scholarly journals Categorization of the Ocular Microbiome in Japanese Stevens–Johnson Syndrome Patients With Severe Ocular Complications

2021 ◽  
Vol 11 ◽  
Author(s):  
Mayumi Ueta ◽  
Koji Hosomi ◽  
Jonguk Park ◽  
Kenji Mizuguchi ◽  
Chie Sotozono ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Cross Sectional Study ◽  
Stevens Johnson Syndrome ◽  
Ocular Complications ◽  
Cross Sectional ◽  
Commensal Microbiota ◽  
Control Subjects ◽  
Persistent Inflammation ◽  
Johnson Syndrome ◽  
Healthy Control

The commensal microbiota is involved in a variety of diseases. Our group has noticed that patients with Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) often present with persistent inflammation of the ocular surface, even in the chronic stage, and that this inflammation is exacerbated by colonization of the mucosa by certain bacteria. However, the changes in the composition of the ocular microbiome in SJS/TEN patients with severe ocular complications (SOCs) remain to be fully investigated. Here, we conducted a cross-sectional study of 46 Japanese subjects comprising 9 healthy control subjects and 37 SJS/TEN patients with SOC. The 16S rRNA-based genetic analyses revealed that the diversity of the ocular microbiome was reduced in SJS/TEN patients with SOC compared with that in healthy control subjects. Principal coordinate analysis based on Bray–Curtis distance at the genus level revealed that the relative composition of the ocular microbiome was different in healthy control subjects and SJS/TEN patients with SOC, and that the SJS/TEN patients with SOC could be divided into four groups based on whether their microbiome was characterized by enrichment of species in genus Corynebacterium 1, Neisseriaceae uncultured, or Staphylococcus or by simultaneous enrichment in species in genera Propionibacterium, Streptococcus, Fusobacterium, Lawsonella, and Serratia. Collectively, our findings indicate that enrichment of certain bacteria at the ocular surface could be associated with ocular surface inflammation in SJS/TEN patients with SOC.

scholarly journals High perceived isolation and reduced social support affect headache impact levels in migraine after the Covid-19 outbreak: A cross sectional survey on chronic and episodic patients

Cephalalgia ◽  
2021 ◽  
pp. 033310242110275
Author(s):  
Chiara Cerami ◽  
Chiara Crespi ◽  
Sara Bottiroli ◽  
Gaia Chiara Santi ◽  
Grazia Sances ◽  
...  
Keyword(s):  
Social Support ◽  
Clinical Condition ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Control Subjects ◽  
Emotional Loneliness ◽  
Lower Social Support ◽  
Healthy Control ◽  
Headache Impact

Background Psychosocial variables are key factors influencing psycho-physical equilibrium in migraine patients. Social isolation and vulnerability to stressors may prevent efficient psychological adjustment negatively affecting adaptation to life changes, as that imposed during Covid-19 lockdown. Here, we explored psychosocial dimensions and changes in clinical condition during Covid-19 lockdown in migraine patients, with regard to migraine type and headache impact. Methods Sixty-four migraine patients (32 episodic and 32 chronic) and 64 healthy control subjects were included in a case-control cross-sectional study. A two-step clustering procedure split patients into two clusters, based on the Headache Impact Test. Perceived global distress, loneliness, empathy, and coping levels were compared in groups, as well as changes in clinical condition. Results Migraine patients reported higher general loneliness and lower social support compared to healthy control subjects. Emotional loneliness was more marked in patients with higher headache impact. This subgroup of patients more frequently reported changes in the therapeutic and care paths as the perceived cause of the occurrence of motor or extra-motor symptomatology. Conclusions Migraine patients, especially those more severely affected, proved more vulnerable than healthy control subjects to Covid-19 lockdown. Long-lasting interruption of social interactions may be detrimental in fragile patients that are in need of structured support interventions to maintain psycho-physical wellbeing.

scholarly journals Pathogenesis of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications

2021 ◽  
Vol 8 ◽  
Author(s):  
Mayumi Ueta
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Acute Stage ◽  
Stevens Johnson Syndrome ◽  
Prostaglandin E ◽  
Ocular Complications ◽  
Chronic Stage ◽  
Snp Association ◽  
Johnson Syndrome ◽  
Burn Units

Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is an acute inflammatory vesiculobullous reaction of the mucosa of the ocular surface, oral cavity, and genitals, and of the skin. Severe ocular complications (SOC) are observed in about half of SJS/TEN patients diagnosed by dermatologists and in burn units. Ophthalmologists treat SOC, and they tend to encounter the patients not only in the acute stage, but also in the chronic stage. Our investigation of the pathogenesis of SJS/TEN with SOC led us to suspect that abnormal innate mucosal immunity contributes to the ocular surface inflammation seen in SJS/TEN with SOC. We confirmed that cold medicines such as NSAIDs and multi-ingredient cold medications are the main causative drugs for SJS/TEN with SOC. Single nucleotide polymorphism (SNP) association analysis of cold medicine-related SJS/TEN with SOC showed that the Toll-like receptor 3 (TLR3)-, the prostaglandin-E receptor 3 (PTGER3)-, and the IKZF1 gene were significantly associated with SNPs and that these genes could regulate mucocutaneous inflammation including that of the ocular surface. We also examined the tear cytokines of SJS/TEN with SOC in the chronic stage and found that IL-8, IL-6, IFN-γ, RANTES, eotaxin, and MIP-1β were significantly upregulated in SJS/TEN with SOC in the chronic stage. Only IP-10 was significantly downregulated in SJS/TEN with SOC in the chronic stage. This mini-review summarizes the pathological mechanisms that we identified as underlying the development of SJS/TEN with SOC.

EVALUASI BIAYA MEDIS LANGSUNG PADA PASIEN STEVENS JOHNSON SYNDROME DI RSUP DR. SARDJITO YOGYAKARTA

2020 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Darwis Darwis ◽  
Dyah Aryani Perwitasari ◽  
Sri Awalia Febriana
Keyword(s):  
Cross Sectional Study ◽  
Stevens Johnson Syndrome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Johnson Syndrome

Stevens-Johnson Syndrome (SJS) merupakan suatu reaksi hipesensitivitas akut ditandai dengan nekrosis kutaneus dan masuk 10 besar efek samping terbanyak yang dilaporkan di Indonesia sebesar 3%. Banyaknya terapi dan lama perawatan di Rumah sakit berdampak pada meningkatnya morbiditas, mortalitas dan biaya kesehatan. Tujuan penelitian untuk mengetahui biaya medis langsung pada pasien SJS akibat penggunaan obat dari perspektif rumah sakit. Metode penelitian ini merupakan jenis penelitian deskriptif yang menggunakan desain penelitian cross sectional study dengan pengambilan data retrospektif. Data yang diambil adalah pasien yang terdiagnosa SJS akibat penggunaan obat dan menjalani rawat inap di RSUP Dr. Sardjito Yogyakarta selama periode tahun 2014-2018 sesuai kriteria inklusi dan eksklusi. Hasil penelitian dari sebanyak 40 kasus pasien SJS di RSUP Dr. Sardjito Yogyakarta selama periode tahun 2014-2018. Rata-rata total biaya pada pasien SJS sebesar Rp. 14.568.255,89 ± 10.053.115,58 dengan rata-rata lama rawat inap 12,45 ± 5,69 hari. Dari penelitian ini disimpulkan bahwa rata-rata total biaya medis langsung pada SJS sebesar Rp. 14.568.255,89 ± 10.053.115,58 dan dapat menjadi beban biaya cukup tinggi bagi pasien sehingga rumah sakit dapat mengambil langkah alternatif dalam menentukan kebijakan berkaitan regimen terapi yang efektif untuk mengobati, mencegah dan menurunkan keparahan penyakit pada pasien SJS akibat penggunaan obat. 

scholarly journals Clinical Aspects of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis With Severe Ocular Complications in Brazil

2021 ◽  
Vol 8 ◽  
Author(s):  
Tais Hitomi Wakamatsu ◽  
Myrna Serapião dos Santos ◽  
Telma Pereira Barreiro ◽  
Ana Estela Besteti Pires Ponce Sant'Anna ◽  
Fabíola Murta ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Minor Salivary Gland ◽  
European Ancestry ◽  
Stevens Johnson Syndrome ◽  
Clinical Aspects ◽  
Ocular Complications ◽  
Gram Positive ◽  
Johnson Syndrome

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute and potentially fatal inflammatory vesiculobullous reactions that affect the skin and mucous membranes, and which are most often triggered by particular medications and infections. In Brazil, the drugs most frequently associated with TEN and SJS include cold medicine such as dipyrone and NSAIDs, followed by carbamazepine, phenobarbital, penicillin, and allopurinol. Genetic variations have been found to increase the risk of SJS/TEN in response to triggering factors such as medications. The most closely associated genes found in Brazilian cold-medicine-related SJS/TEN patients with severe ocular complications are HLA-A*66:01 in those of mixed African and European ancestry and HLA-B*44:03 and HLA-C*12:03 in those of solely European ancestry. Our classification system for grading ocular surface complication severity in SJS/TEN patients revealed the most severe complications to be limbal stem cell deficiency and dry eye. Changes to the conjunctival flora have also been observed in SJS/TEN patients. Our group identified bacterial colonization in 95% of the eyes (55.5% of which were gram-positive cocci, 25.5% of which were gram-negative bacilli, and 19% of which were gram-positive bacilli). Several new treatment options in the acute and chronic ocular management of the SJS/TEN patients have been described. This article highlights some Brazilian institutions' contributions to ocular surface care in both the acute phase (including the use of amniotic membrane transplantation) and the chronic phase (such as eyelid margin and fornix reconstruction, minor salivary gland transplantation, amniotic membrane and limbal transplantation, scleral contact lenses, anti-angiogenic eyedrops for corneal neovascularization, ex-vivo cultivated limbal epithelium transplantation, conjunctival-limbal autografting, oral mucosa transplantation, and keratoprosthesis).

scholarly journals Findings by an International Collaboration on SJS/TEN With Severe Ocular Complications

2021 ◽  
Vol 8 ◽  
Author(s):  
Mayumi Ueta
Keyword(s):  
International Collaboration ◽  
Ocular Surface ◽  
Japanese Patients ◽  
Visual Disturbance ◽  
Acute Stage ◽  
European Ancestry ◽  
Stevens Johnson Syndrome ◽  
Ocular Complications ◽  
Johnson Syndrome ◽  
Burn Units

Stevens-Johnson Syndrome (SJS) is an acute inflammatory vesiculobullous reaction of the skin and mucosa, e.g., the ocular surface, oral cavity, and genitals. In patients with extensive skin detachment and a poor prognosis, the condition is called toxic epidermal necrolysis (TEN). Not all, but some patients with SJS/TEN manifest severe ocular lesions. Approximately 50% of SJS/TEN patients diagnosed by dermatologists and in burn units suffer from severe ocular complications (SOC) such as severe conjunctivitis with pseudomembrane and ocular surface epithelial defects in the acute stage. In the chronic stage, this results in sequelae such as severe dry eye and visual disturbance. Before 2005, our group of Japanese scientists started focusing on ophthalmic SJS/TEN with SOC. We found that cold medicines were the main causative drugs of SJS/TEN with SOC and that in Japanese patients, HLA-A*02:06 and HLA-B*44:03 were significantly associated with cold medicine-related SJS/TEN with SOC (CM-SJS/TEN with SOC). We expanded our studies and joined scientists from Korea, Brazil, India, Taiwan, Thailand, and the United Kingdom in an international collaboration to detect the genetic predisposition for SJS/TEN with SOC. This collaboration suggested that in Japanese patients, cold medicines, including NSAIDs, were the main causative drugs, and that HLA-A*02:06 was implicated in Japanese and Korean patients and HLA-B*44:03 in Japanese-, Indian-, and European ancestry Brazilian patients. Our joint findings reveal that there are ethnic differences in the HLA types associated with SJS/TEN with SOC.

scholarly journals MicroRNA-21 as a biomarker for ovarian cancer detection

2018 ◽  
Vol 23 (1) ◽  
pp. 35
Author(s):  
Aprilia Indra Kartika ◽  
Siti Nur Chasanah ◽  
Akbar Satria Fitriawan ◽  
Dewi Sahfitri Tanjung ◽  
Addin Trirahmanto ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Blood Plasma ◽  
Early Stage ◽  
Predictive Biomarker ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Advanced Stage ◽  
Cross Sectional ◽  
Control Subjects ◽  
Healthy Control

Ovarian cancer is a lethal disease. One of the problems faced by patients with ovarian cancer is the lack of symptoms in its early stages, which results in it only being detected when it is at an advanced stage. Therefore, there is an urgent need for biomarkers that can predict ovarian cancer precisely. The purpose of this study was to determine the expression of microRNA-21 as a predictive biomarker candidate in both early- and advanced-stage ovarian cancer. This was a cross-sectional study using the blood plasma of 21 healthy control subjects and 37 blood plasma samples from patients with ovarian cancer. Blood plasmas were collected, from which the RNA was isolated. Based on the RNA, the cDNA was synthesized and run through qPCR, the results of which were analyzed using the Livak method. The results showed an upregulation of microRNA-21 in the advanced stage by 2.14 fold compared with the early stage, and 6.13 fold compared with the healthy controls (p < 0.05). The upregulation of microRNA-21 in early-stage ovarian cancer was 2.86 fold compared with the healthy control subjects (p < 0.05). In addition, there was an increase in the expression of microRNA-21 in ovarian cancer by 4.14 fold compared with the healthy controls (p < 0.05). Based on these results, it can be concluded that the expression of microRNA 21 upregulated with the severity of the disease.

scholarly journals Omega-3 Index and Clinical Outcomes of Severe COVID-19: Preliminary Results of a Cross-Sectional Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7722
Author(s):  
Rodrigo Zapata B. ◽  
José Miguel Müller ◽  
Juan Enrique Vásquez ◽  
Franco Ravera ◽  
Gustavo Lago ◽  
...  
Keyword(s):  
Preliminary Evidence ◽  
Cross Sectional Study ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Sectional Study ◽  
Cross Sectional ◽  
Control Subjects ◽  
Blood Marker ◽  
Healthy Control ◽  
Biometric Indices

The potentially detrimental effects of the worldwide deficiency of Omega-3 fatty acids on the COVID-19 pandemic have been underestimated. The Omega-3 Index (O3I), clinical variables, biometric indices, and nutritional information were directly determined for 74 patients with severe COVID-19 and 10 healthy quality-control subjects. The relationships between the OI3 and mechanical ventilation (MV) and death were analyzed. Results: Patients with COVID-19 exhibited low O3I (mean: 4.15%; range: 3.06–6.14%)—consistent with insufficient fish and Omega-3 supplement consumption, and markedly lower than the healthy control subjects (mean: 7.84%; range: 4.65–10.71%). Inverse associations were observed between O3I and MV (OR = 0.459; C.I.: 0.211–0.997) and death (OR = 0.28; C.I.: 0.08–0.985) in severe COVID-19, even after adjusting for sex, age, and well-known risk factors. Conclusion: We present preliminary evidence to support the hypothesis that the risk of severe COVID-19 can be stratified by the O3I quartile. Further investigations are needed to assess the value of the O3I as a blood marker for COVID-19.

Long-term Progression of Ocular Surface Disease in Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Cornea ◽  
2020 ◽  
Vol 39 (6) ◽  
pp. 745-753
Author(s):  
Yamato Yoshikawa ◽  
Mayumi Ueta ◽  
Hideki Fukuoka ◽  
Tsutomu Inatomi ◽  
Isao Yokota ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome
Sign in / Sign up

Export Citation Format

Share Document