<i>Objective</i>. To investigate ovarian reserves in attack-free familial Mediterranean fever (AF-FMF) patients at the reproductive age by anti-M&#xfc;llerian hormone (AMH), antral follicle count (AFC), ovarian volume, and hormonal parameters. <i>Methods</i>. Thirty-three AF-FMF patients aging 18&#x2013;45 years and 34 healthy women were enrolled and FSH, LH, E2, PRL, and AMH levels were measured in the morning blood samples at 2nd&#x2013;4th days of menstruation by ELISA. Concomitant pelvic ultrasonography was performed to calculate AFC and ovarian volumes. <i>Results</i>. In FMF patient group, median AMH levels were statistically significantly lower in the M69V mutation positive group than in the negative ones (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.2063999pt" id="M1" height="8.80314pt" version="1.1" viewBox="-0.0498162 -8.59674 52.051 8.80314" width="52.051pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-81" d="M622 479C622 589 545 650 400 650H146L140 618C229 609 230 602 215 527L135 132C117 43 112 41 27 32L18 0H305L313 32C213 40 205 44 222 132L251 284L324 262H365C484 269 622 333 622 479ZM528 477C528 356 420 305 344 305C300 305 276 314 259 321L303 554C311 597 313 600 331 606C345 611 361 614 379 614C463 614 528 580 528 477Z"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><path id="g54-34" d="M556 331V384H55V331H556ZM556 140V193H55V140H556Z"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><path id="g50-47" d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,39.128,0)"><path id="g50-50" d="M389 0V32C297 38 291 46 291 118V635C234 613 175 595 109 583V556L161 554C203 552 207 547 207 497V118C207 46 201 38 110 32V0H389Z"/></g><g transform="matrix(.013,0,0,-0.013,45.459,0)"><path id="g50-57" d="M253 635C142 635 71 555 71 471C71 401 113 353 178 316C144 294 106 267 91 252C70 231 46 202 46 157C46 51 132 -12 241 -12C328 -12 442 52 442 168C442 257 379 305 311 343C354 373 380 398 388 407C406 428 417 458 417 487C417 568 348 635 253 635ZM240 600C288 600 340 563 340 481C340 423 313 387 279 360C207 394 148 427 148 499C148 549 182 600 240 600ZM252 23C188 23 129 73 129 163C129 217 162 266 211 298C289 260 360 217 360 144C360 69 312 23 252 23Z"/></g></svg>). There was no statistically significant difference in median AMH levels between E148Q mutation positive patients and the negative ones (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.2063999pt" id="M2" height="8.80314pt" version="1.1" viewBox="-0.0498162 -8.59674 52.0509 8.80314" width="52.0509pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-81"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><use xlink:href="#g50-47"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><path id="g50-58" d="M247 635C116 635 39 518 39 421C39 315 113 237 221 237C239 237 258 241 281 253L349 289C315 140 204 42 60 19L66 -15C90 -15 153 -5 207 16C344 70 447 199 447 385C447 521 373 635 247 635ZM231 598C329 598 356 478 356 390C356 371 355 347 352 325C330 309 297 297 262 297C179 297 127 369 127 456C127 515 156 598 231 598Z"/></g><g transform="matrix(.013,0,0,-0.013,39.129,0)"><path id="g50-51" d="M414 144C384 79 371 75 317 75H135L276 221C367 316 408 376 408 465C408 570 327 635 237 635C179 635 131 609 100 575L42 494L67 471C94 510 138 565 205 565C277 565 321 517 321 435C321 348 258 270 195 195C146 137 88 81 33 26V0H411C423 44 433 88 446 135L414 144Z"/></g><g transform="matrix(.013,0,0,-0.013,45.46,0)"><use xlink:href="#g50-49"/></g></svg>). There was also no statistically significant difference in median AMH levels between M680I mutation positive patients and the negative ones (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.2063999pt" id="M3" height="8.80314pt" version="1.1" viewBox="-0.0498162 -8.59674 52.051 8.80314" width="52.051pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-81"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><use xlink:href="#g50-47"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><use xlink:href="#g50-57"/></g><g transform="matrix(.013,0,0,-0.013,39.128,0)"><path id="g50-55" d="M141 347C171 480 264 541 327 570C364 587 403 599 436 605L429 641C389 634 339 622 300 609C191 570 37 458 37 239C37 86 126 -12 245 -12C367 -12 454 89 454 210C454 314 380 397 272 397C252 397 230 390 208 380L141 347ZM231 338C323 338 366 257 366 174C366 108 340 27 263 27C180 27 129 123 129 244C129 268 130 292 135 310C158 323 193 338 231 338Z"/></g><g transform="matrix(.013,0,0,-0.013,45.459,0)"><use xlink:href="#g50-57"/></g></svg>). No statistically significant difference was observed in median AMH levels between patients who had at least one mutation and those with no mutations (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.2063999pt" id="M4" height="8.80314pt" version="1.1" viewBox="-0.0498162 -8.59674 52.051 8.80314" width="52.051pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-81"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><use xlink:href="#g50-47"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><use xlink:href="#g50-57"/></g><g transform="matrix(.013,0,0,-0.013,39.128,0)"><use xlink:href="#g50-55"/></g><g transform="matrix(.013,0,0,-0.013,45.459,0)"><use xlink:href="#g50-57"/></g></svg>). We realized that there was no difference in comparisons between ovarian volumes, number of follicles, and AMH levels ovarian reserves when compared with FMF patients and healthy individuals. <i>Conclusions</i>. Ovarian reserves of FMF pateints were similar to those of healthy subjects according to AMH. However, AMH levels were lower in FMF patients with M694V mutation.

Ali &#x15e;ahin

Sava&#x15f; Karaku&#x15f;

Yunus Durmaz

&#xc7;a&#x11f;lar Y&#x131;ld&#x131;z

H&#xfc;seyin Ayd&#x131;n

Ahmet K&#x131;van&#xe7; Cengiz

Duygu G&#xfc;ler

Evaluation of Ovarian Reserve with Anti-M&#xfc;llerian Hormone in Familial Mediterranean Fever

<i>Introduction</i>. Parenteral iron formulations are frequently used to correct iron deficiency anemia (IDA) and iron deficiency (ID). Intravenous formulation efficacy on ferritin and hemoglobin level improvement is greater than that of oral formulations while they are associated with lower gastrointestinal side effects. Ferric carboxymaltose- (FCM-) related hypophosphatemia is frequent and appears without clinical significance. The aim of this study was to assess the prevalence, duration, and potential consequences of hypophosphatemia after iron injection. <i>Patients and Methods</i>. The medical records of all patients who underwent parenteral iron injection between 2012 and 2014 were retrospectively reviewed. Pre- and postinjection hemoglobin, ferritin, plasma phosphate, creatinine, and vitamin D levels were assessed. Patients who developed moderate (range: 0.32&#x2013;0.80&#x2009;mmol/L) or severe (&#x3c;0.32&#x2009;mmol/L) hypophosphatemia were questioned for symptoms. <i>Results</i>. During the study period, 234 patients received iron preparations but 104 were excluded because of missing data. Among the 130 patients included, 52 received iron sucrose (FS) and 78 FCM formulations. Among FS-treated patients, 22&#x25; developed hypophosphatemia versus 51&#x25; of FCM-treated patients, including 13&#x25; who developed profound hypophosphatemia. Hypophosphatemia severity correlated with the dose of FCM (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.32502pt" id="M1" height="11.6608pt" version="1.1" viewBox="-0.0498162 -8.33578 45.37 11.6608" width="45.37pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-113" d="M573 302C573 402 527 451 414 451C386 451 343 446 313 437L330 513L320 522C295 508 261 484 243 463L230 415C194 400 159 383 126 359L131 330C159 344 187 357 222 368L109 -147C96 -204 80 -214 18 -223L13 -255L256 -244L259 -212L236 -210C184 -205 180 -195 191 -141L219 -1C240 -10 268 -12 284 -12C352 4 431 48 484 104C543 166 573 240 573 302ZM481 290C481 165 381 37 305 37C280 37 249 56 235 71L302 395C328 399 353 402 372 402C427 402 481 378 481 290Z"/></g><g transform="matrix(.013,0,0,-0.013,11.438,0)"><path id="g54-34" d="M556 331V384H55V331H556ZM556 140V193H55V140H556Z"/></g><g transform="matrix(.013,0,0,-0.013,23.056,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z"/></g><g transform="matrix(.013,0,0,-0.013,29.387,0)"><path id="g50-47" d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,32.468,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,38.799,0)"><path id="g50-53" d="M462 177V227H365V632H320C217 496 116 350 21 208V177H284V109C284 43 280 38 190 31V0H451V31C369 38 365 43 365 108V177H462ZM284 227H88C155 336 218 430 282 519H284V227Z"/></g></svg>) but not with the initial ferritin, hemoglobin, or vitamin D level. Mean hypophosphatemia duration was 6 months. No immediate clinical consequence was found except for persistent fatigue despite anemia correction in some patients. <i>Conclusions</i>. Hypophosphatemia is frequent after parenteral FCM injection and may have clinical consequences, including persistent fatigue. Further studies of chronic hypophosphatemia long-term consequences, especially bone assessments, are needed.

S. Hardy

X. Vandemergel

Intravenous Iron Administration and Hypophosphatemia in Clinical Practice

<i>Introduction</i>. Ectopic lymphoid neogenesis and the presence of IgG4-positive plasmacytes have been confirmed in chronic inflammatory sclerosing diseases. This study aims to investigate hip synovial tissues of ankylosing spondylitis (AS) patients for IgG4-positive plasma cells and ectopic lymphoid tissues with germinal centers (GCs). <i>Methods</i>. Synovial samples were collected from 7 AS patients who received total hip replacement and were evaluated using immunohistochemistry for the presence of CD20+ B-cells, CD3+ T-cells, CD21+ follicular dendritic cells (FDC), and CD38+ plasma cells. Furthermore, immunoglobulin G (IgG and IgG4), IgA, IgM, and complement components C3d and C4d in synovia were evaluated. Both synovial CD21+ FDCs and IgG4-producing plasmacytes were analyzed. <i>Results</i>. All seven patients had severe fibrosis. Massive infiltrations of lymphocytes were found in 5 out of 7 patients&#x2019; synovia. Ectopic lymphoid tissues with CD21+ FDC networks and IgG4-positive plasma cells were observed coincidentally in two patients&#x2019; synovia. <i>Conclusion</i>. The pathophysiological mechanism of AS patients&#x2019; hip damage might be related to the coincidental presence of ectopic lymphoid tissue with FDCs network and IgG4-positive plasma cells identified here for the first time in AS patients&#x2019; inflamed synovial tissue.

Xiugao Feng

Xiangjin Xu

Yue Wang

Zhiyong Zheng

Guiying Lin

Ectopic Germinal Centers and IgG4-Producing Plasmacytes Observed in Synovia of HLA-B27+ Ankylosing Spondylitis Patients with Advanced Hip Involvement

We describe the design and operationalization of a blinded corticosteroid-tapering regimen for a randomized trial of tocilizumab in giant cell arteritis (GCA). To our knowledge, no clinical trial in any disease has ever employed a blinded corticosteroid-tapering regimen, but this was necessary to the design of our trial which is likely to be relevant to other investigations of steroid-sparing regimens. Two standardized corticosteroid-tapering regimens are required for this GCA trial: a 6-month regimen in 3 arms (taken with tocilizumab 162&#x2009;mg subcutaneously weekly or every other week or with placebo) and a 12-month regimen with placebo (fourth arm). Investigators select initial prednisone doses, tapered in an open-label fashion until 20&#x2009;mg/day. Doses &#x3c;20&#x2009;mg/day are blinded. At least 27 blinded blister packs are required to ensure blinding and encourage compliance. This permits all possible daily doses but requires &#x2264;5 capsules/day. The number of capsules taken at any point during tapering is identical across groups. Our approach may be extrapolated to trials beyond GCA.

Neil Collinson

Katie Tuckwell

Frank Habeck

Monique Chapman

Micki Klearman

John H. Stone

Development and Implementation of a Double-Blind Corticosteroid-Tapering Regimen for a Clinical Trial

<i>Background</i>. Autoantibodies to citrullinated peptides have been shown to be valuable in the diagnosis of rheumatoid arthritis (RA). The expanding repertoire of antibodies to citrullinated peptide antigens (ACPA) has been a topic of great interest in recent reviews and research studies, as has the ability of these autoantibodies to predict disease outcome. <i>Objectives</i>. The aim of this review was to provide an update on the relevance of ACPA as prognostic markers in RA. The ability to identify patients predisposed to an aggressive outcome at the time of initial diagnosis greatly facilitates the selection of appropriate and cost-effective treatment. <i>Methods</i>. A systematic review of the literature was carried out. Studies from 1967 up to June 2014 with data on prognostic value of ACPA were included. Quality assessment was done by using the modified Hayden list for prognostic studies. Meta-analysis was performed using BioStat software. <i>Results</i>. The results of 25 studies were selected for the final review. A total of 6421 patients with RA were included, mainly in inception cohorts, with follow-up duration ranging from one year to ten years. All studies carried prognostic data on all available isotypes of anticyclic citrullinated protein (CCP), while four had data on antimutated citrullinated vimentin (MCV). There was a single relevant study each on anticitrullinated enolase peptide 1 (CEP1) and antichimaeric fibrin/filaggrin citrullinated peptide 1 (CFFCP1). All studies showed ACPA to be strong predictors of joint erosions in RA. Other factors, particularly baseline erosions, showed an additive effect. Anti-MCV appeared to be a marker of a more aggressive form of disease. Ten studies had data on which a meta-analysis could be performed. This gave an overall odds ratio of 4.85 for ACPA (anti-CCP/MCV) positivity being predictive for the development of joint erosions. Two studies with data on anti-CEP1 and anti-CFFCP1 also showed this positive predictive role of ACPA for joint erosions. <i>Conclusions</i>. ACPA are strong predictors of severity in RA. Their use should be part of routine rheumatology practice.

A. A. Jilani

C. G. Mackworth-Young

The Role of Citrullinated Protein Antibodies in  Predicting Erosive Disease in Rheumatoid Arthritis:  A Systematic Literature Review and Meta-Analysis

<i>Aim</i>. To detect the frequency of subclinical atherosclerosis in rheumatoid arthritis patients without clinically evident atherosclerosis and to correlate its presence with the disease activity. <i>Patients and Methods</i>. Our study includes 112 RA patients (group 1) and 40 healthy controls (group 11). All patients and controls were subjected to full history taking, clinical examination, and laboratory investigations. Carotid intima media wall thickness (IMT) and carotid plaques were measured in both groups by B-mode ultrasonography; also color duplex Doppler ultrasound of the brachial artery was done to detect endothelial function. <i>Results</i>. There is atherosclerosis in 31.3&#x25; of asymptomatic RA patients compared with only 5&#x25; in controls <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.3617pt" id="M1" height="12.8881pt" version="1.1" viewBox="-0.0498162 -10.5264 74.7945 12.8881" width="74.7945pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><path id="g113-41" d="M300 -147C201 -63 143 98 143 270S200 602 300 686L282 710C136 610 70 450 70 271V270C70 89 136 -72 282 -170L300 -147Z"/></g><g transform="matrix(.0135,0,0,-0.0135,4.688,0)"><path id="g113-81" d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"/></g><g transform="matrix(.0135,0,0,-0.0135,16.837,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g><g transform="matrix(.0135,0,0,-0.0135,28.575,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.0135,0,0,-0.0135,35.078,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.0135,0,0,-0.0135,38.167,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,44.67,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,51.173,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.0095,0,0,-0.0095,57.842,-5.984)"><path id="g50-43" d="M486 158C486 177 478 202 466 220C413 228 386 236 336 262C386 288 413 297 466 304C478 323 486 347 485 366C470 376 444 381 422 380C389 338 368 319 321 288C323 345 329 372 349 422C339 442 322 461 305 470C289 461 271 442 262 422C281 372 287 345 290 288C243 319 222 338 189 380C167 381 142 376 125 366C125 347 133 322 145 304C198 296 225 288 275 262C225 236 198 227 145 220C133 201 125 177 126 158C141 148 167 143 189 144C222 186 243 205 290 236C288 179 282 152 262 102C272 82 289 63 306 54C322 63 340 82 350 102C330 152 324 179 321 236C368 205 390 186 422 144C444 143 470 148 486 158Z"/></g><g transform="matrix(.0095,0,0,-0.0095,63.636,-5.984)"><use xlink:href="#g50-43"/></g><g transform="matrix(.0135,0,0,-0.0135,69.972,0)"><path id="g113-42" d="M275 270C275 450 212 609 64 710L45 686C145 604 203 442 203 270S147 -63 45 -147L64 -170C213 -68 275 89 275 270Z"/></g></svg>. A significant difference was detected in patients with and without atherosclerosis regarding duration of the disease <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.3617pt" id="M2" height="12.8881pt" version="1.1" viewBox="-0.0498162 -10.5264 87.1383 12.8881" width="87.1383pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-41"/></g><g transform="matrix(.0135,0,0,-0.0135,4.688,0)"><use xlink:href="#g113-81"/></g><g transform="matrix(.0135,0,0,-0.0135,16.837,0)"><use xlink:href="#g117-34"/></g><g transform="matrix(.0135,0,0,-0.0135,28.575,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,35.078,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,38.167,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,44.67,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,51.173,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,57.676,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.0095,0,0,-0.0095,64.369,-5.984)"><use xlink:href="#g50-43"/></g><g transform="matrix(.0095,0,0,-0.0095,70.164,-5.984)"><use xlink:href="#g50-43"/></g><g transform="matrix(.0095,0,0,-0.0095,75.958,-5.984)"><use xlink:href="#g50-43"/></g><g transform="matrix(.0135,0,0,-0.0135,82.316,0)"><use xlink:href="#g113-42"/></g></svg> and patient&#x2019;s age <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.3617pt" id="M3" height="12.8881pt" version="1.1" viewBox="-0.0498162 -10.5264 62.4508 12.8881" width="62.4508pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-41"/></g><g transform="matrix(.0135,0,0,-0.0135,4.688,0)"><use xlink:href="#g113-81"/></g><g transform="matrix(.0135,0,0,-0.0135,16.837,0)"><use xlink:href="#g117-34"/></g><g transform="matrix(.0135,0,0,-0.0135,28.575,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,35.078,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,38.167,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,44.67,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.0095,0,0,-0.0095,51.314,-5.984)"><use xlink:href="#g50-43"/></g><g transform="matrix(.0135,0,0,-0.0135,57.628,0)"><use xlink:href="#g113-42"/></g></svg>. There is highly statistical significant correlation between atherosclerosis and disease activity index. <i>Conclusion</i>. The frequency of subclinical atherosclerosis was high in long-term active RA patients.

Rawhya R. Elshereef

Aymen Darwish

Amal Ali

Mohammed Abdel-kadar

Lamiaa Hamdy

Asymptomatic Atherosclerosis in Egyptian Rheumatoid Arthritis Patients and Its Relation to Disease Activity

<i>Background.</i> Systemic lupus erythematosus (SLE) is a chronic inflammatory, multisystem, and autoimmune disease. <i>Objective.</i> The aim of this study was to describe the prevalence of hyposalivation in SLE patients and evaluate factors associated.  <i>Methods.</i> This is a cross-sectional study developed at the Cuiaba University General Hospital (UNIC-HGU), Mato Grosso, Brazil. The study population consisted of female SLE patients treated at this hospital from 06/2010 to 12/2012. Unstimulated salivary flow rates (SFRs) were measured. Descriptive and inferential analyses were performed in all cases using a significance level <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.6617603pt" id="M1" height="9.65971pt" version="1.1" viewBox="-0.0498162 -8.99795 46.7259 9.65971" width="46.7259pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><path id="g113-81" d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"/></g><g transform="matrix(.0135,0,0,-0.0135,12.15,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g><g transform="matrix(.0135,0,0,-0.0135,23.887,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.0135,0,0,-0.0135,30.39,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.0135,0,0,-0.0135,33.48,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,39.983,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g></svg>. <i>Results.</i> The results showed that 79&#x25; of patients with systemic lupus erythematosus suffered from hyposalivation and that the disease activity and age in years were the factors that resulted in statistically significant differences. <i>Conclusion.</i> The activity of the disease, age &#x3e;27 years, and the drugs used were factors associated with hyposalivation, resulting in a statistically significant decrease in saliva production.

Cristhiane Almeida Leite

Marcial Francis Galera

Mariano Mart&#xed;nez Espinosa

Paulo Ricardo Teles de Lima

Vander Fernandes

&#xc1;lvaro Henrique Borges

Eliane Pedra Dias

Prevalence of Hyposalivation in Patients with Systemic Lupus Erythematosus in a Brazilian Subpopulation

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<p><em>International Journal of Rheumatology</em>&nbsp;publishes original research articles and&nbsp;review articles on paediatric and adult rheumatological and musculoskeletal conditions, including topics such as basic research, therapy, surgery, and imaging.</p>


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International Journal of Rheumatology - Table of contents 2015

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International Journal of Rheumatology publishes original research articles and review articles on paediatric and adult rheumatological and musculoskeletal conditions, including topics such as basic research, therapy, surgery, and imaging.

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