Outcomes for circulatory death and brainstem death pancreas transplantation with or without use of normothermic regional perfusion

Simultaneous pancreas and kidney transplantation is the optimum treatment for patients with type 1 diabetes and renal failure, providing survival benefit over deceased donor kidney transplant alone. Here the authors demonstrate that utilization of donation after circulatory death pancreases is a safe approach to expanding the donor pool with equivalent results to donation after brainstem death transplantation. They also demonstrate that pancreas transplantation after normothermic regional perfusion is feasible, but it will require ongoing prospective study to ensure that the benefits seen for liver transplantation do not come at the expense of pancreas transplant outcomes.

Comparison of tear characteristics, outcome parameters and healing in traumatic and non-traumatic rotator cuff tear: a prospective cohort study

PURPOSE

Acute traumatic and chronic non-traumatic rotator cuff tears are etiologically distinguishable entities. However, prospective studies comparing tear characteristics and outcomes between these two types of tears are lacking. The purpose of this study was to compare the tear characteristics, clinical and functional outcomes, and tendon healing as assessed on magnetic resonance imaging (MRI), between traumatic and non-traumatic rotator cuff tears.

METHODS

MRI proven rotator cuff tears were allocated into two groups according to the history of injury: Group 1 included 28 patients with traumatic tears and group 2 included 33 patients of non-traumatic cuff tears. Both the groups were compared for preoperative tear characteristics (tear size, muscle atrophy, fatty degeneration), range of motion, strength of shoulder abduction and external rotation, functional outcomes, and tendon integrity on MRI, 2 years after the surgery.

RESULTS

Postoperative mean active range of abduction (p = 0.005), abduction strength (p = 0.013), external rotation strength (p = 0.027), University of California at Los Angeles score (p < 0.001), Constant score (p = 0.002), American Shoulder and Elbow Surgeons scores (p = 0.028) and visual analog scale for pain (p = 0.02) were significantly better in group 1 as compared to group 2. The postoperative structural integrity of the cuff on MRI was better in group 1 as compared to group 2, but the values did not reach statistical significance (p = 0.13).

CONCLUSION

Findings from this study suggest that traumatic tears affect younger patients and while having a larger tear size, they have lesser muscle atrophy, fatty degeneration, and tendon retraction. Functional outcomes are better after treatment of traumatic tears as compared to non-traumatic tears. Chronicity of the tear and tendon retraction negatively affected healing in traumatic cuff tears. Muscle atrophy was found to be associated with poorer healing in non-traumatic tears. However, tear size was not associated with healing.

LEVEL OF EVIDENCE

II, Prospective cohort study.

Seasonal analysis of food items and feeding habits of endangered riverine catfish Rita rita (Hamilton, 1822)

This investigation presents the food and feeding activity of and endangered riverine catfish Rita rita, during February 2017-January 2018. A total of 225 fish individuals was analyzed for stomach contents by characterizing the dominant food items and morphometric features. The results divulged ten major food items consumed, preferably fish scales and eggs, teleost fishes, copepods, cladocerans, rotifers, and mollusks. Total length and body weight of fish varied between 9-34 cm (20.53 ± 6.90 cm) and 10-400 g (9125.94 ± 102.07 g), respectively. The index of relative importance (IRI%) showed the importance of rotifers over the other food items. Morisita's index of diet overlap indicated seasonal variations in catfish diets with summer and monsoon displaying the least overlap, while maximum overlap during monsoon and winter seasons. The non-metric multidimensional scaling (nMDS) indicated the close association between the food items available during summer and winter seasons with a significant difference among the seasons (ANOSIM, R = 0.638, P = 0.013). Levin's niche breadth index arranged in the order of 0.88>0.81>0.78>0.63>0.43 for the size classes of V, IV, III, II and I, respectively. The PCA explained 95.39% of the total variance among the food items and fish size groups. Small-sized fish individuals displayed a greater correlation with food items suitable for their mouth size. In conclusion, the variety and frequency of food items recorded indicated considerable feeding plasticity and opportunistic feeding behavior with a shift from carnivorous to omnivorous feeding nature. This study could render useful information on the food and feeding habits of R. rita and provide background for preparing its diet for future aquaculture practices.

POS0068 HIGH LEVELS OF PORPHYROMONAS GINGIVALIS AND PREVOTELLA INTERMEDIA ANTIBODIES IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Background:

Idiopathic juvenile arthritis (JIA) is a heterogeneous group of pathologies whose origin remains unknown at present (1). They are characterised by a systemic inflammatory and joint disease affecting children under 16 years of age. The current classification groups the different forms of JIA into 7 distinct entities (systemic forms, polyarticular forms with or without rheumatoid factors, oligoarticular forms, inflammatory arthritis associated with enthesopathies (ERA), arthritis associated with psoriasis and unclassifiable arthritis). Exact etiology of JIA is still unknown. To date, the various hypotheses put forward on the occurrence of JIAs integrate the genetic and environmental framework.

The link between periodontal disease and rheumatoid arthritis (RA) is largely reported. Recently, Porphyromonas gingivalis (P. gingivalis) infection explained the occurrence of arthritis in rodent and in RA (2). Several studies mention the beneficial effect of P. gingivalis treatment on disease activity.

Currently, there are very few studies on the prevalence of P. gingivalis in patients with JIA and the possible involvement of the germ in the development of inflammatory joint diseases in the pediatric population(3)(4).

Objectives:

The objective of our study is to determine presence of high IgG antibodies against P. gingivalis and Prevotella Intermedia in a cohort of patients with JIA compared to a control population and to determine variation of level according to sub-classes of JIA.

Methods:

Sera were obtained from 101 patients satisfying the ILAR classification criteria for JIA and in 25 patients with two other dysimmune disorders (type 1 diabetes and juvenile inflammatory bowel disease). Level of IgG antibodies against P. gingivalis and Prevotella Intermedia were obtained by homemade ELISA already used previously (5).

Results:

In the JIA group, major children were oligarthritis (47.5%), polyarthritis represents 31.7% of JIAs, ERA and systemic forms of JIA are respectively 9 and 11%. For the control group, 10 (40%) children had diabetes and 15 (60%) had IBD.

Levels of anti-P. gingivalis anti-Prevotella Intermedia antibodies were higher in AJI group compared at control groups (P<0.01, P<0.05). Theses difference are mainly related to oligoarthritis and ERA subsets for both P. gingivalis and Prevotella Intermedia.

Figure 1.

Relative titer of antibodies to P. gingivalis and anti Prevotella intermedia. *: P<0.05; **: P<0.01; ***: P<0.001. P. gingivalis (control vs oligoarthritis p= 0.0032. control vs ERA p= 0.0092). Prevotella intermedia (control vs oligoarthritis p= 0.0194. control vs ERA p= 0.0039).

Conclusion:

We confirmed high level of anti-P. gingivalis and anti-Prevotella intermedia antibodies in JIA compared to other inflammatory disorders. For the first time, we observed that this high level was mainly in oligoarthritis and ERA. Further investigations are required to investigate involvement of oral dysbiosis in AJI pathogenesis. As observed in RA, it could be a new way to integrate in JIA therapy management.

References:

[1]Thatayatikom A, De Leucio A. Juvenile Idiopathic Arthritis (JIA). StatPearls Publishing; 2020

[2]Cheng Z, Meade J, Mankia K, Emery P, Devine DA. Periodontal disease and periodontal bacteria as triggers for rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2017;31(1):19–30.

[3]Romero-Sánchez C, Malagón C, Vargas C, Fernanda Torres M, Moreno LC, Rodríguez C, et al. Porphyromonas Gingivalis and IgG1 and IgG2 Subclass Antibodies in Patients with Juvenile Idiopathic Arthritis. J Dent Child Chic Ill. 2017 May 15;84(2):72–9.

[4]Lange L, Thiele GM, McCracken C, Wang G, Ponder LA, Angeles-Han ST, et al. Symptoms of periodontitis and antibody responses to Porphyromonas gingivalis in juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2016 Feb 9

[5]Rinaudo-Gaujous M, Blasco-Baque V, Miossec P, Gaudin P, Farge P, Roblin X, et al. Infliximab Induced a Dissociated Response of Severe Periodontal Biomarkers in Rheumatoid Arthritis Patients. J Clin Med. 2019 May 26;8(5).

Disclosure of Interests:

None declared.

AB0074 NO DIFFERENCE BETWEEN THE SEROLOGIES OF DENTAL GERMS AND THE PHENOTYPES OF SPONDYLOARTHRITIS WITHIN THE DESIR COHORT

Background:

Porphyromonas gingivalis (PG) and Prevotella Intermedia (PI) are two oral pathogens involved in the pathophysiology of chronic periodontopathies. Several studies have determined a role of these periodontal pathologies in the pathophysiology of rheumatoid arthritis (1) while the link with spondyloarthritis is not clearly established with currently contradictory studies (2,3,4).

Objectives:

The purpose of this work is to investigate a link between spondylarthritis and the presence of chronic periodontopathy evaluated by PG and IP serologies.

Methods:

The positivity and quantity of anti-PG and anti-PI antibodies were determined by ELISA method in patients from the DESIR cohort with one of the spondyloarthritis phenotypes compared to patients with common low back pain (n=50) (population control). Patients with spondyloarthritis were classified according to the following phenotypes (diagnosis chosen at 3 years in the DESIR cohort): axial spondylarthritis (n=126), psoriatic rheumatism (n=101), spondyloarthritis associated with chronic inflammatory bowel disease (n=36), undifferentiated spondylitis (n=241), reactive arthritis (n=2), SAPHO (acronym for Synovite, Acne, Pustulose, Hyperostosis and Osteitis. Correlations between patients’ serological status, and smoking status, body mass index and age were sought.

Results:

According to the general characteristics, the control group was significantly older than the axial spondylarthritis (p<0.001), and the psoriatic rheumatism group had a higher body mass index than the control population (p<0.05). The positivity and concentration of anti-PG and anti-PI antibodies were similar between different groups of spondyloarthritis compared to the control group. However, the subgroups “reactive arthritis” and “SAPHO” could not be analyzed due to insufficient staffing. Smoking status and body mass index were not related to antibody concentrations, however there was a statistical correlation between anti-PG antibody concentrations and age. After adjusting on age, there was no difference between the axial spondylarthritis and control groups.

Conclusion:

Our results therefore suggest the absence of a link between periodontal germs involved in chronic periodontopathies and spondyloarthritis, provided that the two phenotypes involving germs in their pathophysiology could not be analyzed. Our results from a population of beginner spondylitis are therefore not in favour of the involvement of oral flora in the pathophysiology of spondyloarthritis, as is the case in rheumatoid arthritis (1). The associations found previously could therefore be favoured by a systemic inflammatory phenomenon. In conclusion, our study suggests no link between chronic periodontopathy and the occurrence of spondyloarthritis. However, the effect of chronic periodontopathy on the evolution of spondylarthritis remains to be explored.

References:

[1]Detert J, Pischon N, Burmester GR, Buttgereit F. The association between rheumatoid arthritis and periodontal disease. Arthritis Res Ther. 2010;12(5):218.

[2]Ratz T, Dean LE, Atzeni F, Reeks C, Macfarlane GJ, Macfarlane TV. A possible link between ankylosing spondylitis and periodontitis: a systematic review and meta-analysis. Rheumatology. 2015;54(3):500-10.

[3]Pischon N, Pischon T, Gülmez E, Kröger J, Purucker P, Kleber B-M, et al. Periodontal disease in patients with ankylosing spondylitis. Ann Rheum Dis. janv 2010;69(01):34-8.

[4]Sezer U, Erciyas K, Pehlivan Y, Üstün K, Tarakçioğlu M, Şenyurt SZ, et al. Serum cytokine levels and periodontal parameters in ankylosing spondylitis: Ankylosing spondylitis and periodontal diseases. J Periodontal Res. juin 2012;47(3):396-401.

Disclosure of Interests:

None declared

Depression among Patients Presenting with Gastrointestinal Symptoms: Prevalence and Associated Factors

Gastrointestinal diseases frequently affect patients' physical and emotional wellbeing as being heavily affected by stress. This study was conducted to find out prevalence and severity of depressive symptoms among patients presenting with gastrointestinal symptoms. This cross sectional study was conducted at Outpatients Department jointly by Department of Gastroenterology and Department of Psychiatry of a tertiary care hospital in north east part of Bangladesh from November 2011 to June 2012. Consecutive patients with gastrointestinal symptoms underwent psychiatric evaluation using HDRS and analyzed. 442 patients, 38(8.6%) were found normal. Among the rest 128(28.96%), 138(31.22%), 72(16.29%) and 66(14.93%) had mild, moderate, severe and very severe depressive symptoms respectively. Female sex (95.03% vs. 89.32%), married people (93.77 vs. 86.13%), older age (98.24%), rural people (94.26% vs. 84.36%), farmers (96.36%) and house wives (96.24%) were more affected. Prevalence of depression was also higher among patients with lower socioeconomic class, less educated people and rural background. Depressive symptoms are very common in patients presenting with gastrointestinal symptoms. Awareness regarding psychiatric assessment and intervention may reduce sufferings and thus improve wellbeing of these patients.

Evidence for X(3872)→J/ψπ^{+}π^{-} Produced in Single-Tag Two-Photon Interactions

We report the first evidence for X(3872) production in two-photon interactions by tagging either the electron or the positron in the final state, exploring the highly virtual photon region. The search is performed in e^{+}e^{-}→e^{+}e^{-}J/ψπ^{+}π^{-}, using 825  fb^{-1} of data collected by the Belle detector operated at the KEKB e^{+}e^{-} collider. We observe three X(3872) candidates, where the expected background is 0.11±0.10 events, with a significance of 3.2σ. We obtain an estimated value for Γ[over ˜]_{γγ}B(X(3872)→J/ψπ^{+}π^{-}) assuming the Q^{2} dependence predicted by a cc[over ¯] meson model, where -Q^{2} is the invariant mass squared of the virtual photon. No X(3915)→J/ψπ^{+}π^{-} candidates are found.

Stacking-Dependent Spin Interactions in Pd/Fe Bilayers on Re(0001)

Using spin-polarized scanning tunneling microscopy and density functional theory, we have studied the magnetic properties of Pd/Fe atomic bilayers on Re(0001). Two kinds of magnetic ground states are discovered due to different types of stacking of the Pd adlayer on Fe/Re(0001). For fcc stacking of Pd on Fe/Re(0001), it is a spin spiral propagating along the close-packed (ΓK[over ¯]) direction with a period of about 0.9 nm, driven by frustrated exchange and Dzyaloshinskii-Moriya interactions. For the hcp stacking, the four-site four-spin interaction stabilizes an up-up-down-down state propagating perpendicular to the close-packed direction (along ΓM[over ¯]) with a period of about 1.0 nm. Our work shows how higher-order exchange interactions can be tuned at interfaces.

Search for Axionlike Particles Produced in e^{+}e^{-} Collisions at Belle II

We present a search for the direct production of a light pseudoscalar a decaying into two photons with the Belle II detector at the SuperKEKB collider. We search for the process e^{+}e^{-}→γa, a→γγ in the mass range 0.2<m_{a}<9.7  GeV/c^{2} using data corresponding to an integrated luminosity of (445±3)  pb^{-1}. Light pseudoscalars interacting predominantly with standard model gauge bosons (so-called axionlike particles or ALPs) are frequently postulated in extensions of the standard model. We find no evidence for ALPs and set 95% confidence level upper limits on the coupling strength g_{aγγ} of ALPs to photons at the level of 10^{-3}  GeV^{-1}. The limits are the most restrictive to date for 0.2<m_{a}<1  GeV/c^{2}.

Probing Few-Body Nuclear Dynamics via ^{3}H and ^{3}He (e,e^{'}p)pn Cross-Section Measurements

We report the first measurement of the (e,e^{'}p) three-body breakup reaction cross sections in helium-3 (^{3}He) and tritium (^{3}H) at large momentum transfer [⟨Q^{2}⟩≈1.9  (GeV/c)^{2}] and x_{B}>1 kinematics, where the cross section should be sensitive to quasielastic (QE) scattering from single nucleons. The data cover missing momenta 40≤p_{miss}≤500  MeV/c that, in the QE limit with no rescattering, equals the initial momentum of the probed nucleon. The measured cross sections are compared with state-of-the-art ab initio calculations. Overall good agreement, within ±20%, is observed between data and calculations for the full p_{miss} range for ^{3}H and for 100≤p_{miss}≤350  MeV/c for ^{3}He. Including the effects of rescattering of the outgoing nucleon improves agreement with the data at p_{miss}>250  MeV/c and suggests contributions from charge-exchange (SCX) rescattering. The isoscalar sum of ^{3}He plus ^{3}H, which is largely insensitive to SCX, is described by calculations to within the accuracy of the data over the entire p_{miss} range. This validates current models of the ground state of the three-nucleon system up to very high initial nucleon momenta of 500  MeV/c.

Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial

PURPOSE

Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This study compares the effect of subacromial injections of ketorolac with steroids.

METHODS

A randomized controlled study was planned with 35 patients in each group. Patients in group-1 were infiltrated with subacromial ketorolac (60 mg with 2% lignocaine) and in group-2 with a steroid (methylprednisolone-40 mg with 2% lignocaine). A similar rehabilitation protocol was followed, and clinical outcomes were analyzed using visual analog scale (VAS) for pain and shoulder pain and disability score (SPADI) and range of motion at one-month and three-months follow-up.

RESULTS

Total data of 67 patients were analyzed, as three patients were lost to follow-up. In group 1, mean VAS improved from 7.9 [Formula: see text] 0.95 to 3.19 [Formula: see text] 0.81 (p < 0.001) and SPADI improved from 61.41 [Formula: see text] 11.86 to 28.91 [Formula: see text] 9.06 (p < 0.001) at three months, respectively. In group 2, mean VAS improved from 8.05 [Formula: see text] 0.94 to 2.9 [Formula: see text] 0.64 (p < 0.001) and SPADI improved from 63.45 [Formula: see text] 9.64 to 25.32 [Formula: see text] 6.87 (p < 0.001) at three months, respectively. However, there were no differences in functional outcomes between the groups (p = 0.21 for VAS, p = 0.16 for SPADI).

CONCLUSION

Subacromial ketorolac infiltration has an equivalent outcome as that of steroid infiltration. Ketorolac could be considered as a reasonable alternative to steroids in cases where it is contraindicated.

Measurement of R(D) and R(D^{*}) with a Semileptonic Tagging Method

The experimental results on the ratios of branching fractions R(D)=B(B[over ¯]→Dτ^{-}ν[over ¯]_{τ})/B(B[over ¯]→Dℓ^{-}ν[over ¯]_{ℓ}) and R(D^{*})=B(B[over ¯]→D^{*}τ^{-}ν[over ¯]_{τ})/B(B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ}), where ℓ denotes an electron or a muon, show a long-standing discrepancy with the standard model predictions, and might hint at a violation of lepton flavor universality. We report a new simultaneous measurement of R(D) and R(D^{*}), based on a data sample containing 772×10^{6}  BB[over ¯] events recorded at the ϒ(4S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. In this analysis the tag-side B meson is reconstructed in a semileptonic decay mode and the signal-side τ is reconstructed in a purely leptonic decay. The measured values are R(D)=0.307±0.037±0.016 and R(D^{*})=0.283±0.018±0.014, where the first uncertainties are statistical and the second are systematic. These results are in agreement with the standard model predictions within 0.2, 1.1, and 0.8 standard deviations for R(D), R(D^{*}), and their combination, respectively. This work constitutes the most precise measurements of R(D) and R(D^{*}) performed to date as well as the first result for R(D) based on a semileptonic tagging method.

Search for an Invisibly Decaying Z^{'} Boson at Belle II in e^{+}e^{-}→μ^{+}μ^{-}(e^{±}μ^{∓}) Plus Missing Energy Final States

Theories beyond the standard model often predict the existence of an additional neutral boson, the Z^{'}. Using data collected by the Belle II experiment during 2018 at the SuperKEKB collider, we perform the first searches for the invisible decay of a Z^{'} in the process e^{+}e^{-}→μ^{+}μ^{-}Z^{'} and of a lepton-flavor-violating Z^{'} in e^{+}e^{-}→e^{±}μ^{∓}Z^{'}. We do not find any excess of events and set 90% credibility level upper limits on the cross sections of these processes. We translate the former, in the framework of an L_{μ}-L_{τ} theory, into upper limits on the Z^{'} coupling constant at the level of 5×10^{-2}-1 for M_{Z^{'}}≤6  GeV/c^{2}.

Observation of the Radiative Decays of ϒ(1S) to χ_{c1}

We report the first observation of the radiative decay of the ϒ(1S) into a charmonium state. The significance of the observed signal of ϒ(1S)→γχ_{c1} is 6.3 standard deviations including systematics. The branching fraction is calculated to be B[ϒ(1S)→γχ_{c1}]=[4.7_{-1.8}^{+2.4}(stat)_{-0.5}^{+0.4}(sys)×10^{-5}]. We also searched for ϒ(1S) radiative decays into χ_{c0,2} and η_{c}(1S,2S), and set upper limits on their branching fractions. These results are obtained from a 24.9  fb^{-1} data sample collected with the Belle detector at the KEKB asymmetric-energy e^{+}e^{-} collider at a center-of-mass energy equal to the ϒ(2S) mass using ϒ(1S) tagging by the ϒ(2S)→ϒ(1S)π^{+}π^{-} transitions.