Characteristics Of Lesions In Patients Research Articles

A cross-sectional study of fundus lesion characteristics in patients with acute visual impairment caused by COVID-19 infection.

To investigate the characteristics of acute visual dysfunction and fundus lesions in patients with COVID-19 pneumonia. A retrospective case series study was conducted. Data from 48 patients (96 eyes) with COVID-19 infection who presented to our ophthalmology department with acute onset visual disturbance between December 5, 2022, and February 28, 2023 were collected. Asymptomatic patients and those who had already recovered were excluded. Data collected included patient demographics, ophthalmic examinations, multicolor imaging (MCI), infrared autofluorescence (IR), spectral-domain optical coherence tomography (OCT), fundus fluorescein angiography (FFA). Of the 48 patients, 15 were male and 33 were female, with a mean age of 32 years. All patients had bilateral involvement. OCT showed hyperreflective signals in the outer plexiform layer and outer nuclear layer of the macular region in all 96 eyes of 48 patients (100%). Additionally, 66 eyes of 33 patients (68.8%) of eyes demonstrated abnormal reflectivity in the ellipsoid and interdigitation zones. MCI revealed petaloid or wedge-shaped hyperreflective areas in the macula in 46 (47.9%) of eyes, corresponding to hyporeflective areas on IR. Cotton-wool spots were observed in the peripapillary or posterior pole area in 54 (56.3%) of eyes. COVID-19 infection can lead to acute, bilateral, symmetric, and widespread retinal damage. Characteristic findings can be observed in ophthalmological examinations such as OCT, MCI, and IR.

Humoral immune disorders affect clinical outcomes of oral lichen planus.

The molecular characteristics of oral lichen planus (OLP) are still unclear, and it is not possible to distinguish the clinical outcome of OLP patients in a short period of time for follow-up. Here, we investigate the molecular characteristics of lesions in patients with stable lichen planus (SOLP) and recalcitrant erosive oral lichen planus (REOLP). Our clinical follow-up cohort was split into SOLP and REOLP groups based on the follow-up clinical data. The core modules associated with the clinical information were identified by weighted gene co-expression network analysis (WGCNA). The OLP cohort samples were divided into two groups by molecular typing, and a prediction model for OLP was created by training neural networks with the neuralnet package. We screened 546 genes in five modules. After doing a molecular type of OLP, it was determined that B cells might have a significant impact on the clinical outcome of OLP. In addition, by means of machine learning, a prediction model was developed to predict the clinical regression of OLP with greater accuracy than the existing clinical diagnostic. Our study revealed humoral immune disorders may make an important contribution to the clinical outcome of OLP.

Coronary angiographic and culprit lesion characteristics in patients resuscitated from out-of-hospital cardiac arrest

Abstract Funding Acknowledgements Type of funding sources: None. Background Emergent coronary angiography is recommended in patients with return of spontaneous circulation (ROSC) after out of hospital cardiac arrest (OHCA) of suspected cardiac origin. The aim of this study was to analyze the prevalence of coronary artery disease (CAD), characteristics of the culprit lesions in case of acute coronary syndrome (ACS) and the success of percutaneous coronary intervention (PCI) in patients resuscitated from OHCA due to a shockable rhythm, i.e. ventricular fibrillation (VF) and ventricular tachycardia (VT). Methods We analyzed the data of 150 patients in whom coronary angiography was performed in the setting of ROSC after OHCA. Patients were categorized to have non obstructive CAD or obstructive CAD. Patients with obstructive CAD were classified as acute myocardial infarction (ST-elevation myocardial infarction (STEMI), Non-ST-elevation myocardial infarction (NSTEMI)) and chronic coronary syndrome. The culprit vessel was identified by means of electrocardiographic findings, echocardiography and coronary angiography. Coronary angiograms and all clinical data were reviewed in consensus by two experienced interventional cardiologists. Successful PCI was defined as angiographic restoration of TIMI III flow. Results Significant CAD was ruled out in 27 patients (18.0%). Obstructive CAD with at least one coronary artery stenosis was found in 123 patients (82.0%). According to clinical and angiographic findings, ACS was found in 105/150 patients (70.0%). Of the 105 patients with ACS, 53 (35.3%) presented with STEMI and 52 (34.7%) presented with NSTEMI. 18/123 patients (14.6%) showed chronic coronary syndrome. Among the patients with obstructive CAD, 1-vessel CAD was found in 32 patients (26.0%), 2-vessel CAD in 44 patients (35.8%), 3-vessel CAD in 47 patients (38.2%). 41 (33.3%) of the patients with CAD showed a chronic total occlusion (CTO) of at least one vessel. In patients presenting with ACS, the most common culprit vessels were LAD (37.4%) and CX (23.6%), followed by RCA (11.4%) and LM (2.4%). In 22.8% of the patients, the culprit vessel could not be unambiguously identified. In 82.9% of the patients with ACS/CAD, PCI was performed. TIMI flow after intervention was TIMI III in 92.1%, TIMI II in 3.9%, TIMI I in 2.0% and TIMI 0 in 2.0%. Conclusion In patients resuscitated from OHCA due to VF/VT, multivessel disease is common. Most frequently, culprit lesions are located in the LAD and CX. PCI in OHCA patients can be performed at a high success rate.

Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response

Obsessive-compulsive disorder (OCD) affects 2–3% of the population. One-third of patients are poorly responsive to conventional therapies, and for a subgroup, gamma knife capsulotomy (GKC) is an option. We examined lesion characteristics in patients previously treated with GKC through well-established programs in Providence, RI (Butler Hospital/Rhode Island Hospital/Alpert Medical School of Brown University) and São Paulo, Brazil (University of São Paolo). Lesions were traced on T1 images from 26 patients who had received GKC targeting the ventral half of the anterior limb of the internal capsule (ALIC), and the masks were transformed into MNI space. Voxel-wise lesion-symptom mapping was performed to assess the influence of lesion location on Y-BOCS ratings. General linear models were built to compare the relationship between lesion size/location along different axes of the ALIC and above or below-average change in Y-BOCS ratings. Sixty-nine percent of this sample were full responders (≥35% improvement in OCD). Lesion occurrence anywhere within the targeted region was associated with clinical improvement, but modeling results demonstrated that lesions occurring posteriorly (closer to the anterior commissure) and dorsally (closer to the mid-ALIC) were associated with the greatest Y-BOCS reduction. No association was found between Y-BOCS reduction and overall lesion volume. GKC remains an effective treatment for refractory OCD. Our data suggest that continuing to target the bottom half of the ALIC in the coronal plane is likely to provide the dorsal–ventral height required to achieve optimal outcomes, as it will cover the white matter pathways relevant to change. Further analysis of individual variability will be essential for improving targeting and clinical outcomes, and potentially further reducing the lesion size necessary for beneficial outcomes.

Association between ACE I/D gene polymorphism and coronary artery lesion characteristics in patients with acute myocardial infarction

Abstract Funding Acknowledgements Type of funding sources: None. Background Acute myocardial infarction (AMI) remains a public health issue with high morbidity and mortality rates and significantly reduces patients' health-related quality of life. The identification of factors influencing coronary artery lesion characteristics in patients with AMI can contribute to the strategy of primary and secondary prevention for AMI. Purpose This study was aimed to investigate the ACE I/D genotype rate and its relationship with coronary artery lesion characteristics in AMI patients. Methods This study was conducted with the prospective cross-sectional method among AMI patients admitted to the Department of Cardiology and Department of Interventional Cardiology, Cho Ray Hospital from January 1, 2020 to June 30, 2021. The minimum sample size of this study was 163 patients. The ACE I/D genotype was determined at the Center for Molecular Biomedicine. Results During the study period, a total of 522 AMI patients were recruited at the Department of General Cardiology and Department of Interventional Cardiology. The mean age of the AMI patients was 63.9±11.7 and the age group 45-64 accounted for the most (46.4%). Males were predominant (71.5%). The patients' median Gensini score was 34.3. The II, ID and DD genotype rates of ACE I/D polymorphism were 48.9%, 36.4%, and 14.7% respectively. The ACE DD genotype was not associated with the location and number of diseased coronary arteries but was associated with the severity of coronary artery disease. Multivariable linear regression analysis showed that along with the Killip class, the ACE DD genotype was independently associated with a higher Gensini score compared with the II or ID genotype. Conclusions This has been the first study in Vietnam demonstrated the association between ACE I/D gene polymorphism and coronary artery lesion characteristics in patients with AMI. The ACE I/D gene polymorphism may be considered for testing to contribute to the comprehensive assessment and aggressive treatment of AMI patients.

Effects of Oral Nutritional Supplementation on Patients with Venous Ulcers: A Clinical Trial.

Background: The dosage and safety of nutritional supplements for patients with venous ulcers are still not well established. Aim: To evaluate the effects of a high calorie, high protein, arginine-, zinc-, and vitamins A, C, and E-enriched nutritional supplement on the biochemical profile, dietary intake, anthropometry, muscle strength, and characteristics of lesions of patients with venous ulcers. Methods: A controlled before–after clinical trial with a four-week follow-up involved 27 patients with venous ulcers under outpatient treatment in Brazil. It was administered in two to three doses per day (200 mL each) of a high-calorie and high-protein supplement enriched with arginine, zinc, and vitamins A, C, and E. Patients were assessed for anthropometric parameters, dietary intake, biochemical tests, and healing conditions according to the Pressure Ulcer Scale for Healing (PUSH). Results: It was observed that an increase in energy and protein supply led to an adequate intake of immunonutrients (zinc and vitamins A, C, and E), increased body weight, increased body mass index, and stronger handgrip strength. The injury area and the score on the PUSH notably decreased after the intervention (p < 0.001). Conclusions: The administered supplement, at the tested dosage, improved the nutritional status and characteristics of lesions in patients with venous ulcers.

Knee Kinematic Patterns and Early Cartilage Lesion Characteristics in Patients with Anterior Cruciate Ligament Reconstruction.

Specific knee kinematic alterations have been theorized to correlate with the progression of cartilage degeneration, and therefore, post-traumatic osteoarthritis in patients with anterior cruciate ligament reconstruction (ACLR). However, how specific knee kinematic alterations contribute to knee joint cartilage degenerations remains to be unclear. To solve this problem, we hypothesized that there are specific cartilage-degenerating kinematic gait patterns that could be supported by the specific areas of cartilage lesions in ACLR knees. Thirty patients with unilateral ACLR knees and 30 healthy controls were recruited for the study. The kinematic differences between the ACLR knees and the healthy control knees during the stance phase were calculated to identify the kinematic patterns. Cartilage lesion distribution characteristics were acquired for patients with ACLR knees to validate the kinematic patterns using magnetic resonance images. Two kinematic patterns were modeled, i.e., sagittal (increased flexion angle and posterior tibial translation) and coronal (increased lateral tibial translation and abduction angle) kinematic patterns. For the sagittal pattern, the cartilage lesion distributions showed that there were more cartilage lesions (CLs) in the superoposterior regions than the posterior regions in the femoral condyles (p = 0.001), and more CLs in the posterior regions than the middle regions in the tibial plateau (p < 0.001). For the coronal pattern, the cartilage lesion distributions showed that there were more CLs in the lateral compartments near the tibial spine than the medial compartments near the tibial spine (tibial sides, p = 0.005 and femoral sides, p = 0.290). To conclude, the cartilage degeneration distribution evidence largely supports that the two kinematic patterns may contribute to cartilage degeneration in ACLR knees. These findings may provide a potential strategy of delaying early cartilage degeneration in ACLR knees by using motion (kinematic) pattern modification or training. However, investigations should be conducted on the actual effects of this potential strategy.

The effect of calf and thigh circumferences in determining brain lesion characteristics in patients with acute stroke: A hospital-based study

The role of stroke risk factors in stroke patterning and differentiation is poorly investigated, especially for measures of body composition. This study aimed to investigate the effect of skinfold thickness, waist and limb circumference measurements in patterning and differentiation of stroke in hospitalized patients. Prospective study of acute stroke patients hospitalized in Aminu Kano Teaching Hospital in Nigeria was conducted in 16 months. Biceps brachii, triceps brachii, suprailiac and subscapular skinfold thickness measurements were taken using Skyndex Research Caliper. Upper arm, waist, thigh, and calf circumferences were taken, using an inelastic measuring tape according to the same standards. The data was analyzed using descriptive statistics, unpaired sample t-test, and Binary logistic regression using SPSS IBM version 20. The results shown that the studied anthropometric parameters, do not only predispose to stroke but tend to determine the specific stroke pathologic type. Thigh circumference predisposes more, and calf circumference predisposes less to ischemic stroke subtype. This means that these studied anthropometric parameters can predict stroke subtype and serve as predisposing factors conclusively.

Relationship of Microchannels and Plaque Erosion in Patients with ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study

Abstract Objective: Microchannels are associated with the progression of atherosclerotic vulnerable plaques. However, in patients with culprit optical coherence tomography (OCT)-defined plaque erosion, the knowledge of microchannels and culprit lesion vulnerability is limited. The aim of this study was to investigate culprit lesion characteristics in patients with ST-segment elevated myocardial infarction (STEMI) caused by plaque erosion with and without microchannels using OCT. Methods: In all, 348 STEMI patients with plaque erosion who underwent OCT of the culprit lesion at the 2nd Affiliated Hospital of Harbin Medical University (Harbin, China) from August 2014 to December 2017 were included and divided into the microchannel group (n = 116, 33.3%) and no-microchannel group (n = 232, 66.7%). The clinical characteristics and OCT-derived plaque features were compared between both groups. Results: Among the 348 STEMI patients with plaque erosion, culprit lesions with microchannels had higher incidence of lipid plaque (59.5% vs. 45.3%, P = 0.012); calcification (41.4% vs. 24.6%, P = 0.002); spotty calcification (30.2% vs. 18.1%, P = 0.014); macrophages accumulation (72.4% vs. 45.7%, P &lt; 0.001); and cholesterol crystals (32.8% vs. 14.2%, P &lt; 0.001) than those without microchannels. In addition, minimal lumen area was smaller ((1.9 ± 0.9) mm2 vs. (2.8 ± 2.3) mm2, P &lt; 0.001) and lumen area stenosis was greater ((71.3% ± 13.4%) vs. (65.3% ± 19.3%), P = 0.001) in the microchannel group than in the no-microchannel group. Conclusion: In patients with STEMI caused by plaque erosion, one-third manifested typical microchannel characteristics, and those with microchannels were associated with more severe luminal stenosis and more vulnerable plaque features than those without microchannels.

Oral manifestations of systemic fungal infections: 25-year experience in an endemic region

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms, histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycoses necessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.

Upper gastrointestinal tumors are unrelated to the APC genotype in APC-associated polyposis.

In patients with APC-associated polyposis, the prevalence of upper gastrointestinal tumors and the relationship between these and Helicobacter pylori infection have not been clarified in detail. The present study aimed to clarify the features of upper gastrointestinal lesions in patients with APC-associated polyposis. Consecutive patients with APC-associated polyposis who underwent esophagogastroduodenoscopy between 2004 and 2018 were recruited. In total, 36 patients were enrolled. The types of gastrointestinal tumor observed were fundic gland polyposis in 28 patients (77.8%), gastric adenoma in 15 patients (41.7%), duodenal adenoma in 27 patients (75.0%) and periampullary adenoma in 20 patients (55.6%). The phenotype of these upper gastrointestinal tumors was not necessarily the same in patients belonging to the same family. Germline variants in the APC gene were distributed across various sites, regardless of the presence or absence of upper gastrointestinal lesions, and none of the tumors correlated with the genotype or phenotype of upper gastrointestinal tumors. Fundic gland polyposis was observed in 28 of 31 patients without a H. pylori infection and in none of the patients with a H. pylori infection (P=0.00015). After eradication therapy for H. pylori, fundic gland polyposis developed in one, previously infected patient. The upper gastrointestinal tumor phenotype was not associated with the genotype in patients with APC-associated polyposis. Ascertaining the H. pylori infection status is helpful for endoscopic surveillance of upper gastrointestinal tumors in patients with APC-associated polyposis.

Clinical and pathogenetic features of intestinal lesions in patients with type 2 diabetes mellitus

Objective — to study the incidence and clinical and pathogenetic features of intestinal injury in patients with type 2 diabetes mellitus.&#x0D; Materials and methods. Examinations involved 138 patients with type 2 diabetes mellitus (DM 2), aged from 39 to 67 years (mean age 53 ± 5 years), including 82 women (59 %) and 56 men (41 %). In addition to general clinical methods, investigations included plasma levels of the transforming growth factor‑b1 (TGF‑b1) and vascular endothelial growth factor (VEGF), the hydrogen breath test with lactulose, endoscopic examination of the intestine with biopsy followed by staining with hematoxylin‑eosin, immunohistochemical determining of claudin‑1 and VEGF, and conduction of PAS‑reaction.&#x0D; Results. Diabetic enterocolopathy (DECP) was diagnosed in 72 (52.2 %) patients with DM 2. Clinical manifestations were nonspecific and similar to those of irritable bowel syndrome (IBS). It has been found that DECP correlates with the duration of the DM 2 course and was diagnosed more often in middle‑aged patients (52.1 ± 4.1 years). In patients with DECP, the increase in the proinflammatory cytokines TGF‑b1 and VEGF significantly exceeded those in IBS patients. Histologically the inflammatory cell infiltration in patients with DECP was more intense and diverse, there were signs of subatrophy of the glands with a relative decrease in the number of vacuoles in the goblet cells. The immunohistochemical study revealed that VEGF in the colon mucosa was visualized mainly in patients with DECP. Moreover, a tendency to a decrease in the claudin‑1 levels was established in these patients.&#x0D; Conclusions. Intestinal damage was revealed in 67.4 % of patients with type 2 diabetes mellitus, and DECP was diagnosed in more than half of patients. Diabetic enterocolopathy had nonspecific clinical symptoms, required differential diagnosis with IBS, and was not always accompanied with abdominal pain. The presence of DECP more often correlated with the bacterial overgrowth syndrome, and levels of proinflammatory cytokines in the blood plasma and intestinal mucosa of these patients was raised.&#x0D;

Transcriptome Analysis Reveals the Molecular Immunological Characteristics of Lesions in Patients with Halo Nevi When Compared to Stable Vitiligo, Normal Nevocytic Nevi and Cutaneous Melanoma

BackgroundGiven their similar appearance and histology, halo nevi (HN) were considered as a type of vitiligo. However, whether HN have stronger immune response than stable vitiligo (VL) remains unclear. In addition, the molecular alterations in HN compared with normal nevocytic nevi (NN) and primary cutaneous melanoma (MM) must be determined. This study aimed to systematically characterize the molecular immunological features of HN.MethodsSkin samples from patients with HN, VL, NN, and MM were obtained with informed consent. Each of the four groups underwent transcriptome sequencing and data analysis were for pairwise comparison. Quantitative real-time PCR (RT-qPCR) was conducted to confirm the transcriptional expression of some differentially expressed genes (DEGs) that were closely related to immunity.ResultsA total of 441 and 1507 DEGs were found in the HN/NN and HN/MM groups, respectively. Compared with those of VL, HN lesions contained 162 up-regulated DEGs and 12 down-regulated DEGs. Bioinformatics analysis showed that the up-regulated genes in HN were substantially enriched in immune response, immune deficiency, and immune rejection; biological stimulation (virus, bacteria); and proliferation and activation of immune cells. Immune cell composition analysis also confirmed high expression levels of multiple immunocytes in HN.ConclusionThe molecular immune mechanisms of HN and VL were similar, but the immune activity of HN was stronger than that of VL. Innate and adaptive immunity were involved in the pathogenesis and progression of HN and VL.

Indicators of regional arterial stiffness depending on the characteristics of coronary lesions in patients with coronary artery disease younger and older than 50 years

Indicators of regional arterial stiffness depending on the characteristics of coronary lesions in patients with coronary artery disease younger and older than 50 years

Morphological characteristics of sacroiliac joint MRI lesions in axial spondyloarthritis and control subjects.

To investigate SI joint MRI inflammation, structural and degenerative lesion characteristics in patients with axial spondyloarthritis (axSpA) and various control groups. Patients with axSpA (n = 41) and lumbar disc herniation (n = 25), women with (n = 46) and without (n = 14) post-partum (childbirth within 4-16 months) buttock/pelvic pain, cleaning assistants (n = 26), long-distance runners (n = 23) and healthy men (n = 29) had MRI of the SI joints prospectively performed. MRI lesions were assessed on nine slices covering the cartilaginous compartment by two experienced readers according to the definitions of the Spondyloarthritis Research Consortium of Canada SI joint inflammation and structural scores, and were evaluated according to depth and extent. Other morphological characteristics were also analysed. Total depth scores for bone marrow oedema (BME) and fat lesion (FAT) and total extent score for erosion were statistically significantly highest in axSpA, while scores for sclerosis were numerically highest in women with post-partum pain. Maximum BME depth >10 mm was frequently and exclusively found in axSpA and post-partum women (39% vs 14-17%) while FAT depth >5 mm was predominantly found in axSpA (76% vs 0-10%). Erosions were primarily seen in axSpA, especially when extensive (≥4 or confluent; 17% vs 0%). Capsulitis was absent in non-axSpA groups. BME and FAT in the ligamentous compartment were primarily found in axSpA (17/22% vs 0/2% in non-axSpA groups). In non-axSpA, osteophytes (axSpA vs non-axSpA: 0% vs 3-17%) and vacuum phenomenon (7% vs 30-66%) were more frequent, and the joint space was wider [mean (s.d.) 1.5 (0.9) vs 2.2 (0.5) mm]. FAT depth >5 mm, but not BME depth >10 mm, could almost differentiate axSpA patients from all other groups. When excluding post-partum women, BME >5 mm and erosion were highly specific for axSpA.

Clinical characteristics of oral mucosal lesions in patients with systemic lupus erythematosus and their association with clinical and laboratory parameters

Introduction. Systemic lupus erythematosus (SLE) is an autoimmune disease that includes a broad spectrum of mucocutaneous manifestations. Objectives. To characterize the clinical spectrum of oral mucosal lesions in patients with SLE and to analize their association with clinical and laboratory parameters. Methods. We performed a cross-sectional study with systematic oral evaluations in SLE adult patients. Systemic and cutaneous lupus activities were recorded. We collected epidemiologic, clinical, and laboratory data. Statistical analysis included the kappa coefficient, X2 test, Fisher’s exact test and Mann-Whitney U-test, adjusting for multiple comparisons according to Bonferroni’s method. Results. A total of 181 patients (92.8% females) were included, with a median age of 37 (range 16-76) years. Cutaneous, systemic, and oral manifestations of lupus erythematosus (LE) activity were found in 31.5%, 23.8% and 18.8% of patients, respectively. Higher titres of anti-double-stranded (ds) DNA antibodies were detected in patients with LE-related oral lesions (LEOL) when compared to those without LEOL [356 (82-1083) UI vs 45 (0-417) UI; p=0.02). LEOL did not correlate to cutaneous (k=0.380) nor systemic (k=0.228) LE-activity (p&lt;0.01). Conclusions. Oral manifestations related to SLE were significantly associated to anti double-ds DNA antibodies. LEOL were independent of cutaneous and systemic activity.

Novel blue blotch lesions in folliculitis decalvans – a clinical, histopathological and immunohistochemical study of seven cases

Folliculitis decalvans (FD) is a neutrophilic primary scarring alopecia characterized by chronic inflammation and intense fibrosis. It usually affects the vertex and occipital scalp of young males with recurrent outbreaks and poor therapeutic outcomes.1 In this study, our goal was to describe clinical, histopathological and immunohistochemical features of the novel scalp blue lesions in patients with FD. A descriptive cross-sectional study included seven patients with FD biopsy-proven seen at the University of Sao Paulo from 2018 to 2020.

The expression and clinical significance of miRNA-183 in cerebral ischemia-reperfusion injury patients with cerebral small vessel disease.

BackgroundTo investigate the expression and clinical significance of micro (mi)RNA-183 in cerebral ischemia-reperfusion injury (CIRI) in patients with cerebral small vessel disease (CSVD).MethodsA total of 138 patients with CSVD complicated with CIRI admitted to our hospital from May 2018 to May 2019 were selected and divided into the CIRI group (138 cases of patients with cerebral vascular disease complicated with CIRI) and the control group [60 cases with no abnormalities in cranial magnetic resonance imaging (MRI) in healthy volunteers]; the results of craniocerebral MRI were subsequently recorded. The serum levels of miRNA-183 were detected by quantitative real-time polymerase chain (RT-qPCR), and the levels of interleukin-6 (IL-6), IL-8, IL-1β, and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA). A correlation analysis of serum miRNA-183 level and imaging lesion characteristics in patients with CSVD was also conducted.ResultsRT-qPCR showed that the peripheral blood miRNA-183 level in the CIRI group was increased compared to that in the control group; the level of miRNA-183 in the control group was 30.03±6.32, while the level of miRNA-183 in the CIRI group was 36.78±10.11, which was a statistically significant difference (t=2.475, P<0.05). Compared with the control group, the patient levels of TNF-α, IL-6, IL-8, and IL-1β in the CIRI group were significantly increased (P<0.05). Correlation analysis showed that the serum miRNA-183 level in the CIRI group was positively correlated with an increase of imaging lesions (r=0.997, P<0.05).ConclusionsThe level of miRNA-183 in CIRI patients with CSVD was higher than that of controls, and the level of miRNA-183 was positively correlated with the increase of imaging lesions.

Comparison of Archival Angiographic Findings in Patients Later Developing Acute Coronary Syndrome or Stable Angina.

Acute coronary syndrome (ACS) can develop in patients with mildly to moderately stenotic lesions. However, the angiographic characteristics of lesions in patients who will later develop ACS have not been systematically investigated. For this reason, we examined the earlier angiographic findings of such patients in a retrospective study.The study population consisted of 45 consecutive ACS and 45 stable angina (SA) patients who require revascularization. All of them had received cardiac catheterization within 5 years prior to onset, for different reasons. The detailed parameters of the earlier coronary angiographies at the culprit site the whole culprit vessel, and all three vessels were compared between the two groups.Mild-to-moderate stenosis was present exclusively at the culprit site in the earlier angiographies, both in ACS and SA patients. Lesions associated with ACS progression were significantly shorter in length than those associated with SA progression (11.5 ± 5.5 versus 16.1 ± 10.5 mm, P = 0.02) and were more eccentric (eccentricity index: 0.5 ± 0.3 versus 0.7 ± 0.3, P = 0.04). Percent diameter stenosis was similar (42.2 ± 14.5 versus 44.0 ± 13.8%, P = 0.5). The mean grading scores for plaque extension and size (1-3) were significantly lower in ACS than in SA (1.4 ± 0.6 versus 1.8 ± 0.6, P = 0.01, and 1.3 ± 0.6 versus 1.7 ± 0.7, P = 0.01, respectively). Residual SYNTAX scores were significantly lower in ACS (12.5 ± 7.4 versus 16.4 ± 8.6, P = 0.03).Despite equivalent degrees of stenosis in previous angiographies, ACS occurred more frequently in patients with more focal and eccentric lesions but with less diseased coronary arteries than SA.

Relationships of coronary culprit-plaque characteristics with duration of diabetes mellitus in acute myocardial infarction: an intravascular optical coherence tomography study

BackgroundDiabetes mellitus (DM) or pre-diabetes status is closely associated with features of vulnerable coronary lesions in patients with stable coronary heart disease or acute coronary syndrome. However, the association between duration of diabetes and the morphologies and features of vulnerable plaques has not been fully investigated in patients with acute myocardial infarction (AMI).MethodsWe enrolled a total of 279 patients who presented with AMI between March 2017 and March 2019 and underwent pre-intervention optical coherence tomography imaging of culprit lesions. Patients with DM were divided into two subgroups: a Short-DM group with DM duration of < 10 years and a Long-DM group with DM duration of ≥ 10 years. Baseline clinical data and culprit-plaque characteristics were compared between patients without DM (the non-DM group), those in the Short-DM group, and those in the Long-DM group.ResultsPatients with DM represented 34.1% of the study population (95 patients). The Short- and Long-DM groups included 64 (67.4%) and 31 patients (32.6%), respectively. Glycated hemoglobin A1c (HbA1c) levels were significantly higher in the Long-DM group than the Non- or Short-DM groups (8.4% [Long-DM] versus 5.7% [Non-DM] and 7.6% [Short-DM], P < 0.001). In addition, the highest prevalence of lipid-rich plaques, thin-cap fibroatheroma (TCFA), and plaque ruptures of culprit lesions were observed in the Long-DM group (lipid-rich plaques: 80.6% [Long-DM] versus 52.2% [Non-DM] and 62.5% [Short-DM], P = 0.007; TCFA: 41.9% [Long-DM] versus 19.6% [Non-DM] and 31.3% [Short-DM], P = 0.012; plaque rupture: 74.2% [Long-DM] versus 46.7% [Non-DM] and 48.4% [Short-DM], P = 0.017). The frequency of calcification was significantly higher among patients with DM than among those without (62.1% versus 46.2%, P = 0.016); however, no significant differences were found between the DM subgroups (61.3% [Long-DM] versus 62.5% [Short-DM], P = 0.999).ConclusionsIncreased duration of DM combined with higher HbA1c levels influences culprit-plaque characteristics in patients with DM who suffer AMI. These findings might account for the higher risks of cardiac death in DM patients with long disease duration.Trial registration This study is registered at clinicaltrials.gov as NCT03593928