scholarly journals EVALUATION OF PATIENTS WITH AUTOIMMUNE HEPATITIS IN A SPECIALIZED OUTPATIENT CLINIC IN SOUTHERN BRAZIL

2020 ◽  
Vol 57 (4) ◽  
pp. 361-365
Author(s):  
Renata S FEDRIZZI ◽  
Gabriela P CORAL ◽  
Angelo A de MATTOS ◽  
Ângelo Z de MATTOS ◽  
Cristiane V TOVO
Keyword(s):  
Autoimmune Diseases ◽  
Autoimmune Hepatitis ◽  
Treatment Response ◽  
Treatment Time ◽  
Clinical Laboratory ◽  
Response To Treatment ◽  
Considerable Proportion ◽  
Southern Brazil ◽  
Significance Level ◽  
Significant Difference

ABSTRACT BACKGROUND: Autoimmune hepatitis (AIH) is a chronic liver disease, characterized by necroinflammation and autoimmune etiology. Studies evaluating the characteristics of patients with AIH are scarce in Brazil. OBJECTIVE: Our objective was to evaluate the profile of patients with AIH in a specialized center in Southern Brazil and to verify factors related to treatment response. METHODS: this was a retrospective cohort study, which analyzed demographic, epidemiological, clinical, laboratory, and histologic data. Patients with AIH diagnosed according to the criteria of the International Autoimmune Hepatitis Group (IAIHG) were included. In liver biopsies, the degree of fibrosis, histological activity, presence of hepatocyte rosettes, plasma cell infiltrates, and confluent necrosis were evaluated. In the statistical analysis, the significance level was 5%. RESULTS: Forty adults patients diagnosed with AIH were included. The evaluated population predominantly consisted of women (75.0%) and the average age at diagnosis was 44.2 years. The association with extrahepatic autoimmune diseases occurred in 20.0% of cases. Clinically, 35.0% of patients presented with acute onset hepatitis, 37.5% with cirrhosis, and 27.5% with other forms of presentation. The most common clinical manifestation was jaundice (47.5%). Thirty-five patients were treated, and of these, 97.1% used prednisone combined with azathioprine. The average treatment time was 2.7 years. Response to treatment was complete or partial in 30 (85.7%) and absent in 5 (14.3%) patients. There was no statistically significant difference when evaluating response to treatment in relation to forms of presentation, histological findings, and the presence of autoantibodies. Regarding fibrosis, regression was observed in 18.75% of the cases. CONCLUSION: Most patients with AIH were young at presentation and of female sex. The association with extrahepatic autoimmune diseases and cirrhosis at presentation was seen in a considerable proportion of patients. Treatment was effective, but there were no clinical, histological or serological parameters capable of predicting treatment response.

scholarly journals AB1119 U9: A NOVEL CLINICALLY ORIENTED ULTRASONOGRAPHIC SCALE AS A USEFUL MARKER FOR MONITORING THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS (MULTI CENTERS STUDY)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.2-1849
Author(s):  
M. A. Mortada ◽  
H. Eitta ◽  
R. Elmallah ◽  
A. Radwan ◽  
A. Elsaman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Laboratory ◽  
Pearson Correlation ◽  
Response To Treatment ◽  
P Value ◽  
Clinical Parameters ◽  
Biologic Dmards ◽  
Das 28 ◽  
Significant Difference

Background:Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA, which affects many joints and tendons in different presentations. In previous study (1) U9 score was proven to be correlated with disease activity parameters.Objectives:To determine whether US assessment using U9 score is useful for monitoring response to treatment for RA or not?Methods:A prospective, multicenter study were conducted in period from July 2019 to December 2019. All recruited RA patients were subjected to: Disease activity assessment by clinical disease activity indices (CDAI and DAS28 ESR). Functional status assessment by (HAQ) and ultrasonographic assessment using U9 score which include 8 joints (bilateral wrists,2ndMCP,3RDMCP and knees) plus most clinically affected joint or tendon (one joint or one tendon). Most clinically affected joints from 48 joints. Any affected tendons could be choosing. All targeted joints were evaluated according to EULAR guidlines and by EULAR/ OMERACT combined score (0-3). Targeted tendons were scored (0-3).All patients received their treatment (biologic and non biologic DMARDs) according to the decision of the treating physicians. No specific therapy is needed. CDAI and DAS28 ESR, HAQ and U9 score were repeated after 3 months to detect the response to change after receiving the therapy.Results:One hundred and forty patients (23.6% were male) with mean age 39.26±11.30 were recruited from 4 tertiary referral university hospitals.There was a significant difference (<0.001) between the first and second visits as regards clinical, laboratory and ultrasonographic parameters. DAS 28 decreased form (5.29±1.21) to (3.95±0.99), ESR decreased from (42.12±15.24) to (26.84±12.32), HAQ2 improved from (0.652±0.350) to (0.510±0.237) and U9 total US score decreased from (13.56±5.18) to (8.02±4.28).There was significant correlation between U9 ultrasonographic score and clinical parameters at both visits (table 1).Table 1.correlation between U9 ultrasonographic score and clinical parameters.U9 at 1stvisitU9 at 2ndvisitDAS-28Pearson Correlation(P value)0.806<0.0010.790<0.001CDAIPearson Correlation(P value)0.787<0.0010.773<0.001HAQPearson Correlation(P value)0.431<0.0010.317<0.001We found that the most suitable cut-off value of U9 score to predict high disease activity was 11.5 (sensitivity 85.7% and specificity 80.6%), cut off value for moderate disease activity was 5.5(sensitivity 83.2% and specificity 88%) and cut off value for low disease activity was 3.5 (sensitivity of 83.3% and specificity 57.1%). These results are summarized in the following table:Conclusion:U9 ultrasonographic score is very useful method for evaluating the monitoring the response of treatment.References:[1]Mortada, et al. Annals of the Rheumatic Diseases 2019;78:1009.Disclosure of Interests:None declared

A comparative Study Between Needling and Homologous Autoimplantation Techniques in Treatment of Multiple Plantar Warts

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nermeen Samy Abdel Fattah ◽  
Rania Mahmoud Elhusseiny ◽  
Aml Magdy Darahem
Keyword(s):  
Treatment Response ◽  
De Novo ◽  
Response To Treatment ◽  
Clinical Appearance ◽  
Skin Contact ◽  
Common Warts ◽  
Significant Difference ◽  
Assess Treatment Response ◽  
Skin To Skin ◽  
Plantar Warts

Abstract Background Warts are a common dermatologic complaint resulting from infection with HPV which spread by direct skin-to-skin contact or by autoinoculation. The clinical appearance of warts is variable depends on the type of HPV involved and the site of infection. There are various types of viral warts including common warts, plantar warts, plane warts and genital warts, usually diagnosis of warts is made through clinical examination of the lesions and no laboratory investigations are required. Objective To compare between the therapeutic efficacy and safety of needling versus homologous autoimplantation techniques in treatment of multiple plantar warts and assess their recurrence rate. Patients and Methods Our study included 40 patients with multiple de novo planter warts(3 -10 warts) of (&gt;1 and &lt;3 years duration) divided into 2 groups, 20 patients per group, one group subjected to autoimplantation of wart tissue and the other subjected to needling procedure. Follow up of studied patients was assessed by physician after 2,8 and 12 weeks of procedure through clinical and dermoscopic examination to assess treatment response and after 16 weeks to assess recurrence Results Results of our study reported that there was high statistically significant difference between the 2 studied groups as regard response to treatment after 12 weeks being higher among autoimplantation group (p = 0.001). Moreover, there were no significant relations between treatment response of both patient groups and each of gender, age of patients, number of warts and duration of lesions. Conclusion Autoimplantation technique is more effective and less painful than needling procedure in treatment of multiple plantar warts (both manipulated and remote warts). No significant relations were found between treatment response of either techniques and demographic or clinical characteristics of studied patients.

scholarly journals Mini-implant and Nance button for initial retraction of maxillary canines: a prospective study in cast models

2012 ◽  
Vol 17 (4) ◽  
pp. 134-139 ◽  
Author(s):  
Flávia de Moraes Arantes ◽  
Juliana Kina ◽  
Matheus José Bueno Gonçalves ◽  
Júlio de Araújo Gurgel ◽  
Omar Gabriel da Silva Filho ◽  
...  
Keyword(s):  
Model Comparison ◽  
Treatment Time ◽  
T Test ◽  
Significance Level ◽  
Canine Retraction ◽  
Mini Implants ◽  
Significant Difference ◽  
Group B ◽  
Anchorage Loss ◽  
Paired T Test

OBJECTIVE: Bone anchorage is a key factor for the successful management of some malocclusions for it allows the application of continuous forces, decreases treatment time and is independent from patient compliance. METHODS: The goal of this work was to establish a dental model comparison in order to measure the anchorage loss after the initial retraction of upper canines between the two groups. Group A used mini-implants and Group B used Nance button. All patients had two models cast (M1 and M2). The first models were taken on baseline (M1) and the other models were taken after canine retraction (M2). RESULTS: All measurements were pooled and submitted to statistical analysis. In order to verify the inter-examiner systematic error a paired t-test was performed. Dahlberg's formula was used to estimate the casual error. For comparison purposes between Before and After stages, a paired t-test was done. For the comparison between mini-implant and Nance button groups, a Student t-test was applied. All tests adopted a 5% (p<0.05) significance level. CONCLUSION: No statistically significant difference was observed between the two groups when measurements and comparisons to assess molar anchorage loss after canine initial retraction were performed. Two different anchorage systems were applied on dental models (mini-implants and Nance's button) for each group.

scholarly journals Computed tomographic perfusion imaging for the prediction of response and survival to transarterial chemoembolization of hepatocellular carcinoma

2017 ◽  
Vol 52 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Peter Popovic ◽  
Ana Leban ◽  
Klara Kregar ◽  
Manca Garbajs ◽  
Rok Dezman ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Perfusion Imaging ◽  
Transarterial Chemoembolization ◽  
Intermediate Stage ◽  
Complete Response ◽  
Response To Treatment ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Pre Treatment

Abstract Background The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE). Patients and methods Between December 2010 and January 2013 eighteen patients (17 men, 1 woman; mean age 69 ± 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE. Treatment response was evaluated on follow-up imaging according to modified Response Evaluation Criteria in Solid Tumors. Pre-treatment CTPI parameters were compared between patients with complete response and partial response with a Student t-test. We compared survival times with Kaplan-Meier method. Results CTPI parameters of patients with complete response and others did not show statistical significant difference. The mean survival time was 25.4 ± 3.2 months (95%; CI: 18.7-32.1). Survival was statistically significantly longer in patients with hepatic blood flow (BF) lower than 50.44 ml/100 ml/min (p = 0.033), hepatic blood volume (BV) lower than 13.32 ml/100 ml (p = 0.028) and time to peak (TTP) longer than 19.035 s (p = 0.015). Conclusions CTPI enables prediction of survival in patients with intermediate stage HCC, treated with DEBTACE based on the pre-treatment values of BF, BV and TTP perfusion parameters. CT perfusion imaging can’t be used to predict treatment response to DEBTACE.

Changing profile of platelet activity and turnover indices during treatment response of immune thrombocytopenia

2021 ◽  
Author(s):  
Chewei Ou ◽  
Hung Chang ◽  
Yu-Shin Hung ◽  
Ming-Chung Kuo ◽  
Pei-Ling Li ◽  
...  
Keyword(s):  
Treatment Response ◽  
Immune Thrombocytopenia ◽  
Clinical Laboratory ◽  
Sample Analysis ◽  
Platelet Activity ◽  
Soluble Cd40 Ligand ◽  
Paired Sample ◽  
Platelet Counts ◽  
Significant Difference ◽  
Plasma Markers

Abstract Both platelet count and function change after treatment of immune thrombocytopenia (ITP). Platelet function can be measured by plasma markers, including platelet activity (e.g. soluble P-selectin [sP-selectin] and soluble CD40 ligand [sCD40L]) and platelet turnover markers (e.g. glycocalicin [GC]). Patients were classified into no response (NR, including new diagnosis), partial response (PR) and complete response (CR). One hundred and sixteen samples (29 CR, 32 PR, and 55 NR) from 79 patients were collected. Plasma markers (sP-selectin, sCD40L and GC) were measured by ELISA. Platelet counts and mean platelet volume (MPV) were obtained in the clinical laboratory using GenS System-2. The results showed that responsive patients (PR + CR) had higher levels of sP-selectin (P = 0.026) and sCD40L (P = 0.001). Although there was no difference in MPV (P = 0.077) or GC (P = 0.078), there was a marked decrease of GC index (P < 0.001) in responsive patients. Paired sample analysis showed no difference in sP-selectin, sCD40L, MPV or GC but significant difference in GC index (P = 0.017) between NR and PR. Another paired sample analysis showed no difference in sP-selectin, sCD40L, MPV or GC but significant difference in GC index (P = 0.029) between PR and CR. Patients with refractory and newly diagnosed disease had significant difference in GC (P = 0.020) and sCD40L (P = 0.001), despite similarly low platelet counts. In conclusion, platelet activity markers (sP-selectin and sCD40L) and GC indices change in parallel with treatment response. Plasma levels of GC and sCD40L may be predictors of treatment response.

scholarly journals Clinical response to interferon beta and glatiramer acetate in multiple sclerosis patients: a Brazilian cohort

2012 ◽  
Vol 70 (10) ◽  
pp. 774-779 ◽  
Author(s):  
Valéria Coelho Santa Rita Pereira ◽  
Fabíola Rachid Malfetano ◽  
Isabella D'Andrea Meira ◽  
Letícia Fêzer de Souza ◽  
Assuncion Martinez Liem ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Response ◽  
Treatment Response ◽  
Glatiramer Acetate ◽  
Interferon Beta ◽  
Response To Treatment ◽  
Clinical Criteria ◽  
Significant Difference ◽  
One Year ◽  
Multiple Sclerosis Patients

INTRODUCTION: Many patients with multiple sclerosis (MS) are currently receiving treatment with interferon beta (IFNb) and glatiramer acetate (GA). Identifying nonresponders patients is important to define therapy strategies. Several criteria for treatment response to IFNb and GA have been proposed. OBJECTIVE: It was to investigate the response to treatment with IFNb-1a, IFNb-1b and GA among relapsing-remitting multiple sclerosis (RRMS) patients. METHODS: We analyzed treatment response to IFNb and GA in ninety-one RRMS patients followed for at least one year. Clinical response was established by clinical criteria based on relapses, disability progression or both. RESULTS: We observed a proportion of nonresponders, ranging from 3.3 to 42.9%, depending on the stringency of the criteria used. CONCLUSIONS: Our sample of Brazilian patients with MS has similarities when compared to other studies and there was no statistically significant difference regarding age, gender, ethnicity or disease duration between responders and nonresponders.

scholarly journals Research on zinc blood levels and nutritional status in adolescents with autoimmune hepatitis

2011 ◽  
Vol 48 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Thalita Cremonesi Pereira ◽  
Margareth L. G. Saron ◽  
Wagner Alves de Carvalho ◽  
Maria Marluce Vilela ◽  
Nelci Fenalti Hoehr ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Autoimmune Hepatitis ◽  
Zinc Deficiency ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Zinc Level ◽  
Control Group ◽  
Blood Levels ◽  
Significance Level ◽  
Significant Difference

CONTEXT: Zinc deficiency in children and adolescents impairs their growing, development and immune system. OBJECTIVE: To verify the existence of plasma and leukocyte zinc deficiency in adolescents with autoimmune hepatitis. METHODS: The study comprised 23 patients with autoimmune hepatitis, aged 10-18 years, assisted at the Ambulatory Service of Pediatric Hepatology of the University of Campinas Teaching Hospital, Campinas, SP, Brazil, and adolescents with ages compatible with the patients' ages comprised the control group. Sample of blood in both groups was collected for the analyses of plasma zinc and leukocyte zinc by atomic absorption spectrophotometry, beyond the nutritional status was evaluated in each adolescent. The following statistical tests were used: Mann-Whitney, Spearman's correlation and interclass concordance analysis. RESULTS:The significance level adopted was 5%. The average zinc level in plasma in patients was 71.91 ± 11.79 µg/dL and, in the control group, it was 80.74 ± 10.92 µg/dL, showing a significant difference (P = 0.04). The leukocyte zinc level in patients was 222.33 ± 166.13 pmol/10(6) cells and, in the control group, it was 226.64 ± 217.81 pmol/10(6) cells; there was no statistical significance between them (P = 0.45). CONCLUSION:The evaluation of the nutritional status showed that eutrophy is prevalent in patients, and they presented a higher body fat value than the control group, with a significant difference. More research is needed with adolescents with autoimmune hepatitis regarding levels of essential micronutrients, such as zinc, because a good nutritional status can improve the prognostic of liver disease.

Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

2020 ◽  
Vol 41 (6) ◽  
pp. 436-441 ◽  
Author(s):  
Daniel A. Rosloff ◽  
Kunal Patel ◽  
Paul J. Feustel ◽  
Jocelyn Celestin
Keyword(s):  
Diagnostic Criteria ◽  
Statistical Significance ◽  
Case Series ◽  
Poor Response ◽  
Response To Treatment ◽  
Fisher Exact Test ◽  
Subjective Symptoms ◽  
Significant Difference ◽  
Physical Findings ◽  
Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

Effect of a-Week Summer Camp on the Hopelessness and Self-Esteem of the University Students Attending Sport Sciences Faculty

2018 ◽  
Vol 7 (4) ◽  
pp. 42-49 ◽  
Author(s):  
Korkmaz YİĞİTER ◽  
Hakan TOSUN
Keyword(s):  
University Students ◽  
Summer Camp ◽  
Pearson Correlation ◽  
Self Esteem ◽  
Female Students ◽  
T Test ◽  
Significance Level ◽  
Significant Difference ◽  
Post Test ◽  
The University

The aim of this study is to investigate the effects of participation in a 1-week summer camp on thehopelessness and self-esteem of the university students attending Sport Sciences Faculty. Participants were 36university students assigned to experiment group using a random procedure. Coopersmith Self-esteem and Beck Hopelessness Scales were completed at the beginning and end of the summer camp by designed the university. The obtained data were analysed in the SPSS 18.0 program and the significance level was taken as 0.05. The descriptive statistics, independent simple t test, paired simple t test and Pearson correlation were used for analyse the data in the study. According to the results of the research, no significant difference was observed in the comparison of the hopelessness and self-esteem levels between pre and post-test. In addition, there was a significant difference in the hopelessness level of male and female students but any significant difference was not observed in terms of self-esteem. There was a significant relationship between hopelessness and self-esteem pre and post-test. These result shows that a 1-week summer camp cannot change the hopelessness or self-esteem level. However, as the self-esteem rises, the rate of despair decreases whereas as the despair rises, the selfesteem decreases.

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