Prevalence and duration of symptoms among moderate and severe COVID-19 patients 12 months after discharge

Abstract. Background: The aim of this prospective single-centre study was to analyse the immediate results, failures and complications of percutaneous mechanical thrombectomy using the Rotarex catheter in the treatment of acute and subacute occlusions of peripheral arteries and bypasses, as well as to evaluate long-term outcomes of this method. Patients and methods: Patients with acute (duration of symptoms < 14 days) or subacute (duration of symptoms > 14 days and < 3 months) occlusions of peripheral arteries and bypasses were selected consecutively for treatment. The cohort consisted of 113 patients, aged 18 - 92 years (median 72 years). In all, 128 procedures were performed. Results: Angiographic success was obtained in 120 interventions (93.8 %). Reasons for failures were rethrombosis of a partially recanalised segment in six procedures, and embolism into crural arteries in one intervention - percutaneous aspiration thromboembolectomy (PAT) and/or thrombolysis were ineffective in all these cases. Breakage of the Rotarex catheter happened in one procedure. Embolisation into crural arteries as a transitory complication solvable with PAT and/or thrombolysis occurred in four cases. Rethrombosis was more frequent in bypasses than in native arteries (p = 0.0069), in patients with longer occlusions (p = 0.026) and those with poorer distal runoff (p = 0.048). Embolisation happened more often in patients with a shorter duration of symptoms (p = 0.0001). Clinical success was achieved in 82.5 %. Major amputation was performed in 10 % of cases. Cumulative patency rates were 75 % after one month, 71 % after six months, 38 % after 12 months, 33 % after 18 months and 30 % after 24, 30, 36 and 42 months. Conclusions: Rotarex thrombectomy has excellent immediate results with a low rate of failures and complications. In comparison to thrombolysis, it enables the fast and efficient treatment of acute and subacute occlusions of peripheral arteries in one session.

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Serum Magnesium Levels in Exacerbation of COPD: A Single Centre Prospective Study from Kashmir, India.

JMS SKIMS ◽

10.33883/jms.v13i1.38 ◽

2010 ◽

Vol 13 (1) ◽

pp. 15-19

Author(s):

Bashir Ahmed Shah ◽

Muzafar Ahmed Naik ◽

Sajjad Rajab ◽

Syed Muddasar ◽

Ghulam Nabi Dhobi ◽

...

Keyword(s):

Acute Exacerbation ◽

Serum Magnesium ◽

Stage Iii ◽

Advanced Stage ◽

Copd Exacerbation ◽

Post Discharge ◽

Duration Of Symptoms ◽

Copd Patients ◽

Exacerbation Of Copd ◽

Time Of Admission

Objective: To study the significance of serum magnesium levels during COPD exacerbation and stability.Materials & Methods: The patient population consisted of all patients of COPD admitted as acute exacerbation as defined by the Anthonisens criteria, from June 2006 to may 2008. Same patients one month post discharge presenting to the OPD for routine check up as stable COPD served as controls. Results: A total number of 77 patients of COPD presenting as acute exacerbation were included in the study. The incidence of Hypomagnesaemia was 33.8% at admission; 5% at discharge and 4% at one month of post discharge in COPD patients. The mean serum magnesium levels were significantly lower in cases than controls (1.88±0.67mg/ dl V/S 2.3±0.36mg/dl; p<0.0001). Also, hypomagnesemia was present in higher number of cases (22/77, 33.8%) compared to controls, 3/75, 4.0%; (p<0.0001). Patients of COPD with acute exacerbation and hypomagnesemia, had longer duration of symptoms and had advanced stage III of COPD (p<0.001); and had raised mean corpuscle volume (p<0.045) and longer hospital stay (p<0.008). Conclusion: We conclude COPD exacerbation is associated with hypomagnesemia. The duration of symptoms of more than 8 days, advanced stage of COPD (stage III) and raised MCV were associated with hypomagnesemia. We recommend to monitor serum magnesium levels in COPD patients with acute exacerbation at the time of admission and during their stay in the hospital.J Med Sci.2010;13(1);15-19

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Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200218115400 ◽

2020 ◽

Vol 20 ◽

Cited By ~ 1

Author(s):

Sara Abolghasemi ◽

Mohammad Alizadeh ◽

Ali Hashemi ◽

Shabnam Tehrani

Keyword(s):

Chlamydia Trachomatis ◽

Clinical Symptoms ◽

Urine Culture ◽

Clinical Manifestations ◽

Urinary Frequency ◽

Serological Tests ◽

Duration Of Symptoms ◽

Two Samples ◽

History Of ◽

Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

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Incomplete Kawasaki disease - a diagnostic and therapeutic challenge

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v9i4.10234 ◽

2014 ◽

Vol 9 (4) ◽

pp. 30-35

Author(s):

S Datta ◽

S Maiti ◽

G Das ◽

A Chatterjee ◽

P Ghosh

Keyword(s):

Kawasaki Disease ◽

Intravenous Immunoglobulin ◽

Incomplete Kawasaki Disease ◽

Duration Of Symptoms ◽

Clinical Criteria ◽

Echocardiographic Finding ◽

2D Echocardiography ◽

Acquired Heart Disease ◽

The Mean ◽

One Year

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234

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Clinical evaluation of rapid point-of-care antigen tests for diagnosis of SARS-CoV-2 infection

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04274-7 ◽

2021 ◽

Author(s):

Johannes G. M. Koeleman ◽

Henk Brand ◽

Stijn J. de Man ◽

David S. Y. Ong

Keyword(s):

Health Care ◽

Health Care Workers ◽

Antigen Test ◽

Duration Of Symptoms ◽

Large Variability ◽

Clinical Sensitivity ◽

Care Workers ◽

Upper Respiratory ◽

Antigen Tests ◽

Respiratory Specimens

AbstractThe RT-qPCR in respiratory specimens is the gold standard for diagnosing acute COVID-19 infections. However, this test takes considerable time before test results become available, thereby delaying patients from being diagnosed, treated, and isolated immediately. Rapid antigen tests could overcome this problem. In the first study, clinical performances of five rapid antigen tests were compared to RT-qPCR in upper respiratory specimens from 40 patients with positive and 40 with negative RTq-PCR results. In the second study, the rapid antigen test with one of the best test characteristics (Romed) was evaluated in a large prospective collection of upper respiratory specimens from 900 different COVID-19-suspected patients (300 emergency room patients, 300 nursing home patients, and 300 health care workers). Test specificities ranged from 87.5 to 100.0%, and test sensitivities from 55.0 to 80.0%. The clinical specificity of the Romed test was 99.8% (95% CI 98.9–100). Overall clinical sensitivity in the study population was 73.3% (95% CI 67.9–78.2), whereas sensitivity in the different patient groups varied from 65.3 to 86.7%. Sensitivity was 83.0 to 86.7% in patients with short duration of symptoms. In a population with a COVID-19 prevalence of 1%, the negative predictive value in all patients was 99.7%. There is a large variability in diagnostic performance between rapid antigen tests. The Romed rapid antigen test showed a good clinical performance in patients with high viral loads (RT-qPCR cycle threshold ≤30), which makes this antigen test suitable for rapid identification of COVID-19-infected health care workers and patients.

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Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

BMJ Open ◽

10.1136/bmjopen-2021-049944 ◽

2021 ◽

Vol 11 (6) ◽

pp. e049944

Author(s):

Sarah K Schäfer ◽

Robert Fleischmann ◽

Bettina von Sarnowski ◽

Dominic Bläsing ◽

Agnes Flöel ◽

...

Keyword(s):

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care ◽

Functional Health ◽

Care Hospital ◽

Duration Of Symptoms ◽

Post Stroke ◽

Self Rated Health ◽

Modifying Factors ◽

Study Results

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.

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Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03821-3 ◽

2021 ◽

Author(s):

Shun-Jie Yang ◽

Jian Li ◽

Yang Xue ◽

Zhong Zhang ◽

Gang Chen

Keyword(s):

Logistic Regression ◽

Age Of Onset ◽

Univariate Analysis ◽

Arthroscopic Surgery ◽

Lateral Meniscus ◽

Postoperative Outcomes ◽

Discoid Lateral Meniscus ◽

Work Intensity ◽

Duration Of Symptoms ◽

Ordered Logistic Regression

Abstract Introduction The postoperative effect of arthroscopy in the treatment of symptomatic discoid lateral meniscus (DLM) varies greatly among individuals. Therefore, this study aims to investigate the factors affecting the postoperative outcomes of symptomatic DLM. Materials and methods According to the inclusion and exclusion criteria, patients with symptomatic single-knee DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were included. Retrospectively collected 16 factors probably affecting postoperative outcomes. The Ikeuchi grade system was used to evaluate the knee joint function. Univariate analysis was performed by Kruskal–Wallis rank-sum test or Mann–Whitney U test, and multivariate analysis by ordered logistic regression. P < 0.05 was considered statistically significant. Results A sum of 502 patients was included, including 353 females (70.3%) and 149 males (29.7%). Difference between preoperative and postoperative Ikeuchi grade was statistically significant (P < 0.001). Female was bad to obtain a good Ikeuchi grade (P = 0.009, OR 0.458). Outerbridge grade (P = 0.018, OR 0.638) was negatively correlated with Ikeuchi grade. BMI (P = 0.001, OR 0.875) and work intensity (P = 0.020, OR 0.611) were inversely correlated with Ikeuchi grade. Age of onset (P < 0.001, OR 0.956) and symptoms duration (P < 0.001, OR 0.988) were negatively correlated with Ikeuchi grade. Besides, compared to total meniscectomy, meniscoplasty with a repair was an unfavourable factor for Ikeuchi grade (P = 0.044, OR 0.245). Conclusions With the increase of BMI, work intensity, age of onset, duration of symptoms, and the severity of cartilage lesion, the postoperative results become worse. Moreover, female and meniscoplasty with repair are risk factors for the postoperative outcomes.

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POS1120 PRESENCE OF TOPHI IS ASSOCIATED WITH A RAPID DECLINE IN THE RENAL FUNCTION IN PATIENTS WITH GOUT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.50 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 839.1-839

Author(s):

Y. J. Oh ◽

K. W. Moon

Keyword(s):

Renal Function ◽

Renal Dysfunction ◽

Clinical Characteristics ◽

Multivariate Logistic Regression Analysis ◽

Joint Involvement ◽

Rapid Decline ◽

Symptom Duration ◽

Tophaceous Gout ◽

Duration Of Symptoms ◽

Increased Risk

Background:Gout is the most common inflammatory arthritis resulting from a chronic deposition of MSU crystals in the joints and other soft tissues. After the process of repeated tissue damage and repair due to gout, tophi could be formed around the affected joints. Intra-articular tophi may sometimes result in bone destruction, joint deformities, and dysfunction which can adversely affect the patient’s quality of life. Furthermore, early-onset tophaceous gout patients are more likely to develop renal dysfunction, however, few studies have investigated if the presence of tophi is related with the progression of renal dysfunction in gout patients.Objectives:We aimed to compare clinical characteristics of patients with and without tophi at the time of the diagnosis of gout and investigate the effect of tophi on the renal function in gout patients.Methods:Data of 257 patients who were first diagnosed with gout at the Kangwon National University Hospital from January 2012 to December 2018 were retrospectively studied. Patients were divided into 2 groups according to the presence of tophi at the diagnosis. We compared clinical characteristics and the progression of renal dysfunction between the two groups.Results:Of all patients, 66 (25.5%) initially presented with tophi. Patients with tophi were older, had a longer duration of symptoms, and had a higher prevalence of multiple joint involvement than those without tophi. The decline in the eGFR was more prominent in patients with tophi than in those without (-4.8±14.5 ml/min/1.73m2vs. -0.7±11.9 ml/min/1.73m2, respectively; P=0.039). In multivariate logistic regression analysis, a prolonged symptom duration (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.004–1.017; P=0.001) and multiple joint involvement (OR, 3.027; 95% CI, 1.831–5.004; P<0.001) were significantly associated with increased risk of formation of tophi. The presence of tophi was significantly associated with a rapid decline in the eGFR (β=-0.141; P=0.035).Conclusion:A prolonged symptom duration and multiple joint involvement were independent risk factors for tophi as the presenting symptom in gout patients. The presence of tophi was associated with a declining renal function. Therefore, an early diagnosis and active treatment are important in tophaceous gout.References:[1]Bardin T, Richette P. Definition of hyperuricemia and gouty conditions. Curr Opin Rheumatol 2014;26:186-91.[2]Liu F, Du GL, Song N, Ma YT, Li XM, Gao XM, et al. Hyperuricemia and its association with adiposity and dyslipidemia in Northwest China: results from cardiovascular risk survey in Xinjiang (CRS 2008-2012). Lipids Health Dis 2020;19:58.[3]Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet 2016;388:2039-52.[4]Ruoff G, Edwards NL. Overview of Serum Uric Acid Treatment Targets in Gout: Why Less Than 6 mg/dL? Postgrad Med 2016;128:706-15.[5]Bieber A, Schlesinger N, Fawaz A, Mader R. Chronic tophaceous gout as the first manifestation of gout in two cases and a review of the literature. Semin Arthritis Rheum 2018;47:843-8.Disclosure of Interests:None declared.

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1501. Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED): Updates from Year 2 of multi-site trial

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1682 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S752-S753

Author(s):

Stephanie A Richard ◽

Timothy Burgess ◽

Limone Collins ◽

Rhonda Colombo ◽

...

Keyword(s):

Influenza Vaccine ◽

Clinic Visit ◽

Vaccine Effectiveness ◽

Symptom Duration ◽

Blood Draw ◽

Duration Of Symptoms ◽

Nasal Swabs ◽

Second Year ◽

Military Facilities ◽

Pragmatic Assessment

Abstract Background Despite nearly universal influenza vaccination for active duty military personnel, breakthrough influenza infections occur. We are reporting on the second year of the Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED), comparing three FDA-licensed influenza vaccine types (egg-based, cell -based, and recombinant) to assess differences in immunogenicity and effectiveness. Methods Participants in the second year of PAIVED were enrolled from Oct 2019 through Jan 2020 at 9 military facilities. Participants received weekly inquiries about influenza-like-illnesses (ILI) experienced in the past week, and if the participant reported having a cough or sore throat and a) muscle/body aches or fatigue and/or b) being feverish or having chills, they were scheduled for a clinic visit. During this visit, a blood sample and a nasal swab were collected, as well as information about symptom duration and severity. A second (convalescent) visit was conducted approximately 4 weeks later, which involved collecting additional information about the duration of symptoms and illness burden, as well as a second blood draw. Due to the COVID-19 pandemic, acute and convalescent visits were disrupted at most sites in March and April due to COVID-19 precautions. Results PAIVED year 2 enrolled 5,892 participants who completed demographic forms (Table 1). Among those who reported any ILIs, most reported one ILI (1,345), while 264 reported two ILIs, and 42 reported three ILIs. Nasal swabs were processed from 273 ILIs at four sites (Fig 1), and 14 cases of influenza were identified thus far. The median duration of ILIs was ten days, with a median of three days of limited activity, and two days with fever. Nine individuals were hospitalized. Table 1. Demographic characteristics of individuals enrolled in PAIVED 2019/20 Figure 1. Lab results as of 5/15 (N=273 samples) Conclusion Over 25% of participants reported an ILI, and 5% of the nasal swabs that have been tested thus far have been positive for influenza. While most samples have not yet been analyzed, we have identified some breakthrough cases of influenza among vaccinated participants. Planned analyses include comparative vaccine effectiveness in order to inform future vaccine purchasing decisions. Disclaimer Disclosures All Authors: No reported disclosures

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POS1281 HOW DOES OBESITY INFLUENCE THE FEATURES OF KNEE OSTEOARTHRITIS?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3602 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 923.4-924

Author(s):

H. Hachfi ◽

D. Khalifa ◽

M. Brahem ◽

N. Ben Chekaya ◽

M. Younes

Keyword(s):

Knee Osteoarthritis ◽

Functional Impairment ◽

Statistical Significance ◽

Obese Group ◽

University Hospital ◽

Obese Patients ◽

Cross Sectional ◽

Duration Of Symptoms ◽

Lequesne Index ◽

The Mean

Background:Knee osteoarthritis and obesity are both major health problems. It is now admitted that the prevalence of knee osteoarthritis gets higher with obesity and that weight loss helps knee function and allows patients to avoid surgery.Objectives:The aim of this study was to study the influence of obesity on knee osteoarthritis features.Methods:A cross-sectional study was conducted in the university hospital Taher Sfar of Tunisia over a period of 6 months. Patients who had knee osteoarthritis confirmed by radiographs were included. Sociodemographic, clinical, radiological and therapeutic data were collected from medical records and visits. Obesity was defined by a body mass index (BMI) ≥30. Functional impairment was assessed by the Womac index and Lequesne index.Results:The study included 186 patients. There were 31 males and 155 femmes. The mean age was 60±10 years. The percentage of obese patients was 53,8%. The mean age was similar in both groups obese and non obese. There were more women in the obese group compared to the non obese group (p=0.0001), more patients who had diabetes mellitus and dyslipidemia (p=0.002). Non-obese patients had a shorter duration of symptoms with no statistical significance (p=0.151). Obese patients had more involvement of both knees (p<0.0001). Obesity did not have an impact on pain severity. Severity of radiological images (p=0,0001) were more frequent in obese patients. Functional impairment was similar in both groups. However, the percentage of patients having a very important functional impairment with Lequesne index was higher in obese patients (p<0.029). Obese patients also needed more physical therapy sessions (p=0.035).Conclusion:Knee osteoarthritis in obese patients is characterized with the femlae gender predominance, bilateral knee involvement, and a more severe images on radiographs. Thus the need for better control of weight and the importance of physical activity.References:[1]Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 2001; 25: 622–627.Disclosure of Interests:None declared

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