Systemic Inflammation In Patients Research Articles

The connection of vitamin D with biomarkers of systemic inflammation in patients with COVID-19

The connection of vitamin D with biomarkers of systemic inflammation in patients with COVID-19

BDMARD can prevent the progression of AA amyloidosis to end-stage renal disease.

AA amyloidosis (AA) can be the consequence of any chronic inflammatory disease. AA is associated with chronic inflammatory diseases (cid+AA), autoinflammatory syndromes (auto+AA) or AA of unknown origin or idiopathic AA (idio+AA). The major organ manifestation is renal AA that can progress to end-stage renal disease (ESRD) and multiple organ failure. This study is a monocentric retrospective analysis of the renal outcome and survival of patients with cid+AA (n=34), auto+AA (n=24) and idio+AA (n=25) who were treated with cytokine-inhibiting biological disease-modifying antirheumatic drugs (bDMARDs). 83 patients with renal AA were identified and followed for a mean observational period of 4.82 years. C reactive protein (CRP), serum amyloid alpha and proteinuria were significantly reduced with bDMARD therapy. Progression to ESRD was prevented in 60% (cid+AA), 88% (auto+AA) and 81% (idio+AA) of patients. Tocilizumab was given to 34 patients with cid+AA and idio+AA and was more effective in reducing CRP and progression to ESRD and death compared with other bDMARDs. bDMARDs reduce systemic inflammation in various diseases, leading to a reduction of proteinuria and prevention of ESRD. Importantly, tocilizumab was more effective than other bDMARDs in controlling systemic inflammation in patients with chronic inflammatory diseases and idiopathic AA, leading to better renal and overall survival.

Cognitive behavioral and mindfulness with daily exercise intervention is associated with changes in intestinal microbial taxa and systemic inflammation in patients with Crohn’s disease

ABSTRACT Crohn’s disease (CD) is a chronic inflammatory bowel disease associated with psychological distress and intestinal microbial changes. Here, we examined whether a 3-month period of Cognitive Behavioral and Mindfulness with Daily Exercise (COBMINDEX) intervention, which improves the wellbeing and inflammatory state of CD patients, may also affect their gut microbiome. Gut microbiota, circulating inflammatory markers and hormones were analyzed in 24 CD patients before (T1) and after 3 months of COBMINDEX (T2), and in 25 age- and sex-matched wait-list control patients at the corresponding time-points. Microbiota analysis examined relative taxonomical abundance, alpha and beta diversity, and microbiome correlations with inflammatory and psychological parameters. At T1, CD patients exhibited a characteristic microbial profile mainly constituted of Proteobacteria (17.71%), Firmicutes (65.56%), Actinobacteria (8.46%) and Bacteroidetes (6.24%). Baseline bacterial abundances showed significant correlations with psychological markers of distress and with IFN γ . Following COBMINDEX, no significant changes in alpha and beta diversity were observed between both study groups, though a trend change in beta diversity was noted. Significant changes occurred in the abundance of phyla, families and genera only among the COBMINDEX group. Furthermore, abundance of phyla, families and genera that were altered following COBMNIDEX, significantly correlated with levels of cytokines and psychological parameters. Our results demonstrated that a short-term intervention of COBMINDEX was associated with changes in microbial indices, some of which are linked to psychological manifestations and systemic inflammation in CD patients. Psychological interventions to reduce chronic stress, such as COBMINDEX, appear to be beneficial in mitigating the pathobiology of CD patients, and may thus provide a useful adjunct to pharmacological therapy.

Salivary CRP predicts treatment response to virtual reality exposure therapy for social anxiety disorder

BackgroundSocial anxiety disorder (SAD) places a profound burden on public health and individual wellbeing. Systemic inflammation may be important to the onset and maintenance of SAD, and anti-inflammatory treatments have shown promise in relieving symptoms of SAD. In the present study, we conducted secondary analyses on data from a randomized clinical trial to determine whether C-reactive protein (CRP) concentrations and social anxiety symptoms decreased over the course of virtual reality exposure therapy, and whether changes in social anxiety symptoms as a function of treatment varied as a function of CRP. MethodAdult participants (N = 78) with a diagnosis of SAD (59 % female) were randomized to receive exposure therapy alone, or exposure therapy supplemented with scopolamine. Social anxiety symptoms, salivary CRP, and subjective units of distress were measured across three exposure therapy sessions, at a post-treatment extinction retest, and at a 1-month follow-up. ResultsCRP decreased over the course of treatment, b = −0.03 (SE = 0.01), p =.02 95 %CI [−0.06, −0.004], as did all social anxiety symptom domains and subjective distress. Higher CRP was associated with greater decreases from pre-treatment to 1-month follow-up in fear, b = −0.45 (SE = 0.15), p =.004 95 %CI [−0.74, −0.15], and avoidance, b = −0.62 (SE = 0.19), p =.002 95 %CI [−1.01, −0.23], and in-session subjective distress from pre-treatment to post-treatment, b = −0.42 (SE = 0.21), p =.05 95 %CI [−0.83, −0.001]. However, declines in CRP were not correlated with declines in fear, r = −0.07, p =.61, or avoidance, r = −0.10, p =.49, within-persons. ConclusionsVirtual reality exposure therapy may be associated with an improvement in systemic inflammation in patients with severe SAD. Pre-treatment CRP may also be of value in predicting which patients stand to benefit the most from this treatment.

Indoor and ambient black carbon and fine particulate matter associations with blood biomarkers in COPD patients

BackgroundSystemic inflammation contributes to cardiovascular risk and chronic obstructive pulmonary disease (COPD) pathophysiology. Associations between systemic inflammation and exposure to ambient fine particulate matter (PM ≤ 2.5 μm diameter; PM2.5), and black carbon (BC), a PM2.5 component attributable to traffic and other sources of combustion, infiltrating indoors are not well described. MethodsBetween 2012 and 2017, COPD patients completed in-home air sampling over one-week intervals, up to four times (seasonally), followed by measurement of plasma biomarkers of systemic inflammation, C-reactive protein (CRP) and interleukin-6 (IL-6), and endothelial activation, soluble vascular adhesion molecule-1 (sVCAM-1). Ambient PM2.5, BC and sulfur were measured at a central site. The ratio of indoor/ambient sulfur in PM2.5, a surrogate for fine particle infiltration, was used to estimate indoor BC and PM2.5 of ambient origin. Linear mixed effects regression with a random intercept for each participant was used to assess associations between indoor and indoor of ambient origin PM2.5 and BC with each biomarker. Results144 participants resulting in 482 observations were included in the analysis. There were significant positive associations between indoor BC and indoor BC of ambient origin with CRP [%-increase per interquartile range (IQR);95 % CI (13.2 %;5.2–21.8 and 11.4 %;1.7–22.1, respectively)]. Associations with indoor PM2.5 and indoor PM2.5 of ambient origin were weaker. There were no associations with IL-6 or sVCAM-1. ConclusionsIn homes of patients with COPD without major sources of combustion, indoor BC is mainly attributable to the infiltration of ambient sources of combustion indoors. Indoor BC of ambient origin is associated with increases in systemic inflammation in patients with COPD, even when staying indoors.

Changes in indicators of local and systemic inflammation in patients with uncomplicated diverticular disease in combination with obesity

Changes in indicators of local and systemic inflammation in patients with uncomplicated diverticular disease in combination with obesity

The prognostic role of markers of systemic inflammation in patients with metastatic lung cancer receiving immunotherapy: A comprehensive review of the literature

Lung carcinoma stands as a prevalent malignancy characterized by a distressingly elevated fatality rate. Immunotherapy, administered either as a monotherapy or together with chemotherapy, represents the primary therapeutic approach for the majority of individuals grappling with advanced non-small cell lung cancer. The influence of systemic inflammation in fostering cancer dissemination and progression is a well-documented phenomenon. This literature review examines contemporary indices and scoring systems, which have emerged as informative indicators of systemic inflammation in recent years. These indices and scores are valuable prognostic and predictive elements in assessing treatment response among patients with metastatic lung cancer undergoing immunotherapeutic treatment.

Expression of Inflammation Depending on the Stage of Cervical Cancer.

Background and Objectives: Cervical cancer (CC) remains a major public health problem, ranking as the fourth most common cause of cancer incidence and mortality in women globally. The development of CC is believed to be closely related to chronic inflammation. Thus, we aimed to evaluate the expression of systemic inflammation in patients with CC and to determine the threshold prognostic value of the systemic inflammation markers for CC and its advanced stage. Materials and Methods: 182 participants were recruited: 94 histology-proven patient with CC and 88 healthy women with NILM confirmed by liquid-based cytology test. The pre-treatment serum concentrations of cytokines, including IFN-β, IFN-γ, IL-1β, IL-2, IL-6, IL-10, IL-12p70, LCN2, TREM-1, and TNF-α, were determined for all study patients. Results: The odds ratio (OR) of having IL-6 concentration >17.4 pg/mL in the CC group compared to control patients was 11.4 (95% CI: 4.897-26.684); that of having TREM-1 concentration >355.6 pg/mL was 5.9 (95% CI: 2.257-15.767); and that of having LCN2 concentration >23,721.5 pg/mL was 3.4 (95% CI: 1.455-8.166). The odds ratio (OR) of having IL-6 concentration >28.7 pg/mL in advanced-stage CC (III-IV stage) compared to early-stage CC (I-II stage) was 2.921 (95% CI: 1.06-8.045), and that of having LCN2 concentration >25,640.0 pg/mL was 4.815 (95% CI: 1.78-13.026). Conclusions: The pre-treatment serum inflammation markers IL-6, TREM-1, and LCN2 at specified levels could be used as predictors of cervical cancer, and IL-6 and LCN2 as predictors of an increased chance of advanced-stage (III-IV stages) cervical cancer. Patients with cervical cancer had expressed systemic inflammation, and expression of inflammation elevated the chance of having CC and advanced-stage disease.

Effect of fractional exhaled carbon monoxide on patients with sleep apnea-hypopnea syndrome and its mechanism.

Sleep-disordered breathing (SDB) is a common sleep disorder as-sociated with chronic airway inflammation and lung function impairment. This article aimed to investigate the fractional exhaled carbon monoxide (FeCO) expression level in obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with disease indicators. Subjects with OSAHS, asthma, chronic obstructive pulmonary disease (COPD), and healthy subjects were selected to collect clinical data. FeCO concentration, eosinophil (Eos), erythrocyte sed-imentation rate (ESR), C-reactive protein (CRP), FEV1, and FEV1/FVC were measured. The Pearson correlation coefficient and receiver operating charac-teristic (ROC) curve were used for statistical analysis. The FeCO concentra-tion, Eos count, ESR and CRP levels, and lung function in the OSAHS group were higher than the healthy and COPD groups (p<0.05) and slightly lower than the asthma group. FeCO was positively correlated with Eos, ESR, and CRP (p<0.05), but there was no apparent correlation between FeCO and lung func-tion. FeCO has a high sensitivity and specificity in the diagnosis of OSAHS. There is chronic airway inflammation and systemic inflammation in patients with OSAHS. Lung function impairment in patients with OSAHS is mild, but some limitations remain. FeCO may be an auxiliary diagnostic index particu-larly valuable in diagnosing OSAHS.

Periodontitis and postoperative inflammation in gastric cancer patients: Propensity score analysis.

The objective of this study was to clarify the association between preoperative periodontitis and postoperative systemic inflammation in patients with gastric cancer. This retrospective cohort study analyzed data from 140 gastric cancer patients who underwent surgery at Hiroshima University Hospital between May 2019 and May 2022. Periodontal inflamed surface area (PISA) scores were determined to assess periodontitis severity using modified Nesse's methods. Propensity score matching was used to compare patients with high and low PISA scores (> or < the median PISA score of 92.4, respectively). Propensity scores were calculated using a logistic regression model, based on 17 clinical parameters: age, sex, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia, cardiovascular disease, stroke, clinical stage, surgical procedure, surgical approach, neoadjuvant chemotherapy, surgery duration, blood loss during surgery, remaining teeth, and denture use. Thirty-seven patients were propensity-score-matched. Participants with high PISA scores had a higher incidence of surgical site infection (10.5%) than those with low PISA scores (5.3%). Moreover, participants with high PISA scores had significantly higher C-reactive protein levels on postoperative days 1 than those with low PISA scores. Preoperative periodontitis may determine the level of postoperative systemic inflammation in patients with gastric cancer.

Retraction: prognostic effect of systemic inflammation in patients undergoing surgery for hepatocellular carcinoma: comparison of composite ratios and cumulative scores.

[This retracts the article DOI: 10.21037/tcr-20-2089.].

Cytokine profile and markers of fat metabolism in bronchial asthma patients with obesity and multimorbidity

BACKGROUND: The number of people with multimorbidity has been steadily increasing in recent years. In patients with bronchial asthma, the level of control and cytokine profile with markers of fat metabolism may depend on body mass index and the presence of multimorbidity.&#x0D; AIM: To assess the relationships of disease control level, cytokine profile, adiponectins and oxidant stress level in asthma patients depending on body mass index and multimorbidity&#x0D; MATERIALS AND METHODS: Patients with asthma (n = 237) were divided into 3 groups depending on body mass index. We analyzed multimorbid pathology, assessed asthma control according to Asthma Control Questionnaire-5; determined interleukin-6, -4, resistin, tumor necrosis factor-alpha, degree of oxidative damage to biomolecules, antioxidant capacity of serum, leptin, adiponectin levels. Statistical analysis: Microsoft Excel, Statistica 12.0, Statgraphics XVIII.&#x0D; RESULTS: There were significantly more (p 0.05) comorbidities among the obese and asthma patients. The levels of leptin, resistin, interleukin-6, tumor necrosis factor-alpha, and degree of oxidative damage to biomolecules were significantly higher in the obese group. Direct correlations were found between body mass index, cumulative pathology rating scale, Asthma Control Questionnaire-5 and interleukin-6, tumor necrosis factor-alpha, degree of oxidative damage to biomolecules, leptin, and resistin control levels of asthma. An inverse correlation with adiponectin was detected with body mass index.&#x0D; CONCLUSIONS: Authentic increase of adipokins and anti-inflammatory cytokines, oxidative stress indexes and decrease of anti-inflammatory effects of adiponectin are noted in patients with asthma and obese patients. Multimorbidity further contributes to the development of systemic inflammation in patients with asthma. Obesity and multimorbidity are factors complicating the achievement of asthma control.

Abstract 16734: Patterns of Inflammatory Activation in Cardiovascular Disease: Insights From the Randomized Colchicine PCI Trial

INTRODUCTION: Recent studies demonstrate that neutrophils accumulate in atherosclerotic lesions and that neutrophil counts correlate with disease severity. The randomized double-blind Colchicine-PCI study demonstrated that colchicine attenuated systemic inflammation (IL-6, CRP) after percutaneous coronary intervention compared with placebo. GOALS/AIMS: We characterized neutrophil activity in patients across a spectrum of cardiovascular phenotypes, including severity of coronary artery disease (CAD) and presentation of acute myocardial infarct (AMI). METHODS: The Colchicine-PCI biomarker sub-study enrolled 478 participants with pretreatment assessment of inflammatory biomarkers. White blood cell count and differential were performed using a hematology analyzer. Soluble markers of neutrophil activity, including neutrophil extracellular traps (NETs), and systemic inflammation were assessed using multiplex assays. Neutrophil surface markers of activity and neutrophil platelet aggregates were assessed using an Accuri C6 flow cytometer. RESULTS: We observed neutrophil concentration, adhesion, transmigration, and activation, as well as increased NETs complexes; but no difference in extent of neutrophil platelet aggregation or systemic inflammation in patients with versus without obstructive CAD. Conversely, in patients with versus without AMI, neutrophil markers of adhesion and transmigration did not differ, but systemic markers of inflammation and neutrophil activation were elevated. CONCLUSION: This single-site, prospective study is the largest neutrophil biorepository in patients with cardiovascular risk factors. Inflammatory activation, and particularly neutrophil profiles, differ in patients with obstructive CAD and in the setting of AMI.

P10-2 Prognostic value of systemic inflammation in patients undergoing 1st-line chemotherapy for metastatic pancreatic cancer: Tokushukai REAl-world Data project

P10-2 Prognostic value of systemic inflammation in patients undergoing 1st-line chemotherapy for metastatic pancreatic cancer: Tokushukai REAl-world Data project

Gamma-glutamyl transpeptidase and indirect bilirubin may participate in systemic inflammation of patients with psoriatic arthritis

BackgroundPrevious studies have suggested that systemic metabolic abnormalities are closely related to psoriatic arthritis (PsA). Gamma-glutamyl transpeptidase (GGT) and indirect bilirubin (IBIL), two essential active substances in hepatic metabolism that have been demonstrated as an oxidative and anti-oxidative factor respectively, have been proved to be involved in oxidative stress damage and inflammation in several human diseases. However, their role in PsA remains unclear.MethodsIn this retrospective comparative cohort study, a case group of 68 PsA patients and a control group of 73 healthy volunteers from the Third Hospital of Hebei Medical University were enrolled. Serum GGT, IBIL, GGT/IBIL ratio and C-reactive protein (CRP), a well applied bio-marker of systemic inflammatory in PsA, were compared between the two groups. Furthermore, the relationship of GGT, IBIL and GGT/IBIL with CRP were explored in PsA patients. Finally, the patients were divided into high inflammation group and low inflammation group according to the median value of CRP. Multivariate logistic regression analyses were used for the association of systemic inflammation level with GGT, IBIL and GGT/IBIL.ResultsCompared with healthy controls, PsA patients exhibited significantly higher serum GGT, GGT/IBIL, and CRP levels and lower IBIL levels. Serum GGT and GGT/IBIL were positively correlated with CRP, whereas IBIL were negatively correlated with CRP. Binary logistic regression analysis revealed that serum GGT was a risk factor for high CRP in PsA, whereas IBIL was a protective factor. Furthermore, GGT/IBIL was a better indicator of high CRP condition in PsA patients than either GGT or IBIL alone, as determined by the receiver operating characteristic curves.ConclusionGGT and IBIL may participate in the pathogenesis of PsA. Additionally, GGT, IBIL and the balance of the two may reflect systemic inflammation mediated by oxidative stress events related to metabolic abnormalities to a certain extent.

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in the Patients with Euthyroid Hashimoto's Thyroiditis.

This study aimed to compare the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) values in patients with euthyroid Hashimoto's thyroiditis (HT) with healthy control subjects. This was a single-center, retrospective, cross-sectional study conducted on obese patients aged 18 years and over. The medical records of patients who presented with complaints of being overweight at the obesity clinic between April 2017 and May 2019 were examined. Patients and healthy individuals were included in the study consecutively until the sample sizes reached saturation. Patients with diabetes, cardiovascular disease, chronic inflammatory disease, and malignancy were excluded from the study. The patients' anthropometric measurements, smoking status, blood examination, and thyroid ultrasounds were evaluated. The difference in means between the groups was calculated using the Mann-Whitney U test. The study included 179 participants, consisting of 93 patients and 86 healthy controls. The mean age was 46.6±14.1 years, with most females (91.6%). Although the NLR and PLR values in patients were higher than those in the control group, the difference did not reach statistical significance (p=0.427 and p=0.089, respectively). Furthermore, no significant difference was observed in NLR (p=0.191) and PLR (p=0.668) values between levothyroxine-treated and untreated patients. Correlation analysis revealed weak positive associations between C-reactive protein and thyroid peroxidase antibodies (p<0.05), neutrophils (p<0.01), platelets (p<0.01), and NLR (p<0.05). The findings of this study suggest that NLR and PLR may not serve as effective indicators of systemic inflammation in patients with euthyroid HT, nor do they adequately assess the impact of levothyroxine usage on systemic inflammation.

A-384 Laboratory Evaluation of the SeptiCyte Rapid Host Response Assay In Differentiating Infection-Positive Versus Infection-Negative Systemic Inflammation Patients Suspected of Sepsis

Abstract Background Early diagnosis of sepsis is critical for timely treatment but remains challenging. A rapid host response assay, SeptiCyte, was recently approved by the FDA for aiding early differentiation of infection-positive from infection-negative systemic inflammation in patients suspected of sepsis. This test is a fully automated reverse transcription polymerase chain reaction (RT-qPCR) assay that quantifies changes in the expression of two host immune response genes and results are available in about 1 hour. The present study aimed to evaluate the SeptiCyte assay performance in a clinical setting at a large medical center. Methods Eighty-two patients admitted to the University Hospitals Cleveland Medical Center with suspected sepsis from July to September 2022 were included in the study. SeptiCyte samples were obtained at the time of initial evaluation. In addition, healthy donor blood samples and extracted RNA samples were also utilized for assay validation. The SeptiCyte assay was performed according to the manufacturer's instructions using multi-chambered fluidic cartridges and the Idylla Console (Immunexpress, Seattle, WA). The assay result was reported as the SeptiScore (range 0–15), a calculated ratio of the expression of two host immune response genes, and the SeptiCyte band (ranging from 1 to 4, with 1 indicating the lowest risk of sepsis and 4 indicating the highest risk). The assay cutoff values are 5.0, 6.2 and 7.4 respectively for the band 2, 3 and 4. Results Intra- and inter-assay precision was 0.2–6.2% and 0–3.2%, respectively. % Recovery at the cutoff for band 3 (SeptiScore 6.0) was 102.4% with a CV of 2.4%. Method comparison with the Immunexpress lab demonstrated equivalent performance, as evidenced by a slope of 0.99 and an intercept of 0.27 by Deming regression. SeptiScore showed a weak positive correlation with CRP (Correlation Coefficient 0.389, P &amp;lt; 0.01) but no association with procalcitonin (n = 76), lactate (n = 78), international normalized ratio (INR), platelet, neutrophil, lymphocyte, or white blood cell (WBC) count (n = 82). CRP (n = 71) median concentration in patients with band 4 (16.8) was significantly higher than in patients who were band 1 (3.6). The SeptiScore of blood culture positive cases (n = 22) was 7.2 ± 2.0 (mean ± SD) and that of pathogen negative non-sepsis (by sepsis retrospective review of event only, n = 10) cases was 5.6 ± 1.6 (P &amp;lt; 0.05). In addition, the median SeptiScore was notably higher in patients with viral infection compared to those without infection (9.2 vs 6.2, P &amp;lt; 0.05). Further analysis showed 92% (11/12) of patients with hematologic cancer were categorized as band 4 including one non-sepsis case per the retrospective review. SeptiScore was similar between patients with non-hematologic cancer and those without malignancy (P &amp;gt; 0.05). Conclusion The SeptiCyte RAPID assay showed good analytical performance. SeptiScore represents an independent factor to quantify host response in patients suspected of sepsis. It may add value in aiding differentiation between infection-positive from infection-negative systemic inflammation with promising results in patients with viral infections or those with positive blood cultures. The negative predictive value of low SeptiScore within band 1 or 2 may need further investigation.

24-hour blood pressure profile and systemic inflammation in patients with stable coronary artery disease with obstructive sleep apnea

 Aim. To evaluate 24-hour blood pressure (BP) profile and systemic inflammation in patients with coronary artery disease (CAD) depending on the presence of obstructive sleep apnea (OSA).Material and methods. This cross-sectional cohort study included 132 patients with CAD aged 62,3±6,9 years. Depending on OSA, all patients were divided into 2 groups: group 1 (n=60) — without OSA, group 2 (n=72) — with OSA. Systemic inflammation was assessed using neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), Systemic immune-inflammation index (SII) — platelets´neutrophils/lymphocytes. Blood pressure was monitored with assessment of average daily values, circadian rhythm, and variability.Results. Patients with OSA had higher nighttime blood pressure values (p&lt;0,05) and 24-hour variability (p&lt;0,05). In group 2 patients, a pathological blood pressure profile was detected in 66,7% of cases, while in group 1 — in 36,7%. The systemic inflammation indices were significantly higher in patients with OSA than in the group without OSA — NLR by 18,8% (p&lt;0,01), PLR by 22,5% (p&lt;0,01), MLR by 19,0% (p&lt;0,01), SII by 41,0% (p&lt;0,001).Conclusion. We established that patients with coronary artery disease and OSA have more pronounced systemic inflammation, more often have a pathological 24-hour BP profile ("non-dipper", "night-peaker"), BP variability, higher values of average 24-hour, daytime and nighttime BP compared with patients without OSA.

The Role of FDG-PET in the Evaluation of Hidradenitis Suppurativa: A Systematic Review.

Hidradenitis suppurativa (HS) is a chronic skin disorder characterized by nodules, comedones, and sinus tracts that often leave prominent scarring. In recent years, non-invasive imaging techniques have been used to assess the inflammatory activity, vascularization, and treatment response of lesions. Specifically, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans may aid in identifying systemic inflammation in patients with HS, improving diagnosis. Inflamed hypermetabolic tissues exhibit a greater uptake of FDG due to increased glucose uptake and vascularity. A systematic review was conducted to summarize the utility of nuclear imaging techniques in the diagnosis and treatment follow-up of HS. PubMed, Scopus, and ScienceDirect databases were utilized for relevant articles discussing the utility of PET scans in managing HS. A total of 51 citations were identified in the initial search. Following the review of titles, abstracts, and duplicates, 43 articles were excluded, leaving a total of eight articles for analysis. Data were extracted from each article, encompassing the number of patients, imaging techniques employed, and final results. An analysis of the data demonstrated that FDG-PET showed evidence of identifying subclinical lesions of the disease, improving the visualization of HS, and providing an objective method of assessing severity.

Early Neuromuscular Electrical Stimulation Preserves Muscle Size and Quality and Maintains Systemic Levels of Signaling Mediators of Muscle Growth and Inflammation in Patients with Traumatic Brain Injury: A Randomized Clinical Trial.

To investigate the effects of an early neuromuscular electrical stimulation (NMES) protocol on muscle quality and size as well as signaling mediators of muscle growth and systemic inflammation in patients with traumatic brain injury (TBI). Two-arm, single-blinded, parallel-group, randomized, controlled trial with a blinded assessment. Setting. Trauma intensive care unit at a university hospital. Participants. Forty consecutive patients on mechanical ventilation (MV) secondary to TBI were prospectively recruited within the first 24 hours following admission. Interventions. The intervention group (NMES; n = 20) received a daily session of NMES on the rectus femoris muscle for five consecutive days (55 min/each session). The control group (n = 20) received usual care. Main Outcome Measures. Muscle echogenicity and thickness were evaluated by ultrasonography. A daily blood sample was collected to assess circulating levels of insulin-like growth factor I (IGF-I), inflammatory cytokines, and matrix metalloproteinases (MMP). Both groups were similar at baseline. A smaller change in muscle echogenicity and thickness (difference between Day 1 and Day 7) was found in the control group compared to the NMES group (29.9 ± 2.1 vs. 3.0 ± 1.2, p < 0.001; -0.79 ± 0.12 vs. -0.01 ± 0.06, p < 0.001, respectively). Circulating levels of IGF-I, pro-inflammatory cytokines (IFN-y), and MMP were similar between groups. An early NMES protocol can preserve muscle size and quality and maintain systemic levels of signaling mediators of muscle growth and inflammation in patients with TBI. This trial is registered with https://www.ensaiosclinicos.gov.br under number RBR-2db.