Definition of fibromyalgia severity: findings from a cross-sectional survey of 2339 Italian patients

Rheumatology ◽  
2020 ◽  
Author(s):  
Fausto Salaffi ◽  
Marco Di Carlo ◽  
Laura Bazzichi ◽  
Fabiola Atzeni ◽  
Marcello Govoni ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Fibromyalgia Impact Questionnaire ◽  
Cross Sectional Survey ◽  
External Criterion ◽  
Cross Sectional ◽  
Mild Disease ◽  
Moderate Disease ◽  
Definition Of ◽  
Distress Scale

Abstract Objective To establish optimal cut-off values for the scores of the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromialgia Assessment Scale (FAS 2019mod), and the Polysymptomatic Distress Scale (PDS) in order to distinguish five levels of FM disease severity. Methods Consecutive FM patients were evaluated with the three clinimetric indices, and each patient was required to answer the anchor question: ‘In general, would you say your health is 1 = very good, 2 = good, 3 = fair, 4 = poor, or 5 = very poor?’—which represented the external criterion. Cut-off points were established through the interquartile reconciliation approach. Results The study sample consisted of 2181 women (93.2%) and 158 men (6.8%), with a mean age of 51.9 (11.5) years, and mean disease duration was 7.3 (6.9) years. The overall median FIQR, FAS 2019 mod and PDS scores (25th–75th percentiles) were respectively 61.16 (41.16–77.00), 27.00 (19.00–32.00) and 19.0 (13.00–24.00). Reconciliation of the mean 75th and 25th percentiles of adjacent categories defined the severity states for FIQR: 0–23 for remission, 24–40 for mild disease, 41–63 for moderate disease, 64–82 for severe disease and >83 for very severe disease; FAS 2019 mod: 0–12 for remission, 13–20 for mild disease, 21–28 for moderate disease, 29–33 for severe disease and >33 for very severe disease; PDS: 0–5 for remission, 6–15 for mild disease, 16–20 for moderate disease, 21–25 for severe disease and >25 for very severe disease. Conclusions Disease severity cut-offs can represent an important improvement in interpreting FM.

scholarly journals Lymphopenia as an early predictor of disease severity in COVID-19

2020 ◽  
Vol 6 (3) ◽  
pp. 08-11
Author(s):  
Shaheen Ali Khan ◽  
Muhammad Naveed Anwar ◽  
Laraib Saeed ◽  
Wajeeha Qayyum ◽  
Zuhayr Ahmad Mufti ◽  
...  
Keyword(s):  
Disease Severity ◽  
Statistical Significance ◽  
Severe Disease ◽  
Relevant Information ◽  
Adverse Outcomes ◽  
Medical Institute ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Mild Disease ◽  
Moderate Disease

Introduction: Research has implicated an exaggerated or self-directed immune response as a factor in determining patient outcome in COVID-19. Initial reports identify lymphopenia as having a predictive role in COVID-19 related disease severity.Objective: To document the occurrence of lymphopenia in COVID-19 patients and explore its association with demographic factors and disease course.Materials & Methods: This cross sectional, observational study was conducted at Rehman Medical Institute, Peshawar from May, 2020 to August, 2020. All patients admitted to the hospital with COVID-19 diagnosis were included. Relevant information including demographics, disease severity, laboratory findings & outcomes were noted in a predesigned Performa. The data were analyzed on SPSS 22 for descriptive and comparative statistics; p≤0.05 denoted significance.Results: A total of 216 patients were included, of whom 172 (79.6%) were males. The mean age was 54.61 ± 14.35 years. Classic lymphopenia was found in 67 (31.5%), 66 (31.0%) had borderline lymphopenia, and 80 (37.6%) had no lymphopenia. Of the classic lymphopenia group, 14 (20.9%) had mild disease, 21 (31.3%) had moderate disease, 18 (26.9%) had severe disease & 14 (20.9%) had critical disease. In patients with borderline lymphopenia 31 (47.0%) had mild disease, 17 (25.8%) moderate disease, 14 (21.2%) had severe disease and 04 (6.1%) had critical disease. In patients with no lymphopenia, 32 (40.0%) had mild, 32 (40.0%) had moderate, 14 (17.5%) had severe & 02 (2.5%) had critical disease. Mortality associated with classical lymphopenia was 37.3% (n=25) whereas 43.3% (n=29) patients recovered. Male gender, disease severity and outcome were statistically linked to lymphopenia; no statistical significance was observed with age.Conclusion: A statistically significant association of lymphopenia with severe/critical disease and adverse outcomes was noted.Keywords: Lymphopenia, COVID-19, Pandemic.

scholarly journals The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2,339 patients

2021 ◽  
Author(s):  
Fabiola Atzeni ◽  
Alessandra Alciati ◽  
Fausto Salaffi ◽  
Marco Di Carlo ◽  
Laura Bazzichi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Fibromyalgia Impact Questionnaire ◽  
High Body Mass Index ◽  
Overweight And Obesity ◽  
Clinical Severity ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Individual ◽  
Distress Scale

Abstract Objective Various studies have shown that overweight and obesity are central features of fibromyalgia syndrome (FM), but the real impact of a high body mass index (BMI) on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a web-based registry of patients with FM. Methods Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests, and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, as well as the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status (ModFAS) questionnaire, and the Polysymptomatic Distress Scale (PDS). Results A total of 2339 patients were recruited and divided into two weight categories, Underweight/Normal (U/N, n = 1127, 48.39%) and Overweight/Obese (O/O, n = 1212, 51.81%). The total and subscale of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all of the mean scores of the individual FIQR items (p < 0.001 for all). Conclusion Our findings demonstrate that O/O patients with FM are significantly more impaired in all of the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS than U/N patients, thus suggesting that being O/O has an additional effect on symptoms and function.

scholarly journals Serum β2-microglobulin levels in Coronavirus disease 2019 (Covid-19): Another prognosticator of disease severity?

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247758
Author(s):  
Walter Conca ◽  
Mayyadah Alabdely ◽  
Faisal Albaiz ◽  
Michael Warren Foster ◽  
Maha Alamri ◽  
...  
Keyword(s):  
Disease Severity ◽  
Viral Infections ◽  
Linear Trend ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mhc I ◽  
Mild Disease ◽  
Moderate Disease ◽  
Single Center Study

β2-microglobulin (β2-m), a 11.8 kDa protein, pairs non-covalently with the α3 domain of the major histocompatibility class (MHC) I α-chain and is essential for the conformation of the MHC class I protein complex. Shed β2-m is measurable in circulation, and various disorders are accompanied by increases in β2-m levels, including several viral infections. Therefore, we explored whether β2-m levels could also be elevated in Coronavirus disease 2019 (Covid-19) and whether they predict disease severity. Serum β2-m levels were measured in a cohort of 34 patients infected with SARS-CoV-2 on admission to a tertiary care hospital in Riyadh, Saudi Arabia, as well as in an approximately age-sex matched group of 34 uninfected controls. Mean β2-m level was 3.25±1.68 mg/l (reference range 0.8–2.2 mg/l) in patients (mean age 48.2±21.6) and 1.98±0.61 mg/l in controls (mean age 48.2±21.6). 17 patients (mean age 36.9± 18.0) with mean β2-m levels of 2.27±0.64 mg/l had mild disease by WHO severity categorization, 12 patients (mean age 53.3±18.1) with mean β2-m levels of 3.57±1.39 mg/l had moderate disease, and five patients (of whom 2 died; mean age 74.4±13.8) with mean β2-m levels of 5.85±1.85 mg/l had severe disease (P < = 0.001, by ANOVA test for linear trend). In multivariate ordinal regression β2-m levels were the only significant predictor of disease severity. Our findings suggest that higher β2-m levels could be an early indicator of severity of disease and predict outcome of Covid-19. As the main limitations of the study are a single-center study, sample size and ethnicity, these results need confirmation in larger cohorts outside the Arabian Peninsula in order to delineate the value of β2-m measurements. The role of β2-m in the etiology and pathogenesis of severe Covid-19 remains to be elucidated.

scholarly journals Implications in the quantitation of SARS-CoV2 copies in concurrent nasopharyngeal swabs, whole mouth fluid and respiratory droplets

2021 ◽  
Author(s):  
Priya Kannian ◽  
Bagavad Gita Jayaraman ◽  
Swarna Alamelu ◽  
Chandra Lavanya ◽  
Nagalingeswaran Kumarasamy ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Virus Shedding ◽  
Mild Disease ◽  
Copy Numbers ◽  
Respiratory Droplets

AbstractImportanceThe nasopharyngeal swab (NPS) is considered the ideal diagnostic specimen for Covid-19, while WMF is recently promoted due to collection simplicity and importance in disease transmission. There is limited knowledge on the relative viral load in these samples – NPS, whole mouth fluid (WMF) and respiratory droplets (RD; another important source in transmission), on how the loads vary with disease severity and on how much virus is shed.ObjectiveTo quantify and compare SARS-CoV2 copies in the NPS, WMF and RD samples, and correlate with disease severity.DesignCross sectional study.SettingTertiary care multi-speciality hospital with limited resources in a low-to-middle income country.ParticipantsEighty suspected COVID-19 patients were recruited from the COVID-19 out-patient clinic and hospital isolation wards.InterventionConcurrent NPS, WMF and RD samples were collected from all the recruited patients and tested for SARS-CoV2 copies by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR).Main outcomes and measuresThe main outcome was COVID-19 measured by SARS-CoV2 quantitative RT-PCR in NPS samples. COVID-19 disease severity was determined according to NIH criteria. Virus shedding was defined as the presence of SARS-CoV2 copies in the WMF and RD samples.ResultsSARS-CoV2 was detected in 55/80 (69%) of the NPS samples. Of these 55, WMF and RD samples were positive in 44 (80%) and 17 (31%), respectively. The concordance of WMF with NPS was 84% (p=0.02). SARS-CoV2 copy numbers were comparable in the NPS (median: 8.74×10^5) and WMF (median: 3.07×10^4), but lower in RD samples (median: 3.60×10^2). Patients with mild disease had higher copies in the NPS (median: 3.46×10^6), while patients with severe disease had higher copies in the WMF (median: 1.34×10^6) and RD samples (median: 4.29×10^4). The 25-75% interquartile range of NPS SARS-CoV2 copies was significantly higher in the WMF (p=0.0001) and RD (p=0.01) positive patients.Conclusion and relevanceSARS-CoV2 copies are highest in NPS samples. WMF is a reliable surrogate sample for diagnosis. High copy numbers in the NPS imply initial virological phase and higher risk of virus shedding via WMF and RD.Key pointsQuestionHow the numbers of SARS-CoV2 copies in nasopharyngeal swab (NPS) samples might reflectvirus shedding from the whole upper aerodigestive tract and indicatedisease severity?FindingsIn this cross-sectional study involving 80 suspected COVID-19 patients, the data indicate higher SARS-CoV2 copies in NPS samples of patients with mild disease,and in the whole mouth fluid (WMF) and respiratory droplet (RD) samples of patients with severe disease. Patients with higher SARS-CoV2 copies in the NPS shed the virus in the WMF and RD samples at statistically higher levels.MeaningHigh SARS-CoV2 copies in NPS samples imply initial virological phase withhigh levels of shedding through both WMF and RD.

The mental health of Australian medical practitioners during Covid-19

2021 ◽  
pp. 103985622110108
Author(s):  
Michelle Anne Adams ◽  
Matthew Brazel ◽  
Richard Thomson ◽  
Hannah Lake
Keyword(s):  
Mental Health ◽  
Junior Doctor ◽  
Demographic Factors ◽  
Cross Sectional Survey ◽  
Mental Health Diagnosis ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Psychological Distress Scale ◽  
Distress Scale ◽  
Health Diagnosis

Objectives: To ascertain whether doctors were experiencing higher rates of distress during Covid-19 and whether this was impacted by demographic factors. Our hypotheses were that being a junior doctor, having a previous mental health diagnosis and treating Covid-19 positive patients would predict higher rates of distress. Methods: Cross-sectional survey conducted via Survey Monkey. Voluntary participants were recruited from the mailing list of a national-based referral service for doctors to psychiatrists. Distress was measured using the Kessler Psychological Distress Scale (K10). Demographic factors were analysed for predictive value of a higher rating on the K10. Areas of concern in relation to Covid-19 and preference for support services were measured on a Likert scale and compared to levels of distress. Results: The rate of very high distress was 15%. Being a junior doctor and having a previous mental health diagnosis were predictive factors of a higher K10 score. K10 was not affected by likelihood of contact with Covid-19-positive patients. Social isolation had a larger impact on mental health in the context of a previous psychiatric diagnosis. Face-to-face assessments were preferred. Conclusions: Rates of distress in doctors have been higher than baseline during Covid-19. Some groups have been particularly vulnerable.

1329 Can One Size Fit All: Is Laparoscopic Roux-En-Y Gastric Bypass the Best Bariatric Procedure for Treating Type 2 Diabetes Mellitus (T2DM)?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
V Mahendran ◽  
P Ricart ◽  
S Robinson ◽  
A Perry ◽  
M Wadley
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Morbidly Obese ◽  
Disease Remission ◽  
Mild Disease ◽  
Moderate Disease ◽  
Remission Rates

Abstract Introduction Bariatric surgery produces superior weight loss and reversal of comorbidities in morbidly obese individuals compared to medical therapy alone. Laparoscopic Roux-en-Y gastric bypass (LRYGB) was traditionally considered to prolonged remission of T2DM compared to other procedures such as Laparoscopic Sleeve-Gastrectomy (LSG). But recently published studies seek to disprove this by emphasising on duration and severity of T2DM before surgery rather than the type of procedure. We aim to verify if the severity of T2DM and type of operation (LRYGB Vs LSG) influence remission rates. Method In this retrospective cohort study, 204 patients were diagnosed with T2DM pre-operatively and had undergone either LRYGB or LSG. We used the Individualised Metabolic Surgery Score (IMSS) tool to divide patients into mild, moderate, and severe categories. Results Results showed that of the 204 patients 15% (n = 31) had mild disease, 62%( n = 127) had moderate disease and 23% (n = 46) had severe disease. Remission rates in each category were as follows: Conclusions We agree that patients with longstanding and severe T2DM have low remission rates after bariatric surgery, probably due to diminished beta-cell reserve. It is in contrary to recent publications which recommend LSG over LRYGB in patients with severe disease. This evidence necessitates further prospective studies before deciding which is the best procedure for patients with severe and longstanding T2DM.

scholarly journals Profile of Patients with Mitral Stenosis in Dr. Soetomo General Hospital, Surabaya in January 2015 – December 2017

2021 ◽  
Vol 12 (1) ◽  
pp. 42
Author(s):  
Nadia Mulyanti Gunawan ◽  
Raden Mohammad Budiarto ◽  
Andriati Andriati
Keyword(s):  
High School ◽  
General Hospital ◽  
Disease Severity ◽  
Educational Level ◽  
Mitral Stenosis ◽  
Severe Disease ◽  
Educational Background ◽  
Vascular Medicine ◽  
Cross Sectional ◽  
Appropriate Treatment

Introduction: The most common valvular heart disease is mitral stenosis. Mitral stenosis is an abnormality of the heart valve which causes reduced blood flow from the left atria to the left ventricle due to narrowing of mitral valve orifice during its opening motion. If the condition continues, it will result in complications. The most common complications are pulmonary hypertension, atrial fibrillation, heart failure, and stroke. Appropriate treatment for mitral stenosis may produce more favorable prognosis in these patients. Therefore, the aim of this study was to describe the profile of patients with mitral stenosis in Department of Cardiology and Vascular Medicine, Dr. Soetomo General Hospital, Surabaya from January 2015 to December 2017. It is expected that mitral stenosis can be detected earlier, thus the appropriate treatment can be administered promptly and further complications can be prevented. Methods: This study was a descriptive retrospective study with cross-sectional approach and accidental sampling method obtained from the inpatients medical records of patients diagnosed with mitral stenosis from echocardiography in Department of Cardiology and Vascular Medicine Dr. Soetomo General Hospital, Surabaya from January 2015 to December 2017. The variables were age, gender, disease severity, and the patient’s educational background. The data was processed using Microsoft Excel and IBM SPSS version 20. Results:  This study obtained 41 patients who met the inclusion criteria, then the patients were categorized according to their age, gender, disease severity, and educational background. The results of the study showed that the subjects were dominated by those of productive age at 30-39 years old (39%), the most prevalent gender was female (85.4%), severe disease severity (85.4%), and educational level was from high school (85.4%). Conclusion: The majority of the patients with mitral stenosis were from productive age, female, with severe disease severity, and educational background from middle educational level (high school). 

scholarly journals Healthcare Students’ Perception of Social Distancing during the 2019 Coronavirus Pandemic: A Cross-Sectional Survey

2021 ◽  
Author(s):  
Devon L Barrett ◽  
Katharine W Rainer ◽  
Chao Zhang ◽  
Travis W Blalock
Keyword(s):  
Public Health ◽  
Disease Spread ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Social Distancing ◽  
Healthcare Students ◽  
Common Definition ◽  
Grouping Students ◽  
Control And Prevention ◽  
Definition Of

Background: Since the implementation of social distancing practices during the global coronavirus disease 2019 (COVID-19) pandemic there have been a myriad of definitions for ‘social distancing.’ The objective of this study was to determine students’ awareness of the various definitions of social distancing, how strictly they adhered to social distancing guidelines, and how they perceived the importance of various social distancing practices.  Methods: This cross-sectional survey was distributed via email to students at Emory-affiliated graduate schools, including the Medical, Nursing, and Public Health Schools. Results: Of the 2,453 recipients of the survey, 415 students responded (16.9% response rate). The majority of respondents were medical students (n=225, 55.6%). Of the respondents, 357 noted that they “frequently” or “always” abided by social distancing. The most common definition of social distancing with which respondents were familiar was the Centers for Disease Control and Prevention (CDC)’s (n=276 of 369 responses, 74.8%). There were significant differences across groups  when grouping students by the definition of social distancing that they were aware of, the social distancing guideline they most closely followed, and their school of attendance regarding the importance of specific social distancing examples (p<0.05 for each). Conclusions: A survey of healthcare students identified differences in the importance of social distancing practices based on the definition of social distancing that they were aware of. The results of this study underscore the importance of having unified definitions of public health messaging, which ultimately may impact disease spread.

scholarly journals Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e001735
Author(s):  
Francesco Ursini ◽  
Jacopo Ciaffi ◽  
Luana Mancarella ◽  
Lucia Lisi ◽  
Veronica Brusi ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Fibromyalgia Impact Questionnaire ◽  
Admission Rate ◽  
Male Gender ◽  
Multivariate Logistic Regression Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Hospital Admission Rate ◽  
American College Of Rheumatology

ObjectivePostacute COVID-19 syndrome (PACS) is an emerging entity characterised by a large array of manifestations, including musculoskeletal complaints, fatigue and cognitive or sleep disturbances. Since similar symptoms are present also in patients with fibromyalgia (FM), we decided to perform a web-based cross-sectional survey aimed at investigating the prevalence and predictors of FM in patients who recovered from COVID-19.MethodsData were anonymously collected between 5 and 18 April 2021. The collection form consisted of 28 questions gathering demographic information, features and duration of acute COVID-19, comorbid diseases, and other individual’s attributes such as height and weight. The American College of Rheumatology (ACR) Survey Criteria and the Italian version of the Fibromyalgia Impact Questionnaire completed the survey.ResultsA final sample of 616 individuals (77.4% women) filled the form 6±3 months after the COVID-19 diagnosis. Of these, 189 (30.7%) satisfied the ACR survey criteria for FM (56.6% women). A multivariate logistic regression model including demographic and clinical factors showed that male gender (OR: 9.95, 95% CI 6.02 to 16.43, p<0.0001) and obesity (OR: 41.20, 95% CI 18.00 to 98.88, p<0.0001) were the strongest predictors of being classified as having post-COVID-19 FM. Hospital admission rate was significantly higher in men (15.8% vs 9.2%, p=0.001) and obese (19.2 vs 10.8%, p=0.016) respondents.ConclusionOur data suggest that clinical features of FM are common in patients who recovered from COVID-19 and that obesity and male gender affect the risk of developing post-COVID-19 FM.

Sign in / Sign up

Export Citation Format

Share Document