Sarcopenia on patients with autoimmune diseases

George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. The European Working Group on Sarcopenia in Older People(EWGSOP) developed a clinical definition for sarcopenia as a syndrome which affects at the same time muscle mass, muscle strength and physical function. Sarcopenia appears from the imbalance between the hormonal and immunological changes that occur during the aging process. The autoimmune diseases cause the appearance of sarcopenia by increasing cytokines (TNF- α tumor necrosis factor and IL-6 interleukin-6, which play an important role in the loss of muscle mass) and inflammation in the body. Aim of the study. The Aim of this study is to evaluate the sarcopenia of the patients with the autoimmune disease from rheumatology department. Materials and methods. A prospective, pure observational and non-interventional study was conducted which included 17 patients with autoimmune diseases admitted in the rheumatology department of Country Hospital of Targu Mures, Romania. The muscle mass was evaluated ultrasonographic for a 5-day period (day 1 and day 5) at biceps brachii (BB) and rectus femoris (RF) muscles, the physical function was evaluated with 400 meter walk test (sarcopenic if 15s) which measures the time needed for every patient to rise and seated for five times. The SarQoL questionnaire was used to assess quality of life of sarcopenic patients. The statistical analysis was assessed with GraphPad Prism 6 and Microsoft Office Excel package. Results. The mean age of the patients were 55 years old. The autoimmune diseases studied were systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and ankylosing spondylitis with a mean age of disease of 8 years. 88% of patients can be considered sarcopenic with a mean 400 meter walk test of 0,575 m/s and a mean of chair stand test of 22,17s. Ultrasonographic determinations showed a mean BB of day 1 vs day 2 of 5,07/5,04 cm2 and RF of day 1 vs day 2 1,94/1,78 cm2 with no statistical difference between the measurement days (p=0,06-0,94). A higher difference was observed at the RF(p=0,06-0,3) vs BB(p=0,43- 0,91). The SarQoL questionnaire showed a mean result of 48.75(cut-off point 70). Conclusions. In conclusion sarcopenia is very common in patients with autoimmune diseases, having also a big impact in patients quality of life

Ultrasonographic intra-inter-variability on patients with Sarcopenia and autoimmune diseases

George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Sarcopenia is a muscle disease, which affect the muscle mass, strength and the physical performance at the older patients. Ultrasound is a new research and accurate technique for measure the muscle mass and quantity. The use of ultrasound was recently approved for diagnosis of sarcopenia. Aim of the study. The aim of this study is to evaluate intra and inter-variability for ultrasonographic measured areas of biceps brachii (BB), rectus femoris (RF) and the diaphragm (DF) end- expiratory and maximum-inspiratory. Materials and methods. The study included 17 patients with autoimmune disease of rheumatology department of County Hospital of Targu Mures, Romania. They were ultrasonographic evaluated for a 5-day period (day 1 and day 5) on the biceps brachii, rectus femoris and diaphragm DF (end- expiratory and maximum inspiratory) muscle to identify the intra- inter-variability between the two operators. The study is a prospective, pure observational, non-interventional and the statistical analysis was perform with Microsoft Office Excel package, GraphPad Prism 6 and SPSS. Intraclass correlation coefficient (ICC) was considered statistically significant if ICC>0,7. Results. ICC proves good inter-observer variability (P&W2009) at the following levels: BB right assessment 1 and 2 (0,755/0,847 p<0,0001), BB left assessment 1 and 2 (0,8/0,818 p<0,0001), RF right assessment 1 and 2 (0,858/0,927 p<0,0001), RF left assessment 1 and 2 (0,89/0,77 p<0,0001). Poor results were found on the diaphragm investigation: DF endexpiratory evaluation 1 and 2 (0,42/0,65 p<0,0001), DF maximum inspiratory evaluation 1 and 2 (0,32/0,608 p<0,0001). Regarding the intra-reliability we obtain good statistically significant results on the level of BB right 0,86, RF right 0,78 and RF left 0,78. Conclusions. In conclusion biceps brachii and rectus femoris ultrasound showed a good interintra variability and the results revealed a ultrasonographic skill improvement from day 1 to day 5

Chronic myeloid leukemia associated with early lymphoblastic crisis

University of Medicine and Pharmacy of Targu Mures, RomaniaBackground. The blastic crisis of chronic myeloid leukemia (CML-BC) is usually the final phase of the disease, in which the percentage of the young, often undifferentiated cells, known as blastocytes gets above 20%. Nowadays, in the era of the therapy with Tyrosine Kinase Inhibitors, the transformation from CML to CML-BC occurs much later and more rarely

Is the gender an important variable in evaluating the psoriatic arthritis activity when using stockerau activity score?

University of Medicine and Pharmacy Targu Mures, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Background: In last decade, several disease activity scores for the inflammatory diseases such as rheumatoid and psoriatic arthritis were validated. Still, the auto - evaluation in real life is less utilised in clinical practice. A new score – the Stockerau Activity Score for Psoriatic Arthritis (SASPA), aimed to be used by the patients is to be validated. Aim: to evaluate the gender as an independent variable for the SASPA score. Material and method: A prospective, cross-sectional study was started on February 2016 in the rheumatology ambulatory settings. SAPSA activity score consisting of five questions aiming the tender joints, the degree of arthritis, the stiffness, the general health and the skin disease was completed by thirty - six (17 women, 19 men) patients diagnosed with psoriatic arthritis (PsA). Mann Whitney test was applied. Results: All the patients completed the SAPSA in less than 2 minutes. No differences were observed concerning the tender joints (p: 0.6067), the arthritis overall evaluation (p: 0.6863), the general health (p: 0.5074) and the stiffness (p: 0.8951) comparing the results of women versus men. On the p scale we observed a tendency to achieve a differentiation when asked by the skin involvement (p: 0.0789), being with a delta of 0.4 more affected the women. Conclusions: The skin involvement in association with the gender is to be carefully considered when applying activity scores in PsA

Is psoriatic arthritis a risk factor for diabetes mellitus?

University of Medicine and Pharmacy, Targu Mures, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: Three meta-analyses evaluated the role of psoriasis and/or psoriatic arthritis in the development of type 2 diabetes mellitus. The difference of the three studies consisted in evaluating different parameters involved alongside psoriasis (Ps) and/or psoriatic arthritis (PsA) in the onset of diabetes. The aim of our study is to find if psoriatic arthritis is an independent risk factor. Material and Method: We enrolled 330 patients diagnosed with psoriatic arthritis according with CASPAR criteria in our observational study. The following variables were monitored: the presence of diabetes pre or post onset of psoriasis or psoriatic arthritis, the onset of the disease, the gender, the treatment – classical or biological disease disease-modifying anti-rheumatic drugs (DMARDs), corticotherapy, body mass index, alcohol intake, smoking habits, dyslipidaemia, active or inactive status in society. Graph Pad Prism 6.0 software was used to assess the statistically the data. Results: Two-hundred and eighty-seven patients (pts.) with psoriatic arthritis and lack of diabetes were enrolled to the control group. Forty-three patients were associating type 2 diabetes mellitus. In the control group, we found a positive association between overweight (p: 0.008, r: 0.159), obesity (p:0.020, r: 0.138) and glucose intolerance and a protective role of methotrexate (p: 0.023, r: - 0.134). In the study group, according with the statistics, all the patients that developed diabetes were obese and the onset was correlated with the skin lesions (p: 0.038, r: 0.317). Conclusions: Obesity and skin disease seemed to play an important role in the onset of type 2 diabetes mellitus. A nutritionist should be involved in the management of the disease

Intraventricular hemorrhage with subsequent ventriculomegaly in preterm infants

University of Medicine and Pharmacy of Targu MuresBackground. Preterm infants are at risk for developing many perinatal complications such as intraventricular haemorrhage (IVH) and subsequent ventriculomegaly. Babies born before 32 weeks of pregnancy present an even higher risk for IVH, an important cause of severe cognitive and motor neurologic impairment in very low birth weight infants. The risk of IVH is inversely related to gestational age and birth weight

Switching the little kids lives on

University of Medicine and Pharmacy of Targu MuresBackground. Cormatrix is an innovation in bioengineering, introduced in the medical world in 2013. The material is based on the extracellular matrix derived from the porcine intestine submucosa, allowing for tissue restructure and growth in the "site" where it is used. The composition consists of collagen, glycosaminoglycans, glycoproteins, proteoglycans and growth factors VEGF, FGF. The superior characteristics are given by acellularity, resistance to infection, anti-inflammatory effect and immunomodulator, the most important element being the reactivity depending on the impulse from the tissue where it is involved

Myeloid proliferation associated with Down syndrome: a case report

University of Medicine and Pharmacy of Targu Mures, RomaniaBackground. Atypical chronic myeloid leukemia (aCML), BCR-ABL1 negative is a rare myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN) for which no current standard of care exists. ACML is characterized by many clinical features (splenomegaly, myeloid predominance in the bone marrow with some dysplastic features but without a differentiation block) and laboratory abnormalities (myeloid proliferation, low leukocyte alkaline phosphate values). A review of the literature suggests that the presence of an abnormal chromosome 21 may predispose to the development of leukemia

Partial 13 monosomy with corpus callosum agenesis and other congenital abnormalities – a case report

University of Medicine and Pharmacy of Targu Mures, RomaniaBackground. The corpus callosum comprises the largest tract of nerve fibres in the human brain. It is developed from the telencephalon starting in the 11th week of foetal life. Partial or complete agenesis of the corpus callosum is a rare developmental anomaly of unknown cause. A case of corpus callosum agenesis is described

Treatment of chronic lymphocytic leukemia – a difficult choice for severe complications: a case report

University of Medicine and Pharmacy of Targu MuresBackground. Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the western European countries and is characterized by the relentless accumulation of monoclonal B cells with the appearance of small mature lymphocytes and with a characteristic immunophenotype. Even with the right treatment, this disease is known to have a variable course: some patients die within one year after diagnosis while others live for longer than ten years