High triglycerides and low HDL-c lipid profile in rheumatoid arthritis: a potential link among inflammation, oxidative status and dysfunctional HDL

Background The interactions between inflammation and lipid profile in rheumatoid arthritis (RA) are poorly understood. The lipid profile study in RA has been biased toward lipoprotein levels, whereas those of triglycerides (TGs) and lipoprotein functionality have been underestimated. Objectives Since recent findings suggest a role for TG and TG-rich lipoproteins (TRL) on inflammation, we aimed to evaluate a combined lipid profile characterized by high TG and low high-density lipoprotein cholesterol levels (TGhighHDLlow) in RA. Methods Lipid profiles were analyzed in 113 RA patients, 113 healthy controls, and 27 dyslipemic subjects. Levels of inflammatory mediators, paraoxonase-1 (PON1) activity, and total antioxidant capacity were quantified in serum. PON1-rs662 status was evaluated by real-time polymerase chain reaction. Results The TGhighHDLlow profile was detected in 29/113 RA patients. Although no differences in prevalence compared with healthy controls or dyslipemic subjects were observed, this profile was associated with increased tumor necrosis factor ? (P = .004), monocyte chemotactic protein (P = .004), interferon-gamma?inducible protein-10 (P = .018), and leptin (P < .001) serum levels in RA, where decreased PON1 activity and total antioxidant capacity were found. TGhighHDLlow prevalence was lower among anti-TNF??treated patients (P = .004). When RA patients were stratified by PON1-rs662 status, these associations remained in the low-activity genotype (QQ). Finally, a poor clinical response on TNF? blockade was related to an increasing prevalence of the TGhighHDLlow profile over treatment (P = .021) and higher TRL levels at baseline (P = .042). Conclusions The TGhighHDLlow profile is associated with systemic inflammation, decreased PON1 activity, and poor clinical outcome on TNF? blockade in RA, suggesting a role of TRL and HDL dysfunction as the missing link between inflammation and lipid profile.This work was supported by European Union FEDER funds, “Fondo de Investigación Sanitaria (FIS, PI12/00523 and PI16/00113; ISCIII, Spain) and SER/FER funds (Sociedad Española de Reumatología, FER043/2016). J.R.-C. is supported by a postdoctoral contract from the “Juan de la Cierva” program (FJCI-2015-23849; MINECO, Spain)

Abordaje de la insuficiencia cardiaca amiloidótica desde la pluripatología

A 88-year-old patient with personal clinical record of heart failure with left ventricular hypertrophy preserved ejection fraction and paroxysmal atrial flutter, is admitted due to a right heart failure, being diagnosed of natural transthyretin cardial amyloidosis. We approach the diagnostic process and its implications under the view of pluripathology which allows us to maintain the balance between nihilism and obstinacy upon the advances of the disease.  Paciente de 88 años con antecedentes de insuficiencia cardíaca, hipertrofia ventricular izquierda con fracción de eyección preservada y flutter auricular paroxístico. Ingresó por insuficiencia cardíaca de predominio derecho, siendo diagnosticada finalmente de amiloidosis cardíaca por transtiretina natural. Abordamos el proceso diagnóstico y las implicaciones del mismo desde una visión global e integradora que nos permite mantener el equilibrio entre el nihilismo y la obstinación ante los avances que se están produciendo en esta enfermedad

Golimumab as rescue therapy for refractory immune-mediated uveitis: a three-center experience

OBJECTIVE: To evaluate, in three Spanish tertiary referral centres, the short-term safety and efficacy of golimumab (GLM) for treatment of immune-mediated uveitis resistant to previous immunosuppressive therapy. METHODS: Nonrandomized retrospective interventional case series. Thirteen patients with different types of uveitis that were resistant to treatment with at least 2 previous immunosuppressors were included in this study. All included patients were treated with GLM (50 mg every four weeks) during at least 6 months. Clinical evaluation and treatment-related side effects were assessed at least four times in all included patients. RESULTS: Eight men and 5 women (22 affected eyes) with a median age of 30 years (range 20-38) and active immune-mediated uveitides were studied. GLM was used in combination with conventional immunosuppressors in 7 patients (53.8%). GLM therapy achieved complete control of inflammation in 12/13 patients (92.3%) after six months of treatment. There was a statistically significant improvement in mean BCVA (0.60 versus 0.68, P = 0.009) and mean 1 mm central retinal thickness (317 versus 261.2 µ, P = 0.05) at the six-month endpoint when compared to basal values. No major systemic adverse effects associated with GLM therapy were observed. CONCLUSIONS: GLM is a new and promising therapeutic option for patients with severe and refractory uveitis

MicroRNA-145 and microRNA-486 are potential serum biomarkers for vascular calcification

INTRODUCTION: MicroRNAs (miRs) regulate vascular calcification (VC), and their quantification may contribute to suspicion of the presence of VC. METHODS: The study was performed in four phases. Phase 1: miRs sequencing of rat calcified and non-calcified aortas. Phase 2: miRs with the highest rate of change, plus miR-145 [the most abundant miR in vascular smooth muscle cells (VSMCs)], were validated in aortas and serum from rats with and without VC. Phase 3: the selected miRs were analyzed in epigastric arteries from kidney donors and recipients, and serum samples from general population. Phase 4: VSMCs were exposed to different phosphorus concentrations, and miR-145 and miR-486 were overexpressed to investigate their role in VC. RESULTS: miR-145, miR-122-5p, miR-486 and miR-598-3p decreased in the rat calcified aortas, but only miR-145 and miR-486 were detected in serum. In human epigastric arteries, miR-145 and miR-486 were lower in kidney transplant recipients compared with donors. Both miRs inversely correlated with arterial calcium content and with VC (Kauppila index). In the general population, the severe VC was associated with the lowest serum levels of both miRs. The receiver operating characteristic curve showed that serum miR-145 was a good biomarker of VC. In VSMCs exposed to high phosphorus, calcium content, osteogenic markers (Runx2 and Osterix) increased, and the contractile marker (α-actin), miR-145 and miR-486 decreased. Overexpression of miR-145, and to a lesser extent miR-486, prevented the increase in calcium content induced by high phosphorus, the osteogenic differentiation and the loss of the contractile phenotype. CONCLUSION: miR-145 and miR-486 regulate the osteogenic differentiation of VSMCs, and their quantification in serum could serve as a marker of VC

Mini: A New Social Robot for the Elderly

The unceasing aging of the population is leading to new problems in developed countries. Robots represent an opportunity to extend the period of independent living of the elderly as well as to ameliorate their economic burden and social problems. We present a new social robot, Mini, specifically designed to assist and accompany the elderly in their daily life either at home or in a nursing facility. Based on the results of several meetings with experts in this field, we have built a robot able to provide services in the areas of safety, entertainment, personal assistance and stimulation. Mini supports elders and caregivers in cognitive and mental tasks. We present the robot platform and describe the software architecture, particularly focussing on the human–robot interaction. We give in detail how the robot operates and the interrelation of the different modules of the robot in a real use case. In the last part of the paper, we evaluated how users perceive the robot. Participants reported interesting results in terms of usability, appearance, and satisfaction. This paper describes all aspects of the design and development of a new social robot that can be used by other researchers who face the multiple challenges of creating a new robotic platform for older people.The research leading to these results has received funding from the projects: Development of social robots to help seniors with cognitive impairment (ROBSEN), funded by the Ministerio de Economía y Competitividad; and Robots Sociales para Estimulación Física, Cognitiva y Afectiva de Mayores (ROSES), funded by the Ministerio de Ciencia, Innovación y Universidades.Publicad

Altered profile of circulating microparticles in rheumatoid arthritis patients

Abstract Microparticles (MPs) could be considered biomarkers of cell damage and activation as well as novel signalling structures. Since rheumatoid arthritis (RA) is characterized by immune and endothelial activation, the main aim of the present study was to analyse MP counts in RA patients. Citrated-blood samples were obtained from 114 RA patients, 33 healthy controls (HC) and 72 individuals with marked cardiovascular (CV) risk without autoimmune manifestations (CVR). MPs were analysed in platelet-poor plasma (PPP) and different subsets were identified by their surface markers: platelet-(CD41 + ), endothelial-(CD146 + ), granulocyte-(CD66 + ), monocyte-(CD14 + ) and Tang-(CD3 + CD31 + ) derived. Disease activity score (DAS28), clinical and immunological parameters as well as traditional CV risk factors (diabetes, hypertension, dyslipidaemia and obesity) were registered from clinical records and all data were integrated using Principal Component Analysis (PCA). Absolute MP number was increased in RA patients compared with HC and positively correlated with traditional CV risk factors, similar to that of CVR subjects. In addition, frequency of the different MP subsets was different in RA patients and significantly associated with disease features. Moreover, in vitro assays revealed that MPs isolated from RA patients were able to promote endothelial activation and exhibited detrimental effects on human microvascular endothelial cells (HMEC-I) endothelial cell functionality. Circulating MPs from RA patients displayed quantitative and qualitative alterations that are the result of both disease-specific and traditional CV risk factors. Accordingly, this MP pool exhibited in vitro detrimental effects on endothelial cells, thus supporting their role as biomarkers of vascular damage

Artificial reefs built by 3D printing: systematisation in the design, material selection and fabrication

The recovery of degraded marine coasts and the improvement of natural habitats are current issues of vital importance for the development of life, both marine and terrestrial. In this sense, the immersion of artificial reefs (ARs) in the marine environment is a way to stimulate the recovery of these damaged ecosystems. But it is necessary to have a multidisciplinary approach that analyses the materials, designs and construction process of artificial reefs in order to understand their true impact on the environment. For this reason, this paper presents the manufacture of artificial reefs by 3D printing, proposing designs with a combination of prismatic and random shapes, with different external overhangs as well as inner holes. For the definition of the artificial reef designs, criteria provided by marine biologists and the results obtained from a numerical simulation with ANSYS were taken into account, with which the stability of the artificial reefs on the seabed was analysed. Three dosages of cement mortars and three dosages of geopolymer mortars were studied as impression materials. The studies included determination of the rheological properties of the mortars, to define the printability, determination of the cost of the materials used, and determination of the mechanical strength and biological receptivity in prismatic specimens that were immersed in the sea for 3 months. To evaluate the environmental impact of the materials used in the production of the mortars, a Life Cycle Assessment (LCA) was carried out. In order to choose the mortars that encompassed the best properties studied, Multi-Criteria Decision Making (MCDM) was applied and the two best mortars were used for the manufacture of the artificial reefs. Finally, the advantages and disadvantages of the 3D printing process used were analysed. The results of the studies carried out in this research show that cement mortars have better characteristics for artificial reef applications using 3D printing, and that the technique applied for the manufacture of the artificial reefs allowed the digital models to be faithfully reproduced.This work has been co-financed by the European Regional Development Fund through the Interreg Atlantic Area Programme, under the project “Artificial Reef 3D Printing for Atlantic Area - 3DPARE” (EAPA_174/2016). Besides, the authors want to thank the following companies for their contribution: Solvay, for supplying the fly ash and sodium hydroxide; BASF, for providing the additives used in the research; Abonomar S.L., for providing the seashells sand; FCC ámbito, for providing the crushed recycled glass and Grupo Cementos Portland Valderribas (Mataporquera plant) for providing the cement

Comorbidities in patients with Primary Sjögren's Syndrome and Systemic Lupus Erythematosus: A comparative registries-based study

OBJECTIVE: To compare the prevalence of the main comorbidities in 2 large cohorts of patients with primary Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE), with a focus on cardiovascular (CV) diseases. METHODS: This was a cross-sectional multicenter study where the prevalence of more relevant comorbidities in 2 cohorts was compared. Patients under followup from SJOGRENSER (Spanish Rheumatology Society Registry of Primary SS) and RELESSER (Spanish Rheumatology Society Registry of SLE), and who fulfilled the 2002 American-European Consensus Group and 1997 American College of Rheumatology classification criteria, respectively, were included. A binomial logistic regression analysis was carried out to explore potential differences, making general adjustments for age, sex, and disease duration and specific adjustments for each variable, including CV risk factors and treatments, when appropriate. RESULTS: A total of 437 primary SS patients (95% female) and 2,926 SLE patients (89% female) were included. The mean age was 58.6 years (interquartile range [IQR] 50.0-69.9 years) for primary SS patients and 45.1 years (IQR 36.4-56.3 years) for SLE patients (P?<?0.001), and disease duration was 10.4 years (IQR 6.0-16.7 years) and 13.0 years (IQR 7.45-19.76 years), respectively (P?<?0.001). Smoking, dyslipidemia, and arterial hypertension were associated less frequently with primary SS (odds ratio [OR] 0.36 [95% confidence interval (95% CI) 0.28-0.48], 0.74 [95% CI 0.58-0.94], and 0.50 [95% CI 0.38-0.66], respectively) as were life-threatening CV events (i.e., stroke or myocardial infarction; OR 0.57 [95% CI 0.35-0.92]). Conversely, lymphoma was associated more frequently with primary SS (OR 4.41 [95% CI 1.35-14.43]). The prevalence of severe infection was lower in primary SS than in SLE (10.1% versus 16.9%; OR 0.54 [95% CI 0.39-0.76]; P?<?0.001). CONCLUSION: Primary SS patients have a consistently less serious CV comorbidity burden and a lower prevalence of severe infection than those with SLE. In contrast, their risk of lymphoma is greater

Geobotanical excursion guide of the XIII International Seminar Management and Biodiversity Conservation-Vale do Lobo, Loulé (Algarve-Portugal)

43 páginas, 10 figuras.[EN] This field guide was developed as part of the XIII International Seminar Management and Biodiversity Conservation – Vale do Lobo, Loulé (Algarve – Portugal), that aims to contribute for the scientific knowledge of the flora and vegetation of the Algarvian territories. The itinerary of the geobotanical excursion have been chosen to present the remarkable floristic richness and plant communities of three different landscape subunits: i) Faixa Litoral (dunes and saltmarshes of the Ancão Peninsula); ii) Barrocal (Nave do Barão); and, iii) Serra Algarvia (Caldeirão and Monchique mountains). For each sites the plant communities are briefly stated, as well as the vascular flora observed, including species with special conservation interest. Finally, we present the syntaxonomic scheme, and the floristic catalog of the field trip.[PO] No âmbito das atividades do XIII Seminário Internacional de Gestão e Conservação da Biodiversidade – Vale do Lobo, Loulé (Algarve – Portugal), desenvolveu-se o presente trabalho, com o objetivo de aprofundar o conhecimento da flora e vegetação dos locais a visitar no contexto do itinerário da excursão geobotânica aos territórios algarvios. Assim, a seleção dos locais de paragem procurou evidenciar a originalidade florística e fitocenótica de três sub-unidades paisagísticas de carácter e identidade distintas: i) Faixa Litoral (dunas e sapais da Península do Ancão); ii) Barrocal (Nave do Barão); e, iii) Serra Algarvia (Serra do Caldeirão e Serra de Monchique). Após uma breve descrição dos aspetos litológicos, das condições bioclimáticas e do enquadramento biogeográfico, evidenciam-se as associações vegetais e espécies presentes nas paragens realizadas, com identificação dos elementos florísticos com interesse para a conservação. Por último, tendo por base a descrição da vegetação, apresenta-se o esquema sintaxonómico, e um elenco florístico dos locais percorridos