Serological Factors Research Articles

Impact of Sex, Serostatus, and Smoking on Risk for Rheumatoid Arthritis-Associated Interstitial Lung Disease Subtypes.

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) includes multiple subtypes with varying histopathology, prognosis, and potential treatments. Limited research has investigated risk factors for different RA-ILD subtypes. Therefore, we examined demographic, serologic, and lifestyle associations with RA-ILD subtypes. We systematically identified RA-ILD cases and RA controls without ILD (RA-noILD) in the Brigham RA Sequential Study and Mass General Brigham Biobank RA cohort. We determined RA-ILD subtype (usual interstitial pneumonia [UIP], nonspecific interstitial pneumonia [NSIP], and other/indeterminate) through chest high-resolution computed tomography imaging pattern. We investigated associations of demographic, lifestyle, and serologic factors with major RA-ILD subtypes using multivariable logistic regression. Among 3,328 patients with RA, we identified 208 RA-ILD cases and 547 RA-noILD controls. RA-UIP was associated with older age (odds ratio [OR] 1.03 per year, 95% confidence interval [95% CI] 1.01-1.05), male sex (OR 2.15, 95% CI 1.33-3.48), and seropositivity (OR 2.08, 95% CI 1.24-3.48), whereas RA-NSIP was significantly associated only with seropositive status (OR 3.21, 95% CI 1.36-7.56). Nonfibrotic ILDs were significantly associated with smoking (OR 2.81, 95% CI 1.52-5.21). Having three RA-ILD risk factors (male, seropositive, smoking) had an OR of 6.89 (95% CI 2.41-19.7) for RA-UIP compared with having no RA-ILD risk factors. Older age, seropositivity, and male sex were strongly associated with RA-UIP, whereas RA-related autoantibodies were associated with RA-NSIP. These findings suggest RA-ILD sex differences may be driven by RA-UIP and emphasize the importance of further studies to clarify RA-ILD heterogeneity and optimize screening and treatment approaches.

Discrete prognostic implication of sarcopenia according to nutritional status in surgically treated patients with hypopharyngeal cancer.

Nutritional status and sarcopenia affects the prognosis of head and neck cancers including hypopharyngeal cancer. Hypopharyngeal cancer patients tend to exhibit sarcopenia, which is associated with poor treatment outcomes. This study aims to determine the correlation between nutritional status and sarcopenia, and their prognostic role in surgically treated hypopharyngeal cancer. Patients who had been diagnosed with squamous cell carcinoma originating from the hypopharynx and underwent surgery between January 2009 and December 2019 were enrolled in this study. The median neutrophil-to-lymphocyte ratio and prognostic nutritional index (PNI) of the cohort were considered the cut-off values. Sarcopenia was evaluated by measuring skeletal muscle index (SMI) at the third lumbar vertebra. Clinical and serological factors predictive of survival outcomes were evaluated. Patients with high PNI showed better 5-year Overall survival (OS) (52.8% vs. 27.2%, p=0.001) and disease-free survival (DFS) (59.6% vs. 44.6%, p=0.033) than those with low PNI. Likewise, patients with low SMI showed worse 5-year OS (25.0% vs. 60.9%, p=0.002) and DFS (42.4% vs. 68.7%, p=0.034) than patients with high SMI. Among the patients with high PNI, those with sarcopenia displayed significantly worse OS than those with high SMI (78.0% vs. 34.4%, p=0.049). High PNI with high SMI presented better overall (p=0.010) and DFS (p=0.055) than any other group. Both sarcopenia and PNI were associated with the prognosis of hypopharyngeal cancer. Considering that PNI and sarcopenia indicate the nutritional status, nutritional status may be a significant risk factor. Therefore, nutritional support that ameliorates sarcopenia may improve survival outcomes in surgically treated patients with hypopharyngeal cancer.

Effectiveness of Bairui granules in the treatment of respiratory tract infections: A systematic review and meta-analysis.

Respiratory tract infections (RTIs) are characterized by a high mortality rate and clinical incidence. Bairui granules (BG), which employ a method of heat elimination and detoxification, have demonstrated benefits in the treatment of infectious respiratory diseases. A computerized search of 6 databases was conducted to identify randomized controlled trials (RCTs) relevant to the treatment of RTIs with BG up to November 30, 2023. Two researchers independently conducted data extraction, risk of bias assessment, and grading analysis. To evaluate the stability of the results, trial sequential analysis was employed. This meta-analysis included 31 RCTs with a total of 4073 patients and demonstrated that the use of BG in the treatment of RTIs was associated with enhanced treatment efficacy (relative risk = 1.19, 95% credible interval: 1.16-1.22, P < .001). It also indicated a faster resolution of symptoms including pulmonary rales, cough, and fever, as well as a reduction in serological index factors, compared to the use of Western medicine treatment (WT) alone. Additionally, the duration of hospitalization for patients was significantly reduced (relative risk = -1.36, 95% credible interval: -1.55 to -1.17, P < .001). Trial sequential analysis confirmed the stability and conclusive evidence of the study results. The efficacy of treating RTIs with BG, either alone or in combination with WT, was found to be superior to WT alone. However, further high-quality RCTs are necessary to validate these outcomes. The effectiveness of treating RTIs using BG alone or in combination with WT was determined to be superior to using WT alone, with no serious adverse effects observed. However, additional RCTs are essential to further confirm the findings of this study.

Serological Screening and Risk Factors Associated with Leishmania infantum Positivity in Newly Diagnosed HIV Patients in Greece.

A serological screening was conducted to detect IgG antibodies against Leishmania infantum (L. infantum) in newly diagnosed human immunodeficiency virus (HIV) patients in Greece. The study also examined potential risk factors and the agreement of commercially available serological methods. IgG antibodies against L. infantum were detected using enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence antibody test (IFAT), and Western blot (WB). Out of 155 samples, 14 (9.0%) tested positive for IgG antibodies against L. infantum using at least two methods. Statistical analysis showed substantial agreement between WB and IFAT methods (Cohen's kappa = 0.75) but moderate overall agreement among the three methods (Fleiss' kappa = 0.42). Additionally, HIV+ intravenous drug users faced 3.55 times (p = 0.025) higher risk of testing positive for L. infantum IgG, positing that anthroponotic transmission between these patients is a plausible hypothesis based on existing literature. Non-invasive and cost-effective techniques are preferred to detect asymptomatic infections, and leishmaniasis screening should be conducted immediately after HIV diagnosis in endemic regions to enable prophylactic treatment for leishmaniasis in addition to antiretroviral therapy. To maximize sensitivity, performing at least two different serological methods for each patient is recommended.

Diagnostic value of serum NLRP3, metalloproteinase-9 and interferon-γ for postoperative hydrocephalus and intracranial infection in patients with severe craniocerebral trauma.

Traumatic brain injury (TBI) is a major cause of morbidity and mortality globally. We unveiled the diagnostic value of serum NLRP3, metalloproteinase-9 (MMP-9) and interferon-γ (IFN-γ) levels in post-craniotomy intracranial infections and hydrocephalus in patients with severe craniocerebral trauma to investigate the high risk factors for these in patients with TBI, and the serological factors predicting prognosis, which had a certain clinical predictive value. Study subjects underwent bone flap resection surgery and were categorized into the intracranial infection/hydrocephalus/control (without postoperative hydrocephalus or intracranial infection) groups, with their clinical data documented. Serum levels of NLRP3, MMP-9 and IFN-γ were determined using ELISA kits, with their diagnostic efficacy on intracranial infections and hydrocephalus evaluated by receiver operating characteristic curve analysis. The independent risk factors affecting postoperative intracranial infections and hydrocephalus were analysed by logistic multifactorial regression. The remission after postoperative symptomatic treatment was counted. The intracranial infection/control groups had significant differences in Glasgow Coma Scale (GCS) scores, opened injury, surgical time and cerebrospinal fluid leakage, whereas the hydrocephalus and control groups had marked differences in GCS scores, cerebrospinal fluid leakage and subdural effusion. Serum NLRP3, MMP-9 and IFN-γ levels were elevated in patients with post-craniotomy intracranial infections/hydrocephalus. The area under the curve values of independent serum NLRP3, MMP-9, IFN-γ and their combination for diagnosing postoperative intracranial infection were 0.822, 0.722, 0.734 and 0.925, respectively, and for diagnosing hydrocephalus were 0.865, 0.828, 0.782 and 0.957, respectively. Serum NLRP3, MMP-9 and IFN-γ levels and serum NLRP3 and MMP-9 levels were independent risk factors influencing postoperative intracranial infection and postoperative hydrocephalus, respectively. Patients with hydrocephalus had a high remission rate after postoperative symptomatic treatment. Serum NLRP3, MMP-9 and IFN-γ levels had high diagnostic efficacy in patients with postoperative intracranial infection and hydrocephalus, among which serum NLRP3 level played a major role.

Investigating incidence of and factors associated with SARS-CoV-2 infection over a nine-month period in a highly-vaccinated healthcare worker cohort.

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection. This risk persists despite the implementation of mitigating factors, including vaccination. The ongoing impact of incident SARS-CoV-2 infection and symptomatic COVID-19 disease in vaccinated healthcare workers is poorly understood. We aimed to describe the epidemiology of incident SARS-CoV-2 infections, as well as investigating the serological, clinical and demographic factors associated with developing infection. This was a multi-centre prospective longitudinal study followed a HCW cohort over a nine-month period. Spike and nucleocapsid SARS-CoV-2 antibodies were measured at enrolment. Vaccination status, demographics, and medical history were collated. Incident infection over the study period was recorded. Multivariable regression models investigated factors associated with nucleocapsid antibody status, incident infection, and symptomatic infection. 1,260 participants took part, of whom n = 1,006 were anti-nucleocapsid antibody positive. Negative anti-nucleocapsid antibody was associated with older age and having a known SARS-CoV-2 acquisition risk. There were n = 274 (22%) incident infections, with n = 225 (87%) diagnosed using antigen tests. Incident infections were associated with lower anti-nucleocapsid titres, increased time since previous SARS-CoV-2 infection, and having a known acquisition risk, but were not associated with vaccination status. This study demonstrates a high rate of incident SARS-CoV-2 infection amongst healthcare workers, despite broad vaccine coverage. There is a shift in diagnostics, from PCR to antigen testing. We identify at-risk groups for incident infection, and these should continue be targeted as part of risk reduction campaigns. Vaccination status and prior infection status alone are not surrogates for protection.

Serologic Response to the Epstein-Barr Virus Peptidome and the Risk for Multiple Sclerosis

It remains unclear why only a small proportion of individuals infected with the Epstein-Barr virus (EBV) develop multiple sclerosis (MS) and what the underlying mechanisms are. To assess the serologic response to all EBV peptides before the first symptoms of MS occur, determine whether the disease is associated with a distinct immune response to EBV, and evaluate whether specific EBV epitopes drive this response. In this prospective, nested case-control study, individuals were selected among US military personnel with serum samples stored in the US Department of Defense Serum Repository. Individuals with MS had serum collected at a median 1 year before onset (reported to the military in 2000-2011) and were matched to controls for age, sex, race and ethnicity, blood collection, and military branch. No individuals were excluded. The data were analyzed between September 1, 2022, and August 31, 2023. Antibodies (enrichment z scores) to the human virome measured using VirScan (phage-displayed immunoprecipitation and sequencing). Rate ratios (RRs) for MS for antibodies to 2263 EBV peptides (the EBV peptidome) were estimated using conditional logistic regression, adjusting for total anti-EBV nuclear antigen 1 (EBNA-1) antibodies, which have consistently been associated with a higher MS risk. The role of antibodies against other viral peptides was also explored. A total of 30 individuals with MS were matched with 30 controls. Mean (SD) age at sample collection was 27.8 (6.5) years; 46 of 60 participants (76.7%) were male. The antibody response to the EBV peptidome was stronger in individuals with MS, but without a discernible pattern. The antibody responses to 66 EBV peptides, the majority mapping to EBNA antigens, were significantly higher in preonset sera from individuals with MS (RR of highest vs lowest tertile of antibody enrichment, 33.4; 95% CI, 2.5-448.4; P for trend = .008). Higher total anti-EBNA-1 antibodies were also associated with an elevated MS risk (top vs bottom tertile: RR, 27.6; 95% CI, 2.3-327.6; P for trend = .008). After adjusting for total anti-EBNA-1 antibodies, risk estimates from most EBV peptides analyses were attenuated, with 4 remaining significantly associated with MS, the strongest within EBNA-6/EBNA-3C, while the association between total anti-EBNA-1 antibodies and MS persisted. These findings suggest that antibody response to EBNA-1 may be the strongest serologic risk factor for MS. No single EBV peptide stood out as being selectively targeted in individuals with MS but not controls. Larger investigations are needed to explore possible heterogeneity of anti-EBV humoral immunity in MS.

Comprehensive Association Analyses of Extraintestinal Manifestations in Inflammatory Bowel Disease

Patients with inflammatory bowel disease (IBD) frequently develop extraintestinal manifestations (EIMs) that contribute substantially to morbidity. We assembled the largest multicohort data set to date to investigate the clinical, serologic, and genetic factors associated with EIM complications in IBD. Data were available in 12,083 unrelated European ancestry IBD cases with presence or absence of EIMs (eg, ankylosing spondylitis [ankylosing spondylitis and sacroiliitis], primary sclerosing cholangitis [PSC], peripheral arthritis, and skin and ocular manifestations) across 4 cohorts (Cedars-Sinai Medical Center, National Institute for Diabetes and Digestive and Kidney Diseases IBD Genetics Consortium, Sinai Helmsley Alliance for Research Excellence Consortium, and Risk Stratification and Identification of Immunogenetic and Microbial Markers of Rapid Disease Progression in Children with Crohn's Disease cohort). Clinical and serologic parameters were analyzed by means of univariable and multivariable regression analyses using a mixed-effects model. Within-case logistic regression was performed to assess genetic associations. Most EIMs occurred more commonly in female subjects (overall EIM: P= 9.0E-05, odds ratio [OR], 1.2; 95% CI, 1.1-1.4), with CD (especially colonic disease location; P= 9.8E-09, OR, 1.7; 95% CI, 1.4-2.0), and in subjects who required surgery (both CD and UC; P= 3.6E-19, OR, 1.7; 95% CI, 1.5-1.9). Smoking increased risk of EIMs except for PSC, where there was a "protective" effect. Multiple serologic associations were observed, including with PSC (anti-nuclear cytoplasmic antibody; IgG and IgA, anti-Saccharomyces cerevisiae antibodies; and anti-flagellin) and any EIM (anti-nuclear cytoplasmic antibody; IgG and IgA, anti-Saccharomyces cerevisiae antibodies; and anti-Pseudomonas fluorescens-associated sequence). We identified genome-wide significant associations within major histocompatibility complex (ankylosing spondylitis and sacroiliitis, P= 1.4E-15; OR, 2.5; 95% CI, 2.0-3.1; PSC, P= 2.7E-10; OR, 2.8; 95% CI, 2.0-3.8; ocular, P= 2E-08, OR, 3.6; 95% CI, 2.3-5.6; and overall EIM, P= 8.4E-09; OR, 2.2; 95% CI, 1.7-2.9) and CPEB4 (skin, P= 2.7E-08; OR, 1.5; 95% CI, 1.3-1.8). Genetic associations implicated tumor necrosis factor, JAK-STAT, and IL6 as potential targets for EIMs. Contrary to previous reports, only 2% of our subjects had multiple EIMs and most co-occurrences were negatively correlated. We have identified demographic, clinical, and genetic associations with EIMs that revealed underlying mechanisms and implicated novel and existing drug targets-important steps toward a more personalized approach to IBD management.

Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers.

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.

Clinical and Serological Associations of Subclinical Atherosclerosis in Systemic Sclerosis

Background: While patients with systemic sclerosis (SSc) are predisposed to cardiovascular events, data regarding this from India is sparse. We analysed correlates of subclinical atherosclerosis in Indian patients with SSc. Methods: Patients with SSc fulfilling the 2013 classification criteria ( n = 61) were recruited after obtaining written informed consent. Clinical risk factors for cardiovascular disease (CVD) were assessed. A carotid ultrasound was performed to assess the mean carotid intima-media thickness (CIMT). Total and endothelial microparticles (EMP, positive for CD31 and CD146) were estimated from plasma. Serum cytokines known to play a role in atherosclerosis (interleukin-1β [IL-1β], tumour necrosis factor-alpha, IL-6 and IL-17) were assessed. Forty-one age- and sex-similar healthy controls were recruited for comparison. Clinical and serological risk factors for CVD were compared between SSc with and without carotid plaque. Linear regression analyses were conducted to identify predictors of CIMT and carotid plaque in SSc. Results: Patients with SSc had lower body-mass index than healthy controls, however, had higher CIMT, higher serum IL-1β, IL-6, total microparticles and EMP than control subjects. SSc with carotid plaque ( n = 13) were older, and more likely to be male, but demonstrated no differences in serological markers of CVD. On multivariable-adjusted regression analyses, age was the only significant predictor of CIMT in SSc and male sex was the only significant predictor of carotid plaque in SSc. Conclusions: Carotid plaques were present in one-fifth of young patients with SSc. Older age and male sex predicted a higher risk of subclinical atherosclerosis in SSc.

Chronic viral hepatitis C micro-elimination program using telemedicine in Guigang city.

Hepatitis C virus (HCV) represents a formidable menace to human health, necessitating urgent attention. The objective of this study was to assess the efficacy and safety of HCV health management in the city of Guigang which consists of five districts, employing a comprehensive multi-modal approach. The study systematically carried out HCV screening in Guigang city which consists of five districts, such as Gangbei District, Gangnan District, Guiping District, Qintang District, and Pingnan District from 1 January 2016 to 30 December 2022. The target population consisted of individuals residing in these aforementioned districts, falling within the age range of 30-75 years. A multidisciplinary HCV management team was established to deliver anti-HCV screening, diagnosis, and direct-acting antiviral (DAA) therapy. The primary outcome of interest was the achievement of sustained virologic response (SVR). A total of 2489 individuals were included as the target population, with 1694 individuals residing in Gangbei District, 202 in Gangnan District, 111 in Qintang District, 167 in Pingnan District, and 315 in Guiping District. Out of these individuals, 2478 were subjected to anti-HCV screening. The screening rates varied across the districts, ranging from a peak of 99.55% in Guigang City to a nadir of 98.41% in Guiping District. Remarkably, within Guigang City, a noteworthy enhancement was observed in the HCV-RNA diagnosis rate from 23.4% prior to program implementation to a remarkable 100% following 7 years of intervention and management. Furthermore, the diagnosis and treatment coordination rate experienced a substantial improvement, rising from 26.8% before program inception to 80%. Importantly, a total of 1180 individuals affected by hepatitis C were successfully cured, equating to a 100% cure rate. Logistic regression analysis revealed a significant association between serological status and factors such as Aging, bilirubin, and glutamic oxalacetic transaminase. The findings from our investigation unveil a pioneering HCV management model, exemplified by the Guigang model, which has contributed crucially to HCV microclearance efforts and serves as an invaluable reference for future initiatives.

Seropositivity, Comparison Between the Efficiency of Serological Tests and Risk Factors of Brucella Infection in Small Ruminants with History of Abortion in the Afar Region of North-Eastern Ethiopia.

Brucellosis is one of the most important reproductive diseases that cause abortion and breeding failure in small ruminants in Ethiopia. Therefore, our objective was to detect the seropositivity and risk factors of Brucella infection in small ruminants with history of abortion using modified RBPT, cELISA, and CFT in the Amibara district of the Afar Region, Ethiopia. Sera were collected from 226 animals (195 goats and 31ewes) and assessed for seropositivity of Brucella infection using modified RBPT, CFT, and competitive ELISA. The overall seroprevalence was 12.0% (27 out of 226), 7.5% (17 out of 226), and 26.5% (60 out of 226) by mRBPT, CFT, and cELISA, respectively. Out of 27 sera that were reactive by mRBPT, 17 (63.0%) were also reactive by (CFT). Out of the 17 sera that were reactive by CFT and mRBPT, 14 (82.4%) were reactive by cELISA. Out of the 29 sera that were non-reactive by both mRBPT and CFT, 10 (34.5%) were found reactive by cELISA. Out of the 226 sera that were tested by both mRBPT and cELISA, 20 (8.9%) were reactive by both tests, while 159 (70.4%) were non-reactive by both tests. The percentage of test agreement (79.2%) between mRBPT and cELISA was poor (k=0.353). High seropositivity for Brucella infection was significantly associated with the presence of retained placenta in the studied animals (adjusted OR=2.2, 95% CI, 1.1-4.4, P=0.030) as detected by cELISA. The current study revealed that a cELISA-based seroepidemiological survey increases the likelihood of detecting individuals with brucellosis and provides reliable evidence for mRBPT. Furthermore, there was a significant association between seropositivity for Brucella infection and retained placenta. These findings emphasize the necessity for proactive measures to reduce the economic impact of brucellosis and mitigate the risk of zoonotic transmission.

Serological survey and risk factors associated with visceral leishmaniasis in dogs from the Northeast region, Brazil

Serological survey and risk factors associated with visceral leishmaniasis in dogs from the Northeast region, Brazil

A Serological Survey and Risk Factors of Respiratory Syncytial Virus in Goats in Different Locations in Al-Najaf, Iraq

Bovine respiratory syncytial virus (BRSV) is one of the most common causes of respiratory illness in goats globally, resulting in major financial losses. The goal of this Survey was to determine the incidence of Bovine Respiratory Syncytial virus in Al-Najaf goats and the risk factors for this disease. Between December 2021 and November 2022 For this study, 200 goats of various ages and breeds from Al Kufa, Qadisiyia, Hayderia, and Abbasyia in Al-Najaf, Iraq, were tested. The animals’ epidemiological information was recorded. An indirect Elisa test kit was used to establish the disease’s incidence. The incidence of BRSV in goats was 44.5%, and it was substantially higher in Goats aged more than one-year (50.4%). The incidence of BRSV in male and female goats did not vary significantly. Compared to samples taken during the other seasons, those collected in the winter had a significantly higher BRSV incidence. There was a significantly difference in disease infection rate (P≤0.05) among mixed goats compared with others that were not mixed with other specious. The results revealed that the imported animals had a significantly higher prevalence than the native goats. In Conclusion: Bovine Respiratory Syncytial Virus is predominant in goats from the Al-Najaf province and risk factors such as animal age, herd size, origin, and the herd’s geographical location are related to an increased occurrence of the disease in this region. Routine vaccination plans must be assumed to decrease the incidence of BRSV in goats.

1378. Seroprevalence and risk factors for cysticercosis in Mexican-Americans in Starr County, Texas

Abstract Background Neurocysticercosis (NCC) is a parasitic infection caused by the tapeworm Taenia solium, and is a leading cause of epilepsy and chronic headaches in endemic areas including Latin America, Africa, and Asia. The epidemiology of NCC has not been well-studied in the United States to date, but small epidemiological studies suggest evidence of this disease in populations living in poverty and who have immigrated from an endemic region. There is a population living in Starr County, Texas along the Texas-Mexico border in whom the presence of other neglected tropical diseases has been demonstrated due to the intersection of poverty, climate, and high rate of immigration. Methods Our study was a serologic survey and risk factor analysis of cysticercosis in a pre-existing cohort of Mexican-Americans in Starr County, Texas. We used a triplex enzyme-linked immunoassay (ELISA) against cysticercosis-specific antigens and self-reported survey data and neighborhood-level variables to conduct a risk-factor analysis of seropositive participants. Results We identified an overall seropositivity to T. solium in 7.4% (45/605) of the cohort which likely represents a combination of parasite exposure, T. solium disease outside of the central nervous system, old calcified NCC, and viable or degenerating NCC. Female gender, specific occupation and indoor versus outdoor occupation were found to be significantly associated with cysticercosis seropositivity. Thirty-nine of the 45 seropositive participants were female (p 0.021), 26 were employed in healthcare, caregiving, or social service (p 0.009), and 42 were employed in an indoor occupation (p &amp;lt; 0.001). These occupations could pose a risk for T. solium transmission. A geospatial analysis of cases at the census tract level showed increased percentage of seropositivity centered around urban cities Rio Grande City and Roma, as well as smaller city La Grulla and census-designated place Alto Bonito. Conclusion There is a critical need to investigate these cysticercosis-seropositive cases with brain imaging to evaluate for neurocysticercosis, as well as conduct an epidemiological investigation to determine disease transmission in Starr County. Disclosures All Authors: No reported disclosures

Serological evidence and factors associated with Crimean-Congo haemorrhagic fever in sheep in Burkina Faso.

Crimean-Congo haemorrhagic fever (CCHF) is caused by an orthonairovirus transmitted by bites from infected ticks or by direct contact with blood or tissues of infected ticks, viraemic patients or viraemic livestock. It was implemented to access the seropositivity and associated factors with CCHF in sheep in two provinces in Burkina Faso. Three hundred and sixty-four sheep sera have been taken from 73 herds in four municipalities and two provinces. The double-antigen sandwich ELISA test was used to test for antibodies against CCHF virus (CCHFV). Data have also been collected using questionnaire to assess factors associated with CCHF seropositivity. Fifty-four (54out to 364 sheep were seropositive given an overall seropositivity of 14.8% (95% confidence interval [CI]: 10.9%-19.8%) with an adjusted seropositivity of 13.1%. The study showed that 15.6% (95% CI: 10.2-21.0) and 14.1% (95% CI: 9.2-19.1) of sheep in the provinces of Mouhoun and Kénédougou, respectively, had antibodies against CCHFV. The highest seropositivity was found in Dédougou municipality (24.4%). The study showed that sheep from the municipalities of Dédougou (AOR=8.4; 95% CI: 2.2-31.8), N'dorola (AOR=14.7; 95% CI: 3.8-56.8), Sindou (AOR=4.9; 95% CI: 1.2-20.7), sheep aged between 27 and 36 months (AOR=6.4; 95% CI: 2.3-17.3) and sheep with ticks (AOR=24.8; 95% CI: 7.7-80.1) were more likely to be seropositive to CCHF. The study revealed that sheep in Burkina Faso experienced contacts with CCHFV and suggests the importance of implementing control action in the country.

A predictive and prognostic model for surgical outcome and prognosis in ovarian cancer computed by clinico-pathological and serological parameters (CA125, HE4, mesothelin).

Numerous prognostic models have been proposed for ovarian cancer, extending from single serological factors to complex gene-expression signatures. Nonetheless, these models have not been routinely translated into clinical practice. We constructed a robust and readily calculable model for predicting surgical outcome and prognosis of ovarian cancer patients by exploiting commonly available clinico-pathological factors and three selected serum parameters. Serum CA125, human epididymis protein 4 (HE4) and mesothelin (MSL) were quantified by Lumipulse® G chemiluminescent enzyme immunoassay (Fujirebio) in a total of 342 serum samples from 190 ovarian cancer patients, including 152 paired pre- and post-operative samples. Detection of pre-operative HE4 and CA125 was the optimal marker combination for blood-based prediction of surgical outcome (AUC=0.86). We constructed a prognostic model, computed by serum levels of pre-operative CA125, post-operative HE4, post-operative MSL and surgical outcome. Prognostic performance of our model was superior to any of these parameters alone and was independent from BRCA1/2 mutational status. We subsequently transformed our model into a prognostic risk index, stratifying patients as "lower risk" or "higher risk". In "higher risk" patients, relapse or death was predicted with an AUC of 0.89 and they had a significantly shorter progression free survival (HR: 9.74; 95 % CI: 5.95-15.93; p<0.0001) and overall survival (HR: 5.62; 95 % CI: 3.16-9.99; p<0.0001) compared to "lower risk" patients. We present a robust predictive/prognostic model for ovarian cancer, which could readily be implemented into routine diagnostics in order to identify ovarian cancer patients at high risk of recurrence.

Risk Factors for Pulmonary Arterial Hypertension in Patients With Systemic Lupus Erythematosus: A Systematic Review and Expert Consensus.

This study aimed to identify risk factors associated with the development of pulmonary arterial hypertension (PAH) in patients with systemic lupus erythematosus (SLE). We conducted a systematic literature review of studies focusing on adult patients classified as having SLE-related PAH by searching the electronic databases Embase, Medline, Medline in-progress, Wanfang, China National Knowledge Infrastructure, Ichushi Web, Kmbase, and KoreaMed. Based on the findings, we conducted a Delphi survey to build expert consensus on issues related to screening for PAH in patients with SLE and on the importance and feasibility of measuring the identified factors in clinical practice. We included 21 eligible studies for data synthesis. Sixteen factors were associated with an increased risk of SLE-PAH: pericardial effusion, serositis, longer duration of SLE, arthritis, acute and subacute cutaneous lupus, scleroderma pattern on nailfold capillaroscopy, diffusion capacity of carbon monoxide in the lungs (DLCO) <70% predicted, interstitial lung disease, thrombocytopenia, and seven serological factors. Six factors were associated with a decreased risk of SLE-PAH: malar/acute rash, hematologic disorder, renal disorder, higher Systemic Lupus Erythematosus Disease Activity Index score, and two serological factors. Among these, there were six risk factors on which the panelists reached strong or general consensus (peak tricuspid regurgitation velocity on echocardiography >2.8 m/s, pericardial effusion, DLCO <70% predicted, scleroderma pattern on nailfold capillaroscopy, brain natriuretic peptide >50 ng/l, and N-terminal pro-brain natriuretic peptide >300 ng/l). The Delphi panel confirmed the need for a screening tool to identify patients with SLE at high risk of developing PAH and provided consensus on the importance and/or practicality of measuring the identified factors. The risk factors we identified could be used in a screening algorithm to identify patients with SLE with a high risk of developing PAH to facilitate early diagnosis, which could improve prognosis and management of these patients.

Incidences of Hepatitis-B Within Kirkuk Province in Iraq, a Biochemical Study of Some Liver Enzymes

Geographical distribution of Hepatitis-B, both acute and chronic caused by the hepatitis-B virus (HBV) has always been attracting attention worldwide. Prevalence of HBV does vary among genders and ages while symptomatic and asymptomatic are not uncommon. The present research involved assessment of three different parameters i.e. four liver enzymes, hematological and serological factors in 91 patients (70 male and 21 female) compared with 28 control counterpart (23 male and 5 female) admitted a private Medical laboratory in Kirkuk province. The arithmetic values of the 4 main liver enzymes, Alanine Trans-Aminase (ALT), Alkaline phosphatase (ALP); aspartate transaminase (AST) and GammaGlutamyl transferase (GGT) showed significant increase (p≤0.05-0.001) in Hepatitis-B patients in comparison with their counterpart healthy individuals. An insignificant differences was detectable in both WBC and Hb% values meanwhile significant increases (20-25 folds) elevation was detected in the total serum bilirubin (TSB) of HBV patients. Variations in the values of these enzymes, particularly ALT enzyme, was also prominent between the genders e.g. in male patients were comparable with their counterparts female. The values of the enzyme ALT, particularly in female hepatitis, were four folds higher than males; however, other enzyme showed lesser value variations ranged between significant to insignificant. It is conclude that regular check-up of these enzymes deems necessary for personal health purposes of HBV patients.

Serum immunoglobulin G level reduction is a predictor of short-term improvement in patients with myasthenia gravis undergoing plasmapheresis.

The aim of the study was to investigate the serological factors in predicting symptom improvement in myasthenia gravis (MG) patients who underwent plasmapheresis (PP). The relationship between symptom improvement and change in immunoglobin G (IgG) and acetylcholine receptor antibody (AchR-Ab) levels in 21 MG patients after PP was analyzed. Patients were divided into two groups: the favorable (n = 11) or unfavorable (n = 10) response groups around the median MG composite improvement rate (50 [29, 56]%) 2 weeks after a PP course. In all patients, the IgG reduction rate before and after PP was higher in the favorable than the unfavorable response group. In AChR-Ab-positive patients, IgG and AChR-Ab reduction rates were higher in the favorable than the unfavorable response group. IgG reduction rate is a predictor of symptom improvement in MG patients who underwent PP.