Apparent Diseases Research Articles

Lightweight Sewer Pipe Crack Detection Method Based on Amphibious Robot and Improved YOLOv8n.

Aiming at the problem of difficult crack detection in underground urban sewage pipelines, a lightweight sewage pipeline crack detection method based on sewage pipeline robots and improved YOLOv8n is proposed. The method uses pipeline robots as the equipment carrier to move rapidly and collect high-definition data of apparent diseases in sewage pipelines with both water and sludge media. The lightweight RGCSPELAN module is introduced to reduce the number of parameters while ensuring the detection performance. First, we replaced the lightweight detection head Detect_LADH to reduce the number of parameters and improve the feature extraction of modeled cracks. Finally, we added the LSKA module to the SPPF module to improve the robustness of YOLOv8n. Compared with YOLOv5n, YOLOv6n, YOLOv8n, RT-DETRr18, YOLOv9t, and YOLOv10n, the improved YOLOv8n has a smaller number of parameters of only 1.6 M. The FPS index reaches 261, which is good for real-time detection, and at the same time, the model also has a good detection accuracy. The validation of sewage pipe crack detection through real scenarios proves the feasibility of the proposed method, which has good results in targeting both small and long cracks. It shows potential in improving the safety maintenance, detection efficiency, and cost-effectiveness of urban sewage pipes.

Artificial Intelligence in Fluorescence Lifetime Imaging Ophthalmoscopy (FLIO) Data Analysis-Toward Retinal Metabolic Diagnostics.

The purpose of this study was to investigate the possibility of implementing an artificial intelligence (AI) approach for the analysis of fluorescence lifetime imaging ophthalmoscopy (FLIO) data even with small data. FLIO data, including the fluorescence intensity and mean fluorescence lifetime (τm) of two spectral channels, as well as OCT-A data from 26 non-smokers and 28 smokers without systemic and ocular diseases were used. The analysis was performed with support vector machines (SVMs), a well-known AI method for small datasets, and compared with the results of convolutional neural networks (CNNs) and autoencoder networks. The SVM was the only tested AI method, which was able to distinguish τm between non-smokers and heavy smokers. The accuracy was about 80%. OCT-A data did not show significant differences. The feasibility and usefulness of the AI in analyzing FLIO and OCT-A data without any apparent retinal diseases were demonstrated. Although further studies with larger datasets are necessary to validate the results, the results greatly suggest that AI could be useful in analyzing FLIO-data even from healthy subjects without retinal disease and even with small datasets. AI-assisted FLIO is expected to greatly advance early retinal diagnosis.

Canid attacks on sea turtles along the Northeastern Brazilian Coast

Abstract The aim of the present study was to report canid attacks on sea turtles in northeastern Brazil. The study was conducted on the Sergipe-Alagoas Basin coastline between March 2010 and October 2019. Injured-stranded sea turtles or carcasses were recorded through systematic beach monitoring. The specimens were submitted for clinical or postmortem assessments, providing evidence for the identification of injuries caused by canids. In the study period, 9841 stranded sea turtles were recorded, with the diagnosis of canid attacks in 55 (0.55%) events. Lepidochelys olivacea was the species with the largest number of events (90.90%), followed by Chelonia mydas (7.27%), and Caretta caretta (1.81%). The attacked sea turtles were clinically healthy, with a good body score and no apparent diseases; most were in the reproductive stage. The injuries were mainly found on the front flippers, with considerable loss of musculature affecting the brachial plexus, with the rupture of large blood vessels, and in some cases, exposure of the humerus or oesophagus. Thus, these events hampered the reproductive cycle, limiting the egg-laying process and preventing the hatching of hundreds of new turtles. Therefore, mitigating measures should be implemented, addressing the consequences of abandoning pets and their unsupervised presence on beaches.

Immunoglobulin G4-Related Lesions in Autoimmune Diseases: Unusual Presentations at Atypical Sites-A Tale of 2 Cases with Literature Review.

Immunoglobulin G4-related disease (IgG4-RD) coexisting with clinically apparent autoimmune diseases, such as rheumatoid arthritis (RA) or antiphospholipid syndrome (APS), is a rarely documented combination in the scientific literature. In this case-based review, we present 2 intriguing cases with preexisting autoimmune diseases, namely, RA and primary APS, who exhibited coexistent IgG4- related lesions at unusual sites. The first case pertains to a patient with known RA who presented with an encasing mass in the esophagus leading to stricture, with histopathological diagnosis of IgG4-RD.The second patient, diagnosed with primary APS, experienced breathlessness, and imaging revealed a right atrial mass. Histopathological examination of the mass confirmed IgG4-RD. Notably, both patients demonstrated significant clinical improvement upon initiation of steroid therapy. Rheumatoid arthritis patients commonly exhibit elevated levels of IgG4 in their sera; however, RA with coexisting IgG4-RD is rarely reported in the literature. Similarly, APS with IgG4-related lesions is exceedingly rare. Although there are few case reports and series on esophageal and cardiac IgG4-RD, the occurrence of such unusual location of IgG4-related lesions in the context of known autoimmunity is presented here for the first time.

Urinary levels of cortisol but not catecholamines are associated with those of 8-hydroxy-2'-deoxyguanosine in uncomplicated primary hypertension.

The relationships between stress hormones and oxidative DNA damage have not yet been explored in human hypertension. We investigated the associations of urinary levels of cortisol or catecholamines with those of 8-hydroxy-2'-deoxyguanosine, a marker of oxidative DNA damage in primary hypertension. Untreated 156 primary hypertensives without apparent cardiovascular diseases were entered into the study. Following blood sampling after an overnight fast, 24-h blood pressure monitoring and 24-h urinary sampling were performed simultaneously to determine 24-h averaged values for blood pressure and urinary levels of cortisol, catecholamines and 8-hydroxy-2'-deoxyguanosine. Urinary cortisol significantly correlated positively with urinary 8-hydroxy-2'-deoxyguanosine in all studied participants (r = 0.334, P < 0.001). Contrary, either urinary adrenaline or urinary noradrenaline did not significantly correlate with urinary 8-hydroxy-2'-deoxyguanosine (r = 0.050, P = 0.553 or r = 0.063, P = 0.435). Additionally, the positive association of urinary cortisol with urinary 8-hydroxy-2'-deoxyguanosine remained highly significant after the adjustments for multiple confounders of oxidative stress such as age, gender, body mass index, smoking status, 24-h blood pressure, C-reactive protein and estimated glomerular filtration rate (partial r = 0.323, P < 0.001), although only approximately 10% of the variance in urinary cortisol was attributable to differences in urinary 8-OHdG (partial r2 = 0.104). Thus, our data indicate that cortisol but not catecholamines could at least partially contribute to the occurrence of oxidative DNA damage in primary hypertensives. The present study suggested the possibility that the overactivation of hypothalamic-pituitary-adrenal axis rather than sympathoadrenal system could enhance oxidative stress and attendant DNA oxidation in uncomplicated primary hypertension.

RISK CONFERRED BY POLYMORPHIC VARIANTS OF VITAMIN D RECEPTOR (VDR) AND ANGIOTENSIN II TYPE 1 RECEPTOR (AGTR1) GENES FOR ESSENTIAL HYPERTENSION

Objective: The aim of this study was to establish the role of 1166A&gt;C polymorphism of the AGTR1 gene (rs5186) and A/G polymorphism of the VDR gene (rs2228570) in risk prediction of essential hypertension (EH). Design and method: The study included patients with EH and hypertensive-mediated organs damage (2nd stage), moderate, high/very high cardiovascular risk. 100 subjects were involved in the case-control study. There were 70.84% females, 29.16% males among them, the mean age was 57.86±7.81 yo. Age- and gender-matched controls (n = 60) whose blood pressure measurements were in normal range and without any apparent diseases were randomly selected to compare with the patient data. In order to detect AGTR1 (rs5186) and VDR (rs2228570) gene polymorphism the qualitative real-time polymerase chain reaction was done. AGTR1 gene genotyping was performed for 72 patients and 48 healthy individuals and VDR gene – for 100 patients and 60 healthy subjects. Results: The distribution of genotypes and alleles AGTR1 (rs5186) and VDR (rs2228570) in the study and control groups did not differ significantly (p&gt;0.05). C-allele of AGTR1 gene (rs5186) increases the risk of EAH more than 2 times [OR–2.31; 95% CI OR:1.19–4.47; p = 0.011], as well as AC- and the combination of AC- + CC-genotypes [OR–2.09; 95% CI OR:1.03–4.25; p = 0.038 and OR–2.30; 95% CI OR:1.14–4.64; p = 0.017]. The epidemiological analysis showed that polymorphic variants VDR (rs2228570) genes are not the risk factors of EH in the observed. Although, the combination of wild alleles of both genes in the homozygous state (AAAGTR1/AAVDR) makes a protective effect [OR = 0,42; OR 95%CI:0,18-1,0; ⇙2 = 3,74; p = 0,05], the combination of minor alleles (C-allele AGTR1 /AAVDR+C-allele AGTR1/AGVDR) increases the risk of EH more than threefold [OR = 3,36; OR 95%CI:1,24-9,09; ⇙2 = 5,88; p = 0,015]. Conclusions: Genotypes and alleles of VDR (rs2228570) gene are not associated with the risk of developing EH in the examined. C-allele of AGTR1 gene (rs5186) increases the risk of hypertension more than 2 times [OR–2.31; p = 0.011]. Combination of minor C-allele of AGTR1 gene and A-allele of VDR gene (C-allele AGTR1 /AAVDR+C-allele AGTR1/AGVDR) escalates the risk of EH more than 3 times [OR = 3,36; p = 0,015].

Host, environment, and anthropogenic factors drive landscape dynamics of an environmentally transmitted pathogen: Sarcoptic mange in the bare-nosed wombat.

Understanding the spatial dynamics and drivers of wildlife pathogens is constrained by sampling logistics, with implications for advancing the field of landscape epidemiology and targeted allocation of management resources. However, visually apparent wildlife diseases, when combined with remote-surveillance and distribution modelling technologies, present an opportunity to overcome this landscape-scale problem. Here, we investigated dynamics and drivers of landscape-scale wildlife disease, using clinical signs of sarcoptic mange (caused by Sarcoptes scabiei) in its bare-nosed wombat (BNW; Vombatus ursinus) host. We used 53,089 camera-trap observations from over 3261 locations across the 68,401 km2 area of Tasmania, Australia, combined with landscape data and ensemble species distribution modelling (SDM). We investigated: (1) landscape variables predicted to drive habitat suitability of the host; (2) host and landscape variables associated with clinical signs of disease in the host; and (3) predicted locations and environmental conditions at greatest risk of disease occurrence, including some Bass Strait islands where BNW translocations are proposed. We showed that the Tasmanian landscape, and ecosystems therein, are nearly ubiquitously suited to BNWs. Only high mean annual precipitation reduced habitat suitability for the host. In contrast, clinical signs of sarcoptic mange disease in BNWs were widespread, but heterogeneously distributed across the landscape. Mange (which is environmentally transmitted in BNWs) was most likely to be observed in areas of increased host habitat suitability, lower annual precipitation, near sources of freshwater and where topographic roughness was minimal (e.g. human modified landscapes, such as farmland and intensive land-use areas, shrub and grass lands). Thus, a confluence of host, environmental and anthropogenic variables appear to influence the risk of environmental transmission of S. scabiei. We identified that the Bass Strait Islands are highly suitable for BNWs and predicted a mix of high and low suitability for the pathogen. This study is the largest spatial assessment of sarcoptic mange in any host species, and advances understanding of the landscape epidemiology of environmentally transmitted S. scabiei. This research illustrates how host-pathogen co-suitability can be useful for allocating management resources in the landscape.

Evolutionary psychiatry: foundations, progress and challenges.

Evolutionary biology provides a crucial foundation for medicine and behavioral science that has been missing from psychiatry. Its absence helps to explain slow progress; its advent promises major advances. Instead of offering a new kind of treatment, evolutionary psychiatry provides a scientific foundation useful for all kinds of treatment. It expands the search for causes from mechanistic explanations for disease in some individuals to evolutionary explanations for traits that make all members of a species vulnerable to disease. For instance, capacities for symptoms such as pain, cough, anxiety and low mood are universal because they are useful in certain situations. Failing to recognize the utility of anxiety and low mood is at the root of many problems in psychiatry. Determining if an emotion is normal and if it is useful requires understanding an individual's life situation. Conducting a review of social systems, parallel to the review of systems in the rest of medicine, can help achieve that understanding. Coping with substance abuse is advanced by acknowledging how substances available in modern environments hijack chemically mediated learning mechanisms. Understanding why eating spirals out of control in modern environments is aided by recognizing the motivations for caloric restriction and how it arouses famine protection mechanisms that induce binge eating. Finally, explaining the persistence of alleles that cause serious mental disorders requires evolutionary explanations of why some systems are intrinsically vulnerable to failure. The thrill of finding functions for apparent diseases is evolutionary psychiatry's greatest strength and weakness. Recognizing bad feelings as evolved adaptations corrects psychiatry's pervasive mistake of viewing all symptoms as if they were disease manifestations. However, viewing diseases such as panic disorder, melancholia and schizophrenia as if they are adaptations is an equally serious mistake in evolutionary psychiatry. Progress will come from framing and testing specific hypotheses about why natural selection left us vulnerable to mental disorders. The efforts of many people over many years will be needed before we will know if evolutionary biology can provide a new paradigm for understanding and treating mental disorders.

Analysis on the causes of cracking and excessive deflection of long span box girder bridges based on space frame lattice models

Long-span prestressed concrete box girder bridges (continuous girder and rigid frame bridges) tend to have some apparent diseases. On the one hand, cracks in various directions appear in different positions of different slabs of the box girder; on the other hand, the deflection of the structure develops for a long time, which significantly exceeds the design expectation eventually. This paper intends to use the space frame lattice model, combined with the complete stress index system, to analyze the causes of cracks in different forms in an actual bridge. Unlike the single beam model and the transverse frame model under the guidance of the existing code system, the space frame lattice model that discretizes an entire box girder section into individual slabs can more precisely simulate the load that exceeds the code but exists. In addition, the complete stress index system enriches the design of box girder bridges and can well explain the cracking causes of old bridges. This paper also discusses the effect of the difference in creep and shrinkage caused by the difference in thickness among slabs on the deflection.

Intensive reduction of high normal blood pressures: PRINT-TAHA9 randomized clinical trial

Abstract Background Currently, the best treatment strategy for patients with (Prehypertension) a high normal blood pressure (130 mmHg &amp;lt; systolic blood pressure [SBP]&amp;lt;140 mmHg) is controversial. While the ESC guideline does not recommend treating high normal blood pressure, the ACC/AHA recommends pharmacological treatments in these patients if the 10-year ASCVD risk is above 10%. Purpose We aimed to determine whether pharmacological reduction of SBP to a normal level (&amp;lt;120mmHg) would prevent cardiac morbidity and mortality in patients with high normal blood pressure levels. Methods We randomly assigned 466 persons with high normal blood pressure (130 mmHg &amp;lt; SBP&amp;lt;140 mmHg and a DBP&amp;lt;90 mm Hg) and an increased cardiovascular risk (10-year ASCVD risk ≥7.5%), but without diabetes, and apparent clinical cardiovascular diseases to standard treatment (n=235) which consisted of clinical follow up till SBP goes above 140 mmHg and then staring medications to keep SBP&amp;lt;140 mmHg or to the intensive treatment (n=231) receiving pharmacological SBP reduction to &amp;lt;120 mmHg upon enrollment. The primary composite outcome was myocardial infarction, stroke, heart failure, or death. Results Throughout the 1.66 years of follow-up, a primary outcome event was confirmed in 5 participants (0.13% per year) in the intensive-treatment group and 16 (0.39% per year) in the standard-treatment group (hazard ratio (HR), 0.31; 95% confidence interval [CI], 0.11 to 0.85; P=0.024). Rates of serious adverse events were not increased by intensive-treatment (HR, 1.78; 95% CI, 0.68 to 2.03; P=0.57). Conclusion Based on this clinical trial, intensive SBP reduction may probably be beneficial for primary prevention of cardiovascular morbidity and mortality in patients with high normal blood pressure level. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Shiraz University of Medical Sciences

Evaluation the role of CRP, D-dimer and osteopontin as biomarkers in assessing the severity of COVID-19 patients with pre-existing diabetes

COVID-19 is a new coronavirus that has the potential to be deadly. The World Health Organization (WHO) has declared the COVID-19 outbreak to be an international public health emergency. According to new evidence, comorbid diabetes in COVID-19 patients is linked to disease progression and even death. Aim of study is to evaluate the role of serum osteopontin, CRP and D-Dimer activity in the severity of covid19 and possibility of using these biomarker as predictors for mortality of covid19 in diabetic patients. This is a cross sectional, hospital based study. This study was carried out from 1st December 2021 to 30th January 2022 and included 60 Patients admitted to COVID19 isolation centers in Alshefa-14 and Kirkuk general hospital (30 COVID-19 without D.M and 30 COVID-19 with D.M) and 30 control samples. All data were collected through a face-to-face interview by a questionnaire. The current study showed a significant increase in all the measured parameters in patients with positive COVID-19 when compared to control group with no apparent clinical diseases. D-dimer increased in patients by a mean of (3215 ng/l, SD ± 50) when compared to control group (218 ng/L SD ± 27.3) with (p-value &lt;0.05).

Wearable e-textile integrated sensors for detecting hyperkalemia and hypokalemia

Recent evolutions in wearable and personalized healthcare devices have led to the emergence of real-time monitoring of the physiological and metabolic status of human beings. Detection of disorders related to potassium levels including hyperkalemia and hypokalemia is very much challenging in the current scenario. Potassium imbalance leads to massive change in electrical activity of the body especially disturbs the function of the brain, heart, nerves, bone and muscles in hospitalized patients. Potassium loss is a major concern in disorders such as hyperhidrosis and Cystic Fibrosis. Hence the real-time monitoring of potassium levels in the hospitalized patients may provide information related to latent cardiac problems and also assist in the diagnosis of apparent life-threatening diseases. Comprehensively, the real-time monitoring of potassium concentrations may shed light on the electrolyte loss, dehydration status and also the other associated diseases. In this study, the correlation between the electrocardiogram (ECG) signals and the potassium levels can diagnose the potassium imbalance in a non-invasive manner. The novelty of our work is to develop a wearable E-textile integrated sensor for the detection of hyperkalemia and hypokalemia through ECG signal. The main advantage of this product is wearable and portable, and also ensures the patient safety and user friendly particularly for elderly and disabled patients and also for children.

Psychological profiles, quality of life, and parental attitudes in children with Sighing dyspnea.

There are a limited number of studies investigating the relationship of sighing dyspnea (SD) with psychiatric disorders and various mental states. This cross-sectional study enrolled 39 pediatric patients with SD, but free from apparent cardiopulmonary diseases, who presented to a pediatric pulmonology policlinic between June and December 2019 and age-gender matched 34 healthy children were recruited for comparison. Patient characteristics, psychological or physical trauma history, and cigarette smoke exposure were recorded. All the participants completed the "NOSE scale," "Modified Borg Scale," "Children Depression Inventory," "Screen for Child Anxiety Related Disorders," "Pediatric Quality of Life Inventory," "Stress Coping Style Scale," "Family Assessment Device," and "Parents Attitude Scale." Compared to the control group, there was a statistically significantly higher rate in the SD group of physical or psychological trauma history (35.9% vs. 14.7%, p = .04) and passive cigarette smoking (60.5% vs.27.3%, p = .005). When the groups were compared in respect of depression and anxiety levels, the depression score, total anxiety level, somatic/panic, generalized anxiety and fear of school points were determined to be statistically significantly higher in the SD group. The QoL scores (total, physical, and psychosocial) in the SD group were found to be statistically significantly lower than those of the control group. To the best of our knowledge, this is the first study to have examined the psychological profiles of SD patients and their families in detail, and to have evaluated the effect of SD on quality of life.

An Unsupervised Tunnel Damage Identification Method Based on Convolutional Variational Auto-Encoder and Wavelet Packet Analysis.

Finding a low-cost and highly efficient method for identifying subway tunnel damage can greatly reduce catastrophic accidents. At present, tunnel health monitoring is mainly based on the observation of apparent diseases and vibration monitoring, which is combined with a manual inspection to perceive the tunnel health status. However, these methods have disadvantages such as high cost, short working time, and low identification efficiency. Thus, in this study, a tunnel damage identification algorithm based on the vibration response of in-service train and WPE-CVAE is proposed, which can automatically identify tunnel damage and give the damage location. The method is an unsupervised novelty detection that requires only sufficient normal data on healthy structure for training. This study introduces the theory and implementation process of this method in detail. Through laboratory model tests, the damage of the void behind the tunnel wall is designed to verify the performance of the algorithm. In the test case, the proposed method achieves the damage identification performance with a 96.25% recall rate, 86.75% hit rate, and 91.5% accuracy. Furthermore, compared with the other unsupervised methods, the method performance and noise immunity are better than others, so it has a certain practical value.

COVID-19 vaccination triggered autoimmune hepatitis

Background and Aim: Autoimmune phenomena and clinically apparent autoimmune diseases, including autoimmune hepatitis, are increasingly been reported not only after natural infection with the SARS-CoV-2 virus, but also after vaccination against it. We report the case of a 53-year-old woman with diabetes mellitus on oral hypoglycemic drugs and who developed severe autoimmune hepatitis (with typical features including strongly positive anti mitochonial antibody and severely elevated immunoglobulins G, positive ANA as well as typical histological findings) following SARS-CoV-2 vaccination (ChAdOx nCoV- 19 Corona Virus recombinant (CoviShield) Vaccine).

Exercise Effects on Bone Mineral Density in Men.

In contrast to postmenopausal women, evidence for a favorable effect of exercise on Bone Mineral Density (BMD) is still limited for men. This might be due to the paucity of studies, but also to the great variety of participants and study characteristics that may dilute study results. The aim of the present systematic review and meta-analysis was to evaluate the effect of exercise on BMD changes with rational eligibility criteria. A comprehensive search of six electronic databases up to 15 March 2021 was conducted. Briefly, controlled trials ≥6 months that determined changes in areal BMD in men >18 years old, with no apparent diseases or pharmacological therapy that relevantly affect bone metabolism, were included. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) and femoral neck (FN) were considered as outcomes. Twelve studies with 16 exercise and 12 control groups were identified. The pooled estimate of random-effect analysis was SMD = 0.38, 95%-CI: 0.14–0.61 and SMD = 0.25, 95%-CI: 0.00–0.49, for LS and FN, respectively. Heterogeneity between the trials was low–moderate. Funnel plots and rank and regression correlation tests indicate evidence for small study publication bias for LS but not FN-BMD. Subgroup analyses that focus on study length, type of exercise and methodologic quality revealed no significant difference between each of the three categories. In summary, we provided further evidence for a low but significant effect of exercise on BMD in men. However, we are currently unable to give even rough exercise recommendations for male cohorts.

ГЕНЕТИЧЕСКАЯ ЭПИДЕМИОЛОГИЯ НАСЛЕДСТВЕННОЙ ПРЕДРАСПОЛОЖЕННОСТИ К КЕРАТОКОНУСУ

The survey of the literature devoted to genetic epidemiology of keratoconus and also principles of genetic markers search showed predisposition to this disease suitable for screening test in the course of genetic certification of the population. It was revealed that hereditary predisposition to keratokonus was caused by gene mutations, encoding cellular cycle and metabolism of the keratocytes regulating the activity of tissue proteolytic enzymes, and also mechanisms of natural detoxification. Genes associated with keratoconus are characterized by allelic variation and multiple mutations taking different degrees of association with clinically apparent diseases. It was discovered that genotypes of people from different geographic regions can differ in terms of signs and markers showing predisposition to the disease.

Acute autoimmune-like hepatitis with atypical anti-mitochondrial antibody after mRNA COVID-19 vaccination: A novel clinical entity?

Autoimmune phenomena and clinically apparent autoimmune diseases, including autoimmune hepatitis, are increasingly been reported not only after natural infection with the SARS-CoV-2 virus, but also after vaccination against it. We report the case of a 63-year old man without a history of autoimmunity or SARS-CoV-2 natural infection who experienced acute severe autoimmune-like hepatitis seven days after the first dose of the mRNA-1273 SARS-CoV-2 vaccine. Liver histology showed inflammatory portal infiltrate with interface hepatitis, lobular and centrilobular inflammation with centrilobular necrosis, in absence of fibrosis and steatosis. Serum immunoglobulin G was slightly elevated. Autoimmune liver serology showed an indirect immunofluorescence pattern on triple rodent tissue compatible with anti-mitochondrial antibody (AMA), but, unexpectedly, this pattern was not mirrored by positivity for primary biliary cholangitis (PBC)-specific molecular tests, indicating that this antibody is different from classical AMA. Anti-nuclear antibody (ANA) was also positive with a rim-like indirect immunofluorescence pattern on liver and HEp2 cell substrates, similar to PBC-specific ANA; however, anti-gp210 and a large panel of molecular-based assays for nuclear antigens were negative, suggesting a unique ANA in our patient. He carries the HLA DRB1*11:01 allele, which is protective against PBC. Response to prednisone treatment was satisfactory. The clinical significance of these novel specificities needs to be further evaluated in this emerging condition.

The experimental infection with a field isolate of the infectious bronchitis virus from eastern Saudi Arabia resulted in seroconversion of the challenged birds with no apparent clinical diseases.

The infectious bronchitis virus (IBV) is still one of the major respiratory viral pathogens of chickens. The IBV infection resulted in a wide range of clinical syndromes in the affected chickens, including respiratory, renal, gonads affections as well as generalized infections. Despite the intensive application of various commercial vaccines against the virus, many outbreaks are still reported in chickens worldwide. Several studies reported the circulation of several strains and genotypes of the IBV in eastern Saudi Arabia. The main goal of the current study was to isolate some of the circulating strains of IBV and assess its ability to reproduce the IBV infections in the challenge birds. Another objective was to monitor the immune status of the infected chickens during the course of this study. To achieve these goals, we used some filed IBV isolates retrieved from an outbreak in a broiler chicken farm in eastern Saudi Arabia in 2014. A total of 220-day-old chickens (110 Ross and 110 native Saudi breed chickens), twenty birds per each group, were used in this study. The chickens in some groups received some IBV vaccines on day one of the experiment, and some are boosted on day 19. All birds were challenged on day 28 of the experiment. Our results showed mild IBV signs in the non-vaccinated control group of chickens; however, the vaccinated chickens did not show any signs of IBV infections. Meanwhile, both the vaccinated and the none- vaccinated birds seroconverted to the IBV as shown by the ELISA results. In conclusion, the response of the IBV infected birds is mainly driven by the vaccination plans they received as a prime-boost regime. Further studies are required for a better understanding of the dynamics of IBV infection in native Saudi chickens.

POS-589 HYPOTHALAMIC PITUITARY AXIS DISORDERS IN HEMODIALYSIS PATIENTS: AN ANALYSIS OF 15 CASES.

Hypothalamic pituitary axis disorders are still underestimated in hemodialysis patients. Even though commonly not associated with apparent diseases, they can induce or worsen many complications. The aim of this study was to investigate basic endocrinological disorders among patients with recent deterioration of general condition or hemodynamic disorders. We investigated the endocrine profile of hemodialysis patients with recently exacerbated acute complications, including severe weakness, acute hypotension, severe hypoglycemia and/or the onset of chronic hypotension with no cardiac dysfunction. We analyzed the blood levels of the thyroid-stimulating hormone (TSH), the adrenocorticotropin hormone (ACTH), the growth hormone (GH), the follicle stimulating hormone (FSH), the luteinizing hormone (LH), the prolactin and sexual hormones each time we found a gonadotrophic disorder. Over the 47 patients of our hemodialysis unit, we colligated 15 patients with new symptomatology corresponding to the signs mentionned above. There were 7 males and 8 females, with sex ratio 0,87. Age ranged from 22 to 68 years with an average of 46,5 years. Underlying renal disease consists on an end-stage undetermined glomerulonephritis in 5 cases, membranous glomerulonephritis in one case, Alport syndrome in one case, nephroangiosclerosis in one case, diabetic nephropathy in 2 cases, and tubulointerstitial nephritis in 5 cases. Hemodialysis was carried on for all patients with an average of 152,75 months [55-351months], three times a week, four hours each session, with blood pump flow at 300ml/min and dialysate fluid flow at 500ml/min. Eleven patients were dialysate with high flux membrane, four with medium flux membrane. Symptoms at time of the endocrine check were: severe hypoglycemia in 3 cases, chronic hypotension in 7cases, severe weakness in 8 cases.The mean hormones levels and intervals are summarized in figure1.We noticed peripheric hypothyroidism in 3 patients, moderate hyperprolactinemia in 7 cases, hypergonatrophic hypogonadism in3 cases and hypogonadotrophic hypogonadism in 2 cases. One patient presents an anterior pituitary deficiency with three axes affected (hypogonadotrophic hypogonadism, central adrenal deficiency and central hypothyroidism). All abnormalities found were treated with replacement hormonal therapy. We noticed an improvement in the initial symptomatology in all cases. As kidney function declines, sexual hormones, the hypothalamic–pituitary axis, and the thyroid frequently function aberrantly. The pathogenesis of those disorders is multifactorial, with extrinsic and intrinsic factors. Their screening in hemodialysis patients must be early because of the added risk of many complications’ occurrence. Their management requires multidisciplinary approach.