Medical Journal Armed Forces India最新文献

英文中文

Pyrethroid poisoning: Insecticide with mild human toxicity 拟除虫菊酯中毒：对人体有轻微毒性的杀虫剂

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.09.009

Ramya Iyadurai , J.V. Peter , Audrin Lenin , Bijesh Yadav , Alex Reginald , K.P.P. Abhilash , J.V. Punitha , Samuel George Hansdak

Background

Pyrethroid insecticides are commonly used insecticides. This study was undertaken to characterize the clinical profile and outcome of deliberate self-harm (DSH) with type 1 and type 2 pyrethroids and identify factors associated with need for hospitalization.

Methods

This retrospective study was conducted in a tertiary care hospital in South India to study the clinical features, treatment, and outcome of patients with pyrethroid poisoning due to DSH. Patients were categorized as poisoning with type 1 or type 2 pyrethroid compounds. Factors associated with need for hospital admission was explored using bivariate and multivariate regression analysis and expressed as odds ratio (OR) with 95% confidence intervals (CIs).

Results

A total of 379 patients presented with pyrethroid poisoning; 202 (53.3%) patients were male. The median (interquartile range) age was 26 (22–33) years. Transfluthrin (n = 48, 58%) and cypermethrin (n = 149, 50%) were the most frequently implicated type 1 compounds and type 2 compounds, respectively. Of the 130 (34.3%) patients who were admitted, 13 (3.4%) patients required mechanical ventilation. All patients survived. On multivariate logistic regression analysis, ingestion of type 2 pyrethroids (OR: 2.55, 95%CI: 1.31–4.97), history of seizures (OR: 2.62, 95%CI 1.06-6.48), and treatment prior to presentation to the referral hospital (OR: 2.99, 95%CI: 1.87–4.74) were associated with the need for hospitalization.

Conclusion

A third of patients with pyrethroid poisoning require hospitalization. Type 2 pyrethroid poisoning is more frequent in clinical practice. Ingestion of type 2 pyrethroids, seizures, and need for pre-hospital treatment are associated with hospitalization.

拟除虫菊酯类杀虫剂是常用的杀虫剂。本研究旨在描述使用1型和2型拟除虫菊酯的故意自残（DSH）的临床特征和结果，并确定与住院需要相关的因素。方法回顾性研究印度南部某三级医院DSH致拟除虫菊酯中毒患者的临床特点、治疗及转归。患者被分为1型或2型拟除虫菊酯化合物中毒。使用双变量和多变量回归分析探讨与住院需求相关的因素，并以95%置信区间（ci）的优势比（OR）表示。结果379例患者出现拟除虫菊酯中毒；男性202例（53.3%）。年龄中位数（四分位数间距）为26岁（22-33岁）。氟氯菊酯（n = 48, 58%）和氯氰菊酯（n = 149, 50%）分别是最常涉及的1类化合物和2类化合物。在入院的130例（34.3%）患者中，13例（3.4%）患者需要机械通气。所有患者都存活了下来。在多因素logistic回归分析中，摄入2型拟除虫菊酯（OR: 2.55, 95%CI: 1.31-4.97）、癫痫发作史（OR: 2.62, 95%CI: 1.06-6.48）和转诊医院前的治疗（OR: 2.99, 95%CI: 1.87-4.74）与住院需求相关。结论拟除虫菊酯中毒患者需住院治疗的占1 / 3。2型拟除虫菊酯中毒在临床上更为常见。摄入2型拟除虫菊酯、癫痫发作和需要院前治疗与住院有关。

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引用次数: 0

Randomized control trial to compare mini-PCNL vs standard-PCNL for treatment of 1–2 cm size inferior calyceal renal stone 比较微型 PCNL 和标准 PCNL 治疗 1-2 厘米大小的下盏肾结石的随机对照试验

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.10.008

Puneet Aggarwal , Sanjeev Tandon

Background

Lower calyceal anatomy makes the stone clearance a difficult task across all treatment formats. Improvement in optics and miniaturization of instruments have offered an effective and safer alternative to percutaneous nephrolithotomy (PCNL). The study was conducted to compare the efficacy and complications associated with mini-PCNL vs standard-PCNL.

Methods

The study was a randomized control trial to compare mini-PCNL vs standard-PCNL for treatment of 1 to 2 cm inferior calyceal stones. Objectives were to compare peri-operative bleeding, operative-time, post-op analgesia requirement, hospital-stay and stone-free rate at 1 month. Patients with 1–2 cm inferior calyceal stones were included. Morbidly obese individuals, patients with renal malformation and paediatric age group were excluded.

Result

One hundred and fifty seven patients were included out of 207 who underwent PCNL in this period. 80 underwent mini-PCNL and 77 standard-PCNL. Mini-PCNL scored over standard in hospital-stay (3.96 vs 4.73 days), post-operative analgesia requirement (2.58 vs 5.55 gms) and drop in Hb (0.59 vs 0.81 gm/dl). Even stone clearance rate was better for mini-PCNL (87.01% vs 93.75%). Mean surgery time was marginally better for standard-PCNL (44.03 vs 43.33 mins). Stone clearance rate and average surgery time were comparable with no statistically significant difference in the two groups. Analgesia requirement was statistically lower in mini-PCNL due to smaller tract and tubeless-PCNL. Hospital stay was statistically lower in mini-PCNL due to lesser post-operative pain. Peri-operative bleeding was statistically lower in mini-PCNL due to smaller track dilatation and lesser tract bleeding.

Conclusions

Mini-PCNL is a safe and effective treatment option in the management of 1–2 cm inferior calyceal stones with significantly less bleeding, shorter hospital-stay and analgesia requirement as compared to standard-PCNL with comparable stone clearance rates.

下盏解剖结构使得结石清除在所有治疗形式中都是一项困难的任务。光学技术的进步和仪器的小型化为经皮肾镜取石术（PCNL）提供了一种更有效、更安全的选择。这项研究是为了比较迷你pcnl和标准pcnl的疗效和并发症。方法采用随机对照试验，比较迷你pcnl与标准pcnl治疗1 ~ 2 cm下盏结石的疗效。目的是比较围手术期出血、手术时间、术后镇痛需求、住院时间和1个月无结石率。下盏结石1 ~ 2 cm的患者纳入研究。排除病态肥胖个体、肾脏畸形患者和儿童年龄组。结果同期行PCNL患者207例，共纳入157例。迷你pcnl 80例，标准pcnl 77例。Mini-PCNL在住院时间（3.96 vs 4.73天）、术后镇痛需求（2.58 vs 5.55克）和Hb下降（0.59 vs 0.81克/分升）方面得分高于标准。mini-PCNL的结石清除率较好（87.01% vs 93.75%）。标准pcnl的平均手术时间稍好（44.03 vs 43.33分钟）。两组结石清除率和平均手术时间比较，差异无统计学意义。mini-PCNL的镇痛需求在统计学上较低，这是由于更小的管道和无管pcnl。由于术后疼痛较轻，迷你pcnl患者住院时间较短。由于径道扩张较小和小束出血，mini-PCNL患者围术期出血在统计学上较低。结论mini - pcnl是治疗1-2 cm下盏结石的安全有效的治疗方法，与标准pcnl相比，出血少，住院时间短，镇痛需求少，结石清除率相当。

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引用次数: 0

Doege Potter syndrome in patient with solitary fibrous tumor of the pleura 胸膜单发纤维瘤患者的多伊格-波特综合征

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.12.004

Sachinkumar Dole , Samir Gupta , M.S. Barthwal , Ashwin Ramesh

Solitary fibrous tumors of pleura (SFTP) are rare neoplasms derived from mesenchymal cells of the pleura. A 63-year-old male patient, laborer by profession, presented with progressive dry cough and breathlessness for one month. Clinically he had left-sided intrathoracic mass which was confirmed by CT thorax. While in hospital, patient had recurrent episodes of hypoglycemia. Histopathological examination and immunohistochemistry of the mass revealed a SFTP. Complete surgical resection of the mass led to left lung expansion and post-operative stay was uneventful. Patient was discharged with advice for follow-up. When SFTPs are associated with recurrent hypoglycemia, which is caused by the secretion of a high-molecular-weight insulin-like growth factor 2 (IGF-2), it is referred to as the Doege–Potter syndrome (DPS).

孤立性胸膜纤维性肿瘤（SFTP）是一种罕见的来源于胸膜间充质细胞的肿瘤。患者男，63岁，职业为体力劳动者，表现为进行性干咳、呼吸困难1个月。临床表现为左侧胸内肿块，经胸部CT证实。住院期间，患者反复发作低血糖。组织病理学检查和免疫组化显示SFTP。完全手术切除肿块导致左肺扩张，术后住院无大碍。患者出院，建议随访。当stfs与复发性低血糖（由一种高分子量胰岛素样生长因子2 （IGF-2）的分泌引起）相关时，称为doge - potter综合征（DPS）。

引用次数: 0

A rare presentation of left atrial tumor as acute stroke 罕见的左心房肿瘤表现为急性脑卒中

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.02.003

Harish Venkata Kasarabada , Sudhir Joshi , Sreenivasa Iyenger , D.V. Desvin

This case report deals with a case of stroke in young female patient who was later diagnosed to have left atrial tumor. This female patient in her late 20s presented with a history of 1 month of progressive postural giddiness (in upright position), which was followed by sudden onset right monoparesis. The patient arrived to the hospital with above mentioned complaints. Her National Institutes of Health Stroke Scale was 5, and on examination of cardiovascular system, she had a middiastolic murmur in upright position, which resolved in lying position. Her brain imaging noncontrast computerized tomography (NCCT), magnetic resonance imaging (MRI) revealed lacunar infarcts in multiple vascular territories. Her transthoracic echocardiography revealed a pedunculated mass of around 4 × 2 cm from inter atrial septum in left atrium. She was started on anticoagulation and was referred to a cardio thoracic, and vascular center for tumor excision and biopsy. She underwent successful tumor excision and histopathological examination of the resected mass revealed cardiac myxoma. Incidence of primary cardiac tumor is very less in realtime world data. An atrial myxoma presenting as acute stroke secondary to tumor embolization is extremely rare.

本病例报告处理的情况下，中风的年轻女性患者谁后来被诊断为左心房肿瘤。该女性患者20岁左右，有1个月进行性体位性头晕（直立体位），随后出现突发性右侧单眼。病人以上述主诉来医院就诊。她的美国国立卫生研究院卒中评分为5分，心血管系统检查发现她在直立体位时有舒张中期杂音，躺姿时消失。她的脑成像非对比计算机断层扫描（NCCT），磁共振成像（MRI）显示在多个血管区域腔隙性梗死。经胸超声心动图显示左心房房间隔处约4 × 2 cm有带蒂肿块。她开始使用抗凝剂，并被转到心胸和血管中心进行肿瘤切除和活检。她接受了成功的肿瘤切除和切除肿块的组织病理学检查显示心脏黏液瘤。在实时世界数据中，原发性心脏肿瘤的发生率非常低。心房黏液瘤表现为继发于肿瘤栓塞的急性中风是非常罕见的。

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引用次数: 0

Docetaxel-induced lung injury 多西他赛诱导的肺损伤

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.02.002

Amit Singh Vasan , Gurjeet Singh Chowdhary , Indramani Pandey , Yadvir Garg , Dharmesh Soneji

Docetaxel is a chemotherapeutic agent commonly used against breast cancer, nonsmall cell lung cancer, gastric, prostate, head and neck cancer. Docetaxel- or taxane-induced interstitial lung disease (ILD) remains a relatively rare reported adverse event. Although rare, this complication remains an important event to identify and it carries a high mortality. We reported the case series of three patients who had pulmonary toxicity after docetaxel administration. Although literature has described patients progressing to respiratory failure and intubation, our patients responded well to steroid treatment and discontinued docetaxel administration.

多西紫杉醇是一种常用的化疗药物，用于治疗乳腺癌、非小细胞肺癌、胃癌、前列腺癌、头颈癌等。多西紫杉醇或紫杉烷诱导的间质性肺疾病（ILD）仍然是一个相对罕见的不良事件报道。虽然罕见，但这种并发症仍然是一个需要识别的重要事件，它具有很高的死亡率。我们报道了3例多西紫杉醇给药后出现肺毒性的患者的病例系列。虽然文献描述了患者进展为呼吸衰竭和插管，但我们的患者对类固醇治疗和停止多西他赛治疗反应良好。

引用次数: 0

Role of chemoprophylaxis during de-induction in preventing complicated falciparum malaria 去诱导期化学预防在预防复杂恶性疟疾中的作用

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.07.011

Suraj Kapoor, Sujoy Sahu, Rakhi Dhawan, Shravani Datta

引用次数: 0

Frog spawn scrotum 蛙卵阴囊

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2023.03.002

Deepak Vashisht, Choudhary Sampoorna Raj, Preema Sinha, Manoj Gopal Madakshira, Parul Kamboj, Juhi Sharma

引用次数: 0

ST elevation myocardial infarction as presenting feature of acute myeloid leukemia ST段抬高型心肌梗死是急性髓性白血病的表现特征

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2022.11.002

K.V. Harish , Revanth Boddu , Kundan Mishra , Kanwaljeet Singh , S.K. Pramanik

A 35-year-old male patient with acute myeloid leukemia (AML), with hyperleukocytosis, presented with acute myocardial infarction. The individual had acute onset chest pain and reached the hospital within the window period. His electrocardiogram (ECG) revealed ST elevated myocardial infarction (STEMI), ST elevated myocardial infarction, and thrombolysis was performed. Postthrombolysis, there was no resolution of ST elevation, and coronary angiography revealed normal coronaries. His blood picture showed hyperleukocytosis with 80% blasts, and bone marrow and flow cytometry confirmed the diagnosis of AML. Considering the central role of white blood cell in the remodeling of myocardial tissue, it was obvious that administration of chemotherapy with its inevitable pancytopenia could impose an increased risk for further cardiac complications. Nevertheless, cytarabine-based induction chemotherapy was initiated; on the third day, he developed bilateral diffuse alveolar hemorrhage. He was managed with mechanical ventilation, component support, empirical antibiotics, and other bundled care. The patient died 2 days later with diffuse alveolar hemorrhage and leukemia.

一例35岁男性急性髓性白血病（AML）患者，伴白细胞增多症，表现为急性心肌梗死。该患者有急性胸痛，并在窗口期到达医院。心电图显示ST段抬高型心肌梗死（STEMI）， ST段抬高型心肌梗死，行溶栓治疗。溶栓后，ST段抬高未见缓解，冠状动脉造影显示冠状动脉正常。他的血液图像显示白细胞增多，80%为原细胞，骨髓和流式细胞术证实了AML的诊断。考虑到白细胞在心肌组织重塑中的核心作用，很明显，化疗不可避免地会导致全血细胞减少，这可能会增加进一步心脏并发症的风险。然而，还是开始了以阿糖胞苷为基础的诱导化疗；第3天出现双侧弥漫性肺泡出血。他接受了机械通气、部件支持、经验性抗生素和其他捆绑护理。患者2天后死于弥漫性肺泡出血和白血病。

{"title":"ST elevation myocardial infarction as presenting feature of acute myeloid leukemia","authors":"K.V. Harish , Revanth Boddu , Kundan Mishra , Kanwaljeet Singh , S.K. Pramanik","doi":"10.1016/j.mjafi.2022.11.002","DOIUrl":"10.1016/j.mjafi.2022.11.002","url":null,"abstract":"<div><div><span><span><span>A 35-year-old male patient with acute myeloid leukemia (AML), with hyperleukocytosis, presented with </span>acute myocardial infarction<span>. The individual had acute onset chest pain<span><span> and reached the hospital within the window period. His electrocardiogram (ECG) revealed </span>ST elevated myocardial infarction<span> (STEMI), ST elevated myocardial infarction, and </span></span></span></span>thrombolysis was performed. Postthrombolysis, there was no resolution of ST elevation, and </span>coronary angiography<span> revealed normal coronaries. His blood picture showed hyperleukocytosis with 80% blasts, and bone marrow and flow cytometry confirmed the diagnosis of AML. Considering the central role of white blood cell in the remodeling of myocardial tissue, it was obvious that administration of chemotherapy with its inevitable pancytopenia<span> could impose an increased risk for further cardiac complications. Nevertheless, cytarabine-based induction chemotherapy<span><span> was initiated; on the third day, he developed bilateral diffuse alveolar hemorrhage. He was managed with </span>mechanical ventilation<span>, component support, empirical antibiotics, and other bundled care. The patient died 2 days later with diffuse alveolar hemorrhage and leukemia.</span></span></span></span></div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S243-S246"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41723644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating prognosis and survival in patients with glioblastoma in contact with subventricular zone: Tumor location and its correlation with prognosis 评估脑室下区胶质母细胞瘤患者的预后和生存:肿瘤位置及其与预后的关系

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2022.06.012

Ehsan Fattahi , Samuel Berchi Kankam , Alireza Khoshnevisan , Amir Pajman Hashemi

Background

To explore the altered malignant behavior, prognosis and survival of glioblastoma in contact with Subventricular Zone (SVZ) and independent predictors on patients’ overall survival.

Method

The records of 131 patients with supratentorial primary glioblastoma who underwent surgery at our hospital between 2012 and 2018 were reviewed retrospectively. The authors reviewed preoperative MRI images and divided patients into two groups: Glioblastoma not in contact with SVZ (G-SVZ) and glioblastoma in contact with SVZ (G + SVZ). They computed and compared the overall survival (OS) of these two groups using the Kaplan–Meier method. The correlation between G + SVZ and OS was investigated using the Cox Proportional Hazard Ratio Model.

Results

The median progression-free survival (PFS) of the patient was 10 months (Interquartile Range), and the median OS was 13 months. At six months and one year, the OS was 81 percent and 51.1 percent, respectively. Patients with G + SVZ and G-SVZ had a median OS of 12 months and 15 months, respectively (p = 0.0093). According to Cox Multivariate model, repeat surgery (p = 0.001), among other independent predictors, including age ≥60, Karnofsky Performance Score (KPS) < 70, and extent of resection (Subtotal/biopsy vs total resection), had the strongest associated decreased OS. G + SVZ independently correlated significantly with reduced patient survival (p = 0.014).

Conclusion

Repeat surgery had the strongest association with decreased OS among the independent predictors of survival in patients with G + SVZ lesions. Prospective studies about molecular mechanisms are needed to explain why G + SVZ lesions are thought to be aggressive and associated with a poor prognosis.

背景探讨与脑室下带（SVZ）接触的胶质母细胞瘤的恶性行为、预后和生存的改变以及患者总生存的独立预测因素。方法回顾性分析我院2012 ~ 2018年收治的131例幕上原发性胶质母细胞瘤患者的手术资料。作者回顾了术前MRI图像，并将患者分为两组：未接触SVZ的胶质母细胞瘤（G-SVZ）和接触SVZ的胶质母细胞瘤（G + SVZ）。他们使用Kaplan-Meier方法计算并比较了两组患者的总生存率（OS）。采用Cox比例风险比模型研究G + SVZ与OS的相关性。结果患者的中位无进展生存期（PFS）为10个月（四分位间距），中位OS为13个月。在6个月和1年时，OS分别为81%和51.1%。G + SVZ和G-SVZ患者的中位生存期分别为12个月和15个月（p = 0.0093）。根据Cox多变量模型，重复手术（p = 0.001），在其他独立预测因素中，包括年龄≥60岁，Karnofsky Performance Score (KPS) <；70，和切除程度（次全/活检vs全切除），有最强的相关OS降低。G + SVZ与患者生存率降低独立相关（p = 0.014）。结论在G + SVZ病变患者的独立生存预测指标中，重复手术与OS降低的相关性最强。需要对分子机制的前瞻性研究来解释为什么G + SVZ病变被认为具有侵袭性并与不良预后相关。

{"title":"Evaluating prognosis and survival in patients with glioblastoma in contact with subventricular zone: Tumor location and its correlation with prognosis","authors":"Ehsan Fattahi , Samuel Berchi Kankam , Alireza Khoshnevisan , Amir Pajman Hashemi","doi":"10.1016/j.mjafi.2022.06.012","DOIUrl":"10.1016/j.mjafi.2022.06.012","url":null,"abstract":"<div><h3>Background</h3><div><span><span>To explore the altered malignant behavior, prognosis and survival of </span>glioblastoma in contact with </span>Subventricular Zone<span> (SVZ) and independent predictors on patients’ overall survival.</span></div></div><div><h3>Method</h3><div>The records of 131 patients with supratentorial primary glioblastoma who underwent surgery at our hospital between 2012 and 2018 were reviewed retrospectively. The authors reviewed preoperative MRI images and divided patients into two groups: Glioblastoma not in contact with SVZ (G-SVZ) and glioblastoma in contact with SVZ (G + SVZ). They computed and compared the overall survival (OS) of these two groups using the Kaplan–Meier method. The correlation between G + SVZ and OS was investigated using the Cox Proportional Hazard Ratio Model.</div></div><div><h3>Results</h3><div>The median progression-free survival (PFS) of the patient was 10 months (Interquartile Range), and the median OS was 13 months. At six months and one year, the OS was 81 percent and 51.1 percent, respectively. Patients with G + SVZ and G-SVZ had a median OS of 12 months and 15 months, respectively (p = 0.0093). According to Cox Multivariate model, repeat surgery (p = 0.001), among other independent predictors, including age ≥60, Karnofsky Performance Score (KPS) < 70, and extent of resection (Subtotal/biopsy vs total resection), had the strongest associated decreased OS. G + SVZ independently correlated significantly with reduced patient survival (p = 0.014).</div></div><div><h3>Conclusion</h3><div>Repeat surgery had the strongest association with decreased OS among the independent predictors of survival in patients with G + SVZ lesions. Prospective studies about molecular mechanisms are needed to explain why G + SVZ lesions are thought to be aggressive and associated with a poor prognosis.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S21-S28"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42462034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors associated with interstitial lung disease and the progressive fibrosing phenotype in rheumatoid arthritis–related interstitial lung disease 与间质性肺病相关的因素和类风湿关节炎相关间质性肺病的进行性纤维化表型

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2024-12-01 DOI: 10.1016/j.mjafi.2022.08.004

Sahajal Dhooria , Vikram Babu , Varun Dhir , Inderpaul Singh Sehgal , Kuruswamy Thurai Prasad , Valliappan Muthu , Amanjit Bal , Uma Debi , Mandeep Garg , Ritesh Agarwal , Ashutosh Nath Aggarwal

Background

The risk factors for interstitial lung disease (ILD) in rheumatoid arthritis (RA) are inconsistent among previous studies. Furthermore, the factors associated with the emergence of the recently defined progressive fibrosing (PF) phenotype are unknown. Herein, we analyze the risk factors for ILD in RA. We also analyze the factors associated with a PF phenotype.

Methods

We collected the clinical and laboratory details of subjects with RA with (cases) or without (controls) ILD. Scoring of high-resolution computed tomography (HRCT) features of ILD was performed. We identified the subgroup that developed the PF phenotype during follow-up. We analyzed the factors associated with ILD using logistic regression (primary objective). We also compared the characteristics of ILD subjects with or without the PF phenotype (secondary objective).

Results

We included 60 subjects (30 cases, 30 controls). Subjects with ILD had higher age, lower body mass index, longer duration of RA, and poorer lung function than the controls. Age (p = 0.007) and the duration of RA (p = 0.049) were the only significant predictors of ILD on univariate and multivariate analysis, respectively. Six (20%) subjects with RA-ILD developed a PF phenotype. These subjects were older, had greater frequency of honeycombing, and higher HRCT scores for honeycombing and aggregate fibrosis than those without the PF phenotype. Among subjects with honeycombing, 41.7% developed the PF phenotype.

Conclusions

RA-ILD was associated with the duration of RA and age. Subjects with the PF phenotype were older and had higher honeycombing and fibrosis scores on HRCT chest.

背景：类风湿关节炎（RA）间质性肺疾病（ILD）的危险因素在以往的研究中并不一致。此外，与最近定义的进行性纤维化（PF）表型出现相关的因素尚不清楚。在此，我们分析类风湿关节炎中ILD的危险因素。我们还分析了与PF表型相关的因素。方法收集伴有或不伴有ILD的RA患者的临床和实验室资料。对ILD的高分辨率计算机断层（HRCT）特征进行评分。我们在随访期间确定了出现PF表型的亚组。我们使用逻辑回归分析与ILD相关的因素（主要目标）。我们还比较了有无PF表型的ILD患者的特征（次要目标）。结果共纳入60例受试者（病例30例，对照组30例）。ILD患者年龄较大，体重指数较低，RA病程较长，肺功能较差。在单因素和多因素分析中，年龄（p = 0.007）和RA病程（p = 0.049）分别是ILD的唯一显著预测因素。6例（20%）RA-ILD患者出现PF表型。与没有PF表型的受试者相比，这些受试者年龄更大，蜂窝频率更高，蜂窝和聚集性纤维化的HRCT评分更高。在有蜂窝病的人群中，41.7%的人出现了PF表型。结论RA- ild与RA病程和年龄相关。具有PF表型的受试者年龄较大，HRCT胸部蜂窝状和纤维化评分较高。

{"title":"Factors associated with interstitial lung disease and the progressive fibrosing phenotype in rheumatoid arthritis–related interstitial lung disease","authors":"Sahajal Dhooria , Vikram Babu , Varun Dhir , Inderpaul Singh Sehgal , Kuruswamy Thurai Prasad , Valliappan Muthu , Amanjit Bal , Uma Debi , Mandeep Garg , Ritesh Agarwal , Ashutosh Nath Aggarwal","doi":"10.1016/j.mjafi.2022.08.004","DOIUrl":"10.1016/j.mjafi.2022.08.004","url":null,"abstract":"<div><h3>Background</h3><div><span>The risk factors for interstitial lung disease (ILD) in </span>rheumatoid arthritis (RA) are inconsistent among previous studies. Furthermore, the factors associated with the emergence of the recently defined progressive fibrosing (PF) phenotype are unknown. Herein, we analyze the risk factors for ILD in RA. We also analyze the factors associated with a PF phenotype.</div></div><div><h3>Methods</h3><div>We collected the clinical and laboratory details of subjects with RA with (cases) or without (controls) ILD. Scoring of high-resolution computed tomography (HRCT) features of ILD was performed. We identified the subgroup that developed the PF phenotype during follow-up. We analyzed the factors associated with ILD using logistic regression (primary objective). We also compared the characteristics of ILD subjects with or without the PF phenotype (secondary objective).</div></div><div><h3>Results</h3><div>We included 60 subjects (30 cases, 30 controls). Subjects with ILD had higher age, lower body mass index<span>, longer duration of RA, and poorer lung function than the controls. Age (p = 0.007) and the duration of RA (p = 0.049) were the only significant predictors of ILD on univariate and multivariate analysis<span>, respectively. Six (20%) subjects with RA-ILD developed a PF phenotype. These subjects were older, had greater frequency of honeycombing, and higher HRCT scores for honeycombing and aggregate fibrosis than those without the PF phenotype. Among subjects with honeycombing, 41.7% developed the PF phenotype.</span></span></div></div><div><h3>Conclusions</h3><div>RA-ILD was associated with the duration of RA and age. Subjects with the PF phenotype were older and had higher honeycombing and fibrosis scores on HRCT chest.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"80 ","pages":"Pages S57-S65"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45720381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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