CVD in RA patients Personal non-commercial use only

ABSTRACT. Objective. To evaluate the incidence of cardiovascular disease (CVD) among Greek patients with rheumatoid arthritis (RA) under medical followup, and to assess the contribution of traditional CVD and RA-specific factors associated with CVD development. Methods. This is a historic cohort study; information was collected from medical records of patients who had > 2 years' followup. Sociodemographic, clinical, laboratory, and therapeutic variables were evaluated for association with development of CVD. Results. A total of 325 RA patients were studied: 250 women, mean age at RA onset 44 ± 15 years, and 75 men, mean age at RA onset 51 ± 15 years; median followup was 10 years. Fourteen women (5.6%) and 12 men (16%) developed CVD (p = 0.004). Multi-adjusted analysis revealed that hypertension (hazard ratio 3.76, 95% CI 0.99-15.06) was associated with incidence of CVD; late age at disease onset (HR 1.07, 95% CI 1.04-1.11), elevated C-reactive protein (CRP) level 1 year after start of followup (HR 1.03, 95% CI 1.00-1.05), and leflunomide treatment (HR per 1 year of treatment = 1.02, 95% CI 1.00-1.05) were also positively associated with CVD development. Conclusion. Hypertension was an important risk factor for CVD development in patients with RA

The crucial role of sulfur in a phytoremediation process : Lessons from the Poaceae species as phytoremediants : a review

Among living organisms plants are the most tolerant to pollution. This fact, emphasizes their utility for phytoremediation, a promising technology for environmental cleanup. Many botanical families include multiple species which exhibit a notable phytoremediation potential. Each of these species enjoys certain advantages, but at the same encounters some limitations with respect to its application as phytoremediants. Careful selection of the appropriate family and genotype to match the particular pollutant and environment is crucial for successful phytoremediation; the Poaceae family seems to be one of the most important for this technology. Phytoremediation of inorganic and organic pollutants largely depends on sulfur (S) metabolism. Therefore, S sufficient conditions and efficient S metabolism constitute the prerequisites for the effectiveness of the process. In the modern societies, heavy-metal pollution of soils is causing ever greater problems, exacerbated by the fact that most heavy metals accumulated in plants may, either directly or indirectly, find their way into animals and human beings. Wheat, rice and maize are among the world\u2019s most prominent crops, whilst cadmium (Cd) and nickel (Ni) are among the most toxic metals. Therefore, the physiological adaptations induced in cereals, by Cd for example, are alarming and subsequently, the responsiveness of these species has been studied extensively as model plants. Studies with Arundo donax as phytoremediant have proven that this species is tolerant to increased concentrations of Cd and Ni in its rhizosphere, and as a consequence, it can be cultivated in contaminated areas for phytoremediation and energy production purposes. S-deficiency of crops is frequently reported, especially during the past two decades, worldwide. The main reasons for this deficiency are: the reduction of sulfur dioxide emission from power plants and various industrial sources, the ever increasing use of high-analysis low-S-containing fertilizers and the decreasing use of S-containing fertilizers, S-containing fungicides, pesticides and high-yielding varieties. A sufficient S supply of cereal crops is required in early growth stages, which cannot be fully compensated by S fertilization during later growth. Elemental S proved to contribute continuously to the crop\u2019s S nutrition due to its constant release after oxidation. Therefore, the early diagnosis of S deficiency, the profiling of S forms in the soil of the phytoremediation site and the prediction of S-fertilizer requirements are of key importance for achieving a successful process

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis

Background Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased mortality associated with cardiometabolic disorders including dyslipidaemia, insulin resistance, and cachectic obesity. Tumour necrosis factor inhibitors and interleukin 6 receptor blocker licensed for the treatment of RA decrease inflammation and could thus improve cardiovascular risk, but their effects on body composition and metabolic profile need to be clarified. We investigated the effects of tocilizumab (TCZ), a humanized anti‐interleukin 6 receptor antibody, on body composition and metabolic profile in patients treated for RA. Methods Twenty‐one active RA patients treated with TCZ were included in a 1 year open follow‐up study. Waist circumference, body mass index, blood pressure, lipid profile, fasting glucose, insulin, serum levels of adipokines and pancreatic/gastrointestinal hormones, and body composition (dual‐energy X‐ray absorptiometry) were measured at baseline and 6 and 12 months of treatment. At baseline, RA patients were compared with 21 non‐RA controls matched for age, sex, body mass index, and metabolic syndrome. Results Compared with controls, body composition was altered in RA with a decrease in total and appendicular lean mass, whereas fat composition was not modified. Among RA patients, 28.6% had a skeletal muscle mass index below the cut‐off point for sarcopaenia (4.8% of controls). After 1 year of treatment with TCZ, there was a significant weight gain without changes for fat mass. In contrast, an increase in lean mass was observed with a significant gain in appendicular lean mass and skeletal muscle mass index between 6 and 12 months. Distribution of the fat was modified with a decrease in trunk/peripheral fat ratio and an increase in subcutaneous adipose tissue. No changes for waist circumference, blood pressure, fasting glucose, and atherogenic index were observed. Conclusions Despite weight gain during treatment with TCZ, no increase in fat but a modification in fat distribution was observed. In contrast, muscle gain suggests that blocking IL‐6 might be efficient in treating sarcopaenia associated with RA

Idiopathic sclerosing mesenteritis in paediatrics: Report of a successfully treated case and a review of literature

A 6 year old female with symptoms of small bowel obstruction underwent an exploratory laparotomy which revealed widespread evidence of inflammatory fibrotic adhesions involving the jejunal mesentery. In view of persistent growth failure, chronic anaemia, elevated acute phase reactants and imaging evidence of a diffuse progressive inflammatory process, the child was treated with corticosteroids and methotrexate with complete response. The literature on juvenile idiopathic sclerosing mesenteritis has been reviewed