Features Of Instrument Research Articles

Characterization and natural history of different phenotypes in hereditary transthyretin amyloidosis: 40-year experience at a single Italian referral centre.

Hereditary transthyretin amyloidosis (ATTRv) is one of the leading aetiologies of systemic amyloidosis with more than 135 mutations described and a broad spectrum of clinical manifestations. We aimed to provide a systematic description of a population of individuals carrying pathogenic mutations of transthyretin (TTR) gene and to investigate the major clinical events during follow-up. This was an observational, retrospective, cohort study including consecutive patients with mutations of TTR gene, admitted to a tertiary referral centre in Bologna, Italy, between 1984 and 2022. Three hundred twenty-five patients were included: 106 asymptomatic carriers, 49 cardiac phenotype, 49 neurological phenotype, and 121 mixed phenotype. Twenty-two different mutations were found, with Ile68Leu (41.8%), Val30Met (19%), and Glu89Gln (10%) being the most common. After a median follow-up of 51 months, 111 patients (38.3%) died and 9 (11.5%) of the 78 asymptomatic carriers developed ATTRv. Carriers had a prognosis comparable with healthy population, while no significant differences were seen among the three phenotypes adjusted by age. Age at diagnosis, New York Heart Association class III, left ventricular ejection fraction, modified polyneuropathy disability score IV, and disease-modifying therapy were independently associated with survival. This study offers a wide and comprehensive overview of ATTRv from the point of view of a tertiary referral centre in Italy. Three main phenotypes can be identified (cardiac, neurological, and mixed) with specific clinical and instrumental features. Family screening programmes are essential to identify paucisymptomatic affected patients or unaffected carriers of the mutation, to be followed through the years. Lastly, disease-modifying therapy represents an evolving cornerstone of the management of ATTRv, with a great impact on mortality.

Structural Flexibility Effect on Spaceborne Solar Observation System’s Micro-Vibration Response

The spaceborne solar observation system is crucial for the study of space phenomena such as solar flares, which requires high tracking accuracy. This study presents a coupling model that integrates mechanical, electrical, and control models to investigate the structural flexibility effect on the micro-vibration response. We established a rigid–flexible model using mechanical parts. We considered the influence of flexible features while studying the dynamic responses in its operation. The state-space equations of the system showed that modal frequency, damping, and modal participation factors played significant roles. We derived transfer functions using the Laplace transform of the coupling models to better understand this mechanism, and Simulink models were thereby established. We simulated the acceleration responses of the rigid–flexible and rigid models under angle tracking modes, and the results showed significant differences. We also simulated the acceleration responses of the models under various control frequencies, and the optimal control frequency was thus obtained. Finally, we performed experiments, and the results indicated that the rigid–flexible model could better predict the motion and acceleration responses for the spaceborne solar observation system. This study provides valuable information for understanding the role of flexible features in space performance high-tracking accuracy instruments and for micro-vibration suppression research.

Mining the Performance Characteristics of Yao Nationality Musical Instruments under Multivariate Statistical Analysis

Abstract In the context of the rapid development of modernization and urbanization, the inheritance and research of music and musical instruments by ethnic minorities are facing great challenges. It is, therefore, of enormous significance to uncover the performance characteristics of ethnic minority musical instruments. This paper focuses on four categories of Yao musical instruments, namely reed instruments, air-pipe instruments, wind instruments, and percussion instruments. We mine the performance features of Yao musical instruments using MFCC feature extraction, perceptual linear prediction parameter extraction, and other methods. The performance of this paper’s algorithm is explored by comparing the detection and recognition accuracy of its algorithm with SVM on four types of musical instruments. The performance characteristics of Yao musical instruments are explored by analyzing the timbre characteristics, auditory characteristics, and beat statistics of the four instruments. This paper’s algorithm significantly outperforms the SVM algorithm in the recognition correct rate of four different types of musical instruments, with differences of 2.1905%, 7.1574%, 5.3758%, and 3.6962%, respectively. The extracted performance features of Yao music instruments reveal that reed instruments and air-pipe instruments have a superior timbral effect than wind instruments and percussion instruments. The sound of pneumatic instruments and wind instruments is the best when it comes to audibility, and the beats of reed instruments and wind instruments are the best among the four instruments.

Circumscribed choroidal hemangioma and non-pigmented choroidal melanoma: clinical, instrumental and molecular genetic features

This study attempts to develop a method of non-invasive molecular genetic differential diagnostics of CCH and non-pigmented CM. Based on the results of clinical and instrumental examination methods, 60 patients (60 eyes) with CCH (n=30) and non-pigmented CM (n=30) were included in this prospective study. The control group consisted of 30 individuals without intraocular tumors. Mutations in the GNAQ/GNA11 genes were determined by real-time PCR using the analysis of genomic circulating tumor DNA isolated from peripheral blood plasma. The average follow-up period was 12.1±1.8 months. The study revealed a significant association of mutations in exons 4 and 5 of the GNAQ/GNA11 genes with the presence of non-pigmented CM (27/30; 90%). These mutations were not detected in the group of patients with CCH. Mutations in exons 4 and 5 of the GNAQ/GNA11 genes were also not detected in the control group of healthy individuals. This study proposes a method of non-invasive and low-cost differential diagnostics based on molecular genetic analysis and detection of mutations in exons 4 and 5 of the GNAQ and GNA11 genes, which are specific for CM (90%).

О стилистике Камерной симфонии Дж. К. Адамса

The article is devoted to a comprehensive study of the stylistic features of the Chamber Symphony by contemporary American composer John Coolidge Adams, a topic that is currently dwelt upon insufficiently. The author explores the paths of formation of the chamber symphony genre and provides examples of its manifestation in the works of 20th century Russian composers and those from other countries. The similarities and differences between Adams’ Chamber Symphony and Arnold Schoenberg’s Chamber Symphony No. 1, opus 9: the specific features of instrumentation and the compositional structure are examined. The programmatic nature of the composer’s works received separate attention in the article: approaches intrinsic to the Romantic era are compared with the poetics of the titles of Adams’ composition. The author of the article pays special attention to the timbral and rhythmic features of the composition as well as its formal structure. Drawing on a wide range of sources, the specificity of the creation of the Chamber Symphony and Adams’ perspectives of the minimalist method of composition are disclosed. The influence of minimalism on Adams’ compositional style is established. On the basis of the analysis of the three movements of the cycle, the idea is substantiated that in the musical material of the Chamber Symphony, Adams managed to maintain the balance between traditional and non-traditional approaches to symphonic music.

The role of heredity in cutaneous mastocytosis and C-KIT gene mutation

Introduction. Mastocytosis is a rare disease associated with the proliferation of clonal mast cells in the skin and other organs and systems. In the last decade, studies have appeared on the role of genetic factors in the development of the disease. According to their results, the mode of inheritance of mastocytosis was determined to be autosomal dominant with incomplete penetrance of the gene. Aim. To analyze the frequency of familial cases of mastocytosis and describe a familial case of monomorphic type maculopapular cutaneous mastocytosis (monoPPCM). Results. A family history was present in 6.7% of 341 children with mastocytosis. The article presents a description of the clinical, laboratory and instrumental features of monoPPCM in cousins (paternal kinship). The course of mastocytosis in a patient with the KIT D816V mutation in the peripheral blood was more severe than in her cousin without the mutation. Conclusion. The family case of monoMPCM presented in the article demonstrated the need for careful examination and dynamic monitoring of children with this pathology. The diagnosis of monomorphic (“adult”) type of MPCM is associated with a long course and the risk of developing systemic mastocytosis. Determining KIT mutations is necessary not only for prognosis, but also for developing a strategy for monitoring and treating the patient.

Подозрение на септический сакроилиит у молодого пациента с псориатическим артритом

Sacroiliitis in psoriatic arthritis (PsA) was previously considered rare, mild, and non-disabling disorder, but recent studies have demonstrated gross axial impairment in many patients with PsA. The lack of a generally accepted definition of axial involvement in sacroiliitis in PsA worldwide leads to difficulties and doubts when establishing a diagnosis and determining treatment strategy for patients who often require urgent therapeutic measures. This article discusses a patient with sacroiliitis who required a complex differential diagnosis, including specific infections. It reviews the clinical, laboratory and instrumental features of aseptic and septic sacroiliitis. It is essential for specialists to be aware of a range of diseases, including infectious ones, associated with sacroiliitis, and to verify and exclude them in order to provide high-quality medical care. KEYWORDS: psoriatic arthritis, sacroiliitis, septic sacroiliitis, brucellosis, tuberculosis. FOR CITATION: Akulinushkina E.Y., Yakupova S.P., Yakupov E.Z., Ivanova L.V., Maksimov N.I. Young patient with psoriatic arthritis with suspected septic sacroiliitis. Russian Medical Inquiry. 2024;8(2):84–88 (in Russ.). DOI: 10.32364/2587-6821-2024-8-2-5.

Toward a European Facility for Ground-Based Radar Observations of Near-Earth Objects

In this work, we present the preliminary results of radar observations of Near-Earth Objects (NEOs) carried out by European radio telescopes in the framework of the European Space Agency (ESA) project “NEO observation concepts for radar systems”, aimed at deriving the functional requirements of a planetary radar system, evaluating the available European assets to perform NEO radar observations, and carrying out test radar campaigns. In the first part of the project, we executed the performance analysis of a possible European planetary radar system. Instrumental features, as much as issues like the impact of weather conditions on signal propagation at different radio frequencies, were considered. This paper focused on the test campaigns, performed in the years 2021–2022 in collaboration with the Jet Propulsion Laboratory (JPL), which led to the observation of several asteroids including 2021 AF8, (4660) Nereus, and 2005 LW3, which allowed us to derive astrometric measurements, as well as to measure physical properties, such as rotation periods, and observe how one of the targets is actually a binary asteroid. The obtained results demonstrated that European radio astronomical dishes, although employed only as receivers (in bistatic or multistatic configurations) and for a limited amount of time, are able to provide a significant contribution to the constitution of a European network to increase the opportunities for NEO monitoring and studies, if a transmitting antenna—equipped with a suitable high-power transmitter—were made available.

Clinical cases of “MR-negative” myelopathy amid SARS-CoV-2 infection

INTRODUCTION. Neurological complications are often observed in patients with a new coronavirus infection. Cerebrovascular diseases prevail among them. There is damage to the peripheral nervous system and spinal cord of various kind, including inflammatory and vascular myelopathy. The incidence of myelopathy syndrome among all neurological complications of the new coronavirus infection reaches 3%.
 OBJECTIVE. To characterize clinical and instrumental features of the rare case – “МR-negative” myelopathy amid SARS-CoV-2 infection.
 MATERIALS AND METHODS. The article describes a clinical case of myelopathy, associated with COVID-19 without structural changes in the spinal cord on MR-imaging using standard pulse sequences, however, visualized via spinal tractography.
 CONCLUSION. COVID-19 associated myelopathy is one of the characteristic complications amid the new coronavirus infection. To verify “MR-negative” damage to the central nervous system in COVID-19, advanced protocols of MRI studies might be used, including the promising method – МR-tractography.

Musical Instruments in the Cultural Life of the Xơ Đăng Ethnic Group In Quảng Ngãi

In this paper, entitled "Musical Instruments in the Cultural Life of the Xơ Đăng Ethnic Group in Quảng Ngãi, Vietnam (Chordophone)," the author conducts an in-depth study of folk musical instruments in the social life of the Cadong people, a sub-ethnic group of the Xơ Đăng ethnic group, who have long settled in the eastern foothills of the Trường Sơn mountain range in the northwest of Quảng Ngãi province, Vietnam. The paper will systematically present issues related to Xơ Đăng’s chordophone, including classification, material, structure, and crafting methods; playing techniques, performance environments, and instrument features; and the system of compositions of the Xơ Đăng’s chordophone (V'roac, Goong, Kaní, and Rauốt). This study was conducted based on the results of the author's survey and fieldwork in the following Xơ Đăng villages: Sơn Bua, Sơn Tân, Sơn Mùa, Sơn Dung (in Sơn Tây district), Trà Kem, and Trà Xinh (in Tây Trà district) in Quảng Ngãi province.

Multiple Chord Coding in China’s Minority Dance Music

Abstract In this paper, we first use CNNS to collect rich samples of folk dance music, establish a model framework and a functional system framework, and conduct a comprehensive process analysis of the music. Then, the instrumental features, frequency features, and timbre features are extracted to obtain the spectral information. In the stage of chord analysis and encoding, a multivariate chord encoding model is established based on the acquired spectral information, including two parts: chord representation preprocessing and chord encoding. By utilizing this model, the chord structure of music was successfully and accurately encoded, allowing for analysis with up to 98% accuracy. Furthermore, significant recall results were achieved, reaching over 0.9, which suggests that the extracted chord features are highly reliable and accurate in recognizing musical chord information.

Unpacking human activities and the social attributes shaping street vitality in a Chinese context – a microscale analysis

ABSTRACT The social attributes of streets have been disregarded in China, and a contextualized understanding of social vitality was missing. This research employs behavioral mappings, spatial analyses, and structured interviews to analyze human activities on residential streets in Shanghai at a microscale. Different activity patterns inform street vitality differently. The highest vitality level is organically-shaped by multiple intertwined activities taking place in hotspots significantly correlated with small shops and residential entrance gates – instrumental features in creating vibrant scenes where street space was extensively appropriated. Mid-vitality streets had pockets of activities. In less interesting streets, the few “business-related” or “dynamic” activities helped shape a lower (but not entirely missing) vitality. From this in-depth mapping of activities and observed symbiosis between local shopkeepers and residents, recommendations for policy and practice are derived.

Clinical and instrumental features of vertebrogenic lumbosacral pathology in machine milking operators

In the structure of occupational pathology, female workers of modern agricultural production, along with diseases of the musculoskeletal system and soft tissues of the upper extremities, vertebrogenic lesions of the lumbosacral level have become more often diagnosed. The aim of the study was to study the features of vertebrogenic pathology of the lumbosacral region with the analysis of radiological and electroneuromyographic data in machine milking operators of the Republic of Bashkortostan. The following results were obtained. On radiographs of the lumbosacral spine, degenerative-dystrophic changes in the form of a decrease in the height of discs, spondylosis, spondyloarthrosis were noted in machine milking operators. Electroneuromyographic criteria revealed a decrease in amplitude and velocity parameters of conduction along the peripheral nerves of the lower extremities. The revealed changes in vertebrogenic lumbosacral pathology in the examined patients make it possible to ensure timely diagnosis and prevention of production-related pathology with the formation of rational schemes of therapeutic and recreational measures.

Ultra-Fast Ion Mobility Spectrometer for High-Throughput Chromatography.

Fast chromatography systems especially developed for high sample throughput applications require sensitive detectors with a high repetition rate. These high throughput techniques, including various chip-based microfluidic designs, often benefit from detectors providing subsequent separation in another dimension, such as mass spectrometry or ion mobility spectrometry (IMS), giving additional information about the analytes or monitoring reaction kinetics. However, subsequent separation is required at a high repetition rate. Here, we therefore present an ultra-fast drift tube IMS operating at ambient pressure. Short drift times while maintaining high resolving power are reached by several key instrumental design features: short length of the drift tube, resistor network of the drift tube, tristate ion shutter, and improved data acquisition electronics. With these design improvements, even slow ions with a reduced mobility of just 0.94 cm2/(V s) have a drift time below 1.6 ms. Such short drift times allow for a significantly increased repetition rate of 600 Hz compared with previously reported values. To further reduce drift times and thus increase the repetition rate, helium can be used as the drift gas, which allows repetition rates of up to 2 kHz. Finally, these significant improvements enable IMS to be used as a detector following ultra-fast separation including chip-based chromatographic systems or droplet microfluidic applications requiring high repetition rates.

Impact of Personality Traits on Sustainable Entrepreneurship Development

The evolving landscape of globalization is bringing about inevitable changes in the development of sustainable entrepreneurship. Sustainable entrepreneurship combines entrepreneurial traits with a focus on both market success and social impact. However, in today's competitive environment, it is imperative for every entrepreneur to possess specific personality traits to enhance their competitiveness. The primary objective of this research was to investigate the influence of four significant personality traits: agreeableness, openness, extraversion, and neuroticism, on the sustainable development of entrepreneurship in small and medium-sized enterprises (SMEs). The study employed a positivist research philosophy, an explanatory research design, and a quantitative survey method using a convenience sampling technique. A total of 396 entrepreneurs from the registered SMEs in the Surkhet district were identified as samples. Inferential statistics, specifically structural equation modeling, were used to analyze the data. The study revealed that personality traits such as agreeableness, openness, and extraversion had a positive influence on the development of sustainable entrepreneurship. This suggests that individuals possessing interpersonal skills, innovativeness, curiosity, situational sociability, confidence, and passion played a foundational role in promoting entrepreneurial sustainability. On the other hand, the personality trait of neuroticism demonstrated an insignificant positive impact on sustainable entrepreneurial development. This implies that neurotic individuals, prone to anxiety, stress, and emotional instability, may hinder decision-making processes and disrupt the stability of sustainable entrepreneurship. Based on these findings, the study suggests that entrepreneurs should prioritize instrumental features of personality traits like agreeableness, openness, and extraversion for sustainable entrepreneurship development, while minimizing the influence of neuroticism.

Characterization and natural history of phenotypes in hereditary transthyretin amyloidosis

Abstract Background Hereditary systemic amyloidosis (ATTRv), caused by mutations in the transthyretin (TTR) gene, is a rare systemic disease with autosomal dominant transmission, incomplete penetrance, and variable expressivity. Purpose The purpose of this study was to describe the population of individuals with pathogenic mutations for TTR, comparing the genotype and clinical-instrumental characteristics of patients based on phenotype. Subsequently, the disease course was investigated in terms of the onset of new clinical manifestations, survival, and hospitalizations for heart failure. Methods Clinical and instrumental data from 325 consecutive patients carrying a pathogenic mutation of the TTR gene (asymptomatic carriers, n=106; cardiac phenotype, n=49; neurological phenotype, n=49; mixed phenotype, n=121) were analyzed at Our Center between 1979 and August 2022. Results A total of 23 different mutations were found, with Ile68Leu (41.8%), Val30Met (19%), and Glu89Gln (10%) being the most represented. Dominant mutations were found in patients with cardiac and neurological phenotypes, respectively Ile68Leu and Val30Met, while patients with mixed phenotype had marked genotypic variability. Patients with cardiac amyloidosis (CA) were predominantly male and had a more advanced NYHA functional class at presentation, while subjects with neurological involvement showed greater motor disabilities. There was also a significant difference in the age of disease diagnosis between the three groups: cardiac phenotype 73.2 years (IQR 66.5 – 78.1), mixed phenotype 58.4 years (IQR 47- 66.3), neurological phenotype 44 years (IQR 33.5 – 62.9). At the end of a median follow-up of 51 months (IQR 24 – 90 months), data from 290 subjects were analyzed, of whom 111 (38.3%) died and 123 (42.4%) had a major clinical event, including death or hospitalization for heart failure. Subjects without signs of disease had a prognosis similar to that of the healthy population, while patients with CA, with or without neurological manifestations, had a worse overall and event-free survival compared to those with isolated neurological phenotype. On multivariate analysis, age at diagnosis, NYHA functional class, and an mPND score ³ 2 were independently associated with adverse clinical events. Conclusions This study confirms the important clinical heterogeneity of patients with ATTRv, where three main phenotypes can be identified, characterized by specific clinical, demographic, and instrumental features. Although in some cases it is possible to identify a genotype-phenotype correlation, the extreme variability of clinical presentation is evident even among patients sharing the same mutation. In the study cohort, patients with CA had a worse prognosis. However, this finding should be interpreted with caution because it is influenced by disease-modifying therapy, which was performed unevenly among the three phenotypes.Univariate and multivariateKaplan-Meier curves

2 Satellite-Based Decision Support Tools to Assist Grazing Cattle Production

Abstract Grasslands cover approximately 40.5% of the surface of the earth and 80% of agriculturally productive land. After forests, grasslands are the primary carbon sink source and the most used feed source for livestock production. Regularly monitoring grasslands assures efficient management and sustainability of pasture-based production systems. Conventional ground-based methods to monitor grassland production and management rely on field measurements, which are time-consuming and usually restricted to small-scale assessment. Using satellite information allows for large-scale monitoring of grasslands and capturing the spatial variability of the land surface with high temporal resolution. Various methods for grassland monitoring based on satellite data can be applied, such as classifications, correlations/regression analyses, and time series analyses. Depending on the purpose of the application, these methods are sometimes combined to derive grassland management and production information. The ability of satellite-based data to quantify vegetation characteristics depends on the type of sensor and instrumentation features, such as spectral, radiometric, spatial, and temporal resolution, polarization, and angularity. The models to estimate grassland biomass based on remote sensing have been chiefly focused on optical systems. The spectral reflectance of raw bands and vegetation indices were used as proxies to investigate spatial and temporal patterns of grassland production. Optical (multispectral or hyperspectral) sensors are passive and require sunlight, so they depend highly on the weather (cloud) and light conditions. Thus, there has been increasing interest in active sensors, such as Synthetic Aperture Radar (SAR) and Light Detection and Ranging (LIDAR) sensors, which are not constrained due to clouds but are more complex. Using satellite data in combination with field measurements has commonly yielded regression models (e.g., linear, power, logarithmic, multiple linear) for estimating grassland biomass or biophysical characteristics (e.g., chlorophyll, leaf area index) of different types of grasslands. The exponential evolution of digital computers has pushed forward machine learning-based regression methods to estimate biomass. Random forest, support vector machines, and artificial neural networks are the most used algorithms. The possibility of accurate mapping and monitoring of biomass and nutritional attributes of grasslands based on satellite provides essential insights into the decision support system for pasture management. A better understanding of the nitrogen status of pastures, forage biomass, and its nutritive value is instrumental in livestock and forage management. Timely prediction of these variables can help improve decision-making by grazing land managers on, for instance, the adjustment of stocking rate or adequate supplementation to match the needs of animals toward more sustainable production. Future use of satellite-based grazing models in tandem with ruminant nutrition models will enable to development of decision-support tools to assist with many aspects of livestock production in diverse environmental conditions and accounting for temporal variability. (FAPESP #2020/14367-7)

Clinical and instrumental features in 82 patients with insufficient sleep syndrome.

Insufficient sleep syndrome possibly represents the worldwide leading cause of daytime sleepiness, but remains poorly recognised and studied. The aim of this case series is to comprehensively describe a cohort of patients with insufficient sleep syndrome. Eighty-two patients were studied concerning demographic and socio-economic features, medical, psychiatric and sleep comorbidities, substance use, sleep symptoms, actigraphy, video-polysomnography, multiple sleep latency tests and treatment. The typical patient with insufficient sleep syndrome is a middle-aged adult (with no difference of gender), employed, who has a family, often carrying psychiatric and neurological comorbidities, in particular headache, anxiety and depression. Other sleep disorders, especially mild sleep apnea and bruxism, were common as well. Actigraphy was a valuable tool in the characterisation of insufficient sleep syndrome, showing a sleep restriction during weekdays, associated with a recovery rebound of night sleep during weekends and a high amount of daytime sleep. An over- or underestimation of sleeping was common, concerning both the duration of night sleep and daytime napping. The average daily sleep considering both daytime and night-time, weekdays and weekends corresponds to the recommended minimal normal duration, meaning that the burden of insufficient sleep syndrome could mainly depend on sleep fragmentation and low quality. Sleep efficiency was elevated both in actigraphy and video-polysomnography. Multiple sleep latency tests evidenced a tendency toward sleep-onset rapid eye movement periods. Our study offers a comprehensive characterisation of patients with insufficient sleep syndrome, and clarifies their sleeping pattern, opening avenues for management and treatment of the disorder. Current options seem not adapted, and in our opinion a cognitive-behavioural psychotherapy protocol should be developed.

Comparative characteristics of pneumonia caused by <i>Mycoplasma pneumoniae</i> in children

The urgency of the problem of community-acquired pneumonia in children is due to the high incidence rate. In the etiological structure of bacterial pneumonia, Streptococcus pneumoniae and Mycoplasma pneumonia (Mp) prevail.Purpose: to identify clinical, laboratory and instrumental features of mycoplasmal pneumonia in children.Materials and methods. A retrospective, single-center cohort study of 266 case histories of children aged 4 months to 17 years who were in Children’s City Clinical Hospital No. 9 in 2019 with a referral diagnosis of pneumonia was carried out. To verify the diagnosis of pneumonia, the method of chest X-ray was used, for the etiological diagnosis, the method of PCR swabs from the nasopharynx, ELISA for the detection of antibodies of the IgM and IgG classes was used. Results. The diagnosis of pneumonia was confirmed in 190 children. The diagnosis of pneumonia caused by M. pneumoniae (MpP) was established in 76 (40%) children, they made up the 1st group. The remaining 114 (60%) children with community-acquired pneumonia of another etiology (CAP) made up the 2nd group – comparisons. The diagnosis of MpP was confirmed in 46 (60.5%) children by the detection of IgM, in 12 (15.8%) by the detection of Mp genetic material, and in 18 (23.7%) by positive both IgM and PCR. The median age of children in the group with MpP was 9.6 years, in the comparison group – 4 years (p<0.01). Significantly more often MpP occurs in children aged 11–17 years (p < 0.01), and CAP – up to 7 years (p < 0.01). With MpP, catarrhal phenomena in the form of hyperemia of the oropharynx, nasal congestion, and unproductive cough are observed less frequently than with CAP. With MpP, rales in the lungs are heard more often than with CAP, they are significantly more often wet (p<0.01). Respiratory failure and dyspnea are less common in MpP than in CAP. Bilateral lesions and lesions of the upper lobe of the lungs are more often detected in MpP, and in CAP – right-sided lesions. In the general blood test, leukocytosis, incl. above 15 thousand/µl, as well as leukopenia below 4 thousand/µl were significantly more frequent in the group of patients with CAP (p<0.01). Conclusion. No clear clinical and laboratory criteria for mycoplasmal etiology of pneumonia have been obtained, which dictates the need for laboratory confirmation for the choice of therapy tactics.

Myocarditis in anti-synthetase syndrome: clinical features and diagnostic modalities.

Myocarditis is an overlooked manifestation of anti-synthetase syndrome (ASS). Our study describes the clinical and instrumental features of ASS myocarditis and evaluates the performance of cardiac MRI (CMRI) with mapping techniques in assisting diagnosis of ASS myocarditis. Data from patients with ASS were retrospectively analysed. CMRI data for patients diagnosed with myocarditis, including late gadolinium enhancement (LGE), T2 ratio, T1 mapping, extracellular volume (ECV) and T2 mapping, were reviewed. Myocarditis was defined by the presence of symptoms and/or signs suggestive for heart involvement, including increased high-sensitive troponin T (hs-TnT) and/or N-terminal pro-brain natriuretic peptide (NT-proBNP), and at least an instrumental abnormality. The clinical features of patients with ASS with and without myocarditis were compared. A P-value of <0.05 was considered statistically significant. Among a cohort of 43 patients with ASS [median age 58 (48.0-66.0) years; females 74.4%; anti-Jo1 53.5%], 13 (30%) were diagnosed with myocarditis. In 54% of those 13 patients, myocarditis was diagnosed at clinical onset. All patients with ASS with myocarditis had at least one CMRI abnormality: increased ECV in all cases, presence of LGE in 91%, and increased T1 and T2 mapping in 91%. The 2009 Lake Louise criteria (LLC) were satisfied by 6 patients, and the 2018 LLC by 10 patients. With the updated LLC, the sensitivity for myocarditis improved from 54.6% to 91.0%. Patients with ASS with myocarditis were more frequently males (53% vs 13%; P = 0.009) with fever (69% vs 17%; P = 0.001), and had higher hs-TnT [88.0 (23.55-311.5) vs 9.80 (5.0-23.0) ng/l; P < 0.001], NT-proBNP [525.5 (243.5-1575.25) vs 59.0 (32.0-165.5; P = 0.013) pg/ml; P = 0.013] and CRP [7.0 (1.7-15.75) vs 1.85 (0.5-2.86) mg/l; P = 0.011] compared with those without myocarditis. In ASS, myocarditis is frequent, even at clinical onset. Patients with ASS with myocarditis frequently presented with fever and increased CRP, suggesting the existence of an inflammatory phenotype. The use of novel CMRI mapping techniques may increase diagnostic sensitivity for myocarditis in ASS.