Mean Erythrocyte Sedimentation Rate Research Articles

The Relationship of Immune Markers with Severity and Heritability of Depressive Disorder: A Cross-Sectional Hospital-Based Study from North India

Background: Inflammatory response plays a pivotal role in the pathophysiology of depression. With this background, we planned this study to see if immune markers, interleukin 6 (IL-6), and erythrocyte sedimentation rate (ESR) are raised in subjects with major depressive disorder (MDD) and compare its level with healthy controls and first-degree relatives of subjects. We also explored if variation in the level of these markers was related to the severity of depression. Methods: This comparative observational study included 120 subjects, who were divided into three groups of 40 individuals each. Group 1 was the MDD group, group 2 was the healthy first-degree relative group, and group 3 was the healthy control group. All the subjects were then made to undergo estimation of IL-6 (pg/mL) and ESR (mm/h) from our hospital biochemistry lab. The patients in group 1 were additionally screened for the severity of depression. Results: The mean IL-6 and ESR measure within the MDD group was 9.20 ± 13.40 (pg/mL) and 5.90 ± 5.35 (mm/h), respectively. We found that the mean and median values of both IL-6 and ESR were highest in the MDD group as compared to other groups, which were statistically significant ( p <0.05). A pairwise comparison found no significant difference in the IL-6 and ESR scores among the healthy controls and healthy first-degree relatives. The mean of IL-6 was highest in individuals with moderate severity of depression, while the mean of ESR was highest in individuals with severe depression. Conclusion: The immune markers, IL-6 and ESR, were significantly raised in the MDD group; however, the levels did not correlate significantly with the differential severity of the depressive disorder as per Hamilton depression rating scale (HAM-D) scores.

Is the development of arrhythmia predictable in rheumatoid arthritis?

Objectives: This study aimed to determine whether there is a difference in the electrocardiography (ECG) measurements of healthy controls and rheumatoid arthritis (RA) patients and to predict whether they can be used to determine the risk of arrhythmia in patients. Patients and methods: The prospective study included 50 cardiac asymptomatic RA patients (38 males, 12 females; mean age: 46.8±9.1 years; range, 18 to 60 years) who met the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology RA criteria and 50 healthy volunteers (34 males, 16 females; mean age: 43.4±10.4 years; range, 18 to 60 years) as a control group between June 1, 2022, and August 31, 2022. Disease activity of the patients was calculated with the Disase Activity Score (DAS28). Heart rate, minimum and maximum QT intervals, QT dispersion, minimum and maximum P waves, P wave dispersion (Pd), minimum and maximum Tp-e intervals, Tp-e dispersion, minimum and maximum corrected QT (QTc) intervals, QTc dispersion, and the Tp-e/QTc ratio in ECGs were calculated. Results: The mean disease duration of the RA group was 9.09±5.74 years. The mean C-reactive protein level was 9.83±8.29, the mean erythrocyte sedimentation rate was 26.12±16.28 mm/h, and the mean DAS28 was 3.03±0.37. There was a statistically significant increase in the maximum P wave, Pd, maximum QT, QT dispersion, maximum QTc, QTc dispersion, maximum Tp-e, Tp-e dispersion, and Tp-e/QTc dispersion parameters in the RA group compared to the control group, while there was a significant decrease in the minimum P wave, minimum QT, and minimum QTc parameters. Conclusion: In our study, the Pd, QTc dispersion, Tp-e dispersion, and Tp-e/QTc dispersion values of our patients, which indicate the risk of atrial and ventricular arrhythmia, were found to be significantly higher. This finding suggests that our patients had an increased risk of cardiac morbidity and mortality. Arrhythmias are the likely source of the increase in sudden cardiac death in RA, and these new indicators measured on ECG can be used as standardized cardiovascular morbidity and mortality indicators in the future.

Application of Constant Rate of Supply Model for the Determination of Sediment Accumulation Rates and Chronology of Bukit Merah Reservoir Perak, Malaysia

The Constant Rate of Supply (CRS) model is used to measure the continuous influx of unsupported 210Pb into the sediment, allowing for the assessment of changes in the rate of sediment accumulation due to anthropogenic impacts over time. Thus, the CRS model was used to analyze a 25 cm bottom sediment core extracted from Bukit Merah Reservoir. Results revealed a high sedimentation rate in the reservoir, which ranged from 0.14 to 0.37 gcm-2 yr-1, with a mean sedimentation rate of 0.31 cm yr-1. The presence of 137Cs was not observed in the core, while the activity of 241Am was detected in two isolated samples but was insufficient for use as a marker. The constant rate of 210Pb supply (CRS) model dated the oldest sediments (22.5-24.5 cm) to AD 1985 ± 34 years of human influences. Overall, the sedimentation rate in the reservoir experienced a rapid increase from the 1980s to the 2000s and fluctuated to the top of the core indicating continuous anthropogenic impacts on the reservoir. The study identified continuous increases in agricultural activities, expansion in the tourism industry, population growth, and changes in land use, as the main cause of heightened sedimentation and sediment particles delivery into the reservoir. Therefore, urgent measures are needed to address the current siltation state of the reservoir.

Clinical impacts of immunomodulator withdrawal from anti‐tumor necrosis factor combination therapy in pediatric inflammatory bowel disease

AbstractObjectivesCombination therapy consists of both anti‐tumor necrosis factor (anti‐TNF) and an immunomodulator (IMM) and has been shown to improve outcomes in patients with inflammatory bowel disease (IBD). This study assesses the impacts of IMM withdrawal from combination therapy to anti‐TNF monotherapy in children with IBD.MethodsThis single‐center retrospective cohort study included children with IBD initiated on combination therapy between 2014 and 2019 who discontinued the IMM. We evaluated whether IMM withdrawal impacts laboratory values and disease activity. Linear mixed effects models with random intercepts were used to compare differences between groups. Chi‐square and Kruskal–Wallis tests were used for comparisons between patients who did and did not require subsequent escalation of therapy.ResultsOne hundred and fifty‐two patients discontinued the IMM which did not significantly affect disease activity. However, 18% of patients escalated therapy after IMM withdrawal, primarily due to low anti‐TNF levels. Lower anti‐TNF and higher erythrocyte sedimentation rate (ESR) and C‐reactive protein (CRP) levels before IMM withdrawal were associated with subsequent escalation of therapy. Overall, there was no statistically significant effect on anti‐TNF drug levels. Patients with Crohn's disease (CD) on infliximab (IFX) and methotrexate (MTX) who discontinued the IMM had an increase in mean ESR and CRP (p < 0.05).ConclusionsIMM withdrawal from anti‐TNF combination therapy may be considered safe in the setting of higher anti‐TNF levels and normal serum inflammatory markers. Clinicians should consider assessing anti‐TNF levels and inflammatory markers after IMM withdrawal, especially in patients with CD receiving IFX who discontinued MTX.

Different biomarker ratios in peripheral blood have limited value in diagnosing periprosthetic joint infection after total joint arthroplasty: a single-center, retrospective study

BackgroundPeriprosthetic joint infection (PJI) is a severe complication that can occur after total joint arthroplasty (TJA). The timely and accurate diagnosis of PJI is the key to treatment. This study investigated the diagnostic value of platelet to lymphocyte ratio (PLR), platelet count to mean platelet volume ratio (PVR), neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) in PJI after total knee arthroplasty (TKA) and total hip arthroplasty (THA).MethodsWe performed a retrospective analysis of the patients who underwent revision hip or knee arthroplasty at our Institute between June 2015 and June 2020. Of the 187 patients reviewed, 168 were included in the study. According to the diagnostic criteria of the Musculoskeletal Infection Society (MSIS), 58 patients were in the PJI group, and 110 patients were in the aseptic loosening (AL) group. We recorded and compared the preoperative peripheral blood white blood cell (WBC) count, platelet count (PLT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), PLR, PVR, NLR, and MLR in both groups. The diagnostic performance of the WBC, PLT, PLR, PVR, NLR, and MLR individually and in combination with the ESR and CRP for PJI diagnosis was evaluated by receiver operating characteristic (ROC) curves, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated.ResultsCompared to those in the AL group, the mean WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR in the peripheral blood of the PJI group were significantly greater (P < 0.05). The analysis of the ROC curve revealed that the ESR, CRP, PLR, PVR, NLR, and MLR in peripheral blood had moderate effectiveness in diagnosing PJI, with area under the curve (AUC) values of 0.760 (95% CI: 0.688–0.823), 0.758 (95% CI: 0.687–0.821), 0.714 (95% CI: 0.639–0.781), 0.709 (95% CI: 0.634–0.777), 0.723 (95% CI: 0.649–0.789), and 0.728 (95% CI: 0.654–0.793), respectively. Conversely, the WBC and PLT counts demonstrated poor diagnostic value for PJI, with AUC values of 0.578 (95% CI: 0.499–0.653) and 0.694 (95% CI: 0.619–0.763), respectively. The results of the prediction model calculations revealed that the combined AUC of the WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR was the highest at 0.853 (95% CI, 0.790–0.909), indicating good value in the diagnosis of PJI, with a sensitivity of 82.8% and a specificity of 72.7%. Moreover, the novel composite of parameters improved the accuracy and reliability in diagnosing PJI compared to the traditional biomarkers ESR and CRP (P = 0.015).ConclusionOur study suggested that the diagnostic value of the peripheral blood biomarkers PLR, PVR, NLR, and MLR for diagnosing PJI is limited and not superior to that of the ESR or CRP. However, when the WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR are combined, the diagnostic performance of PJI in TJA patients can be improved.

E039 Multiple myeloma and neurological complications: prevalence and risk factors

Abstract Background/Aims Multiple myeloma (MM) is a malignant haematological disorder with a highly variable clinical presentation. Few studies have explored the neurological complications (CN) associated with MM. The objectives of this study were to describe the neurological manifestations observed in MM and to determine predictive factors for neurological complications. Methods We collected data from 126 cases of symptomatic multiple myeloma patients followed in our department over a 30-year period (1993 - 2023). We gathered sociodemographic, clinical, and laboratory data. Neurological complications were diagnosed based on clinical findings and magnetic resonance imaging data. Results Our study included 126 patients with an average age of 65.23 ± 11.63 years [36-92], and a male-to-female sex ratio of 3.8. Bone pain was present in 92.1% (116 cases) with an average duration of 4 months. The mean erythrocyte sedimentation rate and C-reactive protein levels were 99.08 mm at H1 [3-190] and 27.74 [0-196], respectively. Hemoglobin levels were less than 10g/dl in 51.2% of cases, with an average of 9.902 ± 2.22 g/dl [5-13.9]. Calcium levels exceeded 2.75 mmol/l in 20% of cases, with an average of 2.49 ± 0.33 mmol/l. The mean creatinine level was 88.28 ± 77.9 μmol/l [36-587], with levels above 177 μmol/l observed in 15 cases (10.4%). The Durie and Salmon prognostic classification categorized our patients as follows: Stage IA (3.2%), Stage IIA (4%), Stage IIB (0.8%), Stage IIIA (72.2%), and Stage IIIB (18.3%). Neurological complications were present in 22.2% of patients (n = 28). Sixteen patients (12.7%) had spinal cord compression, with nine having dorsal involvement, six having conus medullaris involvement, and one having cervical involvement. Radicular pain affected 14 patients, with eight experiencing sciatalgia and four having cruralgia. Two patients (1.8%) had carpal tunnel syndrome. No cerebral involvement was observed in our series. In our study, only creatinine levels were significantly lower in patients who developed neurological complications (64.35 vs. 95.19, p = 0.004). However, the occurrence of neurological complications was independent of age (p = 0.696), duration of evolution (p = 0.669), erythrocyte sedimentation rate (p = 0.541), C-reactive protein (p = 0.963), hemoglobin (p = 0.076), or calcium levels (p = 0.274). No association was found between neurological complications and gender (p = 0.849) or prognostic stage (p = 0.119) Conclusion Neurological manifestations in MM are diverse and often underestimated. The diagnosis of MM should be considered in the presence of spinal or radicular compression, especially when the laboratory findings suggest it. Disclosure M. Dhifallah: None. I. Fenniche: None. A. Feki: None. S. Ben Djemaa: None. M. Kallel: None. H. Fourat: None. R. Akrout: None. S. Baklouti: None.

Association between follicular fluid bacteria with inflammatory markers of the complete blood count and the outcomes of assisted reproductive technology in women with endometriosis: A case-control study.

Endometriosis is a common reason for infertility and poor outcomes of assisted reproductive technology (ART). Inflammation is involved in the pathogenesis of this disease. The presence of microorganisms in women with endometriosis may increase levels of inflammatory markers. The purpose of this study is to determine the relationship between the presence of bacteria in the follicular fluid with the inflammatory markers of the complete blood count (CBC) and the outcomes of in vitro fertilization(IVF) in women with endometriosis. This case-control study was conducted on 74 patients undergoing IVF, referred to Al-Zahra Hospital in Rasht (Iran) in 2021. The patients were divided into two case groups including 37 women with endometrioma and the control group, including 37 infertile women with a male factor and normal ultrasound. In total, 74 follicular fluids were collected from the case and control groups and were cultured in the laboratory. The relationship between culture results with IVF outcomes and the levels of CBC inflammatory markers including the number of white blood cells (WBCs), lymphocytes, neutrophils, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) was analyzed. There was no significant statistical difference between the frequency of bacteria present in the follicular fluid (p = 0.861), the mean rate of fertilization (p = 0.363), the frequency of CRP (p = 0.999), and the mean WBCs, lymphocytes, neutrophils, NLR, LMR, and PLR in the two groups. There was a significant statistical difference between the mean number of oocytes of metaphase II (p = 0.034) and the mean ESR (p = 0.018) in the two groups. It seems necessary to evaluate follicular fluid as a biological substance that is considered an optimal factor for predicting oocyte quality, fertilization rate, embryo quality, and the success rate of ART.

The Effect of the Holy Quran Recitation on Inflammatory Markers in Hemodialysis Patients in Iran: A Randomized Clinical Trial.

Increased inflammation is a common complication in chronic hemodialysis (HD) patients. Addressing the psychological symptoms of patients may help reduce inflammation and its negative impact on the body. Considering the calming effects of listening to the Holy Quran, this may help reduce mental, psychological, and physical problems in Muslim patients. The present study sought to examine the effects of listening to Holy Quran recitation on the level of inflammatory markers in HD patients. This was a randomized controlled trial involving 50 HD patients at Kowsar Hospital in Semnan, Iran, in 2019-2020. The participants were divided into experimental and control groups using simple randomization by sealed envelopes. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in blood were measured before the intervention. The participants in the experimental group listened by headphones to the Holy Quran being recited three times a week, 20 min each time, for one month. For those in the control group, headphones were placed but on silent mode. At the end of the intervention one month later, inflammatory markers were measured again for participants in both groups. Data were analyzed in SPSS-16 using descriptive and inferential statistics (t test, Wilcoxon, and Mann-Whitney U). Mean IL-6 level decreased by 20.2pg/ml, mean ESR level by 16.8mm/hr, and mean CRP level by 19.9mg/dl in the experimental group, while these values increased in the control group. The between-group differences in the intervention and control groups at follow-up were significant for all three inflammatory markers (p < 0.05). Listening to the Holy Quran being recited is recommended as a complementary therapy for reducing systemic inflammation (as indicated by inflammatory markers) in Muslim HD patients.Trial registration: Iranian Registry of Clinical Trials, Trial No: IRCT20120109008665N9. Registered 4 Nov 2019.

Inflammatory Status and Chronic Kidney Disease in Cats: Old and New Inflammatory Markers—A Pilot Prospective Study

This prospective study aimed to evaluate inflammatory status in cats affected by chronic kidney disease (CKD) at IRIS stages 2–4, using serum amyloid A (SAA) and the erythrocyte sedimentation rate (ESR) as inflammatory markers. Thirty-two cats with CKD and ten clinically healthy cats (i.e., control group) were enrolled. The recording of signalment data, complete physical examinations, and abdominal ultrasonography were performed for each animal. Additionally, ESR levels, complete blood count, clinical chemistry (including SAA determination), serum protein electrophoresis, and complete urinalysis were executed. This study’s results showed that mean ESR and SAA concentrations in cats with CKD were statistically higher compared to those of the control group (p = 0.0005 and p = 0.007, respectively). The SAA concentration was significantly increased at IRIS stages 2, 3, and 4 compared to the control group. Meanwhile, the ESR was significantly higher in cats at IRIS stages 3 and 4 (p = 0.0003 and p = 0.0007, respectively), but not at IRIS stage 2, compared to the control group. These results provide evidence that feline CKD is associated with a systemic inflammatory status. Moreover, the rise in ESR appears to be more linked to advanced stages of the disease and could, therefore, correlate with the uremic condition.

Systemic inflammatory disease in patients with spontaneous coronary artery dissection

Abstract Background Spontaneous coronary artery dissection (SCAD) is an increasingly recognised cause of non-atherosclerotic myocardial infarction (MI). Systemic inflammatory diseases are commonly associated with SCAD patients, but the link between inflammatory diseases and SCAD remains unclear. Purpose To determine the prevalence of systemic inflammatory disease (SID) and elevated inflammatory markers (EIM) at SCAD presentation. To compare long-term outcomes between SCAD patients with and without SID, and with and without EIM at presentation. Methods We reviewed patients enrolled in the Canadian SCAD Study who had laboratory measurements of inflammatory markers at presentation with SCAD. We compared the baseline demographics, presence of SID, presentation characteristics, and long-term outcomes between patients with and without SID, and between patients presenting with and without EIM at time of SCAD. SID was determined using past medical history and patient self-identification. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were used as inflammatory biomarkers. Major adverse cardiovascular events (MACE) were defined as the composite of all-cause mortality, stroke or transient ischemic attack, MI, hospitalization for heart failure and unplanned revascularization. Results Of 1307 patients with SCAD, 360 had inflammatory markers measured at presentation. Of these 360 patients, 150 (43.1%) had EIM at presentation, and 13 (3.6%) reported a history of SID. Mean age was 52.9±9.8 years for patients with EIM, vs. 50.8±10.9years for patients without EIM (p=0.06). Patients with EIM had significantly higher body mass index compared to those without EIM (35.5% vs 17.6%, p=0.001). Of the patients with reported SID, there was higher prevalence of diabetes and hypertension. There was no significant difference in mean inflammatory marker levels, ESR (13.4±15.6mm/h vs 13.7±13.2mm/h, p=0.965) and CRP (15.6± 23.1mg/L vs 11.9± 26.8mg/L, p=0.644) among SID vs. no SID patients at SCAD presentation. Overall mean follow-up was 3.7±1.9 years. There was no difference in in-hospital MACE and overall MACE between patients with EIM vs. no EIM, and between SID and no SID cohorts. There were also no significant difference in angiographic findings, fibromuscular dysplasia prevalence, proportion treated conservatively vs. with revascularization in these cohorts. Conclusion There was no significant difference between presentation, laboratory values, treatment, or outcomes between SCAD patients with or without SID, and between patients who present with and without EIM. This suggests that both active inflammation and history of inflammatory diseases do not contribute to SCAD or outcomes.Table 1.SCAD cohort demographics &amp; data

COVID-19 and the Brain: A Psychological and Resting-state Functional Magnetic Resonance Imagin (fMRI) Study of the Whole-brain Functional Connectivity.

Coronavirus-2019 (COVID-19) spreads rapidly worldwide and causes severe acute respiratory syndrome. The current study aims to evaluate the relationship between the whole-brain functional connections in a resting state and cognitive impairments in patients with COVID-19 compared to the healthy control group. Resting-state functional magnetic resonance imaging (rs-fMRI) and Montreal cognitive assessment (MoCA) data were obtained from 29 patients of the acute stage of COVID-19 on the third day of admission and 20 healthy controls. Cross-correlation of the mean resting-state signals was determined in the voxels of 23 independent components (IC) of brain neural circuits. To assess cognitive function and neuropsychological status, MoCA was performed on all participants. The relationship between rs-fMRI information, neuropsychological status, and paraclinical data was analyzed. The COVID-19 group got a lower mean MoCA score and showed a significant reduction in the functional connectivity of the IC14 (P<0.001) and IC38 (P<0.001) regions compared to the controls. The increase in functional connectivity was observed in the COVID-19 group compared to the controls at baseline in the default mode network (DMN) IC00 (P<0.001) and dorsal attention network (DAN) IC08 (P<0.001) regions. Furthermore, the alternation of functional connectivity in the mentioned ICs was significantly correlated with the mean MoCA scores and inflammatory parameters, i.e. erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Functional connectivity abnormalities in four brain neural circuits are associated with cognitive impairment and increased inflammatory markers in patients with COVID-19. The patients with coronavirus-2019 (COVID-19) got a lower mean Montreal cognitive assessment (MoCA) score.The patients with COVID-19 showed significant reduction in the functional connectivity of the IC14 and IC38 regions.The patients with COVID-19 showed significant increase of functional connectivity in the default mode network (DMN) IC00 and dorsal attention network (DAN) IC08 regions.Alternation of functional connectivity was significantly correlated with the mean MoCA scores and ESR and CRP. The researcher aimed at assessing cognitive impairments and investigating the whole-brain functional connectivity using resting state fMRI in patients with COVID-19 compared with healthy control group. The result showed That COVID-19 group got a lower mean cognitive score and showed a significant reduction in the functional connectivity of the IC14 and IC38 regions of brain compared with controls. Also, the increase of functional connectivity was observed in the COVID-19 group compared with controls at baseline in the default mode network (DMN) and dorsal attention network (DAN) regions of brain. Moreover, Functional connectivity abnormalities in four brain neural circuits associated with cognitive impairment and increased inflammatory markers in patients with COVID-19.

Setting the basis for a high-resolution record of the late Quaternary to present climate variability from Castiglione maar, central Italy: First results from AMUSED project

The AMUSED (A MUltidisciplinary Study of past global climatE changes from continental and marine archives in the MeDiterranean region) project aims at improving knowledge of late Quaternary climate variability and its expressions in different geological settings of the Mediterranean region. In this framework, the Castiglione maar, in the Colli Albani Volcanic District, central Italy, was selected for acquiring a high-resolution and geochronologically well-constrained multi-proxy record by drilling the entire lacustrine succession. Electrical Resistivity Tomography (ERT) profiles were acquired across the central portion and the SW crater edge to depict the geometry of the sedimentary infilling and select the best drilling site. Two parallel cores (C1 and C2), 116 m- and 126.5 m-depth respectively, were recovered from the central sector of the Castiglione basin, where, according to ERT profiles, the sedimentary succession reaches the maximum thickness. The sedimentary infilling consists of fine-grained sediments: mainly fine sand, silt and clay, with minor gravel intervals and numerous tephra layers and volcaniclastic lenses. Specifically, more than 60 tephras were identified and used, alongside other lithostratigraphic features, to correlate the C1 and C2 cores and to assemble a composite section. The variability in magnetic susceptibility, led by glacial-interglacial cycles, and the geochemical fingerprinting of key tephra layers allowed to establish a preliminary chronological framework for the Castiglione succession which certainly spans the last 365 ka, with a mean sedimentation rate of 0.33 mm/yr. The relatively long time span of the Castiglione maar succession arises as a new potentially meaningful node of the network of Mediterranean records for better reconstructing the late Quaternary climate dynamics on a regional and extra-regional scale.

Assessment of Clinical Profile in Patients Suffering from Non-radiographic Axial Spondyloarthropathy

Objectives Axial Spondyloarthritis is an inflammatory, immune-mediated condition comprising clinically dif- ferentiated ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). Clinically, as the name suggests, nr-axSpA lacks definitive plain X-ray evidence of structural damage to the sacroiliac (SI) joint. This study was undertaken to assess the patients with newly diagnosed nr-axSpA clinically and compare the same with those with radiographic AS. The laboratory profile of patients suffering from nr-axSpA and their outcomes over three months were also studied. Material and Method This study was conducted in the Department of Medicine over 18 months in a tertiary health care institution, being a prospective observational type done with 43 subjects. Results We observed a major improvement as per ankylosing spondylitis disease activity score (ASDAS) criteria present among 53.49% of subjects, followed by clinically significant improvement among 27.91% of subjects. 18.60% of subjects did not show any improvement. 9.3 % of subjects showed radiological progression. Out of 8 cases that did not show improvement, all presented with lower back pain (LBP) and morning stiffness. 62.5% had peripheral arthritis. 87.5% had Schober’s test positive, flexion, abduction and external rotation (FABER) test (62.50%), and SI joint tenderness was found among 7.5% of subjects. A total of 4 (9.3%) patients showed radiological progression. They all have low back aches and morning stiffness, and three have peripheral arthritis at presentation. We found that patients who showed progression had higher mean erythrocyte sedimentation rate (ESR) and C-Reactive protein (CRP) levels (45 and 36.5, respectively) values and very high disease activity as per ASDAS and bath ankylosing spondylitis disease activity index (BASDAI) criteria. Conclusion There is a great scope and need for research to differentiate the magnetic resonance imaging (MRI) changes in the normal population against the patients with spinal diseases to be able to use MRI with precision in patients with non-radiographic axial spondyloarthropathy (nr-axSpA). As assessed, physiotherapy and Non-steroidal anti-inflammatory drugs (NSAIDS) are currently first-line therapy for patients suffering from nr-axSpA.

Haematological responses of replacement levels of fish meal with chicken offal in catfish (Clarias gariepinus) diets

Fish demand by consumers keeps increasing, yet constraints to the production of fish are encountered, the commonest of which is the high cost and difficulty in acquiring fish feeds in Nigeria. The objective of this study was to determine the effect of the formulated test diets of 40% protein concentrate using varying levels of chicken offal diets on the haematological parameters of the African Catfish (Clarias gariepinus). The chicken offal was used to replace fish meal at inclusion levels of 0% (control, treatment A), 25% (treatment B), 50% (treatment C), 75% (treatment D) and 100% (treatment E) respectively. Three hundred (300) fingerlings of average length, 8.12±0.48 cm, and average weight, 3.68±0.00 g, were stocked in concrete tanks. Fish were fed at 5 per cent body weight for 8 months. Physicochemical parameters including; water temperature (°C), pH, dissolved oxygen and ammonia were monitored every four days and maintained within acceptable ranges for fish culture. Data obtained were analysed using analysis of variance (ANOVA). Results showed haemoglobin (Hb), Packed cell volume (PCV), Mean corpuscular haemoglobin concentration (MCHC) and mean corpuscular volume (MCV) to be statistically different (ANOVA, p&lt;0.05) between the treatments, although no significant difference (ANOVA, p&gt;0.05) was observed in white blood cell (WBC), Mean Corpuscular haemoglobin (MCH) and erythrocyte sedimentation rate (ESR). Haematological parameters results were within the ranges for fish well-being. Chicken offal were suitable as partial replacement at (25, 50, 75 and 100%) for fish meal, it enhanced the hematological performance of C. gariepinus due to its mineral components.

Biological Predictors of Osteoarticular Infection Due to K. kingae-A Retrospective Cohort Study of 247 Cases.

Pediatric osteoarticular infections (OAIs) are serious conditions that can lead to severe septic complications, prolonged morbidity with long-term impaired function, and perturbed subsequent bone development. Kingella kingae (K. kingae) is currently accepted as the predominant pathogen in pediatric OAIs, especially among 6-48 month olds. The present study aimed to identify clinical and biological markers that would refine the detection of patients with an OAI due to K. kingae. We retrospectively studied every consecutive case of pediatric OAI admitted to our institution over 17 years. Medical records were examined for patient characteristics such as temperature at admission, affected segment, and biological parameters such as white blood cell (WBC) count, left shift, platelet count (PLT), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The 247 patients included 52.2% males and 47.8% females and mean age was 18.5 ± 10 months old. Four patients were older than 48 months; none were younger than 6 months old. Mean temperature at admission was 37.4 ± 0.9 °C. Regarding biological parameters, mean WBC count was 12,700 ± 4180/mm3, left shift was only present in one patient, mean PLT was 419,000 ± 123,000/mm3, mean CRP was 26.6 ± 27.8 mg/L, and mean ESR was 35.0 ± 18.9 mm/h. Compared to the modified predictors of OAI defined by Kocher and Caird, 17.2% of our cases were above their cut-off values for temperature, 52.3% were above the WBC cut-off, 33.5% were above the ESR cut-off, and 46.4% were above the CRP cut-off. OAIs due to K. kingae frequently remain undetected using the classic biological parameters for investigating bacterial infections. As an addition to the predictors normally used (°C, WBC, CRP, and ESR), this study found that elevated platelet count was frequently present during OAIs caused by K. kingae. Although this biological characteristic was inconstant, its presence was highly significant and very suggestive of an invasive infection due to K. kingae.

E14 Is there a correlation between inflammation and cardiovascular risk in juvenile idiopathic arthritis

Abstract Introduction Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease and, like any chronic inflammatory rheumatic disease, has an increased risk of cardiovascular disease compared with the general population. Objectives In this work, we investigated the relationship between inflammation and cardiovascular risk during JIA. Methods This was a retrospective study including adults with long-standing JIA according to the International League of Associations for Rheumatology (ILAR) criteria over a period of 28 years (1994–2022). Clinical and biological parameters were collected. Cardiovascular risk factors (CVRF) were also assessed: family history of cardiovascular event, physical inactivity, smoking, arterial hypertension, diabetes, dyslipidaemia, obesity. Results We included 29 patients (17 females and 12 males) with an average age of 35.69 ± 11.72 [18–61] years, an average age of disease onset of 11.10 ± 4.25 [2–16] years and an average diagnostic delay of 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years. Mean C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 42.74 ± 63.37 [2–218] mg/l and 69.67 ± 36.23 [36–108] mm/h. A biological inflammatory syndrome was noted in 65.5% of cases (n = 19). CVRF were present in 41.4% (n = 12) of cases: family history of cardiovascular event (n = 2 cases), physical inactivity (n = 5 cases), smoking (n = 3 cases), arterial hypertension (n = 4 cases), diabetes (n = 4 cases), dyslipidaemia (n = 4), and BMI ≥ 25 kg/m2 (n = 4). Our statistical study concluded that CVRF (all types) were more frequent in case of elevated inflammation markers (60% vs 15.4%; P = 0.016). In addition, the presence of biological inflammatory syndrome associated with smoking in our population (20% vs 0%; P = 0.048). In contrast, we found no significant difference when comparing the rest of CVRF according to the elevation of inflammation markers. Furthermore, we found a correlation between biological inflammation and the presence of CVRF (all type) (r = 0.456; P = 0.015). However, no correlation was found with the CVRF taken separately. Conclusion Inflammation is correlated with cardiovascular risk in JIA. Control of inflammation and modifiable CVRF is recommended in this disease.

E13 Cervical spine involvement in juvenile idiopathic arthritis: frequency and associated factors

Abstract Background Juvenile idiopathic arthritis (JIA) is a pediatric rheumatism including several subgroups. The cervical spine involvement is poorly studied in JIA compared with adult rheumatism. Objectives This study aimed to assess the frequency and associated factors with cervical spine involvement in JIA. Methods We conducted a retrospective study including adults with long-standing JIA according to International League of Associations of Rheumatology (ILAR) criteria over a 28-year period (1994 – 2022). We retrieved radiographs of the cervical spine in anteroposterior, lateral, and lateral flexion views in search of an atlantoaxial dislocation (AAD). Demographic, clinical, biological, and radiological data were compared according to the presence or absence of AAD. Results A total of 29 Patients were enrolled (12 men and 17 women), the mean age was 35.69 ± 11.72 [18–61] years. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average diagnostic delay was 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years. The mean body mass index (BMI) was 21.20 ± 4.88 [14.17–27.55] kg/m2. Most patients had a polyarticular form (55.2%, n = 16). Mean C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 42.74 ± 63.37 [2–218] mg/l and 69.67 ± 36.23 [36–108] mm/h. A biological inflammatory syndrome was present in 19 cases. Rheumatoid factor, ACPA and anti-nuclear antibodies were observed in 12, 7 and 5 cases respectively. At least one extra-articular involvement was noted in 16 cases. Bone erosions and hip involvement were noted in 18 and 14 cases, respectively. AAD was noted in 4 patients (13.8%). It was diagnosed on average 4.28 ± 10.07 [0–27] years after disease onset. AAD was only associated with extra-articular involvement in our study (75% vs 13.6%; P = 0.047). On the other hand, our study showed that age, gender, age at onset, diagnostic delay, duration of symptoms, BMI, JIA sub form, inflammation markers, rheumatoid factor, ACPA, antinuclear antibodies, bone erosions, and hip involvement were not associated with AAD. Conclusion The cervical spine involvement was not negligible in our study and was associated with extra-articular involvement. This condition is serious and can be life threatening. Therefore, it is important to perform more studies to better evaluate its frequency, clinical presentation, and imaging.

E18 What is the relationship between body mass index and juvenile idiopathic arthritis characteristics?

Abstract Introduction Juvenile idiopathic arthritis (JIA) is a group of pediatric chronic inflammatory joint diseases. The various forms of JIA may be associated with delayed growth or local growth disturbances. Objectives We conducted this study to evaluate the relationship between the different clinical and biological characteristics of JIA and the anthropometric parameters of patients. Methods Retrospective study including adults with long-standing JIA according to International League of Associations of Rheumatology (ILAR) criteria over a period from 1994 to 2022. Clinical and biological parameters were collected. Body mass index (BMI) was interpreted according to World Health Organization cut-offs as follows: underweight &amp;lt;18.5, normal [18.5–24.9], overweight [25–29.9], and obese ≥30 kg/m2. Results Seventeen women and 12 men were included. The mean age was 35.69 ± 11.72 [18–61] years. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average diagnostic delay was 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years. The polyarticular form was the most frequent (55.2%). Rheumatoid factor, ACPA and antinuclear antibodies were present in 41.4%, 24.1% and 17.2% of cases respectively. At least one extra-articular manifestation was noted in 16 patients: ophthalmologic (n = 6), skin (n = 4), cardiac (n = 4), pulmonary (n = 3) and renal (n = 2) involvement. Osteoporosis was noted in 7 cases. Mean C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 42.74 ± 63.37 [2–218] mg/l and 69.67 ± 36.23 [36–108] mm. An elevation of inflammation markers was noted in 19 cases. The mean haemoglobin value was 11.31 ± 2.10 [6.5–15] g/dl Anaemia was noted in 20 cases. The mean body mass index was 21.20 ± 4.88 [14.17–27.55] kg/m2, 36.4% of patients were underweight, 27.2% had a normal BMI, and 36.4 were overweight. No patient was obese. Growth delay was noted in 3 cases. Our statistical study found a correlation of BMI with ESR (r = 0.998; P &amp;lt; 0.001), rheumatoid factor positivity (r = -1.000; P &amp;lt; 0.001), and osteoporosis (r = 0.803; P = 0.030). No other correlation of BMI with clinical and biological characteristics of the study population was identified. Conclusion BMI should be well considered in the JIA evaluation and treatment. BMI correlated with ESR, rheumatoid factor positivity, and osteoporosis in our study.

E15 Immunopositive and immunonegative juvenile idiopathic arthritis: what makes the difference?

Abstract Background Juvenile idiopathic arthritis (JIA) is a complex pediatric rheumatic disease of polymorphic expression. The immunological assessment is commonly performed during this disease. Objectives The objective of this work was to evaluate the difference between immunopositive and immunonegative forms of JIA. Methods We conducted a retrospective study including adults with long-standing JIA according to International League of Associations of Rheumatology (ILAR) criteria over a 28-year period (1994 – 2022). We retrieved the immunological results of all patients. The disease was considered immunopositive in case of rheumatoid factor (RF) and/or anti-citrullinated peptide antibody (ACPA) positivity. Results We included 29 patients (12 men and 17 women) with a mean age of 35.69 ± 11.72 [18–61] years. The mean age of disease onset was 11.10 ± 4.25 [2–16] years. The average diagnostic delay was 52.96 ± 95.97 [0–336] months. The average disease duration was 24.48 ± 12.76 [1–47] years. The mean body mass index (BMI) was 21.20 ± 4.88 [14.17–27.55] kg/m2, 8 patients had a normal BMI. Growth delay was noted in 3 cases. The polyarticular form was the most frequent, observed in 55.2% of cases. At least one extra-articular manifestation was noted in 16 patients: ophthalmologic, skin, cardiac, pulmonary, and renal involvement were found in 6,4,4,3 and 2 cases, respectively. Osteoporosis was noted in 7 cases. Mean C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were 42.74 ± 63.37 [2–218] mg/l and 69.67 ± 36.23 [36–108] mm/h. Bone erosions, hip involvement and atlantoaxial dislocation were noted in 18, 14, and 4 cases, respectively. Rheumatoid factor, ACPA and anti-nuclear antibodies were observed in 12, 7 and 5 cases respectively. The disease was considered immunopositive in 13 cases. Our comparative study found that women had more immunopositive forms (84.6% vs 15.4%; P = 0.010). In addition, osteoporosis was less frequent in immunopositive JIA (11.1% vs 88.9%; P = 0.003). Growth delay was only observed in immunopositive JIA (P = 0.012). Furthermore, the age at disease onset was greater in the immunopositive group (12.85 ± 2.94 vs 9.69 ± 4.7 years; P = 0.045). However, no significant differences were identified when comparing the rest of the JIA characteristics. Conclusion Evaluation of the immunological profile is required in JIA. Our study found associations of RF and/or ACPA positivity with age at disease onset, female gender, osteoporosis, and growth delay in JIA.

E06 Does GGT level correlate with activity parameters in enthesitis-related arthritis?

Abstract Introduction Enthesitis-related arthritis (ERA) is one of the main subgroups of juvenile idiopathic arthritis. As in the adult population, monitoring of patients with ERA is based on clinical and laboratory evaluation. Some studies showed a correlation between Gamma-glutamyl transferase (GGT) levels and rheumatoid arthritis disease activity markers. Thus, we aimed to evaluate the correlation between GGT levels and ERA activity parameters. Methods This is a cross-sectional monocentric study including patients meeting the International League of Associations for Rheumatology (ILAR) 2001 criteria for ERA. We collected the demographic and clinical data. We assessed the ERA activity using clinical parameters including Patient Global Assessment (PGA), Visual Analogue Scale (VAS), Morning stiffness (MS), tender joint count (TJC), swollen joint count (SJC), active enthesitis count (AEC), clinical sacroiliitis, back mobility, and ocular involvement. We collected biological parameters such as the C-reactive protein (CRP) and the Erythrocyte sedimentation rate (ESR). We calculated the Juvenile spondyloarthritis disease activity (JSpADA). GGT level was measured on the same day. The correlation was evaluated using Spearman’s rho coefficient (r). r-value &amp;lt;0.3 was considered poor; between 0.3 and 0.39, moderate; between 0.4 and 0.69, strong; and &amp;gt;0.7 very strong. Results Thirty patients with a mean age of 15.1 ± 4.1 years, and a ratio-sex of 2.75 were included. The mean disease duration was 4.3 ± 3.2 years. The mean PGA and the mean VAS were 6.2 ± 7.1 and 8.9 ± 2.9 respectively. Mean TJC, mean SJC, and mean AEC were 1.53 ± 2.8, 0.18 ± 0.47, and 1.2 ± 1.6 respectively. Clinical sacroiliitis was found in eight patients, limited back mobility in six, and uveitis in three patients. The mean CRP and ESR were 15.1 ± 22.7 mg/l and 23.8 ± 21.2 mm, respectively. The mean JSpADA was 2.6 ± 1.7. Mean GGT was 14.3 ± 6.6 mg/l. A strong correlation was noted between the GGT level and both CRP (r = 0.504, P = 0.05) and ESR (r = 0.601, P = 0.01). However, no correlation was noted between GGT level and PGA (r = 0.107, P = 0.6), VAS (r = 0.03, P = 0.9), SJC (r = -0.17, P = 0.368), nor JSpADA (r = 0.323, P = 0.87). Conclusion Our results suggest a strong correlation between GGT level and biological ERA activity parameters, unlike clinical parameters and disease activity scores. More studies are needed to confirm these findings. Ethics The authors have no conflicts of interest to declare.