Comparison of Liver Condemnation and Bile Microscopy As Tools to Estimate Fasciola hepatica Prevalence and Burden in the Anta Province of Cusco in Peru

Fascioliasis is a zoonotic infection linked to significant economic losses in the livestock industry. Infection prevalence and estimated financial burden vary across locations owing to different diagnostic tests used. The accuracy of liver condemnation to estimate the prevalence and costs of fascioliasis has seldom been evaluated. We performed a pilot study to determine the prevalence and burden of Fasciola hepatica infection among cattle slaughtered at the municipal abattoir in the Anta province of the Cusco highlands in Peru. We compared liver condemnation with bile microscopy for the diagnosis of infection and prediction of carcass weight. Data were collected from 2009 slaughtered cattle for 1 year. The overall prevalence of Fasciola infection by bile microscopy was 62.5% (1247/2009). A higher prevalence was observed after the rainy season from March to August than from September to February (p < 0.01). Fascioliasis prevalence during the first 6 months was 77.4% (714/923), combining the results of condemnation and microscopy. Bile microscopy diagnosed more infections than liver condemnation (62.7% (579/923) versus 55.4% (511/923), McNemar test p < 0.01). The agreement of the bile microscopy testing with liver condemnation was fair (κ = 0.247). Animal age, gender, breed, and liver condemnation predicted carcass weight [F (df 4, 704) = 61.1, p < 0.001]. Liver condemnation and bile microscopy are complementary tools for evaluation of the prevalence and burden of fascioliasis in livestock. Large scale studies are warranted to confirm our results.

SAT0567 USE OF THERMOGRAPHY OF HANDS AND MACHINE LEARNING TO DIFFERENTIATE PATIENTS WITH ARTHRITIS FROM HEALTHY SUBJECTS

Background:

The early diagnosis of rheumatic diseases improves their prognosis. However, patients take several months to reach the rheumatologist from the beginning of the first symptoms. Thermography is a safe and fast technique that captures the heat of an object through infrared photography. The inflammation of the joints causes an increase in temperature and, therefore, can be measured by thermography. Machine learning methods have shown that they are capable of analyzing medical images with an accuracy similar or superior to that of a healthcare professional.

Objectives:

Develop an algorithm that, based on thermographic images of hands and machine learning, differentiates healthy subjects from patients with rheumatoid arthritis (RA), psoriatic arthritis (PA), undifferentiated arthritis (UA) and arthritis of hands secondary to other diseases (SA).

Methods:

Multicenter observational study conducted in the rheumatology and radiology service of two hospitals. Patients with RA, PA, UA and SA who attended the followup visit and healthy subjects (companions and healthcare proffesionals) were recruited. In all cases, a thermal image of the hands was taken using a Flir One Pro or Thermal Expert TE-Q1 camera connected to the mobile and an ultrasound of both hands. The degree of synovial hypertrophy (SH) and power doppler (PD) was assessed for each joint (score from 0 to 3). Inflammation was defined as the presence of SH> 1 or PD> 0. Machine learning was used to classify patients with RA, PA, UA and SA with inflammation evidenced by ultrasound and healthy subjects from thermographic images. The evaluation of the classifier was performed by leave-one-out cross-validation and the area under the ROC curve (AUCROC) in those subjects whose thermal image was performed with the Thermal Expert TE-Q1 camera. The study was approved by the Clinical Ethics and Research Committee of the centers.

Results:

500 subjects were recruited from March 2018 to January 2020, of these 73 were excluded due to poor quality in the thermal image (moved or absence of temperature contrast between hand and background). Of the 427 subjects analyzed, 129 corresponded to healthy subjects, 138 to patients without evidence of inflammation and 160 to patients with inflammation evidenced by ultrasound (116 RA and 44 PA, UA or SA). Of these, 42% were taken using the Thermal Expert TE-Q1 camera. An AUCROC of 0.73 (p-value <0.01) was obtained for the healthy classifier vs RA and 0.72 (p-value <0.01) for the healthy classifier vs PA, UA and SA.

Conclusion:

A classification model has been developed capable of differentiating patients with RA, PA, UA and SA with evidence of inflammation from healthy subjects. These results open an opportunity to develop tools that facilitate early diagnosis.

References:

[1]Barhamain AS, Magliah RF, Shaheen MH, Munassar SF, Falemban AM, Alshareef MM, Almoallim HM. The journey of rheumatoid arthritis patients: a review of reported lag times from the onset of symptoms. Open Access Rheumatol. 2017 Jul 28;9:139-150. doi: 10.2147/OARRR.S138830. eCollection 2017. Review.

[2]Lynch CJ, Liston C. New machine-learning technologies for computer-aided diagnosis. Nat Med. 2018 Sep;24(9):1304-1305. doi: 10.1038/s41591-018-0178-4.

[3]Brenner M, Braun C, Oster M, Gulko PS. Thermal signature analysis as a novel method for evaluating inflammatory arthritis activity. Ann Rheum Dis. 2006 Mar;65(3):306-11.

Disclosure of Interests:

None declared

AB1219 ADHERENCE TO THE MEDITERRANEAN DIET IN PATIENTS WITH RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS, MULTICENTER STUDY

Background:

The Mediterranean diet (MD) has proven beneficial in a large number of chronic diseases. The relationship between the MD and rheumatic diseases is complex and there are few studies that have studied this relationship. These show that there could be a positive association between adherence to the Mediterranean diet (MD-A) and a lower prevalence of OA. In the case of RA, it has been proposed that the MD could reduce pain and improve functionality.

Objectives:

To determine the MD-A diet of patients with RA and OA, and compare it with that of healthy subjects.

Methods:

Multicenter, cross-sectional, observational study. Patients who attend the rheumatology outpatient and meet the ACR / EULAR 2010 criteria for RA and ACR for OA of hands, knees or hips are included in the study. The healthy are recruited among health personnel and companions of patients who do not live in the same address as the patient. The study is being carried out in the rheumatology consultations of two Hospitals and an outpatient center with specialized care. All participants have answered a survey of 14 questions (MEDAS-14), based on the Predimed study, which assesses MD-A. Fisher’s exact test and the Mann-Whitney U test have been used to assess statistical significance. The study was approved by the Clinical Ethics and Research Committee of the centers.

Results:

There have been 279 surveys (132 RA, 82 OA and 65 healthy). The MD-A in patients with RA is lower than in healthy (6.26 vs. 7.15, p <0.05). Patients with OA also have less adherence to the MD than healthy ones but this difference is not statistically significant (6.85 vs. 7.15, p> 0.05). The proportion of patients with RA and OA who consume 2 or more servings of vegetables daily is lower than that of healthy subjects (RA 20%; OA 13% and healthy 34%, p <0.05). The proportion of RA and OA that eats more than 3 weekly servings of nuts compared to healthy is also lower (RA 21%, OA 17%, healthy 35% p <0.05). The proportion of RA and OA that consume less than 1 serving of butter is lower than that of healthy (RA 86%; OA 82% and 98%, p <0.05). The proportion of RA that consumes 3 or more servings of legumes per week is lower than healthy (23% vs 40%, p <0.05). These differences between the OA group and healthy are not appreciated. The consumption of more than three pieces of fruit daily is more frequent in OA than in healthy ones (45% vs 26%, p <0.05).

Conclusion:

The MD-A diet quantified by MEDAS-14 in subjects with RA and OA is lower than in healthy subjects, being significant in RA. Patients with RA and OA eat less vegetables and nuts but the intake of butter is higher. The RA group consumes less legumes than healthy ones. Patients with OA eat more fruit than healthy ones, this is the only food in the MD valued by MEDAS-14 that is consumed in a lower proportion in healthy ones. Longitudinal intervention studies are necessary to assess whether the differences observed in this study have any causal relationship.

References:

[1]Estruch R, Ros E, Salas-Salvadó J, Covas M-I, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.

[2]Trichopoulou A, Martínez-González MA, Tong TY, Forouhi NG, Khandelwal S, Prabhakaran D, et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med. 2014;12:112.

[3]Morales-Ivorra I, Romera-Baures M, Roman-Viñas B, Serra-Majem L. Osteoarthritis and the Mediterranean Diet: A Systematic Review. Nutrients. 2018;10(8) pii: E1030. doi: 10.3390/nu10081030.

[4]Forsyth C, Kouvari M, D’Cunha NM, Georgousopoulou EN, Panagiotakos DB, Mellor DD, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018 May;38(5):737–47.

Disclosure of Interests:

None declared

An experimental approach to language training in second language acquisition: Focus on negation

The effect of negation training in a second language on the expression of negation in the native language was investigated. Four-year-old children from bilingual (Spanish/English) homes who showed no expressive or receptive ability in Spanish negation and were either proficient or nonproficient in English negation received Spanish negation training. Children who were proficient in English negation maintained correct responses in English and showed increased correct responses in Spanish following simultaneous training in both languages or in Spanish alone. Children who were nonproficient in English negation demonstrated a decrease in correct English responses following training in Spanish alone; however, children who received training in English and Spanish simultaneously showed increases in correct responses in both languages. These findings suggest that language training programs with children learning a second language should consider the relationship of the two language training conditions (simultaneous vs. independent) with the child's level of native language proficiency.