On the use of discrete cosine transforms for multicarrier communications

In this correspondence, the conditions to use any kind of discrete cosine transform (DCT) for multicarrier data transmission are derived. The symmetric convolution-multiplication property of each DCT implies that when symmetric convolution is performed in the time domain, an element-by-element multiplication is performed in the corresponding discrete trigonometric domain. Therefore, appending symmetric redun-dancy (as prefix and suffix) into each data symbol to be transmitted, and also enforcing symmetry for the equivalent channel impulse response, the linear convolution performed in the transmission channel becomes a symmetric convolution in those samples of interest. Furthermore, the channel equalization can be carried out by means of a bank of scalars in the corresponding discrete cosine transform domain. The expressions for obtaining the value of each scalar corresponding to these one-tap per subcarrier equalizers are presented. This study is completed with several computer simulations in mobile broadband wireless communication scenarios, considering the presence of carrier frequency offset (CFO). The obtained results indicate that the proposed systems outperform the standardized ones based on the DFT

External Validation of SAFE Score to Predict Atrial Fibrillation Diagnosis after Ischemic Stroke: A Retrospective Multicenter Study

Diagnóstico; Fibrilación auricular; Ictus isquémicoDiagnòstic; Fibril·lació auricular; Ictus isquèmicDiagnosis; Atrial fibrillation; Ischemic strokeIntroduction: The screening for atrial fibrillation (AF) scale (SAFE score) was recently developed to provide a prediction of the diagnosis of AF after an ischemic stroke. It includes 7 items: age ≥ 65 years, bronchopathy, thyroid disease, cortical location of stroke, intracranial large vessel occlusion, NT-ProBNP ≥250 pg/mL, and left atrial enlargement. In the internal validation, a good performance was obtained, with an AUC = 0.88 (95% CI 0.84-0.91) and sensitivity and specificity of 83% and 80%, respectively, for scores ≥ 5. The aim of this study is the external validation of the SAFE score in a multicenter cohort. Methods: A retrospective multicenter study, including consecutive patients with ischemic stroke or transient ischemic attack between 2020 and 2022 with at least 24 hours of cardiac monitoring. Patients with previous AF or AF diagnosed on admission ECG were excluded. Results: Overall, 395 patients were recruited for analysis. The SAFE score obtained an AUC = 0.822 (95% CI 0.778-0.866) with a sensitivity of 87.2%, a specificity of 65.4%, a positive predictive value of 44.1%, and a negative predictive value of 94.3% for a SAFE score ≥ 5, with no significant gender differences. Calibration analysis in the external cohort showed an absence of significant differences between the observed values and those predicted by the model (Hosmer-Lemeshow's test 0.089). Conclusions: The SAFE score showed adequate discriminative ability and calibration, so its external validation is justified. Further validations in other external cohorts or specific subpopulations of stroke patients might be required.We acknowledge FIBAO (Biomedical Research Foundation) and Adrián Aparicio Mota for their assistance with statistical analysis. Adrián Aparicio (a FIBAO statistician) analyzed the collected data. The project was the winner of the IV research grant “STROKE PROJECT 2020” from the Spanish Society of Neurology

Assessment of Exercise Capacity in Post-COVID-19 Patients: How Is the Appropriate Test Chosen?

There is a wide range of sequelae affecting COVID-19 survivors, including impaired physical capacity. These sequelae can affect the quality of life and return to work of the active population. Therefore, one of the pillars of following-up is the evaluation of physical capacity, which can be assessed with field tests (such as the six-minute walk test, the one-minute standing test, the Chester step test, and the shuttle walking test) or laboratory tests (such as the cardiopulmonary exercise test). These tests can be performed in different contexts and have amply demonstrated their usefulness in the assessment of physical capacity both in post-COVID-19 patients and in other chronic respiratory, metabolic, cardiologic, or neurologic diseases. However, when traditional tests cannot be performed, physical function can be a good substitute, especially for assessing the effects of an intervention. For example, the Short Physical Performance Battery assessment and the Timed Up and Go assessment are widely accepted in older adults. Thus, the test should be chosen according to the characteristics of each subject

PYY1-36 and PYY3-36 secretory response after a mixed meal in healthy individuals

[Resumen] Introducción. El péptido YY (PYY) tiene 36 aminoácidos y lo sintetizan fundamentalmente las células L del intestino. El PYY aumenta tras las comidas y alcanza su nadir tras el ayuno. Tras la ingestión se liberan dos formas: PYY1-36 y PYY3-36. Se ha demostrado que el PYY3-36 reduce la ingesta en humanos y roedores. Hay poca información sobre los valores plasmáticos de PYY, especialmente de PYY3-36, en respuesta a la ingestión y su relación con la respuesta de ghrelina. Objetivos. Estudiar la respuesta secretora de PYY1-36 y PYY3-36 en sujetos normales tras ingerir una comida mixta y su relación con la secreción de ghrelina total y acilada. Sujetos y métodos. Estudiamos a 8 sujetos sanos, 4 mujeres y 4 varones, con una mediana de edad de 53 (intervalo, 36-59) años. Tras el ayuno nocturno, recibieron en 2 días diferentes y de forma aleatoria: una comida oral mixta estándar, que consistía en 400 ml de Isosource Energy (159 kcal/100 ml) o placebo por vía oral (400 ml de agua). Se obtuvieron muestras sanguíneas en los tiempos 0, 30, 45, 60 y 120 min para la determinación de PYY1-36, PYY3-36, ghrelina total y ghrelina acilada. Las comparaciones se realizaron mediante la prueba de Wilcoxon. Las correlaciones numéricas se analizaron mediante la prueba de correlación de Spearman. Se consideró significativo un valor de p ≤ 0,05. Resultados. Tras ingerir la comida, se produce un máximo de PYY1-36 (mediana [intervalo]) de 141,5 (81-198) pg/ml y no hay respuesta tras placebo, con un máximo de 92,5 (46-219) pg/ml (p = 0,04). Los valores del área bajo la curva (ABC) de PYY1-36 tras la ingesta fueron 14.865 (8.032-19.822) pg/ml/min y tras placebo, 8.992 (4.455- 21.382) pg/ml/min (p = 0,06). Tras ingerir la comida se produce un máximo de PYY3-36 de 92,5 (59-135) pg/ml y no hay respuesta tras placebo, con un máximo de 46,5 (30- 66) pg/ml (p = 0,02). Los valores del ABC de PYY3-36 tras la ingesta fueron 9.086 (6.412-14.970) pg/ml/min y tras placebo, 4.984 (3.142-6.772) pg/ml/min (p = 0,012). El cociente nadir de ghrelina total/máximo de PYY1-36 disminuye de forma marcada tras la ingestión; los valores preprandiales son 7,44 (3,64-14,56) y los posprandiales, 3,55 (1,64-7,16) (p = 0,03), mientras que no se modifica tras placebo. El cociente nadir de ghrelina acilada/máximo de PYY3-36 disminuye de forma marcada tras la ingestión, y los valores preprandiales son 2,03 (0,92-3) y los posprandiales, 0,73 (0,26-1,27) (p = 0,02), mientras que no se modifican tras placebo. Conclusiones. En sujetos normales, PYY1-36 y PYY3-36 aumentan de forma paralela tras ingerir una comida mixta; simultáneamente, los valores de ghrelina total y acilada disminuyen. El cociente entre el nadir de ghrelina acilada y el máximo de PYY3-36 disminuye tras ingerir una comida mixta. Este conjunto de datos indica su posible participación en la regulación aguda del apetito tras la comida.[Abstract] Background. Peptide YY (PYY) is a 36 amino acid peptide synthesized mostly by intestinal L cells. This peptide reaches its nadir during fasting and increases immediately after meals. After food intake, two molecular forms are released, PYY1-36 and PYY3-36. PYY3-36 reduces food intake in both humans and rodents. There is scarce information about plasmatic concentrations of PYY, especially of PYY3-36, after food ingestion, and their relationship to ghrelin. Objectives. To study PYY1-36 and PYY3-36 secretory response after a mixed meal, and its relationship to total and acylated ghrelin secretion in healthy subjects. Subjects and method. We studied eight healthy subjects, 4 women and 4 men, with a median age of 53 (range, 36-59) years. After an overnight fast, the subjects received either a mixed standard meal (400 ml Isosource Energy® [159 kcal/100 ml]) or placebo (400 ml of water) orally in random order on two different days. Blood samples were obtained at 0, 30, 45, 60 and 120 min for measurement of PYY1-36, PYY3-36, total ghrelin and acylated ghrelin. Comparisons were made by Wilcoxon's test. Numerical correlations were performed using Spearman's test. P-values ≤ 0.05 were considered significant. Results. After a mixed meal, PYY1-36 reached a peak of (median [range]) 141.5 (81-198) pg/ml. There was no response to placebo, with a peak of 92.5 (46-219) pg/ml (p = 0.04). The area under the curve (AUC) of PYY1-36 levels after a mixed meal were 14,865 (8,032-19,822) pg/ml/min and after placebo were 8,992 (4,455-21,382) pg/ml/min (p = 0.06). After ingestion of a mixed meal, PYY3-36 reached a peak of 92.5 (59-135) pg/ml, with no response to placebo (46.5 [30-66] pg/ml) (p = 0.02). The AUC of PYY3-36 levels after a mixed meal were 9,086 (6,412-14,970) pg/ml/min, and after placebo were 4,984 (3,142-6,772) pg/ml/min (p = 0.012). The quotient between nadir total ghrelin/peak PYY1-36 was markedly diminished after food ingestion, with preprandial values of 7.44 (3.64-14.56) and postprandial values of 3.55 (1.64-7.16) (p = 0.03). The former quotient was unmodified by placebo. The quotient between nadir acylated ghrelin/peak PYY3-36 was markedly diminished after ingestion of a mixed meal, with preprandial values of 2.03 (0.92-3) and postprandial values of 0.73 (0.26-1.27) (p = 0.02). This quotient was unmodified by placebo. Conclusions. In healthy subjects, blood levels of both PYY1-36 and PYY3-36 increase after ingestion of a mixed meal. Simultaneously, total and acylated ghrelin levels diminish. The quotient between nadir acylated ghrelin/peak PYY3-36 diminishes after a mixed meal. All these data suggest the possible contribution of these peptides to appetite regulation after ingestion.Instituto de Salud Carlos III, PI051024Instituto de Salud Carlos III, PI070413Xunta de Galicia, PGIDT05PXIC91605PNXunta de Galicia, PS07/1

Protocol for regional implementation of collaborative self-management services to promote physical activity

Background: Chronic diseases are generating a major health and societal burden worldwide. Healthy lifestyles, including physical activity (PA), have proven efficacy in the prevention and treatment of many chronic conditions. But, so far, national PA surveillance systems, as well as strategies for promotion of PA, have shown low impact. We hypothesize that personalized modular PA services, aligned with healthcare, addressing the needs of a broad spectrum of individual profiles may show cost-effectiveness and sustainability. Methods: The current manuscript describes the protocol for regional implementation of collaborative self-management services to promote PA in Catalonia (7.5 M habitants) during the period 2017-2019. The protocols of three implementation studies encompassing a broad spectrum of individual needs are reported. They have a quasi-experimental design. That is, a non-randomized intervention group is compared to a control group (usual care) using propensity score methods wherein age, gender and population-based health risk assessment are main matching variables. The principal innovations of the PA program are: i) Implementation of well-structured modular interventions promoting PA; ii) Information and communication technologies (ICT) to facilitate patient accessibility, support collaborative management of individual care plans and reduce costs; and iii) Assessment strategies based on the Triple Aim approach during and beyond the program deployment. Discussion: The manuscript reports a precise roadmap for large scale deployment of community-based ICT-supported integrated care services to promote healthy lifestyles with high potential for comparability and transferability to other sites. Trial registration: This study protocol has been registered at ClinicalTrials.org ( NCT02976064 ). Registered November 24th, 2016

Neural plasticity and proliferation in the generation of antidepressant effects: hippocampal implication

It is widely accepted that changes underlying depression and antidepressant-like effects involve not only alterations in the levels of neurotransmitters as monoamines and their receptors in the brain, but also structural and functional changes far beyond. During the last two decades, emerging theories are providing new explanations about the neurobiology of depression and the mechanism of action of antidepressant strategies based on cellular changes at the CNS level. The neurotrophic/plasticity hypothesis of depression, proposed more than a decade ago, is now supported by multiple basic and clinical studies focused on the role of intracellular-signalling cascades that govern neural proliferation and plasticity. Herein, we review the state-of-the-art of the changes in these signalling pathways which appear to underlie both depressive disorders and antidepressant actions. We will especially focus on the hippocampal cellularity and plasticity modulation by serotonin, trophic factors as brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) through intracellular signalling pathways-cAMP, Wnt/ β -catenin, and mTOR. Connecting the classic monoaminergic hypothesis with proliferation/neuroplasticity-related evidence is an appealing and comprehensive attempt for improving our knowledge about the neurobiological events leading to depression and associated to antidepressant therapies

Screen-printed electrode based electrochemical detector coupled with ionic liquid dispersive liquid–liquid microextraction and microvolume back-extraction for determination of mercury in water samples

A novel approach is presented, whereby gold nanostructured screen-printed carbon electrodes (SPCnAuEs) are combined with in-situ ionic liquid formation dispersive liquid–liquid microextraction (in-situ IL-DLLME) and microvolume back-extraction for the determination of mercury in water samples. In-situ IL-DLLME is based on a simple metathesis reaction between a water-miscible IL and a salt to form a water-immiscible IL into sample solution. Mercury complex with ammonium pyrrolidinedithiocarbamate is extracted from sample solution into the water-immiscible IL formed in-situ. Then, an ultrasound-assisted procedure is employed to back-extract the mercury into 10 µL of a 4 M HCl aqueous solution, which is finally analyzed using SPCnAuEs. Sample preparation methodology was optimized using a multivariate optimization strategy. Under optimized conditions, a linear range between 0.5 and 10 µg L−1 was obtained with a correlation coefficient of 0.997 for six calibration points. The limit of detection obtained was 0.2 µg L−1, which is lower than the threshold value established by the Environmental Protection Agency and European Union (i.e., 2 µg L−1 and 1 µg L−1, respectively). The repeatability of the proposed method was evaluated at two different spiking levels (3 and 10 µg L−1) and a coefficient of variation of 13% was obtained in both cases. The performance of the proposed methodology was evaluated in real-world water samples including tap water, bottled water, river water and industrial wastewater. Relative recoveries between 95% and 108% were obtained.The authors would like to thank the Spanish Ministry of Science and Innovation (Project nos. CTQ2011-23968 and CTQ2011-24560), the Generalitat Valenciana (Spain) (Project nos. ACOMP/2013/072, PROMETEO/2013/038 and GV/2014/096) and the University of Alicante (Spain) (Project no. GRE12-45) for the financial support. E. Fernández and D. Martín-Yerga also thank Generalitat Valenciana and Ministry of Economy and Competitiveness, respectively, for their fellowships

In-depth analysis of T cell immunity and antibody responses in heterologous prime-boost-boost vaccine regimens against SARS-CoV-2 and Omicron variant.

With the emergence of novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Variants of Concern (VOCs), vaccination studies that elucidate the efficiency and effectiveness of a vaccination campaign are critical to assess the durability and the protective immunity provided by vaccines. SARS-CoV-2 vaccines have been found to induce robust humoral and cell-mediated immunity in individuals vaccinated with homologous vaccination regimens. Recent studies also suggest improved immune response against SARS-CoV-2 when heterologous vaccination strategies are employed. Yet, few data exist on the extent to which heterologous prime-boost-boost vaccinations with two different vaccine platforms have an impact on the T cell-mediated immune responses with a special emphasis on the currently dominantly circulating Omicron strain. In this study, we collected serum and peripheral blood mononuclear cells (PBMCs) from 57 study participants of median 35-year old's working in the health care field, who have received different vaccination regimens. Neutralization assays revealed robust but decreased neutralization of Omicron VOC, including BA.1 and BA.4/5, compared to WT SARS-CoV-2 in all vaccine groups and increased WT SARS-CoV-2 binding and neutralizing antibodies titers in homologous mRNA prime-boost-boost study participants. By investigating cytokine production, we found that homologous and heterologous prime-boost-boost-vaccination induces a robust cytokine response of CD4+ and CD8+ T cells. Collectively, our results indicate robust humoral and T cell mediated immunity against Omicron in homologous and heterologous prime-boost-boost vaccinated study participants, which might serve as a guide for policy decisions

Current threats faced by amphibian populations in the southern cone of South America

In this work, we update and increase knowledge on the severity and extent of threats affecting 57 populations of 46 amphibian species from Chile and Argentina in southern South America. We analyzed the intrinsic conservation problems that directly impact these populations. We shared a questionnaire among specialists on threats affecting target amphibian populations with information on i) range, ii) historical occurrence and abundance, iii) population trends, iv) local extinctions, v) threats, and vi) ongoing and necessary conservation/research. We assessed association patterns between reported threats and population trends using multiple correspondence analysis. Since 2010, 25 of 57 populations have declined, while 16 experienced local extinctions. These populations were affected by 81% of the threat categories analyzed, with those related to agricultural activities and/or habitat modifications being the most frequently reported. Invasive species, emerging diseases, and activities related to grazing, ranching, or farming were the threats most associated with population declines. Low connectivity was the most frequent intrinsic conservation problem affecting 68% of the target populations, followed by low population numbers, affecting 60%. Ongoing monitoring activity was conducted in 32 (56%) populations and was the most frequent research activity. Threat mitigation was reported in 27 (47%) populations and was the most frequent ongoing management activity. We found that habitat management is ongoing in 5 (9%) populations. At least 44% of the amphibian populations surveyed in Chile and Argentina are declining. More information related to the effect of management actions to restore habitats, recover populations, and eliminate threats such as invasive species is urgently needed to reverse the conservation crisis facing amphibians in this Neotropical region.Fil: Kacoliris, Federico Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Berkunsky, Igor. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Exactas. Instituto Multidisciplinario de Ecosistemas y Desarrollo Sustentable; ArgentinaFil: Acosta, Juan Carlos. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Acosta, Rodrigo. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Agostini, Maria Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; ArgentinaFil: Akmentins, Mauricio Sebastián. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; ArgentinaFil: Arellano, María Luz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Azat, Claudio. Universidad Andrés Bello; ChileFil: Bach, Nadia Carla. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Blanco, Mirta Blanco. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Calvo, Rodrigo. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Charrier, Andres. Pontificia Universidad Católica de Chile; ChileFil: Corbalán, Valeria Elizabeth. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Correa, Claudio. Universidad de Concepción. Facultad de Ciencias Naturales y Oceanografía. Departamento de Zoología; ChileFil: Cuello, Maria Elena. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; ArgentinaFil: Deutsch, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; ArgentinaFil: Di Pietro, Diego Omar. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Gastón, María Soledad. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; ArgentinaFil: Gomez Alez, Rodrigo. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Kaas, Camila. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Kaas, Nicolas. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Lobos, Gabriel. Universidad de Chile; ChileFil: Martínez, Tomás Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Martínez Aguirre, Tomás. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Mora, Marta. Vida Nativa NGO; ChileFil: Nieva Cocilio, Rodrigo Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Pastore, Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Administración de Parques Nacionales; ArgentinaFil: Pérez Iglesias, Juan Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentina. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Laboratorio de Biología; ArgentinaFil: Piaggio Kokot, Lia Elena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Rabanal, Felipe. Universidad Austral de Chile; ChileFil: Rodríguez Muñoz, Melina Jesús. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; ArgentinaFil: Sanchez, Laura Cecilia. Provincia de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Universidad Autónoma de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción; ArgentinaFil: Tala, Charif. Ministerio del Medio Ambiente de Chile; ChileFil: Ubeda, Carmen Adria. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; ArgentinaFil: Vaira, Marcos. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; ArgentinaFil: Velasco, Melina Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; ArgentinaFil: Vidal, Marcela. Universidad del Bio Bio. Facultad de Ciencias. Departamento de Ciencias Basicas; ChileFil: Williams, Jorge Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados. Sección Herpetología; Argentin

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

Objectives. This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE. Methods. RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoimmunity, which was defined as the co-occurrence of SLE and another autoimmune disease, such as autoimmune thyroiditis, RA, scleroderma, inflammatory myopathy and MCTD. We also recorded the presence of multiple autoimmune syndrome, secondary SS, secondary APS and a family history of autoimmune disease. Multiple logistic regression analysis was performed to investigate possible risk factors for polyautoimmunity. Results. Of the 3679 patients who fulfilled the criteria for SLE, 502 (13.6%) had polyautoimmunity. The most frequent types were autoimmune thyroiditis (7.9%), other systemic autoimmune diseases (6.2%), secondary SS (14.1%) and secondary APS (13.7%). Multiple autoimmune syndrome accounted for 10.2% of all cases of polyautoimmunity. A family history was recorded in 11.8%. According to the multivariate analysis, the factors associated with polyautoimmunity were female sex [odds ratio (95% CI), 1.72 (1.07, 2.72)], RP [1.63 (1.29, 2.05)], interstitial lung disease [3.35 (1.84, 6.01)], Jaccoud arthropathy [1.92 (1.40, 2.63)], anti-Ro/SSA and/or anti-La/SSB autoantibodies [2.03 (1.55, 2.67)], anti-RNP antibodies [1.48 (1.16, 1.90)], MTX [1.67 (1.26, 2.18)] and antimalarial drugs [0.50 (0.38, 0.67)]. Conclusion. Patients with SLE frequently present polyautoimmunity. We observed clinical and analytical characteristics associated with polyautoimmunity. Our finding that antimalarial drugs protected against polyautoimmunity should be verified in future studies