Clinical utility of ANA-ELISA vs ANA-immunofluorescence in connective tissue diseases

We investigated the performance of ANA-ELISA for CTDs screening and diagnosis and comparing it to the conventional ANA-IIF. ANA-ELISA is a solid-phase immune assay includes 17 ANA-targeted recombinant antigens; dsDNA, Sm-D, Rib-P, PCNA, U1-RNP (70, A, C), SS-A/Ro (52 and 60), SS-B/La, Centromere B, Scl-70, Fibrillarin, RNA Polymerase III, Jo-1, Mi-2, and PM-Scl. During the period between March till December 2016 all requests for ANA from primary, secondary, and tertiary care centers were processed with both techniques; ANA-IIF and ANA-ELISA. The electronic medical record of these patients was reviewed looking for CTD diagnosis documented by the Senior rheumatologist. SPSS 22 is used for analysis. Between March and December 2016, a total of 12,439 ANA tests were requested. 1457 patients were assessed by the rheumatologist and included in the analysis. At a cut-off ratio ≥ 1.0 for ANA-ELISA and a dilutional titre ≥ 1:80 for ANA-IIF, the sensitivity of ANA-IIF and ANA-ELISA for all CTDs were 63.3% vs 74.8% respectively. For the SLE it was 64.3% vs 76.9%, Sjogren’s Syndrome was 50% vs 76.9% respectively. The overall specificity of ANA-ELISA was 89.05%, which was slightly better than ANA-IIF 86.72%. The clinical performance of ANA-ELISA for CTDs screening showed better sensitivity and specificity as compared to the conventional ANA-IIF in our cohort.Other Information Published in: Scientific Reports License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1038/s41598-021-87366-w</p

Increased Fracture Risk After Bariatric Surgery: a Case-Controlled Study with a Long-Term Follow-Up

Purpose Bariatric surgeries are common procedures due to the high prevalence of obesity. This study aimed to investigate whether bariatric surgery increases fracture risk. Material and Methods It was a case-controlled study. Patients who underwent bariatric surgery during 2011 and 2012 were matched for age (± 5 years) and gender to patients on medical weight management during the same period with a ratio of 1:2. The index date was defined as the date of bariatric surgery for both groups. The subject’s electronic medical records were reviewed retrospectively to identify fractures documented by radiology during January 2020. Results Randomly selected 403 cases were matched to 806 controls with a median age of 36.0 years (IQR 14.0) and 37.0 years (IQR 14.0), respectively. Seventy per cent of the cohort were females. Eighty per cent received sleeve gastrectomy, and the remaining (17%) underwent gastric bypass. The mean duration of follow-up was 8.6 years. The fracture rate was higher in the surgical group as compared to the controls (9.4% vs 3.5%) with a crude odds ratio of 2.71 (95% CI 1.69–4.36). The median duration for time to fracture was 4.17 years for the surgical group and 6.09 years for controls (p-value = 0.097). The most common site of fractures was feet, followed by hands. Apart from a few wrist fractures, there was no typical osteoporotic sites fracture. Conclusion Subjects who underwent bariatric procedures had more non-typical osteoporotic site fractures affecting mainly feet and hands, and fractures tend to occur earlier as compared to controls.Other Information Published in: Obesity Surgery License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s11695-021-05655-9</p