1%)Age m (SD)31 (17)Development of inhibitors to factor VIII/IX n (%)16 (18%)Haemophilia A severe with inhibitors n (%)10 (11%)Haemophilia A moderate with inhibitors n (%)3 (3%)Haemophilia B severe with inhibitors n (%)3 (3%)AHRS scale 1 n (%)18 (20%)AHRS scale 2 n (%)17 (19%)AHRS scale 3 n (%)18 (20%)AHRS scale 4 n (%)15 (17%)AHRS scale 5 n (%)19 (21%)ConclusionsContrary to what has been observed in other studies, in our cohort it does not seem that the presence of inhibitor or the type of haemophilia has a negative effect on the severity of the radiological findings. The age and severity of haemophilia do seem to influence the radiological stage.Disclosure of InterestNone declared