Objectives Statin-associated immune-mediated necrotizing myopathy (IMNM) and idiopathic inflammatory myositis (IIM) are myopathies with overlapping features. This study compared the manifestations of IMNM to IIM in Native Americans. Method Twenty-one Native American patients with inflammatory myopathy (IM) were characterized as to diabetes mellitus, hyperlipidemia, statin exposure, myopathy diagnosis, muscle histology, autoimmune and myositis-specific autoantibodies, therapy, and outcome. Results IM consisted of 52.4% IMNM, 42.9% IIM, and 4.8% metabolic myopathy. IMNM vs. IIM had greater age (61.6±9.8 vs. 39.8±14.3 years), diabetes mellitus (100% vs. 55.6%), hyperlipidemia (100% vs. 33.3%), statin-exposure (100% vs. 22.2%), creatine kinase (CK) (11,780±7064 vs.1707±1658 IU), anti-HMG CoA reductase (anti-HMG CoA) antibodies (85.7% vs. 11.1%), and necrotizing IM (81.8% vs. 11.1%), but lesser disease duration (26.2±395 vs. 78.4±47.9 months), Raynaud’s phenomenon (9.1% vs. 55.6%), cutaneous manifestations (0% vs. 55.6%), antinuclear antibodies (18.2% vs. 66.7%), or any autoantibody (18.2% vs. 88.9%) (all p < 0.05). Magnetic resonance abnormalities, histologic IM, myositis-specific autoantibodies, pulmonary hypertension, esophageal dysfunction, interstitial lung disease, disability, and persistently elevated CK were similar. IMNM vs. IIM was treated more with intravenous immunoglobulin (72.7% vs. 11.1%, p = 0.009) and less with antimetabolites (45.5% vs. 88.9%, p = 0.05) and rituximab (18.2% vs. 55.6%, p = 0.09). Conclusions IMNM may occur in Native Americans and is associated with diabetes mellitus, hyperlipidemia, statin use, and older ages, and characterized by marked CK elevation, necrotizing myopathy, and anti-HMGCoA antibodies with few cutaneous or vascular manifestations.

Background The prevalence of diabetes in pregnant women has increased in the USA over recent decades. The primary aim of this study was to assess the association between diabetes in pregnancy and maternal near-miss incident, maternal mortality and selected adverse foetal outcomes. Methods We conducted a retrospective, cross-sectional analysis among pregnancy-related hospitalizations in USA between 2002 and 2014. We examined the association between DM and GDM as exposures and maternal in-hospital mortality, maternal cardiac arrest, early onset of delivery, poor foetal growth and stillbirth as the outcome variables. Results Among the 57.3 million pregnant women in the study population, the prevalence of GDM and DM was 5.4 and 1.3%, respectively. We found that pregnant women with DM were three times more likely to experience cardiac arrest (OR = 3.21; 95% CI = 2.57–4.01) and in-hospital maternal death (OR = 3.05; 95% CI = 2.45–3.79), as compared to those without DM. Among pregnant women with GDM and DM, the risk for early onset of delivery was higher, compared to women without GDM or DM. Conclusion A diagnosis of diabetes prior to pregnancy contributes significantly to the risk of maternal cardiac arrest, maternal mortality and adverse foetal outcomes.

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and is caused by compression of the median nerve (MN) at the level of transverse carpal ligament of the volar wrist. Radiomics is an advanced semi‐automated image analysis method that is utilized to identify characteristics in the MN that can detect CTS with considerable reproducibility.