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Objetivos: evaluar si los pacientes con lupus eritematoso sistémico (LES) al momento del diagnóstico con baja actividad de la enfermedad presentaron un curso más benigno de la enfermedad vs. aquellos que tuvieron actividad moderada/severa. Materiales y métodos: estudio observacional, analítico, de cohorte retrospectiva. Se revisaron historias clínicas de pacientes con diagnóstico de LES según criterios del American College of Rheumatology (ACR 1982/1997), del Systemic Lupus International Collaborating Clinics (SLICC 2012) o del ACR/European League Against Rheumatism (EULAR 2019), con un seguimiento mínimo de un año, que acudieron a la Sección de Reumatología del Hospital Rivadavia de la Ciudad Autónoma de Buenos Aires. Resultados: se incluyeron 100 pacientes con diagnóstico de LES, de los cuales el 44% presentaba actividad leve, mientras que el 56% tenía actividad moderada o severa al diagnóstico. Se observaron diferencias estadísticamente significativas entre ambos grupos en la cantidad de brotes a lo largo de la evolución de la enfermedad (mediana del grupo con actividad leve 0 (RIC 0-1) vs. mediana del grupo actividad moderada o severa 1 (RIC 1-2); p<0,01). Se detectó un menor compromiso de órganos durante la evolución de la enfermedad en aquellos con actividad basal leve en comparación con actividad basal moderada/severa, con diferencias estadísticamente significativas en el compromiso renal (15,91% vs. 55,36%; p<0,01). Conclusiones: los pacientes con actividad basal baja tuvieron un curso más benigno de la enfermedad y una menor cantidad de brotes severos, en comparación con quienes presentaron actividad moderada/severa al inicio de la enfermedad.
Objectives: to assess whether patients with systemic lupus erythematosus (SLE) and low disease activity at the time of diagnosis have a more benign course of the disease vs those who have moderate/severe activity at the time of diagnosis. Materials and methods: observational, analytical, retrospective cohort study. Clinical records of patients diagnosed with SLE according to ACR 1982/1997 Criteria, SLICC 2012 or ACR/EULAR 2019, who attended the Rheumatology Section of Rivadavia hospital in CABA, Argentina, were reviewed. Results: a total of 100 patients diagnosed with SLE were included, of which 44% had mild activity, while the remaining 56% had moderate or severe activity at diagnosis. Statistically significant differences were observed between the group that had mild baseline activity vs the group that presented moderate/severe baseline activity, with the first group presenting fewer flares throughout the course of the disease (median of the first group 0 (IQR 0-1) vs median of the second, 1 (IQR 1-2); p<0.01). Less organ involvement was observed throughout the course of the disease in those with mild baseline activity compared with moderate/severe baseline activity, with statistically significant differences in renal involvement (15.91% versus 55.36%; p<0.01). Conclusions: patients with low baseline activity had a more benign disease course, presenting fewer severe flares compared to patients who presented moderate to severe activity at disease onset.
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Abstract Background: Vasculitis damage index (VDI) is a validated damage index for systemic vasculitis, and as Behçet's disease is considered one of systemic vascular disease we aimed to study the relationship of the vasculitis damage index to clinical manifestations and comorbidity in patients with Behçet's disease (BD) to determine if VDI could be used to assess damage in patients with BD. Methods: A total of 109 patients with BD were recruited from the Rheumatology Department (outpatient and inpatient clinic), Cairo University Hospitals. All patients were subjected to full history taking, clinical examination, and routine laboratory investigations. Disease activity was assessed by the BD current activity form, and the VDI was calculated in all patients. The relationship of the VDI to the disease clinical manifestations was studied. Mann-Whitney and Kruskal Wallis tests were used to estimate differences in quantitative variables. Spearman correlation test was used to test for correlation between quantitative variables. Results: In the current study, the VDI ranged from 1 to 10, with a mean of 3.5 ± 1.8. It was significantly associated with total thrombosis (P = 0.022); total neurological manifestations (P = 0.000), especially stroke and cranial nerve affection; uveitis (P = 0.005); avascular necrosis (AVN) (P = 0.015); osteoporosis (P = 0.01); impaired vision (P < 0.0001); cataract (P < 0.0001); and diabetes (P = 0.012). Generally, immunosuppressive treatment was significantly associated with VDI (P = 0.039), especially cyclophosphamide (P < 0.0001), biological agent (P = 0.008), chlorambucil (P = 0.003), and anticoagulant (P = 0.02). VDI was also significantly correlated with age (P = 0.033), disease duration (P = 0.029), and duration of eye involvement (P = 0.003). Conclusion: VDI is significantly associated with most disease parameters of BD, except for parameters such as mucocutaneous manifestations and uncomplicated venous thrombosis; however, further studies may be needed to establish BD-specific damage index.
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T cell-mediated rejection (TCMR) is one of the main mechanisms of rejection in organ transplantation, which is also the most common type of acute rejection.Based on Banff classification on allograft pathology (Banff classification) in 2019, TCMR can be divided into acute TCMR (aTCMR) and chronic active TCMR (caTCMR) according to the characteristics of immune lesions.In this article, the basic definition of TCMR, the research progress on TCMR pathology according to Banff classification for renal allograft, and the basic pathological changes and diagnostic grading of TCMR were reviewed, aiming to provide evidence for early identification, diagnosis and treatment of TCMR and prevent the progression of TCMR into caTCMR, thereby guarantying the long-term survival of both the renal allograft and recipient.
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Introducción: El minador de hojas de tomate, Tuta absoluta (Meyrick), la plaga más peligrosa para la producción de tomate, Solanum lycopersicum L., en todo el mundo; puede causar pérdidas totales y es difícil de controlar. Por lo tanto, comprender la dinámica de sus poblaciones en el cultivo es una prioridad para mitigar el daño. Objetivo: Aquí, los parámetros de la población de T. absoluta fueron evaluados en tomate var. Sonero en invernadero, en tres sistemas de gestión (comercial, población máxima y control total). Métodos: Durante 25 semanas en La Unión, Antioquia, Colombia, se aplicaron modelos matemáticos para describir las poblaciones de larvas y adultos (machos) en el tiempo, en relación con los parámetros de producción y las pérdidas asociadas. Resultados: La tasa de crecimiento intrínseco fue de 0.4466 larvas por semana. Los modelos gaussianos y exponenciales describieron mejor a la población en el tiempo. Las pérdidas se asociaron con el peso y la cantidad de frutos comercializables, y también con el peso total de producción y la cantidad de racimos y frutos totales. Conclusión: Las larvas de T. absoluta tienen un crecimiento exponencial en invernadero ventilado, con una tasa de crecimiento intrínseca menor que la calculada por las tablas de vida en el laboratorio.
Introduction: The tomato leafminer, Tuta absoluta (Meyrick), the most threatening pest for tomato, Solanum lycopersicum L., production worldwide, may cause total losses, and is difficult to control. Thus, understanding its populations dynamic in the crop is a priority to mitigate damage. Objective: Herein, population parameters of T. absoluta were evaluated in tomato var. Sonero in the greenhouse, in three management systems (commercial, maximum population and total control). Methods: During 25 weeks in La Union, Antioquia, Colombia, mathematical models were applied to describe the populations of larvae and adults (males) in time, as related to production parameters and associated losses. Results: The intrinsic growth rate was 0.447 larvae per week. The Gaussian and exponential models described best the population over time. The losses were associated with weight and number of marketable fruits, and with total production weight, and number of clusters and total fruits. Conclusion: T. absoluta larvae have growth exponentially in a ventilated greenhouse, with a smaller intrinsic growth rate than that calculated by life tables in the laboratory.
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Objective To explore urinary NAG,Cr,MA,α1-MG andβ2-MG as the early renal damage index in children hydronephrosis.Methods The clinical data of 206 patients in the Bayi Children's Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital from May 2018 to January 2019 were analyzed retrospectively.Among them,152 children with hydronephrosis were set as observation group,54 children without hydronephrosis were set as control group.In the observation group,the age ranged from 1 month to 18 years old,and the median age was 2 years old.There were 123 cases of hydronephrosis caused by ureteropelvic junction obstruction (UPJO) and 29 cases of posterior urethral valve complicated with hydronephrosis.In the control group,the age ranged from 1 month to 15 years old,with a median age of 5 years.There were 18 hypospadias cases,15 occult penis cases and 21 phimosis.All children with hydronephrosis underwent nuclear medicine renal dynamic imaging.Urine specimens were tested for urinary NAG,Cr,MA,α1-MG,and β2-MG.According to renal dynamic results,the observed components were the renal function injury group and the normal renal function group.The above indicators analyzed to judge the clinical value to find the early renal damage.Results The expression levels of urinary NAG,MA,α1-MG and β2-MG in the observation group were higher than those in the control group,and the difference was statistically significant.The expression of urinary Cr and the abnormal rate were no significant difference between any two groups(P =0.647,P =0.572).The expression levels of urinary NAG,MA,α1-MG and β2-MG were not significantly different between the normal renal hydronephrosis group and the renal function impairment group (P =0.365,P =0.448,P =0.379,P =0.338).The abnormal expression rate of Urine MA and β2-MG was not statistically significant in the patients with normal renal hydronephrosis and the renal function impairment group (P =0.436,P =0.478).MA got the highest sensitivity of (58.8％),and NAG had the highest specificity of 89.3％ to detect early renal demage.Four indexes combined analysis,sensitivity,negative predictive rate,diagnostic coincidence rate improved obviously.Joint analysis of posterior urethral valves combined with hydronephrosis,the abnormal rate was 89.7％ (26/29).The renal dysfunction of the posterior urethral valve showed that the renal dynamics dysfunction rate was only 37.9％ (11/29).Conclusions The combined analysis of urinary NAG,MA,α1-MG and β2-MG can accurately predict early renal injury.The index of early renal loss may be the early evidence to judge whether the posterior urethral valve is complicated with upper urinary tract function injury.
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Objective@#To explore urinary NAG, Cr, MA, α1-MG andβ2-MG as the early renal damage index in children hydronephrosis.@*Methods@#The clinical data of 206 patients in the Bayi Children′s Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital from May 2018 to January 2019 were analyzed retrospectively. Among them, 152 children with hydronephrosis were set as observation group, 54 children without hydronephrosis were set as control group. In the observation group, the age ranged from 1 month to 18 years old, and the median age was 2 years old. There were 123 cases of hydronephrosis caused by ureteropelvic junction obstruction (UPJO) and 29 cases of posterior urethral valve complicated with hydronephrosis. In the control group, the age ranged from 1 month to 15 years old, with a median age of 5 years. There were 18 hypospadias cases, 15 occult penis cases and 21 phimosis. All children with hydronephrosis underwent nuclear medicine renal dynamic imaging. Urine specimens were tested for urinary NAG, Cr, MA, α1-MG, and β2-MG. According to renal dynamic results, the observed components were the renal function injury group and the normal renal function group. The above indicators analyzed to judge the clinical value to find the early renal damage.@*Results@#The expression levels of urinary NAG, MA, α1-MG and β2-MG in the observation group were higher than those in the control group, and the difference was statistically significant. The expression of urinary Cr and the abnormal rate were no significant difference between any two groups(P=0.647, P=0.572). The expression levels of urinary NAG, MA, α1-MG and β2-MG were not significantly different between the normal renal hydronephrosis group and the renal function impairment group (P=0.365, P=0.448, P=0.379, P=0.338). The abnormal expression rate of Urine MA and β2-MG was not statistically significant in the patients with normal renal hydronephrosis and the renal function impairment group (P=0.436, P=0.478). MA got the highest sensitivity of (58.8%), and NAG had the highest specificity of 89.3% to detect early renal demage. Four indexes combined analysis, sensitivity, negative predictive rate, diagnostic coincidence rate improved obviously. Joint analysis of posterior urethral valves combined with hydronephrosis, the abnormal rate was 89.7%(26/29). The renal dysfunction of the posterior urethral valve showed that the renal dynamics dysfunction rate was only 37.9%(11/29).@*Conclusions@#The combined analysis of urinary NAG, MA, α1-MG and β2-MG can accurately predict early renal injury. The index of early renal loss may be the early evidence to judge whether the posterior urethral valve is complicated with upper urinary tract function injury.
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PURPOSE: The aim of this study was to identify the associations among physical activity, disease activity, and organ damage in patients with systemic lupus erythematosus (SLE). MATERIALS AND METHODS: A total of 415 patients with SLE were consecutively enrolled from the KORean lupus Network (KORNET) registry. This registry assessed clinical features, disease activity [Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K)], and organ damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI)] upon enrollment in the study. Self-reported physical activity was measured by the International Physical Activity Questionnaire. Statistical analyses were conducted using the Mann-Whitney U test and multivariate logistic regression analysis. RESULTS: A significant difference in vigorous activity was noted between patients with lupus nephritis (LN) (n=93) and those without LN (n=322) (p=0.012), but not in moderate and walking activities. In contrast, no differences in physical activity, walking, moderate, and vigorous intensity, according to SLEDAI-2K and SDI were found. In addition to younger age (p=0.032), high physical component summary of SF-36 (p=0.004) and SLEDAI-2K (p=0.038), and less vigorous physical activity were associated with LN (p=0.024). However, cardiovascular disease was not associated with physical activity in SLE patients. CONCLUSION: This study showed that patients with LN had less vigorous physical activity than patients without LN. The results suggest that lupus nephritis might be associated with physical activity.
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Humans , Cardiovascular Diseases , Logistic Models , Lupus Erythematosus, Systemic , Lupus Nephritis , Motor Activity , Rheumatology , WalkingABSTRACT
Objective To evaluate the tonic and health effects of Xuebijing injection,a traditional Chinese medicine injection,by means of corn low-nutritional mice model combined with benefit-damage index-general score (BDI-GS) evaluation system under a physiological dosage.Further,to investigate the scientific and practical benefits of the evaluation system in efficacy and safety re-evaluation of clinical traditional Chinese medicine injections.Methods Healthy ICR mice during growth period were randomly divided into blank control group and low,middle and high dose groups.All the mice were fed with corn diets,and treated by intraperitoneal injection once a day.The mice in the blank control group were injected with 0.4 ml 0.9％ sodium chloride injection,and the mice in the low,medium and high dose groups were injected with 0.2,0.4 and 0.6 ml Xuebijing injection,respectively,for seven days.On the 8th day,the mice were killed,dissected,and took nine kinds of organs including heart,lung,thymus,spleen,pancreas,kidney,gonad and femur.The weight BDI,index BDI and the corresponding weight BDI general score (GSw) and index BDI general score (GSI) were calculated,and the serum biochemical parameters were measured.Results Under the physiological dose,Xuebijing injection shows good safety of continuous infusion,tonic and health effects,and slight damages on the rest of organs.More specifically,the values of weight BDI and index BDI were all higher than 9.0,and values of GSw and GSI were all higher than the basic value of 9.0.Furthermore,these parameters increased in a dose-dependent manner.In addition,the total protein level of (47.6 ± 4.30) g/L in the high dose groups was significantly higher than (43.18 ± 2.60) g/L in the blank control group (P＜0.05).Conclusions The Xuebijing injection has a lower risk for conventional usage.This injection is safe under the physiological dosage and much safer in higher dosage designed in this study.The low-nutritional model combined with BDI-GS evaluation system can be used for re-evaluating the function and safety of clinical traditional Chinese medicine injections.
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Objective To evaluate the tonic and health effects of Xuebijing injection,a traditional Chinese medicine injection,by means of corn low-nutritional mice model combined with benefit-damage index-general score (BDI-GS) evaluation system under a physiological dosage.Further,to investigate the scientific and practical benefits of the evaluation system in efficacy and safety re-evaluation of clinical traditional Chinese medicine injections.Methods Healthy ICR mice during growth period were randomly divided into blank control group and low,middle and high dose groups.All the mice were fed with corn diets,and treated by intraperitoneal injection once a day.The mice in the blank control group were injected with 0.4 ml 0.9％ sodium chloride injection,and the mice in the low,medium and high dose groups were injected with 0.2,0.4 and 0.6 ml Xuebijing injection,respectively,for seven days.On the 8th day,the mice were killed,dissected,and took nine kinds of organs including heart,lung,thymus,spleen,pancreas,kidney,gonad and femur.The weight BDI,index BDI and the corresponding weight BDI general score (GSw) and index BDI general score (GSI) were calculated,and the serum biochemical parameters were measured.Results Under the physiological dose,Xuebijing injection shows good safety of continuous infusion,tonic and health effects,and slight damages on the rest of organs.More specifically,the values of weight BDI and index BDI were all higher than 9.0,and values of GSw and GSI were all higher than the basic value of 9.0.Furthermore,these parameters increased in a dose-dependent manner.In addition,the total protein level of (47.6 ± 4.30) g/L in the high dose groups was significantly higher than (43.18 ± 2.60) g/L in the blank control group (P＜0.05).Conclusions The Xuebijing injection has a lower risk for conventional usage.This injection is safe under the physiological dosage and much safer in higher dosage designed in this study.The low-nutritional model combined with BDI-GS evaluation system can be used for re-evaluating the function and safety of clinical traditional Chinese medicine injections.
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Objective To explore the impacts of Danhong injection on physiological and biochemical indicators in malnourished mice at physiological low doses, evaluate its safety, and test the practical value of safety re-evaluation of Traditional Chinese Medicinal ( TCM) injections. Methods A total of 32 ICR mice during growth period were selected to set up corn deficient nutrition mice model. Mice were assigned into the normal control group (given 0. 9% saline), Danhong injection at low, medium and high dosages (0. 2, 0. 4 and 0. 6 mL) groups (n=8 in each group);Mice were administered with respective medications intraperitoneally for 7 consecutive days. Blood samples were taken and mice were executed on the 8th day. All 9 kinds of organ or tissue were obtained completely, to measure related physiological and serum biochemical parameters. The safety of Danhong injection was evaluated by using Benefit and Damage Index - General Score ( BDI-GS ) system. Results The Danhong injection showed only slight damages on major organs or tissues, the BDI values were all above 0. 85, and the GS values were all above 9. 0;BDI values for Danhong injection at different dosages were all above 1. 0 for spleen and pancreas, showing better replenishing and healthy effects, and the differences were of statistical significance compared with the normal control group (P<0. 05 or P<0. 01). Meanwhile, it exerted obviously hypoglycemic effect. Conclusion Danhong injection is of rather low risk under physiological dosages, and therefore is safe to use. The mal-nutrition model combined with the BDI-GS system may be developed as a novel approach for safety re-evaluation of TCM injection in clinic.
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Objective To conduct the comparative comprehensive evaluation on the actual healthy effects and safety of two kinds of healthy foods capsule A and B made of Chinese medicinal herbs on sale through the low-nutritional sub-health mice model com-bined with the benefit-damage index-general score(BDI-GS) approach ,and to perform the discussion on the relevant problems a-round healthy foods .Methods The experimental healthy ICR male mice during growth period were fed with maize low-nutritional feed and the mixed feed with 3 doses of 0 .25% ,0 .5% ,0 .75% healthy foods for 12 d and the mice body masses were recorded .Af-ter dissection ,9 items of the organ index and their BDI ,GS and serum biochemical indicators were performed the statistics .Results In the capsule A ,the medium and high dose groups manifested certain health-promoting effect ,while the slight negative effect exis-ted in the low dose group ,which was expressed in the GS values ;but in the capsule B ,3 doses all caused the damage to main internal organs in different degrees ,which was expressed in BDI<1 .0 and GS<9 .0 .Conclusion At present ,despite of possessing similar ingredients ,Chinese medicinal healthy foods in market are of greater differences in intrinsic qualities ,and even partial products have some adverse effect ,the healthy functions and safety are not enough to be fully ensured .Through the systematic evaluation of the BDI-GS system ,the criteria of marketing threshold for healthy foods will be increased so as to enhance their effects and safety level .
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A major problem in renal transplantation is identifying a grading system that can predict long-term graft survival. The present study determined the extent to which the two existing grading systems (Banff 97 and chronic allograft damage index, CADI) correlate with each other and with graft loss. A total of 161 transplant patient biopsies with chronic allograft nephropathy (CAN) were studied. The samples were coded and evaluated blindly by two pathologists using the two grading systems. Logistic regression analyses were used to evaluate the best predictor index for renal allograft loss. Patients with higher Banff 97 and CADI scores had higher rates of graft loss. Moreover, these measures also correlated with worse renal function and higher proteinuria levels at the time of CAN diagnosis. Logistic regression analyses showed that the use of angiotensin-converting enzyme inhibitor (ACEI), hepatitis C virus (HCV), tubular atrophy, and the use of mycophenolate mofetil (MMF) were associated with graft loss in the CADI, while the use of ACEI, HCV, moderate interstitial fibrosis and tubular atrophy and the use of MMF were associated in the Banff 97 index. Although Banff 97 and CADI analyze different parameters in different renal compartments, only some isolated parameters correlated with graft loss. This suggests that we need to review the CAN grading systems in order to devise a system that includes all parameters able to predict long-term graft survival, including chronic glomerulopathy, glomerular sclerosis, vascular changes, and severity of chronic interstitial fibrosis and tubular atrophy.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Graft Survival , Graft Rejection/pathology , Kidney Transplantation , Kidney/pathology , Severity of Illness Index , Biopsy , Chronic Disease , Logistic Models , Predictive Value of Tests , Retrospective Studies , Young AdultABSTRACT
OBJECTIVE: This study was designed to identify the risk factors associated with seizure attack in patients with systemic lupus erythematosus (SLE) and to propose the usefulness of them as predictive factors for seizure attack. METHODS: One hundred patients with SLE were included in this study. Twenty-five of these patients had seizure attacks during the course of their disease and age-, sex-matched 75 patients who did not have seizure were control group. We compared clinical manifestations and laboratory findings between the two groups. Seizures not related to SLE were excluded. RESULTS: Risk factors associated with seizure attack in SLE were high damage index at initial presentation and the presence of anticardiolipin antibody IgG regardless of its titer. Underlying illness other than SLE, duration of SLE, presence of previous organic brain abnormality, SLEDAI at initial presentation, clinical manifestations of SLE, laboratory findings (including hematologic, immunologic parameters and known laboratory activity indices) and medications before seizure attack were not significantly associated with seizure attack. Recurred seizure was not associated with any of these factors. CONCLUSION: High damage index at initial presentation and the presence of anticardiolipin antibody IgG were associated with seizure attacks in patients with SLE. These factors may be used as predictive factor for seizure attack in SLE.