Diffusion tensor imaging analysis of rheumatoid arthritis patients with neuropsychiatric features to determine the alteration of white matter integrity due to vascular events

Clinical Rheumatology - The pathophysiology of neuropsychiatric manifestations in rheumatoid arthritis is not well known. The magnetic resonance imaging of the brain in rheumatoid arthritis...     

Cost‐effective screening method for antinuclear antibody detection

Aim: To evaluate indirect immunoenzyme (IIE) technique, for detection of antinuclear antibodies (ANA) using serum and filter paper blood clots (FPBC) especially for screening. Methods: Antinuclear antibody processing from FPBC (prepared by expressing blood drops by finger pricking) was standardized in a pilot study. Paired samples (serum and corresponding FPBC) from 224 individuals [142 patients of systemic rheumatic diseases, chiefly lupus and rheumatoid arthritis (RA) and 82 healthy controls (HC)] were tested by the standard immunofluorescence (IIF) and IIE (using light microscope); samples were coded, blinded and randomly processed as per the protocol. End‐point titres were determined for positive serum samples only. Standard reagents (Immunoconcepts Incorporation, US) and controls (CDC, Atlanta, US) were used. All patients were identified in a rheumatology referral practice in an Indian metropolis. Results: The sensitivity of IIE and IIF for SLE, using serum and FPBC was ≈90%. The specificity of IIE and IIF for SLE, using serum and FPBC was in the range 66–73% and 58–63%, respectively. Good–perfect agreement (κ > 0.8) between the results was obtained by IIE and IIF for all groups except RA. Except the RA group, all other paired samples showed good concordance (72%) on testing for ANA patterns by both techniques. Conclusions: Indirect immunoenzyme technique is a robust technique and should be considered a viable option to IIF at least in countries like India; its further use on FPBC is a socioeconomically appealing proposition for carrying out population studies on lupus and related uncommon connective tissue disorders.     

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

Purpose

Many echocardiographic indices (or methods) for assessing right ventricular (RV) function are available, but each has its strengths and limitations. In some cases, there might be discordance between the indices. We conducted a systematic review to audit the echocardiographic RV assessments in critical care research to see if a consistent pattern existed. We specifically looked into the kind and number of RV indices used, and how RV dysfunction was defined in each study.

Methods

Studies conducted in critical care settings and reported echocardiographic RV function indices from 1997 to 2017 were searched systematically from three databases. Non-adult studies, case reports, reviews and secondary studies were excluded. These studies’ characteristics and RV indices reported were summarized.

Results

Out of 495 non-duplicated publications found, 81 studies were included in our systematic review. There has been an increasing trend of studying RV function by echocardiography since 2001, and most were conducted in ICU. Thirty-one studies use a single index, mostly TAPSE, to define RV dysfunction; 33 used composite indices and the combinations varied between studies. Seventeen studies did not define RV dysfunction. For those using composite indices, many did not explain their choices.

Conclusions

TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction amongst these studies.

     

Antimicrobial properties of black grape (Vitis vinifera L.) peel extracts against antibiotic-resistant pathogenic bacteria and toxin producing molds

Aim:

Black grape peel possesses a substantial amount of polyphenolic antimicrobial compounds that can be used for controlling the growth of pathogenic microorganisms. The purpose of this study was to assess antibacterial and antifungal activity of black grape peel extracts against antibiotic-resistant pathogenic bacteria and toxin producing molds, respectively.

Materials and Methods:

Peel of grape was subjected to polyphenolic extraction using different solvents viz., water, ethanol, acetone, and methanol. Antibiotic-resistant strains of Staphylococcus aureus, Enterococcus faecalis, Enterobacter aerogenes, Salmonella typhimurium, and Escherichia coli were screened for the antibacterial activity of different grape extracts. Antibacterial activity was analyzed using agar well diffusion method. Penicillium chrysogenum, Penicillium expansum, Aspergillus niger and Aspergillus versicolor were screened for the antifungal activity. Antifungal activity was determined by counting nongerminated spores in the presence of peel extracts.

Results:

As compared to other solvent extracts, methanol extracts possessed high antibacterial and antifungal activity. S. typhimurium and E. coli showed complete resistance against antibacterial action at screened concentrations of grape peel extracts. Maximum zone of inhibition was found in case of S. aureus, i.e., 22 mm followed by E. faecalis and E. aerogenes, i.e., 18 and 21 mm, respectively, at 1080 mg tannic acid equivalent (TAE)/ml. The maximum and minimum percent of growth inhibition was shown by P. expansum and A. niger as 73% and 15% at 1080 TAE/ml concentration of grape peel extract, respectively.

Conclusions:

Except S. typhimurium and E. coli, growth of all bacterial and mold species were found to be significantly (P < 0.05) inhibited by all the solvent extracts.KEY WORDS: Antibacterial activity, antifungal activity, polyphenolic compounds, Vitis vinifera L, zone of inhibition     

Mycophenolate in idiopathic inflammatory myositis: outcome data of a large South Asian cohort

Clinical Rheumatology - Consensus on treatment of idiopathic inflammatory myositis (IIM), particularly with regard to flares and interstitial lung disease (ILD), does not exist. We studied the...