المؤلفون: Lashen SA; Departments of Internal Medicine., Salem P; Departments of Internal Medicine., Ibrahim E; Departments of Internal Medicine., Abd Elmoaty D; Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt., Yousif WI; Departments of Internal Medicine.

المصدر: European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2024 Jul 01; Vol. 36 (7), pp. 952-960. Date of Electronic Publication: 2024 May 09.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Lippincott Williams And Wilkins Country of Publication: England NLM ID: 9000874 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-5687 (Electronic) Linking ISSN: 0954691X NLM ISO Abbreviation: Eur J Gastroenterol Hepatol Subsets: MEDLINE

مواضيع طبية MeSH: Acute-On-Chronic Liver Failure*/blood , Acute-On-Chronic Liver Failure*/mortality , Acute-On-Chronic Liver Failure*/diagnosis , Severity of Illness Index* , C-Reactive Protein*/analysis , Neutrophils* , Predictive Value of Tests*, Humans ; Male ; Female ; Middle Aged ; Prognosis ; Adult ; Case-Control Studies ; Leukocyte Count ; Aged ; Lymphocyte Count ; Monocytes ; Lymphocytes ; Platelet Count ; Liver Cirrhosis/blood ; Liver Cirrhosis/complications ; Liver Cirrhosis/mortality ; Liver Cirrhosis/diagnosis ; Blood Platelets ; Biomarkers/blood ; Time Factors

مستخلص: Background and Aims: Acute-on-chronic liver failure (ACLF) is the most severe form of acutely decompensated cirrhosis and is characterized by the presence of intense systemic inflammation. Leucocyte quantification can serve as an indirect indicator of systemic inflammation. In our study, we investigated the predictive value of hematological ratios (neutrophils to lymphocytes, monocyte to lymphocytes, platelets to lymphocytes, lymphocytes to C-reactive protein, and neutrophils to lymphocytes and platelets) in acute decompensation (AD) and ACLF patients and their relation to disease severity and early mortality.
Patients and Methods: We included 60 patients with ACLF and AD, and 30 cirrhotic controls. Clinical data were collected, and survival was followed for 1 and 6 months. Blood samples were analyzed at admission for differential leucocytes and assessed for liver and renal function tests. The leukocyte ratios were calculated and compared, and their correlation with liver function indicators and prognosis was assessed.
Results: All ratios were significantly higher in AD and ACLF patients compared to control (except for lymphocyte to C-reactive protein ratio which was significantly lower), and were positively correlated with Child-Pugh score, model for end-stage liver disease (MELD)-Na, and ACLF severity scores. Multivariate regression revealed that neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, and MELD-Na were independent prognostic factors of 1-month and 6-month mortality. A unique prognostic nomogram incorporating MELD-Na, neutrophil to lymphocyte ratio, and monocyte to lymphocyte ratio could be proposed for predicting prognosis in AD and ACLF patients.
Conclusions: Cheap, easy, and noninvasive hematological ratios are introduced as a tool for early identification and risk stratification of AD and ACLF patients.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

المؤلفون: Yuan B; Department of Gastroenterology and Hepatology, Jinling Clinical College of Nanjing Medical University, Jinling Hospital., Huang P; Department of Ultrasound, Jinling Hospital, Jiangsu Province, China., Yang M; Department of Gastroenterology and Hepatology, Jinling Clinical College of Nanjing Medical University, Jinling Hospital., Tang G; Department of Gastroenterology and Hepatology, Jinling Clinical College of Nanjing Medical University, Jinling Hospital., Wang F; Department of Gastroenterology and Hepatology, Jinling Clinical College of Nanjing Medical University, Jinling Hospital.

المصدر: European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2024 Jul 01; Vol. 36 (7), pp. 884-889. Date of Electronic Publication: 2024 Apr 17.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Lippincott Williams And Wilkins Country of Publication: England NLM ID: 9000874 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-5687 (Electronic) Linking ISSN: 0954691X NLM ISO Abbreviation: Eur J Gastroenterol Hepatol Subsets: MEDLINE

مواضيع طبية MeSH: Colitis, Ulcerative*/surgery , Colitis, Ulcerative*/diagnostic imaging , Colitis, Ulcerative*/drug therapy , Colectomy* , Ultrasonography* , Severity of Illness Index* , Predictive Value of Tests* , Adrenal Cortex Hormones*/therapeutic use , ROC Curve* , Treatment Failure*, Humans ; Male ; Female ; Retrospective Studies ; Adult ; Middle Aged ; Young Adult ; Risk Assessment ; Aged

مستخلص: Objective: Intestinal ultrasound (IUS) is an emerging modality for assessing disease activity, extent, and treatment response in ulcerative colitis. This study aimed to evaluate the potential of IUS in predicting severe flares, the need for rescue therapy (corticosteroid failure), and colectomy in patients with ulcerative colitis.
Methods: We conducted a retrospective review of medical records, collecting clinical and IUS data. The Milan Ultrasound Criteria (MUC) score was used to assess ulcerative colitis severity. Group comparisons were performed to identify differences in MUC scores between mild-to-moderate and severe ulcerative colitis, between steroid responders and nonresponders, and between patients who underwent colectomy and those who did not. Receiver operating characteristic (ROC) analysis was used to predict outcomes in patients with ulcerative colitis.
Results: This analysis included 102 patients with ulcerative colitis categorized as mild/moderate (60) or severe (42). MUC scores were significantly higher in the severe ulcerative colitis group compared with the mild/moderate group ( P  < 0.001). Analysis (using ROC) identified a cutoff MUC score of >8.54 to indicate severe ulcerative colitis with good sensitivity (64.29%) and excellent specificity (93.33%). Similarly, a cutoff of MUC > 10.54 showed promise in predicting corticosteroid failure, with acceptable sensitivity (50%) and high specificity (90.91%). Finally, a cutoff MUC score >12.5 demonstrated potential for predicting colectomy, exhibiting moderate sensitivity (55.56%) but excellent specificity (96.97%).
Conclusion: IUS may be useful for differentiating severe ulcerative colitis from mild-to-moderate disease, identifying early stage failure of corticosteroid therapy, and predicting the potential need for colectomy.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

المؤلفون: de Andrade JBC; Universidade Federal de São Paulo, São Paulo, Brazil; United Health Group Brazil, Sao Paulo, Brazil; Centro Universitario Sao Camilo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil; Institute of Aeronautics Technology, Bioengineer Laboratory, Sao Paulo, Brazil. Electronic address: joao.andrade@unifesp.br., Pacheco EP; United Health Group Brazil, Sao Paulo, Brazil., Camilo MR; Universidade de Sao Paulo, Ribeirao Preto, Brazil., Rodriguez CEL; Centro Universitario Sao Camilo, São Paulo, Brazil., Nascimento PS; Centro Universitario Sao Camilo, São Paulo, Brazil., de Oliveira NS; Centro Universitario Sao Camilo, São Paulo, Brazil., Carneiro TS; University of Florida, Florida, USA., de Oliveira RAC; Coopers, New Jersey, USA., Silva GS; Universidade Federal de São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil.

المصدر: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Jul; Vol. 33 (7), pp. 107723. Date of Electronic Publication: 2024 Apr 15.

نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial; Validation Study

بيانات الدورية: Publisher: Saunders Country of Publication: United States NLM ID: 9111633 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8511 (Electronic) Linking ISSN: 10523057 NLM ISO Abbreviation: J Stroke Cerebrovasc Dis Subsets: MEDLINE

مواضيع طبية MeSH: Stroke*/diagnosis , Stroke*/therapy , Stroke*/physiopathology , Mobile Applications* , Observer Variation* , Severity of Illness Index* , Predictive Value of Tests* , Algorithms*, Humans ; Reproducibility of Results ; Female ; Male ; Aged ; Middle Aged ; Disability Evaluation ; Video Recording ; Telemedicine ; Remote Consultation

مستخلص: Background: The NIH Stroke Scale (NIHSS) is a validated tool for assessing stroke severity, increasingly used by general practitioners in telemedicine services. Mobile apps may enhance its reliability. We aim to validate a digital platform (SPOKES) for NIHSS assessment in telemedicine and healthcare settings.
Methods: Hospitals using a telemedicine service were randomly allocated to control or SPOKES-user groups. The discrepancy between the NIHSS scores reported and those confirmed by experts was evaluated. Healthcare providers from comprehensive stroke centers were invited for interrater validation. Participants were randomized to assess the NIHSS using videos of real patients. Weighted Kappa (wk) statistics analyzed the agreement, and logistic regression determined the correlation with the congruency.
Results: A total of 299 telemedicine consultations from 12 hospitals were included. The difference between the NIHSS scores reported and double-checked was lower in the SPOKES group (p = 0.03), with a significantly higher level of complete agreement (72.5 % vs. 50.4 %, p = 0.005). Adoption of SPOKES was associated with complete congruency (OR 4.01, 95 %CI 1.42-11.35, p = 0.009). For interrater validation, 20 participants were considered. In the SPOKES group, almost-perfect and strong agreement occurred in 13.3 %(n = 6/45) and 84.4 %(n = 38/45) of ratings, respectively; in the control group, 6.7 %(n = 3/45) were almost-perfect, 28.9 %(n = 13/45) strong and 51 %(n = 23/45) were minimal.
Conclusion: A free and reliable mobile application for NIHSS assessment can significantly improve interrater agreement between healthcare professionals, and between NIHSS-certified neurologists and general practitioners. Our results underscore the importance of ongoing training and education in enhancing the consistency and reliability of NIHSS scores.
Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)

المؤلفون: Li J; Institute for AI in Medicine, School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing 210044, Jiangsu Province, China., Xiang Y; Department of Oncology, The First Affiliated Hospital, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China; Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China., Han J; Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China., Gao Y; Department of Infectious Disease, The People's Hospital of Bozhou, Bozhou 236800, Anhui Province, China., Wang R; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China., Dong Z; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China., Chen H; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China; Department of Ultrasound, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China., Gao R; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China; Medical School, Southeast University, Nanjing, 210009, Jiangsu Province, China., Liu C; Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China., Teng GJ; Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China., Qi X; Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China. Electronic address: qixiaolong@vip.163.com.

المصدر: Annals of hepatology [Ann Hepatol] 2024 Jul-Aug; Vol. 29 (4), pp. 101478. Date of Electronic Publication: 2024 Feb 12.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Fundación Clínica Médica Sur Country of Publication: Mexico NLM ID: 101155885 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1665-2681 (Print) Linking ISSN: 16652681 NLM ISO Abbreviation: Ann Hepatol Subsets: MEDLINE

مواضيع طبية MeSH: Liver Cirrhosis*/diagnosis , Liver Cirrhosis*/complications , Diabetic Retinopathy*/diagnosis , Diabetic Retinopathy*/epidemiology , Nutrition Surveys* , Diabetes Mellitus, Type 2*/complications , ROC Curve* , Predictive Value of Tests* , Severity of Illness Index*, Humans ; Male ; Cross-Sectional Studies ; Female ; Middle Aged ; Aged ; United States/epidemiology ; Risk Factors ; Adult ; Area Under Curve ; Chi-Square Distribution ; Prevalence

مستخلص: Introduction and Objectives: Type 2 Diabetes Mellitus (T2DM), a prevalent metabolic disorder, often coexists with a range of complications, with retinopathy being particularly common. Recent studies have shed light on a potential connection between diabetic retinopathy (DR) and hepatic fibrosis, indicating a possible shared pathophysiological foundation in T2DM. This study investigates the correlation between retinopathy and hepatic fibrosis among individuals with T2DM, as well as evaluates the diagnostic value of DR for significant hepatic fibrosis.
Materials and Methods: Our cross-sectional analysis incorporated 5413 participants from the National Health and Nutrition Examination Survey (NHANES) 2005-2008. The Fibrosis-4 score (FIB-4) classified hepatic fibrosis into different grades (F0-F4), with significant hepatic fibrosis marked as F2 or higher. Retinopathy severity was determined using retinal imaging and categorized into four levels. The analysis of variance or Chi-square tests facilitated group comparisons. Additionally, the receiver operating characteristic (ROC) analysis appraised the predictive accuracy of retinopathy for significant hepatic fibrosis in the T2DM population.
Results: Among 5413 participants, the mean age was 59.56 ± 12.41, with 50.2% male. And 20.6% were diagnosed with T2DM. Hepatic fibrosis grading was positively associated with retinopathy severity (OR [odds ratio]: 1.521, 95%CI [confidence interval]: 1.152-2.008, P = 0.003) across the entire population. The association was amplified in the T2DM population according to Pearson's analysis results. The ROC curve demonstrated retinopathy's diagnostic capacity for significant hepatic fibrosis in the T2DM population (AUC [area under curve] = 0.72, 95%CI: 0.651-0.793, P < 0.001).
Conclusions: Retinopathy could serve as an independent predictor of significant hepatic fibrosis in T2DM population. Ophthalmologists are advised to closely monitor T2DM patients with retinopathy.
Competing Interests: Declaration of interests None
(Copyright © 2024 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)

المؤلفون: Sun L; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.; Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Zhao X; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Guo Y; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Hou X; Department of Pharmacology, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.; China Key Laboratory of Cellular Physiology, Shanxi Medical University, Taiyuan, Shanxi, China.; Environmental Exposures Vascular Disease Institute, Taiyuan, Shanxi, People's Republic of China., Li J; Department of Foreign Languages, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Ren X; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China., Dong L; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Liang R; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Nie J; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Shi Y; Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China., Qin X; School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.; Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.; China Key Laboratory of Cellular Physiology, Shanxi Medical University, Taiyuan, Shanxi, China.; Environmental Exposures Vascular Disease Institute, Taiyuan, Shanxi, People's Republic of China.; Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.

المصدر: International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2024 Jun 04; Vol. 19, pp. 1233-1245. Date of Electronic Publication: 2024 Jun 04 (Print Publication: 2024).

نوع المنشور: Journal Article

بيانات الدورية: Publisher: DOVE Medical Press Country of Publication: New Zealand NLM ID: 101273481 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-2005 (Electronic) Linking ISSN: 11769106 NLM ISO Abbreviation: Int J Chron Obstruct Pulmon Dis Subsets: MEDLINE

مواضيع طبية MeSH: Natriuretic Peptide, Brain*/blood , Peptide Fragments*/blood , Biomarkers*/blood , Predictive Value of Tests* , Smoking*/adverse effects , Smoking*/blood , Smoking*/epidemiology , Hypertension, Pulmonary*/blood , Hypertension, Pulmonary*/diagnosis , Hypertension, Pulmonary*/physiopathology , Hypertension, Pulmonary*/etiology , Severity of Illness Index*, Humans ; Female ; Male ; Middle Aged ; Retrospective Studies ; Aged ; Risk Factors ; Risk Assessment ; Prognosis ; Pulmonary Disease, Chronic Obstructive/blood ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Disease, Chronic Obstructive/complications ; China/epidemiology ; Adult ; Arterial Pressure

مستخلص: Purpose: Smoking is a major risk factor for the group 3 PH. NT-proBNP is a biomarker for risk stratification in PH. This study aims to investigate the effects of smoking status and smoking index (SI) on group 3 PH and to evaluate the value of SI and SI combined with NT-proBNP in early diagnosis and prediction of disease severity.
Patients and Methods: Four hundred patients with group 3 PH at the First Hospital of Shanxi Medical University between January 2020 and December 2021 were enrolled and divided into two groups: mild (30 mmHg ≤ pulmonary artery systolic pressure (PASP)≤50 mmHg) and non-mild (PASP >50 mmHg). The effect of smoking on group 3 PH was analyzed using univariate analysis, and logistic analysis was conducted to evaluate the risk of group 3 PH according to smoking status and SI. Spearman correlation coefficient was used to test the correlation between SI and the index of group 3 PH severity. The predictive value of SI was evaluated using a receiver operating characteristic (ROC) curve.
Results: Correlation and logistic analyses showed that SI was associated with PH severity. Smoking status (P =0.009) and SI ( P =0.039) were independent risk factors for non-mild group 3 PH, and ROC showed that the predictive value of SI (AUC:0.596) for non-mild PH was better than that of the recognized pro-brain natriuretic peptide (NT-proBNP) (AUC:0.586). SI can be used as a single predictive marker. SI and NT-proBNP can be formulated as prediction models for screening non-mild clinical cases (AUC:0.628).
Conclusion: SI is a potentially ideal non-invasive predictive marker for group 3 PH. SI and NT-proBNP could be used to develop a prediction model for screening non-mild PH cases. This can greatly improve the predictive specificity of the established PH marker, NT-proBNP.
Competing Interests: The authors report no conflicts of interest in this work.
(© 2024 Sun et al.)

المؤلفون: Seringec Akkececi N; Department of Physiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey., Ciftcioglu M; Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey., Okyar B; Department of Rheumatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey., Yildirim Cetin G; Department of Rheumatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

المصدر: International journal of rheumatic diseases [Int J Rheum Dis] 2024 Jun; Vol. 27 (6), pp. e15216.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Wiley on behalf of the Asia Pacific League of Associations for Rheumatology Country of Publication: England NLM ID: 101474930 Publication Model: Print Cited Medium: Internet ISSN: 1756-185X (Electronic) Linking ISSN: 17561841 NLM ISO Abbreviation: Int J Rheum Dis Subsets: MEDLINE

مواضيع طبية MeSH: Arthritis, Rheumatoid*/blood , Arthritis, Rheumatoid*/diagnosis , Severity of Illness Index* , Biomarkers*/blood , Predictive Value of Tests* , Granulocytes*/immunology, Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Blood Sedimentation ; Aged ; C-Reactive Protein/analysis ; Remission Induction ; Treatment Outcome

مستخلص: Aim: To determine whether the IG count (#) and IG percentage (%) are associated with disease activity in rheumatoid arthritis (RA).
Methods: This retrospective study included 65 RA patients and 65 healthy controls. Clinical and demographic characteristics of controls and RA patients (at active period and when the patients achieved remission) were obtained from medical records. Disease activity was defined by disease activity score 28 (DAS28). Furthermore, the clinical disease activity index (CDAI), and simple disease activity index (SDAI) were calculated. For the differential diagnosis of RA patients from healthy controls, the cut-off value was estimated by making receiver-operator curves (ROC).
Results: In active RA patients, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), IG#, and IG% levels were significantly higher compared to the healthy controls (p < .001, for all). When the patients achieved remission, DAS28, CDAI, SDAI, ESR, CRP, IG#, and IG% values were significantly decreased (p < .001, for all). IG# and IG% were significantly positively correlated with DAS28, CDAI, SDAI, ESR, and CRP (p = .024, p = .008, p = .003, p < .001, p < .001, respectively). According to ROC curve analysis, IG% and IG# were the biomarkers to have a significant diagnostic value for RA with the area under the curve of 0.853 and 0.865 (p < .001, for all).
Conclusion: The present study demonstrated that two novel inflammatory markers, IG# and IG%, can be useful for monitoring RA patients' disease activity. Furthermore, IG# and IG% can also be used as fast, inexpensive, and easily available complementary diagnostic markers to diagnose RA patients.
(© 2024 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

المؤلفون: Vimalesvaran K; A1 for Healthcare Centre for Doctoral Training, Imperial College London, SW7 2AZ, United Kingdom; National Heart and Lung Institute, Imperial College London, SW7 2AZ, United Kingdom; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom. Electronic address: k.vimalesvaran@imperial.ac.uk., Zaman S; National Heart and Lung Institute, Imperial College London, SW7 2AZ, United Kingdom; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom. Electronic address: sameer.zaman10@imperial.ac.uk., Howard JP; National Heart and Lung Institute, Imperial College London, SW7 2AZ, United Kingdom; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom. Electronic address: james.howard1@imperial.ac.uk., Aziminia N; Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom. Electronic address: nikoo.aziminia@nhs.net., Giannoudi M; Multidisciplinary Cardiovascular Research Centre & Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom. Electronic address: m.giannoudi@leeds.ac.uk., Procter H; Multidisciplinary Cardiovascular Research Centre & Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom. Electronic address: h.procter@leeds.ac.uk., Varela M; National Heart and Lung Institute, Imperial College London, SW7 2AZ, United Kingdom. Electronic address: marta.varela@imperial.ac.uk., Uslu F; Department of Electric-Electronic Engineering, Bursa Technical University, Bursa, Turkiye. Electronic address: fatmatulzehra.uslu@btu.edu.tr., Ariff B; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom. Electronic address: b.ariff@nhs.net., Linton N; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom; Department of Bioengineering, Imperial College London, SW7 2AZ, United Kingdom. Electronic address: nick.linton@imperial.ac.uk., Levelt E; Multidisciplinary Cardiovascular Research Centre & Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom. Electronic address: e.levelt@leeds.ac.uk., Bharath AA; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom; Department of Bioengineering, Imperial College London, SW7 2AZ, United Kingdom. Electronic address: a.bharath@imperial.ac.uk., Cole GD; National Heart and Lung Institute, Imperial College London, SW7 2AZ, United Kingdom; Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom. Electronic address: graham.cole3@nhs.net.

المصدر: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance [J Cardiovasc Magn Reson] 2024 Summer; Vol. 26 (1), pp. 100005. Date of Electronic Publication: 2024 Jan 09.

نوع المنشور: Journal Article; Multicenter Study; Comparative Study

بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 9815616 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-429X (Electronic) Linking ISSN: 10976647 NLM ISO Abbreviation: J Cardiovasc Magn Reson Subsets: MEDLINE

مواضيع طبية MeSH: Aortic Valve Stenosis*/diagnostic imaging , Aortic Valve Stenosis*/physiopathology , Magnetic Resonance Imaging, Cine* , Predictive Value of Tests* , Severity of Illness Index* , Ventricular Function, Left* , Aortic Valve*/diagnostic imaging , Aortic Valve*/physiopathology , Aortic Valve*/pathology , Aortic Valve*/abnormalities, Humans ; Female ; Male ; Retrospective Studies ; Aged ; Middle Aged ; Reproducibility of Results ; Aorta/diagnostic imaging ; Aorta/physiopathology ; Image Interpretation, Computer-Assisted ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Regional Blood Flow ; United States

مستخلص: Background: Cardiovascular magnetic resonance (CMR) imaging is an important tool for evaluating the severity of aortic stenosis (AS), co-existing aortic disease, and concurrent myocardial abnormalities. Acquiring this additional information requires protocol adaptations and additional scanner time, but is not necessary for the majority of patients who do not have AS. We observed that the relative signal intensity of blood in the ascending aorta on a balanced steady state free precession (bSSFP) 3-chamber cine was often reduced in those with significant aortic stenosis. We investigated whether this effect could be quantified and used to predict AS severity in comparison to existing gold-standard measurements.
Methods: Multi-centre, multi-vendor retrospective analysis of patients with AS undergoing CMR and transthoracic echocardiography (TTE). Blood signal intensity was measured in a ∼1 cm ² region of interest (ROI) in the aorta and left ventricle (LV) in the 3-chamber bSSFP cine. Because signal intensity varied across patients and scanner vendors, a ratio of the mean signal intensity in the aorta ROI to the LV ROI (Ao:LV) was used. This ratio was compared using Pearson correlations against TTE parameters of AS severity: aortic valve peak velocity, mean pressure gradient and the dimensionless index. The study also assessed whether field strength (1.5 T vs. 3 T) and patient characteristics (presence of bicuspid aortic valves (BAV), dilated aortic root and low flow states) altered this signal relationship.
Results: 314 patients (median age 69 [IQR 57-77], 64% male) who had undergone both CMR and TTE were studied; 84 had severe AS, 78 had moderate AS, 66 had mild AS and 86 without AS were studied as a comparator group. The median time between CMR and TTE was 12 weeks (IQR 4-26). The Ao:LV ratio at 1.5 T strongly correlated with peak velocity (r = -0.796, p = 0.001), peak gradient (r = -0.772, p = 0.001) and dimensionless index (r = 0.743, p = 0.001). An Ao:LV ratio of < 0.86 was 84% sensitive and 82% specific for detecting AS of any severity and a ratio of 0.58 was 83% sensitive and 92% specific for severe AS. The ability of Ao:LV ratio to predict AS severity remained for patients with bicuspid aortic valves, dilated aortic root or low indexed stroke volume. The relationship between Ao:LV ratio and AS severity was weaker at 3 T.
Conclusions: The Ao:LV ratio, derived from bSSFP 3-chamber cine images, shows a good correlation with existing measures of AS severity. It demonstrates utility at 1.5 T and offers an easily calculable metric that can be used at the time of scanning or automated to identify on an adaptive basis which patients benefit from dedicated imaging to assess which patients should have additional sequences to assess AS.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

المؤلفون: Khan H; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA., Bansal K; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA., Griffin WF; Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA.; Department of Radiology, University of North Carolina, Chapel Hill, NC, USA., Cantlay C; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA., Sidahmed A; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA., Nurmohamed NS; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA., Zeman RK; Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA., Katz RJ; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA., Blankstein R; Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA., Earls JP; Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA.; Cleerly Healthcare, Denver, CO, USA., Choi AD; Division of Cardiology, The George Washington University School of Medicine, Washington, DC, USA. adchoi@mfa.gwu.edu.; Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA. adchoi@mfa.gwu.edu.

المصدر: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2024 Jun; Vol. 40 (6), pp. 1201-1209. Date of Electronic Publication: 2024 Apr 17.

نوع المنشور: Journal Article; Comparative Study

بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 100969716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1875-8312 (Electronic) Linking ISSN: 15695794 NLM ISO Abbreviation: Int J Cardiovasc Imaging Subsets: MEDLINE

مواضيع طبية MeSH: Plaque, Atherosclerotic* , Predictive Value of Tests* , Computed Tomography Angiography* , Coronary Angiography* , Vascular Calcification*/diagnostic imaging , Coronary Stenosis*/diagnostic imaging , Severity of Illness Index* , Coronary Artery Disease*/diagnostic imaging , Artificial Intelligence*, Humans ; Female ; Middle Aged ; Male ; Aged ; Reproducibility of Results ; Coronary Vessels/diagnostic imaging ; Radiographic Image Interpretation, Computer-Assisted ; Multidetector Computed Tomography ; Observer Variation

مستخلص: This study assesses the agreement of Artificial Intelligence-Quantitative Computed Tomography (AI-QCT) with qualitative approaches to atherosclerotic disease burden codified in the multisociety 2022 CAD-RADS 2.0 Expert Consensus. 105 patients who underwent cardiac computed tomography angiography (CCTA) for chest pain were evaluated by a blinded core laboratory through FDA-cleared software (Cleerly, Denver, CO) that performs AI-QCT through artificial intelligence, analyzing factors such as % stenosis, plaque volume, and plaque composition. AI-QCT plaque volume was then staged by recently validated prognostic thresholds, and compared with CAD-RADS 2.0 clinical methods of plaque evaluation (segment involvement score (SIS), coronary artery calcium score (CACS), visual assessment, and CAD-RADS percent (%) stenosis) by expert consensus blinded to the AI-QCT core lab reads. Average age of subjects were 59 ± 11 years; 44% women, with 50% of patients at CAD-RADS 1-2 and 21% at CAD-RADS 3 and above by expert consensus. AI-QCT quantitative plaque burden staging had excellent agreement of 93% (k = 0.87 95% CI: 0.79-0.96) with SIS. There was moderate agreement between AI-QCT quantitative plaque volume and categories of visual assessment (64.4%; k = 0.488 [0.38-0.60]), and CACS (66.3%; k = 0.488 [0.36-0.61]). Agreement between AI-QCT plaque volume stage and CAD-RADS % stenosis category was also moderate. There was discordance at small plaque volumes. With ongoing validation, these results demonstrate a potential for AI-QCT as a rapid, reproducible approach to quantify total plaque burden.
(© 2024. The Author(s).)

المؤلفون: Kumar R; Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India. Electronic address: be10001.18@bitmesra.ac.in., Aggarwal Y; Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India. Electronic address: yaggarwal@bitmesra.ac.in., Nigam VK; Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India. Electronic address: vknigam@bitmesra.ac.in., Sinha RK; Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India. Electronic address: rakeshsinha@bitmesra.ac.in.

المصدر: Nutrition, metabolism, and cardiovascular diseases : NMCD [Nutr Metab Cardiovasc Dis] 2024 Jun; Vol. 34 (6), pp. 1389-1398. Date of Electronic Publication: 2024 Jan 14.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9111474 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1590-3729 (Electronic) Linking ISSN: 09394753 NLM ISO Abbreviation: Nutr Metab Cardiovasc Dis Subsets: MEDLINE

مواضيع طبية MeSH: Heart Rate* , Support Vector Machine* , Atherosclerosis*/physiopathology , Atherosclerosis*/diagnosis , Atherosclerosis*/blood , Disease Progression* , Biomarkers*/blood , Autonomic Nervous System*/physiopathology , Predictive Value of Tests* , Severity of Illness Index*, Humans ; Time Factors ; Male ; Prognosis ; Female ; Diet, High-Fat/adverse effects ; Middle Aged ; Adult ; Lipids/blood ; Case-Control Studies ; Electrocardiography ; Risk Factors

مستخلص: Background and Aim: The regular uptake of a high-fat diet (HFD) with changing lifestyle causes atherosclerosis leading to cardiovascular diseases and autonomic dysfunction. Therefore, the current study aimed to investigate the correlation of autonomic activity to lipid and atherosclerosis markers. Further, the study proposes a support vector machine (SVM) based model in the prediction of atherosclerosis severity.
Methods and Results: The Lead-II electrocardiogram and blood markers were measured from both the control and the experiment subjects each week for nine consecutive weeks. The time-domain heart rate variability (HRV) parameters were derived, and the significance level was tested using a one-way Analysis of Variance. The correlation analysis was performed to determine the relation between autonomic parameters and lipid and atherosclerosis markers. The statistically significant time-domain values were used as features of the SVM. The observed results demonstrated the reduced time domain HRV parameters with the increase in lipid and atherosclerosis index markers with the progressive atherosclerosis severity. The correlation analysis revealed a negative association between time-domain HRV parameters with lipid and atherosclerosis parameters. The percentage accuracy increases from 86.58% to 98.71% with the increase in atherosclerosis severity with regular consumption of HFD.
Conclusions: Atherosclerosis causes autonomic dysfunction with reduced HRV. The negative correlation between autonomic parameters and lipid profile and atherosclerosis indexes marker revealed the potential role of vagal activity in the prognosis of atherosclerosis progression. The support vector machine presented a respectable accuracy in the prediction of atherosclerosis severity from the control group.
Competing Interests: Declaration of competing interest Authors declare that they have no conflict of interest.
(Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

المؤلفون: Özsin KK; Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey., Engin M; Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey., Sanrı US; Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey., Toktaş F; Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey., Kahraman N; Department of Cardiovascular Surgery, Bursa City Hospital, Bursa, Turkey., Huysal K; Department of Clinical Biochemistry, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey., Üstündağ Y; Department of Clinical Biochemistry, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey., Yavuz Ş; Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.

المصدر: Vascular [Vascular] 2024 Jun; Vol. 32 (3), pp. 603-611. Date of Electronic Publication: 2022 Nov 27.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Sage Country of Publication: England NLM ID: 101196722 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1708-539X (Electronic) Linking ISSN: 17085381 NLM ISO Abbreviation: Vascular Subsets: MEDLINE

مواضيع طبية MeSH: Peripheral Arterial Disease*/blood , Peripheral Arterial Disease*/diagnosis , Peripheral Arterial Disease*/physiopathology , Biomarkers*/blood , Severity of Illness Index* , Serum Albumin, Human*/analysis , Predictive Value of Tests* , Intermittent Claudication*/blood , Intermittent Claudication*/diagnosis , Intermittent Claudication*/physiopathology , ROC Curve*, Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Case-Control Studies ; Risk Factors ; Area Under Curve ; Logistic Models ; Up-Regulation ; Odds Ratio

مستخلص: Objectives: Albumin undergoes structural changes under ischemia and oxidative stress, turning into ischemia-modified albumin (IMA). It has been proposed as an early biomarker for various diseases associated with ischemia. We aimed to investigate the relationship between serum IMA and peripheral artery disease (PAD) and whether it is a risk marker for the severity of PAD.
Methods: This prospective case-control study included 100 patients with lower extremity PAD and 50 volunteers without. Patients with resting pain, ulcer, and gangrene were excluded from the study. Patients with PAD included in the study were divided into two groups as mild claudication and moderate-severe claudication. Adjusted-IMA levels were calculated according to the median albumin values of the groups. The basic clinical features and laboratory findings of the participants were recorded and compared. Possible risk factors for presence and severity of PAD and IMA levels were examined by logistic regression and receiver-operating characteristic (ROC) curve analyses.
Results: IMA and adjusted-IMA levels were significantly higher in the PAD group ( p < 0.001, p < 0.001, respectively). IMA and adjusted-IMA levels were significantly higher in PAD group 2, which had moderate-to-severe claudication and more pronounced ischemic symptoms ( p < 0.001, p < 0.001, respectively). Advanced age, presence of hypertension, smoking, low albumin levels, and high adjusted-IMA levels were independent predictors of PAD. There was a negative high correlation between adjusted-IMA levels and ABI ( r : -0.666, p < 0.001, Spearman's correlation). ROC curve analysis demonstrated that adjusted-IMA cut-off values of 0.802 or above could predict presence and severity of peripheral artery disease with 70% sensitivity and 78% specificity (AUC: 0.825, 95% CI: 0.758-0.893, log rank p : 0.000).
Conclusion: We determinated that increased adjusted-IMA levels were a predictors of the presence and severity of PAD. In addition, adjusted-IMA values can be a valuable marker in the follow-up of clinical severity of PAD.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.