FRI0652 Median nerve ultrasound findings and clinical correlations in patients with systemic sclerosis: a comparative analysis with matched control subjects

1 To determine if the risk of aspiration is increased in 'Dettol' (4.8% chloroxylenol, pine oil and isopropyl alco hol) poisoning and the factors that may be responsible, a study was made of 89 patients and 89 matched control subjects with other forms of poisoning admitted to the Prince of Wales Hospital, Hong Kong. 2 Aspiration was more common in patients with Dettol poisoning (8% vs 3%, P = 0.16). There were more control subjects with drowsiness at presentation (54% vs 24%, P < 0.0001), but the use of gastric lavage (88% vs 64%, P < 0.001) and the occurrence of vomiting (62% vs 17%, P < 0.0001) were more common in patients with Dettol poisoning. 3 Our findings suggest that Dettol poisoning may be asso ciated with an increased risk of aspiration. This increase in risk may be related to the use of gastric lavage and the common occurrence of vomiting in patients with Dettol poisoning.

Download Full-text

103. Nerve ultrasound findings in neuropathy associated with anti-mag antibodies

Clinical Neurophysiology ◽

10.1016/j.clinph.2014.10.122 ◽

2015 ◽

Vol 126 (1) ◽

pp. e24

Author(s):

L. Padua ◽

M. Lucchetta ◽

G. Granata ◽

M. Luigetti ◽

M. Campagnolo ◽

...

Keyword(s):

Nerve Ultrasound ◽

Ultrasound Findings

Download Full-text

The Endocrine and Metabolic Characteristics of a Large Bardet-Biedl Syndrome Clinic Population

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-01459 ◽

2018 ◽

Vol 103 (5) ◽

pp. 1834-1841 ◽

Cited By ~ 12

Author(s):

Safa Mujahid ◽

Katharine F Hunt ◽

Yee S Cheah ◽

Elizabeth Forsythe ◽

Jonathan M Hazlehurst ◽

...

Keyword(s):

Metabolic Syndrome ◽

Subclinical Hypothyroidism ◽

Matched Control ◽

Genetic Diagnosis ◽

International Diabetes Federation ◽

Density Lipoprotein ◽

Bardet Biedl Syndrome ◽

Metabolic Characteristics ◽

Control Subjects ◽

The Metabolic Syndrome

Abstract Context Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder in which previous reports have described obesity and a metabolic syndrome. Objective We describe the endocrine and metabolic characteristics of a large BBS population compared with matched control subjects. Design We performed a case-control study. Setting This study was performed at a hospital clinic. Patients Study patients had a clinical or genetic diagnosis of BBS. Main Outcome Measurements Our study determined the prevalence of a metabolic syndrome in our cohort. Results A total of 152 subjects were studied. Eighty-four (55.3%) were male. Mean (± standard deviation) age was 33.2 ± 1.0 years. Compared with age-, sex-, and body mass index–matched control subjects, fasting glucose and insulin levels were significantly higher in subjects with BBS (glucose: BBS, 5.2 ± 1.2 mmol/L vs control, 4.9 ± 0.9 mmol/L, P = 0.04; insulin: BBS, 24.2 ± 17.0 pmol/L vs control, 14.2 ± 14.8 pmol/L, P < 0.001). Serum triglycerides were significantly higher in subjects with BBS (2.0 ± 1.2 mmol/L) compared with control subjects (1.3 ± 0.8 mmol/L; P < 0.001), but total cholesterol, high-density lipoprotein, and low-density lipoprotein were similar in both groups. Systolic blood pressure was higher in the BBS group (BBS, 135 ± 18 mm Hg vs control subjects, 129 ± 16 mm Hg; P = 0.02). Alanine transaminase was raised in 34 (26.8%) subjects with BBS, compared with five (8.9%) control subjects (P = 0.01). The rate of metabolic syndrome, determined using International Diabetes Federation criteria, was significantly higher in the BBS group (54.3%) compared with control subjects (26% P < 0.001). Twenty-six (19.5%) of male subjects with BBS were hypogonadal (serum testosterone, 9.9 ± 5.3 mmol/L), but significant pituitary abnormalities were uncommon. Subclinical hypothyroidism was present in 24 of 125 (19.4%) patients with BBS, compared with 3 of 65 (4.6%) control subjects (P = 0.01). Conclusions Insulin resistance and the metabolic syndrome are increased in adult patients with BBS compared with matched control subjects. Increased subclinical hypothyroidism in the BBS cohort needs further investigation.

Download Full-text

EvidenceIn VivoShowing Increase of Baseline Nitric Oxide Generation and Impairment of Endothelium-Dependent Vasodilation in Normotensive Patients on Chronic Hemodialysis

Journal of the American Society of Nephrology ◽

10.1681/asn.v1191726 ◽

2000 ◽

Vol 11 (9) ◽

pp. 1726-1734 ◽

Cited By ~ 2

Author(s):

JENS PASSAUER ◽

ECKHART BÜSSEMAKER ◽

URSULA RANGE ◽

MARIA PLUG ◽

PETER GROSS

Keyword(s):

Nitric Oxide ◽

Vascular Tone ◽

Forearm Blood Flow ◽

Matched Control ◽

Venous Occlusion ◽

Chronic Hemodialysis ◽

Invasive Technique ◽

Vascular Effects ◽

Control Subjects ◽

Pharmacologic Agents

Abstract.Cardiovascular mortality is excessive in hemodialyzed patients. Observations in atherosclerosis suggest that endothelial dysfunction and impaired nitric oxide (NO) may be involved. However, the relation of endothelial NO to its vascular effects has not been studied conclusively in uremia. Therefore, to study these questions an invasive technique was used in normotensive patients who were on hemodialysis (HD;n= 11) and in matched control subjects (n= 11). Pharmacologic agents were infused into the brachial artery to test the chain of events from NO generation to smooth muscle cell relaxation, measuring forearm blood flow by venous occlusion plethysmography. Glyceroltrinitrate (GTN 1:2.2 nmol/min; GTN 2:4.4; GTN 3:8.8), infused to establish the reaction of the vessel wall to defined doses of NO, caused a reduced response in HD patients (control subjects: 183 ± 20 [SEM], 246 ± 26, and 338 ± 29%; HD patients: 161 ± 7, 206 ± 12, and 262 ± 24%; baseline = 100% for each group,P= 0.032 by ANOVA). All subsequent data were corrected for this decreased response to defined doses of NO in HD patients. L-arginine (10 mg/min), given to exclude substrate deficiency of NO synthase (NOS), caused no significant changes (control subjects: 108 ± 4%; HD patients: 103 ± 4%;P= NS). Acetylcholine (ACH 1:55 nmol/min; ACH 2:110; ACH 3:220), infused to stimulate endothelial NOS, had a significantly reduced effect in HD patients (control subjects: 246 ± 32, 340 ± 40, and 465 ± 52%; HD patients: 251 ± 55, 244 ± 36, and 318 ± 50%;P= 0.002).N-monomethyl-L-arginine (LMA 1:1 μmol/min; LMA 2:2; LMA 3:4), given to block baseline NO generation, showed an enhanced response in HD patients (control subjects: 90 ± 2, 83 ± 2, and 74 ± 4%; HD patients: 84 ± 3, 73 ± 3, and 64 ± 4%;P= 0.037). Vascular response to three doses of norepinephrine (60, 120, and 240 pmol/min) was comparable in both groups, which indicated similar endothelium-independent vasoconstriction. In summary, in normotensive HD patients, (1) vasodilation to defined doses of exogenous NO was reduced, (2) there was no evidence of substrate deficiency of NOS, and (3) stimulation of NOS was impaired; however, (4) baseline NO generation was increased. It is concluded that in HD patients, the NO system has a reduced capacity to regulate vascular tone and this impairment is most significant under conditions of NOS stimulation.

Download Full-text

Intra-Carpal Injection of Ozone versus Methylprednisolone in Carpal Tunnel Syndrome of Systemic Sclerosis Patients: A Randomized Single-Blind Clinical Trial

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.e453 ◽

2021 ◽

pp. E453-E458

Keyword(s):

Systemic Sclerosis ◽

Carpal Tunnel Syndrome ◽

Functional Status ◽

Median Nerve ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Favourable Outcome ◽

University Hospital ◽

Electrophysiologic Study ◽

Tunnel Syndrome

BACKGROUND: Carpal tunnel syndrome (CTS) is the most entrapment syndrome in general and is the most frequent peripheral nervous system involvement in systemic sclerosis (SSc). Local injection of steroid hydrodissection or ozone-oxygen showed favourable outcome in CTS in general. OBJECTIVES: To compare the clinical efficacy of ozone versus methylprednisolone intracarpal injection upon pain, functional status, and nerve conduction in patients with CTS due to SSc. STUDY DESIGN: A randomized single-blinded trial. SETTING: Anesthesia, pain, and rheumatology clinics in a university hospital. METHODS: Fifty CTS patients with > 3 months duration of SSc were equally randomized into either group O (injection of ozone/oxygen 25 mu-g/mL in 20 mL) or group M (methylprednisolone acetate 40mg, and 40 mg lidocaine in 20 mL). Visual analog scale (VAS) was measured pre-injection, then re-evaluated post-injection at 4 time points (1 week, 1 month, 3 months , and 6 months); Cochin Hand Function Scale (CHFS); and a median nerve electrophysiologic study was done before injection, then by the end of 3 months and 6 months. RESULTS: VAS was significantly lower in group M after 1 week (P = 0.01). Group O showed significantly lower VAS after 3 and 6 month (P < 0.001). Additionally, there was a significant decrease in the VAS during the whole study period within each group, in comparison to its baseline value. CHFS was significantly lower in the ozone group after 6 months (P < 0.001). The sixth month’s sensory conduction was significantly higher in group O (P = 0.002). The motor distal latency was significantly lower in the ozone group after 3 and 6 months (P < 0.001). LIMITATIONS: Follow-up period could be furtherly extended. CONCLUSION: Both intracarpal ozone or methylprednisolone afford favorable effects upon CTS in patients with SSc. However, ozone alleviates pain much more, enhances the hand functional status, and improves median nerve conduction in study with over six months duration. KEY WORDS: Carpal Tunnel Syndrome, systemic sclerosis, methylprednisolone, ozone

Download Full-text