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OBJECTIVE: We aimed at determining the relationship between sleep disorders and daily activity and quality of life (QoL) of patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: A systematic search of databases was carried out. We used the Cochrane guidelines to perform the meta-analysis following the PRISMA statement. Fifteen full-text papers were ultimately included in the subsequent statistical analyses. The study was registered in the PROSPERO database (No. CRD42021245664). RESULTS: In group 1, the mean sleep quality score measured with the Pittsburgh Sleep Quality Index (PSQI) was 6.93. The mean QoL score for the physical domain and the mental domain of the Short Form (36) Health Survey (SF-36) was 38.15 and 41.83, respectively. In group 2, the mean PSQI score was 7.21. The mean daily activity score measured with the Health Assessment Questionnaire (HAQ) was 0.80. A strong negative correlation was observed between the PSQI scores, and the SF-36 total score each unit increase in the SF-36 total score was associated with an average decrease of 0.35 points in the PSQI score. A one-point increase in the PSQI score was associated with an average decrease of 2.4 points in the QoL score measured with SF-36. CONCLUSIONS: RA patients have a low quality of sleep. Sleep disorders correlate negatively with the QoL scores in the physical and mental domains.

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OBJECTIVE: Anemia is the hematological issue that occurs most often as a manifestation in RA. The aim of the study was to assess iron deficiency in RA patients. PATIENTS AND METHODS: The study was carried out on 62 RA patients treated between 2016 and 2017. RESULTS: A higher percentage of RA patients compared to the control group had TSAT below 20% (43% vs. 5%), ferritin below the reference range (15% vs. 7%), sTfR above 1.59 mg/l (26% vs. 0%) and hepcidin below 14.5 ng/ml (56% vs. 2%). 60% of RA patients had iron deficiency, and 18% - anemia. Correlations were found between reduced levels of ferritin and patients being younger, female, with lower GGT and higher platelet counts. Correlations were also found between iron deficiency and patients being younger, female, having reduced hemoglobin, increased platelet counts, increased GFR, reduced GGT, lower disease activity, and less frequent use of sulfasalazine. CONCLUSIONS: Iron deficiency is common (64%) in RA patients where there is high disease activity. RA patients had lower transferrin, lower ferritin, lower hepcidin, and higher sTfR. Decreased DAS-28 and reduced hemoglobin were the strongest determinants of iron deficiency.

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Osteoporosis is a metabolic disease of the skeletal system which currently affects over 200 million patients worldwide. The WHO criteria define osteoporosis as low bone mineral density, with a T-score ≤ -2.5 found in the spine, the neck of the femur, or during a full hip examination. Osteoporosis considerably reduces a patient's quality of life. QoL should be carefully evaluated before fractures occur to enable the development of an appropriate treatment plan. The progression of osteoporosis may be significantly inhibited by following a proper diet, leading a healthy lifestyle, taking dietary supplements, and receiving appropriate treatment. Education and the prevention of the disease play a major role. Potentially modifiable risk factors for osteoporosis are vitamin D deficiency, smoking, alcohol consumption, low calcium intake, low or excessive phosphorus intake, protein deficiency or a high-protein diet, excessive consumption of coffee, a sedentary lifestyle or lack of mobility, and insufficient exposure to the sun. Pharmaceutical treatment for osteoporosis involves bisphosphonates, calcium and vitamin D3, denosumab, teriparatide, raloxifene, and strontium ranelate. Data indicates that 30%-50% of patients do not take their medication correctly. Other methods of treatment include exercise, kinesitherapy, treatment at a health resort, physical therapy, and diet.

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BACKGROUND: The purpose of this study was to evaluate the possibility that laparoscopic cholecystectomy has worsened the prognosis of patients with resected gallbladder cancer; particularly for patients whose cancer was accidentally resected. STUDY DESIGN: We conducted a retrospective review of Connecticut Tumor Registry data and data extracted from individual patient records at 15 of 30 hospitals in Connecticut reporting data to the Registry, at two separate time points, 1985-1988 (immediate prelaparoscopic era) and 1992-95 (laparoscopic cholecystectomy well established). There were 194 and 208 patients in each 3-year period, respectively. Additional information was extracted from hospital records in 82 and 91 patients, respectively. Twenty-five percent of patients in both data sets presented with "local" or Tis, T1, T2 disease. RESULTS: Three-year survival for localized disease was 29% in the prelaparoscopic period and 34% once laparoscopic cholecystectomy was established. But analysis of individual patient records indicated that 36% of patients from the laparoscopic period did not actually undergo a laparoscopic procedure. Fifty-nine patients had their gallbladder cancer discovered in the specimen postoperatively (serendipitously treated). A higher proportion of cancers were discovered postoperatively in the laparoscopic era (44% versus 24%). Three-year survival for these patients was 25%. If the data from the two eras are grouped according to whether or not the cancer-bearing gallbladder was manipulated laparoscopically, 24 of 59 patients (41%) turned out to be at risk for the possibility of increased laparoscopic dissemination of tumor. Survival of these patients (11-month median survival) was not statistically different from survival of patients whose serendipitously discovered gallbladder cancer was never manipulated laparoscopically (16-month median survival); p = 0.54 by log rank test. CONCLUSIONS: The widespread adoption of laparoscopic cholecystectomy did not worsen the survival of patients with gallbladder cancer, and patients with serendipitously treated gallbladder cancers did not have a worse survival after laparoscopic manipulation than after a standard open cholecystectomy. The laparoscopic aspects of operative manipulation of a gallbladder with cancer in it do not appear to be a proximate cause of the poor prognosis in this disease.

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An apparatus for the preparation of uniform thin layer chromatography gel layers is described. The apparatus employs rubber cushion runners to compensate for differences in plate thickness and a gel applicator which functions independently of plate edge variability. Consistently uniform layers are prepared by careful establishment of the plate-to-applicator distance. Silica gel layers averaged 87% of the applied thickness with a variability of +/-2% within a single run and +/-8% between independent runs.

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