RA Group Research Articles

Outcomes of Robotic-Assisted Bariatric Surgery Compared to Standard Laparoscopic Approach Using a Standardized Definition: First Look at the 2020 Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) Data.

The primary objective of this study is to evaluate the outcomes of robotic-assisted (RA-) approach compared to the standard laparoscopic (L-) approach usingthe 2020 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)registry Public Use File (PUF). Our secondary objective is to establish standards for the reporting of outcomes using PUF. Using the PUF database (n = 168,568), patients were divided into sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), revisions, and conversions and then analyzed separately. We created balanced covariate through propensity score matching and inverse probability treatment weighting (IPTW). We also conducted multivariable relative risk regression to confirm our results. For RYGB, the incidence of "transfusion" was significantly lower in the RA-RYGB compared to the L-RYGB. There was no significant difference in the rate of Serious Event Occurrences (SEOs) or rate of intervention at 30days. For SG, there was a higher rate of "transfusion" in the RA group. Incidence ofSEOs was also significantly higher in the RA-group. There was no significant difference in SEOs for conversions; however, revisions had a trend toward a lower rate of SEOs favoring the robotic approach. Operative times were significantly higher for all RA-groups. RA- approach in metabolic and bariatric surgery (MBS) remains controversial because of differences in outcomes. The use of SEOs as reported by MBSAQIP in its semi-annual report can be used as a composite score to assess outcomes while using PUF. Further studies are needed to compare RA- to L- MBS.

Association between functional FCGR3A F158V and FCGR2A R131H polymorphisms and responsiveness to rituximab in patients with autoimmune diseases: a meta-analysis.

To investigate the association between the functional Fc gamma receptor 3 A (FCGR3A) V158F and FCGR2A R131H polymorphisms and rituximab therapy in patients with autoimmune diseases. We searched the Medline, Embase, and Cochrane databases for relevant articles. We conducted a meta-analysis of the association between FCGR3A V158F and FCGR2A R131H polymorphisms and responsiveness to rituximab in patients with autoimmune diseases. Eleven studies, consisting of 661 responders and 267 non-responders for FCGR3A V158F polymorphism and 156 responders and 89 non-responders for FCGR2A R131H polymorphism, were included. The meta-analysis revealed a significant association between the FCGR3A V allele and responsiveness to rituximab (odds ratio [OR] = 1.600, 95% confidence interval [CI] = 1.268-2.018, P < 0.001). Furthermore, associations were found using the dominant and homozygous contrast models. Subgroup analysis showed an association between the FCGR3A V allele and responsiveness to rituximab in European, RA, ITP, small (<50) and large (≥50) groups, and short- (≤6 months) and long-term follow-up periods (≥6 months). These associations were also found in recessive, dominant or homozygous contrast models. Meta-analysis revealed no association between the FCGR2A R allele and responsiveness to rituximab (OR = 1.243, 95% CI = 0.825-1.873, P = 0.229). We demonstrated that the FCGR3A F158V polymorphism is associated with better responsiveness to rituximab therapy in patients with autoimmune diseases, indicating that individuals carrying the FCGR3A V allele will likely respond better to rituximab. However, FCGR2A R131H polymorphism was not associated with better response to rituximab.

Upaya Mengembangkan Kreativitas Anak melalui Permainan Warna dengan Media Benang di RA At Taslim Pangalengan

This study aims to develop children's creativity through playing with colors using yarn in the B RA group at Taslim PangalenganRegency. Color game activities with thread media can attract children's interest in developing their creativity. The subjects in this study were the children of group B RA At Taslim Pangalengan, Bandung Regency, with a total of 10 children. Thevariable associated with this research is creativity. The method used to collect data about children's creativity uses observation, performance, and interview methods. This research was conducted into two cycles. This type of research is Classroom Action Research (CAR). Researchers have made improvements in the learning process carried out for 2 days in the cycle and continued with 2 days in cycle 2, considering that the child's creativity has reached the target level of completeness. Based on data analysis through playing with colors with thread media, it can develop children's creativity in the B RA group at Taslim Pangalengan, Bandung Regency

Stratified distribution of Th17 and Treg cells in patients with multi-stage rheumatoid arthritis

ObjectiveRheumatoid arthritis (RA) is a typical, progressive autoimmune disease. Its occurrence and development are associated with dysregulation of T and B cell numbers. However, the specific immune characteristics of different RA courses remain incompletely defined. Here, we describe the peripheral blood lymphocyte subsets, particularly CD4 + T subsets, of different RA courses with a focus on early RA (Ea-RA).MethodsIn all, 131 patients with Ea-RA, 117 with advanced RA (Ad-RA), and 109 with treated RA (Tr-RA) were enrolled. We collected general clinical data. Whole blood samples obtained from the patients and 97 healthy controls (HCs) were analysed via flow cytometry.ResultsDecreased absolute NK cell numbers and increased CD4/CD8 T cell ratios were observed in different RA groups, including Ea-RA, compared to healthy controls. In Ea-RA patients, the Th17 and Treg cell numbers were similar to those in HCs. We performed k-means clustering based on the profiles of Th17 and Treg cells for patients with multi-stage of RA. We identified three patient types: type A characterised by relatively low Treg and Th17 cell numbers, type B with moderate levels of Treg cells and levels of Th17 cells similar to that of type C patients, and type C with high levels of Treg cells and levels of Th17 cells similar to that of type B patients.ConclusionThe immune characteristics of Ea-RA patients differ from those of HCs; an immune system disorder is apparent although no differences in Th17 and Treg levels were evident between Ea-RA patients and HCs. We found distributional heterogeneities of Th17 and Treg cells in patients with multi-stage of RA. Stratified management based on such heterogeneity may serve as a useful novel immunotherapy allowing of early intervention.

Study of some physiological and hematological parameters in obese women with arthritis

Introduction and Aim: Obesity and overweight refers to excessive buildup of fat in the body. Arthritis is a group of medical disorders associated with obesity and being overweight. Obesity associated with rheumatoid arthritis is more pronounced in women. In this study, we aimed to evaluate some physiological and hematological parameters in obese women with arthritis. Materials and Methods: This study included 90 women aged between 18 and 68 years. The women were divided into three groups based on their BMI as Obese (n=30), Obese+RA (n=30) and normal lean women as controls (n=30). Blood drawn from each participant was tested for their complete blood tests, lipid profiles, C-reactive protein reaction and presence of rheumatoid factor. Data was subjected to statistical analysis. Results: Our study revealed the mean +SE for age, WHR and BMI to be elevated in women in the obese as well as Obese+RA groups and to be significantly higher in comparison to women in the control group. Except for HDL, all the other lipid parameters were seen elevated in the obese and Obese+RA group and showed significant difference from the control group. Similarly, among the complete blood count indices only ESR, WBC and PLT were found to be significantly elevated in obese and Obese+RA groups. The prevalence percentage for CRP and RF was seen to be highest in individuals belonging to the Obese+RA group. Conclusion: Obese women as well as obese women with RA have elevated hematological and physiological parameters when compared to lean women.

Incorporation of fresh leaves of wormwood (Artemisia herba alba) and/or rosemary (Rosmarinus officinalis) in the diet of rams: Effect on testicular function, sexual behavior, and blood parameters.

This study aimed to investigate the effect of wormwood and rosemary supplementation on some reproductive traits of Barbarine rams. The experiment lasted 2 months. Twenty-four adult rams were divided into four groups (n=6) balanced for the weight (53.3 ± 1.2 kg body weight [BW] ± SD). All rams received 1200 g of straw and 600 g of barley. Control rams (C) without aromatic medicinal plant (AMP), while experimental rams received 20 g of fresh rosemary leaves (R), 20 g of fresh wormwood leaves (A), and 10 g of fresh rosemary leaves plus 10 g of fresh wormwood leaves (RA). The results revealed that the live weight of all rams increased (p < .05) in the RA group compared to the C, A, and R groups. Scrotal circumference increased in the R rams when compared to the controls rams (p < .05). For sperm parameters we showed that the A rams had higher sperm concentrations (p < .05). But, the sperm volume decreased in the R rams (p > .05). However, when the rams received rosemary plus wormwood, their sperm volume increased (p > .05). The sperm mass motility was higher for the A, R and AR rams in comparison to the C rams (p=.05). On the other hand, biochemical analysis of the seminal fluid showed no effect of diets on calcium and total proteins concentration. But the measurement of glucose and seminal insulin showed a decrease (p < .05) in these two biochemical markers in group A rams and a decrease (p < .05) in insulin without modification of the glucose concentration in R rams. Blood glucose and insulin decreased in the animals on AMP diet compared to the other groups (p < .05) while aspartate aminotransferase (AST) increased (p < .05). Rosemary leaves (R and RA groups) increased (p < .05) plasma cortisol compared to the other groups. It can be concluded that the addition of Rosmarinus officinalis and/or Artemisia herba alba in ram diet can have a positive effect on the reproductive function by increasing the concentration and motility of sperm, plasma testosterone, and sexual behavior.

Glucagon-Like Peptide-1 Receptor Agonist Protects Against Diabetic Cardiomyopathy by Modulating microRNA-29b-3p/SLMAP.

Our aims were to investigate the pathogenesis of diabetic cardiomyopathy (DCM) and to explore the protective effect of glucagon-like peptide-1 receptor agonist (GLP-1RA) on DCM. After 12 weeks of treatment with exenatide-loaded microspheres, a long-acting GLP-1RA, in DCM mice, cardiac structure and function were evaluated by plasma B-type natriuretic peptide (BNP), echocardiography, H&E, oil red and Sirius staining. The expression of glucagon-like peptide-1 receptor in mouse heart tissue was determined by immunofluorescence staining. The label-free proteomic analysis of cardiac proteins was conducted among control, DCM and DM+GLP-1RA groups. Then, quantitative real-time PCR, Western blotting and dual-luciferase reporter assay were performed to verify the regulation of target protein by the upstream microRNA (miRNA). GLP-1RA treatment obviously improved serum BNP, myocardial fibrosis, lipid deposition of the myocardium and echocardiography parameters in DCM mice. Sarcolemmal membrane-associated protein (SLMAP) was one of 61 differentially expressed cardiac proteins found in three groups by proteomic analysis. Up-regulation of microRNA-29b-3p (miR-29b-3p) and down-regulation of SLMAP were found in the ventricular myocardium of GLP-1RA-treated DCM mice. SLMAP was a target of miR-29b-3p, while GLP-1RA regulated SLMAP expression through miR-29b-3p. Furthermore, inhibition of glucagon-like peptide-1 receptor (GLP-1R) in cardiomyocytes reversed the effects of GLP-1RA on miR-29b/SLMAP. SLMAP may play roles in the pathogenesis of DCM and may be a target of GLP-1RA in protecting against DCM. After binding to myocardial GLP-1R, GLP-1RA can regulate the expression of myocardial SLMAP through miR-29b-3p.

Abstract Number ‐ 181: Anterograde versus Retrograde approaches in the Endovascular Management of Tandem Lesions

Introduction There are two approaches for treating stroke patients with tandem occlusions: the anterograde approach (AA, extracranial lesions first) and the retrograde approach (RA, intracranial lesion first). Both techniques are associated with favorable functional outcomes. We aimed to compare both techniques for efficacy and safety outcomes in a multicenter study. Methods Patient data were pooled from 17 centers and divided into AA and RA groups. We performed multivariable logistic regressions to evaluate the association between each group with efficacy and safety outcomes. Results 552 patients were included in the study, 270 (48.4%) were treated with the AA, and 288 (51.6%) with the RA. There were no differences between groups for functional outcome (mRS 0–2) at 90 days (aOR = 0.93, 95%CI: 0.58‐1.48, p = 0.75), and successful reperfusion [mTICI &gt;2b] (aOR = 0.83, 95%CI: 0.44‐1.56, p = 0.57). Similarly, we did not observe any differences for safety outcomes related to sICH (OR = 0.57, 95%CI: 0.25‐1.29, p = 0.18), parenchymal hematoma type 2 (OR = 0.61, 95%CI: 0.3‐1.22, p = 0.16), and all‐cause mortality at 90 days (OR = 1.22, 95%CI: 0.66‐2.26, p = 0.52). However, the median puncture‐to‐reperfusion time was higher in AA compared with RA [59 minutes (IQR: 38–92) vs 53.5 minuntes (IQR: 37–87)]. Conclusions The AA and RA approaches for the treatment of tandem occlusions seem to achieve similar efficacy and safety outcomes. These results are consistent with those of a previous multi‐center study. Additionally, and in line with previous research, there is a puncture‐to‐reperfusion time difference between both approaches, which suggests a potential benefit when using the RA. However, further prospective randomized studies are needed to elucidate its benefit in achieving better clinical outcomes.

Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease

ObjectivesMost studies on difficult-to-treat rheumatoid arthritis (D2T RA) have focused on established RA. Here, we analyse whether disease activity in the early stages of RA could influence progression to a...

Comparison of the Impact of SGLT2-Inhibitors and Exenatide on Body Fat Composition.

To investigate the effect of SGLT2-iand GLP-1RA as an add-on therapy to metformin on weight loss and body composition, and to compare their effects on glucose and lipid parameters. A descriptive study. Place and Duration of the Study: Goztepe Prof Dr Suleyman Yalcin City Hospital, from January 2016 to May 2021. The study included 50 patients with diabetes on metformin+SGLT2-i(dapagliflozin or empagliflozin, group 1) and 50 patients with diabetes on metformin+GLP-1 receptor agonist (RA, exenatide, group 2). The reduction in weight, BMI, total body, abdominal, leg, and arm fat percentage, and the improvement in body fat-free and muscle mass percentage were significantly higher in Group 2 (p<0.001, p<0.001, p=0.014; p=0.031, p<0.001; p=0.002 and p=0.014, p=0.014, respectively). The decline in abdominal fat mass in the GLP-1 RA group was also significant (p=0.031). There was asignificantdecrease in HbA1c, fasting glucose, and triglyceride levels (p<0.001, p<0.001, and p=0.036) with a significant increase in HDL-C (p=0.015). There was no significant difference between groups for glucose, HbA1c, and lipid parameters (p>0.05). Both SGLT2 inhibitors and exenatide, when added to metformin therapy, were effective in reducing weight and body fat, more by the GLP-agonist. SGLT2-i had no significant impact on decreasing abdominal fat depicting that these agents do not have any benefit in treating visceral adiposity. Type 2 diabetes mellitus, Obesity, GLP-1 receptor, SGLT2 inhibitor, Body fat distribution, Visceral adiposity.

Changes of serum IgG glycosylation patterns in rheumatoid arthritis

BackgroundRA is a common chronic and systemic autoimmune disease, and the diagnosis is based significantly on autoantibody detection. This study aims to investigate the glycosylation profile of serum IgG in RA patients using high-throughput lectin microarray technology.MethodLectin microarray containing 56 lectins was applied to detect and analyze the expression profile of serum IgG glycosylation in 214 RA patients, 150 disease controls (DC), and 100 healthy controls (HC). Significant differential glycan profiles between the groups of RA and DC/HC as well as RA subgroups were explored and verified by lectin blot technique. The prediction models were created to evaluate the feasibility of those candidate biomarkers.ResultsAs a comprehensive analysis of lectin microarray and lectin blot, results showed that compare with HC or DC groups, serum IgG from RA patients had a higher affinity to the SBA lectin (recognizing glycan GalNAc). For RA subgroups, RA-seropositive group had higher affinities to the lectins of MNA-M (recognizing glycan mannose) and AAL (recognizing glycan fucose), and RA-ILD group had higher affinities to the lectins of ConA (recognizing glycan mannose) and MNA-M while a lower affinity to the PHA-E (recognizing glycan Galβ4GlcNAc) lectin. The predicted models indicated corresponding feasibility of those biomarkers.ConclusionLectin microarray is an effective and reliable technique for analyzing multiple lectin–glycan interactions. RA, RA-seropositive, and RA-ILD patients exhibit distinct glycan profiles, respectively. Altered levels of glycosylation may be related to the pathogenesis of the disease, which could provide a direction for new biomarkers identification.

Assessment of oligometastasis status of prostate cancer following combined robot-assisted radical prostatectomy and androgen deprivation versus androgen deprivation therapy alone using PSA percentage decline rate.

To compare the tumor control in prostate cancer patients with oligo-metastasis following combined robot-assisted radical prostatectomy and androgen deprivation versus androgen deprivation therapy alone based on total prostate-specific antigen (tPSA) assessment. Medical data of a total of 18 prostate cancer patients with oligometastasis administered in The First Affiliated Hospital of Nanchang University from March 2017 to March 2018 were prospectively collected. 10 patients received a combined therapy of robot-assisted radical prostatectomy and pharmaceutical androgen deprivation (RARP+ADT group), while 8 patients received pharmaceutical androgen deprivation therapy alone (ADT group). Then demographic characteristics, prostate volume, tumor characteristics and tPSA data were analysised and compared. Statistical analysis was performed using t-test for continuous variables and Pearson chi-square test or Fisher's exact test for categorical variables. No significant difference was found in patients' age (p = 0.075), prostate volume (p = 0.134) and number of bone metastasis (p = 0.342). Pre-treatment Gleason score was significantly lower in RA group (p = 0.003). Patients in RARP+ADT group had significantly lower pre-treatment tPSA (p = 0.014), while no statistical difference was noted in reexamined tPSA (p = 0.140) on follow-up. No statistical difference was noted in tPSA decline rates (declined tPSA value per day) in RARP+ADT and ADT group (8.1 ± 4.7 verse 7.5 ± 8.0 ng/ml/d, p = 0.853). However, tPSA percentage decline rate (declined tPSA percentage per day) was significantly higher in RARP+ADT group (11.6 ± 1.5%/d verses 2.9 ± 2.2%/d, p< 0.001). Immediate urinary continence was achieved in 9 patients (90%) upon removal of urethral catheter on post-operative day 7 in RARP+ADT group. ADT alone and in combination with RARP both provide effective tumor control in patients suffering from prostate cancer with oligometastasis. ADT combined with RARP exhibited significant advantage in PSA percentage decline rate without compromising patients' urinary continence. Long-term tumor control requires further follow-up.

Temporomandibular joint arthritis increases canonical Wnt pathway expression in the articular cartilage and trigeminal ganglion in rats

The canonical Wnt pathway participates in inflammatory diseases and it is involved in neuropathic pain. This study evaluated the immunoexpression of the canonical Wnt signaling pathway in the articular cartilage of the temporomandibular joint (TMJ) and along the nociceptive trigeminal pathway in arthritic rats. For this, male Wistar rats were divided into Control (C) and Arthritic (RA) groups. Arthritis induction was performed through subcutaneous injection of methylated bovine serum albumin (mBSA) and complete Freund Adjuvant (CFA)/ Incomplete Freund Adjuvant (IFA) on the first 14 days (once a week), followed by 3 weekly intra-articular injections of mBSA (10 μl/joint; left TMJ). The following parameters were evaluated: nociceptive threshold, inflammatory infiltrate, type I and III collagen birefringence, immunohistochemistry for IL-1β, TNF-α, IL-6, Wnt10b, β-catenin, cyclin-D1 in articular cartilage, c-Myc in synovial membrane, and immunofluorescence analysis for c-Fos, Wnt-10b and β-catenin in the trigeminal ganglion and the trigeminal subnucleus caudalis. The RA group showed intense articular cartilage damage with proliferation of type III collagen, increased immunoexpression of proinflammatory cytokines and Wnt-10b, β-catenin and cyclin-D1 in the articular cartilage and c-Myc in the synovial membrane. In the RA group, a reduction in the nociceptive threshold was observed, followed by a significant increase in the expression of Wnt-10b in neurons and β-catenin in satellite cells of the trigeminal ganglion. c-Fos immunoexpression was observed in neurons, peripherally and centrally, in arthritic rats. Our data demonstrated that TMJ arthritis in rats causes articular cartilage damage and nociceptive behavior, with increased immunoexpression of canonical Wnt pathway in the articular cartilage and trigeminal ganglion.

MÉTODOS DE RECUPERAÇÃO SOBRE OS ATLETAS DURANTE O TREINAMENTO DE ALTA INTENSIDADE

ABSTRACT Introduction: The continuous improvement of the level of modern sports competition compels continuous reform and constant updates on sports training theory; sports training research is migrating from continuous low-intensity to high-intensity interval, and many studies have shown that high-intensity interval training has a good effect on athletes. Objective: Investigate the effect of different recovery modalities during high-intensity interval training on the athletic performance of young male runners. Methods: Using body morphological index measurement, high-intensity intermittent exhaustion test, and statistical analysis, forty young male long-distance runners from sports schools were randomly divided into active recovery group (AR, n=20) and passive recovery group (PR, n=20), maximal oxygen uptake (VO2max) and maximal aerobic speed (MAV) were measured by incremental load exercise test, and interval exercise capacity and time to exhaustion (ET) were recorded. Results: Compared with pre-training, MAV and ET in both groups increased significantly after training (P&lt;0.05); there was no significant difference in MAV on RA group after training (P&gt;0.05). Conclusion: High-intensity interval training with active recovery can significantly improve athletic ability and performance in young male runners in the long term. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

The efficacy of “TiRobot”orthopaedic robot-assisted VS conventional fluoroscopic percutaneous screw fixation of the sacroiliac joint

PurposeThis study is to compare the precision and safety of the orthopaedic robot with conventional fluoroscopy for assisted percutaneous sacroiliac joint screw implantation.MethodsRetrospective analysis was performed on the clinical data of 57 patients with unstable posterior pelvic ring injuries who were admitted and met the criteria between January 2017 and January 2022. All of these patients underwent percutaneous sacroiliac joint screw implantation, and their clinical data were split into two groups based on the surgical technique: a RA group (robot-assisted implantation, 30 patients, 54 screws) and a CF group (conventional fluoroscopic freehand implantation, 27 patients, 42 screws). There were 96 screws placed in total. The durations of the two groups’ operations, fluoroscopy examinations, fluoroscopy doses, total number of fluoroscopies, and intra-operative guide pin applications were noted and compared. On post-operative CT scans, the placement of each screw was assessed using the Gertzbein-Robbins classification. Finally, imaging Matta criteria were used to assess the sacroiliac joint fracture reduction. The Majeed functional score was used to assess clinical function.ResultsBoth groups successfully completed 57 procedures in total. In both groups, there were no consequences from vascular injury, wound infection, or urinary tract infection. Additionally, there were no complications from robotic-induced nerve injury, operating time, fluoroscopic dose, and the frequency of fluoroscopic; the number of percutaneous punctures in the RA group was lower than that of the CF group.There were statistically significant differences between the aforementioned data (P < 0.05). The modified Matta evaluated the effectiveness of fracture reduction. In the RA group, there was no statistically significant difference between the CF group (P > 0.05). According to the modified Gertzbein-Robbins classification criteria, the 54 screws implanted in the RA group were classified as follows: class A (45), class B (5), class C (4), and class D (0); the accuracy rate of the implants was 92.59%. Forty-two screws implanted in the CF group, 30 screws were defined class A, class B (3), class C (7), and class D (2). The accuracy rate of the implants was 78.57%(χ2 = 3.967, P < 0.05). There was a statistically significant difference between the two groups. The Majeed score 30 patients in RA group, one month post-operation, 16 considered exceptional, eight decent, six moderate, and zero bad. Post-operation more than six months,25 recorded exceptional, five decent. By the time,27 patients in CF group,12 exceptional grade, eight decent, six moderate, and one bad,one month post-operation. Post-operation more than six months,22 recorded exceptional, five decent.Both group (P > 0.05).Conclusion“TiRobot” robot-assisted screw implant treatment for unstable posterior pelvic ring injury has a greater success rate than traditional surgery as compared to conventional percutaneous screw implant. It is a precise, secure, and minimally invasive surgical technique that can also be applied to severe pelvic injuries even congenital sacral deformities.

Assessment of Liver Function among Patients with Rheumatoid Arthritis Versus Patients with Psoriatic Arthritis Treated by Methotrexate

Background:Hepatotoxicity is a well-known adverse effect of methotrexate therapy.&#x0D; Objective: To assess liver functions such as ALT and AST in patients with rheumatoid arthritis and psoriatic arthritis receiving methotrexate and compare the liver functions in those patients cured by using methotrexate.&#x0D; Patients and Methods: This observational, cross-sectional analysis involved 50 patients with RA who satisfied EULAR-ACR-2010 standards for RA and 50 PSA cases who fulfilled CASPAR classification criteria for PSA, receiving constant weekly MTX therapy (oral or parenteral) up to 25mg, together with folic acid, liver function parameters such as ALT and AST in patients with rheumatoid and psoriatic arthritis were estimated and compared.&#x0D; Results: 78% of the 100 participants who were enrolled in this study were females. 10% of the participants were smokers, but there was no significant difference between the two groups (p = 0.410). None of the patients were alcoholics. There was a significant difference between the groups regarding the type of medications. 42% of the RA group were on other medications compared with 2% of the PSA cases (p &lt; 0.001). The mean ALT of the PSA group (26.0 IU/L) was considerably (p = 0.005) greater than the mean of the RA group (19.6 IU/L) which shows an insignificant (p = 0.055) change between the two groups regarding the means of AST (26.3 IU/L in the PSA participants matched with 20.6 IU/L in the RA participants).&#x0D; Conclusion: Our research data shows that patients with PSA treated by methotrexate had a higher mean ALT level when compared with RA patients.

Assessment of Liver Function among Patients with Rheumatoid Arthritis Versus Patients with Psoriatic Arthritis Treated by Methotrexate

Background:Hepatotoxicity is a well-known adverse effect of methotrexate therapy. Objective: To assess liver functions such as ALT and AST in patients with rheumatoid arthritis and psoriatic arthritis receiving methotrexate and compare the liver functions in those patients cured by using methotrexate. Patients and Methods: This observational, cross-sectional analysis involved 50 patients with RA who satisfied EULAR-ACR-2010 standards for RA and 50 PSA cases who fulfilled CASPAR classification criteria for PSA, receiving constant weekly MTX therapy (oral or parenteral) up to 25mg, together with folic acid, liver function parameters such as ALT and AST in patients with rheumatoid and psoriatic arthritis were estimated and compared. Results: 78% of the 100 participants who were enrolled in this study were females. 10% of the participants were smokers, but there was no significant difference between the two groups (p = 0.410). None of the patients were alcoholics. There was a significant difference between the groups regarding the type of medications. 42% of the RA group were on other medications compared with 2% of the PSA cases (p &lt; 0.001). The mean ALT of the PSA group (26.0 IU/L) was considerably (p = 0.005) greater than the mean of the RA group (19.6 IU/L) which shows an insignificant (p = 0.055) change between the two groups regarding the means of AST (26.3 IU/L in the PSA participants matched with 20.6 IU/L in the RA participants). Conclusion: Our research data shows that patients with PSA treated by methotrexate had a higher mean ALT level when compared with RA patients. Keywords: Methotrexate, Rheumatoid arthritis, psoriatic arthritis, liver transaminases, Hepatotoxicity

Regional Anesthesia for Carotid Endarterectomy in Patients with Acute Ischemic Stroke (Pilot Study)

Objective. The aim of this study is to assess the safety of the use of regional anesthesia for performing carotid endarterectomy (CEA) in patients in the acute phase of ischemic stroke.Material and methods. The study included 66 patients in the acute phase of ischemic stroke (atherothrom-botic subtype according to the TOAST classification) who underwent carotid endarterectomy. The inclusion criteria for the study were as follows: acute phase of atherothrombotic ischemic stroke (first 28 days), ipsilateral symptomatic ≥ 50% stenosis of the internal carotid artery, 1-4 points neurological deficit according to the modified Rankin Scale (mRS), 1-13 points neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS), size of the cerebral ischemic lesion ≤ 4 cm. This single-center prospective cohort study compared two anesthetic approaches, regional anesthesia (RA, 46 patients) and general anesthesia (GA, 20 patients). The RA techniques included ultrasound-guided superficial and deep cervical plexus blocks on the side of the surgery.Results. The study found no significant differences in the baseline patient characteristics, surgery techniques and clinical outcomes between the groups. There were no neurological or cardiovascular toxic reactions to the local anesthetics. Conversions from RA to GA were not performed. In the RA group, recurrent ipsilateral ischemic strokes, myocardial infarctions, wound hemorrhagic complications and lethal outcomes did not occur.Conclusion. This pilot study has demonstrated the safety of RA for performing CEA in patients in the acute phase of ischemic stroke. RA provides adequate neuromonitoring and timely intraoperative recognition of «new» ischemic complications. To compare the efficacy of RA and GA for performing CEA in patients with acute ischemic stroke, large randomized controlled trials are needed.

Exploring the Subclinical Atherosclerotic Load in Patients With Rheumatoid Arthritis: A Cross-Sectional Study.

Atherosclerosis is the majoretiopathogenic factor that decides cardiovascular mortality and morbidity. While inflammation is the putative mechanism for atherosclerosis in various experimental studies, chronic inflammatory state (e.g. in rheumatoid arthritis [RA])is often neglected as a contributing factor for the development of atherosclerosis. RApatients have two to four times more risk of fatal or non-fatal cardiovascular events, whichis not explained by traditional risk factors alone. For example, low-density lipoprotein (LDL) cholesterollevels may not convey the true atherosclerotic risk in RA patients - "the lipid paradox". Thus, for better risk stratification of future cardiovascular events in RA, the traditionalparameters like diabetes, hypertension, and dyslipidemiamay not suffice. Newer parameters like carotid intimal-medial thickness (CIMT), coronary calcification scores, and C-reactive protein (CRP)may be needed. This study determined subclinical atherosclerotic load in groups of RA and non-RA patients with comparable Framingham risk scores using CIMT values. In this hospital-based cross-sectional study, the RA study group had 64 patients withRA (disease duration > 1 year) and 64 controls were patients with at least one traditional risk factor of cardiovascular disease (e.g., hypertension, cigarette smoking, dyslipidemia, and diabetes mellitus). They were all analyzed for CIMT. The aim was to compare if there was a difference in CIMT scores between groups of RA and non-RA patients, with comparableFramingham score cardiovascularrisk categories. CIMT was significantly higher in the study population compared to controls, indicating increased subclinical atherosclerotic load in the former. Mean CIMT was higher in all age groups in RA patients when compared to the control population (statistically significant in age groups 40-49 years 0.66 ± 0.07 mm vs 0.64 ± 0.06 mm, P < 0.026 and 50-59 years 0.8 ± 0.05 mm vs 0.76 ± 0.05 mm, P < 0.047). CIMT was significantly higher in theintermediate-risk groups (based onthe Framingham risk score) in the RA study population when compared with the same risk categories of the control population. Atherogenic indices such as LDL/high-density lipoprotein (HDL) ratio, atherogenic index, and CIMT were significantly higher in theRA patients with more than five years of disease duration than those with a duration of fewer than five years. Subclinical atherosclerotic load is higher in RA versus controls. The mean CIMT was higher in all age groups in RA compared to the controls. CIMT was significantly higher in theintermediate-risk subgroup (by Framingham risk score) when compared between RA and controls. RA subgroup comparisonsbased on seropositivity/seronegativity, high/normal CRP, and disease activity (low, intermediate, and high) for CIMT were not found to have statistically significant differences. RA group had lower HDL cholesterol and comparable LDL cholesterol values compared to controls.

Automated segmentation and classification of hand thermal images in rheumatoid arthritis using machine learning algorithms: A comparison with quantum machine learning technique

The aims and objectives of the study were to i) perform image segmentation using a color-based k-means clustering algorithm and feature extraction using binary robust invariant scalable key points (BRISK), maximum stable extremal regions (MSER), features from accelerated segment test (FAST), Harris, and orientated FAST and rotated BRIEF (ORB); ii) compare the performance of classical machine learning techniques such as LogitBoost, Bagging, and SVM with a quantum machine learning technique. For the proposed study, 240 hand thermal images were acquired in the dorsal view and ventral view of both the right and left-hand regions of RA and normal subjects. The hot spot regions from the thermograms were segmented using a color-based k-means clustering technique. The features from the segmented hot spot region were extracted using different feature extraction methods. Finally, normal and RA groups were categorized using LogitBoost, Bagging, and support vector machine (SVM) classifiers. The proposed study used two testing methods, such as 10-fold cross-validation and a percentage split of 80–20%. The LogitBoost classifier outperformed with an accuracy of 93.75% using the 10-fold cross-validation technique compared to other classifiers. Also, the quantum support vector machine (QSVM) obtained a prediction accuracy of 92.7%. Furthermore, the QSVM model reduces the computational cost and training time of the model to classify the RA and normal subjects. Thus, thermograms with classical machine learning and quantum machine learning algorithms could be considered a feasible technique for classifying normal and RA groups.