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1.
Artículo en Inglés | MEDLINE | ID: mdl-38824995

RESUMEN

OBJECTIVE: To elucidate the local microcirculation of the infrapatellar fat pad (IFP) in patients with knee osteoarthritis (KOA) by determining the changes in IFP hardness and hemoglobin concentration during isometric quadriceps exercise (IQE). DESIGN: In this observational cross-sectional study, patients diagnosed with bilateral KOA were included in the KOA group (30 knees), healthy older adults in the control group (20 knees), and younger adults in the young group (20 knees). Ultrasonography was performed at rest and during IQE to measure IFP hardness based on shear wave velocity. Near-infrared spectroscopy was performed to measure oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), and total hemoglobin (cHb) in the IFP before (Baseline), during (IQE task), and after IQE (Post). IFP hardness and O2Hb, HHb, and cHb concentration were analyzed using a linear mixed model for the groups and measurement points. RESULTS: During IQE, IFP hardness changes were significantly less in the KOA group than in the other groups (KOA: 95 % confidence intervals (CIs) [-0.854, 0.028]; control: 95 % CI [-0.941, -0.341]; and young: 95 % CI [-2.305, -1.706]). In the KOA group, O2Hb concentration exhibited no significant changes at Post compared with Baseline; however, significant changes were observed in the other groups (KOA: 95 % CI [-1.176, 0.423]; control: 95 % CI [-1.452, -0.276]; and young: 95 % CI [-4.062, -2.102]). CONCLUSIONS: During IQE, changes in hardness and hemoglobin concentration in the IFP were not significant in the KOA group, suggesting impaired local microcirculation of the IFP.

2.
World Neurosurg ; 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38810873

RESUMEN

OBJECTIVES: We retrospectively examined the initial experience and learning curve after the introduction of thrombectomy with the combined technique using an aspiration catheter and a stent retriever as first-line attempt for acute ischemic stroke. METHODS: Consecutive patients undergoing thrombectomy for acute ischemic stroke at our institution between January 2020 and December 2022 were divided into 3 groups according to the year of thrombectomy. Patient characteristics and procedural, safety, and clinical outcomes were compared between the three year periods to determine predictors of favorable clinical outcome. RESULTS: In 2020, 2021, and 2022, the numbers of patients were 74, 70, and 90, respectively, with similar patient characteristics across the three years; successful recanalization rates were 79.7%, 97.1%, and 93.3%, respectively (P < 0.01 for the first 2 years); median procedure times were 67, 43, and 32 minutes, respectively (P < 0.01 for the first 2 years and P = 0.018 for the last 2 years); first pass effect rates were 20.3%, 41.4%, and 44.4%, respectively (P < 0.01 for the first 2 years); symptomatic intracranial hemorrhage rates were 14.9%, 2.9%, and 1.1%, respectively (P = 0.018 for the first 2 years); and percentages of modified Rankin Scale score 0-2 at 90 days were 24.3%, 42.9%, and 41.1%, respectively (P = 0.022 for the first 2 years). Procedure time (P = 0.038) and successful recanalization (P = 0.041) were independent predictors of favorable clinical outcome. CONCLUSIONS: The learning curve effect of the combined technique may be associated with better clinical outcome due to increased successful recanalization rates, shortened procedure time, and reduced symptomatic intracranial hemorrhage.

3.
J Orthop Sci ; 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38760247

RESUMEN

BACKGROUND: The purpose of this study was to determine the effects of high tibial osteotomy (HTO) on varus thrust during gait in patients with medial compartment knee osteoarthritis (KOA), and to identify factors that influence thrust before and one year after surgery. METHODS: HTO was performed in 60 KOA patients (70 knees, including 56 knees by open wedge and 14 by closed wedge). The control group comprised 28 normal, control subjects. Several parameters were evaluated before surgery and one year thereafter. Varus thrust was defined as acceleration of the thigh relative to the lower leg in the coronal plane. Knee-injury-and-osteoarthritis-outcome scores (KOOSs), knee joint angles, radiography, and mediolateral knee acceleration during free speed gait were measured and analyzed. RESULTS: One-year after HTO, KOOSs, knee extension angles, and range of knee motion were improved (p < 0.001). The hip-knee-ankle angle and joint-line-convergent angle (JLCA) had decreased (p < 0.001), and walking speed had increased (p < 0.001). Preoperatively, patient acceleration was significantly (p < 0.05) higher than that of controls, and it did not change after HTO. However, it was reduced significantly (p < 0.05) after adjusting for walking speed. Walking speed correlated significantly with acceleration preoperatively, postoperatively, and among controls. Surgical methods (open-wedge/closed-wedge HTO) and correction angle did not affect postoperative acceleration. There was a low correlation between acceleration and KOOSs (KOOSa, KOOSp), knee joint angles, or JLCA postoperatively, but no relationship was found between acceleration and these parameters in the preoperative or the control group. CONCLUSIONS: Walking speed correlated significantly with acceleration preoperatively, postoperatively, and with those of controls. Mediolateral acceleration of the thigh relative to the lower leg in patients with KOA was significantly higher than that of normal controls before surgery, and it did not change after HTO. However, after surgery it was reduced significantly after adjusting for walking speed.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38808381

RESUMEN

The Epstein-Barr virus (EBV) is associated with various lymphoproliferative disorders (LPD). Additionally, EBV infection has correlated with diverse autoimmune diseases. However, the association between EBV and systemic small vessel vasculitis (SVV) remains controversial. Here, we report a case of SVV with pauci-immune glomerulonephritis accompanied by an EBV-positive polymorphic B-cell LPD, not otherwise specified. The intricate distinction between EBV-positive B-cell LPD and SVV was difficult, as both diseases demonstrated similar clinical presentations. Lymph node and kidney biopsies facilitated the accurate diagnosis of these two conditions. The administration of high-dose prednisolone, combined with rituximab, proved efficacious, with no instances of relapse over the subsequent 2-year period. This case indicates an association between EBV-positive B-cell LPD and SVV. The diligent execution of biopsies is a crucial diagnostic and interpretive strategy, generating precise comprehension of this condition and guiding its appropriate therapeutic management.

5.
Int J Clin Oncol ; 29(7): 889-898, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38722486

RESUMEN

BACKGROUND: Anticipatory chemotherapy-induced nausea and vomiting (CINV) is a conditioned response influenced by the severity and duration of previous emetic responses to chemotherapy. We aimed to evaluate the efficacy of non-pharmacologic interventions for anticipatory CINV among patients with cancer. METHODS: We conducted a systematic search in databases, including PubMed, the Cochrane Library, CINAHL, and Ichushi-Web, from January 1, 1990, to December 31, 2020. Randomized controlled trials, non-randomized designs, observational studies, or case-control studies that utilized non-pharmacological therapies were included. The primary outcomes were anticipatory CINV, with an additional investigation into adverse events and the costs of therapies. The risk-of-bias for each study was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using Revman 5.4 software. RESULTS: Of the 107 studies identified, six met the inclusion criteria. Three types of non-pharmacological treatments were identified: systematic desensitization (n = 2), hypnotherapy (n = 2), and yoga therapy (n = 2). Among them, systematic desensitization significantly improved anticipatory CINV as compared to that in the control group (nausea: risk ratio [RR] = 0.60, 95% confidence interval [CI] = 0.49-0.72, p < 0.00001; vomiting: RR = 0.54, 95% CI = 0.32-0.91, p = 0.02). However, heterogeneity in outcome measures precluded meta-analysis for hypnotherapy and yoga. Additionally, most selected studies had a high or unclear risk of bias, and adverse events were not consistently reported. CONCLUSIONS: Our findings suggest that systematic desensitization may effectively reduce anticipatory CINV. However, further research is warranted before implementation in clinical settings.


Asunto(s)
Antineoplásicos , Náusea , Neoplasias , Humanos , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Náusea/inducido químicamente , Náusea/prevención & control , Neoplasias/tratamiento farmacológico , Vómitos/inducido químicamente , Vómitos/prevención & control , Vómitos/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Vómito Precoz , Hipnosis , Yoga , Antieméticos/uso terapéutico
6.
Int J Clin Oncol ; 29(7): 873-888, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38753042

RESUMEN

BACKGROUND: The Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis 2023 was extensively revised to reflect the latest advances in antineoplastic agents, antiemetics, and antineoplastic regimens. This update provides new evidence on the efficacy of antiemetic regimens. METHODS: Guided by the Minds Clinical Practice Guideline Development Manual of 2017, a rigorous approach was used to update the guidelines; a thorough literature search was conducted from January 1, 1990, to December 31, 2020. RESULTS: Comprehensive process resulted in the creation of 13 background questions (BQs), 12 clinical questions (CQs), and three future research questions (FQs). Moreover, the emetic risk classification was also updated. CONCLUSIONS: The primary goal of the present guidelines is to provide comprehensive information and facilitate informed decision-making, regarding antiemetic therapy, for both patients and healthcare providers.


Asunto(s)
Antieméticos , Oncología Médica , Vómitos , Humanos , Japón , Oncología Médica/normas , Antieméticos/uso terapéutico , Vómitos/prevención & control , Vómitos/tratamiento farmacológico , Neoplasias/tratamiento farmacológico , Antineoplásicos/uso terapéutico , Sociedades Médicas , Náusea/prevención & control , Náusea/tratamiento farmacológico
7.
Artículo en Inglés | MEDLINE | ID: mdl-38608193

RESUMEN

OBJECTIVES: To evaluate the effectiveness and safety of two different intravenous methylprednisolone (IVMP) pulse doses in patients with severe microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). METHODS: We emulated a target trial using observational data from the nationwide registry in Japan. Patients with severe glomerulonephritis or diffuse alveolar haemorrhage were selected and pseudo-randomised into three groups using propensity score-based overlap weighting as follows: non-IVMP, IVMP 0.5 g/day, and IVMP 1.0 g/day. The primary outcome was all-cause death, and the secondary outcomes were composite all-cause death and kidney failure, severe relapse, and serious infection from 2 to 48 weeks after treatment initiation. To estimate the treatment effects, the Cox proportional hazard model and Fine-Gray subdistribution hazard model were used. RESULTS: In this emulated target trial, of 201 eligible patients (MPA, 175; GPA, 26), 6 (2.8%) died, 4 (2.0%) had kidney failure, 11 (5.3%) had severe relapse, and 40 (19.8%) had severe infections. Hazard ratios (HR) for IVMP 0.5 g/day and IVMP 1.0 g/day pulse groups compared with non-IVMP pulse were as follows: all-cause death = 0.46 (95% confidence interval [95%CI]: 0.07-2.81) and 0.07 (95%CI: 0.01-0.41); all-cause death/kidney failure = 1.18 (95%CI: 0.26-5.31) and 0.59 (95%CI: 0.08-4.52); subdistribution HRs for severe relapse = 1.26 (95%CI: 0.12-13.70) and 3.36 (95%CI: 0.49-23.29); and serious infection = 1.88 (95%CI: 0.76-4.65) and 0.94 (95%CI: 0.28-3.13). CONCLUSIONS: IVMP 1.0 g/day pulse may improve 48-week mortality in patients with severe MPA/GPA.

8.
Front Psychiatry ; 15: 1328708, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38439795

RESUMEN

Introduction: Individuals with Autism Spectrum Disorder (ASD) show atypical recognition of facial emotions, which has been suggested to stem from arousal and attention allocation. Recent studies have focused on the ability to perceive an average expression from multiple spatially different expressions. This study investigated the effect of autistic traits on temporal ensemble, that is, the perception of the average expression from multiple changing expressions. Methods: We conducted a simplified temporal-ensemble task and analyzed behavioral responses, pupil size, and viewing times for eyes of a face. Participants with and without diagnosis of ASD viewed serial presentations of facial expressions that randomly switched between emotional and neutral. The temporal ratio of the emotional expressions was manipulated. The participants estimated the intensity of the facial emotions for the overall presentation. Results: We obtained three major results: (a) many participants with ASD were less susceptible to the ratio of anger expression for temporal ensembles, (b) they produced significantly greater pupil size for angry expressions (within-participants comparison) and smaller pupil size for sad expressions (between-groups comparison), and (c) pupil size and viewing time to eyes were not correlated with the temporal ensemble. Discussion: These results suggest atypical temporal integration of anger expression and arousal characteristics in individuals with ASD; however, the atypical integration is not fully explained by arousal or attentional allocation.

9.
Mod Rheumatol ; 2023 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-37801552

RESUMEN

OBJECTIVES: To identify the optimal dose of intravenous cyclophosphamide (IVCY) for induction therapy for anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). METHODS: We retrospectively assessed patients with AAV who received IVCY every 2-3 weeks during the remission induction phase. The associations of the IVCY dose with infection-free survival and relapse-free survival were analysed using a Cox regression model. We compared patients in three categories: very low-dose (VLD), low-dose (LD), and conventional dose (CD) (<7.5 mg/kg, 7.5-12.5 mg/kg, and >12.5 mg/kg, respectively). The non-linear association between IVCY dose and the outcomes were also evaluated. RESULTS: Of the 80 patients (median age 72 years), 12, 42, and 26 underwent the VLD, LD, and CD regimens, respectively, of whom 4, 3, and 7 developed infection or died. The adjusted hazard ratios for infection or death were 4.3 (95% confidence interval (CI) 0.94-19.8) for VLD and 5.1 (95% CI 1.21-21.3) for CD, compared with LD. We found the hazard ratio for infection or death increased when the initial IVCY dose exceeded 9 mg/kg. Relapse-free survival did not differ clearly. CONCLUSION: Low-dose IVCY (7.5-12.5 mg/kg) may result in fewer infections and similar relapse rates compared with the conventional regimen (>12.5 mg/kg).

10.
Autism Res ; 16(9): 1750-1764, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37409496

RESUMEN

People with autism spectrum disorder (ASD) or higher levels of autistic traits have atypical characteristics in sensory processing. Atypicalities have been reported for proprioceptive judgments, which are tightly related to internal bodily representations underlying position sense. However, no research has directly investigated whether self-bodily representations are different in individuals with ASD. Implicit hand maps, estimated based on participants' proprioceptive sensations without sight of their hand, are known to be distorted such that the shape is stretched along the medio-lateral hand axis even for neurotypical participants. Here, with the view of ASD as falling on a continuous distribution among the general population, we explored differences in implicit body representations along with autistic traits by focusing on relationships between autistic traits and the magnitudes of the distortions in implicit hand maps (N ~ 100). We estimated the magnitudes of distortions in implicit hand maps both for fingers and hand surfaces on the dorsal and palmar sides of the hand. Autistic traits were measured by questionnaires (Autism Spectrum [AQ] and Empathy/Systemizing [EQ-SQ] Quotients). The distortions in implicit hand maps were replicated in our experimental situations. However, there were no significant relationships between autistic traits and the magnitudes of the distortions as well as within-individual variabilities in the maps and localization performances. Consistent results were observed from comparisons between IQ-matched samples of people with and without a diagnosis of ASD. Our findings suggest that there exist perceptual and neural processes for implicit body representations underlying position sense consistent across levels of autistic traits.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Humanos , Trastorno del Espectro Autista/complicaciones , Mano , Empatía , Encuestas y Cuestionarios
11.
Sci Rep ; 13(1): 9611, 2023 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-37311776

RESUMEN

Non-synesthetes exhibit a tendency to associate specific shapes with particular colors (i.e., circle-red, triangle-yellow, and square-blue). Such color-shape associations (CSAs) could potentially affect the feature binding of colors and shapes, thus resulting in people reporting more binding errors in the case of incongruent, rather than congruent, colored-shape pairs. Individuals with autism spectrum disorder (ASD) exhibit atypical sensory processing and impaired multisensory integration. Here, we examined whether autistic traits (Autism-Spectrum Quotient; AQ) influence the strength of color-shape associations, as evidenced by the occurrence of binding errors in incongruent minus congruent conditions. Participants took part in an experiment designed to reveal binding errors induced by incongruent and congruent colored-shape pairs, and completed the Japanese version of the AQ score. The results revealed a significant correlation between AQ scores and occurrence of binding errors when participants were presented with the circle-red and triangle-yellow CSAs: That is, individuals with higher autistic traits tend to make more binding errors in incongruent minus congruent colored-shape pairs, indicating a stronger binding of circle-red and triangle-yellow associations. These results therefore suggest that autistic traits play a role in forming color-shape associations, shedding light on the nature of both color-shape associations and autistic perception.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Humanos , Investigadores , Sensación
13.
Sci Rep ; 13(1): 5888, 2023 04 11.
Artículo en Inglés | MEDLINE | ID: mdl-37041298

RESUMEN

The number of clinical diagnoses of autism spectrum disorder (ASD) is increasing annually. Interestingly, the human body temperature has also been reported to gradually decrease over the decades. An imbalance in the activation of the excitatory and inhibitory neurons is assumed to be involved in the pathogenesis of ASD. Neurophysiological evidence showed that brain activity decreases as cortical temperature increases, suggesting that an increase in brain temperature enhances the inhibitory neural mechanisms. Behavioral characteristics specific to clinical ASD were observed to be moderated when people with the diagnoses had a fever. To explore the possible relationship between ASD and body temperature in the general population, we conducted a survey study using a large population-based sample (N ~ 2000, in the age groups 20s to 70s). Through two surveys, multiple regression analyses did not show significant relationships between axillary temperatures and autistic traits measured by questionnaires (Autism Spectrum (AQ) and Empathy/Systemizing Quotients), controlling for covariates of age and self-reported circadian rhythms. Conversely, we consistently observed a negative relationship between AQ and age. People with higher AQ scores tended to have stronger eveningness. Our findings contribute to the understanding of age-related malleability and the irregularity of circadian rhythms related to autistic traits.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Humanos , Trastorno del Espectro Autista/diagnóstico , Trastorno Autístico/diagnóstico , Temperatura Corporal , Encéfalo , Encuestas y Cuestionarios
14.
Surg Neurol Int ; 14: 75, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36895219

RESUMEN

Background: We report a case of proximal internal carotid artery (ICA) collapse due to severe distal stenosis that dilated after angioplasty for distal stenosis. Case Description: A 69-year-old woman underwent thrombectomy for the left ICA occlusion due to stenosis of C3 portion and was discharged home with a modified Rankin Scale score of 0. One year later, she developed cerebral infarction due to progressive stenosis of the C3 portion of the left ICA with proximal ICA collapse and underwent emergency percutaneous transluminal angioplasty (PTA) for distal stenosis. Device guidance to the stenosis was difficult due to proximal ICA collapse. After PTA, blood flow in the left ICA increased, and proximal ICA collapse dilated over time. Due to severe residual stenosis, she underwent more aggressive PTA followed by Wingspan stenting. Device guidance to the residual stenosis was facilitated because proximal ICA collapse had already dilated. Six months later, proximal ICA collapse further dilated. Conclusion: PTA for severe distal stenosis with proximal ICA collapse may result in dilation of proximal ICA collapse over time.

15.
Front Psychiatry ; 14: 1077542, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36846233

RESUMEN

Introduction: Individuals with neurodevelopmental disorders, such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and specific learning disorders (SLD) have various types of sensory characteristics. Methods: This study investigated sensory issues in individuals with neurodevelopmental disorders using a web-based questionnaire for qualitative and quantitative analysis, categorized the contents of their three most distressful sensory issues, and evaluated their order of priority. Results: Auditory problems were reported as the most distressing sensory issue among the participants. In addition to auditory problems, individuals with ASD frequently reported more tactile problems, and individuals with SLD reported more visual problems. Among the individual sensory issues, in addition to aversion to sudden, strong, or specific stimuli, some participants reported confusions regarding multiple stimuli presenting concurrently. Additionally, the sensory issues related to foods (i.e., taste) was relatively more common in the minor group. Conclusion: These results suggest that the diversity of sensory issues experienced should be carefully considered when aiding persons with neurodevelopmental disorders.

16.
R Soc Open Sci ; 10(1): 220585, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36686551

RESUMEN

A series of multiple facial expressions can be temporally perceived as an averaged facial expression in a process known as ensemble perception. This study examined the effect of temporal parameters on the perceived intensity of facial expression in each emotion, and how the effect varies with autistic traits in typically developing people. In the experiment, we presented facial expressions that switched from emotional to neutral expressions, and vice versa, for 3 s. Participants rated the overall perceived intensity of the facial emotions as a whole rather than rating individual items within the set. For the two tasks, a ratio of duration of emotional faces to duration of neutral faces (emotional ratio) and the timing for transitions were manipulated individually. The results showed that the intensity of facial emotion was perceived more strongly when the presentation ratio increased and when the emotional expression was presented last. The effects were different among the emotions (e.g. relatively weak in the anger expression). Moreover, the perceived intensity of angry expressions decreased with autistic traits. These results suggest that the properties and individual differences in the facial ensemble of each emotion affect emotional perceptions.

17.
J Autism Dev Disord ; 53(1): 378-389, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35064873

RESUMEN

Previous psychophysical studies reported a positive aftereffect in tactile temporal order judgments, which can be explained by the Bayesian estimation model ('Bayesian calibration'). We investigated the relationship between Bayesian calibration and autistic traits in participants with typical development (TD) and autism spectrum disorder (ASD). Bayesian calibration was weakened in TD participants with high autistic traits, consistent with the 'hypo-priors' hypothesis for autistic perceptions. The results from the ASD group were generally observed as a continuation of those from the TD groups. Meanwhile, two ASD participants showed irregularly large positive or negative aftereffects. We discussed the mechanisms behind the general results among TD and ASD participants and two particular results among ASD participants based on the Bayesian estimation model.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Humanos , Juicio , Teorema de Bayes , Calibración
18.
Knee ; 40: 111-121, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36423399

RESUMEN

BACKGROUND: Malalignment, knee laxity, and repetitive physical activity are considered biomechanical risk factors for knee osteoarthritis (KOA), though the correlation among these factors is poorly understood. The purpose of this study was to elucidate the relationship between knee laxity and alignment, and to determine the effects of repetitive physical activity on knee laxity in patients with KOA. METHODS: The study subjects were 68 patients with radiographic tibiofemoral KOA and 68 control subjects. Each participant underwent clinical evaluation, muscle strength test, radiography, and knee laxity test. Laxity was evaluated before and after repetitive stepping exercise using tri-axial accelerometer. RESULTS: Mediolateral acceleration correlated (P < 0.01) with two coronal alignments (mechanical axis: hip-knee-ankle angle (HKA); and joint line convergent angle (JLCA)). Pearson correlation coefficient was small (r = 0.23-0.24) before but increased after stepping (r = 0.28-0.33). Increased mediolateral acceleration after stepping correlated with JLCA (r = 0.37, P < 0.001). There were significant differences in coronal alignments, gait speed, mediolateral acceleration, and accelerations in all directions between the control and KOA groups. Anteroposterior acceleration did not correlate with sagittal knee alignment. Multiple logistic regression analysis identified HKA/JLCA, and increased mediolateral acceleration after stepping as significant diagnostic predictors of KOA. CONCLUSIONS: We found a direct relationship between knee laxity and alignment or repetitive physical activity. Repetitive stepping activity significantly increased mediolateral acceleration in KOA patients, compared with the control. Stepping increased the correlation between mediolateral acceleration and coronal alignment. In knees with large JLCA, repetitive stepping caused much larger mediolateral laxity.


Asunto(s)
Osteoartritis de la Rodilla , Humanos , Osteoartritis de la Rodilla/diagnóstico por imagen , Estudios Transversales , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/fisiología , Extremidad Inferior , Ejercicio Físico
19.
Lupus ; 32(1): 63-73, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36317306

RESUMEN

Belimumab is a therapeutic medication that inhibits the B-cell-activating factor (BAFF) used for systemic lupus erythematosus (SLE); however, the response sometimes varies among individuals, even when patients are stratified based on general clinical characteristics. Therefore, we focused on immunological phenotypic changes with belimumab, investigated their association with subsequent clinical courses, and sought to identify relevant immunological indicators to stratify patients who would benefit from belimumab. We assessed changes in B and T cell phenotypes, as well as BAFF-related factors, such as levels of BAFF and a proliferation-inducing ligand, and expression of three BAFF receptors: BAFF receptor (BAFF-R), B-cell maturation antigen (BCMA), transmembrane activator and cyclophilin ligand interactor (TACI), in 19 patients with SLE who were treated with belimumab before and 3 months after treatment. First, to visualize patterns in complex and diverse data, we summarized B cell changes such as subsets and BAFF receptor expressions into two axes, the first and second principal components (PC1 and PC2), and characterized broad phenotypic changes by cluster analysis. Next, we evaluated whether the B cell changes represented by PC1 and PC2 were associated with other concurrent phenotypic changes, baseline factors, and treatment response at 6 months. We found that lower PC2, indicating increased BAFF-R expression and decreased percentage of naïve B cells, was associated with a subsequent therapeutic response at 6 months (odds ratio 5.3, 95% confidence interval 1.2-24, p = .031). Furthermore, higher percentages of effector memory CD3+CD4+ T cells at baseline were associated with lower PC2 and therapeutic response. Further analysis revealed that increased PC1, as reflected by increased BCMA and TACI expression and an increase in the percentage of class-switched memory B cells, was associated with both T and B cell activation. Although belimumab is a B-cell targeted therapy, it can also influence T-cell phenotypes. Thus, early B cell changes could be used to predict treatment response, and their changes could be predicted from baseline T cell phenotypes, indicating the importance of B and T cell interactions.


Asunto(s)
Lupus Eritematoso Sistémico , Humanos , Receptor del Factor Activador de Células B/análisis , Antígeno de Maduración de Linfocitos B , Anticuerpos Monoclonales Humanizados/uso terapéutico , Factor Activador de Células B/metabolismo
20.
RMD Open ; 8(2)2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36581382

RESUMEN

OBJECTIVES: To visualise the trajectories of pulmonary arterial pressure (PAP) in systemic sclerosis (SSc) and identify the clinical phenotypes for each trajectory, by applying latent trajectory modelling for PAP repeatedly estimated by echocardiography. METHODS: This was a multicentre, retrospective cohort study conducted at four referral hospitals in Kyoto, Japan. Patients with SSc who were treated at study sites between 2008 and 2021 and who had at least three echocardiographic measurements of systolic PAP (sPAP) were included. A group-based trajectory model was applied to the change in sPAP over time, and patients were classified into distinct subgroups that followed similar trajectories. Pulmonary hypertension (PH)-free survival was compared for each trajectory. Multinomial logistic regression analysis was performed for baseline clinical characteristics associated with trajectory assignment. RESULTS: A total of 236 patients with 1097 sPAP measurements were included. We identified five trajectories: rapid progression (n=9, 3.8%), early elevation (n=30, 12.7%), middle elevation (n=54, 22.9%), late elevation (n=24, 10.2%) and low stable (n=119, 50.4%). The trajectories, in the listed order, showed progressively earlier elevation of sPAP and shorter PH-free survival. In the multinomial logistic regression analysis with the low stable as a reference, cardiac involvement was associated with rapid progression, diffuse cutaneous SSc was associated with early elevation and anti-centromere antibody was associated with middle elevation; older age of onset was associated with all three of these trajectories. CONCLUSION: The pattern of changes in PAP over time in SSc can be classified into five trajectories with distinctly different clinical characteristics and outcomes.


Asunto(s)
Hipertensión Pulmonar , Esclerodermia Sistémica , Humanos , Arteria Pulmonar , Estudios Retrospectivos , Esclerodermia Sistémica/complicaciones , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/complicaciones , Japón
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