scholarly journals PREVENTION OF PURULENT-NECROTIC INFLAMMATION OF THORACOTOMY WOUND TISSUES IN THE TREATMENT OF PURULENT MEDIASTINITIS WITH PROGRAMMED RETHORACOTOMY

2021 ◽  
pp. 113-122
Author(s):  
D.V. Senichev ◽  
R.R. Sulimanov ◽  
R.A. Sulimanov ◽  
E.S. Spasskiy ◽  
A.V. Rebinok
Keyword(s):  
Spectrophotometric Method ◽  
Statistical Significance ◽  
Infectious Complications ◽  
Wound Complications ◽  
Special Device ◽  
Rib Fixation ◽  
Number Of Patients ◽  
Preventive Method ◽  
Group 2 ◽  
Student’S T

The need to develop new therapeutic methods for diffuse purulent mediastinitis is still an urgent problem in surgery. The purpose of the study is to evaluate the effectiveness of temporary rib fixation in programmed rethoracotomy while treating diffuse purulent mediastinitis. Materials and Methods. The study involved 49 patients with diffuse purulent mediastinitis. All patients underwent programmed rethoracotomy and sanitation of pyogenic sources in the mediastinum. The subjects were divided into 2 groups: group 1 included 19 patients without preventive measures against wound complications; 30 patients of group 2 underwent temporary rib fixation, which contributed to the decrease of wound complications. To reduce trauma and infection of the thoracotomy wound tissue, a special device was created (RF patent No. 2474389). It consists of staples and locks that appose wound edges after rethoracotomy. During the study, we used V.B. Gavrilov and M.K. Mishkorudnaya’s spectrophotometric method; modified Stoke method; N.I. Gabrielian’s spectrophotometric method. Statistical assessment of parameters was carried out using variation statistics. Statistical significance of differences (t) was calculated by Student’s t-test. Results. Measures to prevent purulent-necrotic complications from a thoracotomic wound significantly contributed to their reduction. The indicators of the effectiveness of these measures were changes in the coefficient of lipid peroxidation, antioxidant activity and midmolecule peptides in the blood serum, the sum of infectious complications and wound complications. Conclusion. Temporary rib fixation contributes to a significant decrease in the number of patients with purulent-necrotic inflammation of thoracotomy wound tissues (p <0.05). Key words: diffuse purulent mediastinitis, programmed rethoracotomy, preventive method, wound infection, complications. Необходимость разработки новых методов терапии диффузного гнойного медиастинита всё ещё остаётся актуальной проблемой в хирургии. Цель исследования. Оценка эффективности использования способа временной фиксации ребер при выполнении программированной реторакотомии в лечении диффузного гнойного медиастинита. Материалы и методы. В исследовании приняли участие 49 пациентов с диффузным гнойным медиастинитом, которым при лечении проводились программированные реторакотомии и санации источника нагноения в средостении. Обследуемых разделили на 2 группы: в I группу вошли 19 пациентов, которым не осуществляли профилактику раневых осложнений; во II группе у 30 пациентов выполнили временную фиксацию ребер, которая создавала условия для снижения вероятности раневых осложнений. Для уменьшения травматизации и инфицирования тканей торакотомной раны был создан прибор (патент РФ на изобретение № 2474389), который состоит из скоб и замков, создающих сближение сторон раны после реторакотомии. При проведении исследования использовали спектрофотометрический метод В.Б. Гаврилова, М.К. Мишкорудной; модифицированный метод Stoke; спектрофотометрический способ по Н.И. Габриэляну. Статистическую оценку показателей осуществляли с применением вариационной статистики и расчета критерия достоверности различий (t) по формуле и таблице Стьюдента. Результаты. Меры предупреждения гнойно-некротических осложнений со стороны торакотомной раны достоверно способствовали их сокращению. Показателями результативности этих мер стали изменения коэффициента перекисного окисления липидов, антиоксидантной активности и среднемолекулярных пептидов в сыворотке крови, сумма инфекционных осложнений и осложнений со стороны раны. Выводы. Использование временной фиксации ребер способствует достоверному уменьшению числа пациентов с гнойно-некротическим воспалением тканей торакотомной раны (p<0,05). Ключевые слова: диффузный гнойный медиастинит, программированная реторакотомия, способ предупреждения, раневая инфекция, осложнения.

312 INFLUENCE OF LARGE NONOVULATED FOLLICLES ON ESTROUS INDUCTION AFTER EMBRYO COLLECTION IN SUPEROVULATED JAPANESE BLACK COWS

2013 ◽  
Vol 25 (1) ◽  
pp. 303
Author(s):  
M. Taniguchi ◽  
E. Sasaki ◽  
T. Otoi
Keyword(s):  
Statistical Significance ◽  
Prostaglandin F2α ◽  
Visual Observation ◽  
Corpora Lutea ◽  
Serum Progesterone ◽  
Once Daily ◽  
Group 2 ◽  
Student’S T ◽  
Group 1 ◽  
Donor Cows

Rapid oestrous induction after embryo collection shortens the calving interval of donor cows and improves the efficiency of embryo production. This study aimed to evaluate whether large nonovulated follicles present at the time of embryo collection affect oestrous induction after embryo collection in Japanese Black donor cows. Superovulation treatments were initiated during mid-cycle (9–12 days after oestrus) with 20 AU of FSH (Antrin; Kyoritsu Seiyaku Corp., Tokyo, Japan) administered intramuscularly through 6 injections of decreasing doses at 12-h intervals. On the third day, the cows received 0.5 mg of prostaglandin F2α (PGF; Resipron-C, Asuka Seiyaku Corp., Tokyo, Japan) to induce regression of the corpus luteum and were artificially inseminated 60 to 72 h later. Embryos were collected 7 days after AI. All cows received 0.5 mg of PGF immediately after embryo collection and were allocated to 1 of 2 groups: cows (n = 6) with one or more large nonovulated follicles >18 mm in diameter (Group 1) and cows (n = 5) with no large follicles (Group 2). Oestrus detection was performed by visual observation conducted twice daily after embryo collection. Ovarian ultrasonographic examinations and blood collections (for serum progesterone [P4] and oestradiol [E2] measurements) were performed once daily until the next ovulation. Statistical significance was determined using Student’s t-test. There were no differences in the numbers of corpora lutea, ova/embryos, and transferable embryos or the percentages of transferable embryos between the 2 groups. The interval (mean ± SEM) from embryo collection to the appearance of the dominant follicle and to ovulation was longer (P < 0.05) in Group 1 (5.3 ± 0.7 and 11.0 ± 1.0 days, respectively) than in Group 2 (2.6 ± 0.7 and 8.2 ± 0.7 days, respectively). However, the interval from embryo collection to luteolysis (P4 <1 ng mL–1) did not differ between the 2 groups (4.0 ± 0.7 v. 3.6 ± 0.7 days). In conclusion, the presence of large nonovulated follicles at the time of embryo collection may delay oestrous induction after embryo collection.

scholarly journals Analysis of etiological factors for emergence of endometrial hyperplasia in perimenopause

2019 ◽  
Vol 11 (2) ◽  
pp. 5-10
Author(s):  
Aneta Sima ◽  
Anita Arsovska ◽  
Slagjana Simeonova-Krstevska ◽  
Ana Daneva-Markova ◽  
Drage Dabeski
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Endometrial Hyperplasia ◽  
Statistical Significance ◽  
Etiological Factors ◽  
Number Of Patients ◽  
The Mean ◽  
Group 2 ◽  
Group 1

The aim of this study was to evaluate the possible reasons for the emergence of endometrial hyperplasia in perimenopause. Material and methods: A total of 71 patients with irregular bleeding were analyzed, at the age of 40-50 years, who should have undergone diagnostic curettage. Depending on the histopathological findings, we divided them into 2 groups: group 1-findings for endometrial hyperplasia, group 2 - atrophic or endometrium with deficient secretory changes. Body mass index (BMI) was determined (obesity defined with BMI >30 kg/m2); we measured blood pressure (cut-off value was 135/90 mmHg), waist circumference (cut-off value was 88 cm) as well as data of anamnesis (age, physical activity, type of diet, smoking cigarettes). All these data were analyzed as etiological factors in the emergence of endometrial hyperplasia.Results: The mean age of patients was 47 years, and the results obtained were very similar in both examined groups. BMI and waist circumference were increased, more than 60% of patients had hypertension, but not all had a statistical significance. Most of them were with completed secondary education, and city living statistically significantly increases the risk of endometrial hyperplasia (p <0.05). As for the lifestyle (physical activity, caloric diet, smoking), the results have shown that a small number of patients are active, almost half of them consume caloric food and smoke, but without a statistical significance.Conclusion: Increased body weight and elevated blood pressure have a major impact on the onset and progression of pathological changes in the endometrium. As clinicians, we should always think of hyperplasia in obesity and patients with hypertension who are irregularly bleeding. At the same time, we should educate them to change the lifestyle in order to prevent gynecological and internistic morbidity.

scholarly journals Current approaches in providing medical care for patients with corneal diseases in a large city

2021 ◽  
Vol 6 (4) ◽  
pp. 63-67
Author(s):  
Polina I. Konstantinova ◽  
Larisa V. Kochorova ◽  
Konstantin S. Klyukovkin ◽  
Anastasiya V. Antonova ◽  
Ilya S. Kustov
Keyword(s):  
Medical Care ◽  
Statistical Significance ◽  
Corneal Transplantation ◽  
Large City ◽  
Medical Organization ◽  
Statistical Series ◽  
Number Of Patients ◽  
Student’S T ◽  
The City

Objectives to analyze the aspects of the specialized ophthalmological medical care for patients with corneal diseases on the example of St. Petersburg. Material and methods. The data of the patients with corneal diseases treated in hospitals of St. Petersburg were copied onto specially developed cards from the official reporting forms and medical records of inpatients for the period of 5-year follow-up. To analyze the characteristics of patients with a continuous method of observation, we studied data on 2200 patients hospitalized in large ophthalmological hospitals in the city. We also interviewed 840 ophthalmologists in order to identify the main problems. The obtained data were statistically processed with the calculation of statistical series, extensive and intensive indicators. To assess the statistical significance of the differences in indicators in individual years of the observation, we used Student's t-test. Results. The analysis of statistics revealed an increase in the number of patients hospitalized with corneal diseases in the period from 2015 to 2019. The following problems were identified: nonavailability of keratoplasty in the regions (28.6 per 100 respondents), imperfection of the regulatory basis for corneal transplantation (26.2 per 100 respondents), long waiting list for surgery (22.6 per 100 of respondents), lack of modern medical equipment in a medical organization (20.2 per 100 respondents) and an insufficient number of quotas for operations (20.2 per 100 respondents). Conclusion. The availability of a sufficient amount of donor material will reduce the waiting time for specialized ophthalmic medical care for patients with severe corneal diseases, and will help create conditions for their satisfaction with the medical care provided to them.

scholarly journals Comparing Two Types of Rabbit ATG prior to Reduced Intensity Conditioning Allogeneic Hematopoietic SCT for Hematologic Malignancies

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sandra Paiano ◽  
Eddy Roosnek ◽  
Yordanka Tirefort ◽  
Monika Nagy-Hulliger ◽  
Stavroula Masouridi ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Disease Free Survival ◽  
Hematologic Malignancies ◽  
Infectious Complications ◽  
Reduced Intensity Conditioning ◽  
Hematopoietic Stem ◽  
Number Of Patients ◽  
Reduced Intensity

Different rabbit polyclonal antilymphocyte globulins (ATGs) are used in allogeneic hematopoietic stem cell transplantation (alloHSCT) to prevent graft-versus-host disease (GvHD). We compared 2 different ATGs in alloHSCT after reduced intensity conditioning (RIC) for hematological malignancies. We reviewed 30 alloHSCT for hematologic malignancies performed between 2007 and 2010 with fludarabine and i.v. busulfan as conditioning regimen. Patients alternatingly received Thymoglobulin or ATG-F. Median followup was 3.3 (2.5–4.5) years. Adverse events appeared to occur more frequently during Thymoglobulin infusion than during ATG-F infusion but without statistical significance (P=0.14). There were also no differences in 3-year overall survival (OS), disease-free survival (DFS), relapse incidence, and transplant related mortality (TRM) in the Thymoglobulin versus ATG-F group: 45.7% versus 46.7%, 40% versus 33.7%, 40% versus 33.3%, and 20% versus 33.3%. The same held for graft failure, rejection, infectious complications, immune reconstitution, and acute or chronic GvHD. In patients transplanted for hematologic malignancies after RIC, the use of Thymoglobulin is comparable to that of ATG-F in all the aspects evaluated in the study. However due to the small number of patients in each group we cannot exclude a possible difference that may exist.

RISKS OF ANEMIA DEVELOPMENT IN DONORS ACCORDING TO INHERITED PREDISPOSITION AND REGULARITY OF BLOOD DONATION

2020 ◽  
pp. 72-83
Author(s):  
I.M. Vorotnikov ◽  
V.A. Razin ◽  
I.M. Lamzin ◽  
M.N. Sokolova ◽  
M.E. Khapman ◽  
...  
Keyword(s):  
Blood Donors ◽  
Blood Donation ◽  
Hla Antigens ◽  
Hla Typing ◽  
Main Role ◽  
Inherited Predisposition ◽  
Group 2 ◽  
Student’S T ◽  
A Prospective Study ◽  
Group 1

Anemia is one of the most common complications of blood donation. Thus, the objective of the paper was to assess the risks of anemia development in donors according to the regularity of donation and inherited predisposition. Materials and Methods. The authors carried out a prospective study, which included 241 blood donors, using random sampling and case-control techniques. Depending on blood donation frequency, the donors were divided into 2 groups: Group 1 consisted of 122 people (51.5 %) frequently donating blood; Group 2 included 119 people (48. 5 %) rarely donating blood. We studied the initial indicators of a general blood test and the same indicators a year after the first blood donation. Additionally, we performed HLA typing of donors. Statistica v. 8.0 software package (Stat Soft Inc., USA) was used for statistical analysis. To compare two independent samples, we used a nonparametric Mann-Whitney U-test and a parametric Student’s t-test (depending on the type of distribution). To assess anemia risks, the odds ratio was calculated. Results. One year after the first blood donation, anemia was diagnosed in 13 people (10.6 %) in Group 1 and in 7 people (5.9 %) in Group 2 (p=0.179). A11 and B7 HLA antigens did not increase anemia risks in group 1 (OS=1.257 (95 % CI 0.318–4.973) and OS=0.240 (95 % CI 0.051–1.134, respectively). HLA-antigens A11 and B7 did not increase anemia risks in Group 1 (OR=1.257 (95 % CI 0.318-4.973) and OR=0.240 (95 % CI 0.051–1.134), respectively). In group 2, antigen-A11 was also an insignificant factor (OS=2.902 (95 % CI 0.606-13.889)) for anemia development. Whereas, antigen-B7 increased anemia risks by 14 times (OS=14.364 (95 % CI 1.644-124.011)). Conclusion. In rare blood donors, it is the genetic factor that plays the main role in anemia development. High prevalence rates of anemia in frequent blood donors are probably determined by other factors. Keywords: anemia, blood donors, HLA typing. Механизмы развития анемий и факторы, их индуцирующие, остаются до конца не изученными. Целью исследования стало изучение риска развития анемии у доноров крови в зависимости от частоты донации и наличия наследственной предрасположенности к развитию анемии. Материалы и методы. Проведено проспективное исследование, выполненное методами случайной выборки и «случай-контроль», в которое вошел 241 донор крови. В зависимости от частоты сдачи доноры были поделены на 2 группы: группу 1 составили 122 чел. (51,5 %), часто сдающие кровь; группу 2 – 119 чел. (48,5 %), редко сдающих кровь. Изучались исходные показатели общего анализа крови и через год от начала донации. Дополнительно проводилось HLA-типирование доноров. Статистический анализ осуществлялся с применением программы Statistica v. 8.0 (Stat Soft Inc., США). Для сравнения двух независимых выборок использовался непараметрический U-критерий Манна–Уитни и параметрический t-критерий Стьюдента (в зависимости от типа распределения). Для оценки риска возникновения анемии рассчитывалось отношение шансов. Результаты. Через год с момента первой сдачи крови в группе 1 выявлено 13 чел. (10,6 %) с анемией, в группе 2 – 7 чел. (5,9 %) (р=0,179). Наличие HLA-антигенов А11 и B7 не повышало риск развития анемии в группе 1 (ОШ=1,257 (95 % ДИ 0,318–4,973) и ОШ=0,240 (95 % ДИ 0,051–1,134 соответственно). В группе 2 наличие гена А11 также являлось незначимым фактором (ОШ=2,902 (95 % ДИ 0,606–13,889), присутствие гена В7 в 14 раз повышало риск развития анемии (ОШ=14,364 (95 % ДИ 1,664–124,011). Выводы. Высокий риск развития анемии у редко сдающих кровь доноров обусловливается генетическими факторами. Высокая распространённость анемии у часто сдающих кровь доноров, вероятно, определяется другими факторами. Ключевые слова: анемия, доноры крови, HLA-типирование.

Scientific Substantiation of the Innovative Model of Catering for Cadet Corps Students

2020 ◽  
pp. 31-35
Author(s):  
Novikova ◽  
SP Romanenko ◽  
MA Lobkis
Keyword(s):  
Correlation Coefficient ◽  
School Environment ◽  
Developmental Disorders ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Regression Analyses ◽  
Healthy Nutrition ◽  
Innovative Model ◽  
Scientific Substantiation ◽  
Student’S T

Introduction: In the Russian Federation, much attention is traditionally paid to military education and training. A special place in its structure is occupied by the system of cadet classes and corps. A distinctive feature of the learning mode in such institutions is a combined effect of standard and specific factors of indoor school environment and intensive physical activity owing to sports, applied military and drill training. No evidence-based methods of establishing nutrient requirements of children in modern conditions of cadet corps have been developed so far, which predetermines the potential of transforming nutrition from a health-saving factor into a health risk factor. Our objective was to provide a scientific substantiation of the model of healthy nutrition for students of cadet-type educational establishments. Methods: The statistical significance of the correlation was evaluated using the Student’s t-test. Correlation and regression analyses were used to assess cause-and-effect relationships. The Pearson correlation coefficient (rxy) was used as an indicator of the strength of the relationship between quantitative indicators x and y, both having a normal distribution. Correlation coefficient (rxy) values were interpreted in accordance with the Chaddock scale. For the purpose of statistical modeling, the method of multiple linear regressions was used. Conclusions: We substantiated the innovative model of organizing healthy nutrition for students of cadet-type schools based on the correlation and regression analyses with determination of statistical significance of the studied characteristics. Its efficiency indicators include an increase in average functional capabilities of students by more than 10 % and a reduction in the probability of developmental disorders by more than 25 %.

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals Clinicopathological features of Egyptian colorectal cancer patients regarding somatic genetic mutations especially in KRAS gene and microsatellite instability status: a pilot study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Neemat M. Kassem ◽  
Gamal Emera ◽  
Hebatallah A. Kassem ◽  
Nashwa Medhat ◽  
Basant Nagdy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cpg Island ◽  
Human Cancer ◽  
Statistical Significance ◽  
Public Health Problem ◽  
World Health ◽  
Cpg Island Methylator Phenotype ◽  
Number Of Patients ◽  
The Impact

Abstract Background Colorectal cancer (CRC) is the third most common cause of cancer-related deaths which contributes to a significant public health problem worldwide with 1.8 million new cases and almost 861,000 deaths in 2018 according to the World Health Organization. It exhibits 7.4% of all diagnosed cancer cases in the region of the Middle East and North Africa. Molecular changes that happen in CRCs are chromosomal instability, microsatellite instability (MSI), and CpG island methylator phenotype. The human RAS family (KRAS, NRAS, and HRAS) is the most frequently mutated oncogenes in human cancer appearing in 45% of colon cancers. Determining MSI status across CRCs offers the opportunity to identify patients who are likely to respond to targeted therapies such as anti-PD-1. Therefore, a method to efficiently determine MSI status for every cancer patient is needed. Results KRAS mutations were detected in 31.6% of CRC patients, namely in older patients (p = 0.003). Codons 12 and 13 constituted 5/6 (83.3%) and 1/6 (16.7%) of all KRAS mutations, respectively. We found three mutations G12D, G12C, and G13D which occur as a result of substitution at c.35G>A, c.34G>T, and c.38G>A and have been detected in 4/6 (66.6%), 1/6 (16.7%), and 1/6 (16.7%) patients, respectively. Eleven (57.9%) patients had microsatellite instability-high (MSI-H) CRC. A higher percentage of MSI-H CRC was detected in female patients (p = 0.048). Eight patients had both MSI-H CRC and wild KRAS mutation with no statistical significance was found between MSI status and KRAS mutation in these studied patients. Conclusion In conclusion, considering that KRAS mutations confer resistance to EGFR inhibitors, patients who have CRC with KRAS mutation could receive more tailored management by defining MSI status. MSI-high patients have enhanced responsiveness to anti-PD-1 therapies. Thus, the question arises as to whether it is worth investigating this association in the routine clinical setting or not. Further studies with a larger number of patients are needed to assess the impact of MSI status on Egyptian CRC care.

scholarly journals POS0888 EPIDEMIOLOGICAL AND CLINICAL DIFFERENCES BETWEEN ANTI-MDA5 PHENOTYPES: DATA FROM A LARGE COHORT (MEDRA5) STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 700.1-700
Author(s):  
E. Trallero-Araguás ◽  
F. Romero ◽  
I. Castellví ◽  
V. Ortiz-Santamaria ◽  
S. Castañeda ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Statistical Significance ◽  
Disease Onset ◽  
Amyopathic Dermatomyositis ◽  
Clinically Amyopathic Dermatomyositis ◽  
San Sebastian ◽  
Group 3 ◽  
Group 2 ◽  
Hospital General ◽  
Group 1

Background:Idiopathic inflammatory myopathies are a heterogenous group of systemic autoimmune diseases. Several phenotypes have been linked to specific autoantibodies. Clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease, the most severe form of ILD, is associated with the anti-MDA5 antibodies. However not all the patients with dermatomyositis and anti-MDA5 positive antibodies develop this severe condition.Objectives:We aim to define different phenotypes from a large cohort of patients diagnosed with dermatomyositis who were positive to anti-MDA5 antibodies.Methods:We retrospective analyzed the clinical and immunological data of 90 anti-MDA5 patients [50 female, 55.6%, mean (SD) age at diagnosis 47 (15.4) yrs.] with dermatomyositis recruited from a multicenter register in Spain (MEDRA5) including 30 hospitals. All the patients fulfill de International Myositis Classification Criteria (EULAR/ACR) for dermatomyositis (score >90%). Anti-MDA5 were detected by means of commercial immunoblot (EUROIMMUN©). The chi-square test was used to assess the relationships between qualitative variables. The Kruskal-Wallis test was used to compared medians between groups.Results:Sixty-six patients (73.3%) were diagnosed with clinically amyopathic dermatomyositis. Three different phenotypes linked with the anti-MDA5 antibody were identified. Group 1: patients with rapidly-ILD phenotype (28 patients, 31.1%), group 2: antisynthetase-like phenotype (23 patients, 25.5%), and group 3: non-ILD phenotype (39 patients, 43.3%). Clinical and immunological comparison between the groups disclosed that age at disease onset was higher (median, IQR) in patients from group 1 [53 (43-60)] vs. group 2 [46 (40-56)] or group 3 [42(41-51)] (p=0.01); disease onset was more frequent in spring in patients from group 1 (46.5%) than in the rest of the groups (21.7% and 28.9%) (p<0.01). Cancer was detected in 7 patients, only associated with myositis in 3 cases (3 years interval between cancer and dermatomyositis) without significant differences between phenotypes. Vasculitis (one case ANCA positive) was detected in 9 cases (6 limited to skin, 1 renal and 1 intestinal), 6 of them in the group 3 (statistical significance, in comparison with group 1 and 2, p<0.01). Mortality rate was higher in group 1 (51.9%, 16 out of 17 due to refractory respiratory failure) vs group 2 (12.5%) or 3 (0%) (p<0.001). Anti Ro52 positivity was more frequent in group 1 (65.4%) vs. group 2 (25%) or 3 (35.5%) (p<0.017), although it did not reach statistical significance in terms of mortality (p=0.173) or patients admitted in the intensive care unit (p=0.173). Mechanic hands were more frequent in group 2 (40.6%) than in groups 1 (25%) and 3 (34.4%) (p=0.05). Fever was significantly most frequent in group 1(52.6%) than in group 2 (21.1%) and 3 (26.3%) (p=0.001). Other clinical or immunological features such as arthritis, myositis, or the number of characteristic skin lesions among others were not more frequent in one group or another.Conclusion:Three different phenotypes of patients positive to anti-MDA5 were identified. The presence or not of ILD, or the different type (rapidly progressive or not) of ILD were the main feature that allow to differentiate these phenotypes, which are relevant in clinical practice.References:[1]Allenbach Y, Uzunhan Y, Toquet S, et al; French Myositis Network. Different phenotypes in dermatomyositis associated with anti-MDA5 antibody: Study of 121 cases. Neurology. 2020;95: e70-e78.Acknowledgements:List of contributors of MEDRA5 group: Aguilar-García J (Internal Medicine, Hospital Costa del Sol, Marbella), Carrión-Barberá I (Rheumatology, Hospital del Mar, Barcelona), Cobo-Ibañez T (Rheumatology, Hospital Infanta Sofía, San Sebastián de los Reyes), de Escalante-Yangüela B (Internal Medicine, Hospital Clínico Lozano Blesa, Zaragoza), Fonseca-Aizpuru EM (Internal Medicine, Hospital de Cabueñes, Gijón), González-Cubillo L (Intensive Medicine, Hospital Universitario de Cruces, Barakaldo), González-Gay MA (Rheumatology, Hospital Marqués de Valdecilla, Santander), Prieto-González S (Internal Medicine, Hospital Clinic, Barcelona), Ruiz-Román A (Rheumatology, Hospital Universitario Virgen del Rocío, Sevilla), Calero-Paniagua I (Internal Medicine, Hospital Virgen de la Luz, Cuenca), Callejas-Rubio JL (Internal Medicine, Hospital Clínico San Cecilio, Granada), Gil-Vila A (Internal Medicine, Hospital Vall d’Hebron, Barcelona), de Miguel-Campo B (Internal Medicine, Hospital Doce de Octubre, Madrid), García-Sevilla R (Pneumology, Hospital General Universitario de Alicante, Alicante), Iriarte-Fuster A (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat), Jovani-Casano V (Rheumatology, Hospital General Universitario de Alicante, Alicante), Lozano-Rivas N (Rheumatology, Hospital Virgen de la Arritxaca, Murcia), Martín-Gascón M (Internal Medicine, Hospital Morales Meseguer, Murcia), Martinez-González O (Rheumatology, Hospital Universitario de Salamanca, Salamanca), Monteagudo-Jiménez M (Internal Medicine, Hospital Parc Taulí, Sabadell), Mora-Ortega GM (Pneumology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes), Moral-Moral Pedro (Internal Medicine, Hospital Universitari i Politecnic La Fe, Valencia), Pérez-De Pedro I (Interna Medicine, Hospital Regional Universitario de Málaga, Málaga), Picazo-Talavera MR (Rheumatology, Hospital del Sureste, Madrid), Rubio-Rivas M (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat)Disclosure of Interests:None declared

scholarly journals MRI Spectrum of Japanese Encephalitis in Northeast India: A Cross-Sectional Study

2021 ◽  
Vol 12 (02) ◽  
pp. 281-289
Author(s):  
Pranjal Phukan ◽  
Kalyan Sarma ◽  
Barun Kumar Sharma ◽  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mri Findings ◽  
Mri Scan ◽  
Cross Sectional ◽  
Adc Value ◽  
Group 2 ◽  
Group 1

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

Sign in / Sign up

Export Citation Format

Share Document