Is the Prognosis of Osgood-Schlatter Poorer Than Anticipated?:A Prospective Cohort Study With 24-Month Follow-up

BACKGROUND: Osgood-Schlatter disease (OSD), an apophyseal injury of the tibial tuberosity, affects up to 1 in 10 adolescents. This condition has previously been assumed to be innocuous and to self-resolve with limited intervention. PURPOSE: To investigate the 24-month prognosis of OSD and examine if ultrasound (US) classification is associated with outcomes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This study included a preregistered prospective cohort of 51 adolescents (aged 10-14 years) diagnosed with OSD who were evaluated for 24 months. The primary outcome at 24-month follow-up was whether participants continued to experience OSD-related knee pain. Baseline US scans were collected and characterized by OSD type (De Flaviis classification) as well as maturation of the tibial tuberosity. Secondary outcomes included sports participation, Knee injury and Osteoarthritis Outcome Score (KOOS) Sport/Recreation subscale, and health-related quality of life (European Quality of Life–5 Dimensions–Youth [EQ-5D-Y]). All participants were invited for re-examination by US at follow-up. RESULTS: A total of 51 patients preregistered for the study, with 90% (n = 46) available at follow-up. Of these 46 participants, 37% (n = 17) still reported knee pain due to OSD. In this subgroup, the median duration since symptom onset was 42 months (interquartile range, 38-51 months). More than 1 in 5 participants reported stopping sport due to knee pain, and those who continued to experience knee pain reported significantly worse KOOS Sport/Recreation scores at follow-up compared with patients with no knee pain (mean 74 [95% CI, 63-84] vs 91 [95% CI, 85-97]). Participants with continued OSD-related pain also had lower health-related quality of life (mean difference in EQ-5D-Y, 0.11 [95% CI, 0.06-0.13]). Higher De Flaviis classification at baseline was significantly associated with an increased risk of knee pain at 2 years. Diagnostic US at follow-up demonstrated primarily tendon changes (thickening, positive Doppler signal), as well as an ununited ossicle in 32% of participants who underwent US scanning at follow-up. CONCLUSION: Over one-third of the study participants had knee pain at 2-year follow-up, which was associated with lower sports related function and health related quality of life. This questions the assumption that all patients with OSD experience quick recovery. Participants without any changes on imaging at baseline were less likely to report pain at follow-up

The spectral evolution of AT 2018dyb and the presence of metal lines in tidal disruption events

We present light curves and spectra of the tidal disruption event (TDE) ASASSN-18pg / AT 2018dyb spanning a period of one year. The event shows a plethora of strong emission lines, including the Balmer series, He II, He I and metal lines of O III $\lambda$3760 and N III $\lambda\lambda$ 4100, 4640 (blended with He II). The latter lines are consistent with originating from the Bowen fluorescence mechanism. By analyzing literature spectra of past events, we conclude that these lines are common in TDEs. The spectral diversity of optical TDEs is thus larger than previously thought and includes N-rich events besides H- and He-rich events. We study how the spectral lines evolve with time, by means of their width, relative strength, and velocity offsets. The velocity width of the lines starts at $\sim$ 13000 km s$^{-1}$ and decreases with time. The ratio of He II to N III increases with time. The same is true for ASASSN-14li, which has a very similar spectrum to AT 2018dyb but its lines are narrower by a factor of $>$2. We estimate a black hole mass of $M_{\rm BH}$ = $3.3^{+5.0}_{-2.0}\times 10^6$ $M_{\odot}$ by using the $M$-$\sigma$ relation. This is consistent with the black hole mass derived using the MOSFiT transient fitting code. The detection of strong Bowen lines in the optical spectrum is an indirect proof for extreme ultraviolet and (reprocessed) X-ray radiation and favors an accretion origin for the TDE optical luminosity. A model where photons escape after multiple scatterings through a super-Eddington thick disk and its optically thick wind, viewed at an angle close to the disk plane, is consistent with the observations.Comment: Accepted version. Updated with new photometry and spectra, including an X-shooter spectrum used to determine the BH mass. Two more figures added and line measurements tabulated. No significant scientific updates and the conclusions remain unaffecte

Differential inflammatory microRNA and cytokine expression in pulmonary sarcoidosis

Sarcoidosis is a granulomatous disease of unknown etiology. The disease has an important inflammatory and immune component; however, its immunopathogenesis is not completely understood. Recently, the role of microRNAs (miRNAs), the small non-coding RNAs, has attracted attention as both being involved in pathogenesis and serving as disease markers. Accordingly, changes in the expression of some miRNAs have been also associated with different autoimmune pathologies. However, not much is known about the role of miRNAs in sarcoidosis. Therefore, the aim of this study was to compare the level of expression of selected miRNAs in healthy individuals and patients with sarcoidosis. We detected significantly increased level of miR-34a in peripheral blood mononuclear cells isolated from sarcoidosis patients. Moreover, significantly up-regulated levels of interferon (IFN)-γ, IFN-γ inducible protein (IP-10) and vascular endothelial growth factor were detected in sera of patients when compared to healthy subjects. Our results add to a known inflammatory component in sarcoidosis. Changes in the levels of miR-34a may suggest its involvement in the pathology of this disease

A time-resolved proteomic and prognostic map of COVID-19

COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. We characterized the time-dependent progression of the disease in 139 COVID-19 inpatients by measuring 86 accredited diagnostic parameters, such as blood cell counts and enzyme activities, as well as untargeted plasma proteomes at 687 sampling points. We report an initial spike in a systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution, and immunomodulation. We identify prognostic marker signatures for devising risk-adapted treatment strategies and use machine learning to classify therapeutic needs. We show that the machine learning models based on the proteome are transferable to an independent cohort. Our study presents a map linking routinely used clinical diagnostic parameters to plasma proteomes and their dynamics in an infectious disease

Evidence for the Efficacy of Bright Light Therapy for Bipolar Depression

No abstract availabl