Value of clinical factors in selecting postmenopausal women with rheumatoid arthritis for bone densitometry.

Criteria to decide which patients with rheumatoid arthritis (RA) should be examined by dual energy x ray absorptiometry (DXA) are currently not available. The rheumatologists from Amsterdam have proposed preliminary criteria based on clinical risk factors (age, disease activity, and functional status). These criteria are preliminary and not widely accepted but might be helpful in practice. The value of the proposal in a group of Spanish postmenopausal women with RA is analysed. METHODS DXA (lumbar spine and femoral neck) was performed in 128 patients recruited from a clinical setting, and the proposed criteria were applied. T and Z scores were established for a Spanish reference population. RESULTS The mean (SD) age of the patients was 61.3 (10.7) and mean duration of the postmenopausal period 14.5 (10.1) years. Mean duration of RA was 13.7 (7.7) years. Mean C reactive protein was 22 (21) mg/l; mean erythrocyte sedimentation rate 26 (18) mm/1st h; and mean Health Assessment Questionnaire score 1.25 (0.79). Ninety (70%) patients fulfilled the proposed criteria. Their sensitivity for the diagnosis of osteoporosis (T score ¿¿2.5 SD) was 86% and their specificity, 43%. Positive predictive value was 54% and negative predictive value, 79%. CONCLUSIONS The proposed criteria seem a good screening method for the selection of those patients with RA whose bone mineral density should be assessed as the sensitivity and negative predictive value are acceptable.

Diagnostic and prognostic value of antibodies against chimeric fibrin/filaggrin citrullinated synthetic peptides in rheumatoid arthritis

Introduction: Evidence suggests that citrullinated fibrin(ogen) may be a potential in vivo target of anticitrullinated protein/peptide antibodies (ACPA) in rheumatoid arthritis (RA). We compared the diagnostic yield of three enzyme-linked immunosorbent assay (ELISA) tests by using chimeric fibrin/filaggrin citrullinated synthetic peptides (CFFCP1, CFFCP2, CFFCP3) with a commercial CCP2-based test in RA and analyzed their prognostic values in early RA. Methods: Samples from 307 blood donors and patients with RA (322), psoriatic arthritis (133), systemic lupus erythematosus (119), and hepatitis C infection (84) were assayed by using CFFCP- and CCP2-based tests. Autoantibodies also were analyzed at baseline and during a 2-year follow-up in 98 early RA patients to determine their prognostic value. Results: With cutoffs giving 98% specificity for RA versus blood donors, the sensitivity was 72.1% for CFFCP1, 78.0% for CFFCP2, 71.4% for CFFCP3, and 73.9% for CCP2, with positive predictive values greater than 97% in all cases. CFFCP sensitivity in RA increased to 80.4% without losing specificity when positivity was considered as any positive anti-CFFCP status. Specificity of the three CFFCP tests versus other rheumatic populations was high (> 90%) and similar to those for the CCP2. In early RA, CFFCP1 best identified patients with a poor radiographic outcome. Radiographic progression was faster in the small subgroup of CCP2-negative and CFFCP1-positive patients than in those negative for both autoantibodies. CFFCP antibodies decreased after 1 year, but without any correlation with changes in disease activity. Conclusions: CFFCP-based assays are highly sensitive and specific for RA. Early RA patients with anti-CFFCP1 antibodies, including CCP2-negative patients, show greater radiographic progression.

Diagnostic and prognostic value of antibodies against chimeric fibrin/filaggrin citrullinated synthetic peptides in rheumatoid arthritis

Introduction: Evidence suggests that citrullinated fibrin(ogen) may be a potential in vivo target of anticitrullinated protein/peptide antibodies (ACPA) in rheumatoid arthritis (RA). We compared the diagnostic yield of three enzyme-linked immunosorbent assay (ELISA) tests by using chimeric fibrin/filaggrin citrullinated synthetic peptides (CFFCP1, CFFCP2, CFFCP3) with a commercial CCP2-based test in RA and analyzed their prognostic values in early RA. Methods: Samples from 307 blood donors and patients with RA (322), psoriatic arthritis (133), systemic lupus erythematosus (119), and hepatitis C infection (84) were assayed by using CFFCP- and CCP2-based tests. Autoantibodies also were analyzed at baseline and during a 2-year follow-up in 98 early RA patients to determine their prognostic value. Results: With cutoffs giving 98% specificity for RA versus blood donors, the sensitivity was 72.1% for CFFCP1, 78.0% for CFFCP2, 71.4% for CFFCP3, and 73.9% for CCP2, with positive predictive values greater than 97% in all cases. CFFCP sensitivity in RA increased to 80.4% without losing specificity when positivity was considered as any positive anti-CFFCP status. Specificity of the three CFFCP tests versus other rheumatic populations was high (> 90%) and similar to those for the CCP2. In early RA, CFFCP1 best identified patients with a poor radiographic outcome. Radiographic progression was faster in the small subgroup of CCP2-negative and CFFCP1-positive patients than in those negative for both autoantibodies. CFFCP antibodies decreased after 1 year, but without any correlation with changes in disease activity. Conclusions: CFFCP-based assays are highly sensitive and specific for RA. Early RA patients with anti-CFFCP1 antibodies, including CCP2-negative patients, show greater radiographic progression.

Infectious arthritis in patients with rheumatoid arthritis

Eleven cases of infectious arthritis occurring in patients with rheumatoid arthritis are reported. Staphylococcus aureus was the causative organism in eight patients. Streptococcus anginosus and Streptococcus agalactiae in one patient each, and Mycobacterium tuberculosis in two patients. The mean duration of symptoms before diagnosis was 16 days in patients with pyogenic arthritis. The diagnosis of joint infection caused by Mycobacterium tuberculosis was especially delayed (57 days). Four patients died; they were found to have a longer time to diagnosis and two of them had multiple joint infection. Although Staphylococcus aureus is the microorganism most often affecting patients with rheumatoid arthritis, infection caused by Mycobacterium tuberculosis must also be considered in such patients.

Is syndecan-2 a key angiogenic element?

Angiogenesis is a tightly regulated process in vertebrates that leads to the formation of new blood vessels from pre-existing vessels or by the recruitment of bone marrow-derived endothelial precursor cells[1]. During embryogenesis, after stimulation by proangiogenic factors, such as VEGF or FGF, it contributes to the maturation of the vascular plexus. In adults, it is important in some physiologic conditions, such as wound healing or the reproductive cycle in females, although most of the time it is"switched off" by endogenous inhibitors, such as endostatin or angiostatin. Furthermore, its misregulation is the cause of many pathological situations, as it contributes to tumor development[2], diabetic retinopathy[3], rheumatoid arthritis[4], psoriasis[5], but also cardiovascular disorders[6] and obesity[7]

La raó circular

És un text epistemològic sobre les qüestions cognitives circulars que apareixen: a) Quan el subjecte forma part de l’objecte estudiat; b) En la recerca de les bases del coneixement; c) Al voler justificar la inducció; d) En algunes interpretacions filosòfiques i científiques. S’hi explica l’estat del punt a) el més problemàtic, i s’aclareixen els altres tres punts: els b) i c) pel fet científic que l’evolució cognitiva humana ha anat acoblada a l’evolució biològica, la qual ha generat els a priori kantians i altres innatismes. El d) perquè la formació del coneixement i de la ciència es progressiva, passant una i altra vegada sobre el que ja s’havia tractat però ascendint alhora i ampliant el panorama, tal com fa una escala de cargol.

Balanç de carbó atmosfèric: raó entre les emissions de metà de les vaques i el segrest forestal de CO2

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. L’objectiu d’aquest treball és determinar la capacitat de segrest de CO2 d’un bosc dels Pirineus, per tal de reduir el seu efecte hivernacle, en relació a l’impacte climàtic que tindrien les emissions de metà de les vaques. La metodologia s’ha basat en estimar la producció de fusta a partir d’inventaris forestals d’un bosc del Pallars Sobirà, i calcular-ne el segrest de CO2. Per altra banda, s’ha estimat bibliogràficament les emissions de metà d’una vaca. A partir de factors de conversió s’ha estimat la superfície de bosc que compensaria l’efecte hivernacle de les emissions de metà d’una vaca durant un any. El valor obtingut és de 0,727 hectàrees de bosc per vaca i any. Amb aquest valor s’ha estimat la superfície de bosc necessària per compensar les emissions de metà de la població de vaques de Catalunya. Aquests resultats són aproximats, donades les diferències en el creixement dels boscos de Catalunya. Aquest estudi dóna una dada comprensible que posa de manifest el concepte de balanç de carboni i els diferents elements que el formen.

Ra isotopes and Rn as a tool for the water management resources: the Alberquillas aquifer (Málaga-Granada)

The aim of this project is to evaluate the importance of submarine groundwater discharge sector in order to improve the water balance in Málaga-Granada region. The approach of this study arose from the the geology and the aquifers that indicate that there could be some discharge to the sea between Maro (Málaga) and Almuñécar (Granada) and the Andalusian’s Government and its Water Agence were really interested in evaluating it because there is a lot of population and few water available and the magnitude of groundwater discharge has generated controversy. Is well known that water is a scarce resource in this area and it’s very important for the society and for the environment. The legislation, the water policies, the knowledge of the aquifer and the geology, the water dynamics, the land use and the water perception in the society might help the management of this resource not just in Andalusia but in all the Mediterranean basin. The main objective is to evaluate the submarine groundwater discharge from the Alberquillas Aqufier to the sea by measuring 222Rn and Ra isotopes. Specific objectives have been established to achieve the main objective: A) Reveal the importance of water resources in the Mediterranean basin; B) Learn radiometric techniques for the study of groundwater discharge to the sea; C) Learn of sampling techniques of water samples for the measurement of Ra and Rn; D) Learn the techniques for measuring Ra (RaDeCC) and Rn (RAD7); E) Interpretation and discussion of results. During this semester, and in addition of the present study in Málaga- Granada region, the author has participated in the initial phase (sampling, analysis and interpretation of preliminary results) of other research projects focused on the study of submarine groundwater discharges through the use of Ra isotopes and 222Rn. These studies have been developed in different areas, including Alt Empordà (Roses and Sant Pere Pescador), Maresme with CMIMA’s group (Mediterranean Center for Marine and Environmental Research), Delta de l’Ebre, Peñíscola and Mallorca with the IMEDEA’s group (Mediterranean Institute for Advanced Studies).