Cross-sectional Clinical Study Research Articles

Prevalence profile of burning mouth syndrome in a sample of Egyptian population: A cross-sectional clinical based study

Prevalence profile of burning mouth syndrome in a sample of Egyptian population: A cross-sectional clinical based study

Effects of Infection with Different Types of Helicobacter pylori on Gastric Secretion Function: A Cross-Sectional Clinical Study.

Helicobacter pylori (Hp)-related gastropathies are accompanied by alterations in gastric secretion function, but the effects of infection of different Hp strains on gastric function are not yet well-elucidated. Our cross-sectional clinical study aim to research the effects of infection with different Hp types on gastric function. We analyzed 525 patients' serum cytotoxin-associated protein gene A (CagA), vacuolating cytotoxin-associated protein gene A (VacA), urease (Ure), Gastrin-17 (G-17), Pepsinogen I (PGI), Pepsinogen II (PGII) and PGI/PGII ratio (PGR). The PGII levels (8.19 ± 5.44 vs 5.98 ± 10.75, P = 0.013) were higher in the Hp infected group than in the uninfected, while the PGR levels (16.81 ± 8.22 vs 23.23 ± 8.36, P < 0.001) were lower. The PGR levels were higher in the uninfected group (23.23 ± 8.36, P < 0.001) than in Hp-I (16.47 ± 7.45) and Hp-II infected groups (17.39 ± 8.98). In the uninfected group, the G-17 level was positively correlated with the levels of PGI (Pearson coefficient = 0.177, P = 0.001), PGII (Pearson coefficient = 0.140, P = 0.008) and age (Pearson coefficient = 0.121, P = 0.022), negatively with the PGR levels (Pearson coefficient = -0.201, P < 0.001). In the Hp-I (Pearson coefficient = -0.003, P = 0.975) and Hp-II (Pearson coefficient = 0.018, P = 0.161) infected groups, the G-17 levels were not correlated with age. Hp-I with CagA and/or VacA positive and Hp-II without cytotoxicity can reduce gastric secretion function regardless of age and sex. Gastric function in patients with Hp eradication was similar to that in those without Hp infection. G-17 rises physiologically with age, but infection with Hp will affect it.

The Relationship between Physical Activity and Quality of Life in Postmenopausal Women: A Cross-Sectional Study.

Postmenopausal women frequently encounter a range of symptoms, including fatigue, diminished physical strength, reduced energy levels, vasomotor symptoms such as hot flushes, and vaginal atrophy, all of which adversely affect their overall quality of life. Engaging in physical activity and structured exercise may effectively alleviate these symptoms and enhance overall well-being. The present study aimed to investigate the relationship between physical activity and quality of life in postmenopausal Greek women. This cross-sectional clinical study included 219 postmenopausal women. Women with natural menopause for at least 12 consecutive months were enrolled in this descriptive, cross-sectional study. The female participants were asked to fill out the International Physical Activity Questionnaire-short form (IPAQ), the Hospital Anxiety and Depression Scale (HADS), and the EuroQol (EQ-5D-5L) instrument. Anthropometric measurements included weight, height, and waist circumference measurements. A total of 219 postmenopausal women with an age of 61.4 ± 6.1 years and body mass index (BMI) of 25.6 ± 3.7 kg/m2 were studied. Out of the total postmenopausal women studied, 64.8% were physically active. The mean value of MET-min/week was M = 1383.46 ± 1030.12. Physical activity among postmenopausal Greek women showed a strong correlation of PA with quality of life (r = 0.5; p ≤ 0.001) and age (r = 0.55; p ≤ 0.001) and a medium correlation with the HADS (r = 0.4; p ≤ 0.05). There was a 64.8% prevalence of physically active postmenopausal Greek women. The findings underscore the significance of fostering physical activity and quality of life among postmenopausal women to formulate efficacious therapeutic interventions. The results demonstrate a correlation between physical activity and the age of female participants, quality of life, and the HADS and can be used to improve postmenopausal women's physical activity levels, which is recommended as a strategy for improving the quality of life in postmenopausal women.

Pregnancy-Associated Plasma Protein-A and Free β-Human Chorionic Gonadotrophin in Relation with Oxidative Stress in Obese Pregnant Women: A Clinical Cross-Sectional Study.

Background: The pathophysiological mechanism underlying pregnancy complications is not entirely known. Although it is currently impossible to predict the occurrence of redox imbalance, it is possible to identify women with a high or medium risk of developing this disease prior to a negative outcome by non-invasive diagnostic methods. The Aim: This study aimed to examine the possible role of the parameter of oxidative stress (OS) measured in early pregnancy in the screening/treatment of obesity and its complications during pregnancy. Methods: This research was designed as a prospective observational cross-sectional clinical study which included 40 non-obese and 31 obese pregnant women between 11 and 13 g.w. who were managed in the Department of Obstetrics, University Clinical Center Kragujevac in Serbia. We collected anthropometric and clinical indicators, maternal and pregnancy factors, and measured prooxidative parameters from blood samples. Results: We observed significantly increased levels of the superoxide anion radical, hydrogen peroxide and the index of lipid peroxidation in the Obese group in comparison with the Non-Obese group and significantly decreased bioavailability of nitrites in the Obese group in comparison with the Non-Obese group. Conclusions: The determination of systemic parameters of OS in early pregnancy could be a good methodological approach in the screening/treatment of obesity during pregnancy and this approach should be followed for the screening of endothelial dysfunction in pregnancy which needs further monitoring and/or treatment.

Increased Systemic Immune-Inflammation Index as a Novel Indicator of Alzheimer's Disease Severity.

Inflammatory processes and neurodegeneration are common features of Alzheimer's disease (AD). The systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are easily accessible, cost-effective prognostic indicators of inflammation status. We assessed the diagnostic value of SII and compared the efficacies of NLR, PLR, and SII in predicting AD severity. Between January 2021 and December 2022, this prospective, cross-sectional clinical study included 175 patients with AD and 61 controls. SII, NLR, and PLR were calculated. Age, white blood cell and lymphocyte counts, and NLR and PLR values were significantly different between the patient and control groups (P <.05). Age, hemoglobin, neutrophil, NLR, and SII values were significantly different among dementia severity subgroups (P <.05). Compared with PLR and SII, NLR was more strongly correlated with dementia severity. In the analysis of adjusted data by gender, it was found that hemoglobin level is significantly negatively associated with dementia severity in males, while in females, age and PLR are significantly positively associated with dementia severity, and lymphocyte count and SII are negatively associated. SII, a novel inflammatory marker, was associated with dementia severity in patients with AD. Compared with PLR and SII, NLR was more strongly correlated with dementia severity. In future studies with larger populations, SII and NLR values can be used to determine dementia severity and establish follow-up plans for patients with high dementia risk.

Nociceptive Pain in Patients with Neuromuscular Disorders: A Cross-Sectional Clinical Study.

Muscle pain is a common symptom in patients with neuromuscular disorders (NMD) and accounts for severely reduced quality of life. OBJECTIVE: This clinical study aimed to observe possible differences in pain prevalence among distinct NMDs and to determine whether the patients' nociceptive pain is influenced by gender, muscle strength and psychological factors and to examine potential pain-associated alterations in muscle properties. The cross-sectional study on nociceptive pain in various NMDs involved patient-reported outcomes, muscle strength evaluations (dynamometry and quick motor function test (QMFT)), nociceptive pain evaluations (muscular pressure pain threshold (PPT)), and non-invasive measurement of muscle stiffness, frequency, decrement, relaxation, and creep (myotonometry). Involving 81 NMD patients and a control group, the study found high variability in pain prevalence among the subgroups. Patients with DM2 and FSHD had significantly higher levels of pain prevalence compared to other examined NMD subgroups and the control group. Female gender, high fatigue levels (representing factors such as depression, anxiety, stress, and impairment of quality of life), and low QMFT scores (representing reduced muscle strength) showed an association with increased sensitivity to pressure pain in the arm and leg region. As assessed by myotonometry, less pain is experienced in neck muscles with a high muscle tone, high stiffness, and a short relaxation time highlighting the importance of intrinsic muscular tone for their pressure pain sensitivity. Individualized therapeutic concepts including psychological and physical approaches in the pain management of patients with NMDs, especially in women, should be considered. Further research in this field is necessary to gain a more detailed insight into the perception of muscle pain.

Maxillary sinus membrane perforation rate utilizing osseodensification-mediated transcrestal sinus floor elevation: A multicenter clinical study.

This multicenter cross-sectional clinical study aimed to evaluate the membrane perforation rate during transcrestal sinus floor elevation (TSFE) using osseodensification (OD) burs and assess risk factors associated with the procedure. This study was conducted in six centers, following ethical standards and approved by local committees. It included patients over 18 years old missing maxillary posterior teeth with crestal residual bone height (RBH) ≥2 and ≤6 mm. Preoperative evaluations were done, including CBCT scans, to assess bone dimensions and sinus health. All centers and surgeons followed a standardized surgical protocol for TSFE using OD burs. Surgical complications, particularly sinus membrane perforations, were recorded and analyzed. Factors such as implant site, premolars or molars, as well as, healed or fresh socket, along with initial RBH were evaluated for their impact on membrane perforation rate. Descriptive statistics, χ2, and logistic regression analysis were used to analyze the data. A total of 621 subjects with an average age of 57.9 years were included. Sinus lifting was performed at 670 sites, with 621 implants placed in the maxilla. The majority of sinus lifts were done in the molar region (76.87%) and in healed bone sites (74.33%). The average RBH was 5.1 mm (ranging from 2 to 7 mm). Sinus membrane perforation occurred in 49 cases (7.31%). RBH ≤3 mm posed a risk factor for sinus membrane perforations followed by RBH >3 and ≤5 mm. Tooth region and implant site were not associated as risk factors for sinus membrane perforation. OD drilling used for TSFE resulted in low membrane perforation rate. Challenging scenarios of severe posterior maxillary atrophy presented as risk factors for increased perforation rate.

Different meanings of a three-point decline in MMSE score in Alzheimer's disease and depressive disorder.

The Mini-Mental State Examination (MMSE) is a composite scale that is included in diagnostic algorithms and in procedures to assess severity of cognitive impairment and efficacy of therapeutic interventions. It is unclear, however, whether the MMSE provides information about the same deficits in different diseases. To assess patterns of MMSE scores in patients with confirmed diagnosis of Alzheimer's disease or depressive disorder. We used data from a previously published cross-sectional retrospective observational clinical cohort study. The final analysis included only patients in whom biomarker analysis showed results characteristic of Alzheimer's disease (n = 167) and patients with depressive disorder in whom Alzheimer's disease had been ruled out by analysis of biomarkers (n = 69). A three-point decline in MMSE score from 30 to 27 reflected impairment of memory recall in patients with Alzheimer's disease, whereas it reflected impairments in calculation and memory recall in patients with depressive disorder. A further three-point decline in MMSE score from 27 to 24 predominantly reflected additional calculation impairment in patients with Alzheimer's disease. Our results indicate that memory performance is the most important measure of disease severity and the main contributor to the decline in MMSE score at onset of clinical manifestation of Alzheimer's disease. In general, this suggests that memory should be the primary measure used in routine clinical care and the primary endpoint in clinical trials involving patients with Alzheimer's disease at onset of clinical manifestation. Changes in other measures of cognition should prompt consideration of possible comorbidities as a cause, rather than the impact of Alzheimer's disease itself.

IL-6 LEVELS AND COGNITIVE COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CROSS SECTIONAL STUDY

Objective: It is important to monitor and manage macrovascular and microvascular complications, which are significant causes of mortality and morbidity in type 2 diabetes (T2DM). Diabetes-related cognitive impairment is an important complication that has recently attracted more attention, but its pathophysiology and clinical features are not known. The aim of this study was to evaluate the potential role of inflammation in diabetes-related cognitive impairment. Material and Method: A total of 122 participants (67 patients with T2DM and 55 controls) took part in this cross-sectional observational clinical study. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test. IL-6 levels were measured using the ELISA method on blood samples obtained from the participants. Result and Discussion: Although IL-6 levels increased with diabetes and cognitive impairment, there was no significant difference between the groups (p&amp;gt;0.05). Except for attention and orientation, we observed significantly more impaired cognitive performance in T2DM patients. The MoCA total score was significantly correlated with age, education level, fasting glucose, HbA1c, and vitamin D levels (p&amp;lt;0.05). Our results found no evidence that IL-6 is involved in the pathophysiology of cognitive impairment in T2DM, but these findings the importance of cognitive screening in monitoring complications associated with diabetes.

Impact of using single-file reciprocating system on the quality of root canal treatment treated by undergraduate students

BackgroundThis study aimed to evaluate the use of a single-file reciprocating system on the technical quality of root canal filling and treatment by radiographic assessment of cases treated by undergraduate dental students. Materials and methodsThis was a retrospective cross-sectional clinical study of endodontically treatments conducted by fourth-year undergraduate students during the academic year 2021–2022. Root canal preparation was performed using the WaveOne Gold system with matching single-cone gutta-percha. The collected data included sex, tooth position, number of canals, and treatment time (first or second semester). The quality of the root canal filling was assessed based on the root canal filling length, density, and taper. The presence of ledges, apical transportation, perforation, and instrument separation were recorded. Data were analyzed using SPSS version 28. Chi-square tests were used, and the statistical significance level was set at P < 0.05. ResultsA total of 601 teeth were included. The length of the root canal filling was adequate in 93.51 % of the teeth, underfilled in 2.82 %, and overfilled in 3.66 %. The density and taper were adequate in 96.5 % and 98.16 % of the teeth, respectively. There were no significant differences among the parameters of length, taper, density, or procedural errors relative to the arch type. However, there was a significant difference between the anterior and premolar teeth in terms of taper, density, and overall quality of the root canal filling. The overall quality of root canal treatment was acceptable in 527 teeth (87.68 %), with no significant difference between teeth (P = 0.256). ConclusionThe quality of root canal treatment performed by undergraduate students using a single-file reciprocating system is good or acceptable.

P-241 The in vivo human uterine pH and uterine fluid composition differs from pH and composition of clinically used in vitro preimplantation embryo culture media

Abstract Study question To study the pH and uterine fluid composition in the human uterus three days after a positive LH test or ovum pick-up. Summary answer The uterine pH three days after a positive LH test or ovum pick-up was 6.8. Concentrations of 37 components were determined in uterine fluid. What is known already In assisted reproductive technologies (ART), the in vitro culture of human preimplantation embryos is known to play a crucial role in the success of In Vitro Fertilization (IVF) treatments. It affects live birth rates and child outcomes such as birth weight. Numerous commercial embryo culture media are routinely used in clinical practice worldwide, but their composition is primarily based on laboratory-based clinical insights and experimental studies with animal models. Studies on the natural human preimplantation embryo environment during the physiologically relevant time of the menstrual cycle are limited. Study design, size, duration A cross sectional clinical study was conducted to study the uterine pH and the composition of human uterine fluid. The uterine pH was measured in 53 women on the third day after LH surge (N = 46) or ovum pickup (N = 7), as that time in the menstrual cycle is associated with endometrial receptivity for embryo implantation. Twenty-two samples of aspirated uterine fluid, that were collected at the same time, were analyzed for the concentrations of thirty-seven components. Participants/materials, setting, methods Healthy women of reproductive age with normal functional uterine anatomy were included. Uterine pH was determined using pH probe inserted through outer sheath of an Embryo Transfer (ET) catheter at the lithotomy position. Uterine fluid was then aspirated using a syringe connected to outer sheath of this ET catheter. Collected samples were analyzed using a Cobas 8000 chemistry analyser and ultra-performance liquid chromatography-tandem mass spectrometry. Main results and the role of chance The mean pH in the uterine cavity on the third day after a positive LH test (6.75 ± 0.22) or ovum pick-up (6.82 ± 0.18) was clearly lower than the pH used in routine clinical practice for preimplantation embryo culture (pH 7.3 ± 0.1). Calcium, phosphate, lactate(L), pyruvate, albumin and 21 amino acids were present at different concentrations in human uterine fluid compared to most commonly used preimplantation embryo culture media. Immunoglobulins, citrulline, ornithine and uric acid were present in uterine fluid, but not in clinically used culture media. Limitations, reasons for caution As the uterine cavity is only one part of the reproductive tract, our measurements do not fully represent the complete in vivo environment of preimplantation embryo development. We only studied 37 components, recognizing that uterine fluid likely contains additional components. Wider implications of the findings The observed differences between the uterine pH and the composition of uterine fluid and the pH and composition of preimplantation embryo culture media used in routine clinical practice could be a starting point to further optimize in vitro embryo culture in ART treatments. Trial registration number Not applicable

RETOUR DEXPERIENCE CLINIQUE SUR TROIS ANS DE PRESCRIPTION DE LA FLUOXETINE EN PEDOPSYCHIATRIE UNIVERSITAIRE

Objectives: Our work has three objectives: To analyze our prescribing practices for fluoxetine in the light of international recommendations, to evaluate the tolerance and effectiveness of this molecule in children and adolescent and to identify the rules for proper use in this age group. Patients and method: We conducted a cross-sectional and descriptive clinical study spanning a period of 3 years, from January 2021 to January 2024, concerning children and adolescents aged between 8 and 17 years old who had been diagnosed with major depressive disorder, persistent depression, and/or anxiety disorders, or bulimia and placed on fluoxetine for a minimum follow-up period of 4 months and a maximum of 18 months. Results: The prescription of fluoxetine concerned 76 patients out of 660 patients with mood and anxiety disorder out of a total of 2215 patients. Major depressive disorder is the most common child psychiatric diagnosis (90%), anxiety disorders are present in 10%. Fluoxetine is prescribed as first-line treatment with psychotherapy in 40% of cases. Indicated as second-line treatment in 60% of patients due to an insufficient response or non-response to psychotherapy. No pre-therapeutic assessment is carried out. Fluoxetine is prescribed as monotherapy at an initial dose of 20 mg/day taken in the morning for an average duration of 9 months for depressive disorders and 12 to 18 months for anxiety disorders. Consented cessation of treatment is gradual. We report good therapeutic compliance and good tolerance with an average effectiveness time of 10 days. Mainly two side effects are described: headache and nervousness. We report one case of manic conversion in a 14years old girl. Discussion: The prescription of psychotropic medications in children and adolescents can only be considered as part of multimodal care, generally as second-line treatment when the adequate therapeutic response is not achieved or sometimes as first-line treatment when the clinical case is immediately severe or with there is an impact on the child and/or those around him. Only fluoxetine has label use in children aged over 8 years for moderate to severe depressive episodes. Fluoxetine is supported by the greatest results of evidence for its effectiveness and superiority compared to other SSRIs in this indication. Fluoxetine is also indicated in juvenile anxiety disorders and obsessive-compulsive disorder. Conclusion: In the case of mood and anxiety disorders in children, notably depression, fluoxetine is the choice molecule with the best tolerance-effectiveness ratio.

Measurement properties of the Portuguese version of the rheumatoid arthritis patient-reported experience measure (CQRA-PREM): a cross-sectional single center study

Aims: to test the measurement properties of the Portuguese version of the Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) for patients with rheumatoid arthritis (RA). Methods: This cross-sectional clinical field study recruited adult patients with RA during rheumatology appointments of a Portuguese rheumatology center. Patients completed the Portuguese version of CQRA-PREM, composed of 7 domains and 24 questions. Sociodemographic characteristics, symptoms/disease duration, current treatment, Pain-Visual Analog Scale (VAS), Patient Global Assessment (PGA)-VAS and Health Assessment Questionnaire (HAQ) were also collected from the patient. Disease Activity Score for 28 joints with C-reactive Protein (DAS28-CRP) was recorded by the rheumatologist. The assessment of CQRA-PREM measurement properties followed the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations. Results: A total of 61 patients with RA were included. The domains in which patients showed better experience were the “Needs and preferences”, followed by “Coordination and Communication”. The domain “Information, education and self-care” was an identified area of improvement for providing patient-centered care. Ceiling effects were found in four domains of the CQRA-PREM. Internal consistency of all domains was considered good (α&gt;0.7). Homogeneity was considered good for each question in all domains analyzed (0.30≤rp≤0.70). The divergent validity of the PREM was good, revealing that the domains were not correlated (Pain-VAS, HAQ, DAS28-CRP) or only weakly (PGA-VAS) correlated with clinical outcomes. Conclusions: The CQRA-PREM showed acceptable measurement properties and is a useful tool for evaluating quality of healthcare provided in daily practice, as perceived by RA patients in Portugal.

Psychiatric Co-morbidity with Obsessive Compulsive Disorder

Background: Obsessive-compulsive disorder is a chronic psychiatric disorder. It is associated with substantial psychiatric comorbidity. Major Depressive disorder &amp; mixed anxiety and depressive disorder are the most common psychiatric co-morbidities.Objective: To evaluate the psychiatric co-morbidity with obsessive-compulsive disorder.Materials and Methods: It was a descriptive and cross-sectional clinical study. It was conducted in the Outpatient Department of Psychiatry, Khwaja Yunus Ali Medical College, Sirajganj from January 2021 to December 2022. Total 100 patients were taken. All the selected patients were interviewed in detail by using ICD-10. Analysis was done according to the Statistical Package for Social Science (SPSS) for windows version 25.Results: This study shows obsessive compulsive disorder is more common in young to middle age (21 to 40 years) and mean age of onset of illness was 28.31±10.21 years. Maximum (57%) were female and 43% were male. Depressive disorder, mixed anxiety and depressive disorder were most common psychiatric comorbidity (63% and 22%) in patient with OCD followed by panic disorder in 7% patients, social phobia in 5% patients, generalized anxiety disorder in 5% patients, substance abuse in 5% patients, schizophrenia in 5% patients, bipolar affective disorder in 2% patients and tic disorder in 1% patients.Conclusion: This study demonstrates a high prevalence of psychiatric comorbidities in individuals diagnosed with OCD. The most prevalent co-occurring disorders are depressive disorder &amp; mixed anxiety and depressive disorder. KYAMC Journal Volume: 14, No: 04, January 2024: 206-209.

Neuropsychological Test Performance Differentiates Subgroups of Individuals With Adult Moyamoya Disease: A Cross-Sectional Clinical Study.

Moyamoya disease (MMD) is a rare noninflammatory disorder involving progressive intracranial vasculopathy and impaired cerebral blood flow in the anterior circulation, resulting in stroke and cognitive impairment. We aimed to characterize cognitive impairment and the possible predictive value of sociodemographic and clinical characteristics of adults with MMD. This cross-sectional study examined neurocognitive performance in a group of 42 consecutive adult patients (mean age = 40.52 years; 69% female) referred for a presurgical neuropsychological evaluation. Neuropsychological functioning was assessed with a comprehensive battery, and cognitive dysfunction was defined as 1.5 SDs below the mean. Neurocognitive performance correlated with clinical/demographic characteristics and disease markers. Most patients (91%) had a history of stroke, and 45% had cognitive deficits, most notably on measures of attention/speed (48%), executive functioning (47%), visuoconstruction (41%), and memory (31%-54%). Only higher educational attainment and poor collateral blood flow in the right hemisphere differentiated cognitively impaired (n = 19) and intact groups (n = 23), and MMD-related characteristics (eg, disease duration, stroke history) did not differentiate the 2 groups. Consistent with previous work, frontal-subcortical cognitive deficits (eg, deficits in mental speed, attention, executive functioning) were found in nearly half of patients with MMD and better cognitive performance was associated with factors related to cognitive reserve. Angiographic metrics of disease burden (eg, Suzuki rating, collateral flow) and hemodynamic reserve were not consistently associated with poorer cognitive outcomes, suggesting that cognition is a crucial independent factor to assess in MMD and has relevance for treatment planning and functional status.

Prevalence of Dentin Hypersensitivity Among Dental Students and Effectiveness of Tooth Desensitizing Agents

Objectives Dentin hypersensitivity (DH) is a growing concern in Dentistry. The objective of this study was to evaluate the prevalence and effectiveness of different desensitizing agents of (DH) among undergraduate dental students. Materials and Methods This cross-sectional clinical study was conducted with 161 undergraduate dental students. A self-reporting questionnaire along with a clinical examination was performed to diagnose DH and determine the severity. The effectiveness of home-based and in-office desensitizers was evaluated by comparing the combined DH scale in the pre- and post-treatment periods. The data were analyzed for frequency, correlation, and T-test. Results The prevalence of DH in the tested population was 19.3%, predominantly in females. The Chi-Square test showed significance in gender and oral hygiene practice by the participants (p&lt;0.05). However, none of the tested factors strongly correlated with DH in this population. The post-treatment combined DH scale (5.48±3.1) was statistically significant (p=0.0001) compared to the pretreatment scale (11.29±3.5). The effectiveness of SRA was 87%, and the remaining 13% of DH recovered using GLUMA. Conclusion The prevalence of DH was 19.3% without any strongly correlated etiology. Home-based and in-office desensitizers were effective in reducing DH in the tested population.

#289 Lipocalin-2 promotes cardiovascular calcification in chronic kidney disease by upregulating STAT3/NCOA4-mediated ferritinophagy and ferroptosis

Abstract Background and Aims Cardiovascular calcification (CVC) is a common complication of chronic kidney disease (CKD) and contributes to cardiovascular morbidity and mortality without any effective therapies. To date, the underlying mechanism of CKD-CVC has not been elucidated. Recent studies suggest that ferroptosis is a novel programmed cell death that may play a role in the process of CKD-CVC, but the mechanism is largely unclear. Ferritinophagy is an important inducer of ferroptosis that is regulated by nuclear receptor coactivator 4 (NCOA4). However, the relationship between ferritinophagy and CKD-CVC has not been explored. Lipocalin-2 (LCN2) is an iron-trafficking protein that has been associated with both osteogenesis and ferroptosis, but the exact role and molecular mechanism of LCN2 in CKD-CVC needs to be explored. Method A cross-sectional clinical study was utilized to examine the association between LCN2 expression and CKD-CVC in serum and calcified radial arteries of CKD patients. LCN2 knockout mice, their wild type littermates and mice infected with VSMCs-targeted adeno-associated virus encoding LCN2 gene or negative control gene were all fed by the high adenine and phosphate diet to induce CKD-CVC.VSMCs transfected with LCN2-overexpressing lentivirus, LCN2-shRNA lentivirus or LCN2 siRNA and recombinant LCN2 stimulated VSMCs were treated under the condition of calcifying medium to investigate the role of LCN2 in CKD-CVC in vitro. Cardiovascular calcification was evaluated by Von-kossa staining and tissue calcium content assay. VSMCs calcification were checked by the Alizarin Red Staining and cellular calcium content assay. Cellular reactive oxygen species (ROS) were measured by the DCFDA assay. Lipid peroxidation was measured by the fluorescence of the fatty acid analog C11-BODIPY581/591 probe. Intracellular labile ferrous iron levels were measured by fluorescence of Phen Green SK probe and ferro-orange probe. Transmission electron microscopy was also used to examine mitochondrial change of ferroptosis. Results The cross-sectional study identified that LCN2 levels in serum and radial arteries were significantly increased as the severity of CKD-CVC increased. High adenine and phosphate diet intake provokes renal fibrosis and cardiovascular calcification in vivo. In vitro, five-days high phosphate sodium stimulation induced calcium deposition and osteoblastic trans differentiation of VSMCs. Meanwhile, high phosphate also increased the levels of ferroptosis in VSMCs as evidenced by decreased cell viability, iron and ROS accumulation, upregulated PTGS2 and MDA levels, reduced glutathione peroxidase 4 (GPX4) levels and significantly mitochondrial damage in VSMCs. Intriguingly, calcium deposition in VSMCs could be reversed by the ferroptosis inhibitor ferrostatin-1. LCN2 expression was significantly upregulated both in the aorta of mice and calcified VSMCs. Compared with WT mice, deletion of LCN2 inhibited cardiovascular calcification whereas VSMC-targeted LCN2 overexpression aggravated CKD-CVC. Consistently, LCN2 knockdown also alleviated calcium deposition of VSMCs. Meanwhile, inhibition of ferroptosis were observed after LCN2 silencing as evidenced by decreased ferrous and lipid oxidation while increased levels of GPX4. Mechanically, we demonstrated high phosphate increased the protein level of NCOA4 and downregulated FTH1, which was reversed by depletion of LCN2. Knockdown of NCOA4 partly alleviated the ferritin reduction, ferroptosis, and calcification in VSMCs, indicating that NCOA4-mediated ferritinophagy was required for VSMCs calcification. Furthermore, we found that the recombinant LCN2 treatment significantly upregulated phosphorylated STAT3. STAT3 signaling inhibitor abolished the recombinant LCN2 induced NCOA4 upregulation and calcification in VSMCs. Conclusion Our findings indicate that the pro-calcific effect of high phosphate is due to VSMCs ferroptosis mediated by LCN2 upregulation. LCN2 silencing alleviates CKD-CVC by suppressing the STAT3/ NCOA4/FTH1 signaling mediated ferritinophagy. LCN2 could serve as a candidate therapeutic strategy for CKD-CVC.

Abstract PO3-11-08: High Risk of Metabolic Dysfunction in Non-Obese Breast Cancer Survivors

Abstract Much literature already depicts the relationship between metabolic syndrome (MS), obesity, and breast cancer. Despite that, up to one-third of non-obese individuals may exhibit undiagnosed MS or metabolic dysfunction, posing an independent cancer risk and worse outcomes even for those with a body mass index (BMI) &amp;lt; 30kg/m². In that manner, our study aims to evaluate the metabolic profile of non-obese women with postmenopausal breast cancer compared to non-obese women without breast cancer. In this cross-sectional clinical study at the State University of São Paulo Medical School - UNESP. The study group (n=130) included women aged ≥ 45 and &amp;lt; 75 years, in amenorrhea for at least 12 months, BMI ≤ 30kg/m2, histological diagnosis of breast cancer, without metastatic disease, and without established cardiovascular disease (CVD). The control group (n=130) comprised women with all the same criteria except for breast cancer diagnosis. The groups were matched by age and menopause time in a ratio of one case to one control (1:1). We aimed to analyze their clinical, biochemical, and oncological data to establish relationships between these groups. We presented the data in tables 1 - 3. The groups showed homogeneity in age, time since menopause, BMI, waist circumference (WC), and cholesterol levels. There was a higher occurrence of MS and hypertension (HTN) among women treated for breast cancer compared to the control group (30.8% vs. 20.0% and 25.4% vs.14.6%, respectively) (p&amp;lt; 0.05). Similarly, a higher percentage of women treated for breast cancer had abnormal values for total cholesterol and glucose (56.2% vs. 43.1% and 29.2% vs. 15.4%, respectively) (p&amp;lt; 0.05). In the analysis of metabolic profile risk-adjusted for age time since menopause and BMI, women treated for breast cancer showed an increased risk for MS (OR=2.76, 95% CI 1.48-5.15), elevated glucose (OR=2.69, 95% CI 1.46-4.96), and HTN (OR=3.03, 95% CI 1.51-6.10). In the evaluation of factors influencing the metabolic profile, women with breast cancer had significantly higher mean values of WC (82.6±8.5 vs. 79.9±6.4 cm, p=0.048), systolic and diastolic blood pressure (129.2±17.1 and 77.7±8.8 mmHg vs. 118.2±15.1 and 73.6±8.8 mmHg, p=0.0002 and p=0.01, respectively), and glucose (99.7±32.5 vs. 86.6±7.6 mg/dL, p=0.0002) compared to control group. We conducted a sub-analysis among women with BMI &amp;lt; 25kg/m² from both groups. Women with breast cancer (n=64) had a higher occurrence of MS compared to women without breast cancer (n=53) (17.2% vs. 1.9%, respectively). Even though this sub-analysis did not reach the minimum number of patients with BMI &amp;lt; 25 kg/m² to achieve p value &amp;lt; 0,05, this analysis reveals a significant difference in MS incidence between the groups (p=0.007). This reinforces the hypothesis that oncological diagnosis substantially affects metabolic health, and therefore, breast cancer patients should receive special attention regarding their metabolic profile, regardless of their BMI. Conclusion: Non-obese women with breast cancer showed a higher risk of MS, HTN, and diabetes, with a worse metabolic profile than non-obese postmenopausal women without breast cancer. These findings suggest that postmenopausal women diagnosed with breast cancer, even in the absence of obesity, exhibit significant metabolic dysfunction characterized by a higher occurrence of MS and its components. The findings highlight the importance of a comprehensive assessment of metabolic health in women with breast cancer, regardless of their body mass index, to ensure appropriate and individualized care for these patients. Table 1 - Comparison of clinical and laboratory characteristics among 130 non-obese postmenopausal women with breast cancer and 130 non-obese postmenopausal women (control) (average values ± standard deviation). Table 2 - Comparison of categorized clinical and laboratory characteristics that influence the metabolic profile between 130 non-obese postmenopausal women with breast cancer and 130 non-obese postmenopausal women (control). Values expressed as number and percentage in parentheses. CA, cancer; WC, waist circumference; MS, metabolic syndrome; HDL, high-density lipoprotein, LDL, low-density lipoprotein; TG, triglycerides. *Significant difference p&amp;lt;0.05 (Chi-square Test). Table 3. Association between the presence of Metabolic Syndrome, and its clinical and laboratory components, among the 130 non-obese postmenopausal women with breast cancer and the 130 non-obese postmenopausal women (control). Values expressed as number and percentage in parentheses. CA, cancer; BP, blood pressure; WC, waist circumference; TG, triglycerides. *Odds ratio (OR) adjusted for age, menopause duration and BMI. **Significant difference if p&amp;lt;0.05 (Logistic Regression). Citation Format: Pedro Paulo Perroni Filho, Daniel Buttros, Eliana Aguiar Petri Nahas. High Risk of Metabolic Dysfunction in Non-Obese Breast Cancer Survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-08.

Axial Involvement in Psoriatic Arthritis: A Cross-sectional Clinical and Radiologic Studies.

This study aimed to investigate spinal involvement in psoriatic arthritis (PsA) patients using clinical and radiographic methods. A cross-sectional clinical study was conducted on 50 PsA patients diagnosed according to the CASPAR criteria. Clinical examinations and functional assessments were performed. A radiographic assessment of the spine was performed. Out of 50 PsA patients (mean age of 45.50 ± 9.90 years), (males and females constituted 27 (54.0%) and 23 (46.0%) respectively), 76% had radiological axial involvement; (26%) with inflammatory axial pain and (50%) without inflammatory axial pain (subclinical). Three axial radiographic patterns were detected including spondylitis without sacroiliitis (15.78%), spondylitis with sacroiliitis (78.94%), and sacroiliitis without spondylitis (5.26%). In axial PsA patients, males were more affected than females (χ2=11.679, p = 0.003), with older age (H = 15.817, p < 0.001) and higher body mass index (BMI) (F = 5.145, p = 0.010), increased psoriasis duration (H = 9.826, p = 0.007) and severity (Η=25.171, p < 0.001), and more spinal movement limitations than PsA patients without axial involvement (F = 26.568, p < 0.001). Cervical involvement was higher than lumbar involvement. Axial radiographic severity assessed by the PsA Spondylitis Radiology Index was associated with increased disability as assessed by the Health assessment questionnaire (rs = 0.533, p = 0.001) and decreased quality of life assessed by short form-36 score (rs = -0.321, p = 0.050). This study shows that a high percentage of PsA patients had axial involvement with a high percentage of them having asymptomatic radiological findings. The cervical spine is more frequently and severely affected than the lumbar spine. Axial PsA occurs in males more than females with characteristic older age and higher BMI, increased psoriasis duration, and more limitation of spinal mobility.

Novel point-of-care cytokine biomarker lateral flow test for the screening for sexually transmitted infections and bacterial vaginosis: study protocol of a multicentre multidisciplinary prospective observational clinical study to evaluate the performance and feasibility of the Genital InFlammation Test (GIFT)

IntroductionA prototype lateral flow device detecting cytokine biomarkers interleukin (IL)-1α and IL-1β has been developed as a point-of-care test—called the Genital InFlammation Test (GIFT)—for detecting genital inflammation associated with sexually...