A total of 380 children, 131 in Group I and 249 in Goup II were recruited in the study. H. pylori postivity was found to be higher in Group I (% 48.1 and % 23.1, respectively, p < 0.001). Gastritis and atrophy were associated with H. pylori and both were more prevalent in Group I (p < 0.001). Our study demonstrates that H. pylori prevalence is decreasing in a pediatric population undergoing EGD in Ankara. This is the most recent study regarding pediatric H. pylori prevalence change in Turkey that we know of.
BackgroundThe most commonly used disease activity index in rheumatoid arthritis (RA) is Disease Activity Score 28 (DAS28). However, the need for objective disease activity indices retains. The nutritional and inflammatory indices were recently evaluated in many rheumatologic and non-rheumatic conditions as predictors of disease activity.ObjectivesWe aimed to evaluate the association of six different nutritional and inflammatory indices with disease activity and patient reported outcomes (PROs) in patients with RA.MethodsIn this cross-sectional study, we recruited RA patients who fulfilled the 2010 ACR/EULAR classification criteria. Participants’ demographic features, disease duration, current medication, disease activity indices [DAS28 with erythrocyte sedimentation rate (DAS28-ESR), simplified disease activity index (SDAI), clinical disease activity index (CDAI)], PROs [Health Assessment Questionnaire-Disability Index (HAQ-DI), Rheumatoid arthritis Impact of Disease (RAID)], Multimorbidity Index (MMI), hand and foot erosions, deformities, extra-articular manifestations of RA, nutritional and inflammatory status [prognostic nutritional index (PNI), controlling nutritional status (CONUT) score, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), systemic inflammation response index (SIRI), Mini Nutritional Assessment-Short Form (MNA-SF), body mass index (BMI), waist and hip circumference] were noted. Patients were divided into 2 groups (remission and low disease activity vs. moderate and high disease activity) according to their DAS28-ESR scores.ResultsA total of 183 RA patients were analyzed. The mean age was 29.5±5.7 years, the median time of disease duration was 120 (60-238) months, 83.1% (n=152) were female, 69.9% were RF positive (n=128), 59% (n=108) were anti-CCP positive, 79.1% (n=145) were on conventional synthetic disease-modifying antirheumatic drugs (csDMARD), 5.5% (n=10) used targeted synthetic DMARD (tsDMARD), 16.4% (n=30) were used biologic DMARD (bDMARD). Median PNI values were lower in patients with extra-articular involvement (p<0.001). Mean PNI values were lower in patients with hematologic involvement, anemia, and thrombocytopenia (p<0.001, p=0.026, p=0.033), those with erosion on the foot X-ray (p=0.005), and CCP positive ones (p=0.028). NLR and SIRI were positively correlated with physician’s global assessment (PGA) score (r=0.270, p<0.001; r=0.227, p=0.002), SDAI (r=0.219, p=0.003; r=0.199, p=0.007), CDAI (r=0.192, p=0.009; r=0.154, p=0.037), DAS28-ESH (r=0.232, p=0.002; r=0.186, p=0.012), ESR (r=0.233, p=0.001; r=0.218, p=0.003) and c-reactive protein (r=0.324, p<0.001; r=0.380, p<0.001). MNA-SF was negatively correlated with HAQ-DI (r=-0.199, p=0.007), RAID (r=-0.179, p=0.015), PGA score (r=-0.280, p<0.001), SDAI (r=-0.205, p=0.005), CDAI (r=-0.224, p=0.002), and DAS28-ESH (r=-0.186, p=0.012). PNI was not correlated with disease activity scores and PROs.ConclusionIn this study where we aimed to determine the role of a variety of nutritional inflammatory indices in disease activity ascertainment of RA patients, while NLR, MNA-SF, and SIRI had significant associations with other composite disease activity indices, PNI failed to establish such a relationship. However, PNI was significantly higher in CCP-positive RA patients and ones with extraarticular involvement. Prospective longitudinal studies on larger samples are needed to elucidate the role of nutritional inflammatory indices in determining RA disease activity.References[1] Ahn et al. Nutrients 2019;11(7):1456.[2] Radner et al. Semin Arthritis Rheum 2015;45(2):167-73.[3] Zhang et al. Clin Interv Aging 2021;16:1997-2007.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundPrimary Sjogren syndrome (pSS) is a chronic autoimmune disease that mainly affects the exocrine glands [1]. Type 2 diabetes mellitus (DM) is also autoimmune disease involving not only the pancreas but also salivary glands. In both diseases, sicca symptoms due to different mechanisms were common [1, 2]. The use of salivary gland ultrasonography (SGUS) has become widespread in the diagnosis and follow-up of pSS [3, 4]. In DM, fewer US-based studies have shown abnormalities in the major salivary glands [2].ObjectivesThis study aimed to compare the SGUS findings in patients with pSS and DM patients with sicca symptoms and to examine the relationship between these findings with clinical and laboratory parameters.MethodsIn this study, 32 patients with pSS and 28 DM patients with sicca symptoms (not meet ACR/EULAR pSS criteria) were included. Demographic data and patient characteristics were obtained from medical records. Physical examination was assessed by a rheumatologist. In all patients, bilateral parotid and submandibular gland US was performed by a blind another rheumatologist, using the Hocevar and the Outcome Measures in Rheumatology (OMERACT) scoring system. Clinic and ultrasonographic variables were compared between groups. The association between SGUS score and disease duration was analyzed by correlation analysis.ResultsPatients with pSS presented higher SGUS scores than patients with DM significantly (the Hocevar total score; 20.93(±9.65) vs 3.82(±3.71); p<0.05, the OMERACT total score; 5.96(±2.30) vs 2.07(±1.65); p<0.05, respectively). In patients with pSS, the submandibular gland scores higher than the parotid gland scores while in patients with DM showed higher parotid gland scores. Other demographic data is shown in Table 1. In pSS patients, the Hocevar and the OMERACT total SGUS scores were significantly correlated with disease duration (r=0.584, p<0.01 vs r=0.518, p<0.01, respectively). This correlation was not found in patients with DM (Figure 1).Table 1.Demograpfic data and salivary gland ultrasonography scores in pSS and diabetic patientspSS patients(n=32)DM patients with sicca(n=28)Age, mean(±SD)53.90(±9,70)52.25(±7.65)Disease duration, mean(±SD)7.68(±4.01)8.46(±6.31)First symptom, n(%) Sicca5(15.62%)4(14.28%) Non-sicca23(71.87%)20(71.42%)Parotitis, n(%)7(21.87%)2(7.14%)aAnti-Ro positivity, n(%)22(68.75%)0(0.0%)aUnstimulated saliva flow rate ≤0.1 ml/m, n(%)28(87.5%)13(46.42%)aSchirmer’s test≤5 mm/5 m in at least one eye, n(%)30(93.75%)8(28.57%)aThe Hocevar total SGUS score, mean(±SD)20.93(±9.65)3.82(±3.71)a right parotid4.62(±2.73)1.25(±1.17)a left parotid4.34(±2.57)1.25(±1.08) a right submandibular6.06(±3.07)0.67(±0.41) a left submandibular6.31(±2.95)0.64(±0.43) aThe OMERACT total SGUS score,(mean(±SD)5.96(±2.30)2.07(±1.65) a right parotid1,28(±0.77)0,71(±0.59) a left parotid1,21(±0.65)0,78(±0.62) a right submandibular1,68(±0.82)0,44(±0.25) a left submandibular1,78(±0.83)0,47(±0.32) aap<0.05Figure 1.Correlation between SGUS scores and disease duratin in two groupsConclusionThis study demonstrated that the major salivary gland involvement was more severe, submandibular gland dominant and correlated with disease duration in pSS. Contrarily, in patients with DM, it was mild compared to pSS, parotid dominant and uncorrelated with disease duration.References[1]Mariette, X. and L.A. Criswell, Primary Sjögren’s syndrome. New England Journal of Medicine, 2018.[2]Gupta, A., et al., A Cross-Sectional Study on Ultrasonographic Measurements of Parotid Glands in Type 2 Diabetes Mellitus. Int J Dent, 2021.[3]Finzel, S., et al., Patient-based reliability of the Outcome Measures in Rheumatology (OMERACT) ultrasound scoring system for salivary gland assessment in patients with Sjögren’s syndrome. Rheumatology (Oxford), 2021.[4]Hocevar, A., et al., Ultrasonographic changes of major salivary glands in primary Sjogren’s syndrome. Diagnostic value of a novel scoring system. Rheumatology (Oxford), 2005.Disclosure of InterestsNone declared
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