Patients with gout and hyperuricaemia and suspicion of SAHS had polysomnographically confirmed SAHS in 88.9% of cases. These patients had more severe forms of SAHS and a greater prevalence of documented atherothrombotic disease compared with a control group with OA.

BackgroundInterstitial lung disease (ILD) is one of the most frequent extra-articular manifestations of rheumatoid arthritis (RA) and leads to a significantly increased risk for morbidity and mortality compared with RA alone [1]. The analysis of Electronic Health Records (ERHs) using machine learning (ML) and Natural Language Processing (NLP) holds great promise to better characterize the disease in real-world settings.ObjectivesThis study aims to a) estimate the prevalence of RA in Spain, b) determine the frequency of RA-ILD among RA patients, and c) describe the demographic and clinical characteristics in RA/RA-ILD patients.MethodsObservational, retrospective, and multicenter study based on the secondary use of unstructured clinical data in EHRs from 6 Spanish hospitals between January 1, 2014 and December 31, 2019. The free-text information from patients’ records was captured with SAVANA’s EHRead, a validated NLP technology which extracts clinical information from EHRs and standardizes it into a SNOMED-CT-based clinical terminology [2]. The study population comprised all adult patients ≥18 years with RA in the selected period and sites. Descriptive statistics were presented in summary tables. Prevalence was calculated dividing the total number of patients with RA over the total number of attended patients. This analysis was performed by age and sex.ResultsAmong all attended patients in the participating hospitals within the study period, 11,163 patients with RA were identified; of these, 8.6% (n = 959) had RA-associated ILD (RA-ILD). The age-adjusted prevalence of RA is shown in Figure 1. The estimated prevalence (95% CI) in the overall population was 0.49 (0.37-0.60), being 0.26 (0.19-0.32) in males and 0.71 (0.54-0.87) in females. Most patients in the RA (73.9%; n = 8,250) and RA-ILD populations (63.3%, n = 607) were female (Table 1). The median age (Q1, Q3) was 60.8 (49, 74) and 67 (56, 77) years in the RA and RA-ILD groups, respectively. Regarding disease course, the time from RA to ILD diagnosis was 27.6 (3.7, 73.2) months. Most comorbidities presented higher rates in the RA-ILD population, as shown in Table 1. Among patients with available ILD subtype information (n = 618), the most common was usual interstitial pneumonia (29.8%; n = 184).Table 1.Demographics and comorbidities in the RA and RA-ILD patient populationsRA* N=11,163RA-ILD N=959Gender, n (%) Female8,250 (73.9)607 (63.3) Male2,913 (26.1)352 (36.7)Age at first mention of disease (years)1  Median (Q1, Q3)61 (49, 74)67 (56, 77)Comorbidities, n (%)Dyslipidaemia4369 (39.1)316 (33)Hypertension3851 (34.5)320 (33.4)Diabetes mellitus2970 (26.6)248 (25.9)Infections2129 (19.1)328 (34.2)Bone fracture1875 (16.8)210 (21.9)Osteoporosis1275 (11.4)150 (15.6)Malignancies1004 (9)169 (17.6)Kidney failure1006 (9)156 (16.3)Heart failure993 (8.9)184 (19.2)Depression825 (7.4)99 (10.3)Psoriasis773 (6.9)39 (4.1)Obesity732 (6.6)90 (9.4)Asthma740 (6.6)82 (8.6)Atrial Fibrillation729 (6.5)102 (10.6)*RA includes patients in the RA-ILD population. 1Patients’ age when either RA or ILD was first detected in the EHRs. RA = rheumatoid arthritis; ILD = interstitial lung diseaseConclusionThis pioneering study is the first to characterize RA-ILD using NLP methodology in a multicenter setting. By analyzing readily available real-world data in patients EHRs, we were able to estimate the prevalence of RA in the Spanish population and describe the demographic and clinical characteristics of patients with RA/RA-ILD.References[1]Bongartz T, Nannini C, Medina-Velasquez YF et al. Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study. Arthritis and rheumatism 2010; 62: 1583-1591.[2]Canales L, Menke S, Marchesseau S et al. Assessing the Performance of Clinical Natural Language Processing Systems: Development of an Evaluation Methodology. JMIR Med Inform 2021; 9: e20492.AcknowledgementsRA-W-ILD Study GroupDisclosure of InterestsJose Andrés Román Ivorra Speakers bureau: AbbVie, Bristol Myers Squibb, FER, Galápagos, GlaxoSmithKline, Janssen, Lilly, Novartis, Pfizer, Consultant of: AbbVie, Bristol Myers Squibb, FER, Galápagos, GlaxoSmithKline, Janssen, Lilly, Novartis, Pfizer, Grant/research support from: AbbVie, Bristol Myers Squibb, FER, GlaxoSmithKline, Janssen, Lilly, MSD, Novartis, Pfizer, UCB, Isabel de la Morena Speakers bureau: Pfizer, Novartis, Janssen, AbbVie, MSD, UCB, Sanofi, Roche, Nordic, Lilly, NEREA COSTAS TORRIJO Speakers bureau: UCB, Novartis, Pfizer, Belen Safont Speakers bureau: AstraZeneca, Roche, Boehringer Ingelheim, Grant/research support from: Boehringer Ingelheim, J. Fernández-Melón Speakers bureau: Bristol Myers Squibb, UCB, Galapagos, Belen Nuñez Speakers bureau: Boehringer Ingelheim, Roche, Bristol Myers Squibb, Grant/research support from: Boehringer Ingelheim, Roche, Lucía Silva Fernández Speakers bureau: Bristol Myers Squibb, Consultant of: Novartis, MSD, Laura Cebrián Méndez Speakers bureau: Pfizer, Lilly, Gebro, Novartis, Consultant of: Pfizer, Leticia Lojo Consultant of: UCB, Belén López-Muñiz Speakers bureau: Boehringer Ingelheim, Roche, AstraZeneca, Novartis, Mundipharma, Gebro, GlaxoSmithKline, Ernesto Trallero Speakers bureau: Amgen, MSD, Maria Lopez Lasanta: None declared, Raul Maria Veiga Cabello: None declared, Maria Del Pilar Ahijado Guzman: None declared, Diego Benavent Speakers bureau: Janssen, Roche, Grant/research support from: Novartis, Employee of: Savana, David Vilanova Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Celgene, Raul Castellanos Moreira Speakers bureau: Lilly, Pfizer, Roche, Sanofi, UCB, Bristol Myers Squibb, Consultant of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Sara Lujan Valdés Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb

Background:Bariatric surgery is the set of surgical techniques whose objective is weight reduction, and it could have complications. One of them may be the increase in the incidence of fractures (1), secondary to nutritional defects (2), among others, that could modify bone metabolism with an increase in remodeling (3).Objectives:To carry out a retrospective observational pilot analysis of a cohort of 140 morbidly obese patients after bariatric surgery, of a total of 304, descriptive of axial and peripheral fractures, among other variables.Methods:Data were collected from the University Hospital of Fuenlabrada of a cohort of morbidly obese people who underwent bariatric surgery from 2009 to the present. Were included as variables age in years, sex, body mass index (BMI) before surgery, evolution time since surgery in years, incidence of sleep apnea syndrome (OSAS), incidence and type of fracture, osteoporotic or not, and axial or peripheral. A descriptive and frequency analysis, and a chi-square contingency table between incidence of fracture, and gender, OSAS, or childhood obesity, were performed.Results:A 48.76 years old cohort was observed, 25.7% men/74.3% women, 30.8% childhood obesity, BMI of 45.65 kg / m2, and 45% with a diagnosis of OSAS. A 15% of fractures were noted: 66.66% considered as osteoporotics (40.76% axial, 50.31% peripheral, and 8.93% of both) in a time of evolution of 5.81 years, and without relationship with gender, OSAS or childhood obesity (p = 0.7, p = 0.15, p = 0.16).Conclusion:It is a study that higlights that bariatric surgery in Fuenlabrada area is mainly performed on morbidly obese women in adulthood. There is a high rate of OSAS, and an increase in the incidence of fractures unrelated to gender, OSAS or childhood obesity, despite the fact that in the bariatric surgery protocol densitometric osteoporosis is an exclusion criterion.References:[1]Rousseau C, Jean S, Gamache P, Lebel S, Mac-Way F, Biertho L, et al. Change in fracture risk and fracture pattern after bariatric surgery: nested case-control study. BMJ. 27 july 2016;354:i3794.[2]Scibora LM. Skeletal effects of bariatric surgery: examining bone loss, potential mechanisms and clinical relevance. Diabetes Obes Metab2014;16:1204-13. doi:10.1111/dom.12363 pmid:25132010.[3]Coates PS, Fernstrom JD, Fernstrom MH, Schauer PR, Greenspan SL. Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab2004;89:1061-5. doi:10.1210/jc.2003-031756 pmid:15001587.Disclosure of Interests:None declared

BackgroundSpine is a mechanical structure, which disposes their vertebral bodies in harmony with their stature, and progressively increasing in magnitude from the cervical to the lumbar spine (1). Defects in type II collagen gene are described, and in these cases, flat vertebra can be found, defined with flattening of the vertebral body, with irregular surface or with nodules of Schmorl, in isolation or in a maximum of two vertebral bodies, to distinguish it from Scheuermann’s disease (2). Image 1.ObjectivesCurrent vertebral indexes, don’t measure a relation between a person height and his vertebra, and if the harmony of the individual is accepted, an index that combines these variables must be created in order to guaranteeing the objectivity of the resultant value.Figure 1Figure 2MethodsPatients attending physician since 1994, both sexes, 20-55 years old, in whom Type II collagen disease or vertebral dysplasia was suspected, were selected for the study. A control group was created from patients that didn’t fulfill the last inclusion criteria. Their medical histories were taken. Eighth dorsal flat vertebra in a lateral chest radiograph were assessed by tripleobserver (two rheumatologists and one radiologist) according to the defined criteria. In all selected patients, a DEXA osteoporosis screening was performed, being chest trauma exclusion criteria.Finally, a descriptive study was carried out and a comparative study of average of vertebral index of the eight dorsal vertebra (VIDV8) results was applied: VIDV8 = 10 x LVD8/(HVD8 x stature). Image 2.Results174 subjects were analyzed, 84 in the study group and 90 in the control one, both homogeneous and without statistically significant differences in sex, age and height, with an average value in the study group of 47.15 years old, 48.8% women, 80.5 kg and 1,64 m. In control group: 44.5 years old, 52.2% women, 78.5 kg and 1,65 m. The VIDV8 value, did not show any significant difference compared to the previous variables, except for patient cohort, with an average value of 10.1 Meters-1 in control group, and 12.5 Meters-1 in pathological one (p <0.001). To a value of 11,108 Meters-1 the sensitivity is 90.5% and specificity 92.2%.ConclusionThe VIDV8 is stable for the variables sex, age, height, and weight. To an outcome of 11,108 Meters-1, it discriminates both groups with sensitivity of 90.5% and specificity of 92.2%, in order to avoid the ambiguity of the explorer.References[1] .White AA, Panjabi MM. Clinical Biomechanics of the Spine. 2nd ed, Lippincott Williams & Wilkins, 1990.[2] Rimoin DL, Lachman RS; The condrodysplasias, Practise of Medical Genetics. Edited by AEH Emery, DL Rimoin. New York, Churchill Livingston, 1990.Disclosure of InterestsNone declared