Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared With Patients With Osteoarthritis.

Introduction: The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5-2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA. Materials and Methods: This was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups. Results: A total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2. Conclusions: When comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.

Patterns of Change in Dietary Habits and Physical Activity during Lockdown in Spain Due to the COVID-19 Pandemic.

BACKGROUND: Lockdown due to COVID-19 influenced food habits and lifestyles with potential negative health impact. This study aims to identify patterns of change in eating habits and physical activity during COVID-19 lockdown in Spain and to identify associations with sociodemographic factors and usual habits. METHODS: This cross-sectional study included 1155 adults recruited online to answer a 10-section questionnaire. The protocol assessed usual diet by means of a semi-quantitative food frequency questionnaire, usual physical activity (PA) and supplement use, dietary changes, sedentary time, PA, exposure to sunlight, sleep quality, and smoking during confinement. Patterns of dietary change were identified by factor analysis. Factor scores were included in cluster analysis together with change in PA. RESULTS: Six patterns of dietary change were identified that together with PA changes during lockdown defined three clusters of lifestyle change: a cluster less active, a more active cluster, and a third cluster as active as usual. People who were usually less active were more likely to be classified in the cluster that increased physical activity in confinement. Scores of the Healthy Mediterranean-Style dietary pattern were higher in this group. Conclusions: Different patterns of change in lifestyles in confinement suggest the need to tailor support and advice to different population groups.

Harmonized D-dimer levels upon admission for prognosis of COVID-19 severity: Results from a Spanish multicenter registry (BIOCOVID-Spain study).

Coagulopathy is a key feature of COVID-19 and D-dimer has been reported as a predictor of severity. However, because D-dimer test results vary considerably among assays, resolving harmonization issues is fundamental to translate findings into clinical practice. In this retrospective multicenter study (BIOCOVID study), we aimed to analyze the value of harmonized D-dimer levels upon admission for the prediction of in-hospital mortality in COVID-19 patients. All-cause in-hospital mortality was defined as endpoint. For harmonization of D-dimer levels, we designed a model based on the transformation of method-specific regression lines to a reference regression line. The ability of D-dimer for prediction of death was explored by receiver operating characteristic curves analysis and the association with the endpoint by Cox regression analysis. Study population included 2663 patients. In-hospital mortality rate was 14.3%. Harmonized D-dimer upon admission yielded an area under the curve of 0.66, with an optimal cut-off value of 0.945 mg/L FEU. Patients with harmonized D-dimer ≥ 0.945 mg/L FEU had a higher mortality rate (22.4% vs. 9.2%; p < 0.001). D-dimer was an independent predictor of in-hospital mortality, with an adjusted hazard ratio of 1.709. This is the first study in which a harmonization approach was performed to assure comparability of D-dimer levels measured by different assays. Elevated D-dimer levels upon admission were associated with a greater risk of in-hospital mortality among COVID-19 patients, but had limited performance as prognostic test.

Cambios en los hábitos alimentarios durante el periodo de confinamiento por la pandemia COVID-19 en España

FUNDAMENTOS: El cierre de fronteras, el confinamiento de la población y el distanciamiento físico han sido las principales medidas instauradas en muchos países para contener el alcance y gravedad de la pandemia COVID-19. En este estudio se analizan los cambios en los hábitos alimentarios y en otros estilos de vida durante el periodo de confinamiento en un grupo de población en España. MATERIAL Y MÉTODOS: Se ha realizado un estudio transversal, observacional en una muestra de conveniencia de personas mayores de 18 años de edad, reclutada de forma electrónica entre el 21 de abril y 8 de mayo de 2020 (semanas 6-8 de confinamiento) en España (n= 1036). El protocolo contemplaba datos sociodemográficos, características del confinamiento, hábitos de consumo alimentario y actividad física usuales, y modificaciones durante el periodo de confinamiento. RESULTADOS: Los cambios más frecuentes se refieren a mayor consumo de fruta (27%), huevos (25,4%), legumbres (22,5%), verduras (21%) y pescado (20%) y reducción en el consumo de carnes procesadas (35,5%), cordero o conejo (32%), pizza (32,6%), bebidas alcohólicas destiladas (44,2%), bebidas azucaradas (32,8%) o chocolate (25,8%), con algunas diferencias sobre todo en función de la edad y el grado de adecuación de la dieta usual. Un 14,1% que habitualmente no cocina, lo hace en este periodo. El 15% no realiza ejercicio físico, 24,6% pasa sentado más de 9 horas diarias y el 30,7% de las personas fumadoras (14,7%) fuma más. Un 37% refiere no dormir bien. CONCLUSIONES: Los participantes en este estudio refieren cambios alimentarios en el periodo de confinamiento en España con tendencia hacia mayor consumo de alimentos saludables, menor consumo de alimentos de menos interés nutricional y aumento de la práctica de cocinar en casa BACKGROUND: The lockout of borders, lockdown of the population and social isolation are key measures adopted in many countries to contain the COVID-19 pandemic. This study describes changes in eating habits and other lifestyles during confinement in a population group in Spain. METHODS: A cross-sectional, observational study was conducted on a convenience sample of people aged 18 yr. and over, recruited online between April 21 and May 8, 2020 (weeks 6-8 of lockdown) in Spain (n = 1036). The protocol considered sociodemographic data, characteristics of confinement, usual food consumption and physical activity, and changes during confinement. RESULTS: Most frequently reported changes in dietary habits are increased consumption of fruit (27%), eggs (25.4%), legumes (22.5%), vegetables (21%) and fish (20%) and reduced consumption of processed meats (35.5%), lamb or rabbit (32%), pizza (32.6%), distilled alcoholic beverages (44.2%), sugary drinks (32.8%) or chocolate (25.8%). Some differences were observed depending on age and adequacy of the usual diet. Some 14.1% who do not usually cook do so during this period;15% do not do physical exercise, 24.6% sit more than 9 hours a day and 30.7% of smokers (14.7%) report increased tobacco use. 37% reported not sleeping well. CONCLUSIONS: Participants in this study report dietary changes during lockdown in Spain with a trend towards greater consumption of healthier foods, less consumption of foods of poor nutritional interest and an increase in the practice of cooking at home

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic : Latin American Heart Rhythm Society (LAHRS) in collaboration with: Colombian College Of Electrophysiology, Argentinian Society of Cardiac Electrophysiology (SADEC), Brazilian Society Of Cardiac Arrhythmias (SOBRAC), Mexican Society Of Cardiac Electrophysiology (SOMEEC).

COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.