Group Mean Research Articles

Evaluation of epicardial fat tissue thickness in patients with seborrheic dermatitis.

Seborrheic dermatitis is a common inflammatory skin disease that primarily affects the scalp, face, and body folds. Recent studies have shown that seborrheic dermatitis may be associated with inflammation and cardiometabolic conditions. We aimed to investigate this relationship in our study. Fifty patients with seborrheic dermatitis who came to the dermatology outpatient clinic and completely healthy patients in a similar age group were included in the study. Echocardiographic findings and heart rates of the patient and control groups were recorded on previously prepared forms. The mean epicardial fat tissue thickness of the patient group was 0.72 ± 0.04, while the mean of the control group was 0.62 ± 0.05, and this difference was considered significant (P < 0.001). There was no significant difference between the patient and control groups in terms of left atrium (p = 0.759), interventricular septum thickness (p = 0.252), and heart rate (p = 0.835). Epicardial fat tissue loses its protective role in pathological processes and plays a role in cardiovascular diseases, especially coronary artery disease, in inflammatory processes. In this respect, SD patients should be carefully monitored for long-term, especially for coronary artery disease.

Telemedicine-supported lifestyle intervention for glycemic control in patients with CHD and T2DM: multicenter, randomized controlled trial.

Patients with coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM) have a substantially increased risk for major cardiovascular events and mortality. Increasing physical activity and improving a healthy diet may effectively reduce cardiovascular risk factors; however, the effects are often transient. In a multicenter, 1:1 randomized controlled trial including 502 patients with combined CHD and T2DM (68 ± 8 years; 84% men), we assessed the effects of a home-based telemedicine-supported lifestyle intervention (exercise training, nutritional recommendations and health literacy training) with regular individualized feedback versus usual care. The study met its primary endpoint of reduced glycated hemoglobin after 6 months in favor of the lifestyle intervention group (mean between-group difference in the complete-case analysis (n = 197 and n = 193), -0.13% (95% confidence interval, -0.25 to -0.01), P = 0.04). When individualized feedback and health literacy training were discontinued after 6 months (while other telemedicine tools were maintained), no statistically significant between-group differences were observed at 12 months. At 12 months, 31 patients (6.2%) had a major adverse cardiovascular event (lifestyle intervention, n = 20 (8.0%); usual care, n = 11 (4.4%); P = 0.15), with the main reason being hospitalization for angina or revascularization (lifestyle intervention, n = 15; usual care, n = 8). There were five deaths (lifestyle intervention, n = 2; usual care, n = 3), none of which were categorized as related to the intervention. However, three events that resulted in hospitalization were categorized as potentially related to the intervention (decompensation of heart failure, vertebral disc prolapse and inguinal hernia). In conclusion, a home-based lifestyle intervention with telemedicine support showed modest effects in patients with CHD and T2DM. ClinicalTrials.gov registration: NCT03835923 .

Can nebulised heparin reduce acute lung injury in patients with SARS‑CoV‑2 requiring advanced respiratory support in Ireland: the CHARTER‑Ireland phase Ib/IIa, randomised, parallel-group, open-label study

BackgroundNebulised unfractionated heparin may attenuate COVID-19 ARDS by reducing pulmonary microvascular thrombosis, blocking SARS-CoV-2 entry into cells, and decreasing lung inflammation. COVID-19 patients with a raised d-dimer have areas of pulmonary hypoperfusion on CT perfusion scans of the lung and have increased mortality risk.MethodsThis was a phase Ib/IIa open-label multi-centre, randomised controlled trial. The study was designed to evaluate whether nebulised unfractionated heparin decreased d-dimer concentrations, with safety as a co-primary outcome.ResultsForty patients were recruited, with 20 patients into each group. Mean age was 56.6 (SD 11.5) in the heparin group and 51.3 (SD 14.7) in the standard care group, while 60% of participants were male. There was no change in d-dimers from baseline to day 10 (heparin group mean change − 316.5, [SD 1840.3] and control group mean change − 321.7 [SD 3589.4]; p = 0.996). Fourteen patients suffered at least one serious adverse event, 9 patients the Heparin group and 5 in the control group. Eight patients had one or more bleeding events, 5 in the heparin group and 3 in the control group, but were no cases of pulmonary bleeding, of severe haemorrhage or of heparin-induced thrombocytopenia. Patients receiving heparin therapy had lower PaO2/FiO2 ratios, increased oxygenation indices, and decreased ROX index profiles, up to day 10. The time to separation from respiratory support, and the time to ICU or hospital discharge was similar in both groups. There were 3 deaths in the Heparin group and 2 in the control group.ConclusionsNebulised unfractionated heparin was safe and well tolerated, but did not reduce d-dimer concentrations, and worsened oxygenation indices in patients with COVID-19 ARDS.

ВЛИЯНИЕ АМИНОКИСЛОТНЫХ ПРЕПАРАТОВ НА РАССАДУ КОСМЕИ ДВАЖДЫПЕРИСТОЙ И СЕРНО-ЖЕЛТОЙ

The purpose of research is to study the effect of amino acid preparations on the quality of cosmos seedlings. For this purpose, the following tasks were solved: indicators of the average trend in the parameters of seedlings of two types of Cosmos were established; the contribution of varietal characteristics and preparations to seedling parameters was assessed; The reliability of the differences between the experimental variants was established. We used varieties of double-pinnate Cosmea (lat. Cosmos bippinatus) – Popsoks rozovyj, Limonad, Snezhnyj klik and variety of Cosmea serno-zheltaj (lat. Cosmos sulphureus) Zolotaya dolina. We tested the amino acid preparations Stimul Antistress and Aminozol. Measurements were carried out on such parameters as shoot height, plant height, number of leaves, stem thickness in the first internode. To analyze statistical data, methods of descriptive statistics, analysis of variance and the method of pairwise differences of group means with NSR05 were used. It was established that the Snezhnyj klik variety showed minimal germination, and further studies were not carried out on this variety. The most leveled seedlings of the Limonad variety in height are achieved when treated with Stimul and Aminosol (variation coefficient 14.5 and 15 %), the Popsoks rozovyj variety – in the control variant (11.8 %) and with Stimul Antistress (14 %), the Zolotaya dolina variety gives homogeneous plants without treatment and with Aminosol (12.3 and 12.4 %). Analysis of variance of the parameters of the Cosmos double-pinnate varieties showed that the drugs do not significantly affect the height of the shoot, but they affect the number of leaves and the thickness of the stem in the first internode by 13 % (49 %). When assessing the effect of drugs on cosmos species, it turned out that they only affect the thickness of the stem (by 35 %). Due to the low influence of drugs on the uniformity of seedling parameters, we consider further use of drugs to be ineffective specifically for cosmos species and varieties.

ВЛИЯНИЕ ПРЕПАРАТОВ НА ПРОДОЛЖИТЕЛЬНОСТЬ ЖИЗНИ СРЕЗКИ КОСМЕИ ПРИ РАЗНЫХ ТЕМПЕРАТУРАХ ХРАНЕНИЯ

The purpose of the study is to compare the effectiveness of preparations that prolong the life of cut cosmos plants. We used the most popular and sought-after preparation Chrysal and developments from Russian manufacturers – Forte, Tsvetalon, Zhivoy Buket. Two species of Cosmea took part in the cutting – double-pinnate and sulfur-desire, where representatives of these species were varieties Popsoks rozovyj and Zolotaya dolina, respectively. Plants were grown in open ground on the territory of the Russian State Agrarian University – Moscow Timiryazev Agricultural Academy in 2022. The cutting was carried out during the phase of mass flowering of plants. Next, the samples were placed in solutions of Chrysal, Forte, Tsvetalon, Zhivoy Buket and control in different temperature conditions: room temperature 18–20 °C and in a refrigerator 4–5 °C. The condition of the plants was assessed according to the scoring system of criteria we developed for cosmos: petal color, petal shape, peduncle turgor, leaf turgor and general decorativeness. To analyze the results, the method of descriptive statistics and three-factor analysis of variance were used, testing the significance of differences using the method of pairwise differences of group means with NSR05. The difference between the shelf life of the Zolotaya dolina variety in room conditions and in the refrigerator is insignificant, so if the cosmos must be sold in less than 10 days, you can store it outside the refrigerator. The Popsoks rozovyj variety is stored the longest (on average 27 days) and this result is significantly different from different storage options for the Zolotaya dolina variety. If a flower salon needs flowers with a long shelf life to maintain its assortment, we recommend paying attention to the Popsoks rozovyj variety.

A Randomized Controlled Crossover Trial to Determine the Effects of Three Nostril Regulated Breathing Practices on Attention and Mood.

Previous studies on nostril regulated breathing have contrasting findings attributed to lack of controls or not taking into account baseline nostril patency. This randomized crossover study on the effects of three nostril regulated yoga breathing practices and two controls on mood states and attention attempted to address these issues. Forty-five participants between 20 and 45 years (group mean age ± SD; 24.3±3.8 years; M;F 23:22) were assessed in five sessions in random order on five separate days. Nostril patency recorded pre-interventions in 225 sessions showed right nostril dominant at rest (RNDR) in 136 and left nostril dominant at rest (LNDR) in 89 sessions. The sessions were: (i) SAV or right uninostril breathing, (ii) CAV or left unnostril breathing, (iii) (AV or alternate nostril yoga breathing, (iv) breath awareness (BAW), and (v) quiet seated rest (QS). The practices were for 15 min each. Nostril patency was recorded pre, Brief mood introspection scale (BMIS), Global Vigor and Affect Scale (GVA) and Six letter cancellation test (SLCT) were recorded pre and post each session. Data analysis used general linear mixed model analysis, with fixed effects of states (pre and post), sessions and baseline nostril dominance (right or left). A significant interaction of sessions, states and nostril dominance at baseline was observed for total global affect (GA) (F9,396.194=2.871, p=0.003) which increased after SAV, CAV, AV and QS in participants right nostril dominant at rest (NDR) (padj<0.05 in all cases). A significant main effect of states was observed followed by significant post-hoc pair wise comparison in right NDR for (i) pleasant mood after SAV, CAV, AV and QS, (ii) positive mood after SAV and AV, and (iii) global vigor after SAV, CAV, AV and QS, and (iv) a decrease in negative mood after CAV and AV. While the volunteers who had left NDR showed a significant increase in (i) PU after CAV, AV, and QR, (ii) PT after CAV, and (iii) GV after CAV and QS. Nostril dominance pre intervention appears to influence the effects of nostril regulated yoga breathing practices.

Comparative Analysis of SCM Muscle Fatigue in Office Workers with Hunched Posture: A Study on Chronic Lower Back Pain versus Non-Affected Individuals.

This study examines the disparities between people suffering from chronic lower back pain (LBP) and those who do not, with a particular focus on how extended periods of sitting with poor posture affect fatigue and discomfort in the sternocleidomastoid (SCM) muscles among office employees. Eighty university staff and students were enrolled in the study by matching age, BMI, and type of job. They were split into two groups later: a control group (n = 40) with no back pain and a pain group (n = 40) with a history of lower back pain (LBP). Pain intensity was measured using a Visual Analog Scale (VAS), while SCM muscle activity was measured via surface electromyography (sEMG) during both normal and hunched postures. Participants maintained each posture for a specified duration of 30min. The study revealed that Pain_Hunched group exhibited significantly reduced SCM muscle activity compared to the Control_Hunched group (mean difference = -9.728, p < 0.001). Furthermore, the SCM muscle activity in the Pain_Hunched group was significantly lower than that of the Pain_Normal group (mean difference = -2.769, p = 0.041). These results highlight the heightened SCM muscle activity during hunched postures, particularly in individuals with LBP. The results emphasize the crucial role posture plays in influencing SCM muscle activation and pain perception among individuals with LBP. These results imply that correcting one's posture could be a useful pain management intervention technique for this population. The long-term impacts of postural adjustments and their possible advantages in clinical contexts, such as incorporating ergonomic interventions or specific exercise regimens, should be investigated in future studies.

The Effect of Online Infant Care Education and Postpartum Counseling Based on Meleis's Transition Theory on Mothers' Self-Esteem and Infant Health: A Randomized Controlled Trial.

The aim of this research was to assess the effects of online infant care education and postnatal counseling, based on Meleis's transition theory, on maternal self-esteem and infant health. The randomized controlled trial was conducted between November 2022 and May 2023 with 102 mothers and their infants, n = 52 in the intervention and n = 50 in the control. The intervention group received training across two sessions between 32 and 38 weeks of gestation and counseling support for 3 months postbirth. The control group was shared with additional educational materials in PDF format in addition to their usual care. In the intervention group, the subdimension and total score mean of the Karitane Parental Self-Confidence Scale during pregnancy, postpartum, first, second, and third months were higher than the control group (p = 0.001). The proportion of exclusive breastfeeding in the third month was higher in the intervention group than in the control group (p = 0.001). Newborn nurses' care on Meleis' transition theory will increase the quality of care and newborn health. In our study, Meleis's transition theory provides a strong foundation for understanding mothers' psychological and physical transitions in the postpartum period. Trial Registration: NCT05812833.

Biochemical and Familial Factors Influencing COVID-19 Disease Progression

Introduction: COVID-19 is a global pandemic that has caused significant mortality. The disease severity varies among individuals, and the factors influencing its course remain unclear. This study aimed to investigate the influence of biochemical parameters and familial data on COVID-19 outcomes. Methods: A retrospective analysis of 122 COVID-19 patients was conducted. Patients were categorized into two groups: outpatients with mild symptoms and those admitted to the intensive care unit (ICU) and intubated. Demographic data, biochemical levels of vitamin D, vitamin B12, and magnesium, and COVID-19 outcomes of first-, second-, and third-degree relatives were collected. Results: The ICU group had a higher proportion of males (75%) and older patients (average age: 63.18±12.89 years) than the outpatient group (40% males and an average age of 45.13±13.77 years). Both groups had similar BMI, vitamin D, and vitamin B12 levels. However, magnesium levels were significantly higher in the ICU group (mean 2.25±0.3 mg/dL) than in the outpatient group (mean: 1.98±0.2 mg/dL). A significant familial relationship was identified between COVID-19 outcomes and disease course. Among the ICU patients, 25% had first-degree relatives who died from COVID- 19, compared to only 10% of the outpatient patients. Similarly, second- and third-degree relatives of ICU patients had a higher mortality rate from COVID-19 than relatives of outpatient patients. Conclusion:: Age, gender, and magnesium levels may influence COVID-19 disease severity. Familial ties (genetic relatedness) may also play a role, suggesting potential genetic predisposition. Further research is needed to validate these findings and elucidate the underlying mechanisms

Breast Cancer Recurrence After Cryoablation in Patients Who are Poor Surgical Candidates or Who Refuse Surgery.

To evaluate in-breast recurrence rates after cryoablation in patients with primary breast cancer who were poor surgical candidates or refused surgery. Patients with primary breast cancer who were poor surgical candidates or who refused surgery and were treated with cryoablation at a single academic cancer center between October 2018-June 2023 were retrospectively reviewed. Out of the sixty treated patients, 45 had invasive ductal carcinoma (IDC), 6 patients had invasive lobular carcinoma, 2 patients had multicentric ductal carcinoma in situ (DCIS), and 7 patients had other histology. Tumor size ranged from (0.3-9cm), with a mean of 2.7cm. Recurrence was defined as new tumor or regrowth of residual tumor in the ipsilateral breast. With a mean follow up of 21 months and median follow up of 9.8 months, there was a recurrence rate of 10% (6/60 patients). Patients in the recurrence group had more poorly differentiated disease than those in the non-recurrence group (66.7% vs. 22.2%, p= 0.038). Tumor size did not differ between non-recurrence and recurrence groups (no recurrence group mean 2.7 ± 2.6cm, recurrence group mean 2.5 ± 1.0cm, p = 0.506). Patients who were treated with palliative intent rather than curative intent were significantly older (79.7 ± 12.2 vs. 72.5 ± 11.3, p = 0.032). Cryoablation can be considered in patients who are poor surgical candidates or who refuse surgery, with a 10% recurrence rate at a mean follow up of 21 months in this retrospective review that included patients with tumors up to 9 cm, unfavorable pathology, and multicentric disease.

THE EFFECT OF CREATING TIKTOK VIDEOS ON STUDENTS’ SPEAKING SKILL

This study examined the effect of creating TikTok videos on the speaking skills of the tenth-grade students of SMA Al Irsyad Tegal. The objective of this research was (1) to determine the effect of creating a TikTok video on speaking skills and (2) to describe students’ perception of Creating TikTok on their motivation for speaking skills. This study used a mixed-method approach to answer the research objective. An instrument used in this research was a speaking test. The instruments have been tested for validity and reliability. The study found that there was a difference between the post-test means of the experimental group and the control group. The results of this research showed that creating a TikTok video was successful in improving students’ speaking skills. Based on the questionnaire, students said they had less confidence in speaking English due to a lack of vocabulary. After creating a TikTok video, they said they became more motivated to enrich their vocabulary because the activity is fun, engaging, and not stressful

Evaluating the Effectiveness of a Culturally Adapted Dementia Prevention Animation on Ethnically Diverse participants’ Knowledge of Dementia Prevention

ABSTRACT Objectives To determine whether culturally adapted dementia prevention animations increased dementia prevention knowledge in ethnically diverse communities. Methods A before-and after survey conducted online and in-person between 1 February and 5 June 2022. Participants viewed the animation in Arabic, Hindi, Tamil, Cantonese, Mandarin, Greek, Italian, Spanish, Vietnamese or English. Dementia knowledge was measured using two subscales from the dementia risk reduction knowledge instrument (KoDeRR), measuring knowledge of dementia risk factor mitigation strategies and appraisal of dementia risk factors (misconceptions). Results Among the 318 respondents there was a significant increase in dementia knowledge in most languages after viewing the animation (ps < 05; except for English). Mean performance on knowledge of dementia risk factor mitigation strategies significantly increased after viewing the animation (p < .001), with a clinically meaningful effect (mean change = 3.63). Appraisal of dementia risk factor misconceptions significantly increased in the Spanish group (mean change = 1.29, p < .001), but significantly decreased in the English group (mean change = -1.09, p < .001). Conclusions Viewing the animation in a language other than English was associated with an increase in KoDeRR scores for both the recognition of mitigation strategies and identification of misconceptions subscales. Clinical implications Codesigned, culturally adapted in-language dementia prevention animations improve dementia prevention awareness in ethnically diverse communities.

A Study to Assess the Effectiveness of Castor Oil Massage and Hot Water Application on Knee Joint Pain among Elderly Patients who are Attending the Orthopedic Department at HSK Hospital Bagalkot

Background of the Study: Joint Pain is a chronic, progressive process in which new tissue is produced in response to joint insults and cartilage deterioration. The most prevalent articular disease in adults can seen before 65 years of age and older. Osteoarthritis occurs more commonly in women than in men. It accounts for substantial disability as a result of its effect on the large weight bearing joints and the spine. There are various treatment and intervention are available to reduce joint pain such as hot application and castor oil application, active and passive etc. Aim: The aim of study was to assess the effectiveness of castor oil massage and hot water application on knee joint pain among elderly patients. Methodology: The present study is true experimental pre-test post-test control group design. The sampling technique adopted for this study is non-probability convenient sampling technique. Data divided into 2 groups of 60 elderly knee joint patients through simple random lottery method from HSK Hospital Bagalkot. The samples selected through non-probability convenient sampling technique and divided into two groups, 30 Elderly patients to experimental group and 30 elderly patients to control group. Data analysis done by using descriptive and inferential statistics in terms of frequency, percentage, mean, standard deviation, paired‘t’ test and chi square test. Results: Findings related to significance of difference between the experimental and control group mean pre-test and pain scores and standard deviation was [7.2±1.7100] and control group having [4.4±1.248] before giving the intervention and experimental group [3.666±0.922], control group [4.06667±1.201] after giving the intervention. The effectiveness was statistically tested by using paired‘t’ test which revealed that t value =15.37 and the result was found to be significant at p&lt;0.001. Conclusion: The study proved that administration of Castor oil massage and Hot water application intervention on red

Triaging mammography with artificial intelligence: an implementation study.

Many breast centers are unable to provide immediate results at the time of screening mammography which results in delayed patient care. Implementing artificial intelligence (AI) could identify patients who may have breast cancer and accelerate the time to diagnostic imaging and biopsy diagnosis. In this prospective randomized, unblinded, controlled implementation study we enrolled 1000 screening participants between March 2021 and May 2022. The experimental group used an AI system to prioritize a subset of cases for same-visit radiologist evaluation, and same-visit diagnostic workup if necessary. The control group followed the standard of care. The primary operational endpoints were time to additional imaging (TA) and time to biopsy diagnosis (TB). The final cohort included 463 experimental and 392 control participants. The one-sided Mann-Whitney U test was employed for analysis of TA and TB. In the control group, the TA was 25.6 days [95% CI 22.0-29.9] and TB was 55.9 days [95% CI 45.5-69.6]. In comparison, the experimental group's mean TA was reduced by 25% (6.4 fewer days [one-sided 95% CI > 0.3], p<0.001) and mean TB was reduced by 30% (16.8 fewer days; 95% CI > 5.1], p=0.003). The time reduction was more pronounced for AI-prioritized participants in the experimental group. All participants eventually diagnosed with breast cancer were prioritized by the AI. Implementing AI prioritization can accelerate care timelines for patients requiring additional workup, while maintaining the efficiency of delayed interpretation for most participants. Reducing diagnostic delays could contribute to improved patient adherence, decreased anxiety and addressing disparities in access to timely care.

Utility of left atrial strain in differentiating between cardiac amyloidosis and hypertrophic cardiomyopathy

Abstract Introduction and Objectives Cardiac amyloidosis (AL) is a disease characterized by the abnormal accumulation of anomalous proteins in cardiac tissue, while hypertrophic cardiomyopathy (HCM) is a hereditary cardiac disease characterized by abnormal thickening of the cardiac muscle, associated with tissue fibrosis and cardiac dysfunction in its natural progression. The echocardiogram has emerged as a fundamental tool in the diagnosis and follow-up of these patients, and strain analysis techniques can provide highly useful additional information on cardiac function in these patients, especially in the early stages of the disease. We questioned whether it might be useful in differentiating between these two diseases. Methods This retrospective analysis included adult patients who had undergone echocardiography at our center during the years 2023-2024. A total of 52 patients with a confirmed diagnosis of transthyretin AL confirmed by scintigraphy and/or biopsy, and another group of 51 patients with a confirmed diagnosis of HCM and ICD carriers for being high-risk patients were included. Various left atrial strain values (Reservoir, Conduit, and Pump) were analyzed. Descriptive statistics were calculated for each group and segment, and the Mann-Whitney U test was used to compare the groups. Results Patients with AL showed significantly lower absolute strain values compared to patients with HCM in all three analyzed varieties (Reservoir, Conduit, and Pump) with p&amp;lt;0.01 for all comparisons. The mean strain in the HCM group was 18.57 for reservoir strain, -11.85 for conduit strain, and -6.94 for pump strain; while the mean in the AL group was 9.28, -6.93, and -3.10, respectively. Conclusions Our study found significant differences in left atrial strain values between patients with HCM and patients with transthyretin AL. These findings suggest that left atrial strain analysis could be useful in evaluating cardiac function, follow-up, and differential diagnosis between patients with AL and HCM, especially in the earlier stages of the disease, where it is more challenging to establish a reliable diagnosis. HCM Vs amyloidosis

Utility of left atrial strain in characterizing patients with reablated atrial fibrillation

Abstract Introduction and Objectives Atrial fibrillation (AF) is a highly prevalent condition, with projections indicating it will increase in the future. Various ablation techniques exist to try to eliminate the arrhythmia, but the problem of recurrences and the need for reinterventions are not uncommon. We need markers to predict which patients will benefit from these procedures and which will recur despite our efforts. Atrial strain techniques have emerged as a novel tool in assessing the function and degree of atrial fibrosis, which could improve patient selection and increase the success of procedures. Methods A retrospective analysis was conducted, including adult patients who had undergone echocardiography at our center during the years 2023-2024. A total of 59 healthy patients with no history of cardiovascular disease, labeled as "normal studies" by the examiner, served as the control group, and another group of 47 patients with recurrent AF with at least two ablation procedures were included. Various left atrial strain values (Reservoir, Conduit, and Pump) of each patient were analyzed. Descriptive statistics were calculated for each group and segment, and the Mann-Whitney U test was used to compare the groups. Results Patients with reablated AF showed significantly lower absolute strain values compared to normal patients in all three analyzed varieties (Reservoir, Conduit, and Pump) with p&amp;lt;0.01 for all comparisons. The mean strain in the control group was 41.80 for reservoir strain, -24.01 for conduit strain, and -17.07 for pump strain; while the mean in the AF group was 17.42, -11.72, and -6.33, respectively. Conclusions We found significant differences in left atrial strain values between normal patients and patients with reablated AF. These findings suggest that left atrial strain could be useful in selecting patients for AF ablation procedures, as those more prone to recurrence exhibit lower absolute strain values, indicating a higher degree of atrial fibrosis where anomalous circuits may establish and perpetuate the arrhythmia over time. Normal Vs Atrial fibrillation

Utility of left atrial strain in differentiating between cardiac amyloidosis and reablated atrial fibrillation

Abstract Introduction and Objectives Cardiac amyloidosis (AL) is a disease characterized by the abnormal accumulation of anomalous proteins in cardiac tissue, while atrial fibrillation (AF) is an exceedingly prevalent arrhythmia in the current population, often related to the amount of atrial fibrosis. The echocardiogram has emerged as a fundamental tool in the diagnosis and follow-up of these patients, and strain analysis techniques can provide highly useful additional information on cardiac function in these patients, especially in the early stages of the disease. We questioned whether it might be useful in differentiating between these two pathologies. Methods This retrospective analysis included adult patients who had undergone echocardiography at our center during the years 2023-2024. A total of 52 patients with a confirmed diagnosis of AL by transthyretin, confirmed by scintigraphy and/or biopsy, and another group of 47 patients with recurrent AF with at least two ablation procedures were included. Various left atrial strain values (Reservoir, Conduit, and Pump) were analyzed. Descriptive statistics were calculated for each group and segment, and the Mann-Whitney U test was used to compare the groups. Results Patients with AL showed significantly lower absolute strain values compared to patients with reablated AF in all three analyzed varieties (Reservoir, Conduit, and Pump) with p&amp;lt;0.01 for all comparisons. The mean strain in the reablated AF group was 17.42 for reservoir strain, -11.72 for conduit strain, and -6.33 for pump strain; while the mean in the AL group was 9.28, -6.93, and -3.10, respectively. Conclusions Our study found significant differences in left atrial strain values between patients with reablated AF and patients with transthyretin AL. These findings suggest that left atrial strain analysis could be useful in evaluating cardiac function, follow-up, and differential diagnosis between patients with AL and reablated AF, especially in the earlier stages of the disease, where it is more challenging to establish a reliable diagnosis. Atrial fibrillation Vs amyloidosis

P-2242. Tick-borne Illness Seroprevalence and Meat Allergy (Alpha-Gal Syndrome): A Series of 15 Cases in Long Island, NY

Abstract Background Alpha-gal syndrome (AGS) is a described meat allergy to an oligosaccharide, galactose-alpha-1,3-galactose (alpha-gal), present on mammalian cells and appears to be associated with the Amblyomma Americanum or lone star tick (LST) bite. Suffolk county, NY has an alarmingly high number of cases of AGS. Immunoglobulin E (IgE)-mediated allergic symptomatology has been reported following ingestion of mammalian meat and its by-products though with variable allergy manifestation. The goal of this pilot study was to identify characteristics and clinical manifestations in a cohort of patients with AGS and try to identify possible risk factors for severe manifestations.Table 1:Demographics, atopy history, alpha-gal IgE, serum total IgE and ratios, tick bite history and tick type, onset of symptoms after tick bite, tick-borne infection in patients identified with AGS, N=15.AGS, Alpha-gal syndrome; LST, Lone star tick; IgE, Immunoglobulin E Methods A retrospective study was performed to identify adult patients referred to Allergy Clinic at the Stony Brook Hospital between 2018 and 2023 with symptoms and laboratory testing consistent with AGS. Demographics, atopy history, alpha-gal IgE and serum total IgE ratios, allergy manifestation, tick type and tick-borne infections were obtained from chart review.Figure 1:Comparison of mean alpha-gal IgE/serum total IgE ratios in patients with anaphylaxis (N=10) and non-anaphylactic (N=5) manifestations to meat consumption. The mean alpha-gal IgE/serum total IgE ratio in the anaphylaxis group was 18.9% and the mean alpha-gal IgE/serum total IgE ratio in the non-anaphylaxis group was 12.3%. There was no statistically significant difference in mean alpha-gal IgE/serum total IgE ratio between the anaphylaxis and non-anaphylaxis groups (p = 0.5). Results We identified 15 adults (mean age: 51 years; male 66.7%; 93% White), with clinical presentation consistent with AGS. Out of the 15 subjects, 9 had history of atopy (60%). All patients reported a history of tick bite, of whom 7 recognized as LST (46.7%). One third of the cases were tested for tick-borne co-infections (n= 10). One met CDC criteria for Lyme disease and 1 had Babesiosis. All patients had elevated alpha-gal IgE/serum total IgE ratio (mean 16.8%, range 2.1-71.4); anaphylaxis group mean ratio was 18.9% versus 12.3% in non-anaphylaxis group (p=0.5). Patients had variability in severity of allergy manifestation: 10 (66.7%) with anaphylaxis, 6 (40%) with skin manifestation, 1 (6.7%) with gastrointestinal symptoms.Figure 2. Overview of allergy manifestation reported by patients; anaphylaxis as per AAAAI criteria, N=15.Gastrointestinal; Skin manifestations i.e. urticaria, angioedema, hives; Other i.e itchy throat, eye swelling; AAAA,: American Academy of Allergy, Asthma &amp; Immunology. Conclusion Observational data suggests that alpha-gal IgE/total IgE ratio may not be related to disease severity, but the sample size was small. Although, most patients in this cohort did not have a documented history of a previous tick-borne illness despite tick exposure, it is important for Infectious Diseases physicians to be aware of AGS, as many patients are referred after tick bites. Further research regarding risk factors for severe disease is warranted to recognize those at greatest risk to prompt more rapid allergy evaluation. Disclosures All Authors: No reported disclosures

Effect of Triheptanoin on Caudate Atrophy and Motor Scores in Patients With Early-Stage Huntington Disease: A Phase II Study.

Brain energy deficiency occurs at the early stage of Huntington disease (HD). Triheptanoin, a drug that targets the Krebs cycle, can restore a normal brain energetic profile in patients with HD. In this study, we aimed at assessing its efficacy on clinical and neuroimaging structural measures in HD. We conducted a 6-month bicentric (Paris, Leiden) double-blind randomized controlled trial followed by a 6-month open-label phase, between June 2015 and December 2019. We enrolled 107 patients at the early stage of HD-total motor score (TMS) of the UHDRS between 5 and 40. Participants received triheptanoin 1 g/kg/day or placebo (ratio 1/1). The primary outcome was the rate of caudate atrophy at 6 months using the caudate boundary shift integral (cBSI) method. Main secondary outcomes were cBSI at 12 months, TMS, and diffusion imaging at 6 and 12 months. Analysis was conducted using ANOVA, and data were presented with a 95% CI. To perform a 12-month comparison, we used the placebo arm of a 12-month randomized controlled trial conducted in parallel, using the double robust propensity score method. One hundred patients were randomized (mean age 49 years, 52% women). Fourteen patients withdrew from the study, including 10 because of gastrointestinal effects. There was no difference in cBSI at 6 months between groups (mean 0.026 [0.018-0.033] vs 0.023 [0.014-0.032]). TMS at 12 months was stable in patients treated with triheptanoin for 12 months (mean 0.6 [-1.1 to 2.1]), whereas it increased in patients initially on placebo (2.5 [1.2-3.8]). Compared with the external placebo control group, caudate atrophy decreased by approximately 50% (0.038 [0.028-0.048] vs 0.070 [0.057-0.082]) and TMS stabilized (0.66 [-1.07 to 2.48] vs 2.65 [1.38-3.89]) in patients treated with triheptanoin for 12 months. There was no effect of triheptanoin on caudate atrophy over 6 months. Compared with the external placebo group, triheptanoin was associated with motor stability and decreased caudate atrophy in patients treated for 12 months, but the post hoc nature of these findings is a major limitation. clinicaltrials.gov NCT02453061, May 25, 2015. First patient enrolled on June 29, 2015. This study provides Class I evidence that triheptanoin does not slow caudate atrophy compared with placebo over 6 months in patients with early HD.

Evaluation of treatment for diffuse large B-cell lymphoma using plasma D-dimer levels

It has been documented that D-dimer levels have potential utility as a measure of tumor activity in diffuse large B-cell lymphoma (DLBCL), however whether it can be used as a predictive marker of treatment outcome has not been established. This study means to retrospectively evaluate the role of D-dimer in prediction of treatment efficacy in patients with DLBCL. 151 patients with newly diagnosed DLBCL were enrolled. Blood samples were taken from those patients during the initial visit to our hospital and again after two cycles of chemotherapy to measure D-dimer levels. The link between plasma D-dimer concentrations and patients’ clinical characteristics was explored before and after treatment. D-dimer levels within the range of 0–1 µg/mL were considered negative, while readings above this range were considered positive. D-dimer difference percentage (Ddp) represents the percentage change in D-dimer levels before and after chemotherapy, calculated as (post-chemotherapy D-dimer minus pre-chemotherapy D-dimer) / pre-chemotherapy D-dimer × 100. Patients showed statistically different plasma D-dimer levels at initial consultation across treatment-response groups: CR (0.63 µg/mL [0.43–1.27]), PR (1.39 µg/mL [0.73–2.46]), SD (0.89 µg/mL [0.59–1.24]), and PD (1.34 µg/mL [0.67–2.62]). After chemotherapy, the PR group exhibited a mean D-dimer level of -0.38 µg/mL (range − 1.64 to -0.11), which was significantly lower than that of the PD group (mean 0.04 µg/mL, range − 0.40 to 0.79; p < 0.05). The CR group revealed significantly lower initial D-dimer levels (median 0.63 µg/mL) and greater reductions after chemotherapy compared to the non-CR group (median 1.17 µg/mL, p < 0.05). Patients with coagulation disorders such as DIC, DVT, or PE were excluded to minimize confounding factors. While this study demonstrates the utility of D-dimer in predicting short-term treatment response, the relationship with long-term outcomes such as PFS and OS requires further investigation. Patients who respond well to chemotherapy typically exhibit lower D-dimer levels at the initial diagnosis. Those in the SD or PD groups usually experience a greater increase in D-dimer levels following chemotherapy. Consequently, variations in plasma D-dimer levels before and after treatment may offer valuable insights for evaluating the efficacy of chemotherapy treatment.