Post-COVID-19 Functional Status: Relation to age, smoking, hospitalization and comorbidities

Rational: Recently, a new Post-COVID-19 Functional Status (PCFS) scale is recommended in the current COVID-19 pandemic. It is proposed that it could be used to display direct retrieval and the functional sequelae of COVID-19. Aim of the study: To assess the Post COVID-19 functional status in Egypt and to evaluate if age, gender, comorbidities have any effect on functional limitations in recovered COVID-19 patients. Patients and methods: A total of 444 registered confirmed COVID-19 patients were included. They were interviewed in our follow-up clinics or by calls and filled an Arabic translated PCFS scale in paper or online forms as well as their demographic and clinical data. Results: 80% of COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible (63.1%), slight (14.4%), moderate (2%) to severe (0.5%) based on PCFS. Furthermore, there was a substantial variance between the score of PCFS with age (P= 0.003), gender (P= 0.014), the duration since the onset of the symptoms of COVID-19 (P <0.001), need for oxygen supplementation (P<0.001), need for ICU admittance (P= 0.003), previous periodic influenza vaccination (P<0.001), smoking status (P < 0.001) and lastly the presence of any comorbid disorder (P <0.001). Conclusions: Most of the COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible to severe based on PCFS. These restrictions were affected by age, gender, periodic influenza vaccination, smoking, duration since symptoms onset, need for oxygen or ICU admittance, and lastly the presence of coexisting comorbidity.

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TL 18245 - Analysis of the efficacy of clinical data collection in orthopedic patients using online questionnaires

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1092 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 114S

Author(s):

André Vitor Kerber Cavalcanti Lemos ◽

Moises Cohen ◽

Nacime Salomão Barbachan Mansur

Keyword(s):

Data Collection ◽

Clinical Data ◽

Electronic Device ◽

Ankle Instability ◽

Group Analysis ◽

Online Data ◽

Intergroup Comparison ◽

Comparative Group ◽

Online Forms

Introduction: Clinical data collection is an essential stage in the development of any scientific research study. The recruitment of patients to research centers for data collection may be considerably difficult in some situations. There are few studies examining the use of distance evaluations conducted with digital and online tools. The use of information technology and the Internet to collect clinical data for scientific studies in orthopedics in Brazil remains somewhat limited; nonetheless, such approaches may provide several benefits to and facilitate data collection for Brazilian researchers. Methods: We performed a descriptive, observational study with printed or online (using an electronic device, such as computer, tablet or cell phone) self-administered questionnaires. Data from 40 patients (22 women; 18 men) with a mean age of 36.9 years (min: 15 years; max: 65 years) who were undergoing orthopedic follow-up for acute ankle sprain were collected using the Foot Function Index (FFI), Physical Function, Cumberland Ankle Instability Tool (CAIT), and visual analog scale (VAS) questionnaires. The questionnaires were administered at 4 different times: at the initial evaluation and at 3 weeks, 6 weeks and 12 weeks. Results: A comparative group analysis (digital, online data collection vs physical data collection) showed a higher level of collection of all data for each patient when the online questionnaires were used (87.5% vs 45% p<0.005), along with a higher accuracy of data collection (standard deviation (SD): 1.26; 2.3318; 1.6393 vs SD: 2.948; 3.807; 8.1189 p<0.005). Conclusion: Data collection using a remote approach through digital online forms (Internet) was highly effective in increasing the rate of response to long-term orthopedic follow-up questionnaires and showed improved data quality (decreased variability in collection dates), thus rendering online data more reliable for intergroup comparison.

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Brain atrophy and clinical characteristics predicting SDMT performance in multiple sclerosis: A 10-year follow-up study

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217321992394 ◽

2021 ◽

Vol 7 (1) ◽

pp. 205521732199239

Author(s):

Cecilie Jacobsen ◽

Robert Zivadinov ◽

Kjell-Morten Myhr ◽

Turi O Dalaker ◽

Ingvild Dalen ◽

...

Keyword(s):

Clinical Data ◽

Grey Matter Volume ◽

Lesion Volume ◽

Information Processing Speed ◽

Disability Status ◽

Mri Scans ◽

Patients At Risk ◽

Magnetic Resonance Imaging Mri ◽

Specific Volumes

Objectives To identify Magnetic Resonance Imaging (MRI), clinical and demographic biomarkers predictive of worsening information processing speed (IPS) as measured by Symbol Digit Modalities Test (SDMT). Methods Demographic, clinical data and 1.5 T MRI scans were collected in 76 patients at time of inclusion, and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. For the primary outcome of analysis, SDMT was used. Results Worsening SDMT at 5-year follow-up was predicted by baseline age, Expanded Disability Status Scale (EDSS), SDMT, whole brain volume (WBV) and T2 lesion volume (LV), explaining 30.2% of the variance of SDMT. At 10-year follow-up, age, EDSS, grey matter volume (GMV) and T1 LV explained 39.4% of the variance of SDMT change. Conclusion This longitudinal study shows that baseline MRI-markers, demographic and clinical data can help predict worsening IPS. Identification of patients at risk of IPS decline is of importance as follow-up, treatment and rehabilitation can be optimized.

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Association between digoxin use and sudden cardiac death in individuals with the rs10494366 variant of the NOS1AP gene

European Heart Journal ◽

10.1093/ehjci/ehaa946.3394 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

N Soroush ◽

A Aarnoudse ◽

F Shokri ◽

M Van Den Berg ◽

F Ahmadizar ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Cardiac Death ◽

Smoking Status ◽

Adaptor Protein ◽

Therapeutic Window ◽

P Value ◽

Qtc Interval ◽

Total Study Population ◽

Increased Risk

Abstract Background Digoxin is one of the oldest cardiovascular medications still used to treat heart failure and atrial fibrillation. Due to its narrow therapeutic window, it is associated with life threatening intoxication and arrhythmias, and with QTc-shortening. Common genetic variation in the nitric oxide synthase-1 adaptor protein (NOS1AP) has been associated with QTc interval prolongation. Purpose We investigated whether the rs10494366 variant of the NOS1AP gene modified the risk of SCD in patients using digoxin. Methods In a prospective population-based cohort study, we included data of the three cohorts, started as of January 1st, 1991 until January 1st 2014. Digoxin current use on the date of cardiac death in cases and the same day of follow-up in the remainder of the cohort was a time-dependent exposure. The main outcome was SCD defined as sudden and unexpected death as a result of cardiac causes, according to international criteria. Identification and adjudication of SCD was performed independently, before the start of this study. We used Cox proportional hazard regression analysis to investigate the associations between NOS1AP rs10494366 variant and incident SCD among digoxin users compared to non-users. Associations were adjusted for age, sex (model 1) in addition to BMI, prevalent diabetes, myocardial infarction, baseline hypertension and smoking status (past, current, never) (model 2). Results We included 14,594 individuals, with a mean age of 65.3 (SD 10.3) years. Almost 59% were female. The cumulative incidence of SCD was 9.5% (609 cases) by the end of follow up. Among them, 98 (16%) individuals were exposed to digoxin at the time of death. In model 1, NOS1AP rs10494366 variant was not associated with SCD in the total study population. However, an interaction term of the gene with the daily dose of digoxin was significantly associated with increased risk of SCD (p-value 0.0001). In model 2, the risk of SCD in current users of digoxin was 4.2 [95% CI 1.3–13.8] for the GG genotype; 2.1 [95% CI 1.1–4.2] for the GT genotype, and 1.5 [95% CI 0.7–3.2] for the TT genotype. Conclusion NOS1AP rs10494366 variant modified the risk of sudden cardiac death in users of digoxin. Our study suggests that individuals with the homozygous minor GG allele have a fourfold increased risk of sudden cardiac death. Funding Acknowledgement Type of funding source: None

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Nasal symptoms increase the risk of snoring and snoring increases the risk of nasal symptoms. A longitudinal population study

Sleep And Breathing ◽

10.1007/s11325-020-02287-8 ◽

2021 ◽

Author(s):

Maria Värendh ◽

Christer Janson ◽

Caroline Bengtsson ◽

Johan Hellgren ◽

Mathias Holm ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Health ◽

Smoking Status ◽

Northern Europe ◽

Nasal Breathing ◽

Nasal Symptoms ◽

Increased Risk ◽

Study Population ◽

Independent Risk Factors

Abstract Purpose Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

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Morquio A syndrome and effect of enzyme replacement therapy in different age groups of Turkish patients: a case series

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01761-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Sebile Kılavuz ◽

Sibel Basaran ◽

Deniz Kor ◽

Fatma Derya Bulut ◽

Sevcan Erdem ◽

...

Keyword(s):

Enzyme Replacement Therapy ◽

Replacement Therapy ◽

Clinical Data ◽

Treatment Initiation ◽

Case Series ◽

Enzyme Replacement ◽

Morquio A ◽

Over Time ◽

Morquio A Syndrome

Abstract Background This case series includes longitudinal clinical data of ten patients with Morquio A syndrome from south and southeastern parts of Turkey, which were retrospectively collected from medical records. All patients received enzyme replacement therapy (ERT). Clinical data collected included physical appearance, anthropometric data, neurological and psychological examinations, cardiovascular evaluation, pulmonary function tests, eye and ear-nose-throat examinations, endurance in the 6-min walk test and/or 3-min stair climb test, joint range of motion, and skeletal investigations (X-rays, bone mineral density). Results At the time of ERT initiation, two patients were infants (1.8 and 2.1 years), five were children (3.4–7.1 years), and three were adults (16.5–39.5 years). Patients had up to 4 years follow-up. Most patients had classical Morquio A, based on genotypic and phenotypic data. Endurance was considerably reduced in all patients, but remained relatively stable or increased over time in most cases after treatment initiation. Length/height fell below normal growth curves, except in the two infants who started ERT at ≤ 2.1 years of age. All patients had skeletal and/or joint abnormalities when ERT was started. Follow-up data did not suggest improvements in skeletal abnormalities, except in one of the younger infants. Nine patients had corneal clouding, which resolved after treatment initiation in the two infants, but not in the other patients. Hepatomegaly was reported in seven patients and resolved with treatment in five of them. Other frequent findings at treatment initiation were coarse facial features (N = 9), hearing loss (N = 6), and cardiac abnormalities (N = 6). Cardiac disease deteriorated over time in three patients, but did not progress in the others. Conclusions Overall, this case series with Morquio A patients confirms clinical trial data showing long-term stabilization of endurance after treatment initiation across ages and suggest that very early initiation of ERT optimizes growth outcomes.

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Increased development of radiographic hip osteoarthritis in individuals with high bone mass: a prospective cohort study

Arthritis Research & Therapy ◽

10.1186/s13075-020-02371-0 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

April Hartley ◽

Sarah A. Hardcastle ◽

Monika Frysz ◽

Jon Parkinson ◽

Lavinia Paternoster ◽

...

Keyword(s):

Bone Mass ◽

Functional Limitations ◽

Functional Limitation ◽

Hip Osteoarthritis ◽

Joint Space ◽

Mineral Density ◽

High Bone Mass ◽

High Bone ◽

Subchondral Sclerosis

Abstract Background Individuals with high bone mass (HBM) have a greater odds of prevalent radiographic hip osteoarthritis (OA), reflecting an association with bone-forming OA sub-phenotypes (e.g. osteophytosis, subchondral sclerosis). As the role of bone mineral density (BMD) in hip OA progression is unclear, we aimed to determine if individuals with HBM have increased incidence and/or progression of bone-forming OA sub-phenotypes. Methods We analysed an adult cohort with and without HBM (L1 and/or total hip BMD Z-score > + 3.2) with pelvic radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Superior/inferior acetabular/femoral osteophyte and medial/superior joint space narrowing (JSN) grades were summed and Δosteophyte and ΔJSN derived. Pain and functional limitations were quantified using the WOMAC questionnaire. Associations between HBM status and change in OA sub-phenotypes were determined using multivariable linear/logistic regression, adjusting for age, sex, height, total body fat mass, follow-up time and baseline sub-phenotype grade. Generalised estimating equations accounted for individual-level clustering. Results Of 136 individuals, 62% had HBM at baseline, 72% were female and mean (SD) age was 59 (10) years. HBM was positively associated with both Δosteophytes and ΔJSN (adjusted mean grade differences between individuals with and without HBM βosteophyte = 0.30 [0.01, 0.58], p = 0.019 and βJSN = 0.10 [0.01, 0.18], p = 0.019). Incident subchondral sclerosis was rare. HBM individuals had higher WOMAC hip functional limitation scores (β = 8.3 [0.7, 15.98], p = 0.032). Conclusions HBM is associated with the worsening of hip osteophytes and JSN over an average of 8 years, as well as increased hip pain and functional limitation.

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1369. The Spectrum of Chronic Osteomyelitis in Children

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1551 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S694-S695

Author(s):

Marritta Joseph ◽

Lauren Sommer ◽

Jesus G Vallejo ◽

Jonathon C McNeil

Keyword(s):

Clinical Features ◽

Hospital Admissions ◽

Chronic Osteomyelitis ◽

Functional Limitations ◽

Chronic Recurrent Multifocal Osteomyelitis ◽

Intravenous Therapy ◽

Days Of Therapy ◽

Common Etiology ◽

Multifocal Osteomyelitis

Abstract Background While the majority of pediatric osteomyelitis cases are acute in nature, a significant subset present with prolonged symptoms often associated with substantial morbidity. Little data exist to guide clinicians in the management of these infections. We sought to describe the epidemiology, clinical features and management of chronic osteomyelitis in children. Methods We reviewed hospital admissions with an ICD10 code for chronic osteomyelitis from 2011-2018 at Texas Children’s Hospital. Cases were included if symptoms lasted >28 days on presentation. Patients diagnosed with chronic recurrent multifocal osteomyelitis were excluded. Cases were classified as those 1) associated with a contiguous focus (CoF), 2) penetrating or open trauma, 3) orthopedic hardware (OH), 4) post-acute chronic osteomyelitis (PACO, those occurring after >28 days of therapy for acute osteomyelitis) and 5) primary hematogenous chronic osteomyelitis (PHCO, those with 28 days of symptoms without other clear risk factors). Results 114 cases met inclusion criteria. The median patient age is 11.8 years and 35.9% patients had underlying comorbidities. 83% of patients underwent a surgical procedure. Cases were diverse in terms of pathogenesis (Figure 1). A microbiologic etiology was identified in 72.8% of cases and was polymicrobial in 20.2% of cases; Staphylococcus aureus was the single most common etiology (Figure 2). CoF infection was more often associated with polymicrobial etiology with or without Pseudomonas (P< 0.001) and disease of the foot. PACO was caused by S. aureus in 95% of cases (p< 0.001, Figure 3). The overall median duration of total therapy was 210 days. 41% were discharged from hospital on OPAT with or without later transition to oral antibiotics. 26.3% of patients had persistent functional limitations at time of last follow-up of which 46% experienced repeat hospital admission/surgery. There was no association between duration of intravenous therapy and persistent functional limitations. Figure 1. Categories of Chronic Osteomyelitis Figure 2. Microbiology of Pediatric Chronic Osteomyelitis Figure 3. Clinical Features of Pediatric Chronic Osteomyelitis Conclusion Children with chronic osteomyelitis are diverse both in terms of pathogenesis and microbiology. Pathogenesis and clinical presentation can provide clues to microbiologic etiology. Prolonged intravenous therapy does not appear to improve functional outcomes in chronic osteomyelitis Disclosures Jonathon C. McNeil, MD, Allergan (Research Grant or Support, Allergan provided ceftaroline powder for use in studies described in this abstract)

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Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073439 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3439

Author(s):

Wen-Chou Chi ◽

Chia-Feng Yen ◽

Tsan-Hon Liou ◽

Kwang-Hwa Chang ◽

Hua-Fang Liao ◽

...

Keyword(s):

Functional Status ◽

Social Participation ◽

Negative Relationship ◽

General Function ◽

Living Situation ◽

Persons With Disabilities ◽

Factors Associated ◽

Whodas 2.0 ◽

Household Activities

The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans.

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Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02479-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zhao Yang ◽

Chao Xu ◽

Yong-Gang Zhu ◽

Jun Li ◽

Zi-Xiang Wu ◽

...

Keyword(s):

Soft Tissue ◽

Infection Rate ◽

Clinical Data ◽

Open Fractures ◽

Soft Tissue Reconstruction ◽

Satisfactory Outcome ◽

Tissue Damages ◽

Tissue Reconstruction ◽

Severe Soft Tissue

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

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Years of potential life lost in pre-diabetes and diabetes mellitus: data from a 40-year follow-up of the Israel study on Glucose intolerance, Obesity and Hypertension

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001981 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001981

Author(s):

Micha Rapoport ◽

Angela Chetrit ◽

Dror Cantrell ◽

Ilya Novikov ◽

Jesse Roth ◽

...

Keyword(s):

Glucose Intolerance ◽

Lifestyle Modification ◽

Smoking Status ◽

Age Groups ◽

Tolerance Test ◽

High Risk Group ◽

Oral Glucose ◽

Average Difference ◽

Using Data

IntroductionWe examined years of potential life lost (YPLL) associated with pre-diabetes as compared with either normoglycemia or diabetes, using data of the Israel cohort of Glucose intolerance, Obesity and Hypertension 40-year follow-up.Research design and methodsMen and women (N=2844, mean age 52.0±8.2 years) who underwent oral glucose tolerance test and anthropometric measurements, during 1976–1982, were followed for mortality until May 2019. Multiple imputation procedures for missing mortality dates and multivariable regression mixed models were applied.ResultsAt baseline, 35.8%, 48.8% and 15.4% individuals were found with normoglycemia, pre-diabetes, and diabetes, respectively. The average difference in YPLL associated with pre-diabetes as compared with normoglycemia was 4.3 years (95% CI 3.3 to 5.2; p<0.001). YPLL were 1 year higher in women with pre-diabetes than in men with pre-diabetes. These differences persisted mainly in individuals younger than 60 years, and those with body mass index (BMI) <25 kg/m2, at baseline. Adjusting for age, sex, country of origin, smoking status, BMI, and blood pressure, the average difference in YPLL associated with pre-diabetes as compared with normoglycemia was 2.0 years (95% CI 1.2 to 2.8; p<0.001). Significant reductions of 5.9 years (95% CI 4.8 to 7.0) on average were observed for diabetes as compared with pre-diabetes and 7.9 years (95% CI 6.7 to 9.1) as compared with individuals with normoglycemia.ConclusionsThis study reveals that life expectancy of middle-aged individuals with pre-diabetes is shorter than of normoglycemic ones. These findings are especially relevant in view of the rising worldwide prevalence of pre-diabetes within younger age groups and underscore the crucial importance of interventions by either lifestyle modification or drug therapy capable of delaying progression from pre-diabetes to diabetes to reduce the YPLL in this high-risk group.

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