Concomitant Systemic Diseases Research Articles

ANA-positive versus ANA-negative Antiphospholipid Antibody-positive Patients: Results from the APS ACTION Clinical Database and Repository.

This study focused on the prevalence and impact of antinuclear antibodies (ANA) in antiphospholipid antibody (aPL)-positive patients without concomitant systemic autoimmune rheumatic diseases (SARDs). Data from aPL-positive patients with or without Revised Sapporo APS classification criteria were retrieved from the APS ACTION Registry. Patients with concomitant SARDs were excluded. 430 aPL-positive patients were included in the analysis, 56% ANA-positive and 44% negative. ANA positivity was significantly associated with history of hematologic manifestations (persistent autoimmune hemolytic anaemia, thrombocytopenia, leukopenia and/or lymphopenia) (16% of ANA-positive vs 7% of ANA-negative, p= 0.006). Triple aPL-positivity was more frequent in the ANA-positive subgroup (p= 0.02), along with low baseline C3 and C4 levels (p= 0.05 and p= 0.009, respectively), and higher frequency for extractable nuclear antigens (ENA). Among aPL-positive patients with no APS classification, ANA-positive patients showed a higher rate of arthritis (p= 0.006). Among female patients who have experienced at least one pregnancy, 113 were ANA-positive and 96 were ANA-negative; ANA-negative patients had a higher number of pregnancies (p= 0.018), and number of live births (p= 0.014). A wider proportion of ANA-positive patients were treated with hydroxychloroquine (HCQ) (p< 0.001). When we analysed aPL-positive patients with no other SARDs, ANA status was not associated with thrombosis or pregnancy morbidity. Interestingly, ANA-positive patients showed higher rates of systemic autoimmune features, including hematologic manifestations, multiple aPL positivity, lower complement levels, ENA positivity, and joint involvement, and were more often treated with HCQ. Finally, aPL-positive subjects who were ANA-negative had a higher rate of pregnancies and live births.

The association of systemic condition and medications on alveolar bone loss and tooth attrition.

Periodontal disease is caused by subgingival bacteria that adversely affect the host immune system and create and maintain unmitigated inflammation in gingival and periodontal tissues. The condition is also linked to systemic conditions including cardiovascular disease, diabetes, and arthritis. Periodontitis elevates the bacterial load and spreads systemic inflammation through infection and inflammation. The main radiographic sign of periodontitis is marginal bone loss. Risk factors, including medications, smoking, age, and sex, are known to influence periodontal health. However, there is little information about the impact of systemic conditions and medications on tooth wear. The aim of the present study was to assess the association between systemic conditions and medications and radiographic signs of tooth wear and marginal bone loss. This retrospective analysis was conducted on a group of 2,223 consecutive patients who came for dental treatment in the clinics of a large Health Maintenance Organization in Israel. Data available for the study included details of concomitant systemic diseases and medication and full-mouth radiographic surveys. Odds ratio and logistic regression analysis were used to detect associations between systemic conditions and medication, and marginal bone loss and tooth wear. The results indicated an elevated odds ratio for tooth wear associated with age, sex, and smoking across all age groups. Among young patients, those using proton pump inhibitors and psychiatric medications had an elevated risk of tooth wear. Age, smoking, and diabetes conditions were associated with an increased odds ratio for marginal bone loss in all age groups. Psychiatric medications and sex elevated the odds ratio for marginal bone loss only among older patients. The results highlight the significant impact of age, sex, and smoking on tooth wear, and extend these risks to alveolar bone loss when combined with diabetes and psychiatric conditions.

Possible causes of morbidity and adverse outcomes of COVID-19 in vaccinated elderly patients

A prospective randomized observational study was conducted in cohorts of vaccinated and unvaccinated patients hospitalized in one of the Moscow hospitals and diagnozed with COVID-19 in the period from 06.23.2021 to 01.05.2022.The purpose of the study was to identify the epidemiological features of COVID-19 in vaccinated people and to present scientifically based data on the need for vaccination and its importance in stopping the epidemic process.Materials and Methods. The samples were studied in comparison for a number of indicators: age, clinical condition at admission, the presence and number of concomitant systemic chronic diseases as well as disease outcomes.Results. It was proven that the risk of COVID-19 morbidity in vaccinated people decreased by 1.5 times, mortality by 1.5 times, and hospitalization due to the severity of the condition by 3.1 times. The mortality risk among vaccinated patients shifted to older age (76.9 years), while among unvaccinated patients, the mortality risk was higher for older people (73.7 years), which indicates an increase in life expectancy of vaccinated people.

Experience with interleukin-23 inhibitor guselkumab using in patients with severe psoriasis and the impact of the disease on the psycho-emotional background

Psoriasis is a chronic immune-mediated disease that leads not only to damage to the skin and its appendages, but is also associated with concomitant systemic diseases, including damage to the musculoskeletal system, cardiovascular pathologies, kidney disease, metabolic syndrome and changes in the nervous system. Not long ago, a term was introduced to unite psoriasis and concomitant comorbid diseases – psoriatic disease. Recently, special attention has been paid to assessing the psychoemotional state and quality of life of patients with psoriasis who bear the burden of a chronic disease. It is no secret that any skin disease significantly worsens the quality and standard of life of the patient and can lead to social and professional stigma and discrimination, and a number of restrictions. Psoriatic disease is recognized as a multisystem inflammatory disease and a holistic approach to treatment is recommended, focusing on comorbidities, including mental health, psychosocial well-being and quality of life. The Dermatological Life Quality Index (DLQI) is one of the most convenient indices that allows you to assess the severity of the burden of chronic skin diseases, including psoriasis, on a person’s daily activities; a correlation was found between the severity of psoriasis, the presence of concomitant diseases, especially psoriatic arthritis and the DLQI level. DLQI is higher in patients with moderate to severe psoriasis, in patients with mild psoriasis (low PASI index), but with damage to socially significant areas of the skin (face, hands and feet, scalp, genitals, nail plates), in patients with active manifestations of psoriatic disease in the form of concomitant diseases, which complicates the choice of drug for treatment. The availability, effectiveness, and treatment regimens of modern drugs play an important role in the psycho-emotional state of patients. Today the biological drugs have been actively used in the treatment of psoriasis, which have a number of advantages compared to drugs of basic anti-inflammatory therapy and phototherapy, and, accordingly, are more effective and are of value for patients who experience emotional discomfort from a chronic skin disease in everyday life. The purpose of this article was to study the prevalence and nature of mental and psychiatric pathologies in patients with psoriasis, the possible improvement of DLQI in patients with psoriasis using a biological drug from the group of interleukin-23 inhibitors guselkumab.

Wolf–Parkinson–White Syndrome: Diagnosis, Risk Assessment, and Therapy—An Update

Wolf–Parkinson–White (WPW) syndrome is a disorder characterized by the presence of at least one accessory pathway (AP) that can predispose people to atrial/ventricular tachyarrhythmias and even sudden cardiac death. It is the second most common cause of paroxysmal supraventricular tachycardia in most parts of the world, affecting about 0.1–0.3% of the general population. Most patients with WPW syndrome have normal anatomy, but it may be associated with concomitant congenital heart disease or systemic diseases. Although many individuals are asymptomatic, during supraventricular arrhythmia episodes, they may experience severe symptoms, including syncope or even sudden cardiac death (mainly due to pre-excited atrial fibrillation over rapidly conducting AP). In addition to arrhythmia-related symptoms, for some specific locations of the APs with overt anterograde conduction, there might be a reduction in exercise capacity mediated by a reduction in LV systolic performance due to anomalous LV depolarization. Although it is typically diagnosed through electrocardiography (ECG), additional tests are necessary for risk assessment. Management of WPW syndrome may be quite challenging and can vary from only acknowledging the presence of the accessory pathway to pharmacological treatment or radiofrequency ablation. Early diagnosis, risk assessment, and appropriate treatment are critical steps in the management of WPW syndrome, aiming to improve the quality of life and reduce the risk of life-threatening arrhythmias.

Rationale for Vaccination against COVID-19 among Elderly and Senile People with Comorbid Conditions

Relevance. COVID-19 vaccination reduces mortality and the course of severe diseases. However, there is an insufficiency of studies evaluating factors leading to infection among COVID-19 vaccinated individuals.Aim. Identification of epidemiological features that distinguish cases of the disease in vaccinated and unvaccinated cohorts.Materials and methods. The analysis of the incidence of COVID-19 in 1126 hospitalized patients in the period from 23.06.2021 to 01.05.2022 was carried out taking into account the presence or absence of vaccination against the SARS-CoV-2 virus.Results. It was found that the risk of COVID-19 getting sick in the unimmunized was 1.5 times higher than in the vaccinated (p &lt; 0.05). The incidence of hospitalization, due to the severity of the condition (moderate, severe and extremely severe), in unvaccinated people with no history of comorbidities, is more than 3 times higher than in vaccinated people (p &lt; 0.05) in the same group. The probability of death from COVID-19 among vaccinated people is 1.5 times lower than among unimmunized people (p &lt; 0.05). The age characteristic of mortality in vaccinated people shifts to the «senile» age (76.93 ± 1.32), while among the unimmunized, the age of death is closer to the category of «elderly» (73.74 ± 1.39 years) (p ≤ 0.05). In the structure of mortality among the vaccinated, the main share was made up of patients with a history of 3 to 7 concomitant systemic diseases (66.7%), while among the unvaccinated, the main share (74.5%) were patients either without comorbidities or with a history of 1 to 2 concomitant diseases.Conclusion. The results of the epidemiological features of the COVID-2 epidemic process have shown that vaccination against the SARS-CoV-2 virus is vital for elderly and senile people with comorbid conditions.

Нейросаркоидозɸ — клинико-диагностические аспекты. Лечение пациента с нейросаркоидозом: клинический случай

INTRODUCTION. The complexity of neurosarcoidosis is due to the wide variety of clinical manifestations and variability of signs of concomitant systemic diseases. AIM. To analyze literature data on diagnostic features, clinical manifestations of neurosarcoidosis, and our experience in treating a patient with neurosarcoidosis. MATERIAL AND METHODS. A literature analysis was performed for the period from 2012–2024 28 literary sources (PubMed database) were analyzed, on the basis of which a description of the clinical manifestations and diagnostic methods of neurosarcoidosis was made. Data on the main approaches to the differential diagnosis of the disease are presented, neurological manifestations, imaging results, manifestations of spinal lesions and meningeal lesions in neurosarcoidosis are described in detail. A clinical case is presented.RESULTS AND DISCUSSION. Based on current clinic al guidelines, to diagnose neurosarcoidosis, a patient must have appropriate clinical neurological manifestations and rule out other causes. The results of the biopsy reveal the presence of signs of granulomatous inflammation, and an accurate diagnosis of neurosarcoidosis is made. Key symptoms of neurosarcoidosis in all cases include the presence of infections (tuberculosis, fungal), autoimmune diseases (vasculitis, IgG4-related diseases), lymphoma. Because neurosarcoidosis can affect any part of the nervous system, it is necessary to attempt to establish a unique differential diagnosis tailored to the clinical picture. There are no serum markers that can clearly distinguish sarcoidosis from its mimicking manifestations. Neuroimaging remains an important tool in the diagnosis of sarcoidosis. Contrast-enhanced magnetic resonance imaging is the imaging modality of choice for neurosarcoidosis because it can detect enhancement consistent with active inflammation. CASE PRESENTATION. A clinical case of neurosarcoidosis is presented: a 30-year-old man who was hospitalized with suspected intracerebral hemorrhage. Previously, there were episodes of clouding of consciousness with elements of aggressive behavior, hallucinations, and memory loss. Sarcoidosis of the lungs and skin was diagnosed about 3 months ago. Computed tomography revealed signs of stage 2 pulmonary sarcoidosis. According to the results of contrast-enhanced magnetic resonance imaging of the brain with contrast in the right temporal, frontal lobes, and in the insular lobe on the left, areas of increased T2flair signal were identified, up to 16 mm of subcortical localization, without signs of true limitation of the diffusion of water molecules. After administration of a contrast agent, leptomeningeal contrast was noted in both hemispheres of the brain and cerebellum — a probable manifestation of neuroinfection. CONCLUSION. The presented clinical example confirms a wide range of manifestations of neurosarcoidosis, for effective differential diagnosis of which it is advisable to use instrumental and laboratory diagnostic methods along with a thorough physical and neurological examination and an in-depth study of the patient’s medical history. KEYWORDS: sarcoidosis, neurosacoidosis, central nervous system, differential diagnosis, neuroimaging, autoimmune diseases

The use of calprotectin and other inflammatory parameters in the investigation of pseudoexfoliation syndrome concomitant glaucoma and systemic diseases.

The present study aimed to investigate the value of calprotectin and other inflammatory parameters in patients with glaucoma and systemic diseases accompanying pseudoexfoliation syndrome (PEX-S). This prospective study included 45 PEX-S patients and 45 non-PEX control patients. Patients were investigated for the presence of glaucoma, cardiovascular disease (CVD), ischemic brain disease (IBD), Alzheimer's disease, and neurosensory hearing loss (NSHL). After excluding diseases that may affect inflammatory parameters, a detailed biomicroscopic examination, and blood tests were performed for the patients. Glaucoma, CVD, NVK, Alzheimer's disease, and NSHL were high in the PEX-S group ( P = 0.01, P = 0.01, P = 0.04, P = 0.04, and P = 0.03, respectively). Calprotectin, ferritin, neutrophil-to-platelet ratio, and lymphocyte-to-platelet ratio were found to be high in the PEX-S group ( P < 0.01, P = 0.04, P < 0.01, and P < 0.01, respectively). On evaluating the relationship between PEX-S and glaucoma and systemic diseases, it was found that elevated calprotectin increased the risk of glaucoma by 4.36 times and elevated neutrophil-to-lymphocyte ratio (NLR) increased the risk of CVD by 3.23 times in PEX-S patients ( P = 0.02 and P = 0.03, respectively). This study demonstrated the value of calprotectin elevation in detecting concomitant glaucoma in PEX-S patients and, in addition, the value of NLR elevation in detecting concomitant CVD.

Clinical characterization of patients with HLA-B27-associated uveitis and evaluation of the impact of systemic treatment on the recurrence rate: a cross-sectional study

IntroductionDespite HLA-B27-associated uveitis is one of the most frequent etiologies of uveitis worldwide, there are scarce studies on the clinical spectrum of this disease and the implications of therapeutic strategies used in the Latin-American population, with none conducted in Colombia. Thus, this study aimed to describe the clinical characteristics of a cohort of patients with positive HLA-B27-associated uveitis in Colombia and evaluate the impact of systemic treatment on the recurrence rate.MethodsWe retrospectively reviewed 490 clinical charts of patients with uveitis, searching for those with positive HLA-B27-associated uveitis over eight years in a referral center in Bogotá, Colombia. We used descriptive statistics to summarize demographic and clinical characteristics and conducted a Chi-square test, Fisher Exact test, Spearman correlation, and Mann–Whitney test to assess associations between treatment strategies and the recurrences rate.ResultsWe analyzed 39 patients (59% females) with positive HLA-B27-associated uveitis, with a median age at the first consultation of 44.5 years (Range: 2–80) and a mean follow-up time of 86.4 weeks (1.65 years). Most patients had unilateral uveitis (53.8%) and an anterior anatomical diagnosis (76.6%); two had anterior chamber fibrinous reaction, and only one had hypopyon. Most patients did not show associated systemic symptoms (66.7%). Topical corticosteroids, NSAIDs, methotrexate, mydriatics, and adalimumab were the most used treatments. The most common complications included cataracts, posterior synechiae, and macular edema. We identified that the rate of recurrences decreases over time (r = -0.6361, P = 0.002571), and this decrease seems to be associated with the initiation of disease-modifying antirheumatic drugs (DMARDs) in chronic and recurrent cases.ConclusionThe clinical spectrum of HLA-B27-associated uveitis in Colombian patients is distinct from other latitudes. Notably, we found a female predominance, older age at presentation, higher frequency of bilateral and vitreous involvement, and lower frequency of concomitant systemic diseases. Additionally, our results suggest that DMARDs such as methotrexate and biologic agents are good therapeutic options to avoid recurrences in chronic and recurrent cases.

The scientometric characteristics of cheilitis researched by multidisciplinary specialists: A comparative study

Background/purposeCheilitis is a relatively common lip disease with many etiologies and causes including concomitant mucocutaneous or systemic diseases, which needs multidisciplinary communication. The purpose of this study was to compare the scientometric characteristics of cheilitis publications by multidisciplinary specialists. Materials and methodsAll the papers on cheilitis were comprehensively retrieved from the Scopus database, and divided into three groups (dermatologists, stomatologists, and other scholars). ResultsThere were 478 and 241 papers on cheilitis published by dermatologists and stomatologists, respectively. The total citation count was 5838 and the h index was 36 for cheilitis publications by dermatologists, and the total count was 2983 and the h index was 27 for cheilitis publications by stomatologists. Interestingly, we observed that dermatologists preferentially concerned contact cheilitis/dermatitis and plasma cell cheilitis, while stomatologists preferentially concerned cheilitis-related lip neoplasms including squamous cell carcinoma, dysplasia, and precancerous conditions. The most common disorder researched by both dermatologists and stomatologists was actinic cheilitis. The keywords such as patch test, cosmetic, edema, drug efficacy, toothpaste, lipstick, allergens, and granulomatous inflammation were common in dermatologists' publications; while the keywords such as protein expression, metabolism, risk factor, prevalence, malignant transformation, and carcinogenesis were common in stomatologists’ publications. ConclusionThis study for the first time reported the scientometric characteristics of cheilitis as an interdisciplinary disease researched by specialists. It highlights that cheilitis-related specialists through reciprocal collaboration and communication will improve the patients’ outcomes.

Systematic review and meta-analysis Literature-based Clinical Retrospective Analysis of Acquired Reactive Perforating Collagenosis

Objective: Acquired reactive perforating collagenosis(ARPC) is a rare dermatosis that usually associated with systemic disease. The associations, characteristics and treatment rigemen of ARPC are not well understood.This study was performed to retrospectively evaluate the diagnosis and treatment statuses of acquired reactive perforating collagenosis (ARPC). Methods: A systematic review of the PubMed, Embase, and Scopus databases was independently performed by two reviewers. Data were extracted and qualitatively analyzed. The quality of the articles was assessed by using the Newcastle–Ottawa scale. The data are described in the manuscript. The study was registered with PROSPERO, CRD 42023448576. Results: In total, 189 patients (98 women, 91 men) in 124 studies were analyzed. Their mean age was 57.31 ± 15.21 years. A total of 88.89% (n = 168) of the patients had one or more systemic diseases, of which 57.67% (n = 109) had diabetes mellitus, 29.10% (n = 55) had chronic renal failure, 25.93% (n = 49) had hypertension, and 13.76% had malignancy (n = 26). The most frequently affected area was the lower extremities (72.49%, n = 137), followed by the trunk (70.37%, n = 133) and the upper extremities (63.49%, n = 120). One hundred sixty (84.66%) patients had pruritus, and 32.80% (n = 62) of them were positive for the Koebner phenomenon. Oral antihistamines and topical steroids were the most common treatments in this study, followed by narrow-band ultraviolet B therapy and allopurinol. Management of concomitant systemic diseases also resulted in improvement of ARPC. Conclusion: In this review, ARPC was frequently associated with systemic diseases, especially diabetes mellitus, renal failure, hypertension, and malignancy. The lower extremities and trunk were the most frequently affected areas, and pruritus usually appeared. Antihistamines and topical steroids were the most commonly used treatments, and we recommend narrow-band ultraviolet B therapy as the first-line treatment. Management of systemic diseases and relief of pruritus should be considered simultaneously.

Analysis of the epidemiology, coexisting skin diseases, and variables affecting seborrheic dermatitis severity

Seborrheic dermatitis (SD) is a common chronic skin disease that has a repeating future. SD affects between 1 and 3% of adults with normal immunity. Recent studies have shown that many cutaneous diseases, including SD, are associated with other skin conditions. In this current study, we aimed to assess the epidemiology, comorbid skin diseases accompanying the SD, and factors affecting the severity of the SD. This was a prospective study conducted in dermatology departments between January 2020 and December 2020. The baseline demographic data was recorded. Disease severity was assessed according to the Seborrheic Dermatitis Area and Severity Index (SDASI) scoring system. In this study, 211 patients with SD (92 men and 119 women) were included. The mean age of the patients was 32.51±15.31 years (range: 11–82). The mean disease duration was 38.59 months (range: 1–720 months). Emotional distress was the most common trigger, followed by seasons. The scalp, eyebrows, ears, nasolabial region, forehead, intermammary, postauricular area, and back were the body parts most frequently afflicted. 43 out of 211 patients had concomitant systemic diseases, and 64.5% of the patients had concomitant skin diseases. Also, almost half of the patients applied in the winter. The mean SDASI was 2.92±1.2 (range 0.3–8.1). In this study, SD was more commonly reported in females and the winter. Disease severity was higher in smokers and patients who applied in the summer. The severity of SD was unaffected by concomitant skin disease, gender, age, educational level, working status, skin type, alcohol consumption status, presence of trigger factors, comorbid skin and systemic diseases, and family history of SD or skin diseases. To improve the quality of life for SD patients, factors impacting disease severity should be carefully managed.

Treatment of superior oblique myokymia with pregabalin. Review of a clinical case

Superior oblique myokymia is a rare idiopathic disease, characterized by sudden, spontaneous, unilateral, rhythmic contractions of the superior oblique muscle and typically presents with monocular oscillopsia and diplopia. This pathological condition most often affects middle‑aged patients without concomitant systemic diseases. The aim of the article was to study the features of the clinical course, diagnosis and methods of treatment of superior oblique myokymia based on a clinical case. A review of a clinical case of superior oblique myokymia in a patient born in 1983 is presented. The diagnosis was established on the basis of clinical manifestations in the form of sudden episodes of vertical oscillopsia and diplopia in the field of vision of the right eye, which occurred both spontaneously during prolonged work at the computer, driving a vehicle, and in response to light stimulation. A 38‑year‑old patient described the disease as the presence of periodic attacks, during which blurred vision, doubling and movement of objects in the field of vision of the right eye occurred for 2 — 3 seconds, after which the vision returned to normal. The number of attacks was up to 100 per day and significantly worsened the patient’s quality of life. During the neurological examination, an episode of vertical oscillopsia with diplopia was revealed when light was directed at the right eye. No other pathological changes were observed in the nervous system, eyes and other systems and organs, which was confirmed by laboratory and instrumental examination methods, examinations and consultations of different specialists. The patient had a positive therapeutic effect in the treatment of superior oblique myokymia with pregabalin at a dose of 150 mg per day. Recommendations to reduce the time spent working at the computer and to adopt a healthy lifestyle were important.&#x0D; Thus, superior oblique myokymia is a rare pathological condition manifested by sudden episodes of monocular vertical oscillopsia and diplopia. Pregabalin can be considered as the medication of choice in the treatment of this disease. Further research is needed to establish unified treatment guideline.&#x0D;

The Co-Relation between Disease Activity and Quality of Life among Patients with Peripheral Spondyloarthropathy

Background: More disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA) in the presence of enthesitis is associated with higher disease activity. Objective: To find out the co-relation between disease activity and quality of life among patients with peripheral spondyloarthropathy. Methodology: From March 2021 to February 2022, the Department of Physical Medicine and Rehabilitation at BSMMU, Dhaka, performed a cross-sectional research. A total of 105 individuals diagnosed with pSpA who were included in the trial were chosen on purpose. Excluded from the research were patients with concomitant systemic inflammatory rheumatic diseases such as RA, SSc, lupus, and Dermatomyositis. The validated Bengali version of The Ankylosing Spondylitis Disease Activity Score (ASDAS), including C-reactive protein (ASDAS-CRP), was used to measure disease activity, while the validated Bengali version of the Short Form Health Survey (SF) 12v2 was used to evaluate health-related quality of life. Results: The participants' mean age was 38.8(±9.8) years, and 68(64.8%) were male. The mean duration of sickness was 4.3(±3.3) years, with 55.4% of cases lasting less than 3 years. The mean ASDAS-CRP was 3.9(±0.08), with 69(65.7%) individuals having a very high Disease Activity Score. 100% of the individuals in the research experienced arthritis and inflammatory back pain. The majority of research subjects had the HLA B27 gene (N=101, or 96.2%), and 99(94.3%) had enthesitis. Physical Component Summary (PCS) and Mental Component Summary (MCS) mean scores were 34(±7.8) and 41(±7.7), respectively. A slight negative association existed between age and PCS scores on the SF-12 (r=-0.233, p=0.017). There was a negative connection between illness duration and PCS (r=-0.339, p=0.001) and MCS (r=-0.290, p=0.003) SF-12 scores. Again, there was a moderate negative connection between ASDAS-CRP and the PCS and MCS scores of the SF-12 (r=-0.406, p=0.001) and the MCS scores of the SF-12 (r=-0.461, p0.001). Conclusion: The Disease Activity Score of the majority of individuals with peripheral spondyloarthritis was very high. The psychological health of these patients was superior to their physical health. Both physical and mental health components were negatively linked with illness duration. There was a moderate inverse connection between ASDAS-CRP and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the SF-12.

Improved performance of confirmatory assays for detecting dense fine speckled (DFS) 70 antibodies

The presence of monospecific dense fine speckled 70 (DFS70) pattern in indirect immunofluorescence assay (IFA) without concomitant systemic autoimmune related diseases (SARD)-associated antibodies could be an exclusion biomarker for SARD. Since interpretation of DFS pattern on IFA is subjective, an assay for confirming the presence of anti-DFS70 is required. We evaluated the performance of two commercial assays [fluorescence enzyme immunoassay (FEIA) and line immunoassay (LIA)] for detecting anti-DFS70. Sera with monospecific DFS (n=176) and without DFS (n=179) pattern from referred patients for ANA testing, in two independent laboratories and healthy donors, were investigated for anti-DFS70 by FEIA (Phadia EliA) and LIA (Euroimmun). The assay performance including sensitivity and specificity at different cut-offs was evaluated, and optimal cut-offs were determined. The newly established optimal cut-offs (2.7 U/mL on EliA, band intensity of 28 on LIA) showed significantly better assay performance in detecting anti-DFS70 and confirming monospecific DFS pattern. A relative sensitivity of 93.7% with relative specificity of 100% on EliA and a relative sensitivity of 96.6% with relative specificity of 95.3% on LIA were achieved. Superior Cohen's Kappa agreements with IFA were also achieved for both assays (0.936 for EliA and 0.906 for LIA). Application of an optimal cut-off can significantly increase the assay performance for anti-DFS70 and enhance the accuracy in reporting DFS pattern by IFA.

Influence of systemic diseases on the diagnosis and treatment of dental diseases and prevention of related risks

Patients with dental problems may suffer from various systemic diseases at the same time. The concomitant systemic diseases can have impacts and risks on the diagnosis, treatment planning and therapeutic practice in dentistry. The author briefly expounds the influences of systemic diseases on dental diagnosis and treatment and the prevention of risks from seven aspects: cardio-cerebral vascular system, blood system, respiratory system, endocrine system, digestive system, genitourinary system, nervous system and mental system, in order to provide references for the dental clinicians.

Improved diagnostic accuracy in detecting anti-dense fine speckle 70 antibodies using fluorescence enzyme immunoassay and line immunoassay by optimising their cut-offs

Objective: The presence of monospecific dense fine speckle 70 (DFS70) pattern in immunofluorescence assay (IFA) without concomitant systemic autoimmune related diseases (SARD)-associated antibodies, could be an exclusion biomarker for SARD. Interpretation of DFS patterns could be subjective and inaccurate. We evaluated the performance of two conventional commercial assays [fluorescence enzyme immunoassay (FEIA) and line immunoassay (LIA)] for confirming anti-DFS70.

Characteristics of work-related eye trauma in construction and manufacturing industries

ABSTRACT Clinical relevance Knowledge of work-related eye trauma in the construction and manufacturing industries will facilitate planning of policies and practices to protect against such occurrences. Background The aim of this study was to compare demographic, epidemiological, and clinical characteristics of work-related eye trauma in workers in the construction and manufacturing industries. Methods Medical board disability reports of subjects who experienced work-related eye trauma were investigated in this retrospective comparative study. Subjects were separated into two groups – construction and manufacturing – and the demographic, epidemiologic, and clinical characteristics within the two groups were compared. Results The construction group included 138 eyes of 132 subjects and the manufacturing group included 82 eyes of 77 subjects. Demographic characteristics of the groups were similar (p > 0.05). The number of work-related eye trauma incidents was found as decreased during winter in construction (p < 0.001), but a similar trend was not found in manufacturing (p > 0.05). Head traumas as reason for work-related eye trauma (p < 0.001), and concomitant systemic diseases including bone fracture and traumatic brain injuries (p < 0.001 and p = 0.012) were significantly associated with eye trauma in manufacturing. Open globe injury was more common in construction (p = 0.046), and chemical injury was more common in manufacturing (p < 0.001). Retinal detachment was more prevalent in construction (p = 0.042). Hand motion or worse final visual acuity was more prevalent in manufacturing (p = 0.007) and the final visual acuity better than 6/60 was more prevalent in construction (p = 0.045). Conclusion Chemical injuries are more common in manufacturing, whereas open globe injuries and retinal detachments occur more frequently in construction. Permanent low vision and blindness are more commonly associated with work-related eye trauma in manufacturing.

What is the meaning of ANCA positivity in IgG4-related disease?

To evaluate the prevalence and meaning of antineutrophil cytoplasmic antibodies (ANCA) positivity in a cohort of IgG4-related disease (IgG4-RD). We identified patients with ANCA determination from a retrospective cohort of 69 patients with IgG4-RD. ANCA were measured by indirect immunofluorescence microscopy (IIF) and/or proteinase 3 (PR3)-ANCA and MPO-ANCA by ELISA. IIF patterns were classified as perinuclear (P-ANCA), cytoplasmic (C-ANCA) and atypical (X-ANCA). We compared the ANCA-positive vs the ANCA-negative IgG4-RD group. Out of 69 patients, 31 IgG4-RD patients had an ANCA determination. Four patients with concomitant systemic autoimmune diseases were excluded. We found positive ANCA by IIF in 14 (56%) of 25 patients tested. The most common IIF pattern was C-ANCA in eight (57.1%), followed by dual C-ANCA/X-ANCA in four (28.6%) and P-ANCA and dual C-ANCA/P-ANCA in one each (7.1%). Of the 20 patients with ANCA determination by both IIF and ELISA, four have positive ANCA by ELISA (three for MPO-ANCA and one for PR3-ANCA). Of the two patients with only ELISA determination, one was positive for MPO-ANCA. The prevalence of ANCA positivity by ELISA was 22.7% (5 out of 22 patients). ANCA was more frequent in the Mikulizc/systemic phenotype (42.9%) compared with other phenotypes (P=0.04). ANCA-positive IgG4-RD patients had more frequently lymph node and kidney involvement, high IgG1 levels and erythrocyte sedimentation rate, and positive antinuclear antibodies. ANCA are found in a significant number of patients with IgG4-RD and differed from the ANCA-negative group in terms of clinical and serological features.

КОНСОЛИДАЦИЯ ПЕРЕЛОМОВ КОСТЕЙ СОБАК И КОШЕК

Fracture healing is an essential physiological process that determines quality of life as well as survival. Non-closure of the fracture determines significant limitations in the function of the musculoskeletal system. Deformities formed after fractures due to non-anatomical reposition of bone fragments, for example, reduction or curvature of a limb, determine pronounced limitations of biomechanical movements and capabilities. The ultimate goal is to consolidate the fracture with full return of bone strength as before the fracture. Quite a unique biological and physiological process, significantly long in time. The short phase of endochondral formation of superficial callus is replaced by a long phase of bone remodeling (remodeling). In the process of formation of endochondral callus, there is a possibility of non-fusion of bone fragments with the possibility of recurrence of the fracture. This review summarizes the available data on fracture consolidation in dogs and cats, looking at aspects related to classic, primary healing and what affects the rate of healing. Also aspects of delayed consolidation are: significant mobility due to unstable immobilization in case of bone fracture; the presence of a large diastasis between bone fragments; multifragmented fractures; decreased and impaired blood supply to the bones; possible infection in the fracture zone and concomitant systemic diseases in animals. As a result, the consolidation algorithm is quite complex and lengthy; it characterizes an increase in the number of cells capable of forming bone and connective tissue - osteoblasts and fibroblasts, respectively. Due to the formation of special substances by these cellular structures, all layers of the bone mature and its integrity is restored with the restoration of the musculoskeletal function.