Specific Lesions Research Articles

ID: 200399 Peripheral Brachial Plexus Nerve Stimulation in Coagulopathic Patient Who Responded to Median Nerve Modulation

Through the basis of Gate Control Theory first described by Gate and Melzack (1) as well as the advancement of ultrasound capabilities, Peripheral Nerve Stimulation (PNS) has emerged as a novel treatment modality for a variety of intractable pain conditions resistant to current, first-line therapies. One such condition includes Complex Regional Pain Syndrome (CRPS), which involves non-specific pain that is disproportionate in time or degree to the typical course of a specific trauma or lesion and often includes abnormal sensory, vasomotor, and/or trophic findings with a variable progression over time [2]. Given the challenges often faced by clinicians in treating CRPS, PNS is gaining greater utilization with the goal of decreasing pain and restoring function for patients suffering from this condition.

Placental pathology in pregnancies with late fetal growth restriction and abnormal cerebroplacental ratio

IntroductionLate fetal growth restriction (FGR) is associated with mild growth restriction and normal or mild abnormal doppler flows. The cerebroplacental ratio (CPR) has been demonstrated as more sensitive to hypoxia than its individual components in these fetuses. We hypothesized that abnormal CPR in late FGR is reflected in specific placental vascular malperfusion lesions. MethodsRetrospective cohort study of late FGR newborns between 2012 and 2022 in a tertiary hospital. Overall, 361 cases were included: 104 with pathological CPR (study group), and 257 with normal doppler flows (control group). The primary outcome was a composite of maternal vascular malperfusion lesions (MVM) and fetal vascular malperfusion lesions (FVM). Secondary outcomes were macroscopic placental characteristics and various obstetrical and neonatal outcomes. ResultsThe study group had lower birthweight compared with the normal CPR group (2063.5 ± 470.5 vs. 2351.6 ± 387.4 g. P < 0.0001), higher rates of composite adverse neonatal outcomes (34.2% vs. 22.5%, p < 0.0001), lower mean placental weight (318 ± 71.6 vs. 356.6 ± 76.5 g, p < 0.0001), as well as a higher prevalence of Vascular lesions of MVM (15.3% vs. 5.0%, p = 0.002), villous lesions of FVM (37.5% vs. 24.9%, p = 0.02), and composite FVM lesions (36.5% vs. 25.6%, p = 0.04). On multivariate regression analysis for MVM lesions and composite FVM lesions, abnormal CPR was found as an independent risk factor (aOR 2.17, 95% CI 1.63–4.19, and aOR 1.31, 95% CI 1.09–3.97, respectively). DiscussionsAbnormal CPR in late FGR is reflected in placental histopathologic vascular malperfusion lesions, and the incidence of these lesions is higher than in FGR placentas with normal CPR.

Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke.

Post-stroke depressive symptoms (PSDS) are common and relevant for patient outcome, but their complex pathophysiology is ill understood. It likely involves social, psychological and biological factors. Lesion location is a readily available information in stroke patients, but it is unclear if the neurobiological substrates of PSDS are spatially localized. Building on previous analyses, we sought to determine if PSDS are associated with specific lesion locations, structural disconnection and/or localized functional diaschisis. In a prospective observational study, we examined 270 patients with first-ever stroke with the Hospital Anxiety and Depression Scale (HADS) around 6 months post-stroke. Based on individual lesion locations and the depression subscale of the HADS we performed support vector regression lesion-symptom mapping, structural-disconnection-symptom mapping and functional lesion network-symptom-mapping, in a reanalysis of this previously published cohort to infer structure-function relationships. We found that depressive symptoms were associated with (i) lesions in the right insula, right putamen, inferior frontal gyrus and right amygdala and (ii) structural disconnection in the right temporal lobe. In contrast, we found no association with localized functional diaschisis. In addition, we were unable to confirm a previously described association between depressive symptom load and a network damage score derived from functional disconnection maps. Based on our results, and other recent lesion studies, we see growing evidence for a prominent role of right frontostriatal brain circuits in PSDS.

Racing performance of juvenile Thoroughbreds with femoropatellar osteochondrosis at auction: A retrospective case-control study.

Osteochondrosis dissecans (OCD) is common in the femoropatellar joint in Thoroughbred yearlings for sale at auction and there is no consensus on the effect on racing outcomes. Describe femoropatellar OCD in juvenile Thoroughbreds and compare the racing performance of affected Thoroughbred horses to siblings and unaffected horses from the same sale. Retrospective case-control study of juvenile horses born 2010-2016. Radiographic reports from 27 Thoroughbred auctions of weanling (5-11 months of age) and yearling (12-22 months of age) horses were reviewed to identify femoropatellar OCD. Age and sex of cases and controls were obtained from the sales catalogue. Racing performance was obtained from an online database. Correlation between lesion characteristics and racing performance were assessed using Pearson and Spearman correlations for continuous and ordinal/categorical variables respectively. Racing performance was compared between cases and sibling controls and age- and sex-matched sale number controls from the same sale with Poisson distribution and log link. Significance level of alpha = 0.05 was used. Femoropatellar OCD was identified in 429 horses with North American race records. OCD was present on 519 lateral trochlear ridges and 54 medial trochlear ridges. There were more males in the case group (70%) than in the sibling control group (47%). Case racing performance was compared to 1042 sibling and 757 hip controls. There were significant but small decreases in racing metrics of cases and increases in males for years raced, total starts, starts for 2-5 years of age, total placings, and placings at 2-4 years of age. Analysis of specific lesion metrics revealed weak correlations for performance outcomes (positive and negative) resulting in an inability to draw firm conclusions. Retrospective study where case management was unknown. Femoropatellar OCD in juvenile Thoroughbreds for sale at auction decreases some racing outcomes.

Experimental acute Clostridium perfringens type D enterotoxemia in sheep is not characterized by specific renal lesions.

Type D enterotoxemia, caused by Clostridium perfringens epsilon toxin (ETX), is one of the most economically important clostridial diseases of sheep. Acute type D enterotoxemia is characterized by well-documented lesions in the nervous, cardiocirculatory, and pulmonary systems. However, discrepancies and confusion exist as to whether renal lesions are part of the spectrum of lesions of this condition, which is controversial considering that for many decades it has been colloquially referred to as "pulpy kidney disease." Here, the authors assess renal changes in an experimental model of acute type D enterotoxemia in sheep and evaluate the possible role of ETX in their genesis. Four groups of 6 sheep each were intraduodenally inoculated with either a wild-type virulent C. perfringens type D strain, an etx knockout mutant unable to produce ETX, the etx mutant strain complemented with the wild-type etx gene that regains the ETX toxin production, or sterile culture medium (control group). All sheep were autopsied less than 24 hours after inoculation; none of them developed gross lesions in the kidneys. Ten predefined histologic renal changes were scored in each sheep. The proportion of sheep with microscopic changes and their severity scores did not differ significantly between groups. Mild intratubular medullary hemorrhage was observed in only 2 of the 12 sheep inoculated with the wild-type or etx-complemented bacterial strains, but not in the 12 sheep of the other 2 groups. The authors conclude that no specific gross or histologic renal lesions are observed in sheep with experimental acute type D enterotoxemia.

Cutaneous manifestations in patients with systemic lupus erythematosus: Forms at the beginning of the disease and during follow-up. Retrospective analysis

ObjectivesTo describe skin involvement (SI) in patients with systemic lupus erythematosus (SLE) at onset and during follow-up of the disease and to determine factors associated with SI at lupus diagnosis. Materials and methodsRetrospective, observational, and descriptive study, from a single centre in patients diagnosed with SLE (ACR 1982-97 or SLICC 2012 criteria). The modified Gilliam classification for SI was used. Descriptive statistics and bivariate and multivariate analysis were performed to evaluate the factors associated with SI at diagnosis of the disease. Results149 patients were included, 91.3% women with a median age at diagnosis of 33 years. SI at onset of the disease occurred in 125 patients (83.9%), followed by joint involvement in 120 cases (80.5%). Non-specific skin lesions were more frequent than specific lesions, 92.8% versus 66.4%, respectively. In the bivariate analysis, a longer delay to diagnosis, the presence of joint involvement, a lower presence of thrombocytopenia, and a higher SLEDAI-2K score were associated with the presence of SI at onset of the disease. In the multivariate analysis, the variable that remained independently associated was joint involvement (OR 2.8%–95% CI 1.1–7.5, p: .04). During follow-up, 4/24 patients who had not presented SI at diagnosis and 51/125 patients who had, had at least one new skin flare (range: 1–5 outbreaks). ConclusionsOur study demonstrates the high frequency of skin involvement in SLE, both diagnostically and evolutionarily, and confirms previously reported data regarding the existence of a skin-articular phenotype.

Application of ultrasound in preoperative localization diagnosis of checkrein deformity: A retrospective case series.

Checkrein deformity, is a rare claw toe dynamic deformity of the hallux or great toe. This study investigated the use of diagnostic ultrasound in positioning the accurate injury location causing checkrein deformity and its clinical significance for etiological diagnosis and selection of surgical methods. This retrospective study included patients with confirmed checkrein deformities (according to typical symptoms) at the Department of Traumatic Orthopedics of Tianjin Hospital (Tianjin, China) from March 2017 to July 2021. A total of 11 patients (8 males and 3 females) with a mean age of 36.7 ± 16.8 (range 19-61) were included in this study. The injuries included six cases of tibia and fibula fracture, one case of single tibia fracture, and one case of single fibula fracture. Four patients were treated with steel plate internal fixation, three patients with intramedullary nailing, and one patient with external fixation. Three patients reported no history of any high-energy trauma or surgery. The ultrasound results showed that seven patients suffered from flexor hallucis longus (FHL) lesions, two patients suffered from flexor digitorum longus (FDL) lesions, and two patients suffered from FHL and FDL lesions. The patients underwent different surgeries tailored to their specific lesions. Toe flexion deformity was completely corrected after operation in all patients. The function of the toes was recovered to varying extent. The results of this study demonstrates that the checkrein deformities can be confirmed by ultrasound. It could be used to determine the adhesions before the operation, acting as guidance while establishing the surgical planning.

Pathological changes in Kidney Autops ies from North Maharashtra –A Descriptive Study

Abstract Background: Chronic Kidney disease is a major public health concern. In India, the burden of chronic Kidney disease cannot be assessed properly. In such case autopsy study becomes an indispensible part of Medicine. Aim: To explore the spectrum of changes seen in kidneys and correlating it with clinical findings. Material &amp; Methods: A descriptive study of kidneys of Medico legal autopsies from January 2019 – December 2019 was conducted. A total of 665 Medico legal autopsies were received, in 73 cases kidneys were not received, while 23 kidneys had autolytic change. A total of 569 Kidneys were included in the study. The Gross and Microscopic features along with special stains were studied and the cause of death was noted. Results: A total of 569 kidney autopsies were assessed. On Gross 26% were congested, 13% had contracted granular kidney. On Histopathological examination, Non specific changes were seen in 53.4%, specific nephropathological lesions noted were chronic pyelonephritis (8.9%), acute tubular necrosis (5.6%), sickle cell nephropathy (4.7%), tubercular nephritis (1.2%). Conclusion: Infective etiology was the commonest cause, along with sickle cell nephropathy. It has provided the spectrum of lesions seen in this area along with correlation of cause of death. Screening for diabetes mellitus and hypertension would lead to early detection and timely management which would reduce chronic kidney diseases.

Clinical and Genetic Characteristics of Calvarial Doughnut Lesions with Bone Fragility in Three Families with a Reccurent SGMS2 Gene Variant.

Calvarial doughnut lesions (CDL) with bone fragility with or without spondylometaphyseal dysplasia (MIM: #126550) is a rare autosomal dominant skeletal disorder characterized by low bone mineral density, spinal and peripheral fractures, and specific sclerotic lesions of the cranial bones. In the current classification of skeletal disorders, the disease is included in the group of bone fragility disorders along with osteogenesis imperfecta. The disease is caused by pathogenic variants in the SGMS2 gene, the protein product of which is sphingomyelin synthase 2, which primarily contributes to sphingomyelin (SM) synthesis-the main lipid component of the plasma membrane essential for bone mineralization. To date, 15 patients from eight families with CDL with bone fragility have been described in the literature, and a recurrent variant c.148C>T (p.Arg50Ter) in the SGMS2 gene has been identified, which was found in patients from six families. We diagnosed the disease in 11 more patients from three unrelated families, caused by the same heterozygous nonsense variant c.148C>T (p.Arg50Ter) in the SGMS2 gene. Our results show wide interfamilial and intrafamilial phenotypic variability in patients with a detected recurrent variant in the SGMS2 gene, the presence of which must be taken into consideration in the diagnosis of the disease. The primary analysis of this variant will contribute to optimal molecular genetic diagnostics, which can reduce diagnostic costs and time.

Dose- and dosage-dependent spectrum of respiratory toxicity of cypermethrin in rabbits

Pyrethroids are popular insecticides. Shortness of breath and dyspnea are key signs of exposure; however, their respiratory effects are rarely studied. This study investigated the combination and ratios of specific blood tests and lung lesions as respiratory effects of cypermethrin (CY) in rabbits. The effects of CY at various doses and times are the novelty of this study. Doses (50, 100, and 150 mg.kg-1 body weight) of CY were injected intraperitoneally every week for up to 9 weeks in rabbits assigned into four equal groups. Data analysis revealed various respiratory signs, significantly (p ≤ 0.05) lower fibrinogen, higher neutrophils-lymphocytes (NL), LDH-lymphocytes (LL), and De-Ritis ratios (DR), and lesions in the lungs. The frequency and incidence of these effects were dose and dosage dependent. The CY leads to pulmonary signs and allergic effects. Lung injury increases cell-free heme in plasma, causing pulmonary edema with hemolysis. Emphysema and fibrosis followed the migration of basophils and mononuclear cells to the lungs. This study inferred that CY exposure caused lower fibrinogen, higher NL, LL, and DR ratios, and pulmonary lesions, which forecast poor immunity, especially increased risk for cardiac and lung diseases.

The Writing is on the Wall - Interesting Case of Peduncular Hallucinosis in an Adult Patient (P12-5.006)

<h3>Objective:</h3> Showcase an atypical presentation of peduncular hallucinosis (PH) amenable to vertebral artery stenting. <h3>Background:</h3> PH is a visual hallucination of non-stereotypical and naturalistic images. Although the pathophysiology of PH is unknown, specific brain lesions or neurotransmitter disequilibrium could cause PH. PH is diagnosed clinically however imaging helps rule out structural causes. <h3>Design/Methods:</h3> NA <h3>Results:</h3> 70-year-old man with migraine with an aura of scotoma and strabismus initially presented with hallucination status-post atrial fibrillation ablation. He reported 45 minutes of seeing vivid yellow numbers and colors throughout his vision. Imaging demonstrated no acute infarct. After discharge, he developed recurrent, intermittent, unprovoked, and acephalgic hallucinations of vivid, colorful, and patternless numbers and letters. Though typically brief (1–5 minutes), some lasted an hour. His migrainous auras were different; a pre-cephalgic scotoma and “cellophane” photopsia. Physical examination was unremarkable except baseline strabismus. He returned one week after discharge with acute cervicalgia and vertigo. Head and neck MRA found a chronic occluded right vertebral artery with collateral filling. He was discharged on aspirin, plavix, and a high-intensity statin. Two months later, the patient returned with transient vertigo and right-sided weakness with similar visual hallucinations. MRI brain demonstrated accumulating posterior circulation ischemic stroke burden (acute and subacute infarcts) and CTA redemonstrated right vertebral occlusion but revealed severe short-segment stenosis of the left vertebral artery seen on prior imaging in retrospect, confirmed by digital subtraction angiography. After failure of maximal medical management, he underwent balloon-inflated coronary stenting with no recurrence of hallucinations or transient vascular symptoms despite post-procedural thalamic hemorrhage. <h3>Conclusions:</h3> Due to limited cases and unknown pathophysiology, further research on PH is required to discover the underlying causality and proper treatment. This case highlights an initially overlooked short-segment vertebral artery stenosis that, after failure of maximal medical management, was stented and provided complete relief from hallucination <b>Disclosure:</b> Mr. Suvarna has nothing to disclose. Ms. Shams has nothing to disclose. Dr. Broderick has nothing to disclose.

P164 An emerging role of interferon targeted therapy in mucocutaneous SLE: a prospective real-world evaluation of anifrolumab for refractory cutaneous lupus

Abstract Background/Aims Advances in rational drug design and recent clinical trials are leading to emergence of a range of novel therapies for SLE and therapeutic options in clinical practice are expected to broaden rapidly. The optimal real-world place of emerging and established agents will be guided by understanding their differential efficacy on specific SLE manifestations as well as efficacy for more resistant disease. Anifrolumab, a type-I interferon receptor blocking monoclonal antibody, showed efficacy in SLE in phase III trials with a notable effect on mucocutaneous disease although specific lesion subtypes and chroncicity were not explored. Severe refractory mucocutaneous SLE such as scarring discoid lesions are an important and common clinical challenge in current practice. We therefore prospectively evaluated the real-world efficacy and quality of life impact of anifolumab for active mucocutaneous SLE, recalcitrant to multiple biologic and immunosuppressant therapies. Methods Seven patients commenced anifrolumab (300 mg by monthly iv infusion) following application to the manufacturer’s early access programme (NCT 04750057). Prior biologic therapies were discontinued at least 5 half-lives in advance. Mucocutaneous disease activity was captured by Cutaneous Lupus Disease Area and Severity Index (CLASI) activity score and medical photography. Patient reported health-related quality of life comprising the Dermatology Life Quality Index (DLQI); Lupus-QoL and EQ5D-5L were evaluated at baseline, three and six months. Results Seven female patients with active mucocutaneous SLE (Discoid LE n = 5, chilblain LE n = 1, subacute cutaneous LE n = 1) and median disease duration of 17 years were evaluated. Median baseline CLASI activity score was 17 (range 10-26; higher scores indicating severe disease). Median number of previously failed therapies was 7 and included rituximab in 6/7, belimumab in 2/7 and thalidomide in 4/7. Rapid resolution of scale and erythema in DLE was established within 1 month of anifrolumab treatment. Improvements to chilblain lupus were evident by three months. CLASI activity score was improved ≥75% in all patients at 3 months. Clinical responses were associated with significant improvements in DLQI (p &amp;lt; 0.001) and EQ5D-VAS (p = 0.002) by three months. Lupus-QoL trended toward improvement across all domains but most strongly for fatigue (p = 0.01) and pain (p = 0.002) by 6 months. One patient discontinued treatment after 4 months due to polydermatomal shingles complicated by sensorineural hearing loss. Infection coincided with background prednisolone dose &amp;gt;15 mg daily, recent COVID-19 infection and new on-treatment hypogammaglobulinaemia (IgG &amp;lt;5 g/L). Prolonged aciclovir treatment was required for lesion resolution. Conclusion We report rapid real-world efficacy and quality of life impact of anifrolumab on highly refractory mucocutaneous SLE, which exceeded that anticipated from existing clinical trial data. Findings suggest a unique role for emerging interferon targeting therapies in management of mucocutaneous SLE but emphasize need for enhanced VZV precautions among higher risk patients. Disclosure L. Carter: Consultancies; UCB. Z. Wigston: None. P. Laws: Consultancies; Amgen, Celgene, Janssen, Leo, Lilly and Sanofi. Member of speakers’ bureau; AbbVie, Actelion and BMS. Grants/research support; UCB, Almirall, and Novartis. E.M. Vital: Consultancies; Roche, GSK, AstraZeneca, Aurinia Pharmaceuticals, Lilly and Novartis. Grants/research support; Roche, AstraZeneca and Sandoz.

Laser interstitial thermal therapy (LITT) for pediatric patients affected by intracranial tumors.

The surgical treatment of brain tumors has evolved over time, offering different strategies tailored to patients and their specific lesions. Among these strategies, Laser Interstitial Thermal Therapy (LITT) is one of the most recent advances in pediatric neurooncological surgery, and its results and evolution are still under assessment. We retrospectively analyzed data from six pediatric patients with deep-seated brain tumors treated with LITT at a single center between November 2019 and June 2022. A total of four patients underwent a stereotaxic biopsy during the same operating session. The indications and preparation for LITT, technical issues, clinical and radiological follow-up, impact on quality of life, and oncological treatment are discussed. The mean patient age eight years (ranging from 2 to 11 years). The lesion was thalamic in four patients, thalamo-peduncular in one, and occipital posterior periventricular in one. In total, two patients had been previously diagnosed with low-grade glioma (LGG). Biopsies revealed LGG in two patients, ganglioglioma grade I in one, and diffuse high-grade glioma (HGG) in one. Postoperatively, two patients presented with transient motor deficits. The mean follow-up period was 17 months (ranging from 5 to 32 months). Radiological follow-up showed a progressive reduction of the tumor in patients with LGG. Laser interstitial thermal therapy is a promising, minimally invasive treatment for deep-seated tumors in children. The results of lesion reduction appear to be relevant in LGGs and continue over time. It can be used as an alternative treatment for tumors located at sites that are difficult to access surgically or where other standard treatment options have failed.

Factors associated with increased duration of endoscopic submucosal dissection for rectal tumors: a 22-year retrospective analysis

Colorectal endoscopic submucosal dissection (ESD) is widely used in several countries. However, it is associated with technical difficulties. Rectal ESD is considered an intermediate step in colorectal ESD training. Nevertheless, some rectal lesions require a longer procedure time than usual, and the reason for the prolonged time taken for these specific lesions remains unclear. Therefore, this study aimed to clarify the factors associated with prolonged rectal ESD. In total, 483 rectal lesions resected using ESD from February 1998 to June 2021 were investigated. Prolonged ESD procedure time was defined as the time from the first submucosal injection to lesion removal exceeding 120 minutes, whereas other procedures were defined as average ESD procedure time. Clinicopathologic and endoscopic findings were compared between the 2 groups using univariate and multivariate analyses. One hundred forty-four lesions were resected using a prolonged ESD procedure time of 202.9 ± 92.3 minutes, whereas 339 lesions were resected using an average ESD procedure time of 77.8 ± 29.4 minutes. Multivariate analysis revealed that tumors involving the dentate line (P= .026), resection size≥50mm (P< .001), invasion depth≥T1b (P= .006), and circumferential range≥2/3 (P= .001) were independent risk factors for prolonged-duration ESDs, regardless of whether the procedure was performed by an expert or not. The results of the present study suggest that the location of a lesion involving the dentate line, resection size≥50mm, circumferential range≥2/3, and invasion depth≥T1b are the independent risk factors for prolonged ESD procedure time.

Red Sea Bream Iridovirus Kinetics, Tissue Tropism, and Interspecies Horizontal Transmission in Flathead Grey Mullets (Mugil cephalus).

Red sea bream iridovirus (RSIV) causes significant economic losses in the aquaculture industry. We analyzed the pathogenicity of RSIV in flathead grey mullets (Mugil cephalus), the correlation of histopathological lesions, and interspecies horizontal transmission, through immersion infection and cohabitation challenges. Flathead grey mullets, which were challenged by immersion infection, exhibited mortality at 14 and 24 days after RSIV exposure. Viral shedding in seawater peaked 2-3 days before or after the observed mortality. Specific lesions of RSIV were observed in the spleen and kidney, and the correlation between histopathological grade and viral load was the highest in the spleen. In a cohabitation challenge, flathead grey mullets were the donors, and healthy rock bream, red sea bream, and flathead grey mullets were the recipients. Viral shedding in seawater was the highest in flathead grey mullet and rock bream at 25 °C, with 106.0 RSIV copies L/g at 14 dpi. No mortality was observed in any group challenged at 15 °C, and no RSIV was detected in seawater after 30 dpi. The virus shed from RSIV-infected flathead grey mullets caused horizontal transmission through seawater. These findings suggest that rapid decision-making is warranted when managing disease in fish farms.

89Zr-DFO-Isatuximab for CD38-Targeted ImmunoPET Imaging of Multiple Myeloma and Lymphomas.

Multiple myeloma (MM) is the second most prevalent hematological malignancy. It remains incurable despite the availability of novel therapeutic approaches, marking an urgent need for new agents for noninvasive targeted imaging of MM lesions. CD38 has proven to be an excellent biomarker due to its high expression in aberrant lymphoid and myeloid cells relative to normal cell populations. Using isatuximab (Sanofi), the latest FDA-approved CD38-targeting antibody, we have developed Zirconium-89(89Zr)-labeled isatuximab as a novel immunoPET tracer for the in vivo delineation of MM and evaluated the extension of its applicability to lymphomas. In vitro studies validated the high binding affinity and specificity of 89Zr-DFO-isatuximab for CD38. PET imaging demonstrated the high performance of 89Zr-DFO-isatuximab as a targeted imaging agent to delineate tumor burden in disseminated models of MM and Burkitt's lymphoma. Ex vivo biodistribution studies confirmed that high accumulations of the tracer in bone marrow and bone skeleton correspond to specific disease lesions as they are reduced to background in blocking and healthy controls. This work demonstrates the promise of 89Zr-DFO-isatuximab as an immunoPET tracer for CD38-targeted imaging of MM and certain lymphomas. More importantly, its potential as an alternative to 89Zr-DFO-daratumumab holds great clinical relevance.

Skin involvement in systemic lupus erythematosus: a review article

Cutaneous disease is one of the most frequent manifestations of systemic lupus erythematosus (SLE), being classified as LE-specific and LE-nonspecific. LE-specific skin lesions are divided into acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE) and chronic cutaneous lupus erythematosus (CCLE). The association with systemic involvement varies between each clinical subtype, with non-specific lesions being more frequent associated with active SLE than cutaneous specific lesions. The treatment consists of topical agents (glucocorticoids, topical calcineurin inhibitors) as well as systemic therapies (glucocorticoids, hydroxychloroquine, quinacrine, methotrexate, retinoids, dapsone, mycophenolate mofetil or even biologics). In the presence of strictly cutaneous involvement, periodic patient follow-up and monitoring for the progression to systemic disease remains an important mission for the dermatologist and the rheumatologist.

Impact of Red Sea Bream Iridovirus Infection on Rock Bream (Oplegnathus fasciatus) and Other Fish Species: A Study of Horizontal Transmission.

Red sea bream iridovirus (RSIV) causes significant economic losses in aquaculture. Here, we analyzed the pathogenicity, viral shedding, and transmission dynamics of RSIV in rock bream (Oplegnathus fasciatus) by employing immersion infection and cohabitation challenge models. Rock bream challenged by immersion exposure exhibited 100% mortality within 35 days post RSIV exposure, indicating that the viral shedding in seawater peaked after mortality. At 25 °C, a positive correlation between the viral loads within infected rock bream and virus shedding into the seawater was observed. Specific RSIV lesions were observed in the spleen and kidney of the infected rock bream, and the viral load in the spleen had the highest correlation with the histopathological grade. A cohabitation challenge mimicking the natural transmission conditions was performed to assess the virus transmission and determine the pathogenicity and viral load. The RSIV-infected rock breams (donors) were cohabited with uninfected rock bream, red sea bream (Pagrus major), and flathead grey mullet (Mugil cephalus) (recipients) at both 25 °C and 15 °C. In the cohabitation challenge group maintained at 15 °C, no mortality was observed across all experimental groups. However, RSIV was detected in both seawater and the recipient fish. Our results provide preliminary data for further epidemiological analyses and aid in the development of preventive measures and management of RSIVD in aquaculture.

The Ventral Tegmental Area (VTA), the Nucleus Accumbens (NAc), the Caudate Nucleus (CN) and the Prefrontal Cortex (PFC) role in the Response to Acute and Chronic Methylphenidate

Methylphenidate (MPD) is psychostimulant, similar to cocaine and amphetamine, that is commonly used to treat attention deficit hyperactivity disorder and is increasingly being abused by healthy subjects for its psychoactive effects such as memory retention cognitive enhancement for young, adult and the elderly and recreation. MPD’s action on the brain reward/motive circuit is still under investigation, however it is known that in animals chronic use of MPD leads to behavioral sensitization, an experimental indicator associated with dependence. To investigate this neural circuit’s role in response to acute and chronic MPD, three different lesions (non-specific, dopaminergic specific, and glutaminergic specific lesions) have been conducted at the nucleus accumbens (NAc), the ventral tegmental area (VTA), the caudate nucleus (CN), and the prefrontal cortex (PFC), to assess the structure, dopaminergic signaling, and glutaminergic signaling roles in response to MPD. The three types of lesions show that each one of the above four brain areas participate differently in the acute and chronic effect of MPD and have helped determine which type of signaling is critical for the acute and/or chronic behavioral adaptions to MPD.

Head-to-head comparison of [68Ga]Ga-PSMA-11 and [18F]FDG PET/CT in multiple myeloma.

The aim of this study was to compare [18F]FDG and [68Ga]Ga-PSMA-11 PET/CT image findings in patients with multiple myeloma (MM). Twenty consecutive patients with symptomatic biopsy-proven MM were submitted to whole body[18F]FDG and [68Ga]Ga-PSMA-11 PET/CT with a time interval of 1-8days between procedures. All lesions were counted and had their maximum SUV (SUVmax) measured. Intra-class correlation (ICC) was used to assess the agreement between [18F]FDG and [68Ga]Ga-PSMA-11 PET/CT findings. A total of 266 lesions were detected in 19/20 patients. [18F]FDG detected 223/266 (84%) lesions in 17 patients and [68Ga]Ga-PSMA-11 190/266 (71%) lesions in 19 patients. Both procedures did not identify any active lesion in 1 patient. Forty-three (16%) lesions were detected only by [68Ga]Ga-PSMA-11 and 76 (29%) only by [18F]FDG. Both tracers identified 147 (55%) lesions. Intralesional mismatch of FDG-PSMA uptake was identified in 25 of these 147 lesions, found in 8 different patients. Different lesions with uptake of only [18F]FDG or [68Ga]Ga-PSMA-11 in the same patient were found in 4 patients. The highest SUVmax of [18F]FDG and [68Ga]Ga-PSMA-11 had a median (min-max) SUVmax of 6.5 (2.0-37.8) and 5.5 (1.7-51.3), respectively. [18F]FDG and [68Ga]Ga-PSMA-11 respectively identified 18 and 19 soft tissue lesions. False-positive [18F]FDG findings had minimal or no uptake of [68Ga]Ga-PSMA-11. Good reliability (ICC ≥ 0.75) was found for number of lesions, number of soft tissue lesions and highest SUVmax in each patient. [18F]FDG or [68Ga]Ga-PSMA-11 alone can detect most MM lesions. Almost half of the lesions take up only one of the tracers, reflecting increased glycolysis or angiogenesis in specific lesions, and suggesting their possible complementary role in MM. The marked [68Ga]Ga-PSMA-11 uptake in some cases raises the possibility of a theranostic approach in selected patients.