Controls Of Similar Age Research Articles

Patients with Irritable Bowel Syndrome Exhibit Aberrant Expression of Endogenous Retroviruses and SETDB1

Irritable bowel syndrome (IBS) is a common disease, whose etiopathogenesis is poorly understood. Human endogenous retroviruses (HERVs) originate from ancient infections of germinal cells and represent 8% of our DNA. Most HERVs have become defective due to the accumulated mutations; some can, however, still be activated, and their altered expressions have been associated with a number of chronic inflammatory and immune-mediated disorders, including gastrointestinal diseases. Retroviral transcription is modulated by TRIM28 and SETDB1, which also participate in the regulation of epigenetic mechanisms and in shaping the immune system. Expressions of HERVs and TRIM28/SETDB1 have not been investigated in patients affected by IBS. Using a PCR real-time Taqman amplification assay, we explored the RNA levels of HERV-H-pol, HERV-K-pol, and HERV-W-pol; syncytin 1 (SYN1), SYN2, and HERV-W-env; and TRIM28 and SETDB1 in the peripheral blood of 37 IBS patients and healthy controls (HCs) of similar age. The transcript levels were higher in IBS patients than in HCs for all HERVs except for HERV-W-pol, with significant p-values for HERV-H-pol, HERV-K-pol, and SYN1 and borderline p-values for SYN2 and HERV-W-env. The RNA levels of SETDB1 were significantly enhanced in IBS patients, while those of TRIM28 were in the normal range. Patients with severe disease had significant upregulation of SETDB1 compared to those with mild or moderate symptoms. These findings suggest that overexpression of HERVs and SETDB1 may contribute to the development of IBS and open the way to innovative therapeutic strategies.

Determinants of Chronic Kidney Disease among Young Adults attending a Tertiary Care Hospital in Madurai- A Case-Control Study

Introduction: As with other non-communicable diseases, chronic kidney disease (CKD) also is in a way at the top among the younger population. Apart from diabetes, hypertension, old age, family history of CKD other risk factors like smoking, alcohol, pesticide exposure, heavy metals also made them vulnerable to CKD. The focus on CKD in younger age groups is often overlooked; therefore, this study has been planned to address this gap. Objective: To determine the risk factors for chronic kidney disease among young adult patients <40 years of age. Method: An unmatched case control study was conducted in district hospital in Madurai. The study compared patients with chronic kidney disease aged under 40 (cases) from the Nephrology ward and outpatient with similar-aged controls without CKD from the Medicine ward, using routine eGFR calculations for diagnosis. The calculated sample size was 76, which was rounded up to 100 participants in both the case and control groups. Data collection was done by using semi-structured questionnaire. Univariate and multivariate analysis were used to predict the risk factors for young CKD patients. Results: The study predicted that rural population (OR-5.236, 95% CI-2.489- 11.014), family history of CKD (OR-29.590, 95% CI- 3.351-261.243), hypertension (OR-5.005, 95% CI-2.014-12.437), history of taking alternative medicine (OR- 5.136, 95% CI-1.745-15.117), and recurrent urinary tract infection (OR-11.460, 95% CI-2.288-57.444) were significantly associated risk factors for CKD. Conclusion: This study predicted hypertension, rural population, family history of CKD, history of recurrent urinary tract infection, alcohol consumption as significant risk factors for CKD. Hypertension, history of recurrent urinary tract infection, alcohol consumption were modifiable risk factors. By controlling these modifiable risk factors, the burden of CKD can be reduced. In addition this study predicted that, rural population was more vulnerable to CKD, so the screening service to these populations through primary health care approach is essential.

Spousal care partners have increased levels of anxiety, depression and blood short chain fatty acids

AbstractBackgroundSpousal care partners to people with dementia (PWD) have a higher rate of depression and anxiety when compared to similar age controls. Previous studies have suggested a role of gut microbiota in the pathophysiology of neuropsychiatric symptoms and Alzheimer’s disease (AD). Thus, our study aims to: (1) determine the presence and severity of depression and anxiety in care partners of PWD, and (2) determine the concentrations of short chain fatty acids (SCFA), which are mainly produced by gut microbiota and are important in mediating gut microbiota effects, in the blood of care partners of PWD.MethodsThree groups of participants were recruited for this cross‐sectional study: healthy controls, patients with AD and their spousal care partners. We used the Beck Depression Inventory (BDI‐II) to assess the presence and severity of depression, the State‐Trait Anxiety Inventory to evaluate care partner distress, and repeatable battery for the assessment of neuropsychological status (RBANS) for cognitive assessment. Their blood and feces were harvested.ResultsWe recruited 53 participants: 15, 21 and 17 participants in the control, care partner and AD groups, respectively. Patients with AD had lower mean (SD) total RBANS scores [69 (16)] than controls [110 (11)] (P < 0.001) and care partners [111 (13)] (P < 0.001). Patients with AD and their care partners had higher state and trait anxiety scores than controls (Fig. 1). Care partners had the highest BDI scores (Fig. 2). Care partners had higher concentrations of acetic acid, propionic acid and butyric acid in the blood than those in the control group (Fig. 3).ConclusionsSpousal care partners had evidence of increased levels of depression, anxiety, and concentrations of SCFAs relative to controls. Our results suggest that care partners to PWDs have gut microbiota different from that of controls, which may be related to their elevated anxiety and depression.

Comparative analysis of biometry and anterior chamber metrics in the eyes of extreme hyperopic and emmetropic children

PurposeTo investigate the clinical and biometric features of pediatric eyes with extreme hyperopia and report baseline biometric values. MethodsIn this prospective case-control study, the biometric parameters of eyes in children with extreme hyperopia were compared to those of an emmetropic cohort of similar age. Comprehensive eye examinations were conducted for new patients. Anterior OCT (CASIA-2, Tomey) and ocular biometry imaging (IOL Master 700, Zeiss) were performed for all participants. ResultsA total of 19 children (mean age, 12.3 ± 2.3 years) with extreme hyperopia (+8.84 ± 0.77) were compared with 17 emmetropic (+0.53 ± 0.43) controls of similar age (mean age, 12.4 ± 2.2 years [P = 0.864]). Extreme hyperopic eyes exhibited significantly shorter axial length, normal spherical equivalent corneal keratometry, higher astigmatism, lower anterior chamber area and volume, and narrower iridotrabecular angle optical coherence tomography (OCT) parameters. Lens thickness and curvature were similar, with a slightly anterior and tilted position. ConclusionsIn our study cohort, extreme hyperopia was associated with shorter axial length, reduction in anterior chamber size, with well-formed, regular-sized lens positioned anteriorly, and a narrower iridotrabecular angle.

The effectiveness of Psoriaten products in treatment of patients with chronic plaque psoriasis

Objective — to determine the efficacy and tolerability of Psoriaten ointment and Psoriaten dermatocosmetic products in patients with chronic plaque psoriasis. Materials and methods. The study included 67 patients with chronic plaque psoriasis and 32 healthy individuals of a similar age (control group). All patients were examined according to existing standards. The severity of psoriasis was assessed by PASI and BSA indices. The level of anxiety was determined according to the Spielberger scale, the level of neuroticism — according to the L.I. Wasserman scale, the level of depression — according to the Beck scale, the quality of life — according to the Dermatological Life Quality Index (DLQI) and the CQLS integrative index. After the previous standard therapy, patients with chronic plaque psoriasis were divided into two groups. The experimental group included 32 patients who received topical Psoriaten ointment for therapeutic purposes and Psoriaten delicate cleansing gel as a dermatocosmetic skin care product. In case of psoriasis localisation on the scalp, they were additionally prescribed Psoriaten shampoo for 3 months. The control group included 35 patients with psoriasis who did not receive Psoriaten ointment or dermatocosmetic products of the Psoriaten line. Results and discussion. The use of Psoriaten ointment, Psoriaten delicate cleansing gel and Psoriaten shampoo for 3 months ensured a significant decrease in both — BSA index and PASI index in patients with psoriasis, normalization of skin microbiocenosis disorders. Statistically significantly lower situational anxiety, neuroticism and depression and higher life quality were noted in the experimental group, in comparison with the data obtained at enrollment in the study. The obtained data indicate the high effectiveness of combined use of Psoriaten ointment, Psoriaten delicate cleansing gel and Psoriaten shampoo in patients with chronic plaque psoriasis. Conclusions. Psoriasis is accompanied by cutaneous microbiocenosis changes, high personal and situational anxiety, increased neuroticism, tendency to depression and decreased life quality. The use of Psoriaten ointment and products of the Psoriaten dermatocosmetic line in patients with chronic plaque psoriasis is reasonable and appropriate, as it promotes the regression of psoriatic rashes and improves skin microbiocenosis. The results obtained give grounds to recommend the widespread use of Psoriaten ointment and dermatocosmetic products of the Psoriaten line for the treatment of patients with chronic plaque psoriasis, regardless of the standard therapy performed earlier.

Investigating the relationship between cognitive impairment and brain white matter tracts using diffusion tensor imaging in patients with prolactinoma

BackgroundCognitive impairment is known to occur in patients with prolactinoma, but the underlying mechanism is unclear.ObjectiveTo evaluate cognitive function in patients with prolactinoma and to investigate the basis of possible cognitive impairment in brain white matter changes using diffusion tensor imaging (DTI).Methods37 consecutive patients with prolactinoma and 37 healthy controls of similar age, sex, and education were enrolled in the study. Hormone levels were determined in all participants, comprehensive neuropsychological testing was performed, and DTI was used to reconstruct and evaluate white matter tracts.ResultsIn patients with prolactinoma, short- and long-term visual and verbal memory, attention, concentration, and executive and language functions were impaired compared to the healthy group. When comparing the DTI results, lower fractional anisotropy (FA) values were found in the patients’ right uncinate fasciculus (R-UF), indicating neuronal damage. After applying the Bonferroni correction, the two groups had no significant difference in 42 tracts (p > 0.0012 for all). A positive correlation was found between poor FA scores on the R-UF and low scores on long-term memory, category and letter fluency tests. In addition, patients with hypoprolactinemia had the worst short-term memory scores, while normoprolactinemia had the best scores. Also, the poorer R-UF FA values were found in the patients with hypoprolactinemia and the highest in those with normoprolactinemia.ConclusionThis study is the first to investigate reasons for cognitive dysfunction in patients with prolactinoma by DTI. No significant structural changes were found in brain tracts of patients with prolactinoma. Still, there may be a link between potential damage in the R-UF and cognitive dysfunction, and further research is needed. In addition, the results showed that the development of hypoprolactinemia is associated with cognitive dysfunction and emphasized that overtreatment should be avoided.

Birth Trauma: Incidence and Associated Risk Factors: A Case–Control Study

Obstetric trauma refers to injuries that occur to the newborn during the birth process and can occur despite proper perinatal care. Limiting risk factors could reduce its incidence and avoid significant morbidity and mortality to the infant. The aim of our study was to determine the incidence of birth injury in our setting and to discover its associated risks factors. For this case–control study, all births that took place in our center during the year 2021 were systematically reviewed. A total of 231 full-term newborns, with 77 cases and 154 controls, were included. For each case, two controls of similar sex and gestational age, born during the same shift before and after the case were selected. Preterm infants, outborn patients, twins, and infants with major congenital anomalies were excluded. The incidence of birth injury was 22.8‰ of singleton births. The most frequent injuries were cephalohematoma, peripheral facial paralysis, and clavicle fracture. After the adjusted logistic regression analysis, the variables that were independently associated with obstetric trauma were (aOR; 95% CI) breech presentation: 10.6 (1.2, 92.6), p = 0.032; dystocia: 7.8 (3.8, 16.2), p < 0.001; forceps instrumentation: 3.1 (1.0, 9.1), p = 0.043; induced labor: 3.0 (1.6, 5.5), p < 0.001; and newborn birthweight (per each 100 g): 1.1 (1.0, 1.2), p = 0.004. In conclusion, the incidence of birth trauma in our setting was 22.8‰ of singletons. The most frequent injuries were cephalohematoma, peripheral facial paralysis, and clavicle fracture. There was an independent association between birth trauma and breech presentation, dystocia, forceps instrumentation, labor induction, and infant birthweight.

Brain activation patterns in patients with post-stroke cognitive impairment during working memory task: a functional near-infrared spectroscopy study.

To explore the activation patterns in the frontal cortex of patients with post-stroke cognitive impairment during the execution of working memory tasks. 15 patients with post-stroke cognitive impairment, 17 patients without cognitive impairment, and 15 healthy controls of similar age and sex were included. All participants under-went immediate recall task testing and near-infrared spectroscopy imaging to measure frontal cortex activation during the task. The healthy control group performed the best in the immediate recall task, followed by the post-stroke non-cognitive impairment group. The post-stroke cognitive impairment group had the poorest performance. The near-infrared spectroscopy results revealed that during the immediate recall task, the healthy control group primarily activated the left frontal lobe region. In contrast, post-stroke patients exhibited reduced activation in the left frontal lobe and increased activation in the right frontal cortex, particularly in the right frontopolar and orbitofrontal regions, with the post-stroke cognitive impairment group displaying the most pronounced changes. Patients with post-stroke cognitive impairment exhibit reduced activation in the left prefrontal cortex during the working memory tasks. They rely on compensatory activation in the right prefrontal cortex, particularly in the frontopolar and orbitofrontal cortex, to successfully complete the task.

P-377 Understanding the interplay between multiple sclerosis patterns and ovarian reserve, which influences the other?

Abstract Study question Is multiple sclerosis (MS) associated with diminished ovarian reserve in women? Does ovarian reserve influence multiple sclerosis progression patterns? Summary answer AntiMüllerian Hormone (AMH) is not diminished in MS patients compared to healthy matched controls. Ovarian reserve predicts multiple sclerosis patterns independently from chronological age. What is known already Population registries indicate increased childlessness in individuals with MS, but the influence of MS on ovarian reserve and the need for fertility preservation counseling are topics of ongoing debate. Notably, MS research highlights the concept of immunosenescence: with age the disease shifts from high relapse rates to disability accumulation and fewer relapses. It is uncertain whether ovarian aging, assessed through AMH, could serve as a marker of immunosenescence, offering more precise predictions of MS patterns compared to chronological age alone. Study design, size, duration This prospective observational study enrolled all female MS patients aged 18 to 50 presenting to the neurology service between June and November 2023, matching them in a 1:2 ratio with controls of similar age and BMI. The controls were healthy females, without known causes of female infertility. Exclusion criteria were: postmenopausal state, prior neoplasm requiring gonadotoxic therapy or prior hematopoietic stem cell transplantation. Participants/materials, setting, methods The study was conducted in an academic hospital, regional referral for neurology and fertility preservation. Detailed neurological and gynecological anamnesis was collected for 73 patients and 146 controls. AMH measurements were performed by the same laboratory with the Roche Elecsys AMH system. Multiple generalized linear models were carried out to explore the correlation between AMH and neurological data. All results were adjusted for age and use of hormonal contraception. Bonferroni corrected post-hoc analyses were performed. Main results and the role of chance Cases and controls were matched for age (33.6±6.1 vs. 34.4±4.5 years) and BMI (22.3±3.4 vs. 22.2±3.5 Kg/m2). The AMH values were not significantly different between cases and controls (2.7±3.5 vs. 2.7±1.6 ng/ml, p = 0.7) and showed no correlation with MS duration (p = 0.3) and disability measured with EDSS score (p = 0.9). Interestingly, higher AMH levels correlated with both having relapsed in the prior year (yes: 4.9±5.3 vs. no: 1.7±1.6 p = 0.008) and with the number of relapses in the 2 previous years (zero: 1.9±1.8, one: 2.3±2.9, more than 2: 5.8±6.2 ng/ml, p = 0.02). Consequently, patients with “No Evidence of Disease Activity”(NEDA) in the previous year showed lower AMH levels (1.68±1.3 vs. 4.1±4.7 ng/ml, p = 0.01), since absence of relapses is one of the components to define NEDA. In summary, patients with higher ovarian reserve showed a MS pattern typical of young age (higher relapse rates) independently from the actual chronological age. Limitations, reasons for caution The results should be confirmed by larger/multicenter datasets, powered to properly assess the possible influence of the different disease modifying therapies. Further research is warranted to understand the biological link behind the observed results. Wider implications of the findings Ovarian aging, measured through AMH, may provide a better indicator of a patient’s biological age than chronological age only. This may help neurologists in predicting MS patterns and treating it accordingly, providing a unique perspective on the mechanisms that link immunosenescence to the ovarian reserve reduction. Trial registration number Not Applicable

Non-coding RNA NEAT-1 and interleukin-6 as diagnostic indicators for vitiligo

Vitiligo belongs to chronic autoimmune diseases and results in a loss of functioning melanocytes and skin depigmentation. Nuclear enriched abundant transcript 1 (NEAT-1) is a long non-coding RNA that has a vital role in the diagnostics and treatment of certain autoimmune and inflammatory diseases. It is suggested that NEAT-1 can increase the pro-inflammatory cytokine level via regulatory network. The aim of the work was to measure the serum level of NEAT-1 and IL-6 in vitiligo patients compared with healthy controls and to estimate its relation to disease activity. In the study, 60 individuals were enrolled subdivided into 40 vitiligo patients and 20 healthy controls of similar age and gender. NEAT-1 expression was detected by Quantitative real-time PCR, and IL-6 level was measured by ELISA. To assess the severity of the disease Vitiligo area scoring index (VASI) was calculated. Results showed that there was a significant increase in both NEAT-1 and IL-6 levels in vitiligo patients compared with the control group. A positive correlation between NEAT-1 and IL-6 levels­ and a negative correlation between NEAT-1 level and VASI score was revealed. The elevated serum levels­ of NEAT-1 and IL-6 suggest that these circulating biomarkers have promise as diagnostic indicators for vitiligo and possible targets for therapeutic interventions. Keywords: IL-6, NEAT-1, non-coding RNA, serum, vitiligo

Aerodynamic Study of Velopharyngeal Insufficiency in 22q11.2 Deletion Syndrome.

We aim to verify velopharyngeal sphincter function in 22q11.2 deletion syndrome patients (22q11.2DS) to establish correlations between aerodynamic and perceptual measures of nasality, and to identify aerodynamic measures differentiating typical from atypical velopharyngeal behavior. Eleven subjects with 22q11.2DS and twenty similar-age control subjects were recruited. The aerodynamic measures were mean Sound Pressure Level, air pressure peak, pressure wave duration, airflow pattern and nasal airflow during the sequence /pi/. The nasality perceptual measures were rhinolalia, rhinophony and nasal air escape. Airflow patterns and perceptual measures were statistically different in the two groups. Pressure wave duration and air pressure peak were lower in study subjects than in controls. Air pressure peak and nasal airflow were negatively correlated with rhinolalia; pressure wave duration was negatively correlated with nasal air escape and rhinolalia in 22q11.2DS patients. This aerodynamic study identified velopharyngeal qualitative and quantitative dysfunctions, suggesting heterogeneous models of velopharyngeal function in syndromic subjects as compared to controls.

#2240 The complex fluctuation of circulating T follicular cells in patients with lupus nephritis (LN)

Abstract Background and Aims Follicular T (TF) cells constitute a subgroup of cells recently discovered, located in the germinal center (GC) of lymphoid follicles, where they mediate B lymphocyte development, maturation, and antibody production. Meanwhile, T cells with similar markers have also been detected in the peripheral blood, considered as a circulating memory compartment with unknown origin or function. TF cells seem to be implicated in the pathogenesis of systemic lupus erythematosus (SLE) and lupus nephritis (LN) by assisting the selection of high-affinity B cells in germinal centers; nonetheless, research about their circulating regimen is lacking. Herein, we describe the population of circulating TF cells in patients with LN and their association with disease hallmarks. Method Flow cytometry was performed to identify cTF (CD4+CD45RA-CXCR5+) cells and their subsets, defined as cTF1 (CD4+CD45RA-CXCR5+CXCR3+CCR6-), cTF2 (CD4+CD45RA-CXCR5+CXCR3-CCR6-), cTF17 (CD4+CD45RA-CXCR5+CXCR3-CCR6+), and activated-cTF, cTF-ICOS+ (CD4+CD45RA-CXCR5+ICOS+), as well as cTF-Regulatory (cTFR) (CD4+CD45RA-CXCR5+CD127-CD25+FOXP3+). Peripheral blood was collected from 25 LN patients (LN) and 25 healthy controls (HC) of similar age. Results Here are presented preliminary results analyzed in 15 LN patients (age = 38 ± 8yrs) and compared to 9 HC (age = 31.5 ± 7yrs). Although our findings were not significant in total and the percentage and total number of cTFH cells were similar between LN and HC [7.1 (0.6-22.4)% and 52.57 (3.38-412.7)cells/μL, vs. 6.6 (1.9-12.1)% and 45.65 (13.3-69.6)cells/μL, respectively], the fluctuation of the different subsets is interesting. cTF-ICOS+, cTF1, cTF2, and also surprisingly cTFR cells were upregulated in LN compared to HC [0.9 (0-5.2) vs 0.51 (0-1.45)cells/μL, 9.3 (0.2-31.6) vs. 3.02 (0.4-23.08)cells/μL, 10.89 (0-47.41) vs 3.37 (0.46-39.01)cells/μL, and 0.21 (0-12) vs 0.12 (0-1.53) cells/μL, respectively], while the cTF17 compartment was condensed [5.36 (0.79-213.8) vs 8.37 (0.22-29.2)cells/μL, respectively]. Clinical and laboratory markers of the disease were then assessed, resulting in a strong positive correlation of the SLEDAI score with the percentage of cTF2 and cTFR (r = 0.643 and 0.706, respectively) and of C3 levels with cTF percentage (r = 0.663) and cTF-ICOS (+) number (r = 0.719) while the correlation was negative between C4 levels with the percentage of cTF1 (r = −0.577) and cTF2 (r = −582) and between ANA antibody levels and cTF-ICOS (+) cells (r = −657). The analysis did not show any association between the anti-dsDNA antibody levels and the understudied subpopulations. Conclusion cTF cells tend towards 1 and 2 rather than the 17 phenotype in LN. From the various subsets, cTF2 appear to serve as a possible monitoring marker. Certainly, the complexity of the disease imposes further investigation.

Analysing Pre-Operative Gait Patterns Using Inertial Wearable Sensors: An Observational Study of Participants Undergoing Total Hip and Knee Replacement

Background. Knee and hip arthroplasty are two of the most frequently performed procedures in orthopaedic surgery. They are associated with positive patient-reported outcomes and significant improvements in quality of life for patients. Despite this, there may be room for further progress by quantifying functional improvements with gait analysis. Our study therefore aims to characterise the disease-specific gait pattern of participants with knee and hip osteoarthritis undergoing total joint replacement using a single chest-based wearable sensor. Methods. Twenty-nine participants awaiting total hip replacement and 28 participants awaiting total knee replacement underwent three-dimensional motion analysis with inertial wearable sensors. These gait metrics were then compared with 28 healthy controls of similar ages. Differences in gait metrics were evaluated using a T-test. The participants were recruited through a single centre to participate in this cross-sectional observational study. Participants with osteoarthritis severity sufficient to warrant surgical intervention were considered for inclusion in our study. The participants were instructed to walk 15–120 m in a hospital environment while fitted with a chest-based wearable sensor. Results. In total, three domains were evaluated, including spatiotemporal, variability and asymmetry parameters. There were marked variations in the gait asymmetry parameters and step length variation in both the hip and knee osteoarthritis patients compared with the healthy controls. The magnitude of gait deterioration in terms of step length asymmetry was greater on average in the hip osteoarthritis group than the knee group. The hip osteoarthritis (+180%, p < 0.001) and knee osteoarthritis (+129%, p = 0.001) groups demonstrated marked differences in step length asymmetry. Discussion. A single chest-based sensor was found to be capable of detecting pathological gait signatures in osteoarthritis patients when compared with age-matched controls. Future studies should compare pre- and postoperative changes to disease-specific gait impairments to validate the use of wearable sensors as a clinical adjunct.

Assessing the cortical microstructure in contralesional sensorimotor areas after stroke.

Cortical thickness analyses have provided valuable insights into changes in cortical brain structure after stroke and their association with recovery. Across studies though, relationships between cortical structure and function show inconsistent results. Recent developments in diffusion-weighted imaging of the cortex have paved the way to uncover hidden aspects of stroke-related alterations in cortical microstructure, going beyond cortical thickness as a surrogate for cortical macrostructure. Animal data obtained in rats and monkeys have evidenced that contralesional motor areas undergo degenerative alterations in their microstructure which are accompanied by compensatory changes as well. We hypothesized that cortical diffusion imaging can detect similar changes in human stroke survivors. We re-analysed clinical and imaging data of 42 well-recovered chronic stroke patients from two independent cohorts (mean age 64 years, 4 left-handed, 71% male, 16 right-sided strokes) and 33 healthy controls of similar age and gender. Cortical fractional anisotropy, axial diffusivity, radial diffusivity and cortical thickness values were obtained for six key sensorimotor areas of the contralesional hemisphere. The regions included the primary motor cortex, dorsal and ventral premotor cortex, supplementary and pre-supplementary motor areas and primary somatosensory cortex. Linear models were estimated for group comparisons between patients and controls and for correlations between cortical fractional anisotropy, axial diffusivity, radial diffusivity and cortical thickness and clinical scores. Against our hypothesis, we did not find any significant alterations in contralesional cortical microstructure after stroke. Likewise, we did not detect any correlations between cortical microstructure and behavioural scores. Future analyses are warranted to investigate whether such alterations might occur in different populations, e.g. in later stages of recovery, in more severely impaired patients, or only in the ipsilesional hemisphere in patients with specific lesion patterns.

Early-phase insulin secretion during mixed-meal tolerance testing predicts β-cell function and secretory capacity in cystic fibrosis.

Secondary data analysis of CF-focused prospective studies was performed in PwCF categorized as 1) pancreatic insufficient [PI-CF] or 2) pancreatic sufficient [PS-CF] and in 3) non-CF controls. MMTT: insulin secretory rates (ISR) were derived by parametric deconvolution using 2-compartment model of C-peptide kinetics, and incremental area under the curve (AUC) was calculated for 30, 60 and 180-minutes. GPA: acute insulin (AIR) and C-peptide responses (ACR) were calculated as average post-arginine insulin or C-peptide response minus pre-arginine insulin or C-peptide under fasting (AIRarg and ACRarg), ~230 mg/dL (AIRpot and ACRpot), and ~340 mg/dL (AIRmax and ACRmax) hyperglycemic clamp conditions. Relationships of MMTT to GPA parameters were derived using Pearson's correlation coefficient. Predicted values were generated for MMTT ISR and compared to GPA parameters using Bland Altman analysis to assess degree of concordance. 85 PwCF (45 female; 75 PI-CF and 10 PS-CF) median (range) age 23 (6-56) years with BMI 23 (13-34) kg/m2, HbA1c 5.5 (3.8-10.2)%, and FEV1%-predicted 88 (26-125) and 4 non-CF controls of similar age and BMI were included. ISR AUC30min positively correlated with AIRarg (r=0.55), AIRpot (r=0.62), and AIRmax (r=0.46) and with ACRarg (r=0.59), ACRpot (r=0.60), and ACRmax (r=0.51) (all P<0.001). ISR AUC30min strongly predicted AIRarg (concordance=0.86), AIRpot (concordance=0.89), and AIRmax (concordance=0.76) at lower mean GPA values, but underestimated AIRarg, AIRpot, and AIRmax at higher GPA-defined β-cell secretory capacity. Between test agreement was unaltered by adjustment for study group, OGTT glucose category, and BMI. Early-phase insulin secretion during MMTT can accurately predict GPA-derived measures of β-cell function and secretory capacity when functional β-cell mass is reduced. These data can inform future multicenter studies requiring reliable, standardized, and technically feasible testing mechanisms to quantify β-cell function and secretory capacity.

Hippocampal capillary pericytes in post-stroke and vascular dementias and Alzheimer’s disease and experimental chronic cerebral hypoperfusion

Neurovascular unit mural cells called ‘pericytes’ maintain the blood-brain barrier and local cerebral blood flow. Pathological changes in the hippocampus predispose to cognitive impairment and dementia. The role of hippocampal pericytes in dementia is largely unknown. We investigated hippocampal pericytes in 90 post-mortem brains from post-stroke dementia (PSD), vascular dementia (VaD), Alzheimer’s disease (AD), and AD-VaD (Mixed) subjects, and post-stroke non-demented survivors as well as similar age controls. We used collagen IV immunohistochemistry to determine pericyte densities and a mouse model of VaD to validate the effects of chronic cerebral hypoperfusion. Despite increased trends in hippocampal microvascular densities across all dementias, mean pericyte densities were reduced by ~25–40% in PSD, VaD and AD subjects compared to those in controls, which calculated to 14.1 ± 0.7 per mm capillary length, specifically in the cornu ammonis (CA) 1 region (P = 0.01). In mice with chronic bilateral carotid artery occlusion, hippocampal pericyte loss was ~60% relative to controls (P < 0.001). Pericyte densities were correlated with CA1 volumes (r = 0.54, P = 0.006) but not in any other sub-region. However, mice subjected to the full-time environmental enrichment (EE) paradigm showed remarkable attenuation of hippocampal CA1 pericyte loss in tandem with CA1 atrophy. Our results suggest loss of hippocampal microvascular pericytes across common dementias is explained by a vascular aetiology, whilst the EE paradigm offers significant protection.

Knee biomechanics variability before and after total knee arthroplasty: an equality of variance prospective study

This study evaluated gait variability in patients before and after total knee arthroplasty (TKA) using the equality of variance method to determine where variability differences occur in the movement cycle. Twenty-eight patients underwent TKA with cruciate-sacrificed implants. Patients underwent motion analysis which measured knee biomechanics as they walked overground at their preferred pace before and 12 months after TKA. Equality of variance results were compared with 14 healthy controls of similar age. Before surgery, patients had reduced knee extension moment variability throughout the early stance phase (4–21% gait cycle, p < 0.05) compared to controls. Knee power variability was lower preoperatively compared to controls for most of the stance phase (0–13% and 17–60% gait cycle, p < 0.05). Sagittal knee moment and power variability further decreased following TKA. Knee extension moment variability was lower postoperatively throughout stance phase compared to preoperatively (4–22% and 36–60% gait cycle, p < 0.05) and compared to controls (4–30% and 45–60% gait cycle, p < 0.05). Knee power variability remained lower following TKA throughout stance phase compared to preoperatively (10–24% and 36–58% gait cycle, p < 0.05) and controls (3–60% gait cycle, p < 0.05). TKA patients may be less stable, and this may be in part due to an unresolved adaptation developed while awaiting TKA surgery and the cruciate sacrificing design of the implants utilized in this study.

Exercise Stress Testing Enhances Plasma Protein Carbonyl Levels in Patients With Asymptomatic Moderate-to-Severe Aortic Stenosis.

Background: Exercise stress test-induced hypofibrinolysis and changes in circulating levels of several interleukins have been observed in aortic stenosis (AS). However, it is unknown whether the pattern of exercise-induced changes in oxidative stress differs between AS patients and controls and if the differences are associated with changes in fibrinolysis and inflammation. Methods: We studied 32 asymptomatic patients with moderate-to-severe AS and 32 controls of similar age, sex, and body mass index. We assessed plasma protein carbonyl (PC) concentrations, a marker of oxidative stress, in relation to interleukin (IL)-10 and -6 levels and fibrinolysis capacity, expressed as plasma clot lysis time (CLT) at four time points: at baseline, at peak exercise, 1 and 24 h after a symptom-limited exercise test. Results: AS patients had 12.8% and 27% higher PC concentrations 1 and 24 h after exercise than controls (both p < 0.05), with no differences at baseline and peak exercise. In AS patients, PC concentration was 8.3% higher at peak exercise compared to baseline followed by further PC increase (+12.8% at 1 h and +20.5% at 24 h) compared to peak exercise (all p < 0.05). In controls, PC concentrations increased during exercise, reaching the highest values 1 h after exercise (+21.9%). In the AS group, PC concentrations at baseline correlated with AS severity measured as peak transvalvular velocity (V max: r = 0.49, p < 0.05), mean (PGmean: r = 0.42, p < 0.05), and maximal transvalvular pressure gradients (PGmax: r = 0.41, p < 0.05). PC concentrations correlated with IL-10 levels 1 h (r = 0.37, p < 0.05) and 24 h (r = 0.38, p < 0.05) post exercise in AS patients, whereas in controls only at baseline (r = 0.42, p < 0.05). No associations between PC levels and IL-6 or CLT were observed at any time point. Conclusions: Our findings show that AS patients respond differently to exercise in terms of PC compared to controls, which suggests a novel effect of hemodynamic abnormalities in this disease on intensity of oxidative stress.

Prevalence of iron deficiency anaemia in congenital heart disease in children

Background: Congenital heart disease (CHD), out of all congenital anomalies, is the leading condition of mortality and morbidity in children under 5 years of age. Iron deficiency anaemia (IDA) has been clearly shown to be an important risk factor that increases morbidity and mortality in such patients. The present study is thus conducted to find out the prevalence of iron deficiency anaemia in children less than 15 years with congenital heart disease at a tertiary care centre and compare them with cases without CHD. Methods: Prospective study over a period of 2 years, included 60 cases of children below 15 years of age with echocardiographicaly confirmed CHD, investigated by serum ferritin to diagnosed IDA using cut off 12ng/ml. These cases compared with similar age controls. Results: 51cases (82%) were of acyanotic heart disease and 18% were of cyanotic heart disease. Iron deficiency or storage depletion was seen in 90% cases as compared to 75% controls. Iron deficiency anaemia was seen in 55% cases as compared to 30% controls, the difference was statistically significant. Conclusions: Present study observed higher prevalence of IDA among cases with CHD as compared to general population of children. The prevalence was found to be more in cases with cyanotic heart disease as compared to cases with acyanotic heart disease. We thus conclude that routine screening for iron deficiency should be done for these children and those found to be deficient should be treated.

Proximal nailfold videocapillaroscopy findings of patients with idiopathic macular telangiectasia type 2.

Idiopathic macular telangiectasia type 2 (IMT) is a neurodegenerative disease characterized by bilateral, idiopathic, and perifoveal retinal telangiectatic vessel formations. We aimed to compare proximal nailfold videocapillaroscopy (NV) findings between patients with IMT and healthy individuals and evaluate the optical coherence tomography angiography (OCTA) parameters of the patients with IMT according to their NV findings. The study included 43 patients with IMT and 92 healthy controls of similar age and gender without any additional diseases. The OCTA and NV findings of the patients and controls were examined. The mean age was 59.76 ± 5.73 years in the IMT group and 58.23 ± 4.96 years in the control group. Of the 43 patients with IMT, 19 were found to have increased capillary tortuosity, six had microhemorrhage, and 18 had bizarre capillaries (P < 0.001). In the IMT group, the total vascular density value of the superficial capillary plexus was higher among the patients with capillary microhemorrhage (P = 0.001), and the subfoveal choroidal thickness was lower among those with increased capillary tortuosity and bizarre capillaries (P = 0.04 and P = 0.07, respectively). This is the first study in which the NV findings of patients with IMT were compared with those of a control group. We found higher rates of increased capillary tortuosity, microhemorrhage, and bizarre capillaries in the IMT group compared to the controls. We consider that this situation is caused by microvascular damage. We also think that IMT is a systemic disease that affects both proximal nailfold capillaries and eye vessels.