scholarly journals Early variation of ultrasound halo sign with treatment and relation with clinical features in patients with giant cell arteritis

Rheumatology ◽  
2020 ◽  
Vol 59 (12) ◽  
pp. 3717-3726 ◽  
Author(s):  
Cristina Ponte ◽  
Ana Sofia Serafim ◽  
Sara Monti ◽  
Elisabete Fernandes ◽  
Ellen Lee ◽  
...  
Keyword(s):  
Clinical Features ◽  
Final Diagnosis ◽  
Newly Diagnosed ◽  
Glucocorticoid Treatment ◽  
Cross Sectional ◽  
Halo Sign ◽  
Early Use ◽  
Diagnostic Role ◽  
Sectional Analysis

Abstract Objectives To compare the ultrasound characteristics with clinical features, final diagnosis and outcome; and to evaluate the halo size following glucocorticoid treatment in patients with newly diagnosed GCA. Methods Patients with suspected GCA, recruited from an international cohort, had an ultrasound of temporal (TA) and axillary (AX) arteries performed within 7 days of commencing glucocorticoids. We compared differences in clinical features at disease presentation, after 2 weeks and after 6 months, according to the presence or absence of halo sign. We undertook a cross-sectional analysis of the differences in halo thickness using Pearson’s correlation coefficient (r) and Analysis of Variance (ANOVA). Results A total of 345 patients with 6 months follow-up data were included; 226 (65.5%) had a diagnosis of GCA. Jaw claudication and visual symptoms were more frequent in patients with halo sign (P =0.018 and P =0.003, respectively). Physical examination abnormalities were significantly associated with the presence of ipsilateral halo (P <0.05). Stenosis or occlusion on ultrasound failed to contribute to the diagnosis of GCA. During 7 days of glucocorticoid treatment, there was a consistent reduction in halo size in the TA (maximum halo size per patient: r=−0.30, P =0.001; and all halos r=−0.23, P <0.001), but not in the AX (P >0.05). However, the presence of halo at baseline failed to predict future ischaemic events occurring during follow-up. Conclusion In newly diagnosed GCA, TA halo is associated with the presence of ischaemic features and its size decreases following glucocorticoid treatment, supporting its early use as a marker of disease activity, in addition to its diagnostic role.

Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

2021 ◽  
pp. 1-29
Author(s):  
Amy H. Auchincloss ◽  
Jingjing Li ◽  
Kari A. B. Moore ◽  
Manuel Franco ◽  
Mahasin S. Mujahid ◽  
...  
Keyword(s):  
Healthy Eating Index ◽  
Dietary Quality ◽  
Longitudinal Analyses ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Eating Out ◽  
Restaurant Meals ◽  
Sectional Analysis ◽  
Over Time

Abstract Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

scholarly journals Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

2021 ◽  
Author(s):  
Martina Pecoraro ◽  
Stefano Cipollari ◽  
Livia Marchitelli ◽  
Emanuele Messina ◽  
Maurizio Del Monte ◽  
...  
Keyword(s):  
Chest Ct ◽  
Ct Scans ◽  
Imaging Biomarker ◽  
Cross Sectional ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Sectional Analysis ◽  
Ct And Mri ◽  
Interlobular Septal Thickening

Abstract Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

scholarly journals Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review

2021 ◽  
Vol 9 (T4) ◽  
pp. 267-278
Author(s):  
Pramitha Esha Nirmala Dewi ◽  
Montarat Thavorncharoensap
Keyword(s):  
Acute Coronary Syndrome ◽  
Current Practice ◽  
Utilization Rate ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Early Use ◽  
Risk Patients ◽  
Almost All ◽  
Intensive Regimen

BACKGROUND: The early use of statin with intensive regimen has been recommended by the recent guidelines as the prevention of acute coronary syndrome (ACS) related events among the high-risk patients. Meanwhile, the inconsistent statin utilization for targeted patient in current practice is still an issue. AIM: This study aims to review the utilization rate of statin among patients with ACS. METHODS: A systematic search of relevant studies published between inceptions to June 2020 was conducted in PubMed. Patients and intervention domains were used to build up the searching formula. A study was eligible for inclusion if it was an original study of patients with ACS and it examined the utilization of statin. The risk of bias was assessed using Axis and NOS checklist. RESULTS: Among the 49 eligible studies, 38 were cohort studies while the others were cross-sectional studies. The utilization rate of statin at hospital admission ranged from 16% to 61% while 25% to 75% during the hospitalization. Of the total studies, 35 studies reported the statin rate at discharge ranging from 58% to 99%. Almost all studies revealed the reduction of statin utilization rate along the follow-up period. The number of statins prescribed was found to be lower among female and elderly patients. CONCLUSION: Despite the established benefits of statin among patients with ACS, our study revealed that statin was underutilized for secondary prevention after ACS. To improve patients’ clinical outcomes with ACS, efforts should be made to increase optimal treatment and compliance with a statin.

scholarly journals Incidence of depression in people with newly diagnosed tuberculosis in Ethiopia: a cohort study

2020 ◽  
Vol 7 ◽  
Author(s):  
Fentie Ambaw ◽  
Rosie Mayston ◽  
Charlotte Hanlon ◽  
Atalay Alem
Keyword(s):  
Protective Factor ◽  
Treatment Guidelines ◽  
Incidence Rates ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Primary Care Settings ◽  
Tb Treatment ◽  
Patient Health ◽  
Probable Depression

Abstract Background Cross-sectional studies show that the prevalence of comorbid depression in people with tuberculosis (TB) is high. The hypothesis that TB may lead to depression has not been well studied. Our objectives were to determine the incidence and predictors of probable depression in a prospective cohort of people with TB in primary care settings in Ethiopia. Methods We assessed 648 people with newly diagnosed TB for probable depression using Patient Health Questionnaire, nine-item (PHQ-9) at the time of starting their anti-TB medication. We defined PHQ-9 scores 10 and above as probable depression. Participants without baseline probable depression were assessed at 2 and 6 months to measure incidence of depression. Incidence rates per 1000-person months were calculated. Predictors of incident depression were identified using Poisson regression. Results Two hundred and ninety-nine (46.1%) of the participants did not have probable depression at baseline. Twenty-two (7.4%) and 26 (8.7%) developed depression at 2 and 6 months of follow up. The incidence rate of depression between baseline and 2 months was 73.6 (95% CI 42.8–104.3) and between baseline and 6 months was 24.2 (95% CI 14.9–33.5) per 1000 person-months respectively. Female sex (adjusted β = 0.22; 95% CI 0.16–0.27) was a risk factor and perceived social support (adjusted β = −0.14; 95% CI −0.24 to −0.03) was a protective factor for depression onset. Conclusion There was high incidence of probable depression in people undergoing treatment for newly diagnosed TB. The persistence and incidence of depression beyond 6 months need to be studied. TB treatment guidelines should have mental health component.

Incidence, clinical features and outcomes of atrial fibrillation and stroke in Qatar

2019 ◽  
Vol 15 (1) ◽  
pp. 85-89 ◽  
Author(s):  
Yahia Z Imam ◽  
Saadat Kamran ◽  
Naveed Akhtar ◽  
Dirk Deleu ◽  
Rajvir Singh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Clinical Features ◽  
Stroke Care ◽  
Newly Diagnosed ◽  
Limited Data ◽  
Stroke Patients ◽  
Acute Stroke Care ◽  
Low Rate

Background Atrial fibrillation is an important risk factor for stroke but there are limited data on atrial fibrillation-related stroke from the Middle East. Methods We interrogated the Qatar Stroke Database to establish the occurrence, clinical features, and outcomes of atrial fibrillation-related stroke at Hamad General Hospital, the sole provider of acute stroke care in Qatar. Results A total of 4079 patients (81.4% male, mean age 55.4 ± 13.3 years) were enrolled in the stroke database between January 2014 and 21 October 2017. Atrial fibrillation was present in 260 (6.4%) patients, of whom 106 (2.6%) had newly diagnosed atrial fibrillation. The National Institute of Health Stroke Scale (NIHSS) was significantly higher (7.9 + 7.0 (median 6; IQR 11) vs. 5.9 + 6.4 (median 4; IQR 6), P < 0.001) in atrial fibrillation patients. The modified Rankin Score (mRS) (P < 0.001) and mortality at 90-day follow-up (P = 0.002) were significantly higher in atrial fibrillation compared to non-atrial fibrillation stroke patients. Conclusion We demonstrate a low rate of atrial fibrillation and stroke in Qatar, perhaps reflecting the relatively young age of these patients. Atrial fibrillation-related strokes had higher admission NIHSS, greater disability, and higher mortality at 90 days when compared to non-atrial fibrillation strokes.

scholarly journals Australian general practice trainees’ exposure to ophthalmic problems and implications for training: a cross-sectional analysis

2016 ◽  
Vol 8 (4) ◽  
pp. 295 ◽  
Author(s):  
Simon Morgan ◽  
Amanda Tapley ◽  
Kim M Henderson ◽  
Neil A Spike ◽  
Lawrie A McArthur ◽  
...  
Keyword(s):  
General Practice ◽  
Information Seeking ◽  
Learning Goals ◽  
Training Methods ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Australian General Practice ◽  
Simple Logistic ◽  
Sectional Analysis

ABSTRACT INTRODUCTION Eye conditions are common presentations in Australian general practice, with the potential for serious sequelae. Pre-vocational ophthalmology training for General Practitioner (GP) trainees is limited. AIM To describe the rate, nature and associations of ophthalmic problems managed by Australian GP trainees, and derive implications for education and training. METHODS Cross-sectional analysis from an ongoing cohort study of GP trainees’ clinical consultations. Trainees recorded demographic, clinical and educational details of consecutive patient consultations. Descriptive analyses report trainee, patient and practice demographics. Proportions of all problems managed in these consultations that were ophthalmology-related were calculated with 95% confidence intervals (CI). Associations were tested using simple logistic regression within the generalised estimating equations (GEE) framework. RESULTS In total, 884 trainees returned data on 184,476 individual problems or diagnoses from 118,541 encounters. There were 2649 ophthalmology-related problems, equating to 1.4% (95% CI: 1.38–1.49) of all problems managed. The most common eye presentations were conjunctivitis (32.5% of total problems), eyelid problems (14.9%), foreign body (5.3%) and dry eye (4.7%). Statistically significant associations were male trainee; male patient and patient aged 14 years or under; the problem being new and the patient being new to both trainee and practice; urban and of higher socioeconomic status practice location; the practice nurse not being involved; planned follow up not arranged; referral made; in-consultation information sought; and learning goals generated. DISCUSSION Trainees have comparable ophthalmology exposure to established GPs. However, associations with referral and information-seeking suggest GP trainees find ophthalmic problems challenging, reinforcing the critical importance of appropriate training.

scholarly journals 1320. HIV Care Continuum Outcomes Among Newly Diagnosed PLWH in Washington, DC

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S477-S477
Author(s):  
Maria J Jaurretche ◽  
Morgan Byrne ◽  
Lindsey J Powers Happ ◽  
Matthew E Levy ◽  
Michael A Horberg ◽  
...  
Keyword(s):  
Hiv Care ◽  
Future Research ◽  
Washington Dc ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Aids Diagnosis

Abstract Background In 2019, the US Administration announced the Ending the HIV Epidemic plan to decrease new infections. A key component is the Test and Treat plan to diagnose early, treat rapidly and achieve viral suppression (VS) among persons living with HIV (PLWH). We assessed retention in care (RIC), antiretroviral therapy (ART) initiation and VS among newly diagnosed PLWH in Washington, DC. Methods We conducted a cross-sectional analysis using data from the DC Cohort, an observational longitudinal cohort of PLWH in care in 14 clinics in DC. We included participants enrolled from 2011 to 2016 whose HIV diagnosis was within 1 year of enrollment and with at least 12 months follow-up. RIC was defined as ≥2 visits or HIV lab results 90 days apart in the first year of follow-up. ART initiation was defined as being prescribed ART, VS was defined as HIV RNA <200 copies/mL, and both these outcomes were assessed at 2 time points: by 3 and 12 months. Adjusted multivariable logistic regression was used to identify clinical and sociodemographic factors associated with RIC, ART initiation and VS. Results Among the 455 newly diagnosed participants (6% of all enrollees), median age was 33 years (IQR 25, 45), 69% were Black, 79% male, 60% MSM. Median duration of HIV at enrollment was 4.9 months (IQR 2.3, 7.7). Median nadir CD4 count was 346 cells/μL (IQR 224, 494). Of the 455, 38% had a history of AIDS, 92% were RIC, 65% initiated ART by 3 months and 17% had VS by 3 months. There were no differences by sex or race for RIC, ART initiation and VS. An AIDS diagnosis at enrollment was associated with RIC (aOR 2.28; 1.01–5.15), ART initiation by 3 months (aOR 2.41; 1.54–3.76), and VS by 12 months (aOR 1.92; 1.06–3.46). Lower nadir CD4 (aOR 0.89 per 50 cell increase; 0.84–0.94) and younger age (aOR 0.747 per 10-year increase; 0.584–0.995) were associated with ART initiation by 12 months. Conclusion Although the majority of newly diagnosed PLWH were RIC, fewer started ART or achieved VS. With a large proportion of our sample having an AIDS diagnosis at enrollment, we illustrate the ongoing challenge of late HIV diagnosis in DC. Those with AIDS at diagnosis were more likely to initiate ART within the first 3 months. As same-day ART initiation is scaled up in DC, future research can evaluate if all PLWH, regardless of AIDS status, will achieve this milestone earlier. Disclosures All authors: No reported disclosures.

scholarly journals Idiopathic macrocheilia

2018 ◽  
pp. bcr-2018-225682
Author(s):  
Haren Pandya ◽  
Hiren Dharmendrabhai Patel ◽  
Jigar Mayankbhai Purani ◽  
VIvek Ramesh Rayththa
Keyword(s):  
Triamcinolone Acetonide ◽  
Clinical Features ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Exclusion Criteria ◽  
Gingival Enlargement

A 13-year-boy presented with painless swelling of upper and lower lips accompanied with gingival enlargement. The aetiology for these symptoms included vast pathological varieties but none of them could fit in. Clinical features were similar to orofacial graulomatosis but histopathological examination revealed chronic non-specific infection. Therefore, the final diagnosis was made as idiopathic macrocheilia through exclusion criteria. Management with intralesional triamcinolone acetonide 40 mg, twice a week for 3 weeks, resulted in significant remission in lip swelling without recurrence after a 6-month follow-up.

scholarly journals Effect of changes in green spaces on mental health in older adults: a fixed effects analysis

2019 ◽  
Vol 74 (1) ◽  
pp. 48-56 ◽  
Author(s):  
J Mark Noordzij ◽  
Marielle A Beenackers ◽  
Joost Oude Groeniger ◽  
Frank J Van Lenthe
Keyword(s):  
Mental Health ◽  
Fixed Effects ◽  
Green Space ◽  
Residential Environment ◽  
Green Spaces ◽  
Cross Sectional ◽  
Urban Green Spaces ◽  
Using Data ◽  
Sectional Analysis

BackgroundUrban green spaces have been linked to different health benefits, but longitudinal studies on the effect of green spaces on mental health are sparse and evidence often inconclusive. Our objective was to study the effect of changes in green spaces in the residential environment on changes in mental health using data with 10 years of follow-up (2004–2014).MethodsData from 3175 Dutch adults were linked to accessibility and availability measures of green spaces at three time points (2004/2011/2014). Mental health was measured with the Mental Health Inventory-5. Fixed effects analyses were performed to assess the effect of changes in green spaces on mental health.ResultsCross-sectional analysis of baseline data showed significant associations between Euclidean distances to the nearest green space and mental health, with an increase of 100 m correlating with a lower mental health score of approximately 0.5 (95% CI −0.87 to −0.12) on a 0–100 scale. Fixed effects models showed no evidence for associations between changes in green spaces and changes in mental health both for the entire sample as well as for those that did not relocate during follow-up.ConclusionsDespite observed cross-sectional correlations between the accessibility of green space in the residential environment and mental health, no evidence was found for an association between changes in green spaces and changes in mental health. If mental health and green spaces are indeed causally linked, then changes in green spaces in the Eindhoven area between 2004 and 2014 are not enough to produce a significant effect.

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