Study the Relationship of MDCT Staging in Disease Extent with the Systemic Sclerosis Disease Parameters / Estudiar la relación de la estadificación de la TCMD en la extensión de la enfermedad con los parámetros de la enfermedad de esclerosis sistémica

Background and objectives: The highest incidence of death in systemic sclerosis due to pulmonary disease raises the need for early detection and treatment. The study aim is the assessment of interstitial pulmonary disease by Multi Detector High Resolution CT (MDCT) and finds its relationship with the other disease parameters and the Pulmonary Function tests (PFT). Patients and methods: A prospective cross-sectional study was performed in Assiut University Hospitals from May 2018 to January 2020 and included 62 consecutive SSc female patients. Demographic, clinical, Laboratory, PFT and MDCT assessment were conducted for all participants. Results: The coarseness of fibrosis was 8.32 (range 0.0–17), the average proportion of ground-glass opacification was 28.3% (range, 0.0%–75%). Honey-comb pattern was seen in (52.5%). Mean Extent of disease was 46.25±3.7 (range 5–81). Restrictive deficit found in 42 patients. Significant relation was found between the extent of disease and the percentage predicted FVC (r=0.373, p 0.018) and FEV1/FVC (r=0.593, p 0.000) and coarseness of fibrosis and proportion of ground glass opacification correlated inversely with VC (r=−0.385, p=0.014, r=−0.376, p=0.017 respectively), Rayanud's phenomena, modified Rodnan Skin Score and Medsger's general are positively correlated with MDCT disease extent. Conclusion: Scoring of systemic sclerosis (SSc) related interstitial lung disease (SSc-ILD) could be applicable as one of the important tools for disease assessment.(AU)

Justificación y objetivos: La mayor incidencia de muerte en la esclerosis sistémica por enfermedad pulmonar plantea la necesidad de una detección y un tratamiento precoces. El objetivo del estudio es la evaluación de la enfermedad pulmonar intersticial mediante TC de alta resolución multidetector (TCMD) y encuentra su relación con otros parámetros de la enfermedad y con pruebas de funcionamiento pulmonar (PFP). Pacientes y métodos: Se realizó un estudio transversal prospectivo en los hospitales universitarios de Assiut desde mayo de 2018 hasta enero de 2020 que incluyó 62 pacientes femeninas de esclerosis sistémica consecutivas. Se realizaron evaluaciones demográficas, clínicas, de laboratorio, PFP y TCMD para todos los participantes. Resultados: La aspereza de la fibrosis fue de 8,32 (rango 0,0-17) y la proporción promedio de opacificación en vidrio esmerilado fue del 28,3% (rango 0,0-75%). Se observó un patrón de panal de miel en el 52,5%. La extensión media de la enfermedad fue de 46,25±3,7 (rango 5-81). Se encontró déficit restrictivo en 42 pacientes. Se encontró una relación significativa entre la extensión de la enfermedad y el porcentaje predicho de capacidad vital forzada (CVF) (r=0,373, p=0,018) y FEV1/CVF (r=0,593, p=0,000) y la aspereza de la fibrosis y la proporción de opacificación en vidrio esmerilado se correlacionaron inversamente con la capacidad vital (r=−0,385, p=0,014; r=−0,376, p=0,017, respectivamente), los fenómenos de Rayanud, m Rodnan Skin Score y Medsger general se correlacionan positivamente con la extensión de la enfermedad por TCMD. Conclusión: La puntuación de la enfermedad pulmonar intersticial relacionada con la esclerosis sistémica podría ser aplicable como una de las herramientas importantes para la evaluación de la enfermedad.(AU)

Study the Relationship of MDCT Staging in Disease Extent with the Systemic Sclerosis Disease Parameters.

BACKGROUND AND OBJECTIVES: The highest incidence of death in systemic sclerosis due to pulmonary disease raises the need for early detection and treatment. The study aim is the assessment of interstitial pulmonary disease by Multi Detector High Resolution CT (MDCT) and finds its relationship with the other disease parameters and the Pulmonary Function tests (PFT). PATIENTS AND METHODS: A prospective cross-sectional study was performed in Assiut University Hospitals from May 2018 to January 2020 and included 62 consecutive SSc female patients. Demographic, clinical, Laboratory, PFT and MDCT assessment were conducted for all participants. RESULTS: The coarseness of fibrosis was 8.32 (range 0.0-17), the average proportion of ground-glass opacification was 28.3% (range, 0.0%-75%). Honey-comb pattern was seen in (52.5%). Mean Extent of disease was 46.25±3.7 (range 5-81). Restrictive deficit found in 42 patients. Significant relation was found between the extent of disease and the percentage predicted FVC (r=0.373, p 0.018) and FEV1/FVC (r=0.593, p 0.000) and coarseness of fibrosis and proportion of ground glass opacification correlated inversely with VC (r=-0.385, p=0.014, r=-0.376, p=0.017 respectively), Rayanud's phenomena, modified Rodnan Skin Score and Medsger's general are positively correlated with MDCT disease extent. CONCLUSION: Scoring of systemic sclerosis (SSc) related interstitial lung disease (SSc-ILD) could be applicable as one of the important tools for disease assessment.

Study the Relationship of MDCT Staging in Disease Extent with the Systemic Sclerosis Disease Parameters.

BACKGROUND AND OBJECTIVES: The highest incidence of death in systemic sclerosis due to pulmonary disease raises the need for early detection and treatment. The study aim is the assessment of interstitial pulmonary disease by Multi Detector High Resolution CT (MDCT) and finds its relationship with the other disease parameters and the Pulmonary Function tests (PFT). PATIENTS AND METHODS: A prospective cross-sectional study was performed in Assiut University Hospitals from May 2018 to January 2020 and included 62 consecutive SSc female patients. Demographic, clinical, Laboratory, PFT and MDCT assessment were conducted for all participants. RESULTS: The coarseness of fibrosis was 8.32 (range 0.0-17), the average proportion of ground-glass opacification was 28.3% (range, 0.0%-75%). Honey-comb pattern was seen in (52.5%). Mean Extent of disease was 46.25±3.7 (range 5-81). Restrictive deficit found in 42 patients. Significant relation was found between the extent of disease and the percentage predicted FVC (r=0.373, p 0.018) and FEV1/FVC (r=0.593, p 0.000) and coarseness of fibrosis and proportion of ground glass opacification correlated inversely with VC (r=-0.385, p=0.014, r=-0.376, p=0.017 respectively), Rayanud's phenomena, modified Rodnan Skin Score and Medsger's general are positively correlated with MDCT disease extent. CONCLUSION: Scoring of systemic sclerosis (SSc) related interstitial lung disease (SSc-ILD) could be applicable as one of the important tools for disease assessment.

Fractional Erbium-YAG Laser and Platelet-Rich Plasma as Single or Combined Treatment for Atrophic Acne Scars: A Randomized Clinical Trial.

INTRODUCTION: Acne scarring is a common undesirable complication of acne vulgaris. Fractional erbium-yttrium aluminum garnet (YAG) 2940 nm laser and platelet-rich plasma have been used in treating acne scars with variable outcomes. The objective of this study is to assess the efficacy of fractional erbium-YAG 2940 nm laser and platelet-rich plasma as a single line of treatment in comparison with combined treatment in atrophic postacne scars. METHODS: Seventy-five patients were included in this trial and randomized into three equal groups (25 each). Group A was subjected to six sessions of erbium-YAG laser for 6 months, group B was treated with 12 sessions of platelet-rich plasma over the same period, and group C was subjected to six sessions of erbium-YAG laser plus 12 sessions of platelet-rich plasma over the same period. Each subject was evaluated by acne scar grading, photography, and subjective evaluation. RESULTS: Both treatment modalities showed improvement of acne scars, but the improvement with combined treatment was better than that with erbium-YAG laser or platelet-rich plasma alone regarding scar grade improvement (P = 0.007 and 0.001), clinical improvement (P = 0.001 and 0.001), and patient satisfaction (P = 0.005 and 0.001), respectively. CONCLUSIONS: The combination of platelet-rich plasma plus erbium-YAG laser is superior to either treatment alone for acne scars, with trivial side effects for all treatment modalities. TRIAL REGISTRATION: ClinicalTrials.gov identifier; NCT03933033.