Lichen planus is a chronic disease associated with the occurrence of characteristic papular pruritic lesions. The most significant immunological markers of lichen planus are cytokines. Numerous publications showed changes in the serum level of tumor necrosis factor, interferon g, interleukins 2, 4, 6, 8, 10, 17 and 22. Early lichen planus is associated with a high number of macrophages, T cells, and dendritic cells, while advanced lichen planus with a high number of Treg cells. There is no single specific marker for lichen planus, but certain cytokine levels can be used as a prognostic factor for disease progression and as an indicator of treatment response. Analysis of the immune markers can help to define the disease stage and lichen planus subtype, but histopathology still remains a standard in lichen planus diagnosis.
Background: Left bundle branch area pacing (LBBAP) is one of the methods to deliver conduction system pacing which potentially avoids the negative impact of conventional right ventricular pacing.Objective: To assess echocardiographic outcomes in a long-term observation in patients with LBBAP implemented for bradyarrhythmia indications. Methods and Results:A total of 151 patients with symptomatic bradycardia and LBBAP pacemaker implanted, were prospectively included in the study. Subjects with left bundle branch block and CRT indications (n = 29), ventricular pacing burden <40%(n = 11), and loss of LBBAP (n = 10) were excluded from further analysis. At baseline and the last follow-up visit, echocardiography with global longitudinal strain (GLS) assessment, 12-lead ECG, pacemaker interrogation, and blood level of NT-proBNP were performed. The median follow-up period was 23 months (15.5-28). None of the analyzed patients fulfilled the criteria for pacing induced cardiomyopathy (PICM).Improvement in left ventricular ejection fraction (LVEF) and GLS was observed in patients with LVEF <50% at baseline (n = 39): 41.4 ± 9.2% versus 45.6 ± 9.9%, and 12.9 ± 3.6% versus 15.5 ± 3.7%, respectively. In the subgroup with preserved EF (n = 62), LVEF and GLS remained stable at follow-up: 59.3 ± 5.5% versus 60 ± 5.5%, and 19 ± 3.9% versus 19.4 ± 3.8%, respectively. Conclusion:LBBAP prevents PICM in patients with preserved LVEF and improves left ventricle function in subjects with depressed LVEF. LBBAP might be the preferred pacing modality for bradyarrhythmia indications.
1. A simple quantitative method (based on McCarty’s method) of measuring the RN-ase activity in urine and blood is presented. 2. The RN-ase activity was examined in the blood and urine of patients suffering from chronic granulocytic leukemia, myeloblastic leukemia, lymphatic leukemia, granulocytopenia, lymphogranulomatosis, and in cases of infectious disease with an increased leukocytosis. 3. The RN-ase activity in the urine is increased in chronic granulocytic leukemia, while the RN-ase activity in the blood serum remains unchanged. In other diseases, in spite of an increased or decreased leukocytosis, no essential changes in the RN-ase activity in the urine and blood serum have been observed, which indicates that there is no close relationship between the number of leukocytes in the peripheral blood and the RN-ase activity in the 24-hour sample of urine.
Objectives: Stressful situations have an impact on progression of lichen sclerosus. The aim of the study was to investigate fears and complaints of patients with vulvar lichen sclerosus and progression of disease at the beginning of the COVID-19 pandemic. Material and methods:The analysis was based on 103 women with mean age was 64.81 ± 11.36 years divided into two groups. The first one comprised of patients with stabilization of disease during the pandemic with mean age 66.02 ± 10.01 (32-87), while the second one with progression of vulvar symptoms with mean age 63.49 ± 12.66 (25-87).Results: Delay of diagnosis was reported to be a problem for respectively 25.93% of women from both groups. Fear about COVID-19 was described respectively by 57.4% and 55.1%. Stabilization of disease was more frequent in patients after photodynamic therapy before pandemic. Progression of vulvar symptoms and features were observed more in patients who did not conduct PDT previously. All patients from the second group who underwent photodynamic therapy reported disappointment because of no access for continuation of treatment. On the other hand, 81.4% (43 women) regret that have no chance for trying photodynamic therapy.Conclusions: Photodynamic therapy seems to be a method of treatment with longer survival without progression of lichen sclerosus in times of pandemics. There has been no investigation until now about concerns of patients with vulvar lichen sclerosus. Better understanding of problems connected with the pandemic can help medical personnel in taking care of patients with vulvar lichen sclerosus.
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