scholarly journals THU0345 EFFECT OF THE LONG-TERM RITUXIMAB TREATMENT ON B-LYMPHOCYTES AND ANTINUCLEAR AUTOANTIBODY LEVEL IN PATIENTS WITH SYSTEMIC SCLEROSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 404.2-404
Author(s):  
L. Garzanova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
O. Desinova ◽  
O. Ovsyannikova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
B Lymphocytes ◽  
Clinical Improvement ◽  
Disease Duration ◽  
Absolute Number ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background:Anti-B-cell therapy is seen as a promising therapeutic option for systemic sclerosis (SSc). The study of antinuclear antibody levels during treatment with rituximab (RTX) in patients (pts) with SSc could have theoretical and practical interest.Objectives:To assess the changes in ANA, anti-topoisomerase-1 (Scl-70) levels and B-lymphocytes (B-lymph) count during RTX therapy during prospective observation.Methods:This prospective study included 88 pts with SSc, 83% of them had interstitial lung disease and 75% had positive Scl-70 autoantibody. The mean age was 47 yrs (17-71), female-73 pts (83%), the diffuse cutaneous subset of the disease had 50 pts (57%). The mean disease duration was 5,9±4,8 yrs. The mean follow-up period was 27 months (12-42). The cumulative mean dose of RTX was 2,9±1,1grams. All patients received prednisolone at a dose of 11,7±4,4 mg, immunosuppressants received 42% of them. Patients were divided into groups depending on the duration of the disease: group 1 (n=33) - up to 3 yrs, group 2 (n=25) - from 3 to 6 yrs, group 3 (n=30) - more than 6 years (6-18yrs). The results are presented in the form of mean values, median, upper and lower quartiles.Results:Parallel to clinical improvement in most patients (96%) we found positive changes in many parameters at the end of the study compared to the baseline. The Rodnan skin score decreased from 11,21±9,33 to 6,19±4,74 (p<0,001). The disease activity index (EScSG-AI) decreased from 2,9±1,74 to 1,36±1,15 (p<0,001). Forced vital capacity, % predicted, increased from 76,35±19,65 to 84,37±21,04 (p<0,001). Diffusing capacity for carbon monoxide, % predicted, increased from 45,56±17,72 to 47,62±16,96 (p<0,019). The dose of prednisolone decreased from 11,7±4,4 to 9,2±3,2 mg (p<0,001). The absolute number of B-lymph decreased from 0,224±0,19 to 0,0175±0,058 (p<0,001). The pts of the group 1 showed the highest values of B-lymph at baseline and level of B-lymph decreased from 0,326±0,22 to 0,008±0,01 (Δ 0,318) at the end of the study. In group 2 depletion was less pronounced (from 0,197±0,14 to 0,026±0,07 (Δ 0,171) and the lowest depletion was observed in group 3 (from 0,151±0,16 to 0,019±0,07 (Δ 0,131), p<0,001 for all groups. An initially positive ANA was found in 92% of pts (range 1/320-1/1280). During observation, the number of pts with high (1/640-1/1280) ANA titers decreased from 70 to 41 (p<0,001), and the average level of ANA decreased by 30-40% in all groups. At baseline 63 pts (75%), had positive Scl-70 with equal levels in all groups. At the end of the study level of Scl-70 decreased from 125,02±89,12 to 108,6±86,89 units/ml (p<0,007). A negative correlation was found between the duration of the disease and ANA (r = -0,54; p<0,003) and Scl-70 (r = -0,44; p<0,017).Conclusion:In our study a clinical improvement was shown in most pts at the long-term complex therapy, including RTM. We found a significant decrease in the absolute number of B-lymph, as well as decrease of ANA and Scl-70 levels. Initially pts with a short duration of the disease had a higher level of B-lymph and in these pts depletion was more pronounced, compared to those with a longer duration of the disease. However, the level of Scl-70 and ANA decreased both to those who started RTX therapy at an early stage of the disease (<3yrs) and to those who had a long disease duration.Disclosure of Interests:None declared

scholarly journals THU0338 THE CIRCULATING CD19-POSITIVE LYMPHOCYTES IN PATIENTS WITH SYSTEMIC SCLEROSIS: MODULATION WITHIN A YEAR AFTER THE INITIATION OF RITUXIMAB THERAPY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 400.1-400
Author(s):  
L. P. Ananyeva ◽  
L. Garzanova ◽  
O. Koneva ◽  
M. Starovoytova ◽  
O. Desinova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
B Lymphocytes ◽  
Cumulative Dose ◽  
Negative Correlation ◽  
Early Stage ◽  
Absolute Number ◽  
Short Disease Duration ◽  
Group 2 ◽  
Group 1

Background:Significant disorders of B-cell homeostasis have been detected in systemic sclerosis (SSc) [1,2]. The improvement of the disease with anti-CD20 monoclonal antibody rituximab (RTM) has been shown in SSc [3]. There are limited data on change in circulating B lymphocytes count after RTM treatment in patients with SSc.Objectives:to investigate the modulations in absolute and relative numbers of circulating CD19-positive B lymphocytes (B-lymph) in patients with SSc within a year after the initiation of RTM therapy.Methods:71 pts with SSc were included in the prospective study. Mean age was 46±13 yrs., 83% were women, 59% had diffuse subset. Duration of SSC from the first non-Raynaud`s symptom was 5.6 ± 4.4 yrs. All pts received low doses of glucocorticoids and 45% -immunosuppressive medications. The average follow-up of patients was 13.2 ± 2.0 (11-18) months. The mean dose of RTM for the period of follow up was 1.43 ± 0.60 grams, 48 patients received < 2 g of RTM (group 1, mean of 1.1 ± 0.1 g) and 23 patients received ≥ 2 grams of RTM (group 2, mean dose of 2.2 ± 0.6 g). Peripheral blood CD19-positive cell count was obtained by flow cytometry in patients and in 20 healthy persons, comparable in sex and age. Data are presented as the percentage (P %) and absolute number (AN) of B-lymph per ml of blood. In patients, the number of B-lymph was determined before (n=67 pts), within first month after the first introduction of RTM (n=66), 6 months later (n=34) and at the end of the study (n=71)Results:At baseline, the AN and P% of B-lymph in pts did not differ from the healthy control. In pts with short disease duration (≤ 3 yrs.) the number of B-lymph before treatment with RTM was the higher (compared with longer duration > 3 yrs) those who was ill ≥3 yrs.) and there was negative correlation between B-lymph count and duration of the disease (R - 0.36, p=0.003 for AN and R - 0.48, p=0.001 for P %). The number of B-lymph was significantly lower in patients receiving cyclophosphamide (Cyc) before being started with RTM. There was a negative correlation between the AN of B-lymph and the cumulative dose of Cyc (R -0.293, p=0.016). In 1 month after the initiation of RTM a complete depletion of B-lymph was observed in all pts and in six months it persisted in 79% of cases, the rest began to repopulate (15%) or reached a normal levels (6%). At the end of the follow up the number of B-lymph was significantly lower than before treatment and a complete (n=41 pts) or partial (n=23) depletion of B-lymph remained, and only in 7 (10%) pts the count of this cells was normalized. We revealed a negative correlation between the AN of B-lymph and the cumulative dose of RTM (R-0.237, p=0.048). Higher doses of RTM in group 2 induced a more significant depletion than in group 1. Change in forced vital capacity and diffusing capacity of the lung (% predicted) during follow up were less pronounced for pts in group 1 compared with group 2 (ΔFVC 2,4% and 7,5% p=0,01; ΔDLCO -0,35% and 5,05%, p=0,001, respectively).Conclusion:RTM may be more effective at the early stage of the disease, when the level of B-lymph is the highest. In SSc, the repopulation of B-lymph after depletion with RTM develops slowly. There were a more significant depletion of B-lymph and a more pronounced improvement in pulmonary function with the higher dose of RTM to compare with the lower one. This results indicate the option of a flexible dosing regimen of RTM.References:[1]Sanges S. et al. La Revue de médecine interne 38 (2017) 113–124[2]Forestier A. et al. Autoimmunity Reviews 17 (2018) 244–255[3]Jordan S, et al. Ann Rheum Dis 2015;74:1188–1194.doi:10.1136/annrheumdis-2013-204522Disclosure of Interests:None declared

scholarly journals POS0853 DECREASE IN ANTI-TOPOISOMERASE-1 ANTIBODY TITER IN PATIENTS WITH SYSTEMIC SCLEROSIS DURING LONG-TERM RITUXIMAB THERAPY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 681.1-681
Author(s):  
L. Garzanova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
O. Desinova ◽  
O. Ovsyannikova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
B Lymphocytes ◽  
Vital Capacity ◽  
Clinical Parameters ◽  
Diffusion Capacity ◽  
Positive Group ◽  
Topoisomerase 1 ◽  
The Mean

Background:Rituximab (RTX) is a new option in the treatment of systemic sclerosis (SSc) [1]. There is not enough data on changes in the level of autoantibodies and their clinical significance during RTM therapy. There are only a few reports on the higher efficiency of RTX in patients (pts) with SSc positive for anti-topoisomerase-1 antibodies (a-Topo-1), therefore the study of this issue might be interested.Objectives:To compare clinical parameters and B-lymphocytes (B-lymph) level in SSc pts depending on the presence or absence of a-Topo-1 during RTX therapy with prospective long-term follow-up.Methods:This study included 88 pts with SSc. The mean follow-up period was 26,3±10,7 months. The mean age was 47years (17-71), female-73 pts (83%), the diffuse cutaneous subset of the disease had 50 pts (57%). Symptoms of the interstitial lung disease (ILD) were observed in 70 pts (80%). The mean disease duration was 5,9±4,8 years. The cumulative mean dose of RTX was 2,9±1,1 grams. All patients received prednisone at a dose of 11,7±4,4 mg, immunosuppressants received 42% of them. There were 63 pts positive for a-Topo-1 and 25 pts - negative. The pts of the compared groups did not differ in the main demographic and clinical parameters, excepting lung involvement. In a-Topo-1 positive group 55 (87%) pts had ILD and only 15 (60%) – in a-Topo-1-negative group (p=0,02). The results at baseline and at the end of the follow up are presented in the form of mean values and changes in parameters (delta).Results:Considering the entire cohort, an improvement of almost all outcome parameters was found. When a-Topo-1 positive and a-Topo-1-negative pts were analyzed separately, we observed a significantly higher decrease in the activity score, depletion of B-lymph, an increase in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) in a-Topo-1 positive group of pts (table 1).Table 1.Changes of the main outcome parameters depending on the presence of a-Topo-1 on RTX therapy.Parametersa-Topo-1positive ptsa-Topo-1negative ptsPDelta Activity score (EScSG-AI)1,790,90,001Delta Rodnan skin score (mRSS)4,95,2NSDelta B-lymphocytes (absolute count)0,2120,1930,001Delta FVC*, %8,646,460,001Delta DLCO**, %2,860,0320,001*FVC - forced vital capacity % predicted, **DLCO - diffusion capacity for carbon monoxide % predictedThe a-Тopo-1 level decreased from 174,2±50,1 to 148,1±66,1 units/ml (p=0,0009). In this group, a-Тopo-1 became negative in 5 pts (7,9%). The disappearance of a-Topo-1 positivity was accompanied by a more pronounced decrease in mRSS (delta mRSS=7,4) and a higher depletion of B-lymph. There was a higher cumulative dose of RTX (4±1,4grams) in this 5 pts compared with the pts who sustained a-Topo-1 positivity. There was a moderate negative statistically significant correlation between the a-Topo-1 and the total dose of RTX (r=-0,298, p=0,017). A moderate negative statistically significant correlation was found between the a-Topo-1 and FVC (r=-0,322, p=0,009).Conclusion:In our study, the a-Topo-1 level significantly decreased during RTX therapy in Russian pts. The decrease in a-Topo-1 titers correlated with the total dose of RTX and was accompanied by a decrease in mRSS, disease activity index and an increase in FVC and DLCO. A higher efficacy of RTX in the a-Topo-1 positive group with prevalence of ILD was revealed, therefore a-Topo-1 positivity could be considered as a predictor of a better response to RTX therapy.References:[1]Jordan S, et al. Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group. Ann Rheum Dis.2015;74:1188–94.Doi:10.1136/annrheumdis-2013-204522.[2]Ebata S, Yoshizaki A, et.al. Rituximab therapy is more effective than cyclophosphamide therapy for Japanese patients with anti-topoisomerase I-positive systemic sclerosis-associated interstitial lung disease. J Dermatol.2019.Nov;46(11):1006-1013.doi:10.1111/1346-8138.15079.Disclosure of Interests:None declared

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽  
2021 ◽  
pp. 000331972199141
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Fethi Yavuz ◽  
Nermin Yildiz Koyunsever ◽  
Yusuf Cekici ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular Disease ◽  
Operating Characteristics ◽  
Coronary Artery Disease Severity ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

scholarly journals Chronic kidney disease stage stratifies short- and long-term outcomes after aortic root replacement

2020 ◽  
Author(s):  
Tsuyoshi Yamabe ◽  
Yanling Zhao ◽  
Paul A Kurlansky ◽  
Suzuka Nitta ◽  
Saveliy Kelebeyev ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Aortic Root Replacement ◽  
Mortality Hazard ◽  
Group 3 ◽  
Group 2 ◽  
Mortality Hazard Ratio ◽  
Group 1

Abstract OBJECTIVES Chronic kidney disease (CKD) is prevalent in patients undergoing cardiovascular surgery, and it negatively impacts procedural outcomes; however, its influence on the outcomes of aortic surgery has not been well studied. This study aims to elucidate the importance of CKD on the outcomes of aortic root replacement (ARR). METHODS Patients who underwent ARR between 2005 and 2019 were retrospectively reviewed (n = 882). Patients were divided into 3 groups based on the Kidney Disease: Improving Global Outcomes criteria: Group 1 [estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, n = 421); Group 2 (eGFR = 30–59 ml/min/1.73 m2, n = 424); and Group 3 (eGFR &lt; 30 ml/min/1.73 m2, n = 37). To reduce potential confounding, a propensity score matching was also performed between Group 1 and the combined group of Group 2 and Group 3. The primary end point was 10-year survival. Secondary end points were in-hospital mortality and perioperative morbidity. RESULTS Severe CKD patients presented with more advanced overall chronic and acute illnesses. Kaplan–Meier analysis showed a significant correlation between CKD stage and 10-year survival (log-rank P &lt; 0.001). The number of events for Group 1 was 15, Group 2 was 49 and Group 3 was 11 in 10 years. Group 3 had significantly higher in-hospital mortality (13.5% vs 3.5% in Group 2 vs 0.7% in Group 1, P &lt; 0.001) and stroke (8.1% vs 7.1% vs 1.2%, P &lt; 0.001) as well as introduction to new dialysis (27.0% vs 5.4% vs 1.7%, P &lt; 0.001). eGFR was shown to be an independent predictor of mortality (hazard ratio, 0.98; 95% confidence interval, 0.96–0.99). Comparison between propensity matched groups showed similar postoperative outcomes, and eGFR was still identified as a predictor of mortality (hazard ratio, 0.97; 95% confidence interval, 0.95–0.99). CONCLUSIONS Higher stage in CKD negatively impacts the long-term survival in patients who are undergoing ARR.

scholarly journals Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Aylin Karalezli ◽  
Sema Kaderli ◽  
Ahmet Kaderli ◽  
Cansu Kaya ◽  
Sabahattin Sul
Keyword(s):  
First Year ◽  
Intravitreal Ranibizumab ◽  
Retinal Layers ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

scholarly journals Evaluation of Iron Status, Haemoglobin and Protein Levels of Pregnant Women in Owerri Metropolis

2021 ◽  
pp. 36-43
Author(s):  
I. L. Okoroiwu ◽  
Jane Ugochi Chinedu-Madu ◽  
Emmanuel Ifeanyi Obeagu ◽  
C. C. N. Vincent ◽  
O. M. T. B. Ochiabuto ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Serum Iron ◽  
Iron Deficiency Anaemia ◽  
Iron Status ◽  
Second Trimester ◽  
Protein Levels ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

The study was done to determine iron status, haemoglobin and protein levels of pregnant women in owerri metropolis. A total of 100 pregnant women were recruited for this study. The mean Hb levels in group 1, group 2, and group 3· were 12.00±1.68g/dl, 10.06±1.J4g/dl and 10.96±1.19g/dl respectively. The mean Serum ferritin level of group 1 was 67.00±88.38ng/ml, group 2, 52.48±52.47ng/ml and group 3, 51.26±48.70ng/ml. The mean Serum iron in group 1, 2 and 3 were 46.72±16.41 g/dl, 79.59±63.24 g/dl and 83.35±53.04 g/dl respectively. In group 1, 2 and 3 the mean results. ( g/dl) of TIBC were 295.58 ± 109.53, 324.06 ± 178.00 and 319.88 ± 92.95 and % T.S (%) were 18.78 ± 11.77,26.59 ± 19.40 and 17.97 ± 10.87 percent respectively. The mean total protein was group 1,6.83±l1.77g/dl, group 2,6.39±0.70g/dl and group 3, 6.39 ±0.98 g/dl while the mean albumin (g/dl) in group 1, 2 and 3 were 4.84±0.47, 4.13±0.28 and 4.14±0.29 respectively. The mean values of globulin (g/dl) were 1.98 ± 0.91, 2.29 ± 0.87 and 1.89 ± 0.90 in groups 1, 2 and 3 respectively. As gestational age increased; serum ferritin, total protein, and albumin levels decreased while serum" iron and TIBC increased. The differences in the mean results between the groups were statistically significant (p<0.05) while % T.S and globulin levels when compared showed no significant difference (p>0.05). Iron status showed no statistical difference with increasing parity (p>0.05). However, from this study iron deficiency anaemia was most prevalent in second trimester; hence iron status estimation should be an integral part of routine antenatal care test during second trimester of each pregnancy for proper assessment and management of iron deficiency anaemia in pregnancy.

scholarly journals Serum Bioavailable Testosterone: Assayed or Calculated?

2006 ◽  
Vol 52 (3) ◽  
pp. 474-481 ◽  
Author(s):  
Frank Giton ◽  
Jean Fiet ◽  
Jérôme Guéchot ◽  
Fidaa Ibrahim ◽  
Françoise Bronsard ◽  
...  
Keyword(s):  
Ammonium Sulfate ◽  
Association Constants ◽  
Sex Hormone Binding Globulin ◽  
Precipitation Method ◽  
Microsoft Excel ◽  
Bioavailable Testosterone ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background: Bioavailable testosterone (BT), circulating testosterone not bound to sex hormone–binding globulin (SHBG), is thought to easily penetrate cells. We compared BT measurements obtained by assays with those obtained by calculation with different testosterone association constants. Methods: We obtained sera from 2 groups of hypogonadal men [group 1 (G1), 1421 samples; group 2 (G2), 170 samples] and a group of healthy men [group 3 (G3), 109 samples]. We added minute doses of [3H]testosterone to the sera, precipitated the SHBG-bound fraction of testosterone with ammonium sulfate (50% saturation), and then assayed serum BT (ABT) as %BT × total. Calculated BT (CBT) was determined with theoretical association constants of testosterone for SHBG (Ks = 1 × 109 L/mol) and albumin (Ka = 3.6 × 104 L/mol) and paired optimal Ks and Ka values obtained by use of Microsoft Excel software. Results: CBT calculated with theoretical constants differed from ABT by &gt;30% in 85.7% (G1), 84.1% (G2), and 77.9% (G3) of samples, and the mean CBT/ABT ratios were 1.57 (G1), 1.85 (G2), and 1.50 (G3) in spite of fairly good correlations. CBT calculated with paired optimal Ks and Ka differed from ABT by &lt;30% in 87.4% (G1), 87.5% (G2), and 97.5% (G3) of samples, and mean CBT/ABT ratios were 0.95–1.04. Conclusions: To obtain CBT values as close as possible to ABT, optimal paired association constants determined for each studied population must be used instead of the theoretical association constants. Considering the uncertainty of calculating BT, however, use of the ammonium sulfate precipitation method for determining BT is advisable.

Application of femtolaser-assisted phacoemulsification in combined pathology of cataract and glaucoma

2021 ◽  
pp. 18-21
Author(s):  
A.P. Voznyuk ◽  
◽  
S.I. Anisimov ◽  
S.Y. Anisimova ◽  
L.L. Arutyunyan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Biomechanical Properties ◽  
Mean Values ◽  
Long Term Follow Up ◽  
The Mean ◽  
Group 2 ◽  
Observation Period ◽  
Group 1

Purpose. To evaluate the efficacy and safety of femtolaser-assisted phacoemulsification in glaucomatous eyes in the long-term follow-up. Materials and methods. A retrospective analysis of the results of the surgical treatment of patients with combined cataract and glaucoma pathology was analyzed. The patients were divided into groups depending on the method of surgical intervention: 1) phacoemulsification with femtolaser support (26 eyes, 23 patients); 2) phacoemulsification (36 eyes, 30 patients); Results. Before surgery, there were no statistically significant differences in IOP and corneal hysteresis (СН) between groups 1 and 2. The mean values of IOP cc, IOP g and СН of group 1 before surgery were 22.7±6.1 mm Hg, 20.9±6.9 mm Hg, 8.5±1.6 mm Hg; 2 group – 22.9±8.7 mm Hg, 21.6±8.9 mm Hg, 8.9±1.6 mm Hg respectively. Average values of IOP cc, IOP g and CН 5 years after the surgical treatment in group 1 were 15.3±1.2 mm Hg, 14.4±3.4 mm Hg, 9.6±4.2 mm Hg; in group 2 – 18.0±4.2 mm Hg, 16.1±4.2 mm Hg, 8.8±2.2 mm Hg respectively. In both groups, stabilization of IOP and CH indices was noted, which remained throughout the entire observation period, which shows the normalization of the biomechanical properties of the corneoscleral membrane of the eye in the long-term postoperative period. Conclusion. Femtolaser accompaniment of phacoemulsification is an effective and safe method of cataract surgery for combined pathology. Key words: femtolaser, cataract, glaucoma, phacoemulsification.

Specificities in mechanism of erythrocyte deformability disorders in various diseases

2021 ◽  
Author(s):  
Н.П. Александрова ◽  
В.И. Карандашов ◽  
Д.А. Кудлай
Keyword(s):  
Disease Duration ◽  
Normal Values ◽  
Common Factors ◽  
Erythrocyte Deformability ◽  
Mechanical Resistance ◽  
Hematocrit Level ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Введение. Нарушение текучести крови, обусловленное повышением ее вязкости и снижением эластичности эритроцитов, может привести к столь значительным расстройствам центральной гемодинамики и микроциркуляции, что возникает дисфункция органов. Цель исследования: изучение доминирующих специфических механизмов, вызывающих нарушение деформируемости эритроцитов при различных заболеваниях. Материалы и методы. Обследован 121 пациент: с геморрагическим панкреонекрозом (n = 16) без острой сопутствующей сердечно-сосудистой патологии (группа 1); с тромбоэмболией магистральных артерий нижних конечностей (n = 37) с локализацией в подвздошной, бедренной и подколенной артериях, со сроком заболевания от 2 до 3 сут (группа 2); с острым тромбозом магистральных артерий нижних конечностей (n = 32) с ишемией II степени и длительностью заболевания от нескольких недель до нескольких месяцев (группа 3); с острым венозным тромбозом (n = 36), срок заболевания варьировал от 24 ч до 30 сут (группа 4). Для контроля изучены показатели 26 практически здоровых лиц (группа 5). Проведено исследование деформируемости эритроцитов методом фильтруемости, изучали распределение эритроцитов по диаметру, определяли показатель гематокрита и механическую резистентность эритроцитов, исследование белкового состава плазмы проводили спектрофотометрическим способом, измеряли содержание сиаловой кислоты в плазме и в эритроцитах. Результаты. Самые тяжелые нарушения морфологических и физико-химических свойств эритроцитов выявлены у больных геморрагическим панкреонекрозом (группа 1): скорость фильтрации эритроцитов была в 1,8 раза меньше, чем у здоровых людей; диаметр эритроцитов в 1,2 раза, а уровень гематокрита на 9% превышали норму; механическая резистентность была в 2 раза ниже нормальной. По сравнению с нормальными значениями у больных группы 2 диаметр эритроцитов был увеличен на 18%, гематокрит — на 7%, механическая резистентность была снижена на 27%. У пациентов группы 3 деформируемость была снижена на 14%, диаметр эритроцитов превышал норму на 11%, гематокрит — на 5%, механическая резистентность была снижена на 18%. У больных группы 4 деформируемость эритроцитов была практически не нарушена, все остальные параметры эритроцитов также не отличались от нормальных. Заключение. Существуют как специфические факторы, обусловливающие нарушение деформируемости эритроцитов и присущие только конкретному заболеванию, так и общие факторы, изменяющие деформационные свойства эритроцитов, которые сопровождают практически любую патологию. Общими факторами, снижающими деформационные свойства эритроцитов при исследованных нами заболеваниях, являются выраженная диспротеинемия и ацидоз. Background. Blood flow disorders due to its viscosity increasing and erythrocytes elasticity decreasing, may cause significant disturbances of central hemodynamics and microcirculation that lead to organ dysfunction. Objectives: to studythe basic specific mechanisms of erythrocyte deformability impairment in various diseases. Patients/Methods. We examined 16 patients: with hemorrhagic pancreonecrosis (n = 16) without acute comorbid cardiovascular pathology (group 1); with thrombembolia of the main arteries (iliac, femoral and popliteal) of lower extremities (n = 37), and disease duration of 2 to 3 days (group 2); with acute thrombosis (II degree ischemia) of the main arteries in the lower extremities (n = 32), and disease duration from several weeks to several months (group 3); with acute venous thrombosis (n = 36) and disease duration from 24 hours to 30 days (group 4). Group 5 consisted of 26 practically healthy individuals. We measured erythrocytes deformability (by filterability method), erythrocytes diameter distribution, hematocrit and erythrocytes mechanical resistance, plasma proteins composition (spectrophotometrically), sialic acid concentration in plasma and erythrocytes. Results. The most expressive disorders of erythrocytes morphological and physicochemical properties were found in patients with hemorrhagic pancreonecrosis (group 1): erythrocytes filtration rate was 1.8 times less than in healthy people; erythrocytes diameter was 1.2 times and the hematocrit level was 9% above normal; mechanical resistance was 2 times lower than normal. In patients of group 2 erythrocytes diameter was increased by 18%, hematocrit level — by 7%, mechanical resistance was reduced by 27% compared with normal values. In patients of group 3, deformability was reduced by 14%, erythrocytes diameter exceeded the norm by 11%, the hematocrit was by 5% above the norm, mechanical resistance was reduced by 18%. In patients of group 4, erythrocyte deformability practically was not impaired; all other erythrocytes parameters also did not differ from normal values. Conclusions. Erythrocyte deformability impairment caused by both specific factors that are attributable only for specific disease and by common factors that exists in almost any disease. Expressed dysproteinemia and acidosis are common factors that reduce erythrocyte deformability in examined diseases.

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