Notes

Once the go up rises, blood transfusion decreases: an airplane pilot review of REBOA inside placenta accreta array ailments.
To investigate the predictive value of peri-coronary adipose tissue (PCAT) attenuation for microvascular complications in diabetic patients without significant stenosis and to develop a prediction model for early risk stratification.

This study retrospectively included patients clinically identified for coronary computed tomography angiography (CCTA) and type 2 diabetes between January 2017 and December 2020. All patients were followed up for at least 1 year. The clinical data and CCTA-based imaging characteristics (including PCAT of major epicardial vessels, high-risk plaque features) were recorded. In the training cohort comprising of 579 patients, two models were developed model 1 with the inclusion of clinical factors and model 2 incorporating clinical factors + RCA
using multivariable logistic regression analysis. An internal validation cohort comprising 249 patients and an independent external validation cohort of 269 patients were used to validate the proposed models.

Microvascular complications 0.164).
• Hypertension, HbA1c, duration of diabetes, and RCAPCAT were independent risk factors for microvascular complications. learn more • The prediction model integrating RCAPCAT exhibited improved predictive power over the model only based on clinical factors (AUC = 0.820 versus 0.781, p = 0.003) and showed lower prediction error (Brier score=0.146 versus 0.164).
Imaging appearances of immune checkpoint inhibitor-related nephritis have not yet been described. The primary objective of this study is to describe the appearances of immunotherapy-related nephritis on computerized tomography (CT) and positron emission tomography (PET). The secondary objectives are to investigate the association of radiologic features with clinical outcomes.

CT and PET-CT scans before the initiation of immunotherapy (baseline), at nephritis, and after resolution of pathology-proven nephritis cases were reviewed. Total kidney volume, renal parenchymal SUVmax, renal pelvis SUVmax, and blood pool SUVmean were obtained.

Thirty-four patients were included. The total kidney volume was significantly higher at nephritis compared to baseline (464.7 ± 96.8 mL vs. 371.7 ± 187.7 mL; p < 0.001). Fifteen patients (44.1%) had > 30% increase in total kidney volume, which was associated with significantly higher renal toxicity grade (p = 0.007), higher peak creatinine level (p = 0.004), and more ill-defined wedge-shaped hypoenhancing cortical foci. • FDG-PET features of immune checkpoint inhibitor-related nephritis include an increase in FDG uptake throughout the renal cortex and a decrease in FDG activity/excretion in the collecting system. • > 30% increase in total kidney volume is associated with worse toxicity grade and more aggressive medical management.
30% increase in total kidney volume is associated with worse toxicity grade and more aggressive medical management.
To investigate whether volumetric visceral adipose tissue (VAT) features extracted using radiomics and three-dimensional convolutional neural network (3D-CNN) approach are effective in differentiating Crohn's disease (CD) and ulcerative colitis (UC).

This retrospective study enrolled 316 patients (mean age, 36.25 ± 13.58 [standard deviation]; 219 men) with confirmed diagnosis of CD and UC who underwent CT enterography between 2012 and 2021. Volumetric VAT was semi-automatically segmented on the arterial phase images. Radiomics analysis was performed using principal component analysis (PCA) and the least absolute shrinkage and selection operator (LASSO) logistic regression algorithm. We developed a 3D-CNN model using VAT imaging data from the training cohort. Clinical covariates including age, sex, modified body mass index, and disease duration that impact VAT were added to the machine learning model for adjustment. The model's performance was evaluated on the testing cohort separating from the model's devovariates that cause difference in volumetric visceral adipose tissue, adjusted clinical machine learning model reached stronger performance when distinguishing Crohn's disease patients from ulcerative colitis patients.
• High-output feature data extracted from volumetric visceral adipose tissue on CT enterography had an effective diagnostic performance for differentiating Crohn's disease from ulcerative colitis. • With adjustment of clinical covariates that cause difference in volumetric visceral adipose tissue, adjusted clinical machine learning model reached stronger performance when distinguishing Crohn's disease patients from ulcerative colitis patients.
The relative incremental predictive value of myocardial deformation over ventricular volume for future adverse events in patients with repaired tetralogy of Fallot (rTOF) remains unknown. We aimed to determine the incremental prognostic value of myocardial deformation over ventricular volume to predict adverse events in patients with rToF.

We retrospectively included patients with rTOF who completed cardiac magnetic resonance (CMR) and follow-up in our hospital from January 2014 to October 2020, and stratified according to the presence or absence of adverse events during follow-up. The strain parameters of the right ventricular (RV) and left ventricular (LV) were obtained from CMR-derived feature tracking. Multivariable Cox proportional hazard models and net reclassification improvement analysis were used to analyze the prognostic information of biventricular strain and volume parameters in rTOF patients.

Among 98 patients with rTOF, 54 (55.1%) experienced primary and/or secondary events during a medianepaired tetralogy of Fallot, providing increased prognostic information and significantly improved risk stratification over ventricular size.
• RV volume and strain were significantly associated with both primary events and all adverse events, whereas LV volume and strain were associated with primary events. • Ventricular myocardial deformation is a strong predictor of adverse outcomes of patients with repaired tetralogy of Fallot, providing increased prognostic information and significantly improved risk stratification over ventricular size.This cross-sectional study aims to evaluate the post-traumatic growth (PTG) level and explores its predictors among adult patients with SLE in China. From April 2020 to April 2021, 135 hospitalized adult SLE patients completed the questionnaire including sociodemographic and disease-related data, Post-traumatic Growth Inventory (PTGI), Medical Coping Modes Questionnaire (MCMQ), Social Support Rating Scale (SSRS), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and Self-Perceived Burden Scale (SPBS). Descriptive analysis, pearson's correlation analysis, and forward multiple line regression analysis were used for analysis by SPSS 22.0. Results showed that, the mean PTGI score was 57.52 ± 20.82. Pearson correlation analysis showed that, complicated autoimmune hemolytic anemia (r = - 0.185), CD4 +/CD8 + (r = - 0.383), acceptance-resignation (r = - 0.185), poor PSQI (r = - 0.215), and depression (r = - 0.322) were negatively associated with total PTGI score; while the relationship with lupus nephritis (r = 0.247), confrontation (r = 0.313), avoidance (r = 0.379), and SSRS (r = 0.242) were positive (all P  less then  0.05). The total score of PTGI and its five sub-dimensions were not correlated with anxiety and self-perceived burden. Further, CD4 +/CD8 +, confrontation of MCMQ, and SSRS could explain 30.3% of the variance in total PTGI (F = 6.646, P  less then  0.01). In summary, Chinese adults with SLE experience moderate levels of PTG. Clinical nurses need pay attention to the current disease status and individual characteristics of patients, as well as their mental health, to promote their growth experience, so that they can cope with the future life in a better state and coexist well with SLE.To assess the impact of the COVID-19 pandemic on the training of rheumatology trainees. We conducted an observational cross-sectional study using an online survey-based questionnaire sent to rheumatology trainees in India. Rheumatology trainees from India, including DM/DNB residents and fellows, were included. A total of 78 trainees from 24 institutes in 12 states participated in the study. An overwhelming majority of residents (84%) felt COVID-19 Pandemic Negatively impacted their residency and their Physical (65%), Mental (74%) and Social well-being (80%); 79% of trainees felt burnt out. Majority of trainees felt the pandemic negatively impacted their training with clinical teaching (91%), Clinical examination skills (74%), current (80%) and future (70%) research opportunities suffering during the pandemic. Most had significant reduction in the overall footfall (72%) of patients in rheumatology including OPD (77%) and indoor (67%) admissions along with academics (35%), procedures (66%) and exposure to musculoskeletal ultrasound (71%). Almost 60% and 40% of trainees had OPDs, and indoor admissions stopped during COVID-19 pandemic of these 20% had OPDs, and Admissions closed for more than 6 months. 85% of participants had one or the other psychological symptoms with almost half experiencing anxiety (44%), low mood (47%) or lack of sleep (41%). We found The COVID-19 Pandemic has significantly affected the physical, social and mental well-being of Rheumatology trainees. Academic and clinical training reduced, current and future Research became difficult, disruptions in OPDs and Admissions, recurrent COVID postings and reduction in patient footfall, procedures and MSK-US have been detrimental to trainees.
Urticaria following the COVID-19 vaccine was rarely reported and had a short self-limited resolution. However, there has been relatively little literature published on CSU induced by COVID-19 vaccines.

We describe a case series of patients who experienced CSU after SARS-CoV-2 vaccination.

A retrospective case series of 10 patients referred to the Department of Clinical Pharmacology of the University of Monastir (January 2021-January 2022) and included for evaluation of urticaria after COVID-19 vaccination.

The median age was 31years and patients were mostly female. Atopy was presented in 3 patients and urticaria was accompanied by angioedema in 6 patients. The median time interval between vaccination and the onset of urticaria was 28.5h. The offended dose was the first one in 8 patients. The resolution of the eruption was observed at least 2months later, despite the regular use of a full dose of antihistamine in nine patients. Polynuclear leucocytosis was identified in 5 patients. Anti-TPOAb was positive in one patient after receiving the BNT162b2 vaccine. Total serum IgE was elevated in 4 patients. Skin tests for the suspected vaccine as well as the vaccine excipient were negative.

We add to the medical literature ten new cases of chronic spontaneous urticarial reactions following COVID-19 vaccines uncontrolled with high-dose first-generation H1 antihistamines.
We add to the medical literature ten new cases of chronic spontaneous urticarial reactions following COVID-19 vaccines uncontrolled with high-dose first-generation H1 antihistamines.
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