bluuebunny/crossref_metadata_2025_split huggingface dataset:
Could ultrasound and muscle elastography be associated with clinical assessment, laboratory and nailfold capillaroscopy in juvenile dermatomyositis patients?
Authors: de Andrade Renata Lopes Francisco , Mendonça José Alexandre , Piotto Daniela Petry , Guimarães Julio Brandão , Terreri Maria Teresa 
Published: October 2023

Abstract
Background
Juvenile Dermatomyositis (JDM) is the most common idiopathic inflammatory myopathy in children. Imaging exams are useful for muscle assessment, with ultrasonography (US) being a promising tool in detecting disease activity and tissue damage. There are few studies about muscle elastography.

Objectives
Our aim was to associate clinical, laboratory, and nailfold capillaroscopy (NC) assessments with US in JDM patients; and to compare the findings of US and Strain Elastography (SE) from patients and healthy controls.

Methods
An analytic cross-sectional study was performed with JDM patients and healthy controls. Patients underwent clinical exam to access muscle strength and completed questionnaires about global assessment of the disease and functional capacity. Patients were submitted to NC and measurement of muscle enzymes. All subjects underwent US assessment, using gray scale, Power Doppler (PD), and SE.

Results
Twenty-two JDM patients and fourteen controls, aged between 5 and 21 years, matched for age and sex were assessed. In qualitative and semi-quantitative gray scale, we observed a higher frequency of alterations in patients (p < 0.001), while in PD, there was a higher frequency of positivity in patients’ deltoids and anterior tibialis (p < 0.001). Active disease was associated with an important change in the semi-quantitative gray scale in deltoids (p = 0.007), biceps brachii (p = 0.001) and quadriceps femoris (p = 0.005). The SE demonstrated a high negative predictive value of 87.2.

Conclusion
US was able, through gray scale, to differentiate JDM patients from controls, while PD achieved such differentiation only for deltoids and anterior tibialis. The semi-quantitative gray scale showed disease activity in proximal muscles. SE was not able to differentiate patients from controls.
Hearing assessment and treatment outcome in ENT tuberculosis at a tertiary hospital in India
Authors: Chavan Reshma P. , Parokaran Anish Anto , Nazir Hamna Abdu , Damodhar Ajay P. 
Published: October 2023

Abstract
Aim
An attempt has been made to observe the response of anti-Koch’s treatment and the effect of anti-Koch’s treatment on hearing in ENT tuberculosis patients by pure tone audiometry.

Material and methods
A prospective observational study was carried out at the Government Medical College Hospital. A total of 200 cases diagnosed with tuberculosis in the head and neck regions were included in the study. Sputum/pus of patients were sent for cartridge-based nucleic acid amplification test (CBNAAT). Hearing assessment was done with PTA1 at the start of the treatment, PTA2 after the intensive phase (IP) at 2 months for newly diagnosed patients and at 3 months for previously treated patients, and PTA3 at the end of the AKT treatment given as per guidelines.

Results
Among 200 ENT tuberculosis patients, 176 patients were cured with a new case regimen, and one patient was a defaulter. Among 19 patients who were previously treated cases (CAT II regimen), two patients had treatment failure, and the other 17 patients were cured. Four patients diagnosed to have multidrug-resistant tuberculosis (MDR-TB) on the initial drug susceptibility testing (DST) were given 24 months’ treatment according to the recent guidelines of MDR-TB treatment regimen, and the patients were cured. In the present study of 200 patients, in the first PTA, 192 patients had normal hearing; in the second PTA, 106 patients had normal hearing; and in the third PTA, 35 patients had normal hearing. 21.7% of cases who were on aminoglycoside therapy developed significant sensorineural hearing loss in high frequency.

Conclusion
Anti-Koch’s treatment (AKT) has proven effective in ENT tuberculosis. All patients taking anti-Koch’s treatment should be regularly monitored for hearing loss, adherence to treatment, drug-resistant variants, and local recurrences.
FRI076 Colchicine Treatment Effects On The Gut Microbiome In Adults With Metabolic Syndrome, Insulin Resistance, And High C-reactive Protein (CRP): A Secondary Analysis Of A Randomized, Placebo-controlled Clinical Trial
Authors: Kisimba Celine M , Donahue Jack L , Chivukula Krishna Karthik , Subramanian Poorani , Mistry Shreni D , Wolska Anna , Remaley Alan T , Yanovski Jack Adam , Demidowich Andrew Paul 
Published: October 2023

Abstract
Disclosure: C.M. Kisimba: None. J.L. Donahue: None. K.K. Chivukula: None. P. Subramanian: None. S.D. Mistry: None. A. Wolska: None. A.T. Remaley: None. J.A. Yanovski: None. A.P. Demidowich: None.
Background: Obesity-induced inflammation plays a substantial role in the development of insulin resistance and type 2 diabetes. The altered gut flora in obesity can also contribute to metabolic dysregulation and systemic inflammation. However, it remains unclear how dysregulation of systemic inflammation in obesity affects the gut microbiome. We hypothesized that colchicine’s systemic anti-inflammatory effects in obesity would be associated with improvements in gut microbial diversity. Methods: This study was a secondary analysis of a double-blind randomized placebo-controlled trial, in which 40 adults with obesity, high CRP (≥ 2.0 mg/L), insulin resistance (HOMA-IR ≥ 2.6 mg/L), and metabolic syndrome (MetS) were randomized to three months of colchicine 0.6mg or placebo tablets twice daily. Serum and stool samples were collected at baseline and final visit. Gut microbiota composition was characterized from stool DNA by dual-index amplification and sequencing of 16S ribosomal RNA. Results: Pre- and post-intervention stool samples were available for 15 colchicine- and 12 placebo-treated subjects. Circulating hsCRP, interleukin-6, resistin, white blood count, and neutrophils were significantly decreased in the colchicine arm as compared to placebo. However, changes in stool microbiome alpha diversity, as assessed by the Chao1, Shannon, and Pielou indices, were not significant between groups. Sequence variant counts were unchanged among all examined phyla or families. Oscillibacter was the only genus to demonstrate even a nominally significant change. Conclusion: Among adults with obesity and MetS, colchicine significantly improved systemic inflammation. However, this anti-inflammatory effect was not associated with significant changes in the gut microbiome. Further studies are warranted to investigate this relationship.
Presentation: Friday, June 16, 2023
SAT663 Determination Of Mitochondrial DNA Mass In Women With Polycystic Ovary Syndrome
Authors: Rojo Mailén , Millán Andrea L , Pérez Hernán , Pautasso Constanza M , Maidana Patricia N A , Emily Matos Viloria G , Cerrone Gloria E , Frechtel Gustavo D 
Published: October 2023

Abstract
Disclosure: M. Rojo: None. A.L. Millán: None. H. Pérez: None. C.M. Pautasso: None. P.N. Maidana: None. M.G. Emily: None. G.E. Cerrone: None. G.D. Frechtel: None.
Polycystic ovary syndrome (PCOS) is characterized by the presence of obesity and/or metabolic syndrome that can influence mitochondrial DNA content. Objective: To evaluate the mitochondrial DNA mass in women with PCOS in comparison with control women and its relationship with metabolic parameters and absolute telomeric length (aTL). Materials and methods: We studied 81 women with PCOS and 57 control women aged 16 to 46 years. The copy number of mitochondrial DNA (mtDNA) was determinated in peripheral blood leukocytes by quantitative PCR in real time, SYBR Green method. The relationship between mtDNA copy number and copy number of the single copy β2 microglobulin gene was measured. Anthropometric, metabolic and hormonal variables (PCOS) were studied to carry out linear regression between the ADNmt content and the distinct comparative form variables between the distinct groups. Statistical analysis was carried out in SPSS version 25 with a significance level of 0.05. Results: Compared to controls, PCOS patients have higher body mass index (BMI), waist circumference (WC), levels of TG, LDL-c, total cholesterol, fasting plasma glucose, and lower levels of HDL-c. We observed that mitochondrial DNA mass was significantly lower in the presence of PCOS (216,40±140,9 vs 164.59 ± 102.07; p = 0.020). When corrected for age, this result is still significant. PCOS women were classified as metabolically healthy PCOS (PCOS-MH) and PCOS with metabolic syndrome (PCOS-SM). We observed a progressive decrease in mtDNA content between control, PCOS-MH, and PCOS-SM (215,42±143,39; 179,64±106,12; 149,69±93,13), with statistical significance between control and PCOS-SM (p=0,044), maintained after age correction (p=0,023). By linear regression we found association of mtDNA mass with BMI (p=0,013) and WC (p=0,030). An association tendency was observed between lower mitochondrial DNA mass and higher HOMA index (p=0,086), also, with longer aTL (p = 0.088). Conclusion PCOS-MH was defined as an intermediate phenotype between controls and PCO-SM, when mass mtDNA mass, aTL and metabolic variables were studied, reflecting the oxidative stress associated with PCOS that could cause damage mtDNA, proteins and lipids.
Presentation: Saturday, June 17, 2023
THU072 Association Between Nonalcoholic Fatty Liver Disease And Growth Hormone Deficiency In Patients With Nonfunctioning Pituitary Adenoma
Authors: Hwang Yoon-a , Lee Hye Won , Ahn Sang Hoon , Lee Eun-Jig , Ku Cheol Ryong , Kim Seung Up 
Published: October 2023

Abstract
Disclosure: Y. Hwang: None. H. Lee: None. S. Ahn: None. E. Lee: None. C. Ku: None. S. Kim: None.
Objective: We investigated the association between nonalcoholic fatty liver disease (NAFLD) and growth hormone deficiency (GHD) in patients with non-functioning pituitary adenoma (NFPA). Methods: Patients with NFPA who underwent transsphenoidal adenectomy between January 2005 and December 2018 were recruited. Pituitary function was determined by the insulin tolerance test, thyroid hormone assay, and gonadal hormone levels. NAFLD was defined as a hepatic steatosis index greater than 36. Results: 278 patients were included for the analysis. Mean age was 44.2 years and 58.6%[n=163] patients were female. Among 278 patients,103 (37.0%) had GHD, 139 (50.0%) had hypogonadism. 75 out of 278 patients (27.0%) had NAFLD. The prevalence of NAFLD was significantly higher in patients with GHD than in those without (36.9% vs. 21.1%, p=0.01). Even after adjusting for age, total cholesterol level, gonadal function, and prolactin level, patients with GHD had approximately two-fold higher prevalence of NALFD than those without GHD (adjusted odds ratio [OR]=1.85, 95% confidence interval [CI]=1.05-3.28, p=0.03). Among female patients, the prevalence of NALFD was significantly higher in those with GHD than in those without (adjusted OR=2.39, 95% CI=1.03-5.55, p=0.04). On the other hand, the prevalence of NAFLD among male patients was statistically similar between patients with and without GHD (p&gt;0.05). In addition, gonadal function did not affect the prevalence of NAFLD in patients with NFPA (29.3% with eugonadism vs. 47.8% with hypogonadism, p=0.14). Conclusion: The prevalence of NAFLD among patients with NFPA was twice as high as among patients without GHD. Thus, screening for NAFLD may be necessary in NFPA patients with GHD.
Presentation: Thursday, June 15, 2023
THU074 Plasma Spexin In Metabolic Syndrome Related To Adult Growth Hormone Deficiency: A Cross-sectional Study
Authors: Vergani Edoardo , Oliva Alessandro , Bruno Carmine , Currò Diego , Mancini Antonio 
Published: October 2023

Abstract
Disclosure: E. Vergani: None. A. Oliva: None. C. Bruno: None. D. Currò: None. A. Mancini: None.
Adult growth hormone deficiency (aGHD) shares with metabolic syndrome some clinical features such as higher fat mass percentage, increased total cholesterol, LDL, triglycerides, reduced HDL, and higher risk of developing type 2 diabetes mellitus and cardiovascular complications. Spexin, also known as neuropeptide Q, is a 14-aminoacid polypeptide, related to the galanin-kisspeptin family, produced in several human tissues. It is also secreted along with insulin by pancreatic beta cells; via paracrine effects they blunted reciprocal secretion. In type 2 diabetes mellitus spexin is closely correlated to fasting and post prandial glucose, glycosylated hemoglobin and HOMA index. Moreover, spexin infusion seems to ameliorate ALT and AST levels in non-alcoholic fatty liver disease. Given its controversial role in condition of metabolic impairment, we aimed to evaluate spexin plasmatic levels in aGHD. Thirty-eight subjects were included in the study, 18 aGHD patients (7 females and 11 males) and 20 healthy controls (12 females and 8 males). aGHD was diagnosed by a GHRH plus arginine test. Etiologies of GHD were as follows: 7 empty sellas, 5 post-surgical hypopituitarism, and 6 idiopathic with negative MRI scans. GHRH plus arginine stimulation tests were repeated twice in idiopathic aGHD to confirm the diagnosis. They were evaluated for glucose and insulin, HOMA and QUICKI index, total/LDL/HDL cholesterol, triglycerides, uric acid and IGF-1. Spexin was measured by ELISA, according to manufacturers’ protocols. Fat mass percentage was evaluated by DXA. Mean±SEM age of aGHD group was 59.7±2.7 years, while BMI was 30.2±2.2 kg/m2; control group aged 47.1±2.5 years, while BMI was 24.5±0.9 kg/m2. As expected, aGHD patients showed higher HOMA index, triglycerides and lower HDL than controls. Furthermore mean±SEM fat mass percentage was significantly higher in aGHD than controls (44.41±3.15 vs 32.2±3.64). Spexin levels were similar in the two groups (aGHD 1.17±0.21 vs controls 1.25±0.10 ng/ml). significant correlations were found in both populations. These results, although preliminary, seem to exclude a possible role of spexin in aGHD; however, spexin could represent another possible element of differentiation between aGHD and metabolic syndrome. Such controversial topic requires further evaluations.
Presentation: Thursday, June 15, 2023
FRI279 Submaximal Loss Of KNDy Neurons Accelerates And Amplifies Pulsatile LH Secretion In Female Rats
Authors: Campideli-Santana Ana C , da Costa Silva Kaoma S , Araújo-Lopes Roberta , Antunes Luma M , Szawka Raphael E 
Published: October 2023

Abstract
Disclosure: A.C. Campideli-Santana: None. K.S. da Costa Silva: None. R. Araújo-Lopes: None. L.M. Antunes: None. R.E. Szawka: None.
Kisspeptin is a powerful stimulator neuropeptide in the hypothalamus-pituitary-gonadal axis and is essential for fertility. Neurons in the arcuate nucleus (ARC) of the hypothalamus that coexpress kisspeptin, neurokinin B, and dynorphin (KNDy) play a crucial role in the control of luteinizing hormone (LH) secretion, but the neuroendocrine mechanisms involved in this regulation are not fully understood. Our previous study demonstrated that the moderate loss of KNDy neurons amplifies the LH surge induced by estradiol in ovariectomized rats (1). The current study aimed to perform a longitudinal evaluation of female rats in which KNDy neurons were ablated to determine the integrated role of this neuronal population in the control of pulsatile LH secretion. Adult female rats underwent a neurochemical ablation of KNDy neurons via intra-ARC stereotaxic injections of neurokinin-3 receptor agonist conjugated with saporin (NK3-SAP), while control animals received blank-saporin (Control). Estrous cyclicity was monitored over 21 days before and after the stereotaxic surgery. Three weeks after surgery, blood samples (10 µL) were withdrawn from the tail tip at 6-minute intervals for 180 minutes on the day of diestrus. Rats were then ovariectomized and the ovaries were processed for histological analysis. Whole blood LH levels were measured by ELISA and brains were immunohistochemically labeled for neurokinin B in the ARC. NK3-SAP rats bearing a submaximal loss of KNDy neurons (between 55-95%; n = 8) displayed irregular estrous cycles. The ovarian weight and the number of corpora lutea and atretic follicles were unaltered, whereas the number of healthy early antral follicles decreased in NK3-SAP rats. The frequency of LH pulses was increased and both pulse amplitude and mean LH levels were higher in NK3-SAP compared with Control rats. Thus, the submaximal loss of KNDy neurons affects the regularity of estrous cyclicity but does not preclude ovulation, while seems to stimulate the maturation of early antral follicles. Notably, KNDy neuron loss accelerates and amplifies LH pulsatile secretion during the rat estrous cycle. These results suggest a new role for KNDy neurons in restraining the frequency and amplitude of LH pulses in ovary-intact animals, with possible implications in the rate of recruitment of early antral follicles.
Reference: Campideli-Santana et al., J Neuroendocrinol. 2022 Nov;34(11):e13204. Support: FAPEMIG, CNPq, CAPES, and Pro-reitoria de Pesquisa-UFMG.
Presentation: Friday, June 16, 2023
FRI353 Diabetes Insipidus - Pituitary Apoplexy Or Placental Vasopressinase?
Authors: Rodrigues Nimmy M , Palacios Merchan Juan Diego , Twahirwa Marcel B 
Published: October 2023

Abstract
Disclosure: N.M. Rodrigues: None. J. Palacios Merchan: None. M.B. Twahirwa: None.
Background: Pituitary apoplexy is rare in pregnancy. Diabetes insipidus is rare at apoplexy onset, present in about 5% of patients presenting with apoplexy. Gestational DI can occur due to placental vasopressinase though this is more common in twin pregnancies and pre-eclampsia. Clinical Case: 28-year-old Hispanic woman was admitted at 34-weeks' gestation for 1 week of headache, visual symptoms, elevated blood pressure and polyuria. Her thirst was intact. She had a known history of 8 mm prolactinoma, which was diagnosed 2 years prior to admission. She was treated with Cabergoline 0.5 mg twice weekly, which was stopped once pregnancy was confirmed. A 24-hour urine collection was performed as part of her pre-eclampsia workup. Total volume was 11,250 mL, osmolality 97 mOsm/kg and sodium of 25 mmol/L. Serum sodium was 136 mmol/L. MRI of the brain showed pituitary apoplexy with large suprasellar area hemorrhage, compressing the pituitary gland and infundibulum, resulting in anterior displacement. The optic chiasm was also compressed and displaced superiorly. Her BP remained normal throughout admission and pre-eclampsia workup was negative. Lab work did not show significant hypopituitarism with TSH of 1.3 microIU/mL, Free T4 0.53 ng/dL, random Cortisol of 11.5 mcg/dL, IGF-1 167 ng/mL, Copeptin 3.8 pmol/L. Considering this was the third trimester of pregnancy as well as the chronicity of the bleed, thought to be 5-7 days, neurosurgery suggested conservative management. She continued to maintain normal serum sodium levels throughout admission. She was delivered at 35 weeks by Caesarean section. She received Hydrocortisone 100 mg IV before the surgery. She also received DDAVP 1 mcg IV before delivery since her sodium level increased to 145 mmol/L from a baseline of 133-136 mmol/L. The delivery was uneventful, and she had a healthy baby. After delivery, her urine output decreased to 180 cc/hour with significant improvement in thirst. Her serum sodium remained normal. This raises the question of whether DI was due to apoplexy or placental effect. Conclusion: Even though pregnancy causes hypertrophy of the lactotrophs, pituitary apoplexy is less common in microadenomas. Apoplexy in pregnancy is very rare, occurring only in 1 in 10,000 gestations. The clinical presentation in this case suggests a low threshold to order pituitary imaging in cases presenting with concerning sign symptoms of increase intracranial pressure. Guidelines are limited in the management of pituitary apoplexy in pregnancy. There are case reports and case series where patients with apoplexy were delivered with C- section at 34 weeks. In addition, the element of pregnancy induced DI makes this presentation unique.
Presentation: Friday, June 16, 2023
FRI354 Therapeutic Potential Of Oxcarbazepine In Central Diabetes Insipidus
Authors: Pittampalli Shanti , Pattan Vishwanath , Das Dhriti , Munasinghe Uthpala 
Published: October 2023

Abstract
Disclosure: S. Pittampalli: None. V. Pattan: None. D. Das: None. U. Munasinghe: None.
Introduction: Postoperative central Diabetes insipidus is usually transient but can be persistent. Persistent central Diabetes insipidus is prone to dose fluctuations in clinically unstable patients, especially when concomitant medications influence sodium and water homeostasis. Clinical Case: A 24-year-old female with headache and confusion had sellar and suprasellar mass of 6 cm x 4 cm with moderate to severe hydrocephalus and underwent Right craniotomy with debulking of the mass and pathology showed pilocytic astrocytoma. Postoperative course was complicated by short-term memory loss, right-sided weakness, adrenal insufficiency, and visual impairment. Repeat imaging showed increased size of suprasellar mass consequently requiring a transnasal transphenoidal resection. Post-operative neurological worsening was noted along with diffuse subarachnoid/ intraventricular hemorrhage with intraparenchymal hematoma in the right frontal lobe on CTA head. Hospital course included tracheostomy with mechanical ventilation. She had panhypopituitarism including CDI. CDI was initially managed by DDAVP 10mcg intranasal nightly and free water flushes. She had central adrenal insufficiency and central hypothyroidism treated by hydrocortisone and levothyroxine respectively. Hospital stay lasted for several months with multiple adjustments to the DDAVP dosage and free water flushes due to fluctuating serum sodium levels. She was started on levetiracetam 750 mg twice daily and oxcarbazepine 300 mg twice daily for seizure like activity. After two months, the oxcarbazepine dose was increased to 450 mg twice daily and later to 600 mg twice daily for breakthrough seizures. DDAVP was then discontinued as she developed hyponatremia. The dose of oxcarbazepine was reduced to 450 mg twice daily and she was subsequently discharged to a facility off DDAVP. Discussion: Postoperative CDI managed by DDAVP was complicated with oxcarbazepine-induced hyponatremia. CDI and sodium levels were controlled with oxcarbazepine after DDAVP discontinuation. Thus, oxcarbazepine has therapeutic potential as an antidiuretic agent as it can stimulate collecting tubule V2 receptor - G protein complex independent of ADH.
Presentation: Friday, June 16, 2023