RheumNow’s Post

ICYMI: Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care MSUS has emerged as a powerful asset in rheumatology, providing a real-time, non-invasive, and cost-effective solution for diagnosing and managing inflammatory arthritis conditions such as RA and PsA.

EC Pulmonology and Respiratory Medicine journal's article from Volume 13 issue 10 𝐀𝐫𝐭𝐢𝐜𝐥𝐞 𝐓𝐢𝐭𝐥𝐞: Management of Left Internal Mammary Artery Pseudo Aneurysm: An Early Postoperative Finding and a Modified Algorithm 𝐀𝐮𝐭𝐡𝐨𝐫𝐬: Marwan Sadek, Mohamed Abdelwahab Alassal*, Muhammed Tamim, Mohamed Zayed, Yasser Elkadi, Abdelraouf Fahmy, Hussein Abo Elalaa, Adel Azmy and Khalid Al Faraidy 𝐀𝐛𝐬𝐭𝐫𝐚𝐜𝐭: Pseudoaneurysms of the internal mammary arteries (IMAs) and their branches are seldom seen. Several cases were reported with different cause of pseudoaneurysm various from traumatic chest injuries, post CABG or post none CABG cardiac surgeries due to injuries of LIMA or its branches during sternal closure. Typically, they are asymptomatic and usually presented as an accidentally finding during imaging. However, it could be associated with serious complication of rupture and hemodynamic instability. Management may differ according to the cause and timing of presentation. Urgent intervention either surgical correction or interventional shall be can be the considered soon after diagnosis, they are suitable choices. 𝐕𝐢𝐬𝐢𝐭 𝐜𝐨𝐦𝐩𝐥𝐞𝐭𝐞 𝐚𝐫𝐭𝐢𝐜𝐥𝐞 𝐡𝐞𝐫𝐞: https://lnkd.in/g7djWdHK If you have any questions or need further information, reach me out: Phone: +44 7897 023755, E-Mail: [email protected] #Pulmonology #RespiratoryMedicine #Tuberculosis #Lungs #Asthama #ChestDisease #ECPRM #Submission #Research #Review #Casereport #Comorbidities #Onlinepublication #RheumatoidArthritis #LatentTuberculosis #AsthmaRemission #Predictors #RemissionofAsthma #CABGComplication #Pseudoaneurysm #InternalMammaryArteryInjury

EC Pulmonology and Respiratory Medicine journal's article from Volume 13 issue 10 𝐀𝐫𝐭𝐢𝐜𝐥𝐞 𝐓𝐢𝐭𝐥𝐞: Management of Left Internal Mammary Artery Pseudo Aneurysm: An Early Postoperative Finding and a Modified Algorithm 𝐀𝐮𝐭𝐡𝐨𝐫𝐬: Marwan Sadek, Mohamed Abdelwahab Alassal*, Muhammed Tamim, Mohamed Zayed, Yasser Elkadi, Abdelraouf Fahmy, Hussein Abo Elalaa, Adel Azmy and Khalid Al Faraidy 𝐀𝐛𝐬𝐭𝐫𝐚𝐜𝐭: Pseudoaneurysms of the internal mammary arteries (IMAs) and their branches are seldom seen. Several cases were reported with different cause of pseudoaneurysm various from traumatic chest injuries, post CABG or post none CABG cardiac surgeries due to injuries of LIMA or its branches during sternal closure. Typically, they are asymptomatic and usually presented as an accidentally finding during imaging. However, it could be associated with serious complication of rupture and hemodynamic instability. Management may differ according to the cause and timing of presentation. Urgent intervention either surgical correction or interventional shall be can be the considered soon after diagnosis, they are suitable choices. 𝐕𝐢𝐬𝐢𝐭 𝐜𝐨𝐦𝐩𝐥𝐞𝐭𝐞 𝐚𝐫𝐭𝐢𝐜𝐥𝐞 𝐡𝐞𝐫𝐞: https://lnkd.in/gJHeu-Pb If you have any questions or need further information, reach me out: Phone: +44 7897 023755, E-Mail: [email protected] #Pulmonology #RespiratoryMedicine #Tuberculosis #Lungs #Asthama #ChestDisease #ECPRM #Submission #Research #Review #Casereport #Comorbidities #Onlinepublication #RheumatoidArthritis #LatentTuberculosis #AsthmaRemission #Predictors #RemissionofAsthma #CABGComplication #Pseudoaneurysm #InternalMammaryArteryInjury

Case study #3 - FMT (fecal microbiota transplant). This case study highlights the need to maintain your new microbiome by feeding it the fuels that are best for the health-promotors. A 48 year old male presented with GI symptoms including abdominal pain, diarrhoea, reflux, nausea, and vomiting alongside an element of chronic fatigue syndrome including headaches, foggy thinking, lethargy and myalgia. The patient was diagnosed with IBS. The patient also reported a clinical history of depression. Previously, the patient had been trialled various Tricyclic antidepressants until settling with Lexapro. The patient described exercise “as an essential part of life,” but reported flares in IBS and depression post exercise, often with thoughts of suicidal ideation. The patient received a total of five FMT’s with one delivered by colonoscopy and the remaining four by rectal enemas over one week. Within the following six month period, the patient experienced almost complete remission from all GI symptoms with rare instances of flare ups comprising of abdominal pain and diarrhoea. He could also exercise freely and no longer required an antidepressant with a self-reported improvement in mood and other generalised symptoms of depression. However, after six months the patient’s overall health declined with a significant flare up of neurological and GI symptoms. At the time, this deterioration was compounded by significant financial hardship. Further deterioration was also noted nine years later, after complications from surgery which resulted in physical deformity of the patient. At present the patient’s depression and IBS remains well controlled on Pristiq and Rifaxamin.

ICYMI: Cornea Update: Lacripep for the Treatment of Primary Sjögren–Associated Ocular Surface Disease: Results of the First-In-Human Study: Purpose: The purpose of this study was to assess the safety, tolerability, dosing, and efficacy of the active 19 amino acid fragment of lacritin (Lacripep), a broad regulator of ocular surface homeostasis, in the treatment of ocular surface disease associated with primary Sjögren syndrome. Methods: Two hundred four subjects were randomized to receive vehicle, 22 μM Lacripep, or 44 μM Lacripep 3 times daily for 28 days, preceded by a 14-day run-in and followed by 14-day washout. Outcome measures were corneal fluorescein staining (CFS), lissamine conjunctival staining, Schirmer with anesthesia, tear break-up time, SANDE scoring, and visual analog scale assessment of symptoms. Results: This study established the safety and tolerability of topical treatment with Lacripep in patients with primary Sjögren syndrome. There were few adverse events: Only mild irritation was found in less than 3 percent of patients dosed with Lacripep. Total CFS and Eye Dryness Score were not significantly changed at day 28. Post hoc analysis of patients with Eye Dryness Severity scores of 60 or greater at baseline revealed significant improvements in inferior CFS at 14 and 28 days and complaints of burning and stinging at 14 days. Significant improvement in regional lissamine conjunctival staining was seen at 14 and 28 days. Conclusions: This first-in-human study of Lacripep in patients with primary Sjögren syndrome demonstrated clinically significant improvements in specific signs and symptoms on which to base future studies. This study established safety and tolerability and potential metrics of efficacy in patients with moderate to severe disease. Further work on appropriate dosing and concentration is ongoing. http://dlvr.it/T8Tw9s #Cornea #MostPopularArticles #Ophthalmology

ICYMI: Cornea Update: Lacripep for the Treatment of Primary Sjögren–Associated Ocular Surface Disease: Results of the First-In-Human Study: Purpose: The purpose of this study was to assess the safety, tolerability, dosing, and efficacy of the active 19 amino acid fragment of lacritin (Lacripep), a broad regulator of ocular surface homeostasis, in the treatment of ocular surface disease associated with primary Sjögren syndrome. Methods: Two hundred four subjects were randomized to receive vehicle, 22 μM Lacripep, or 44 μM Lacripep 3 times daily for 28 days, preceded by a 14-day run-in and followed by 14-day washout. Outcome measures were corneal fluorescein staining (CFS), lissamine conjunctival staining, Schirmer with anesthesia, tear break-up time, SANDE scoring, and visual analog scale assessment of symptoms. Results: This study established the safety and tolerability of topical treatment with Lacripep in patients with primary Sjögren syndrome. There were few adverse events: Only mild irritation was found in less than 3 percent of patients dosed with Lacripep. Total CFS and Eye Dryness Score were not significantly changed at day 28. Post hoc analysis of patients with Eye Dryness Severity scores of 60 or greater at baseline revealed significant improvements in inferior CFS at 14 and 28 days and complaints of burning and stinging at 14 days. Significant improvement in regional lissamine conjunctival staining was seen at 14 and 28 days. Conclusions: This first-in-human study of Lacripep in patients with primary Sjögren syndrome demonstrated clinically significant improvements in specific signs and symptoms on which to base future studies. This study established safety and tolerability and potential metrics of efficacy in patients with moderate to severe disease. Further work on appropriate dosing and concentration is ongoing. http://dlvr.it/T87G3n #Cornea #MostPopularArticles #Ophthalmology

ICYMI: Cornea Update: Lacripep for the Treatment of Primary Sjögren–Associated Ocular Surface Disease: Results of the First-In-Human Study: Purpose: The purpose of this study was to assess the safety, tolerability, dosing, and efficacy of the active 19 amino acid fragment of lacritin (Lacripep), a broad regulator of ocular surface homeostasis, in the treatment of ocular surface disease associated with primary Sjögren syndrome. Methods: Two hundred four subjects were randomized to receive vehicle, 22 μM Lacripep, or 44 μM Lacripep 3 times daily for 28 days, preceded by a 14-day run-in and followed by 14-day washout. Outcome measures were corneal fluorescein staining (CFS), lissamine conjunctival staining, Schirmer with anesthesia, tear break-up time, SANDE scoring, and visual analog scale assessment of symptoms. Results: This study established the safety and tolerability of topical treatment with Lacripep in patients with primary Sjögren syndrome. There were few adverse events: Only mild irritation was found in less than 3 percent of patients dosed with Lacripep. Total CFS and Eye Dryness Score were not significantly changed at day 28. Post hoc analysis of patients with Eye Dryness Severity scores of 60 or greater at baseline revealed significant improvements in inferior CFS at 14 and 28 days and complaints of burning and stinging at 14 days. Significant improvement in regional lissamine conjunctival staining was seen at 14 and 28 days. Conclusions: This first-in-human study of Lacripep in patients with primary Sjögren syndrome demonstrated clinically significant improvements in specific signs and symptoms on which to base future studies. This study established safety and tolerability and potential metrics of efficacy in patients with moderate to severe disease. Further work on appropriate dosing and concentration is ongoing. http://dlvr.it/T4G1yV #Cornea #MostPopularArticles #Ophthalmology

https://lnkd.in/gmfbkZTd Article title: Accuracy of the Full Spectrum Endoscopy (FUSE) system for assessment of disease activity in Inflammatory Bowel Diseases (IBD) compared to high-definition endoscopy   Author(s): Heinz Albrecht; Michael Vieth; Gian Eugenio Tontini; Helmut Neumann   Journal: Archives of Clinical Gastroenterology   Journal ISSN: 2455-2283 Abstract   Introduction: Recently, Full Spectrum Endoscopy (FUSE) was introduced as a novel colonoscopy platform. In contrast to other endoscopy systems illumination with the FUSE system is achieved by Light-Emitting Diodes (LEDs) and not by a xenon light source. Currently, the FUSE-system does not provide high-definition imaging yet. In patients with IBD, precise assessment of disease activity (i.e. mucosal healing) is of paramount importance to predict disease outcome and to guide therapy. #InflammatoryBowelDisease #FunctionalGIDisorders #GastrointestinalAndLiverDisease #DigestiveOncology #GastrointestinalSurgery #PediatricGastroenterology #ColorectalCancer #PancreaticCancer #HepatocellularCarcinoma #GastrointestinalBleeding #Endoscopy #Peertechz #PeertechzPublications #SurgicalGastroenterology #StomachUlcers #VirtualColonoscopy #GastricUlceration #RouxenYGastricBypass #GastricAcidSecretion #GastricMucosa #GastricUlcerHealing #GastricCardiaCancer #ReproductiveEndocrinology #EndocrineDisorders #Hepatology #AlimentaryCanal #PancreasCancer

ICYMI: Cornea Update: Lacripep for the Treatment of Primary Sjögren–Associated Ocular Surface Disease: Results of the First-In-Human Study: Purpose: The purpose of this study was to assess the safety, tolerability, dosing, and efficacy of the active 19 amino acid fragment of lacritin (Lacripep), a broad regulator of ocular surface homeostasis, in the treatment of ocular surface disease associated with primary Sjögren syndrome. Methods: Two hundred four subjects were randomized to receive vehicle, 22 μM Lacripep, or 44 μM Lacripep 3 times daily for 28 days, preceded by a 14-day run-in and followed by 14-day washout. Outcome measures were corneal fluorescein staining (CFS), lissamine conjunctival staining, Schirmer with anesthesia, tear break-up time, SANDE scoring, and visual analog scale assessment of symptoms. Results: This study established the safety and tolerability of topical treatment with Lacripep in patients with primary Sjögren syndrome. There were few adverse events: Only mild irritation was found in less than 3 percent of patients dosed with Lacripep. Total CFS and Eye Dryness Score were not significantly changed at day 28. Post hoc analysis of patients with Eye Dryness Severity scores of 60 or greater at baseline revealed significant improvements in inferior CFS at 14 and 28 days and complaints of burning and stinging at 14 days. Significant improvement in regional lissamine conjunctival staining was seen at 14 and 28 days. Conclusions: This first-in-human study of Lacripep in patients with primary Sjögren syndrome demonstrated clinically significant improvements in specific signs and symptoms on which to base future studies. This study established safety and tolerability and potential metrics of efficacy in patients with moderate to severe disease. Further work on appropriate dosing and concentration is ongoing. http://dlvr.it/T4fYqN #Cornea #MostPopularArticles #Ophthalmology

#Teratoma The patient was referred to us by her general practitioner for an X-ray of her right hip in order to exclude the possibility of her having arthritis, and she complained of having a gnawing pain! The X-ray film revealed the presence of a large right-sided teratoma of the ovary containing highly differentiated teeth. Teratomas are known to be ovarian neoplasms of a germ cell origin, and they are classified as mature (96%, also called dermoid cysts), immature, and monodermal teratomas. All teratomas are of the karyotype 46,XX and are derived from ectodermal differentiation of totipotential cells arising from an ovum after the first meiotic division. Teratomas are most commonly found during the reproductive years, with a peak incidence in the second and third decades. Similar to other ovarian neoplasms, teratomas are usually either asymptomatic or produce only vague gastrointestinal symptoms or pelvic pressure. Torsion can occur in up to 15% of the patients with dermoid cysts, because the high fat content of these masses allows them to float in the abdominal cavity. Once detected, the diagnosis of an ovarian teratoma rests primarily on radiologic findings of fat, calcium, or dental elements. Predictive factors of benign disease include age (ovarian teratomas in younger patients are more commonly benign), size (<15 cm usually benign), and CA 125 level (<35 U/mL usually benign). In 2% of the patients with a previously classified benign disease, malignant degeneration can occur, usually from squamous cell elements. The treatment for dermoid cysts is surgical excision, and prognosis is excellent.