scholarly journals Asymmetry indicates more severe and active disease in Graves’ orbitopathy: results from a prospective cross-sectional multicentre study

2020 ◽  
Vol 43 (12) ◽  
pp. 1717-1722 ◽  
Author(s):  
P. Perros ◽  
◽  
M. P. Žarković ◽  
G. C. Panagiotou ◽  
C. Azzolini ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Severe Disease ◽  
Clinical Parameter ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
Patient Demographics ◽  
Male Ratio ◽  
Included Patient ◽  
Graves Orbitopathy ◽  
Active Disease

Abstract Purpose Patients with Graves’ orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves’ orbitopathy. Methods This was a multi-centre study of new referrals to 13 European Group on Graves’ Orbitopathy (EUGOGO) tertiary centres. New patients presenting over a 4 month period with a diagnosis of Graves’ orbitopathy were included. Patient demographics were collected and a clinical examination was performed based on a previously published protocol. Patients were categorized as having asymmetric, symmetric, and unilateral Graves’ orbitopathy. The distribution of clinical characteristics among the three groups was documented. Results The asymmetric group (n = 83), was older than the symmetric (n = 157) group [mean age 50.9 years (SD 13.9) vs 45.8 (SD 13.5), p = 0.019], had a lower female to male ratio than the symmetric and unilateral (n = 29) groups (1.6 vs 5.0 vs 8.7, p < 0.001), had more active disease than the symmetric and unilateral groups [mean linical Activity Score 3.0 (SD 1.6) vs 1.7 (SD 1.7), p < 0.001 vs 1.3 (SD 1.4), p < 0.001] and significantly more severe disease than the symmetric and unilateral groups, as measured by the Total Eye Score [mean 8.8 (SD 6.6) vs 5.3 (SD 4.4), p < 0.001, vs 2.7 (SD 2.1), p < 0.001]. Conclusion Older age, lower female to male ratio, more severe, and more active disease cluster around asymmetric Graves’ orbitopathy. Asymmetry appears to be a marker of more severe and more active disease than other presentations. This simple clinical parameter present at first presentation to tertiary centres may be valuable to clinicians who manage such patients.

scholarly journals Clinical Characteristics and degree of severity of COVID-19 in Hemodialysis Patients in Armed Forces Institute of Urology.

2021 ◽  
Vol 5 (4) ◽  
pp. PP1-6
Author(s):  
Saba Umar ◽  
Sohail Sabir ◽  
Khalid Raja ◽  
Khurram Mansoor ◽  
Tanveer Sajid ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Armed Forces ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Mild Disease ◽  
Spread Of Infection ◽  
Degree Of Severity

Introduction  This study was conducted to evaluate the clinical characteristics and severity of COVID -19 in hemodialysis patients at  from 1st March 2020 to 15th August 2020. Methodology It was a prospective and Cross Sectional Observational Study. We collected data prospectively that includes all patients on maintenance hemodialysis and reviewed clinical characteristics  of those with laboratory-confirmed COVID-19 between March 1and August 15, 2020. Results  39 out of 268 dialysis dependent patients had  COVID-19. Mean age of patients was 55.9yrs. Only 35.8% patients were symptomatic. 15 out of 39 were having mild  disease,12  had moderate and 12  had severe disease. Females (54.5%)  were found to be  more affected  than males(45.5%). Dry cough was the commonest symptom (53.8%) followed by fever (46.1%) and abdominal pain(18.1%).  Patients with multiple comorbidities were found to have severe disease. Conclusion We concluded that patients receiving maintenance hemodialysis are susceptible to COVID-19 and that hemodialysis centers are  high risk for spread of infection. Isolating  patients with COVID-19  can help in preventing the spread of COVID-19.

scholarly journals Thrombotic complications in 2928 patients with COVID-19 treated in intensive care: a systematic review

2021 ◽  
Vol 51 (3) ◽  
pp. 595-607
Author(s):  
William J. Jenner ◽  
Rahim Kanji ◽  
Saeed Mirsadraee ◽  
Ying X. Gue ◽  
Susanna Price ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Venous Thrombosis ◽  
Severe Disease ◽  
Duplex Ultrasound ◽  
Clinical Suspicion ◽  
Systematic Screening ◽  
Patient Demographics ◽  
Included Patient ◽  
Thrombotic Complications

AbstractA prothrombotic state is reported with severe COVID-19 infection, which can manifest in venous and arterial thrombotic events. Coagulopathy is reflective of more severe disease and anticoagulant thromboprophylaxis is recommended in hospitalized patients. However, the prevalence of thrombosis on the intensive care unit (ICU) remains unclear, including whether this is sufficiently addressed by conventional anticoagulant thromboprophylaxis. We aimed to identify the rate of thrombotic complications in ICU-treated patients with COVID-19, to inform recommendations for diagnosis and management. A systematic review was conducted to assess the incidence of thrombotic complications in ICU-treated patients with COVID-19. Observational studies and registries reporting thrombotic complications in ICU-treated patients were included. Information extracted included patient demographics, use of thromboprophylaxis or anticoagulation, method of identifying thrombotic complications, and reported patient outcomes. In 28 studies including 2928 patients, thrombotic complications occurred in 34% of ICU-managed patients, with deep venous thrombosis reported in 16.1% and pulmonary embolism in 12.6% of patients, despite anticoagulant thromboprophylaxis, and were associated with high mortality. Studies adopting systematic screening for venous thrombosis with Duplex ultrasound reported a significantly higher incidence of venous thrombosis compared to those relying on clinical suspicion (56.3% vs. 11.0%, p < 0.001). Despite thromboprophylaxis, there is a very high incidence of thrombotic complications in patients with COVID-19 on the ICU. Systematic screening identifies many thrombotic complications that would be missed by relying on clinical suspicion and should be employed, with consideration given to increased dose anticoagulant thromboprophylaxis, whilst awaiting results of prospective trials of anticoagulation in this cohort.

scholarly journals P600 Real-world clinical characteristics and therapeutic strategies in patients with moderate-to-severe Inflammatory Bowel Disease in Argentina: Data from the RISE AR study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S546-S547
Author(s):  
J S Lasa ◽  
A Sambuelli ◽  
I Zubiaurre ◽  
G J Correa ◽  
P Lubrano ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Real World ◽  
Bowel Disease ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Therapeutic Strategies ◽  
Biologic Agent ◽  
Cross Sectional ◽  
Colonic Involvement ◽  
Inflammatory Bowel

Abstract Background Evidence on the adoption of different pharmacologic strategies in inflammatory bowel disease (IBD) in the real-world setting in Latin America is scarce. Herein, we describe the clinical characteristics and therapeutic strategies of IBD patients (pts) in Argentina. Methods RISE AR (NCT03488030) was a multicentre, non-interventional study with a cross-sectional evaluation and a 3-year retrospective data collection period conducted in Argentina (12/2018-05/2019) to assess the use of IBD treatments. Adult pts (≥18 years old) with a previous diagnosis of moderate-to-severe ulcerative colitis (UC) or Crohn′s disease (CD) based on clinical, endoscopic or imaging criteria at least 6 months prior to enrolment, were included. Results Overall, 101 CD and 145 UC pts were included. Median (range) age (years) at enrolment was 39.5 (18.2–74.0) for CD (51.2% female) and 41.9 (18.0–80.4) for UC (55.2% female); median (range) disease duration (years) was 7.4 (0.6–36.9) for CD and 5 (0.7–33.8) for UC. At enrolment, 51.5% of CD pts had colonic involvement, 32.7% ileocolonic, 8.9% ileal, 1% isolated upper tract and 5.9% had combined L4/other. In UC, 46.2% had extensive colitis, 44.7% left-sided colitis and proctitis 9.1%. 51.6% of CD pts had non-inflammatory behaviour (37.7% stricturing; 13.9% penetrating), and 34% had perianal disease (13.9% as B1p), resulting in a total of 65.5% pts with complicated disease. Only 9.3% of CD (Harvey Bradshaw Index ≥8) and 7.7% of UC (partial Mayo Score ≥5) pts showed moderate-to-severe disease activity at enrolment. In CD, 70.3% of pts were receiving a biologic agent vs. 29.7% of UC pts. Immunosuppressant (IMM) use was similar between groups (CD 39.6%, UC 40.0%); nearly one-third of the pts on a biologic were receiving concomitant IMM (CD 33.8%, UC 34.9%). Aminosalicylates (5-ASA) were used for most UC pts (89.0%) vs. 47.5% of CD pts, mainly in those with L2 disease. 5-ASA monotherapy was prescribed in 32.1% of UC vs. 5.3% of CD pts, but were also used with IMM (UC 25%, CD 11%), biologics (UC 15%, CD 11.6%) or all three therapies combined (UC 6.4%, CD 17.9%). Corticosteroids (CS) were the least prescribed therapy (CD 7.9%, UC 13.8%). IBD treatments ever prescribed during the retrospective period were (CD, UC): biologics: 79.2%, 33.8%; IMM: 65.3%, 58.6%; 5-ASA: 62.4%, 97.9%; CS: 55.4%, 69.7%. Conclusion In this cohort of IBD patients, biologics use was high, especially among CD patients, in line with disease behaviour, and possibly by their increased availability in these reference centres. This study also highlights country-specific clinical features such as the low proportion of CD pts and the high prevalence of colonic involvement in CD.

scholarly journals Profile Of Head And Neck Burns During COVID-19 Pandemic

2021 ◽  
Author(s):  
Dina Amin ◽  
Andrew J Manhan ◽  
Shelly Abramowicz ◽  
Rohit Mittal
Keyword(s):  
Head And Neck ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Burn Injuries ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Demographics ◽  
Burn Care ◽  
Included Patient ◽  
National Emergency

Abstract Coronavirus disease 2019 (COVID- 19) affected daily activities since December 2019. Burn injuries to head and neck can result in cosmetic and functional deformities. The purpose of this study was to characterize patients with burns to head and neck during the pandemic. This cross-sectional study reviewed patients in Burn Care Quality Platform Registry. Patients were included if they were age 18 years of age or older, and sustained burns to head and neck. Patients were stratified according to date of injury into: (1) March 13 to September 13, 2019 (i.e., before COVID-19 pandemic, BC19) or (2) March 13 to September 13, 2020. March 13, 2020 was chosen because (1) COVID-19 was announced as a national emergency on that date and (2) it was the last day of in-person schools in state of Georgia. Data collection included patient demographics, admission details, burn details, and hospital related variables were documented. During the study period, 157 patients had burn to head and neck (BC-19; 70, C-19; 71). Our data showed a 375% increase in March following the announcement of the pandemic (BC19; 4, C19;19). Admissions from another facility were statistically more than in C19 group (p=&lt;0.0001). For C19 group, there were 53% more admissions from ED than BC19 (p=0.001). Additionally, in BC19 group patients presented with concomitant inhalation injuries significantly more than C19 group (p=0.04). In conclusion, the total number of burns is the same during BC and C19, however there was a significant spike in number of cases in March 2020.

Uncovering Lymphatic Transport Abnormalities in Patients with Primary Lipedema

2019 ◽  
Vol 36 (02) ◽  
pp. 136-141 ◽  
Author(s):  
Daniel J. Gould ◽  
Bassim El-Sabawi ◽  
Pedram Goel ◽  
Ido Badash ◽  
Patrick Colletti ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Clinical Characteristics ◽  
Lymphatic Transport ◽  
Lymphatic Flow ◽  
Patient Demographics ◽  
Severe Stage ◽  
Included Patient ◽  
Stage 4 ◽  
The Mean ◽  
Stage 1

Abstract Background Although lipedema is often clinically distinguished from lymphedema, there is considerable overlap between the two entities. The purpose of this study was to evaluate lymphoscintigraphic findings in patients with lipedema to better characterize lymphatic flow in this patient population. Methods Patients with lipedema receiving lymphoscintigraphy between January 2015 and October 2017 were included. Patient demographics, clinical characteristics, and lymphoscintigraphic findings were extracted. Klienhan's transport index (TI) was utilized to assess lymphatic flow in patient's lower extremities (LEs).Scores ranged from 0 to 45, with values > 10 denoting pathologic lymphatic transport. Results A total of 19 total patients with lipedema underwent lymphoscintigraphic evaluation. Mean age was 54.8 years and mean body mass index was 35.9 kg/m2. Severity of lipedema was classified as stage 1 in five patients (26.3%), stage 2 in four patients (21.1%), stage 3 in four patients (21.1%), and stage 4 in six patients (31.6%). The mean TI for all extremities was 12.5; 24 (63.2%) LEs had a pathologic TI, including 7 LEs with stage 1 (29.2%), 3 LEs with stage 2 (12.5%), 6 LEs with stage 3 (25.0%), and 8 LEs with stage 4 lipedema (33.3%). The mean TI was significantly greater for extremities with severe (stage 3/4) lipedema than those with mild or moderate (stage 1/2) lipedema (15.1 vs. 9.7, p = 0.049). Mean difference in TI scores between each LE for individual patients was 6.43 (standard deviation +7.96). Conclusion Our results suggest that patients with lipedema have impaired lymphatic transport, and more severe lipedema may be associated with greater lymphatic transport abnormalities.

scholarly journals Disease Severity, Clinical Characteristics and Outcome of Patients Hospitalized with Novel Coronavirus Disease at a Tertiary Care Hospital, Rawalpindi

2021 ◽  
Vol 2 (4) ◽  
pp. 6
Author(s):  
Muhammad Mahtab Shabir ◽  
Shazia Nisar ◽  
Zobia Urooj ◽  
Uzma Qayyum ◽  
Fozia Fatima ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Novel Coronavirus

Objective: To describe the clinical characteristics, signs & symptoms, disease severity, and outcome of patientsadmitted with novel coronavirus infection.Study Design: Comparative cross-sectional study.Place and Duration of Study: The study was conducted in the Department of Medicine of Pak-Emirates Militaryst th Hospital, (PEMH), Rawalpindi from May 1 , 2020 to June 30 , 2020.Materials and Methods: Patients hospitalized with novel corona virus infection during the study period wereprospectively enrolled in this study. Patients at least 15 years and above, either gender, hospitalized withconfirmed diagnosis of covid-19 (SARS-CoV-2) were eligible to be enrolled. The study outcomes includeddisease presentation, severity at time of reporting, admission to critical care or intensive care unit andmortality. Patients were identified as mild, moderate, severe and critical in accordance with World HealthOrganization guidelines, based on symptom severity, laboratory and imaging findings.Results: There were 400 hospitalized patients with confirmed SARS-CoV-2, out of which 51 (12.8%) werefemales, while 349 (87.3%) were males with overall mean age of 48.45±16.2 years. There were 300 (75.0%)patients with mild disease severity, while 65 (16.3%), 20 (5.0%) and 15 (3.8%) with moderate, severe and criticaldisease condition, respectively. The number of patients died were 22, with fatality rate of 5.5%. Age andpresence of comorbidities (cardiac disease, diabetes, hypertension, pulmonary disease, kidney disease) weresignificantly associated with disease severity and death due to novel coronavirus infection.Conclusion: Patients with older age, diabetes, hypertension, pulmonary disease, kidney disease were at higherrisk of developing severe disease condition and death due to novel coronavirus infection.

scholarly journals Socio-demographic and Clinical Characteristics of Patients with Ulcerative Colitis at a Tertiary Care Centre in Nepal

2019 ◽  
Vol 8 (2) ◽  
pp. 26-29
Author(s):  
Rahul Pathak ◽  
Tshering Wangdi Sherpa ◽  
Anurag Jha ◽  
Rabin Hamal ◽  
Sabin Thapallya
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Colonoscopic Examination

Introduction: The prevalence of ulcerative colitis (UC) has gradually increased in Asia over the last few decades. However, there is a paucity of data regarding UC in Nepal. This study analyzed the socio-demographic and clinical characteristics of patients hospitalized with UC. Methods: This is a hospital based, cross-sectional study. Data was collected among 100 individuals admitted to the hospital with UC from June 2016 to May 2018. A descriptive analysis of the demographic and clinical characteristics was done. Results: Of the 100 patients 51 were male (M:F ratio 1.04:1). Average age at diagnosis was 38}12.53 years. 55% of the patients were Brahmins, 16% Kshetris, 8% Newars, 1% Muslim while the remaining 20% belonged to other indigenous ethnic groups. 79% of the patients were newly diagnosed cases while remaining 21% were admitted for acute flares of the disease. Rectal bleeding (85%) was the most common symptom followed by diarrhea (70%), tenesmus (63%), urgency (61%), pain abdomen (44%), weight loss (14%), fever (7%) and constipation (4%). Clinically, 41% had mild, 46% had moderate and 12% had severe disease activity. Extra intestinal manifestations were seen only in 12% of the patients. On colonoscopic examination, 41% had proctitis, 46% had left sided colitis and 13% had extensive colitis. Conclusion: Our study showed some differences in the demographic variables as well as clinical manifestations in the patients when compared to data from the west and even other Asian countries like India and China. Larger population-based studies are needed to better understand the epidemiology and characteristics of the disease in Nepal.  

Quantitative Clinical Characteristics of 53 Patients with MPS VII: A Cross-Sectional Analysis

2017 ◽  
Vol 48 (S 01) ◽  
pp. S1-S45
Author(s):  
M. Zielonka ◽  
S. Garbade ◽  
S. Kölker ◽  
G. Hoffmann ◽  
M. Ries
Keyword(s):  
Clinical Characteristics ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Mps Vii ◽  
Sectional Analysis

Socio-demographic and Clinical Characteristics of Patient with Thyroid Cancer

2020 ◽  
Vol 11 (1) ◽  
pp. 54-58
Author(s):  
AKM Farhad Hossain ◽  
Md Mahmudur Rahman Siddiqui ◽  
Sayada Fatema Khatun
Keyword(s):  
Public Health ◽  
Thyroid Cancer ◽  
Clinical Characteristics ◽  
Family Income ◽  
Ethical Issues ◽  
Endocrine System ◽  
Public Health Problem ◽  
Follicular Carcinoma ◽  
Public Health Issue ◽  
Cross Sectional

Background: Thyroid cancer is the most common malignant disease in endocrine system. It is an emerging public health issue associated with burden on the family, community and the nation. The aim of this study is to determine the socio-demographic and clinical characteristics of patient with thyroid cancer attending in tertiary hospital. Methods: This cross sectional study was conducted among 246 thyroid cancer patients in two tertiary hospitals of Dhaka city from 01 July 2018 to 30 June 2019. The subjects were selected purposively following specific selection criteria and maintaining ethical issues. Data were collected by face to face interview using a semi-structured questionnaire and checklist. Data were analyzed by the statistical package for the social science (SPSS) version 23. Results: This study revealed that majority (74.4%) of respondents was female, married (72%), housewife (61.4%), rural respondent (41.1%) and had primary education (69%). Mean (± SD) age of the respondent was 37.85(±12.20) years (Range 14-70 years) and mean (± SD) monthly family income was Tk. 17681(±10602). Out of 246 cases, 204 (82.9%) was papillary and 42 (17.1%) was follicular carcinoma. Various clinical presentations included visible neck swelling in 225 (91.5%), swollen lymph node in 103 (41.9%), pain 90 (36.6%), Difficulties in swallowing 87 (35.4%), Hoarseness of voice in 141 (57.3%), cough along with swelling 47(19.1%), Difficulties in breathing due to swelling in 13(5.3%) of the patients. Conclusion: Incidence of thyroid cancer has increased worldwide specially in female patients in 3rd and 4th decades of life. As thyroid cancer is a growing public health problem in Bangladesh, proper screening and early diagnostic facilities at all level should be available to measure its actual burden in the country. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 54-58

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