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It is unclear when the synovial-based inflammatory process of gout begins. The aim of this study was to determine the percentage of patients with inter-critical gout who have chronic synovial-based inflammation as evidenced by synovial pannus on a contrast-enhanced magnetic resonance imaging (MRI) of their most involved joint and determine if the presence and/or severity correlates with their serum urate levels. All patients received a 3 T MRI of their index joint, serum urate level, CRP, and creatinine. The primary endpoint was to determine the prevalence of synovial pannus and the correlation of serum urate levels with the presence and/or severity of the synovial pannus on that same joint. MRI erosions, tophi, swelling, effusion, and osteitis were also documented. Seventy-two of 74 subjects (90 % men) completed the protocol. Fifty-three of 72 (74 %) index joints were the first metatarsophalangeal joint. Thirty-nine (54.2 %) of the patients were on urate-lowering therapy; 15 (20.8 %) and 7 (9.7 %) were taking colchicine or a NSAID daily, respectively. Of the 72 subjects, 63 (87.5 %) had synovial pannus on their MRI with good inter-reader agreement between the two radiologists. The mean serum urate level was 7.93 mg/dL. There was no correlation with the presence ( p  = 0.33) or severity ( p  = 0.34) of synovial pannus and serum urate levels. There was also no correlation with the presence or severity of synovial pannus and the secondary endpoints. The majority of patients with inter-critical gout have evidence of chronic synovial-based inflammation. However, the presence and severity of this inflammation do not appear to correlate with serum urate levels.

To the Editor: I want to correct an error in the first part of the two-part review by Simon and Mills on nonsteroidal antiinflammatory drugs (May 22 and 29 issues). The authors refer to my paper on deafness due to plain and long-acting aspirin tablets* and state that \"twenty-eight per cent of patients who took coated [sic] aspirin and 8 per cent who received plain aspirin tablets had a loss of hearing while taking the drug.\" The authors do not mention that the 8 per cent figure applies only to recipients of plain aspirin tablets who received 4.0 g . . . No extract is available for articles shorter than 400 words.

We investigate the evolution of the PAH population's charge state and size across key physical zones in the Orion Bar, which include the HII region, the atomic PDR (APDR), and three HI/H2 dissociation fronts (DF1, DF2, and DF3). Utilising the NASA Ames PAH Infrared Spectroscopic Database (PAHdb) and the pyPAHdb spectral modelling tool, we analysed the MIRI-MRS observations of the Orion Bar from the \"PDRs4All\" ERS Program. pyPAHdb modelling reveals the fractional contribution of the different PAH charge states and sizes to the total PAH emission across the Orion Bar. Cationic PAH emission peaks in the APDR region, where neutral PAHs have minimal contribution. Emission from neutral PAHs peaks in the HII region that consists of emission from a face-on PDR associated to the background OMC-1 molecular cloud, and in the molecular cloud regions past DF2. PAH anions are observed deep within the DF2 and DF3 zones. The average PAH size ranges between ~\\(60-74\\) Nc. The modelling reveals regions of top-down PAH formation at the ionisation front, and bottom-up PAH formation within the molecular cloud region. The PAH ionisation parameter \\(\\gamma\\) ranges between ~\\(2-9 x 10^4\\). Intensity ratios tracing PAH ionisation scale well with \\(\\gamma\\) in regions encompassing edge-on or face-on PDR emission, but their correlation weakens within the molecular cloud zone. Modelling of the \\(5-15\\) \\(\\mu\\)m PAH spectrum with pyPAHdb achieves comprehensive characterization of the net contribution of neutral and cationic PAHs across different environments, whereas empirical PAH proxy intensity ratio tracers can be highly variable and unreliable outside regions dominated by PDR emission. The derived average PAH size in the different physical zones is consistent with a view of PAHs being more extensively subjected to ultraviolet processing closer to the ionisation front, and less affected within the molecular cloud.