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Objectives: To investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease., Methods: In this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation., Results: In 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age <60 years (OR = 1.78), RAID score >2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy., Conclusions: Mild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms., Clinical Trial Registration Number: This study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483)., Competing Interests: This work was funded by Roche Pharma AG and Chugai Pharma Europe Ltd. Besides Dr. Flacke’s and Dr. Hofmann’s support at the study conception phase and the review of the statistical analysis plan by an independent statistician on behalf of Roche, Roche Pharma AG and Chugai Pharma Europe Ltd. had no further direct role in the collection, analysis, or interpretation of the data. AMS Advanced Medical Services GmbH (Mannheim, Germany) was involved in the study as a contract research organization on behalf of the study sponsors conducting the data analysis in collaboration with the scientific project leaders and supporting manuscript preparation. Drs. Englbrecht, Alten, Aringer, Baerwald, Burkhardt, Fliedner, Kleinert, Kneitz, Krueger, Schett, Schmalzing, Tausche, Tony, and Wendler received grants, honoraria, consulting fees, and/or speaking fees (less than $10,000 each) from Roche Pharma AG and Chugai Pharma Europe Ltd. Dr. Englbrecht has received speaker’s fees, compensation for consultancies or board memberships from: AbbVie, Celgene, Lilly, Mundipharma, Novartis, Pfizer, UCB. Dr. Aringer reports AbbVie, Astra Zeneca, Boehringer Ingelheim, Chugai, GSK, HEXAL, Lilly, MSD, Novartis, Pfizer, Roche, Sandoz and Sanofi advisory boards, speaking fees and/or congress support. Dr. Baewald has received travel grants and speaking honoraria or is on advisory boards for Abbvie, Amgen, Biogen, BMS, Janssen, Lilly, MSD, Pfizer and UCB. Dr. Fliedner is on advisory boards for Abbvie, BMS, and Pfizer and has participated in meetings for UBC, Lilly, and Pfizer. Dr. Schett’s work was supported by the Metarthros program of the BMBF. Dr. Schmalzing has received speaker’s fees, travel grants, research funding, or compensation for consultancies or board memberships from: Abbvie, Actelion, BMS, Celgene, Genzyme, Hexal/Sandoz, Janssen‐Cilag, MSD, Novartis, Pfizer, Sanofi Pasteur, Shire (Baxalta), and UCB. Dr. Wendler is a member of Roche and Chugai advisory boards. Dr. Kneitz has received speaker’s fees, compensation for consultancies or board memberships of: AbbVie, Berlin Chemie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Sanofi, and UCB. Dr. Eby received fees from Roche Pharma AG for manuscript preparation and statistical analysis. Dr. Flacke is an employee of Roche Pharma AG. and Dr. Hofmann is an employee of Chugai Pharma Europe Ltd. Editorial assistance for this manuscript was provided by Physicians World Europe (Mannheim, Germany), sponsored by Roche Pharma AG. Funding by corporate entities does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objective: Abnormalities in the coagulation pathway are often included in the diagnostic work-up of stroke patients, especially in young adults with cryptogenic stroke., Methods: Three common genetic variants within the coagulation cascade were investigated in 500 control subjects and in 167 patients with ischemic stroke defined by TOAST subclassification. Analysed variants were factor V Leiden, prothrombin 20210G-->A and factor XIII Val34Leu., Results: The factor V Leiden mutation was over-represented in patients with cardioembolic stroke for trend, whereas the prothrombin 20210G-->A variant and the factor XIII polymorphism Val34Leu were not associated with stroke of any subtype. The three polymorphisms showed no association with stroke in subgroups of patients defined by age (<40, 40-49, 50-59, > or =60 years)., Discussion: This study suggests that the analysis of prothrombin 20210G-->A and factor XIII Val34Leu is not a useful diagnostic procedure in the work-up of ischemic stroke.

Introduction: Based on the assumption that professional groups with frequent chemical exposure are at an increased risk for developing Multiple Chemical Sensitivity (MCS), a sample of 45 professional pest controllers was investigated., Methods: The examination of the pest controllers consisted of a physical and laboratory examination with urine screening for pyrethroid metabolites, a psychiatric interview, a neuropsychological test battery, and a chemical sensitivity questionnaire., Results: Persistent or serious work related health problems and chemical sensitivity were not reported. In urine, cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (Br(2)CA) was detected in 11%, 4-fluoro-3-phenoxybenzoic acid (F-PBA) in 7%. 3-phenoxybenzoic acid (3-PBA) exceeded the reference range in 9%, cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropane-1-carboxylic acid (Cl(2)CA) in 20%. Increased liver enzymes and blood count deviations were rather common. 38% had psychiatric disorders. With few exceptions, neuropsychological testing results were normal., Conclusions: The results do not support the hypothesis that work-related insecticide exposure promotes chemical sensitivity.

Background and Purpose: Common carotid artery intima-media thickness (CCA IMT) is a predictor of stroke. This study aimed to analyze whether homocysteine (Hcys) metabolism influences CCA IMT., Methods: We analyzed the association of personal, clinical, and biochemical data (multivariate analysis) and of 9 polymorphisms involved in Hcys metabolism (ANOVA) with CCA IMT in 714 individuals of 187 families., Results: CCA IMT was significantly predicted by age, sex, creatinine levels, lipoprotein(a) levels, pack-years of smoking, the presence of hypertension, and the presence of diabetes mellitus but not by Hcys levels. Homozygosity for the T allele of the polymorphism methylenetetrahydrofolate reductase c.677C>T was significantly associated with higher Hcys levels but not with a higher CCA IMT., Conclusions: These data do not support the thesis that elevated Hcys levels are causally involved in cerebrovascular disease.