Mikayla Savastano’s Post

The first guideline for cancer screening in #myositis, a rare muscle disease which has an increased cancer risk, has been developed by Manchester BRC researchers. Myositis is an auto-immune muscle disease affecting approximately 10,000 people in the UK and evidence suggests up to 1 in 4 people with myositis will develop cancer within 3 years of diagnosis. Led by Dr Alexander Oldroyd, the aim of the international guideline is to empower clinicians to detect cancer early, especially those at high risk, contributing to better overall outcomes. Read more 👇 https://lnkd.in/euBfvrgr Dr Oldroyd is part of the Rheumatic and Musculoskeletal Diseases (RMD) Theme in Manchester BRC’s Inflammation Cluster along with Respiratory Medicine, Dermatology and Integrative Cardiovascular Medicine. Watch our Spotlight On film to find out how Manchester BRC’s research is driving health improvements in RMD and other health conditions: https://lnkd.in/dzhmqU2X

Ophthopedia Update:Recombinant Deoxyribonuclease I Eye Drops for Ocular Graft Versus Host Disease: Results of a Randomized Clinical Trial: Objective: We have previously shown that neutrophil extracellular traps (NETs) are present on the ocular surface of patients with ocular graft versus host disease (oGVHD), contributing to inflammation and surface disease. Therefore, we performed a clinical trial using deoxyribonuclease I (DNAase) eye drops to test the hypothesis that reducing the abundance of NETs from the ocular surface will reduce signs and symptoms of oGVHD. Methods: A prospective, phase I or II, randomized, placebo-controlled, double-masked clinical trial was performed to determine the safety and preliminary efficacy of DNAase (0.1%) eye drops four times daily for 8 weeks in patients with oGVHD (n=58). Intent-to-treat analysis was performed to determine the change in safety outcome measures (drug tolerability and proportion of adverse events) and efficacy outcome measures (ocular surface disease index [OSDI] score and corneal staining) between baseline and week 8. Results: Tolerability and adverse events were similar in the vehicle and DNAase groups. Within the DNAase group (but not the vehicle group), corneal staining showed a statistically significant and clinically meaningful reduction at week 8 (3.50 [2.75; 5.00]) compared with baseline (5.00 [3.00; 7.00]). The OSDI score also showed a statistically significant clinically meaningful reduction of 18.4 (9.16; 33.1) (P #Ophthalmology #Eye #Ophthotwitter

Redefining Rural Healthcare: Penn Trafford Family Medicine Pioneer Leads in Skin Cancer Detection with DermaSensor!   Kevin Wong, MD stated, “This is a rare quadruple win in medicine! It’s a win for the patients, a win for the providers, a win for dermatologists, and a win for insurers. For the patients, it may provide peace of mind with an adjunctive medical device for detecting all three common skin cancers. For the providers, DermaSensor generates an immediate, objective assessment of suspicious skin lesions for timely referrals. For dermatologists, DermaSensor helps prioritize patients requiring a higher level of care and more immediate attention. And for the insurers, this can result in prompt evaluation and treatment if malignancy is detected.” Read more https://lnkd.in/dBRdcYQi

Ophthopedia Update:Lessons Learned From Ocular Graft versus Host Disease: An Ocular Surface Inflammatory Disease of Known Time of Onset: Abstract: The ocular surface inflammatory disorders (OSIDs) comprise a group of conditions characterized by persistent inflammation of the ocular surface and adnexal tissues. Systemic autoimmune diseases and hypersensitivity reactions cause them, and, if left untreated, can result in severe inflammatory dry eye, corneal damage, and vision loss. Ocular graft-versus-host disease (oGVHD) forms part of the ocular surface inflammatory disease umbrella. It is a condition occurring after allogeneic hematopoietic stem cell or bone marrow transplantation, usually in chronic graft-versus-host disease. oGVHD can virtually affect any ocular adnexal tissue, especially the meibomian glands, and cause persistent inflammation, tissue fibrosis, and subsequent chronic, severe dry eye disease. Among the OSIDs, oGVHD has the particularity that it has a “time zero,” meaning we know when the disease started. As such, preclinical models have leveraged this to investigate the molecular mechanisms involved in the damage oGVHD causes to the ocular surface. In oGVHD, establishing a “time zero” allows for predicting the clinical course and establishing adequate treatment. This is also possible because the inflammatory infiltration occurs in ocular surface tissues, which are readily accessible. Using oGVHD, we might be able to understand the immune response mechanisms in other OSIDs better (i.e., Sjögren syndrome, Stevens-Johnson syndrome, among others). This review presents an up-to-date overview of the pathogenesis, clinical presentation, and treatment of oGVHD. In addition, we will discuss the value of the “time zero” concept in the study of oGVHD. #Ophthalmology #Eye #Ophthotwitter

Ophthopedia Update:Lessons Learned From Ocular Graft versus Host Disease: An Ocular Surface Inflammatory Disease of Known Time of Onset: Abstract: The ocular surface inflammatory disorders (OSIDs) comprise a group of conditions characterized by persistent inflammation of the ocular surface and adnexal tissues. Systemic autoimmune diseases and hypersensitivity reactions cause them, and, if left untreated, can result in severe inflammatory dry eye, corneal damage, and vision loss. Ocular graft-versus-host disease (oGVHD) forms part of the ocular surface inflammatory disease umbrella. It is a condition occurring after allogeneic hematopoietic stem cell or bone marrow transplantation, usually in chronic graft-versus-host disease. oGVHD can virtually affect any ocular adnexal tissue, especially the meibomian glands, and cause persistent inflammation, tissue fibrosis, and subsequent chronic, severe dry eye disease. Among the OSIDs, oGVHD has the particularity that it has a “time zero,” meaning we know when the disease started. As such, preclinical models have leveraged this to investigate the molecular mechanisms involved in the damage oGVHD causes to the ocular surface. In oGVHD, establishing a “time zero” allows for predicting the clinical course and establishing adequate treatment. This is also possible because the inflammatory infiltration occurs in ocular surface tissues, which are readily accessible. Using oGVHD, we might be able to understand the immune response mechanisms in other OSIDs better (i.e., Sjögren syndrome, Stevens-Johnson syndrome, among others). This review presents an up-to-date overview of the pathogenesis, clinical presentation, and treatment of oGVHD. In addition, we will discuss the value of the “time zero” concept in the study of oGVHD. #Ophthalmology #Eye #Ophthotwitter

13th of JUNE 2024 Good morning! Welcome to the 2nd day of #EULAR2024! 👉Be sure to check out today's Basic Abstrac Session: Pathophysiology in Systemic Sclerosis Disease chaired by Prof. Oliver Distler and Colic Jelena Colic 📍 Room Strauss 3 ⏰10:30-12:00 am Don’t miss! ♦️Capillaroscopy session chaired by Prof. @Mauricio Cutolo and @Vanessa Smith Learn how capillaroscopy can be applied to detect very early abnormalities and to use a fast track algorithm in order to differentiate a "scleroderma pattern" from a "non-scleroderma pattern” 📍Room Strauss 3 ⏰1:30-2:45 pm Join the Practical Skills (Hands-on) session -Ultrasound for the Rheumatologist apart from Joints chaired by Prof Lene Terslev and Francesco Porta 📍 Practical Skills 1 ⏰1:30-2:45 pm ♦️ Tânia Santiago “Ultrasound of the skin in Systemic Sclerosis” Harry up and visit the posters 📍Room Poster View ♦️Poster 0822 “Association between nailfold capillaroscopic pattern and incident interstitial lung disease in systemic sclerosis: A EUSTAR database analysis”- prof.Madelon Vonk ♦️Poster 0832 “Immunosuppression versus combination of immunosuppression and oral glucocorticoids for skin fibrosis in early diffuse systemic sclerosis patients. A target trial emulation study from the EUSTAR database”- Dr. @Michele Iudici ♦️Poster 0842 “Primary heart involvement in systemic sclerosis: the role of ventricular ectopic beats as red flags for active myocardial inflammation detected at cardiac magnetic resonance”- Giacomo De Luca ♦️Poster 06837 “Sex differences in FVC decline and in circulating biomarkers in patients with SSc-ILD”- Dr.Elizabeth Volkmann Don’t miss- Clinical Poster Tour: Systemic Sclerosis, chaired by Prof Yannick Allanore and Prof. Vanessa Smith 📍Room Poster Tour 5 ⏰2.45:-3:45 pm ♦️POS0196 “Evidence-based expert consensus definition of organ involvement in systemic sclerosis – a EUSTAR study”- MD, PhD Liubov Petelytska ♦️POS0211 “PAH treatment at time of diagnosis is associated with improved survival regardless of hemodynamic thresholds and risk stratification - a EUSTAR analysis”- MD Hilde Jenssen Bjørkekjær ♦️POS0230 “Characteristics and disease course of SSc-ILD patients with gastroesophageal reflux – an analysis of the EUSTAR cohort”- MD, PhD Cosimo Bruni ♦️POS0235 “New onset of interstitial lung disease in systemic sclerosis: clinical course and outcomes from a EUSTAR database analysis”- MD, PhD Cosimo Bruni

Cornea Update: Direct Immunofluorescence Findings and Factors Affecting Conjunctival Biopsy Positivity in Ocular Mucous Membrane Pemphigoid: Purpose: The aim of this study was to describe the direct immunofluorescence (DIF) findings and factors affecting conjunctival biopsy positivity in patients clinically diagnosed with ocular mucous membrane pemphigoid (OMMP). Methods: This retrospective observational case series included patients with clinical OMMP who underwent conjunctival biopsy for DIF in at least 1 eye between 2018 and 2021 in an institutional setting. The primary outcome measures were association of age and chronic ocular complications with biopsy positivity. Results: Of 61 patients, DIF positivity was seen in 33 (54.1%) clinically suspected cases of OMMP. Of 39 patients who underwent bilateral biopsy, 23 (59%) were positive, of which 12 (52%) were positive in both eyes while 11 (48%) were positive in 1 eye. Of 22 patients who underwent unilateral biopsy, 10 (45%) were positive. Of the 100 biopsied eyes, 45 (45%) were DIF positive. Among the immunoreactants studied, linear deposition of C3 was seen in all 45 positive eyes (100%). Increasing age was significantly associated with higher likelihood of biopsy negativity (P = 0.032), whereas a greater Sotozono chronic ocular complication score, indicative of disease severity, was associated with low likelihood of biopsy positivity (P = 0.0042) and lower overall expression of immunoreactants on DIF (P = 0.0007). Conclusions: Older patients and patients with more severe ocular surface disease sequelae are likely to have negative DIF results. To optimize the chances of confirming the diagnosis of OMMP by DIF, both eyes should be biopsied early in the disease course. If 1 eye is being biopsied, the less affected eye must be chosen. http://dlvr.it/T9SQHJ #Cornea #MostPopularArticles #Ophthalmology

Thematic Issue: Thyroid Disease 2024 Read our special collection of journal articles, published in 2022–2024: https://bit.ly/3wUXUuy  Journal of the Endocrine Society   •Operative Management of Thyroid Disease in Older Adults    •Thyroglobulin Cutoff Values for Detecting Excellent Response to Therapy in Patients with Differentiated Thyroid Cancer   •Stress-Induced Graves Disease: Spontaneous Recovery After Stress Relief  JCEM Case Reports   •Teprotumumab for Treatment of Pretibial Myxedema    •Hyperthyroidism Due to Graves Disease After Radiofrequency Ablation    •Gestational Transient Thyrotoxicosis Complicated by Thyroid Storm in a Patient with Hyperemesis Gravidarum  Endocrine Reviews   •Medullary Thyroid Cancer: Updates and Challenges    •Radiation-Related Thyroid Cancer    •Levothyroxine: Conventional and Novel Drug Delivery Formulations  Endocrinology   •Thyroid Function and COVID-19 Susceptibility and Its Severity: A Two-Sample Mendelian Randomization Study    •Single Cell Analysis of Human Thyroid Reveals the Transcriptional Signatures of Aging •Mechanistic Insights of Thyroid Cancer Progression  The Journal of Clinical Endocrinology & Metabolism   •Gut Microbiome Associated With Graves Disease and Graves Orbitopathy: The INDIGO Multicenter European Study    •Factors Predicting Long-term Outcome and the Need for Surgery in Graves Orbitopathy: Extended Follow-up From the CIRTED Trial    •Molecular Profiling of 50 734 Bethesda III-VI Thyroid Nodules by ThyroSeq v3: Implications for Personalized Management  #JCEM #JES #JCEMCaseReports #Endocrinology #EndocrineReviews #Thyroid   

#EAU 2024: Rapid Fire Debate 1: Is There Any Role for Urinary Markers Other than Cytology in Era of Modern Cystoscopy in Surveillance of Patients? What About to Decrease Frequency of Cystoscopy? 💠 "One tool that is frequently used for the #diagnosis and #surveillance of #NMIBC patients is #urinary #cytology....it appears that the actual sensitivity for low-grade disease varies between 3% and 67%, compared to 37 – 95% for high-grade disease." 💠 "There are frequently indeterminate findings, including atypia. Importantly, this test (cytology) cannot be performed at home due to processing issues with home-based testing, thus requiring patients to present to a healthcare facility to undergo such testing." ⚠️ "#Cystoscopy remains an invasive test with ~30% of patients reporting discomfort during the procedure and painful voiding up to 7 days post-procedurally. Another issue with cystoscopies is that it remains operator dependent". ✔ ..."#tumor detection rate with cystoscopy improves with the awareness of a positive urine test, highlighting the detection bias inherent with such an approach." ✔ ..."all these reasons provide support for considering #urinary #biomarkers in this setting, particularly in the patient presented who has low-grade disease and is likely to have low-grade recurrences, where the main issue is disease recurrence, as opposed to disease progression" ✔ "Test negative patients may have their cystoscopy omitted, with a corresponding high sensitivity for high-grade disease." 📌 To sum up: "She concluded by noting that urinary markers have the ability to: 👉 Provide additional information, compared to cystoscopy/cytology, by detecting personalized mutations that may signal an anticipatory effect, particularly among patients with negative cystoscopy/cytology and positive urinary marker tests 👉 Reduce costs by replacing cystoscopy and cytology in select circumstances 👉 Improve the sensitivity of cystoscopy by ‘making us look harder’ 👉 Allow for home-based testing 🖇Plz read more here👉🏻 https://lnkd.in/dbBRBbC6 #biomarkers #Uromonitor #bladdercancer

Ophthopedia Update:Recombinant Deoxyribonuclease I Eye Drops for Ocular Graft Versus Host Disease: Results of a Randomized Clinical Trial: Objective: We have previously shown that neutrophil extracellular traps (NETs) are present on the ocular surface of patients with ocular graft versus host disease (oGVHD), contributing to inflammation and surface disease. Therefore, we performed a clinical trial using deoxyribonuclease I (DNAase) eye drops to test the hypothesis that reducing the abundance of NETs from the ocular surface will reduce signs and symptoms of oGVHD. Methods: A prospective, phase I or II, randomized, placebo-controlled, double-masked clinical trial was performed to determine the safety and preliminary efficacy of DNAase (0.1%) eye drops four times daily for 8 weeks in patients with oGVHD (n=58). Intent-to-treat analysis was performed to determine the change in safety outcome measures (drug tolerability and proportion of adverse events) and efficacy outcome measures (ocular surface disease index [OSDI] score and corneal staining) between baseline and week 8. Results: Tolerability and adverse events were similar in the vehicle and DNAase groups. Within the DNAase group (but not the vehicle group), corneal staining showed a statistically significant and clinically meaningful reduction at week 8 (3.50 [2.75; 5.00]) compared with baseline (5.00 [3.00; 7.00]). The OSDI score also showed a statistically significant clinically meaningful reduction of 18.4 (9.16; 33.1) (P #Ophthalmology #Eye #Ophthotwitter