Higher Damage Scores Research Articles

Polymorphism in wild South American potato Solanum chacoense for resistance to Colorado potato beetle Leptinotarsa decemlineata

The Colorado potato beetle (CPB) – Leptonotarsa decemlineata is a dangerous potato pest in Russia. The creation of resistant varieties represents the most reliable method for protecting potatoes from this phytophage. A reliable phenotypic assessment of accessions stored in gene banks as seed collections is necessary before using wild potatoes as sources of resistance traits. Plants of nine accessions of S. chacoense (55 genotypes) from collection of the N.I. Vavilov All-Russian Institute of Plant Genetic Resources (VIR) were grown for three years on the experimental plot of VIR branch (Tambov region), where the environment is favorable for CPB. Annually seven parameters were recorded: the number of overwintered beetles per plant, the population of egg per plant, the number of older larvae per plant, the proportion of plants with more than 20 older larvae, the score of haulm damage, the proportion of plants with a high damage score and the number of second generation beetles. The origin of S. chacoense plants belonging to different accessions (“families”) in the VIR collection reliably affects their infestation and damaging by CPB. The influence of the “family” factor is 12–46 % depending on the assessed parameter. Solanum chacoense plants k-21854 are highly resistant and those of k-7394 are vulnerable to CPB. Plants in accessions k-2732, 2861, 3060, 19769, and 21848 were infested by the pest at different levels and varied in their individual damage parameters. Solanum chacoense genotypes k-19769 (542-3) and k-21854 (546-3) showed a high resistance to CPB during all three years of study.

Determination of Distributional Characteristics and Efficacy of Hand Radiographic Damage in Patients with Rheumatoid Arthritis Using a Novel Damage Assessment Method

Background: The purpose of this study was to identify the distribution characteristics of radiological damage to the hand of rheumatoid arthritis patients and evaluate its effectiveness using a new damage assessment method.Methods: Hand radiographs of a total of 127 rheumatoid arthritis patients were evaluated. We simplified the pre-existing van der Heijde modified total sharp score to assess the extent of bone damage. We selected 36 joints in both hands as regions of interest in our own way, and the erosion and joint space narrowing were scored.Results: When the erosion and joint space narrowing score values of each joint of the hand were added together, the joint space narrowing score was higher than the overall erosion score. We can see that the scaphoid,lunate,radius and ulnar joints have higher erosion scores, and the 4th proximal interphalangeal (PIP), Scaphoid, Lunate, and Radius joints have higher joint space narrowing scores than other joints. These damage assessment results were similar to the results from the previous damage assessment model.Conclusions: The joint space narrowing score is higher than the erosion score, suggesting that joint space narrowing precedes erosion. When checking the hand X-ray of rheumatoid arthritis patients, it is necessary to carefully check the scaphoid,lunate,radius and ulnar and 4th PIP joints, which relatively high radiographic damage scores. Also, the damage assessment model used in this study is relatively simple and does not show difference in analysis results from existing assessment models, so it can be considered for application in follow-up research.

Efficacy of rituximab on disease activity, severity, and disease-related damage in patients with immunosuppressive-resistant systemic sclerosis.

B-cell depletion with rituximab (RTX) is widely used as a rescue therapy in patients with systemic sclerosis (SSc). The aim herein was to analyze the progress of disease-related outcomes after RTX therapy in severe SSc patients. Included in this study were 27 SSc patients who were followed-up between 2012 and 2020 and received at least 1 cycle of RTX for active disease, despite receiving standard immunosuppressives (ISs). In addition to the European Scleroderma Study Group and European Scleroderma Trials and Research Group activity scores, Medsger's severity, and the recently developed Scleroderma Clinical Trials Consortium Damage Index values were evaluated initially and at 1 year after the first infusion. The progress of individual organ damage was also assessed at the end of the follow-up period (at least 6 months after the last infusion) using the data extracted from the medical records. Disease activity and severity-improved and disease-related overall damage worsened after the first year of RTX therapy (p < 0.001, p = 0.008, and p = 0.005). Some of the disease-related organ damage had improved at the end of the follow-up period, indicating its reversibility. Overall damage scores ≥11 after the first year of RTX therapy were found to be associated with mortality (p = 0.035). RTX contributed to reducing the activity and severity in SSc patients with severe disease, nonetheless the efficacy related to the damage was limited. High damage scores in the first year were found to be associated with mortality. Spontaneous progress of manifestations requiring a longer period to improve and irregular consecutive RTX courses might lead to difficulties in differentiation between activity and damage.

Falls and fear of falling: an underestimated sequelae in Behçet’s disease

BackgroundBehçet’s disease (BD) is an inflammatory autoimmune disorder. Balance is a multifactorial process that is ultimately affected in BD leading to frequent falls. Fear of falling (FOF) is a significant risk factor for falls. The study aimed to evaluate the risk of falls and FOF in BD and their relations to disease activity and damage.ResultsIn BD patients, the history of falls and FOF was 65.6% and 48.4%, respectively. The Berg Balance Scale was low in BD patients (P = 0.003). Falls and fear of falling showed significant relations with the disease activity and disease damage (P < 0.001). There were significant relations between fallers with arthritis (P = 0.003) and active neurological affection (P = 0.004) than non-fallers. A higher balance scale significantly independently decreases the risk of falls (AOR = 0.79, P = 0.005) and FOF (AOR = 0.904, P = 0.039); however, high BD damage and disease duration increase the risk with AOR = 2.364, P = 0.009 and AOR = 0.769, P = 0.088, respectively.ConclusionArthritis and active neurological affection are significantly related to falls and FOF; also, FOF is significantly related to active uveitis. Impaired balance, long disease duration, and high disease damage score are significant risk factors for falls and FOF in BD.

KARACİĞER İSKEMİ VE REPERFÜZYON HASARINDA KALP DOKUSUNDA MEYDANA GELEN HASARIN ÖNLENMESİNDE TAKSİFOLİN’İN KORUYUCU ETKİNLİĞİ: DENEYSEL ÇALIŞMA

Aim: Liver ischemia and reperfusion (I/R) is a serious, irreversible health problem in clinical practice. Taxifolin (Tax) is an easy to obtain and use agent found in maritime pine bark, Douglas fir bark and Siberian larch wood. In this study, we examined the protective efficacy of Taxifolin in the correction of cardiac tissue damage that may develop in liver I/R damage. Methods: In our study, a total of 28 Wistar Albino rats, 8-10 weeks old, weighing 250-300 grams, were used. Group 1 (n=7): control group, Group 2 (n=7): Tax group with 50 mg/kg dose orally for 3 weeks, Group 3 (n=7): Liver I/R group for 30 minutes ischemia and 120 minutes of reperfusion were performed. Group 4 (n=7): Tax+Liver I/R group. Results: In our study, MDA analysis was performed to evaluate oxidative stress. In the statistical analysis of MDA values, we observed that there was a statistically significant difference between the serum MDA values of the Tax group and the Tax+Liver I/R group, and the MDA level of the Tax group was lower (p&amp;lt;0.05). In myocyte damage scoring, we observed that the liver I/R group had the highest damage score, while the damage score of the Tax+Liver I/R group was significantly lower than the I/R group (p&amp;lt;0.05). Conclusion: As a result of our study, we observed that there was an increase in serum MDA levels as a result of liver I/R and histopathological changes occurred in the heart tissue. However, Taxifolin has been successful in ameliorating this situation.

Health-related quality of life in patients with ANCA vasculitides compared to rheumatoid arthritis: a cross-sectional comparative study.

There are limited data regarding health-related quality of life (HRQoL) in patients with ANCA-associated vasculitides (AAVs). We aimed to evaluate the HRQoL in patients with AAVs and compare it to another chronic inflammatory disease like RA and to healthy controls (HC). This was a multicentre, cross-sectional study of patients with AAVs and RA recruited from three tertiary rheumatology clinics. HRQoL was assessed with the Short Form 36 Health Survey, which included the physical and mental component summary scores (PCS and MCS). Data from 1007 HC served as historical controls. Sixty-six patients with AAVs and 71 with RA were included. Both AAV and RA patients had significantly lower PCS and MCS scores compared with HC (P < 0.05). HRQoL in AAV patients was worse in patients with microscopic polyangiitis compared with granulomatosis with polyangiitis (physical components) and those with high (VDI ≥ 3) vs low (VDI < 3) damage scores while it did not differ between those with active (BVASv3 ≥ 1) vs. inactive (BVASv3 < 1) disease. In contrast, in RA patients, HRQoL correlated both with disease activity (assessed by the DAS28-ESR) and functional impairment/damage (assessed by the HAQ). Although overall patients with RA had similar HRQoL compared with those with AAVs, those with active RA had worse HRQoL compared with those with active AAV. In patients with AAVs, HRQoL correlated more with organ damage and less with disease activity whereas in RA patients, it correlated with both. These data emphasize the need for AAV therapies aiming at preventing organ damage and thus improving HRQoL.

Co-expression prognostic-related genes signature base on propofol and sevoflurane anesthesia predict prognosis and immunotherapy response in glioblastoma

Objectives Anesthetic drugs had been reported may impact the bio-behavior of the tumor. Propofol and sevoflurane are common anesthetics in the operation for glioblastoma (GBM). This study aims to establish a co-expression prognostic-related genes signature base on propofol and sevoflurane anesthesia to predict prognosis and immunotherapy response in GBM. Method GPM tissues with different anesthetics gene expression profiles (GSE179004) were obtained from the Gene Expression Omnibus (GEO) database. Core modules and central genes associated with propofol and sevoflurane anesthesia were identified by weighted gene coexpression network analysis (WGCNA) and establish a risk score prognostic model. Immune cell signature analysis in TCGA datasets was predicted via CIBERSORT. At last, serum methylation level of O6-methylguanine-DNA methyltransferase (MGMT) promoter was detected in GPM patient in different time during perioperative period. Results The burlywood1 group screened was significantly associated with sevoflurane-treated GBM tissue. 22 independent prognostic differential genes were construct a prognostic-related genes risk score in GBM, and showed good predictive ability. The risk score was strongly correlated with the age of the patients, but not with the sex of the patients. In addition, the differential responses to immunotherapy in high and low risk groups were analyzed, indicating that sevoflurane signature genes were consistent in the classification of gliomas. High-risk patients have high T-cell damage score and are less sensitive to immunotherapy. At last, serum methylation level of MGMT promoter was decreased in GBM patients during propofol and sevoflurane anesthesia. Conclusions Propofol and sevoflurane anesthesia associated impact on the gene expression of GBM, included the methylation level of MGMT promoter. Propofol and sevoflurane anesthesia-based risk score prognostic model, which has good prognostic power and is an independent prognostic factor in GBM patients. Therefore, this model can be used as a new biomarker for judging the prognosis of GBM patients. KEY MESSAGES Propofol and sevoflurane anesthesia-based risk score prognostic model has good prognostic power and is an independent prognostic factor in GBM patients. High Propofol and sevoflurane anesthesia-based risk score GBM patients have high T-cell damage scores and are less sensitive to immunotherapy. Serum methylation level of MGMT promoter decrease during propofol and sevoflurane anesthesia in GBM patients.

Preclinical ocular changes in systemic lupus erythematosus patients by optical coherence tomography.

The aim of the present study was to detect preclinical changes in SLE patients in retinal microvascularization or retinal and optical nerve structure by optical coherence tomography. This cross-sectional, single-centre study aimed to describe structural changes [macular and retinal nerve fibre layer (RNFL) thickness] by structural spectral-domain optical coherence tomography (SD-OCT) and perifoveal vascular [vessel density (VD) and vascular perfusion (VP) and foveal avascular zone (FAZ) structural parameters] findings by OCT angiography (OCTA) in 78 SLE patients and 80 healthy volunteers. In addition, we analysed their association with clinical and laboratory parameters, medications received, disease duration, and SLE activity and damage. Structural parameters by SD-OCT and perifoveal vascular parameters by OCTA were decreased in SLE patients compared with controls. OCTA parameters (VD, VP and FAZ circularity) and macular thickness were also decreased in patients with longer disease duration (>10 years). The presence of aPLs was associated with a decreased RNFL thickness, mainly in the inferior quadrants. Patients developing APS also showed decreased RNFL thickness and OCTA flow changes. SD-OCT and OCTA results were not associated with disease activity. Foveal structural parameters were lower in patients with higher damage score. SD-OCT and OCTA can detect preclinical structural and microcirculatory changes in SLE patients. Structural and perifoveal vascular macular changes in SLE patients are related to disease duration. Macular structural parameters were impaired in patients with higher disease damage. APS seems to be associated with preclinical damage to the optic nerve and impairment of the perifoveal microvasculature.

An overview of the relationship between juvenile idiopathic arthritis and potential environmental risk factors: Do early childhood habits or habitat play a role in the affair?

The current study was undertaken to evaluate the influence of breastfeeding on the development and outcome measures of juvenile idiopathic arthritis (JIA). The second aim was to determine the consequences of particular sociodemographic and sociocultural characteristics and nutritional behavior of early childhood on JIA. The study includes the patients diagnosed with JIA and regularly followed up at the Department of Pediatric Rheumatology in Istanbul University-Cerrahpasa. The comparison group consisted of healthy subjects and patients with juvenile systemic lupus erythematosus (jSLE). A face-to-face survey method was conducted with the parents of the participants between February 1, 2021, and September 1, 2021. The mean age of the JIA cohort (n=324) was 12.2 ± 4.7 years, with a female ratio of 64.8%. The breastfeeding rate differed from the control groups (253 healthy subjects and 88 patients with jSLE) but was higher with a value of 94.8%. There was no difference between the groups (P=.097, P=.064) or within the subgroups of JIA (P=.12) regarding breastfeeding duration. Cow's milk introduction time (P=.02, P=.0001), household pet-keeping (P=.001), income level (P=.0001), maternal literacy (P=0.013) made a statistical difference vs the control groups. No relationship was established between the rate or duration of breastfeeding and the development or severity of JIA. The early introduction of cow's milk was found to be higher in the patient cohorts. The income level and maternal literacy appeared to be relevant with the high disability and damage scores, and frequent relapse rates. Secondhand smoking, higher in JIA, may prompt the basis of primary preventable strategies in JIA.

Fall Armyworm Tolerance of Maize Parental Lines, Experimental Hybrids, and Commercial Cultivars in Southern Africa

Fall armyworm [Spodoptera frugiperda (J./E. Smith); FAW] is negatively impacting sustainable maize production, particularly in smallholder farming systems in sub-Saharan Africa. Two sets of germplasm (commercial cultivars and experimental hybrids, and local and exotic inbred lines) were evaluated under managed and natural FAW infestation to identify FAW tolerant material with superior grain yield performance. Significant genotypic effects on foliar FAW damage, ear FAW damage, and grain yield were observed. Commercial cultivars were significantly more affected by FAW infestation than experimental hybrids, as evidenced by high foliar and ear damage scores, yet they out-yielded experimental genotypes. The introduced FAW donor lines (CML338, CML67, CML121, and CML334) showed better tolerance to FAW, individually and in hybrid combinations. Local inbred lines, SV1P, CML491, and CML 539, also showed FAW tolerance. Hybrids and open pollinated varieties were more vulnerable to FAW damage at early growth stages, but they grew out of it through the mid to late whorl stages. Inbred lines showed increasing damage as they grew to maturity. Husk cover, ear rot, anthesis date, and plant height were highly correlated with FAW tolerance. The identified local and exotic lines with FAW tolerance will contribute to FAW resistance breeding in southern Africa.

Social impact of disease parameters and damage accrual in adult Brazilian patients with childhood-onset Systemic Lupus Erythematosus.

To describe the frequency and investigate potential associations of unemployment, need of financial assistance and health-related quality of life in adult patients with childhood-onset Systemic Lupus Erythematosus (cSLE). In this multicenter cross-sectional retrospective cohort study including cSLE adult patients, questionnaires were applied evaluating demographic characteristics, medical history, treatment, receipt of government financial assistance, work status, quality of life, economic classification, disease activity, and damage accrual. Disease activity and disease damage were measured at the study visit. Sixty-nine cSLE patients with a median age of 21 years from two Brazilian tertiary centers were included (median disease duration 9 years). Twenty-eight (40.6%) patients were unemployed and 16 (23.2%) were receiving financial assistance or retirement pension. Work unemployment was associated with higher damage scores (OR 1.83, 95% CI 1.08 to 3.09, p = 0.024), and the need of financial assistance was associated with longer disease duration (OR 1.15, 95% CI 1.00 to 1.31, p = 0.045) and worse economic score (OR 0.87, 95% CI 0.77 to 0.99, p = 0.038). Emotional health and body image perception were the most compromised domains of quality of life but showed no association with disease parameters. Disease activity, on the other hand, was inversely associated with symptoms scores (β = -1.377, p = 0.014) and scores of adverse effects of medications (β = -1.286, p = 0.020). cSLE is a disease with severe outcomes and high social burden that profoundly impacts patients. Damage accrual is a major contributor to unemployment during adulthood and its prevention must be central in the management of cSLE.

Comparison of the healing effects of mesazaline and Ganoderma lucidum in acetic acid-induced colitis in rats.

PurposeThe etiology and pathogenesis of distal colitis (DC) are poorly understood. Activation of intestinal inflammatory response may lead to intestinal tissue necrosis. Antioxidant and anti-inflammatory agents are among the treatment options. Our study aimed to compare the protective effects of mesalazine and Ganoderma lucidum in acetic acid (AA)-induced colitis in rats.MethodsTwenty-four rats were randomly grouped as colitis, mesalazine, G. lucidum, and combined (G. lucidum + mesalazine) groups. DC was induced by intrarectal administration of AA. Statistical comparisons were done by using parameters including colonic tissue IL-1, IL-6, TNF-α, and CRP levels. Histopathologic changes of the samples of colonic tissue were scored as mucosal damage score and inflammatory score. A P-value of <0.05 was considered significant.ResultsIntrarectal administration of AA leads to increased interleukin and CRP levels. High mucosal damage and inflammatory scores were noted in colitis group animals. Single mesalazine or G. lucidum treatment produced considerably decreased tissue interleukin and CRP levels. The lowest tissue interleukin and CRP levels were noted in the combined treatment group of animals. Mucosal damage and inflammatory scores were found to be significantly low in this group of animals.ConclusionThe intrarectal administration of AA results in an activation of intestinal inflammation and severe mucosal damage in colonic tissue. Single use of mesalazine and G. lucidum treatment decreases the severity of intestinal inflammatory response and mucosal damage. The healing effects of the combined treatment of mesalazine and G. lucidum seem to be more effective than that of separate use in the treatment of DC.

Social impact of disease parameters and damage accrual in patients with juvenile-onset systemic Lupus Erythematosus: a multicenter cross-sectional study

Objectives: To describe the frequency and investigate potential associations of unemployment, need of financial assistance and health-related quality of life in adult patients with Juvenile-onset Systemic Lupus Erythematosus (JSLE). Methods: In this multicenter cross-sectional study including JSLE adult patients, questionnaires were applied evaluating demographic characteristics, medical history, treatment, government financial assistance and work status, quality of life, economic classification, disease activity and damage accrual. Results: Sixty-nine JSLE patients from two Brazilian tertiary centers were included in this study. Twenty-eight (40.6%) patients were unemployed and 16 (23.2%) were receiving financial assistance or retirement. Work unemployment was associated only with higher damage scores (OR 1.95, 95% CI 1.14 to 3.35, p = 0.015), while the need of financial assistance was associated with higher damage scores (OR 1.83, 95% CI 1.02 to 3.27, p = 0.042), longer disease duration (OR 1.15, 95% CI 1.01 to 1.32, p = 0.043) and worse economic score (OR 0.87, 95% CI 0.76 to 0.99, p = 0.036). Emotional health, body image perception and pain were the most compromised domains of quality of life but showed no correlation with disease parameters. Disease activity, on the other hand, was inversely associated with symptoms scores (ρ = -0.34, p = 0.004) and scores of adverse effects of medications (ρ = -0.27, p = 0.024). Conclusion: JSLE is a disease with severe outcomes and high social burden that profoundly impact patients during adulthood. Damage accrual is the main risk factor for both unemployment and need of financial assistance and its prevention must be central in the management of JSLE patients.

Racial Disparities in Medication Adherence between African American and Caucasian Patients With Systemic Lupus Erythematosus and Their Associated Factors.

ObjectiveMedication nonadherence is more common in African Americans compared with Caucasians. We examined the racial adherence gaps among patients with systemic lupus erythematosus (SLE) and explored factors associated with nonadherence.MethodsCross‐sectional data were obtained from consecutive patients prescribed SLE medications seen at an academic lupus clinic between August 2018 and February 2019. Adherence was measured using both self‐report and pharmacy refill data. High composite adherence was defined as having both high self‐reported adherence and high refill rates. Covariates were patient‐provider interaction, patient‐reported health status, and clinical factors. We compared adherence rates by race and used race‐stratified analyses to identify factors associated with low composite adherence.ResultsAmong 121 patients (37% Caucasian, 63% African American), the median age was 44 years (range 22‐72), 95% were female, 51% had a college education or more, 46% had private insurance, and 38% had high composite adherence. Those with low composite adherence had higher damage scores, patient‐reported disease activity scores, and more acute care visits. High composite adherence rate was lower among African Americans compared with Caucasians (30% vs 51%, P = 0.02), and the gap was largest for those taking mycophenolate (26% vs 75%, P = 0.01). Among African Americans, low composite adherence was associated with perceiving fewer “Compassionate respectful” interactions with providers and worse anxiety and negative affect. In contrast, among Caucasians, low composite adherence was only associated with higher SLE medication regimen burden and fibromyalgia pain score.ConclusionSignificant racial disparities exist in SLE medication adherence, which likely contributes to racial disparities in SLE outcomes. Interventions may be more effective if tailored by race, such as improving patient‐provider interaction and mental health among African Americans.

Assessment of damage in Takayasu‘s arteritis

ObjectiveTo assess the progression and the factors associated with damage in Takayasu‘s arteritis (TAK) patients during routine follow-up. MethodsPatients diagnosed with TAK and had >6 months follow-up were enrolled in this study retrospectively. Takayasu's arteritis damage score (TADS) and vasculitis damage index (VDI) were determined at diagnosis and at the end of the follow-up and variables associated with damage scores were assessed. ResultsOne-hundred fourteen patients (F/M: 101/13) were included in the study. The mean age at diagnosis, median symptom duration at baseline visit and mean follow-up duration were 35.3±13.3 years, 12 (0-360) months and 76.9±51.4 months, respectively. Median VDI score was 4.0 (1-8) and median TADS score was 7.0 (1-15) at baseline assessment. At the end of the follow-up, median VDI score increased to 5.0 (1-17) and TADS score to 8.0 (1-19). The median number of disease-related items were higher in TADS (8 items vs 4 items). At least one new corticosteroid (CS)-related damage item occurred in 35 patients (31%). Age at symptom-onset and cumulative CS doses were predictor factors for higher VDI score (≥5), whereas age at symptom-onset and disease duration were associated with increase in TADS (≥8). Gender and number of relapses were not associated with damage scores. ConclusionDamage assessment with VDI seems to capture treatment-related damage better, whereas TADS provides some additional information on disease-related damage in Takayasu's arteritis. Older age at symptom onset, disease duration and cumulative CS dose were associated with higher damage scores. The relapse frequency did not influence the damage level in our routine-follow-up of TAK patients.

Sex Hormones and Development of Advanced Diabetic Nephropathy in Diabetic Kidney Disease

Diabetic kidney disease (DKD) is a common complication of diabetes, which frequently leads to end‐stage renal failure and increases the risk of cardiovascular disease. Hyperglycemia promotes the development of renal pathologies such as glomerulosclerosis, tubular hypertrophy, microalbuminuria, and a decline in glomerular filtration rate. Importantly, recent clinical data have demonstrated distinct sexual dimorphism in the pathogenesis of DKD in people with diabetes, which impacts both severity‐ and age‐related risk factors. Recently, we described the development of advanced forms of diabetic nephropathy (DN) and glomerular damage in the type 2 diabetic nephropathy (T2DN) rat model. Since the progression of renal disease in T2DN rats closely parallels that of human DKD, we questioned whether this strain also displays sexual dimorphisms comparable to the human population. Male and female T2DN rats at &gt;48 weeks of age were used to evaluate hyperglycemia, renal injury, and renal function during the advanced stage of DN. We found that there were significant differences in fasting blood glucose levels for males versus females (156 ± 8 vs. 124 ± 4 mg/dL, respectively). Glucose tolerance tests revealed a higher prevalence of glucose intolerance in males (378 ± 19 vs. 183 ± 48 mg/dL for male vs. female). The development of albuminuria and glomerular damage was significantly different between sexes (11.8 ± 5.7 vs. 0.98 ± 0.64 Alb/Cre ratio, and 28 vs. 4 % with the highest damage score, male vs. female). These changes, accompanied by a significant increase in urinary nephrin shedding in males, suggested pathological changes to the glomerular filtration barrier. Detailed analyses of plasma samples also indicated striking differences in cholesterol (261.2 ± 46.7 vs. 86.7 ± 2.7 mg/dL), blood urea nitrogen (22.2 ± 2 vs. 17.1 ± 0.8 mg/dL), albumin homeostasis and alkaline phosphatase (ALP) levels in males compared to females. Echocardiography analyses of the cardiac output, left ventricle wall thickness, fractional shortening, and heart rate did not differ between strains, suggesting that the DN‐related effects on renal and metabolic phenotypes in the T2DN rats do not induce additional cardiac pathology. Additionally, microbiome analyses indicate that the contribution of microbiota to the observed gender differences in T2DN phenotypes is minimal. To test the role of the endocrine environment in physiology and pathophysiology of type 2 diabetes, we performed gonadectomy on male and female T2DN rats at 9 to 10 weeks old. We found that at 32 weeks of age, gonadectomized male T2DN rats have a significant reduction in fasting blood glucose versus their intact controls; however, female rats have no significant changes between groups (128 ± 9 vs. 170 ± 14, and 94 ± 4 vs. 105 ± 4 mg/dL for gonadectomized vs. control male and female rats, respectively). In conclusion, sex differences in the T2DN renal phenotype are ultimately the result of multiple changes and potentially depend on male hormonal signaling, which likely stimulates the progression of diabetes and the development of renal damage.Support or Funding InformationNIH HL135749, AHA 18PRE34030127 , VA I01 BX004024

Bowel damage and disability in Crohn's disease: a prospective study in a tertiary referral centre of the Lémann Index and Inflammatory Bowel Disease Disability Index.

The notion of Crohn's disease (CD) as a chronic, progressive and disabling condition has led to the development of new indexes: the Lémann Index measuring cumulative bowel damage and the Inflammatory Bowel Disease (IBD) Disability Index, assessing functional disability. To measure the Lémann Index and the IBD Disability Index in a large prospective cohort of CD patients and to assessthe correlation between these two indexes. We performed a prospective study in a tertiary referral centre including all consecutive CD outpatients. We assessed the Lémann Index and the IBD Disability Index questionnaire in all patients. One hundred and thirty CD patients were consecutively included. The mean Lémann Index (±SD) was 11.9±14.1 and ranged from 0 to 72.5 points. Factors associated with a high bowel damage score were: disease duration, anal location, previous intestinal resection, clinical and biological disease activity, exposure to immunosuppressants, and exposure to anti-TNF (P<0.005). Among patients exposed to anti-TNF, the Lémann Index was lower in those who were exposed in the first 2years of their disease (P=0.015). The mean IBD Disability Index was 28.8±6.3 and ranged from 0 to 71 points. The factors associated with high disability score were: female gender, anal location, extra digestive manifestations, clinical and biological disease activity and exposure to anti-TNF (P<0.005). No correlation was observed between the Lémann Index and IBD Disability Index (P=0.15). This is the first study to prospectively evaluate the Lémann Index and the IBD Disability Index in a large cohort of CD patients in a tertiary centre. Early introduction of anti-TNF treatment was associated with lower bowel damage scores, and no correlation was observed between the Lémann Index and the IBD Disability Index. Further dedicated prospective studies are necessary to confirm these results.

Comparison of Disease Characteristics, Course and Outcome between Adults with Juvenile and Adult- onset Systemic Lupus Erythematosus

Abstract Aim of the Work This study was performed to evaluate disease characteristics, activity and damage in adult patients with either juvenile or adult onset SLE. Patients and Method One hundred and fifty consecutive patients with SLE fulfilling the SLICC criteria for the classification of SLE were included in the study. The patients were classified according to the age at disease onset, 100 Adult-onset (ASLE) and 50 juvenile onset (JSLE). Patients records were reviewed for clinical and laboratory evaluation. Disease activity was assessed using SLE Disease Activity Index (SLEDAI). Disease damage was assessed using Systemic Lupus International Collaborating Clinics (SLICC/ACR) damage index. Results The mean age at disease onset of JSLE was 14.120± 1.534 and of ASLE was 22.460± 2.732. The female to male ratio was 9:1 in JSLE compared to 13:1 in ASLE. JSLE had butterfly rash (66%), photosensitivity (30%), oral ulcers (34%), arthritis (44%) and neuropsychiatric manifestations (6%).While ASLE had butterfly rash (35%), photosensitivity (10%), oral ulcers (17%), arthritis (65%) and neuropsychiatric manifestations (13%). There was higher prevalence of anemia, thrombocytopenia, ESR, CRP, 24 h and creatinine in JSLE more than ASLE with statistically significant differences. The mean SLEDAI was significantly higher in JSLE (14.080 ± 4.780) compared to ASLE, (10.760 ± 2.738) (P &amp;lt; 0.001). Conclusion The age at onset of SLE influences its clinical manifestations and laboratory findings. JSLE patients have a more aggressive presentation and course than ASLE patients with a higher frequency of lupus nephritis, more cutaneous symptoms and hematological manifestations. JSLE patients have more severe disease activity with very high SLEDAI and SLICC damage scores. ASLE patients have more musculoskeletal manifestations.

Antiphospholipid syndrome damage index (DIAPS): distinct long-term kinetic in primary antiphospholipid syndrome and antiphospholipid syndrome related to systemic lupus erythematosus.

Antiphospholipid syndrome (APS) is an acquired thrombophilia that affects young productive individuals, with permanent damage and negative impact on quality of life. Recently, a damage index specific for APS (DIAPS) was developed. There are, however, no data regarding the comparison of its performance and long-term damage in primary antiphospholipid syndrome (PAPS) and APS related to systemic lupus erythematosus (SLE; APS + SLE). The primary purpose of this study was therefore to compare the long-term damage in patients with these conditions. This is a retrospective analysis of a single tertiary center cohort followed for approximately 10 years using a standardized prospective electronic chart database. Fifty consecutive PAPS patients age matched with 50 APS+SLE patients were consecutively selected for the study, and DIAPS was calculated once a year during follow-up. Long-term damage and damage kinetics in both groups were compared. PAPS and APS + SLE had comparable age (47.10 ± 12.4 vs. 44.04 ± 10.80 years; p = 0.19) and time of follow-up (9.40 ± 3.60 vs. 10.94 ± 4.50 years; p = 0.06). At diagnosis, PAPS had higher DIAPS than APS + SLE (1.72 ± 1.17 vs. 0.82 ± 0.96; p < 0.001). At the end of the 10-year follow-up, both groups presented comparable mean damage scores (2.04 ± 1.50 vs. 2.24 ± 1.61; p = 0.52). The damage increment throughout the observation period for PAPS was solely 35%, whereas for APS + SLE it was gradual, persistent and reached 139% at the end of follow-up, with a total damage increment for PAPS lower than APS + SLE (0.43 ± 0.30 vs. 1.22 ± 1.24; p < 0.001). Of note, the frequency of individuals who acquired damage was lower in PAPS than in APS + SLE (32% vs. 71%; p < 0.001). PAPS also had a longer delay in diagnosis than APS + SLE (4.00 ± 4.20 vs. 2.54 ± 3.05 years; p = 0.04). This delay was positively correlated with a higher damage score at diagnosis (r = 0.36, p < 0.001) in all groups. We identified a distinct pattern of damage in PAPS and APS related to SLE. Damage in PAPS is an early event, while APS+SLE is associated with higher long-term damage, with a striking increment of damage along the follow-up. A diagnosis delay is correlated with higher damage scores. Damage surveillance therefore requires different approaches for these two conditions.

Effects of Management Treatments on Regeneration of a Geographically Disjunct, Relictual Hybrid Aspen (Populus xsmithii) Population in the Central Great Plains, USA.

Populus xsmithii is an uncommon hybrid of quaking aspen (Populus tremuloides) and bigtooth aspen (Populus grandidentata). Like its parents, Populus xsmithii is an early successional member of boreal forest communities, dependent on disturbance events that clear areas of competitive stems and spur an increase in clonal suckering. In recent years, aspen dieback has been noted across much of the western United States, a condition characterized by mortality of older stems and a lack of recruitment of suckers to maturity. In the Niobrara River Valley of Cherry County, Nebraska, USA, a disjunct population of Pleistocene relict Populus xsmithii has been targeted for management via clearing of competitive conifer species and establishment of fenced refugia to protect suckers from herbivory. The stands currently contain abundant suckers, which occur in three types of sites: the fenced refugia created by managers, the open habitat cleared of other species in the stands, and the woodpiles left by said clearing. This study assessed the growth and vigor of these aspen suckers over a nine-month period (summer 2013-spring 2014) and compared the effects of different site treatments. We found that aspen suckers in the open areas were significantly shorter, had smaller basal diameter, and had higher damage scores than those in the two protected site types (fenced and woodpile). Because this population is on the margin of the distribution for aspen, evaluating the effectiveness of management techniques will provide valuable information for those who seek to ensure the survival of this aspen population and others.