scholarly journals Thermal Disparity among Fingers and Its Amelioration by CO2-Water Bathing in Connective Tissue Disease Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Shigeko Inokuma ◽  
Yasuo Kijima
Keyword(s):  
Carbon Dioxide ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Negative Correlation ◽  
Coefficient Of Variation ◽  
Peripheral Circulation ◽  
Baseline Measurement ◽  
Finger Temperature ◽  
The Mean ◽  
Carbon Dioxide Co2

Objective. Correlation between a low finger temperature and thermal disparity among fingers was studied in connective tissue disease (CTD) patients. Whether the thermal disparity may be ameliorated by hand immersion in a warm carbon dioxide- (CO2-) water bath was analyzed. Methods. CTD patients with suspected peripheral circulation disorder underwent a thermography test. From before to 30 min after hand immersion in CO2-water (CO2 bathing; 1000 ppm CO2, 42°C, 10 min), the nailfold temperatures were measured. The mean temperature (m-Temp) and the coefficient of variation of the temperature ( CV = SD / m ‐ Temp of one hand; the mean of CVs of both hands was adopted as the indicator of thermal disparity) were monitored. The correlation between m-Temp and CV was also analyzed. Results. Forty-seven (45 females and 2 males) patients were included, 32 of whom had Raynaud’s phenomenon. The m-Temp was 30.8 ± 3.0 ° C at the baseline, increased to 35.3 ± 1.0 ° C immediately after CO2 bathing, and remained significantly higher than that at the baseline until 30 min after ( 32.1 ± 1.9 ° C ). The CV was 0.0291 ± 0.0247 at the baseline, decreased to 0.0135 ± 0.0039 immediately after CO2 bathing, and remained significantly lower than the baseline until 30 min after ( 0.0163 ± 0.0143 ). Between m-Temp and CV, a negative correlation was observed throughout the measurements. Conclusion. Thermal disparity was observed at baseline measurement in CTD patients. Warm CO2 bathing markedly ameliorated the disparity, and this amelioration remained until after 30 min. Throughout the observation, the lower the m-Temp, the more severe the thermal disparity among fingers.

scholarly journals P170 The validity and utility of the SLE-key® rule-out serological test when applied in a selected cohort of patients with SLE and other connective tissue diseases

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Sheilla Achieng ◽  
John A Reynolds ◽  
Ian N Bruce ◽  
Marwan Bukhari
Keyword(s):  
Linear Regression ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Negative Correlation ◽  
Connective Tissue Diseases ◽  
Inflammatory Myositis ◽  
The Mean ◽  
Negative Rule ◽  
Spearman’S Correlation ◽  
Rule Out

Abstract Background/Aims  We aimed to establish the validity of the SLE-key® rule-out test and analyse its utility in distinguishing systemic lupus erythematosus (SLE) from other autoimmune rheumatic connective tissue diseases. Methods  We used data from the Lupus Extended Autoimmune Phenotype (LEAP) study, which included a representative cross-sectional sample of patients with a variety of rheumatic connective tissue diseases, including SLE, mixed connective tissue disease (MCTD), inflammatory myositis, systemic sclerosis, primary Sjögren’s syndrome and undifferentiated connective tissue disease (UCTD). The modified 1997 ACR criteria were used to classify patients with SLE. Banked serum samples were sent to Immune-Array’s CLIA- certified laboratory Veracis (Richmond, VA) for testing. Patients were assigned test scores between 0 and 1 where a score of 0 was considered a negative rule-out test (i.e. SLE cannot be excluded) whilst a score of 1 was assigned for a positive rule-out test (i.e. SLE excluded). Performance measures were used to assess the test’s validity and measures of association determined using linear regression and Spearman’s correlation. Results  Our study included a total of 155 patients of whom 66 had SLE. The mean age in the SLE group was 44.2 years (SD 13.04). 146 patients (94.1%) were female. 84 (54.2%) patients from the entire cohort had ACR SLE scores of ≤ 3 whilst 71 (45.8%) had ACR SLE scores ≥ 4. The mean ACR SLE total score for the SLE patients was 4.85 (SD 1.67), ranging from 2 to 8, with mean disease duration of 12.9 years. The Sensitivity of the SLE-Key® Rule-Out test in diagnosing SLE from other connective tissue diseases was 54.5%, specificity was 44.9%, PPV 42.4% and NPV 57.1 %. 45% of the SLE patients had a positive rule-out test. SLE could not be ruled out in 73% of the MCTD patients whilst 51% of the UCTD patients had a positive Rule-Out test and >85% of the inflammatory myositis patients had a negative rule-out test. ROC analysis generated an AUC of 0.525 illustrating weak class separation capacity. Linear regression established a negative correlation between the SLE-key Rule-Out score and ACR SLE total scores. Spearman’s correlation was run to determine the relationship between ACR SLE total scores and SLE-key rule-out score and showed very weak negative correlation (rs = -0.0815, n = 155, p = 0.313). Conclusion  Our findings demonstrate that when applied in clinical practice in a rheumatology CTD clinic setting, the SLE-key® rule-out test does not accurately distinguish SLE from other CTDs. The development of a robust test that could achieve this would be pivotal. It is however important to highlight that the test was designed to distinguish healthy subjects from SLE patients and not for the purpose of differentiating SLE from other connective tissue diseases. Disclosure  S. Achieng: None. J.A. Reynolds: None. I.N. Bruce: Other; I.N.B is a National Institute for Health Research (NIHR) Senior Investigator and is funded by the NIHR Manchester Biomedical Research Centre. M. Bukhari: None.

scholarly journals AB0594 EFFECTIVENESS OF RITUXIMAB IN CSDMARDS-RESISTANT ACTIVE MIXED CONNECTIVE TISSUE DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1593.2-1594
Author(s):  
L. Montolio-Chiva ◽  
J. Narváez ◽  
J. J. Alegre-Sancho ◽  
J. Lluch Pons ◽  
A. V. Orenes Vera ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Mixed Connective Tissue Disease ◽  
Bacterial Infections ◽  
Immunosuppressive Treatment ◽  
Variable Interval ◽  
Complete Response ◽  
Sustained Remission ◽  
The Mean

Background:Objectives:To evaluate rituximab (RTX) effectiveness and safety in treating patients with refractory mixed connective tissue disease (MCTD).Methods:Open observational study including patients with refractory MCTD (active disease despite treatment with glucocorticoids and csDMARDs) from two third-level hospitals who had been treated with RTX (off-label use) from January 2001 to December 2019.Results:Thirteen patients (all women) were included, with a mean age of 32 years (SD: 10, range 17-50) and a median time of evolution of the disease of 55 months (SD: 34.3; range 5-98 months). The main indication for initiating treatment with RTX was refractory arthritis (100%), most of the times accompanied by other features of the disease including shrinking lung syndrome (2), fibrosing progressive non-specific interstitial pneumonia (FP-NSIP) (1), recurrent serositis (2), glomerulonephritis (GMN) (2), lymphadenitis (1) and immune thrombocytopenic purpura (ITP) (1). All patients were treated with RTX at rheumatoid arthritis dosage while the baseline immunosuppressive treatment (methotrexate, azathioprine, mycophenolate, leflunomide or tacrolimus) remained unchanged. Hydroxychloroquine was also associated in 8 of the patients. The follow-up time (median) after starting RTX was 118 months (range, 65-177 months, with a total of 132.6 patient-years of follow-up) and the mean number of cycles of treatment was 4.2 (range, 1-15), with a variable interval (from 6 to 12 months). After the first RTX cycle, a partial or complete response was achieved in 92% of the patients. A significant improvement in the mean DAS28-ESR was observed (initial: 4.56 ± 1.6 / final: 2.21 ± 0.85; p=0.008). In all but one patient, who had previously failed to 2 anti-TNFα DAS28-ESR clinical remission or low activity was achieved, generally from week 16 to 20, although relapses were frequent and all cases need retreatment after 6-9 months. In 4 patients, RTX retreatment dosage was optimized to 1 g/cycle. The 3 patients with pulmonary involvement showed stabilization (2 cases) or improvement (1) of the lung function(as defined by the American Thoracic Society). In patients with GMN, renal response to RTX treatment was complete in a patient and partial in the other. The patient with ITP entered remission after the first RTX cycle and no more cycles were needed. Response in patients with serositis and lymphadenitis was also complete and maintained. Moreover, the glucocorticoid doses were reduced to less than half of the initial dose in all cases. At the end of the follow-up, 7 out of the 13 patients (54%) were still being treated with RTX. For the remaining 6 patients, RTX was withdrawn because of primary failure (1), recurrent bacterial infections (2), gestational desire (2) sustained remission (1).Conclusion:According to our preliminary results, RTX seems to be effective and relatively safe in patients with csDMARDs-resistant active MCTD.Disclosure of Interests:L Montolio-Chiva: None declared, J. Narváez: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis, J Lluch Pons: None declared, Ana V Orenes Vera: None declared, I Vázquez-Gómez: None declared, Maribel Mora: None declared, Xavier González: None declared, Carla Marco: None declared, Jesús Rodriguez: None declared, Montserrat Romera: None declared, Joan Miquel Nolla: None declared

The Temporal Relationship of Raynaud’s Phenomenon and Features of Connective Tissue Disease in Rheumatoid Arthritis

2008 ◽  
Vol 35 (12) ◽  
pp. 2329-2333 ◽  
Author(s):  
JANET E. POPE ◽  
JAMAL AL-BISHRI ◽  
HAFSAH AL-AZEM ◽  
JANINE M. OUIMET
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Disease Duration ◽  
Late Onset ◽  
Raynaud’S Phenomenon ◽  
Joint Damage ◽  
Raynaud's Phenomenon ◽  
Rf Values ◽  
The Mean

ObjectiveIn a prospective cohort study we examined the relationship between Raynaud’s phenomenon (RP) onset and other connective tissue disease (CTD) characteristics in rheumatoid arthritis (RA) to determine if RP is predictive of RA severity and associated with other CTD signs, and if late onset RP in RA has an effect on prognosis compared to other patients with RA.MethodsUsing a standardized assessment, data were collected on 328 subjects with RA [mean age 60.3 ± 0.7; 77% women; 76% erosions, 75% positive rheumatoid factor (RF)] seen at one London, Ontario, rheumatology clinic. The data included RA disease duration; presence and duration of RP; presence of nodules, joint damage, telangiectasia, and sclerodactyly; and RF status (+/−), RF value, antinuclear antibodies, and E-nuclear antibodies.ResultsThe mean RA disease duration was 12 ± 0.6 years. Seventy-one (22%) had RP and the mean RP duration was 9.2 ± 1.5 years. Patients presented with RP a mean of 3.8 ± 1.4 years after the diagnosis of RA. RP status was positively associated with the presence of sclerodactyly (p < 0.001), but not nodules or erosions. Higher RF values were associated with longer RA disease duration (p < 0.002) and longer RP duration (p < 0.01).ConclusionIdiopathic RP may have a different clinical effect on RA than secondary RP; the latter is correlated with more severe RA. Sclerodactyly is associated with erosive arthritis and RP in RA. Higher RF values were indicative of increased RA and RP duration.

scholarly journals Investigating the partial pressure of carbon dioxide (CO2) in the respiratory gases in Laparoscopic Gallbladder Surgery and comparing it with Arterial Partial Pressure of Carbon Dioxide

2019 ◽  
Vol 5 (6) ◽  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Partial Pressure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Carbon Dioxide Pressure ◽  
Gallbladder Surgery ◽  
The Mean ◽  
Carbon Dioxide Co2 ◽  
Respiratory Gases

Objectives: The aim of this paper is determining the end-expiratory dioxide pressure in gallbladder laparoscopic surgery and compares it with the arterial carbon dioxide pressure. Methods: This cross-sectional study was performed on 30 patients undergoing laparoscopic cholecystectomy. At the beginning of operation, ABG sample was taken from the patient's radial artery before CO2 was injected into the abdomen. At the same time, CO2 was measured by a capnography device. At the end of surgery, ABG sample was prepared for the second time before CO2 was removed from the abdomen and CO2 was recorded simultaneously by capnography device. After collecting data from ABG samples, arterial PaCO2 was compared with those obtained from capnography device results and SPSS 16 software was used for data analysis. Results: The mean preoperative PaCO2 for laparoscopic (PaCO2-1) was 34.343 and the mean preoperative ETCO2 for laparoscopic (ETCO2-1) was 31.37. These values after laparoscopic surgery were 34.813 for PaCO2, 34.813 (PaCO2-2) and 33.13 (ETCO2-2). There was also a correlation between PaCO2-1 and ETCO2-1 results between PaCO2-2 and ETCO2-2, which was stronger between PaCO2-2 and ETCO2-2. Conclusion: There was a strong correlation between ETCO2 results from capnography and PaCO2 from ABG and to monitor carbon dioxide retention, capnography can be used as an alternative to ABG for laparoscopic gallbladder surgery patients.

scholarly journals Lung-dominant connective tissue disease among patients with interstitial lung disease: prevalence, functional stability, and common extrathoracic features

2015 ◽  
Vol 41 (2) ◽  
pp. 151-160 ◽  
Author(s):  
Daniel Antunes Silva Pereira ◽  
Olívia Meira Dias ◽  
Guilherme Eler de Almeida ◽  
Mariana Sponholz Araujo ◽  
Letícia Barbosa Kawano-Dourado ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Connective Tissue Disease ◽  
Functional Stability ◽  
Esophageal Dilatation ◽  
The Mean ◽  
Scleroderma Pattern

OBJECTIVE: To describe the characteristics of a cohort of patients with lung-dominant connective tissue disease (LD-CTD). METHODS: This was a retrospective study of patients with interstitial lung disease (ILD), positive antinuclear antibody (ANA) results (≥ 1/320), with or without specific autoantibodies, and at least one clinical feature suggestive of connective tissue disease (CTD). RESULTS: Of the 1,998 patients screened, 52 initially met the criteria for a diagnosis of LD-CTD: 37% were male; the mean age at diagnosis was 56 years; and the median follow-up period was 48 months. During follow-up, 8 patients met the criteria for a definitive diagnosis of a CTD. The remaining 44 patients comprised the LD-CTD group, in which the most prevalent extrathoracic features were arthralgia, gastroesophageal reflux disease, and Raynaud's phenomenon. The most prevalent autoantibodies in this group were ANA (89%) and anti-SSA (anti-Ro, 27%). The mean baseline and final FVC was 69.5% and 74.0% of the predicted values, respectively (p > 0.05). Nonspecific interstitial pneumonia and usual interstitial pneumonia patterns were found in 45% and 9% of HRCT scans, respectively; 36% of the scans were unclassifiable. A similar prevalence was noted in histological samples. Diffuse esophageal dilatation was identified in 52% of HRCT scans. Nailfold capillaroscopy was performed in 22 patients; 17 showed a scleroderma pattern. CONCLUSIONS: In our LD-CTD group, there was predominance of females and the patients showed mild spirometric abnormalities at diagnosis, with differing underlying ILD patterns that were mostly unclassifiable on HRCT and by histology. We found functional stability on follow-up. Esophageal dilatation on HRCT and scleroderma pattern on nailfold capillaroscopy were frequent findings and might come to serve as diagnostic criteria.

scholarly journals Retrieval and Validation of XCO2 from TanSat Target Mode Observations in Beijing

2020 ◽  
Vol 12 (18) ◽  
pp. 3063
Author(s):  
Zhengyi Bao ◽  
Xingying Zhang ◽  
Tianxiang Yue ◽  
Lili Zhang ◽  
Zong Wang ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Atmospheric Carbon Dioxide ◽  
Absolute Error ◽  
Satellite Observation ◽  
Mean Difference ◽  
Satellite Mission ◽  
Target Mode ◽  
Environmental Informatics ◽  
The Mean ◽  
Carbon Dioxide Co2

Satellite observation is one of the main methods used to monitor the global distribution and variation of atmospheric carbon dioxide (CO2). Several CO2 monitoring satellites have been successfully launched, including Japan’s Greenhouse Gases Observing SATellite (GOSAT), the USA’s Orbiting Carbon Observatory-2 (OCO-2), and China’s Carbon Dioxide Observation Satellite Mission (TanSat). Satellite observation targeting the ground-based Fourier transform spectrometer (FTS) station is the most effective technique for validating satellite CO2 measurement precision. In this study, the coincident observations from TanSat and ground-based FTS were performed numerous times in Beijing under a clear sky. The column-averaged dry-air mole fraction of carbon dioxide (XCO2) obtained from TanSat was retrieved by the Department for Eco-Environmental Informatics (DEEI) of China’s State Key Laboratory of Resources and Environmental Information System based on a full physical model. The comparison and validation of the TanSat target mode observations revealed that the average of the XCO2 bias between TanSat retrievals and ground-based FTS measurements was 2.62 ppm, with a standard deviation (SD) of the mean difference of 1.41 ppm, which met the accuracy standard of 1% required by the mission tasks. With bias correction, the mean absolute error (MAE) improved to 1.11 ppm and the SD of the mean difference fell to 1.35 ppm. We compared simultaneous observations from GOSAT and OCO-2 Level 2 (L2) bias-corrected products within a ±1° latitude and longitude box centered at the ground-based FTS station in Beijing. The results indicated that measurements from GOSAT and OCO-2 were 1.8 ppm and 1.76 ppm higher than the FTS measurements on 20 June 2018, on which the daily observation bias of the TanSat XOC2 results was 1.87 ppm. These validation efforts have proven that TanSat can measure XCO2 effectively. In addition, the DEEI-retrieved XCO2 results agreed well with measurements from GOSAT, OCO-2, and the Beijing ground-based FTS.

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