Biological Markers Of Inflammation Research Articles

Loneliness Gets Under the Skin: A Scoping Review Exploring the Link Between Loneliness and Biological Measures of Inflammation.

Research suggests that systemic inflammation may link loneliness to adverse health outcomes, yet there is a gap in comprehensively reviewing recent evidence on the relationship between loneliness and biological measures of inflammation in adults. This scoping review synthesizes current research to address the question: Is there a definitive link between loneliness and biological markers of inflammation in adults? Following the methods outlined by Arksey and O'Malley, we developed a protocol, defined our research question, and systematically searched PubMed, CINAHL, Embase, and Scopus for English-language studies conducted from 2018 to 2023 exploring the relationship between loneliness and biomarkers of inflammation in adults. Twelve studies meeting the inclusion criteria displayed heterogeneity in terms of sample characteristics, loneliness scales, and inflammatory biomarkers. The UCLA Loneliness Scale, in various forms, emerged as the predominant tool for measuring loneliness, while C-reactive protein and interleukin-6 were the most frequently evaluated inflammatory biomarkers. Notably, all 12 studies reported an association between loneliness and at least 1 biological marker of inflammation. Research consistently associates loneliness with poor health outcomes in aging adults, but the underlying mechanisms remain unclear. This scoping review suggests that inflammation may serve as a pathway linking loneliness to adverse health outcomes. However, the variability across studies highlights the need for standardized measurement methods and a consideration of both the duration and extent of loneliness. Enhancing our understanding of how loneliness affects systemic inflammation may help clarify why loneliness is associated with negative health outcomes.

Explaining the Variability of Alzheimer Disease Fluid Biomarker Concentrations in Memory Clinic Patients Without Dementia.

Patients' comorbidities can affect Alzheimer disease (AD) blood biomarker concentrations. Because a limited number of factors have been explored to date, our aim was to assess the proportion of the variance in fluid biomarker levels explained by the clinical features of AD and by a large number of non-AD-related factors. MEMENTO enrolled 2,323 individuals with cognitive complaints or mild cognitive impairment in 26 French memory clinics. Baseline evaluation included clinical and neuropsychological assessments, brain MRI, amyloid-PET, CSF (optional), and blood sampling. Blood biomarker levels were determined using the Simoa-HDX analyzer. We performed linear regression analysis of the clinical features of AD (cognition, AD genetic risk score, and brain atrophy) to model biomarker concentrations. Next, we added covariates among routine biological tests, inflammatory markers, demographic and behavioral determinants, treatments, comorbidities, and preanalytical sample handling in final models using both stepwise selection processes and least absolute shrinkage and selection operator (LASSO). In total, 2,257 participants were included in the analysis (median age 71.7, 61.8% women, 55.2% with high educational levels). For blood biomarkers, the proportion of variance explained by clinical features of AD was 13.7% for neurofilaments (NfL), 11.4% for p181-tau, 3.0% for Aβ-42/40, and 1.4% for total-tau. In final models accounting for non-AD-related factors, the variance was mainly explained by age, routine biological tests, inflammatory markers, and preanalytical sample handling. In CSF, the proportion of variance explained by clinical features of AD was 24.8% for NfL, 22.3% for Aβ-42/40, 19.8% for total-tau, and 17.2% for p181-tau. In contrast to blood biomarkers, the largest proportion of variance was explained by cognition after adjustment for covariates. The covariates that explained the largest proportion of variance were also the most frequently selected with LASSO. The performance of blood biomarkers for predicting A+ and T+ status (PET or CSF) remained unchanged after controlling for drivers of variance. This comprehensive analysis demonstrated that the variance in AD blood biomarker concentrations was mainly explained by age, with minor contributions from cognition, brain atrophy, and genetics, conversely to CSF measures. These results challenge the use of blood biomarkers as isolated stand-alone biomarkers for AD.

Sjögren's Syndrome: A Rare Clinical Entity in Children

Background. Sjögren's syndrome (SS) is a rare autoimmune disease in children, with only a few hundred reported cases. Its clinical presentation is atypical. We report the case of a 14-year-old boy diagnosed with recurrent parotitis.
 Case Presentation. Our patient, a 14-year-old male, presented with a one-year history of recurrent bilateral parotid swellings. Clinical examination revealed an objective oculo-buccal dryness. Ultrasound imaging showed hypoechoic hypertrophy of the parotid glands. Anti-SSA/SSB antibodies were strongly positive. Histological study of the accessory salivary glands revealed lymphocytic sialadenitis with a focus score of 3. The diagnosis of SS was confirmed according to the ACR/EULAR 2016 criteria. The combination of treatment with hydroxychloroquine and corticosteroids resulted in the resolution of clinical signs and biological inflammatory markers.
 Conclusion. Given the rarity of SS in children, several diagnostic and therapeutic difficulties arise, in the absence of classification criteria adapted to the juvenile form of the disease, and the absence of therapeutic recommendations consolidated by clinical trials in children.

The Cytotoxic Effect of Septic Plasma on Healthy RBCs: Is Eryptosis a New Mechanism for Sepsis?

Sepsis is a life-threatening multiple-organ dysfunction induced by infection and is one of the leading causes of mortality and critical illness worldwide. The pathogenesis of sepsis involves the alteration of several biochemical pathways such as immune response, coagulation, dysfunction of endothelium and tissue damage through cellular death and/or apoptosis. Recently, in vitro and in vivo studies reported changes in the morphology and in the shape of human red blood cells (RBCs) causing erythrocyte death (eryptosis) during sepsis. Characteristics of eryptosis include cell shrinkage, membrane blebbing, and surface exposure to phosphatidylserine (PS), which attract macrophages. The aim of this study was to evaluate the in vitro induction of eryptosis on healthy RBCs exposed to septic plasma at different time points. Furthermore, we preliminary investigated the in vivo levels of eryptosis in septic patients and its relationship with Endotoxin Activity Assay (EAA), mortality and other biological markers of inflammation and oxidative stress. We enrolled 16 septic patients and 16 healthy subjects (no systemic inflammation in the last 3 months) as a control group. At diagnosis, we measured Interleukin-6 (IL-6) and Myeloperoxidase (MPO). For in vitro study, healthy RBCs were exposed to the plasma of septic patients and CTR for 15 min, 1, 2, 4 and 24 h. Morphological markers of death and eryptosis were evaluated by flow cytometric analyses. The cytotoxic effect of septic plasma on RBCs was studied in vitro at 15 min, 1, 2, 4 and 24 h. Healthy RBCs incubated with plasma from septic patients went through significant morphological changes and eryptosis compared to those exposed to plasma from the control group at all time points (all, p < 0.001). IL-6 and MPO levels were significantly higher in septic patients than in controls (both, p < 0.001). The percentage of AnnexinV-binding RBCs was significantly higher in septic patients with EAA level ≥0.60 (positive EAA: 32.4%, IQR 27.6-36.2) compared to septic patients with EAA level <0.60 (negative EAA: 14.7%, IQR 5.7-30.7) (p = 0.04). Significant correlations were observed between eryptosis and EAA levels (Spearman rho2 = 0.50, p < 0.05), IL-6 (Spearman rho2 = 0.61, p < 0.05) and MPO (Spearman rho2 = 0.70, p < 0.05). In conclusion, we observed a quick and great cytotoxic effect of septic plasma on healthy RBCs and a strong correlation with other biomarkers of severity of sepsis. Based on these results, we confirmed the pathological role of eryptosis in sepsis and we hypothesized its use as a biomarker of sepsis, potentially helping physicians to face important treatment decisions.

E41 PAPA Syndrome: response to methotrexate in four members of the same family

Abstract Introduction PAPA syndrome (Pyogenic Arthritis, Pyoderma gangrenosum and Acne) is a rare autosomal dominant disease that mainly affects the joints and skin. It is linked to a mutation of a gene of a protein named PSTPIP1 located on chromosome 15q. Arthritis is destructive, oligoarticular and predominantly affects large joints. It usually begins during childhood and not responsive to most treatments. The diagnosis is late and arises with infectious arthritis, given the destructive and pyogenic nature of arthritis and biological inflammatory syndrome. Aim We describe the cases of four members of the same family affected by PAPA syndrome who were treated empirically with long-term corticosteroids and then methotrexate to improve their joint involvement. Case reports We report the cases of 4 male patients belonging to the same large family (3 brothers and a first cousin), aged 28, 23, 21 and 15 years (patients 1–4, classified by age), affected by PAPA syndrome who presented with recurrent osteoarticular infections treated with antibiotics. They have no other conditions except vitiligo in patient 1 and Down syndrome in patient 3. Diagnosis was made in patient 1 based on joint and skin involvement. Other family members were subsequently called for diagnostic evaluation. A treatment combining methotrexate (10–15 mg/week) and corticosteroids (5 mg/day of prednisolone weaned and discontinued after 6–12 months of initiation) was associated with clinical and biological response in all patients with a decrease in pain, clinical and ultrasound improvement of synovitis and normalization of biological inflammatory markers in all four cases. Methotrexate was well tolerated and maintained as monotherapy, associated with on demand NSAIDs. The current average follow-up is 2.3 years. Conclusion Through our observations, we report a possible beneficial effect and good tolerance of methotrexate on joint involvement in PAPA syndrome. A more rigorous study (larger sample size, control arm) is necessary to validate this treatment.

Ambulatory Management of Urinary Tract Infections in Children: Experience of the Pediatric Medical Emergency Department in Rabat

The aim of the study is to describe the clinical epidemiological characteristics and bacteriological profile of UTIs in infants and children, to determine the main risk factors for the occurrence of UTIs, and to identify the causes of UTIs urinary tract infections, to compare the interest of CRP and let procalcitonin assays for the diagnosis of febrile urinary tract infections as well as the interest of imaging (renal scintigraphy and ultrasound of the urinary tree) in the diagnosis of febrile urinary tract infections. This observational study of a cohort of 169 patients (children aged more than 28 days, 119 girls and 40 boys) conducted in the pediatric emergency department of the children's hospital of the university hospital of Rabat over a period of 6 months. The diagnosis of UTIs is based on the detection of germs in the urine, either indirectly by urine dipstick or by urine culture. However, the interpretation of microbiological results can be tricky: an inappropriate urine collection technique, particularly in neonates and young children, is a pitfall that the clinician must take into account to avoid misdiagnosing UTI, usually by over-diagnosis. The location of high UTI involving the renal parenchyma or low UTI limited to the bladder, which determines the morbidity of the infection, the therapeutic management and the imaging work-up, remains a matter of debate. DMSA renal scintigraphy, the reference examination in the case of high UTI, cannot be recommended as a first-line examination because of its cost and the practical difficulties of performing it. Biological markers of inflammation (leucocytosis, CRP, procalcitonin) do not always allow the diagnosis of ANP to be made with certainty.

Abstract P4-07-52: Caloric Restriction for Oncology Research (CaReFOR): Assessing dietary adherence and outcomes in African American patients during breast cancer treatment

Abstract Purpose: Epidemiologic and clinical evidence have shown an association between obesity and increased risk for breast cancer (BC) incidence and mortality. Data from human and animal studies support a potential role for weight loss in counteracting tumor-promoting properties of obesity in BC. However, dietary intervention clinical trials often show low patient adherence, especially among African American (AA) women compared to Caucasian (CC) women. They also show that AA women are disproportionately obese and lose less weight during behavior lifestyle interventions compared to CC with similar risk factors. We evaluated the efficacy and feasibility of a 10-week caloric restricted diet in patients undergoing radiation and have performed analysis to determine if adherence to dietary alterations is feasible in underrepresented patients. Methods: In an IRB approved clinical trial, we determined the feasibility and toxicity of dietary intervention during radiation in breast cancer patients 18 years and older who were undergoing breast conservation therapy with T1-2N0 cancers. The dietary intervention consisted of caloric intake reduction of 25% from baseline for a total of 10 weeks during their six-week radiation treatment which was administered to the whole breast to a dose of 50Gy with a 10Gy boost to the tumor bed. To optimize adherence to caloric restriction (CR), patients received personalized counseling, maintained food diaries, and were educated on behavioral modifications at weekly visits. To characterize the effects of CR, baseline physiologic and blood parameters were collected and compared with post intervention measurements and samples. Biometric and biological data collected during the study comparing compliant participants before and after the CaReFOR intervention was stratified by race and analyzed via two-sample paired t-test. The difference between AA and CC study participants was determined to be significant if the calculated p-value was less than &amp;lt; 0.05 (CI 95%). Results: A total of 32 female patients were enrolled in the CaReFOR trial, 16 were AA and 16 were CC. Participant demographics were similar across age, primary tumor size (pT), nuclear grade, and hormone receptor status. Evaluation of patients’ baseline diet demonstrated similar macronutrients across races, with AA showing less fruit/vegetable and grains. AA patients were more overweight compared to their CC counterparts. They also showed a more inflamed state compared to CC patients. The baseline inflammatory biomarker levels for ESR and cholesterol were significantly higher while adiponectin was significantly lower in AA than that of CC patients. The trends for insulin, HbA1c, and leptin were also higher for AA compared to CC. Following the 10-week diet, AA patients (87.3%) were more compliant than CC’s (81.3%). Both AA and CC patients lost weight during the trial, with AA having a significant loss in body fat and gain in muscle mass compared to CC. Similarly, after completing the CR diet, biological inflammatory markers improved in AA and CC patients. Particularly, in AA, there was a significant decrease in cholesterol levels, while insulin, leptin, and ESR serum levels trended downwards, suggesting a decreased inflammatory state. Conclusions: Contrary to published studies, we found AA patients are successful in adhering to dietary alterations and have a benefit with respect to physiologic and biologic parameters. Our dietary intervention was able to positively affect our AA patients adverse baseline factors such as obesity and inflammation. Future studies should consider dietary alterations as a possible means to decrease AA patient disparate outcomes in breast cancer. Citation Format: Siani Harding, Adeseye Adekeye, Edith P. Mitchell, Nicole Simone. Caloric Restriction for Oncology Research (CaReFOR): Assessing dietary adherence and outcomes in African American patients during breast cancer treatment. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-52.

Relation between Orotracheal Intubation, Inflammatory Markers, Breathing and Voice in Post-COVID-19

COVID-19, an infectious disease with a wide spectrum of clinical manifestations and intensities in the human body, it can cause respiratory and vocal disorders, with fatigue. To verify the relation between biological Inflammatory markers D-dimers and C-Reactive Protein, Forced Vital Capacity, Maximum Phonation Time, vocal performance and fatigue, length of hospitalization period and gender of people affected by COVID-19 who were hospitalized, but did not use orotracheal intubation and compare with a group of post-COVID-19 patients with orotracheal intubation. Data on D-dimers and C-Reactive Protein, spirometry, Maximum Phonation Time, performance and vocal fatigue were collected. The study included 42 adult people affected by COVID-19 who were hospitalized, 22 (52.4%) female and 20 (47.6%) male; 23 (54.8%) critical cases composing the group with orotracheal intubation (average age 48.9 years old) and 19 (45.24%) severe cases in the group without orotracheal intubation (average age 49.9 years old). hospital length of stay was significantly longer for the group with orotracheal intubation; D-dimers were significantly altered in all groups; correlations between maximum phonation times were positive and significant; correlations between maximum phonation times, vocal performance and fatigue were both negative and significant. Patients with orotracheal intubation had longer hospital internment and increased D-dimers and were amazed that, whenever maximum phonation times decreased performance and vocal fatigue increased.

Clustering Patients With Gout Based on Comorbidities and Biomarkers: A Cross-Sectional Study.

This single-center clinical study identifies clusters of different phenotypes and pathophysiology subtypes of patients with gout and associated comorbidities. Patients clinically diagnosed with gout were enrolled between January 2018 and December 2019. Hierarchical cluster analyses were performed using clinical data or biological markers, inflammatory markers, and oxidative stress pathway metabolites assayed from serum and plasma samples. Subgroup clusters were compared using ANOVA for continuous data and chi-square tests for categorical data. Hierarchical cluster analysis identified 3 clusters. Cluster 1 (C1; n = 24) comprised dyslipidemia, hypertension, and early-onset gout, without tophi. Cluster 2 (C2; n = 25) comprised hypertension, dyslipidemia, nephrolithiasis, and obesity. Cluster 3 (C3; n = 39) comprised multiple comorbidities and tophi. Post hoc comparisons of data obtained from samples of patients in C1, C2, and C3 revealed significant differences in the levels of oxidative stress and inflammation-related markers, including 3-nitrotyrosine, tumor necrosis factor, C-reactive protein, interleukin (IL) 1β, IL-6, platelet-derived growth factor (PDGF)-AA, and PDGF-BB. Reclustering patients based on all markers as well as on the biological markers that significantly differed among the initial clusters identified similar clusters. Oxidative stress and inflammatory marker levels may affect the development and clinical manifestations (ie, clinical phenotypes) of gout. Measuring oxidative stress and levels of inflammatory cytokines is a potential adjunctive tool and biomarker for early identification and management of gout.

Methylation of genes and regulation of inflammatory processes on emotional response in young adults with alcoholic parents

Many Americans are adult children of an alcoholic parent (ACoA), which can confer an increased risk of trauma and hazardous alcohol use, as well as heritable and environmental genetic influence. Psychological health and related neural activity can be influenced by inflammation responses, but it is not clear how these factors interact regarding risk or resilience to hazardous alcohol use. The goals of this study were to better understand the relationships between current alcohol use and inflammation, how these are modified by single nucleotide polymorphisms (SNPs) and/or epigenetic modifications of inflammation-associated genes; and how these alter neural reactivity to emotionally-salient stimuli. To do so, ACoA participants were dichotomized as resilient (not engaged in hazardous alcohol use) or vulnerable (currently engaged in hazardous alcohol use). Measures of blood-oxygen-level-dependent (BOLD) activity within regions of interest (ROIs), SNPs and DNA methylation of specific inflammation regulatory genes, and biological markers of inflammation were compared between these groups. Vulnerable ACoAs exhibited higher plasma C-reactive protein (CRP) and greater BOLD activity in the right hippocampus and ventral anterior cingulate cortex in response to emotional cues as well as reduced methylation of CRP and glucocorticoid-related genes. Path analysis revealed significant relationships between alcohol use, SNPs, DNA methylation of inflammatory-related genes, CRP levels, and BOLD activity to emotional stimuli. Taken together, these findings suggest a complex association related to hazardous alcohol use in ACoAs that may predict current inflammation and neural reactivity to emotional stimuli. A better understanding of these associations could direct the future of individual treatment options.

Neutrophil to lymphocyte ratio in predicting postoperative complications and prognosis in patients with colorectal cancer.

&lt;br&gt;&lt;b&gt;Introduction:&lt;/b&gt; Biological markers of inflammation are among the main tools for predicting the risk of developing postoperative infectious complications at the preclinical stage. One of these biomarkers is the neutrophil-lymphocyte ratio (NLR), but the insufficient number of studies does not allow judging its value as a marker of infectious complications in colorectal surgery.&lt;/br&gt;&lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; Aim of the study to determine the predictive value of the neutrophil-leukocyte ratio as a predictor of infectious complications after colon surgery.&lt;/br&gt;&lt;br&gt;&lt;b&gt;Methods:&lt;/b&gt; From September 2018 to December 2021, 234 patients were enrolled in the study after colon surgery. The frequency of infectious complications, the differences in the levels of NLR in patients with and without infectious complications were determined.&lt;/br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; One hundred and thirty-seven patients met the criteria of NLR-low, and 97 patients were categorized as NLR-high. The NLR status was significantly correlated with T-stage, perineural invasion, and increased likelihood of complications. Univariate analysis indicated that both low albumin and meeting the criteria for the NLR-high group correlated with an increased occurrence of complications. Multivariate analysis identified NLR-high and low albumin levels as independent predictors for complications.&lt;/br&gt;&lt;br&gt;&lt;b&gt;Conclusion:&lt;/b&gt; The neutrophil-lymphocyte ratio is a reliable predictor in predicting the risk of developing infectious complications in colorectal surgery. In addition, low values of this biomarker are a significant criterion for a safe discharge of patients from hospital. The prevalence and availability of this test makes it easily reproducible in clinical practice.&lt;/br&gt.

Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa: A Call to Action.

Substance use is increasing throughout Africa, with the prevalence of alcohol, tobacco, cannabis, and other substance use varying regionally. Concurrently, sub-Saharan Africa bears the world’s largest HIV burden, with 71% of people living with HIV (PWH) living in Africa. Problematic alcohol, tobacco, and other substance use among PWH is associated with multiple vulnerabilities comprising complex behavioral, physiological, and psychological pathways that include high-risk behaviors (e.g., sexual risk-taking), HIV disease progression, and mental health problems, all of which contribute to nonadherence to antiretroviral therapy. Physiologically, severe substance use disorders are associated with increased levels of biological markers of inflammation; these, in turn, are linked to increased mortality among PWH. The biological mechanisms that underlie the increased risk of substance use among PWH remain unclear. Moreover, the biobehavioral mechanisms by which substance use contributes to adverse health outcomes are understudied in low- and middle-income countries (LMIC). Syndemic approaches to understanding the co-occurrence of substance use and HIV have largely been limited to high-income countries. We propose a syndemic coupling conceptual model to disentangle substance use from vulnerabilities to elucidate underlying disease risk for PWH. This interventionist perspective enables assessment of biobehavioral mechanisms and identifies malleable targets of intervention.

P078 Multi-system inflammatory syndrome associated with SARS-CoV-2 in children: clinical and therapeutic characteristics

BackgroundThe COVID-19 pandemic was associated with the emergence of a new disease resembling the Kawasaki disease (kDa). That was primarily reported in children of western countries strongly affected by SARS-CoV-2. This syndrome was called Pediatric Multi-System Inflammatory Syndrome (PIMS or MIS-C), and has affected thousands of children, adolescents and young adults throughout the world since the alert launched by the National Health Service of the United Kingdom at the end of April 2020. This work is a literature review of data focusing on the clinical and prognostic characteristics of the MIS-C, the links between Covid-19 and MIS-C, and current therapeutic recommendations.Material and methodsWe carried out research of the studies recently published in the electronic bibliographic databases (Google Scholar, PubMed, Science direct, EmConsults, Research Gate, Medline, Cochrane, Trip).Results25 studies were selected, involving 3015 MIS-C patients from different countries (France, United Kingdom, Italy, Germany, Spain, Brazil, Mexico, Chile, United States, India, Pakistan, Iran). Fever and gastrointestinal disorders were the most frequent clinical manifestations, followed by cardiovascular and respiratory symptom. Biological markers of inflammation and SARS-CoV-2 serology were assessed in all studies. Characteristics similar to Kawasaki disease, and toxic shock syndrome were reported in all studies. Complications such as coronary artery aneurysm; cardiac insufficiency, renal insufficiency, respiratory distress were noted as well as a significant rate of admission to intensive care units. Finally, the mortality rate was low in the majority of studies. The treatment adopted in the majority of the studies was an association of intravenous immunoglobulins and corticosteroids.ConclusionAlthough the fact that the exact pathogenesis of MIS-C remains unknown, post-infectious immune deregulation induced by the SARS-CoV-2 virus appears to be the trigger of MIS-C. MIS- C has been described as a new and serious disease entity with multi-organ involvement and a wide range of signs ranging from fever and gastrointestinal symptoms to myocardial damage, shock, and the development of coronary artery aneurysms.KeywordsCOVID-19, Multi-System Inflammatory Syndrome (MIS-C), Kawasaki Disease (kDa), Child

Associations of dietary intake on biological markers of inflammation in children and Adolescents: A systematic review

Associations of dietary intake on biological markers of inflammation in children and Adolescents: A systematic review

Evaluation of the Oxiris Membrane in Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation Support: Study Protocol for a Single Center, Single-Blind, Randomized Controlled Trial.

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is the rescue treatment proposed to patients with refractory cardiogenic shock. The VA-ECMO implantation promotes inflammation and ischemia-reperfusion injuries through the VA-ECMO flow, causing digestive mucosa barrier disrupture and inducing translocation of bacterial wall components—Lipopolysaccharides (LPS) with further inflammation and circulatory impairment. LPS is a well-studied surrogate indicator of bacterial translocation. Oxiris membrane is a promising and well-tolerated device that can specifically remove LPS. The main study aim is to compare the LPS elimination capacity of Oxiris membrane vs. a non-absorbant classical renal replacement (RRT) membrane in patients with cardiogenic shock requiring VA-ECMO.Methods: ECMORIX is a randomized, prospective, single-center, single-blind, parallel-group, controlled study. It compares the treatment with Oxiris membrane vs. the standard continuous renal replacement therapy care in patients with cardiogenic shock support by peripheral VA-ECMO. Forty patients will be enrolled in both treatment groups. The primary endpoint is the value of LPS serum levels after 24 h of treatment. LPS serum levels will be monitored during the first 72 h of treatment, as clinical and cardiac ultrasound parameters, biological markers of inflammation and 30-day mortality.Discussion: Oxiris membrane appears to be beneficial in controlling the VA-ECMO-induced ischemia-reperfusion inflammation by LPS removal. ECMORIX results will be of major importance in the management of severe cases requiring VA-ECMO and will bring pathophysiological insights about the LPS role in this context.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04886180.

Rehabilitation therapy in patients with psoriatic arthritis after SARS-CoV-2 infection

Objectives. We want to present the evolution of a lot of patients, previously diagnosed with psoriatic arthritis, who last spring went through a difficult period due to infection with the new coronavirus. After healing from COVID-19, the patients had returned to the hospital after a period of 4-6 months, to follow a rehabilitation treatment, the majority of the accusations being those related to psoriatic arthritis, with close follow-up of these patients in connection with the treatment applied. Material and methods. The patients were evaluated at hospitalization (biological inflammatory markers like CRP and ESR), pain scale, DAPSA score, PASI and the quality of life score (DLQI and QOL scale), after which they followed different rehabilitation treatments for a period of 21 days. After 3 months of completing this treatment they were re-evaluated. Patients diagnosed with psoriatic arthritis who do not have documentation to suggest SARS-CoV-2 infection (antibodies/ previous RT-PCR positive tests) were not included in the study. Outcomes. There were some significant differences in terms of the initial score at hospitalization and that performed after rehabilitation treatment. Most of the indices performed had lower values at reassessment (pain scale score, DAPSA, PASI, DLQI and even lower values of CRP and ESR), thus resulting in an important step in terms of the beneficial effects of rehabilitation therapy, both for patients with psoriatic arthritis and for post-COVID-19 recovery. The most important change was observed in the score for quality of life. Conclusions. The inclusion of rehabilitation therapy in patients with psoriatic arthritis should be a step that each patient should take. Its effects are long-term, with periods of pain decreasing in frequency and intensity, thus changing the quality of life of these patients. The mental, social and emotional impact of COVID-19 on people who have gone through the disease can be changed in a good way, also following a rehabilitation therapy.

Rehabilitation therapy in patients with psoriatic arthritis after SARS-CoV-2 infection

Objectives. We want to present the evolution of a lot of patients, previously diagnosed with psoriatic arthritis, who last spring went through a difficult period due to infection with the new coronavirus. After healing from COVID-19, the patients had returned to the hospital after a period of 4-6 months, to follow a rehabilitation treatment, the majority of the accusations being those related to psoriatic arthritis, with close follow-up of these patients in connection with the treatment applied. Material and methods. The patients were evaluated at hospitalization (biological inflammatory markers like CRP and ESR), pain scale, DAPSA score, PASI and the quality of life score (DLQI and QOL scale), after which they followed different rehabilitation treatments for a period of 21 days. After 3 months of completing this treatment they were re-evaluated. Patients diagnosed with psoriatic arthritis who do not have documentation to suggest SARS-CoV-2 infection (antibodies/ previous RT-PCR positive tests) were not included in the study. Outcomes. There were some significant differences in terms of the initial score at hospitalization and that performed after rehabilitation treatment. Most of the indices performed had lower values at reassessment (pain scale score, DAPSA, PASI, DLQI and even lower values of CRP and ESR), thus resulting in an important step in terms of the beneficial effects of rehabilitation therapy, both for patients with psoriatic arthritis and for post-COVID-19 recovery. The most important change was observed in the score for quality of life. Conclusions. The inclusion of rehabilitation therapy in patients with psoriatic arthritis should be a step that each patient should take. Its effects are long-term, with periods of pain decreasing in frequency and intensity, thus changing the quality of life of these patients. The mental, social and emotional impact of COVID-19 on people who have gone through the disease can be changed in a good way, also following a rehabilitation therapy.

Lupus Anticoagulant Single Positivity During the Acute Phase of COVID-19 Is Not Associated With Venous Thromboembolism or In-Hospital Mortality.

ObjectiveThe clinical relevance of antiphospholipid antibodies (aPLs) in COVID‐19 is controversial. This study was undertaken to investigate the prevalence and prognostic value of conventional and nonconventional aPLs in patients with COVID‐19.MethodsThis was a multicenter, prospective observational study in a French cohort of patients hospitalized with suspected COVID‐19.ResultsTwo hundred forty‐nine patients were hospitalized with suspected COVID‐19, in whom COVID‐19 was confirmed in 154 and not confirmed in 95. We found a significant increase in lupus anticoagulant (LAC) positivity among patients with COVID‐19 compared to patients without COVID‐19 (60.9% versus 23.7%; P < 0.001), while prevalence of conventional aPLs (IgG and IgM anti–β2‐glycoprotein I and IgG and IgM anticardiolipin isotypes) and nonconventional aPLs (IgA isotype of anticardiolipin, IgA isotype of anti‐β2‐glycoprotein I, IgG and IgM isotypes of anti–phosphatidylserine/prothrombin, and IgG and IgM isotypes of antiprothrombin) was low in both groups. Patients with COVID‐19 who were positive for LAC, as compared to patients with COVID‐19 who were negative for LAC, had higher levels of fibrinogen (median 6.0 gm/liter [interquartile range 5.0–7.0] versus 5.3 gm/liter [interquartile range 4.3–6.4]; P = 0.028) and C‐reactive protein (CRP) (median 115.5 mg/liter [interquartile range 66.0–204.8] versus 91.8 mg/liter [interquartile range 27.0–155.1]; P = 0.019). Univariate analysis did not show any association between LAC positivity and higher risks of venous thromboembolism (VTE) (odds ratio 1.02 [95% confidence interval 0.44–2.43], P = 0.95) or in‐hospital mortality (odds ratio 1.80 [95% confidence interval 0.70–5.05], P = 0.24). With and without adjustment for CRP level, age, and sex, Kaplan‐Meier survival curves according to LAC positivity confirmed the absence of an association with VTE or in‐hospital mortality (unadjusted P = 0.64 and P = 0.26, respectively; adjusted hazard ratio 1.13 [95% confidence interval 0.48–2.60] and 1.80 [95% confidence interval 0.67–5.01], respectively).ConclusionPatients with COVID‐19 have an increased prevalence of LAC positivity associated with biologic markers of inflammation. However, LAC positivity at the time of hospital admission is not associated with VTE risk and/or in‐hospital mortality.

Associations of Dietary Intake on Biological Markers of Inflammation in Children and Adolescents: A Systematic Review

Chronic low-grade inflammation has been implicated in the pathogenesis of co- and multi-morbid conditions to mental health disorders. Diet quality is a potential mechanism of action that can exacerbate or ameliorate low-grade inflammation. After searching multiple databases adhering to PRISMA guidelines, 53 articles were included that measured dietary intake and inflammatory biomarkers in children and adolescents (2-19 yrs). Adequate adherence to healthful dietary patterns, vegetables and fruit, or macro/micro nutrients (fibre or vitamin C, E) are associated with decreased levels of pro-inflammatory biomarkers, mainly c-reactive protein, interleukin-6 and tumour necrosis factor-alpha. Adherence to a Western dietary pattern and intake of added sugars, saturated fatty acids or ultra-processed foods, is associated with higher levels of the same pro-inflammatory biomarkers. This is the first systematic review examining dietary intake and biological markers of inflammation in children and adolescents. A good quality diet (high in vegetables, fruits, wholegrains, fibre and healthy fats) ameliorates low-grade inflammation, and therefore represents a promising therapeutic approach, as well as an important element for disease prevention in both children and adolescents.

Lung Ultrasound Is More Sensitive for Hospitalized Consolidated Pneumonia Diagnosis Compared to CXR in Children.

Background: Pneumonia is the leading cause of death among children; thus, a correct early diagnosis would be ideal. The imagistic diagnosis still uses chest X-ray (CXR), but lung ultrasound (LUS) proves to be reliable for pneumonia diagnosis. The aim of our study was to evaluate the sensitivity and specificity of LUS compared to CXR in consolidated pneumonia. Methods: Children with clinical suspicion of bacterial pneumonia were screened by LUS for pneumonia, followed by CXR. The agreement relation between LUS and CXR regarding the detection of consolidation was evaluated by Cohen’s kappa test. Results: A total of 128 patients with clinical suspicion of pneumonia were evaluated; 74 of them were confirmed by imagery and biological inflammatory markers. The highest frequency of pneumonia was in the 0–3 years age group (37.83%). Statistical estimation of the agreement between LUS and CXR in detection of the consolidation found an almost perfect agreement, with a Cohen’s kappa coefficient of K = 0.89 ± 0.04 SD, p = 0.000. Sensitivity of LUS was superior to CXR in detection of consolidations. Conclusion: Lung ultrasound is a reliable method for the detection of pneumonia consolidation in hospitalized children, with sensitivity and specificity superior to CXR. LUS should be used for rapid and safe evaluation of child pneumonia.