Reliability and Agreement of Point and 2-D Shear-Wave Elastography in Assessing the Sciatic Nerve Stiffness.

Information is lacking about the reliability and agreement of different shear-wave elastographic modes in the peripheral nervous system evaluation. The aim of this observational study was to evaluate reproducibility and agreement of two different shear-wave elastographic modes for measuring the sciatic nerve stiffness in patients affected by osteoarthrosis. Two sets of three measurements were conducted bilaterally on the sciatic nerve of 20 patients with point and 2-D shear-wave elastography by a unique expert sonographer. This consecutive case series study was performed in 1 mo. No significant difference was found comparing the first with the second set of evaluations (p = 0.08 for point shear-wave elastography and 0.3 for 2-D shear-wave elastography). Correlation between the two sets of measurements was good and excellent (0.799 with point shear-wave elastography and 0.877 with 2-D shear-wave elastography). Intra-class coefficient correlation between the two sets of measurements was excellent for both shear-wave elastographic modes (0.869 and 0.938, respectively); no agreement between them was demonstrated (analysis of variance [ANOVA] test: p = 0.014).Despite the lack of agreement owing to the different procedures for measuring, both shear-wave elastographic modes allow reliable stiffness measurements of the sciatic nerve and may be used to evaluate stiffness changes.

Five-year-term results in cirrhotics without varices, either affected or not by portal hypertensive gastropathy.

OBJECTIVES: Information is lacking on the appearance of varices in cirrhotics, either affected or not by portal hypertensive gastropathy (PHG). We assessed whether the absence or presence and the grade of PHG influenced the development of varices in cirrhotics without varices over time. PATIENTS AND METHODS: Forty cirrhotics without varices affected or not by PHG at baseline underwent follow-up endoscopy after 5 years. One-tailed t-test and the χ-test were used to evaluate variable comparison and the presence of associations. Multivariate logistic regression analysis and the analysis of variance test were carried out to compare the variables and identify predictors of varices. RESULTS: The Child-Pugh score at baseline and after 5 years was significantly different (5.72±0.98 vs. 6.25±1.67, P<0.001). After 5 years, 10 (25%) cirrhotics were affected by varices, whereas 30 (75%) patients remained without varices. PHG was associated significantly with varices (P=0.001), proving to be a significant predictive independent factor for their development over time (F=4.765, significant=0.004; analysis of variance test, P<0.001). CONCLUSION: A link between the duration of PHG and the development of varices is likely. An early therapeutic management of PHG might delay the development of varices in cirrhotics.

Differences in carotid atherosclerosis between patients with ankylosing spondylitis treated with tumor necrosis factor-α antagonists and healthy matched controls.

An increased vascular risk is present in patients with ankylosing spondylitis (AS). In this report, we evaluate the presence and grade of atherosclerosis in patients with AS, uninterruptedly treated with tumor necrosis factor-α (TNF-α) antagonists for 2 years, in comparison to that in a nontreated group of healthy controls.Fourteen patients with AS and 14 healthy controls underwent carotid sonography to measure intima-media thickness (IMT) and to evaluate the presence of plaque. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index scores, erythrocyte sedimentation rate, C-reactive protein, glycemia, total cholesterol, and triglyceride levels were also recorded.Patients with AS showed significantly lower values of mean and maximum IMT at the level of the common carotid (P = .02 and .04, respectively) and the carotid bulb (P = .0006 and .0005, respectively) compared to those of healthy controls. They also had a number of carotid plaques significantly lower than that of healthy controls (P = .02). No differences were found in IMT values at the level of internal carotid between the 2 populations.The significantly lower carotid atherosclerosis found in patients with AS treated with TNF antagonists than in healthy controls shows the important complementary role of this treatment in reducing vascular disease progression probably by decreasing inflammation.