scholarly journals AB0156 NMR-BASED MUSCLE METABOLOMICS IN INFLAMMATORY MYOSITIS- UNDERSTANDING CHANGES IN SERUM AS A REFLECTION OF THE MUSCLE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1378.2-1379
Author(s):  
L. Gupta ◽  
U. Kumar ◽  
A. Anuja ◽  
P. Sharma ◽  
A. Guleria ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Muscle Disease ◽  
P Value ◽  
Healthy Controls ◽  
Inflammatory Myositis ◽  
Activity Assessment ◽  
Muscle Tissues ◽  
Low Levels ◽  
Serum Metabolomics ◽  
Research Grant

Background:We have previously found promise in NMR as a tool to distinguish sera of active from inactive inflammatory myositis (IIM)1. To understand the changes previously found in sera and urine we studied muscle tissue of patients with myositis.Objectives:To identify differences in metabolome on inflamed muscle tissues of patients with active myositis from that of healthy controls and infectious polymyositis.Methods:Muscle (n=17) from patients classifiable as myositis by the ACR-EULAR criteria [34 years (23.5 - 50.5 IQR), M/F 1:3] were compared with healthy controls [n=11, age= 44 (35-50) years, M/F-1:1]. Two disease controls with infectious polymyositis were also compared. Findings were applied to muscle biopsy tissues of two patients with established myositis and superadded infections (HBV, Histoplasmosis) to assess discriminatory potential.Metabolic profiles were obtained at 800 MHZ NMR spectrometer and compared using multivariate partial least-squares discriminant analysis (PLS-DA). The discriminatory metabolites were identified based on variable importance in projection (VIP) statistics and further evaluated for statistical significance (p-value <0.05). Paired T tests, ANNOVA and correlation of individual metabolites were done after normalizing for formate.Results:Metabolomics profiles in IIM were distinct from healthy controls (Fig. 1A).Of the various discriminatory metabolites (Fig. 1B), Succinate had the highest discriminatory potential (AUC 0.8, P=0.01) followed by citrate, glycine, glycerol, glucose, creatine and lactate. (Fig. 1C) Both glucose and creatine were decreased in IIM (Fig. 1D,E) and this was uniform across all types of IIM. However, glycine levels differed across different myositis subsets supporting the fact that they might differ in pathogenesis. (Fig. 1E) Amongst various serum biomarkers of muscle disease and damage, serum Aspartate Transaminase correlated with glutamate (r=0.6, p=0.01), and serum creatinine correlated negatively with glycerol (r-0.8, p=0.04),Biopsies of infectious polymyositis suggested difference in spectra from IIM (Fig. 2A). Trends were observed towards lower succinate and higher citrate levels suggesting metabolomics could possibly be useful to differentiate the two. Muscle of both patients with IIM with superadded infectious polymyositis also exhibited low succinate and elevated citrate.Conclusion:Muscle metabolomics of active myositis is distinctive. Amino acids and creatine are lower in diseases muscle suggesting active breakdown and loss, in turn explaining previous findings of low levels in serum in active disease. Certain metabolite composition differ in different types of myositis supporting different pathogenesis.Infectious polymyositis might exhibit different metabolome from IIM with potential as a biomarker though this needs to be confirmed in larger numbers.Disclosures:Funded by APLAR research grant 2017 awarded to Dr Latika Gupta.References:[1]Gupta L, Kumar D, Gulerai A, Kumar U, Misra R. “NMR-Based Serum, Urine and Muscle Metabolomics in Inflammatory Myositis for Diagnosis and Activity Assessment: Serum Metabolomics Can Differentiate Active from Inactive Myositis” Oral presentation at the ACR, Atlanta 2019.Acknowledgments:MSA and metabolomics supported by APLAR research grant.Disclosure of Interests:None declared

P0356QUANTITATIVE ASSESSMENT OF GALNAC NUMBER IN THE HINGE REGION OF IGA1 IN IGA NEPHROPATHY WITH CRESCENTS FORMING

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Guizhen Yu ◽  
Yong Zhang ◽  
Xinfang Xie ◽  
Bo Meng ◽  
Wantao Ying ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Iga Nephropathy ◽  
Validation Cohort ◽  
High Resolution Mass Spectrometry ◽  
Statistical Significance ◽  
Hinge Region ◽  
P Value ◽  
Healthy Controls ◽  
Discovery Cohort ◽  
Content Ratio

Abstract Background and Aims Aberrant IgA1 O-linked glycosylation of IgA1 hinge region (HR) has been shown playing an important role in the pathogenesis of IgA nephropathy (IgAN). Serum levels of galactose-deficient IgA1 (Gd-IgA1) was associated with the development and progression in IgAN, however variations in the composition of IgA1 HR glycoforms are unknown. In this study we aim to quantitative assessment of GalNAc number in the hinge region of IgA1 in IgAN with crescents forming using mass spectrometry. Method Plasma polymeric IgA1 (pIgA1) was purified from a discovery cohort including crescentic IgAN (n=11) non-crescentic IgAN (n=10) and healthy controls (HC, n=10) and a validation cohort (crescentic IgAN, n=10; non-crescentic IgAN, n=10 and healthy controls, n=11). After denaturation, reduction, alkylation and trypsin digestion, liquid chromatography-high-resolution mass spectrometry (LC-MS) was used to analyse the IgA1 HR glycans. The intensity of the identified IgA1 O-glycopeptide was calculated and expressed as the relative abundance for each glycopeptide. The molecular weight (MW) of intact O-glycopeptide was calculated as the formula following: MW = HR + x GalNAc + y Gal + z NeuAc + H+ (x, y and z represent the number of GalNAc, galactose and NeuAc which bind to one HR in IgA1 O-linked glycopeptides respectively) Glycopeptide content ratio = (glycopeptide peak intensity/ total glycopeptide intensity) ×100%. Results In the discovery cohort population, the level of Gd-IgA1 was highest in patients with crescentic IgAN, middle in patients with non-crescentic IgAN and lowest in healthy controls (347.69±57.89 U/ml vs 336.32±38.44 U/ml vs 330.14±33.22 U/ml), albeit that didn’t reach the statistical significance. There were significantly difference in GalNAc number of IgA1 HR among patients with IgAN and healthy controls. Overall the numbers of GalNAc bound to one HR was much lower in the patients than healthy controls. As shown in the Figure 1, the proportion of GalNAc 3, defined as O-glycans that were bound to one HR at 3 sites, were highest in patients with crescentic IgAN, then the non-crescentic IgAN and lowest in the healthy controls (9.92%±3.37% vs 6.65%±1.53% vs 4.05%±1.24%; p-value for the trend&lt;0.001). Similar results were observed in GalNAc 4 (45.91%±4.75% vs 41.13%±2.95% vs 40.98%±2.95%; P=0.004. However regarding the GalNAc 5 and GalNAc 6, crescentic IgAN was lowest, then non-crescentic IgAN and highest in the healthy control (GalNAc 5: 45.17%±5.46% vs 46.90%±2.78% vs 48.05%±3.02%, P=0.001 GalNAc 6:1.62%±1.60% vs 3.95%±1.92% vs 5.39%±2.38%; P&lt;0.001). These results were consistent in the validation cohort (Figure 1). Conclusion GalNAc numbers in IgA1 HR was lower in patients with IgAN especially in crescentic IgAN. These results suggest that the O-glycans of IgA1 were associated with the severe phenotype in IgA nephropathy.

SERUM PROLACTINE LEVEL IN PATIENTS OF PSORIASIS VULGARIS AND ITS CORRELATION WITH DISEASE SEVERITY: A CASE-CONTROL STUDY

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pawan Kumar Saini ◽  
Devendra Yadav ◽  
Rozy Badyal ◽  
Suresh Jain ◽  
Arti Singh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Prolactin Level ◽  
Case Control Study ◽  
Statistical Significance ◽  
Case Control ◽  
Serum Prolactin ◽  
P Value ◽  
Serum Prolactin Level ◽  
R Value ◽  
Control Study

Background: Psoriasis is an autoimmune chronic inflammatory disorder affecting the skin mediated by T-lymphocytes resulting in production of cytokines which cause hyperproliferation of keratinocytes.  Several factors and hormones like Prolactin have an action similar to these cytokines in promoting the multiplication of keratinocytes and other cells like lymphocytes and epithelial cells may have a role on the etiopathogenesis of psoriasis. Aim:-The aim of study is to compare the serum Prolactin levels in patients of psoriasis with a control group. Setting and study design: This is a case-control study conducted in the department of Dermatology, Venereology and Leprosy GMC, Kota over a period of 1year from July 2017 to June 2018 Material and method: The study included 100 cases of psoriasis (60 males and 40 females) and 100 controls similar for age and sex. Serum Prolactin levels were measured by ECLIA and results were obtained. Statistical analysis: Mean and standard deviation were calculated for each variable. Statistical significance of the results was analyzed using correlation analysis (Pearson correlation coefficient) and independent samples t-test. Statistical significance was assumed at p value<0.05. Result: Serum Prolactin level was significantly higher in cases of psoriasis compared to controls (p-value <0.001). PASI score and serum Prolactin levels were found to have a positive correlation (r value = 0.337; p-value: 0.001). No significant  correlation was found between serum levels of Prolactin and duration of disease r value= -0.034, P value =0.733). Serum Prolactin level was higher in male patients compared to females patients. Conclusion:- High serum Prolactin may be a biological marker of disease severity in psoriasis and may have a role in the pathogenesis of psoriasis. Further studies with large sample size are required to confirm this hypothesis.

Awareness of radiation doses and risks among radiology residents, fellows, specialists, consultants and technologists in Jeddah, Saudi Arabia: Cross-Sectional Study. (Preprint)

2019 ◽  
Author(s):  
Bashayer Hassan Shuaib ◽  
Rahaf Hisham Niazi ◽  
Ahmed Haitham Abduljabbar ◽  
Mohammed Abdulraheem Wazzan
Keyword(s):  
Interventional Radiology ◽  
Ionizing Radiation ◽  
Statistical Significance ◽  
Knowledge Score ◽  
P Value ◽  
Radiation Doses ◽  
Cross Sectional ◽  
The Right ◽  
Interventional Radiology Procedures ◽  
Radiology Staff

BACKGROUND Radiology now plays a major role to diagnose, monitoring, and management of several diseases; numerous diagnostic and interventional radiology procedures involve exposure to ionizing radiation. Radiology now plays a major role to diagnose, monitoring, and management of several diseases; numerous diagnostic and interventional radiology procedures involve exposure to ionizing radiation. OBJECTIVE This study aimed to discover and compare the awareness level of radiation doses, protection issues, and risks among radiology staff in Jeddah hospitals. METHODS A cross-sectional survey containing 25 questions on personal information and various aspects of radiation exposure doses and risks was designed using an online survey tool and the link was emailed to all radiology staff in eight tertiary hospitals in Jeddah. The authors were excluded from the study. A P-value of < .05 was used to identify statistical significance. All analyses were performed using SPSS, version 21. RESULTS Out of 156 participants the majority 151 (96.8%) had poor knowledge score, where the mean scores were 2.4±1.3 for doses knowledge, 2.1±1.1for cancer risks knowledge, 2.3±0.6 for general information, and 6.7±1.9 for the total score. Only 34.6% of the participants were aware of the dosage of a single-view chest x-ray, and 9.0% chose the right answer for the approximate effective dose received by a patient in a two-view. 42.9% were able to know the correct dose of CT abdomen single phase. There is a significant underestimation of cancer risk of CT studies especially for CT abdomen where only 23.7% knew the right risk. A p-value of <0.05 was used to identify statistical significance. No significant difference of knowledge score was detected regarding gender (P =.2) or work position (P=.66). CONCLUSIONS Our survey results show considerable inadequate knowledge in all groups without exception. We recommended a conscientious effort to deliver more solid education and obtain more knowledge in these matters and providing periodic training courses to teach how to minimize the dose of radiation and to avoid risk related. CLINICALTRIAL not applicable

scholarly journals Can diffusion and T2 star-weighted magnetic resonance imaging aid in the diagnosis of ectopic endometrium?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mariam Raafat ◽  
Soha H. Talaat ◽  
Salma M. Abdelghaffar ◽  
Engy A. Ali
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Statistical Significance ◽  
P Value ◽  
Large Sample Size ◽  
Resonance Imaging ◽  
Conventional Mri ◽  
Patient Will ◽  
Magnetic Resonance Imaging Mri ◽  
Ectopic Endometrium

Abstract Background Endometriosis is a common gynecologic disorder characterized by the implantation of the endometrial tissue ectopically outside the endometrial cavity. It affects about 10% of females at the childbearing period and is estimated to be present up to 20–50% in women complaining of infertility. While laparoscopy is considered the mainstay for diagnosis, magnetic resonance imaging (MRI) is recognized as a useful tool for definitive diagnosis, pre-surgical planning, and determining whether the patient will require multi-specialty involvement. The aim of this study is to evaluate the performance of MRI with the addition of diffusion-weighted imaging (DWI) and T2 star (T2*) to conventional MRI, for the accurate assessment of ectopic endometrium. Results Endometriotic lesions that showed diffusion restriction on DWI were 80.7%, and 96.1% of the endometriotic lesions had signal voids on the T2*W sequence, whereas only 65.4% of the lesions had typical signal intensities on T1WI and T2WI. Diagnostic performance of the MRI examination was improved by the use of the diffusion sequence and better improved by the T2* sequence, compared to the conventional MR protocol sensitivity (SE) = 96.12% and specificity (SP) = 85.7% in T2*-weighted images, SE = 80.7% and SP = 71.4% in DWI, and SE = 65.4% and SP = 71.4% in conventional MRI. P value for conventional MRI was 0.1, which is of no statistical significance (p < 0.05). P value for DWI was 0.016, which is statistically significant (p < 0.05). P value for T2*WI was 0.001, which is more statistically significant (p < 0.05) and could be adequately correlated with laparoscopy. Conclusion DWI and T2* significantly increase MRI diagnostic accuracy by allowing the detection of the hemorrhagic character of the endometriotic lesions. Studies with a large sample size are needed to confirm that they can replace invasive laparoscopy for the diagnosis of endometriosis.

Thromboelastography (TEG) results are predictive of ischemic and hemorrhagic complications in patients with unruptured intracranial aneurysms treated with flow diversion

2021 ◽  
pp. 159101992110259
Author(s):  
Kainaat Javed ◽  
Santiago R Unda ◽  
Ryan Holland ◽  
Adisson Fortunel ◽  
Rose Fluss ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Intracranial Aneurysms ◽  
Statistical Significance ◽  
Alpha Angle ◽  
Flow Diversion ◽  
P Value ◽  
Hemorrhagic Complication ◽  
Unruptured Intracranial Aneurysms ◽  
Hemorrhagic Complications ◽  
Groin Hematoma

Introduction Flow diversion is an effective treatment modality for intracranial aneurysms but is associated with ischemic and hemorrhagic complications. Patients treated with flow diversion require dual antiplatelet therapy and subsequent platelet function tests. At our institution, Thromboelastography with Platelet Mapping (TEG-PM) is the test of choice. The primary objective of this study was to identify TEG parameters that are predictive of postoperative complications in patients treated with elective flow diversion. Methods This was a retrospective study of 118 patients with unruptured intracranial aneurysms treated with flow diversion. Data was collected via chart review. Bivariate analyses were performed to identify significant variables in patients who suffered an ischemic stroke or a groin hematoma. ROC curves were constructed for the TEG parameters with statistical significance. Bivariate analyses were repeated using dichotomized TEG results. Results Patients who experienced a symptomatic ischemic stroke had a history of stroke (p value = 0.007), larger aneurysm neck width (p value = 0.017), and a higher alpha angle (p value = 0.013). Cut off point for ischemic complication is 63° on ROC curve with a sensitivity of 100% and specificity of 65%. Patients who experienced a groin hematoma were no different from their healthy peers but had a lower alpha angle (p value = 0.033). Cut off point for hemorrhagic complication is 53.3° with a sensitivity of 82% and specificity of 67%. Conclusion The Alpha Angle parameter of TEG-PM has a sizeable predictive ability for both ischemic complications of the central nervous system and hemorrhagic complications of the access site after elective flow diversion.

scholarly journals AB0799 REAL-WORLD EXPERIENCE OF SECUKINUMAB FOR PSORIATIC ARTHRITIS WITH AXIAL INVOLVEMENT.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1699.3-1699
Author(s):  
M. Martin Lopez ◽  
B. Joven-Ibáñez ◽  
J. L. Pablos
Keyword(s):  
Psoriatic Arthritis ◽  
Adverse Events ◽  
Real World ◽  
Spinal Pain ◽  
Tender Joint Count ◽  
P Value ◽  
X Ray ◽  
Activity Assessment ◽  
Real World Setting ◽  
Axial Involvement

Background:Evidence on the efficacy of biologics in the treatment of psoriatic arthritis (PsA) patients with axial manifestations affecting 30-70% of PsA patients is limited. Secukinumab (SEC) has provided significant and sustained improvement in the signs and symptoms of active PsA and ankylosing spondylitis.Objectives:This study aims to analyze the experience of using SEC for PsA patients with axial involvement in real-world setting.Methods:Multicentric observational, longitudinal, retrospective study conducted in a tertiary hospital between January 2016 and December 2019. Patients with PsA (CASPAR criteria) and clinical and/or image diagnosis of axial involvement receiving at least one dose of SEC were included. Patients with non-pathological sacroiliacs x-ray and MRI had to have spinal pain VAS ≥4/10 after failure to NSAIDs, prior to the onset of SEC, to be included. Medical records were reviewed to collect demographic and clinical data, features of PsA (manifestations, treatments and activity assessment). Descriptive statistics and then a comparative analysis with the Studentt-test to analyze the effectiveness of SEC were performed.Results:Of 98 PsA patients treated with SEC, 58 (59.2%) had axial involvement, of which 41 (71%) female. Mean age was 54 y.o (SD 10) and average duration of the disease was 10 years (SD 8). All 58 patients had peripheral disease (33% joint erosions), 55 (95%) had psoriasis, 20 (34%) showed dactilitis and 39 (67%) had enthesitis. Sacroiliacs x-ray was damaged in 38 (66%) patients (grade I-IV) and 23 (40%) pathological MRI, with HLAB27+ at 8 (14%) patients. Average BMI was 29 (SD 8), with an obesity rate of 33% (19 pt). Observed comorbidities were hypertension (27 pt, 47%), diabetes mellitus (6 pt, 10%), dyslipidemia (23 pt, 40%), active smoking (18 pt, 31%) and malignancy (6 pt, 10%). Regarding previous treatments, 90% had received cDMARDs, particularly methotrexate (86%) and 40 (69%) had been exposed to at least one bDMARD (15 pt to one, 9 to two, 6 to three and 10 to four or more). 7 patients were on 300 mg dose and 51 patients on 150 mg dose (dose escalation to 300 mg was performed in 16 patients and 44% respond and maintain SEC). Average drug survival time was 1.4 (SD 1) years. At 6 months of SEC therapy, tender and swollen joint count, spinal pain VAS, CRP, ASDAS-CRP and DAPSA had significantly decreased (Table 1). 29 (50%) patients suspended SEC during follow-up due to primary ineffectiveness (8), secondary ineffectiveness (16), adverse events (3), latex allergy (1) and remission (1). Adverse events do not differ from those reported in clinical trials.Table 1.Disease activity assessment at 6 months of secukinumab therapy.Baseline6 months after SECMean differenceP valueSJC4,8±5,41,9±3,1-2,8 (IC95% -3,9 a -1,7)p<0,0001TJC7,7±5,83,9±4,1-3,8 (IC95% -5,1 a -2,4)p<0,0001Spinal pVAS6,1±3,24,2±2,9-1,9 (IC95% -2,4 a -1,4)p<0,0001CRP (mg/L)7,7±9,94,9±5,9-2,9 (IC95% -4,5 a -1,2)p=0,0009ASDAS-CRP2,5±1,91,8±1,3-0,7 (IC95% -0,9 a -0,4)p<0,0001DAPSA27,7±12,116,7±10,4-11 (IC95% -15,3 a -6,8)p<0,0001SJC: swollen joint count, TJC: tender joint count, Spinal pVAS: spinal pain visual analog scale, CRP: C-reactive protein, SEC: secukinumab.Conclusion:Secukinumab in real-world setting provided improvements in the axial and peripheral manifestations of PsA, using both the 150 mg and 300 mg doses.Disclosure of Interests:MARIA MARTIN LOPEZ: None declared, Beatriz Joven-Ibáñez Speakers bureau: Abbvie, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, José Luis Pablos: None declared

scholarly journals Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic

2021 ◽  
Author(s):  
Kemar J Brown ◽  
Njambi Mathenge ◽  
Daniela Crousillat ◽  
Jaclyn Pagliaro ◽  
Connor Grady ◽  
...  
Keyword(s):  
Statistical Significance ◽  
The Elderly ◽  
P Value ◽  
Chi Square ◽  
Cardiovascular Patients ◽  
Baseline Characteristics ◽  
Racial Ethnic ◽  
Cardiovascular Care ◽  
Zip Code ◽  
Hispanic White

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. Objectives To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods In this single centre retrospective study, all ambulatory cardiovascular encounters occurring between March 16th - June 19th, 2020 were assessed. Baseline characteristics by visit type (in-person, TM-phone, TM-video) were compared using Chi-square and student t-tests, with statistical significance defined by p value &lt; 0.05. Multivariate logistic regression was used to explore the predictors of TM versus in-person care. Results 8446 patients (86% Non-Hispanic White, 42% female, median age 66.8 +/- 15.2 years) completed an ambulatory cardiovascular visit during the study period. TM-phone (n = 4,981, 61.5%) was the primary mode of ambulatory care followed by TM-video (n = 2693, 33.2%). Non-Hispanic Black race (OR 0.56; 95% CI: 0.35 - 0.94, p-value=0.02), Hispanic ethnicity (OR 0.53; 95% CI: 0.29 - 0.98, p = 0.04), public insurance (Medicaid OR 0.50; 95% CI:0.32 – 0.79, p = 0.003, Medicare OR 0.65; 95% CI: 0.47– 0.89, p = 0.009), zip-code linked median household income (MHI) of &lt;$75,000, age &gt;85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM-video encounters and a higher likelihood of in-person care. Conclusions Significant disparities in TM-video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.

Over-expression of IL-6 coding gene in the peripheral blood of migraine with aura patients

2021 ◽  
pp. 1-5
Author(s):  
Mahdi Ramezani ◽  
Alireza Komaki ◽  
Mohammad Mahdi Eftekharian ◽  
Mehrdokht Mazdeh ◽  
Soudeh Ghafouri-Fard
Keyword(s):  
Migraine With Aura ◽  
Peripheral Blood ◽  
Healthy Subjects ◽  
Migraine Without Aura ◽  
P Value ◽  
Healthy Controls ◽  
Over Expression ◽  
Significant Difference ◽  
Male Patients ◽  
Years Lived With Disability

Migraine is a common disorder which is placed among the top ten reasons of years lived with disability. Cytokines are among the molecules that contribute in the pathophysiology of migraine. In the current study, we evaluated expression levels of IL-6 coding gene in the peripheral blood of 120 migraine patients (54 migraine without aura and 66 migraine with aura patients) and 40 healthy subjects. No significant difference was detected in expression of IL-6 between total migraine patients and healthy controls (Posterior beta = 0.253, P value = 0.199). The interaction effect between gender and group was significant (Posterior beta =-1.274, P value = 0.011), therefore, we conducted subgroup analysis within gender group. Such analysis revealed that while expression of this gene is not different between male patients and male controls (Posterior beta =-0.371, P value > 0.999), it was significantly over-expressed in female patients compared with female controls (Posterior beta = 0.86, P= 0.002). Expression of IL-6 was significantly higher in patients with aura compared with controls (Posterior beta = 0.63, adjusted P value = 0.019). However, expression of this cytokine coding gene was not different between patients without aura and healthy subjects (Posterior beta = 0.193, adjusted P value = 0.281). Therefore, IL-6 might be involved in the pathophysiology of migraine among females and migraine with aura among both sexes.

The Role of Doppler Ultrasound, CT Angiography, and Conventional Angiography in Detection of Peripheral Arterial Disease

2021 ◽  
pp. 154431672110303
Author(s):  
Sayan Sarkar ◽  
Shyam Mohan ◽  
Shakthi Parvathy
Keyword(s):  
Computed Tomography ◽  
Peripheral Arterial Disease ◽  
Ct Angiography ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Color Doppler ◽  
Statistical Significance ◽  
Arterial Disease ◽  
P Value ◽  
Peripheral Arterial

The purpose of this study is to analyze how accurate duplex ultrasonography using color Doppler and computed tomography (CT) angiography are in detection of peripheral arterial disease (PAD) in comparison with the Gold Standard of digital subtraction angiography (DSA). This is a single-center prospective, analytical study done on patients with symptoms of PAD referred to the Department of Radiodiagnosis of Medical Trust Hospital (n = 53). All patients were imaged with color Doppler, CT angiography, and DSA. The peak systolic velocity (PSV) ratio was calculated by Doppler ultrasound, and the percentage stenosis for the same vascular segments was calculated using CT angiography and DSA. To test the statistical significance between the results, chi-square test was used. A P value <.05 indicates statistical significance. The PSV ratio for each grade—normal (<1.5), mild (1.5-2.8), moderate (2.9-4.9), and severe (≥5)—and the percentage of stenosis for each grade observed on CT angiography—normal (<20% stenosis), mild (20%-49% stenosis), moderate (50%-74% stenosis), severe (75%-99% stenosis), and total occlusion (100% stenosis)—were found to be highly sensitive and specific with good positive predictive value, negative predictive value, and accuracy level when compared with DSA with narrow confidence intervals for each range. The P value was <.001 for both color Doppler and CT angiography. Computed tomography angiography can be an effective tool as an alternative to DSA for gradation of stenosis if the artifacts resulting from vascular calcification can be avoided. Duplex ultrasonography can be utilized for gradation of stenosis by using the value of PSV ratio and spectral pattern together. However, it can only act as an adjunct to CT angiography because it is incapable of imaging the full length of the arterial segments in 1 frame.

scholarly journals SAT0290 HIGH SERUM MYOSTATIN LEVELS SUGGEST ACCELERATED MUSCLE SENESCENCE IN ACTIVE IDIOPATHIC INFLAMMATORY MYOSITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1089.2-1090
Author(s):  
A. Anuja ◽  
M. Singh ◽  
M. K. Rai ◽  
H. Singh ◽  
V. Agarwal ◽  
...  
Keyword(s):  
Young Adults ◽  
Elevated Serum ◽  
High Serum ◽  
Inactive Disease ◽  
Healthy Controls ◽  
Muscle Enzymes ◽  
Inflammatory Myositis ◽  
Idiopathic Inflammatory Myositis ◽  
Healthy Control ◽  
Accelerated Senescence

Background:Inflammation is the forerunner to fibrosis and premature ageing in various systemic diseases. Hence it seems plausible that idiopathic inflammatory myopathies (IIM) may exhibit accelerated senescence too.Objectives:Hence we investigated the Myostatin: Follistatin system in the serum as a reflection of early senescence in myositis as compared with healthy and diseased controls.Methods:Patients with inflammatory myositis (ACR/EULAR criteria) presenting to the wards and outpatient clinic between December 2017 to August 2019 were recruited. Those with active infection, pregnancy, renal dysfunction or chronic kidney disease were excluded. Apart from patient and disease variables, activity and damage were assessed using standard IMACS score set measures. Patients in inception cohort were additionally followed up at 1 and 6 months. Myostatin and Follistatin were estimated in sera using ELISA (R&D systems, USA). Juvenile myositis and young adults (18-40 years) were subsequently analyzed separately. Non-parametric tests were used for paired and unpaired analysis. Results expressed as median.Results:95 myositis (8 Juvenile myositis, 26 DM, 10 PM, 29 Overlap, 2 NAM 1 CAM and 19 ASS) patients (23 Male and 72 Female) with median age 38 (24.5-46.0) years and disease duration 0.9 (2.3-5.1) years were included. Serum Myostatin was lower in IIM than in healthy control (HC) (153.5 vs. 243.6 p<0.0001, Fig 1A) but higher in IIM as compared with disease controls (153.5 vs 86.1 p=0.0174 Fig. 1B). Serum myostatin was comparable between juvenile and adult myositis and in the various subsets of adult myositis (Fig. 1 C and D). Myostatin levels were higher in active as compared with inactive myositis in young adults (211.7 vs. 158.9, p=0.0149, Figure 1E). Serum Myostatin correlated with height (r 0.3, p=0.003) and weight (r 0.2, p=0.047) but not MMT8 or muscle enzymes.Figure 1.Serum Myostatin levels in IIM as compared with healthy controls (A) and disease controls (B). Levels in juvenile myositis as compared with adult IIM (C) and in various subsets of IIM (D). Serum Myostatin levels in active and inactive disease (E).Although Follistatin was lower in IIM than HC (198.4 vs 243.6, p=<0.0001), the neither Follistatin nor Myostatin: Follistatin ratios differ between subsets, and in active versus inactive disease Figure 2 A-D). On follow-up, the serial Myostatin estimation paralleled change in disease activity.Figure 2.Serum Follistatin levels in IIM as compared with healthy controls (A) and disease controls (C). Levels in juvenile and adult IIM (D) and in various subsets of IIM (D).Conclusion:Elevated serum Myostatin levels in active myositis raise the possibility of accelerated senescence in the inflamed muscle tissues which need further investigation.Acknowledgments: :Partly funded by APLAR and IRA research grants awarded to LG.Disclosure of Interests:None declared

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