scholarly journals AB1046 JOINT MANIFESTATIONS IN A COHORT OF PATIENTS WITH SARCOIDOSIS IN A THIRD LEVEL HOSPITAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1814.3-1814
Author(s):  
I. Madroñal García ◽  
C. Aguilera Cros ◽  
L. Mendez Diaz

Background:Sarcoidosis (S) is a systemic granulomatous disease of unknown etiology, which most frequently affects the ganglion, lung and skin, although it can affect other organs, including the musculoskeletal system.Objectives:- Describe the clinical, analytical and radiological characteristics of patients diagnosed with S presenting joint manifestations.- To assess the association between patients who have joint manifestations and the use of corticosteroids (C) and immunosuppressants (IS), with respect to those without joint involvement.Methods:Retrospective descriptive study of patients with diagnosis of S with joint manifestations, treated in our Hospital from 2017 to 2019. Data were obtained by reviewing medical records. Chi square tests and Fisher’s exact test have been performed to establish the differences described in the objectives.Results:From a database of 102 patients with S, 18 presented joint manifestations (50% women), with a mean age of 57 ± 6 years. Of these patients, 4 (22.2%) have presented positive ANA. Regarding the clinic, 3 patients presented the association of polyarthritis and bilateral ankle swelling, 8 patients presented with polyarthritis, 3 monoatritis and 4 patients presented bilateral ankle swelling. 61.1% had fever at the onset of the disease.14 patients (77.8%) had high ACE values at the onset of the disease, without presenting significant differences with respect to all patients diagnosed with S who do not have joint involvement.All patients received treatment with C and 10 patients (55.5%) needed an IS treatment, finding no differences with respect to patients who do not have joint involvement (p=0.92).On the course of the disease, the majority of patients with joint involvement have a chronic course (72.2%). Nor were significant differences found when compared with patients who have no joint involvement (p = 0.73).Conclusion:Patients with joint involvement in our study have been 17.6% (18), an approximate result to that described in the literature (over 10%), although our result may be increased by the fact that the patients who are followed in Rheumatology present or have presented joint involvement. No significant differences were found between patients with S who presented joint involvement and those who did not, with respect to the initial ACE values, treatment and disease course. Prospective, multicenter and larger sample studies are necessary to better understand these associations.Disclosure of Interests:None declared

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1814.2-1814
Author(s):  
I. Madroñal García ◽  
C. Aguilera Cros ◽  
L. Mendez Diaz

Background:Sarcoidosis is a systemic disease whose etiology is unknown. It is characterized by the formation of granulomas in any tissue of the organism. Ganglionic, pulmonary and cutaneus involvement is the most prevalent.Objectives:Describe clinical characteristics of a cohort of patients with sarcoidosis diagnosed.Define the association between the ACE’s number at diagnosis, radiological lung stage, treatment and course of disease.Evaluate if the extrapulmonary involvement is related to the course of the disease.Methods:Descriptive retrospective study of patients with S diagnosis treated in our Hospital in 2019. Data were obtained by reviewing medical records. Chi-square tests and parametric tests have been used to establish the differences described in the objectives.Results:102 patients diagnosed with sarcoidosis have been included, (51% females) with an average age of 56±11 years. Suspected diagnosis at the onset of disease was S in 70.6% of patients, followed by suspected lymphoma (20.6%). The average time for the definitive diagnosis of S was 9.5 months. 70.6% of the patients had elevated ACE titles at the beginning. Regarding the clinical manifestations, 18.6% of the patients presented fever at the beginning and 66.7% extrathoracic clinical manifestations. 72.5% have lymph node adenopathies, and in 91% there is thoracic involvement (the most frequent pulmonary stage is stage II). A biopsy was performed in 84.3% of the patients, the lung biopsy being the most performed (52.3%). 88.2% of patients received corticosteroid treatment at the onset of the disease (currently under treatment with corticosteroids 37.3%). 50% of patients are treated with immunosuppressants, Methotrexate was the most used. 5 patients are treated with biological therapy (AntiTNF).Regarding the course of the disease, 51% of the patients have a chronic course, 45.1% are in remission and 3.9% have suffered a relapse of the disease. In this study, no significant relationship was found between the ACE values at the onset of the disease, the pulmonary stage and the course of the disease.According to our data, patients presenting with extrathoracic clinical manifestations need more frequently corticosteroid treatment (p = 0.017) and immunosuppressive treatment (p = 0.001) with respect to patients who do not have an extrathoracic clinic. In addition, patients with an extrathoracic clinic present more frequently a chronic course of the disease than those who do not (p = 0.019).Conclusion:The results described in this study are similar to those found in the literature. The differences found can be explained because patients presenting with extrathoracic clinical manifestations have a more complicated management and need more treatment than those with only pulmonary involvement, even patients with radiological stage I do not usually need treatment, only surveillance.Disclosure of Interests:None declared


2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 20-20
Author(s):  
Masataka Yagisawa ◽  
Michio Nakamura ◽  
Chika Matsuda ◽  
Taichi Murai ◽  
Kazufumi Itaya ◽  
...  

20 Background: Eye disorders (EDs) are common adverse events in patients received S-1 chemotherapy. Although there are some retrospective reports about EDs induced by S-1 mono therapy (mono) as adjuvant chemotherapy (Adj) in gastric cancer (GC), there are few reports about S-1 induced EDs in other gastrointestinal cancer (GIC). So we conducted this retrospective cohort study to investigate the incidence of S-1 induced EDs in GIC and the association with several clinicopathological factors, such as primary site, treatment setting, regimen, and duration. Methods: All the patients received S-1 chemotherapy for GIC in our institution from January 2008 to May 2016 were identified through medical records review extracted by our hospital data warehouse. We analyzed the incidence of S-1 induced EDs by reviewing all the medical records and the association between ED incidence and several clinicopathological factors using a chi-square test or a Fisher's exact test and logistic regression. Results: Two hundred eighty three GIC patients were analyzed on this study. Patients characteristics were as follows; male/female 170/113, GC/colorectal cancer (CRC)/pancreatic cancer (PC)/biliary cancer (BC) 119/67/57/32, non-Adj/Adj 263/20, S-1 mono/S-1 combination therapy (combo) 130/153. The overall incidence rate with EDs such as epiphora, gum, photophobia, nephelopsia was 15.2% (n = 43). The median time to onset of EDs was 109 days (range 5-1100). The each of ED incidence was 16.5% (n = 28) and 13.3% (n = 15) in male and female (p = 0.503), 14.8% (n = 39) and 20.0% (n = 4) in non-Adj and Adj setting (p = 0.520), 13.8% (n = 18) and 16.3% (n = 25) in S-1 mono and combo (p = 0.619), respectively. The incidence of EDs in GC, CRC, PC, and BC were 15.1% (n = 18), 17.9% (n = 12), 17.5% (n = 10), and 9.4% (n = 3) (p = 0.635), respectively. Conclusions: We found that the incidence of EDs induced by S-1 chemotherapy for GIC was relatively high regardless of cancer site, treatment regimen, setting and duration. Further accumulation of data as prospective cohort study is necessary to confirm the incidence of S-1 induced EDs. Clinical trial information: UMIN000024160.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Tifanny Tantoso ◽  
Mega Sari Sitorus ◽  
Lita Feriyawati ◽  
Dian Dwi Wahyuni

Obesity is a worldwide problem that has been steadily increasing even in developing countries. Obesity has been linked to various types of cancer, one of which is breast cancer. Breast cancer has been classified into various types based on gene and hormone receptor expressions, which offered new insights to therapies and prognoses. We conducted a case-control study using 42 breast cancer patients and 43 healthy women, all of which are older than 55 years of age and have experienced menopause, and for case subjects, additional immunohistochemistry profiles have been provided. Data were collected by interviews and medical records. For data analysis, we used Pearson’s Chi-Square test and Fisher’s Exact test. Results showed that high BMI is significantly associated with breast cancer, and risk is elevated (p < 0.05, OR = 1.263, 95% CI = 1.007-1.583). No significant association with molecular subtypes was observed.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1549.3-1550
Author(s):  
R. J. Gil Velez ◽  
E. Rubio Romero ◽  
I. Madroñal García

Background:Takayasu arteritis is a granulomatous vasculitis that affects large vassels, specially aorta and its main ramifications. It is a rare disease with an incidence between 0.3 and 1.2 per million inhabitants in Europe. It is more common in women (80%) and it usually occurs before age 40.Objectives:Describe the characteristics and the use of biological therapy in a cohort of patients with Takayasu arteritis in our Hospital.Methods:Retrospective descriptive study of patients diagnosed with Takayasu arteritis treated in the Rheumatology and Internal Medicine service in our hospital during 2019. Data have been obtained by reviewing medical records.Results:39 patients with takayasu arteritis were included, 33 women (84.4%) and 6 men, withan average age of 48 ±12 years. About treatment, 35 patients received glucocorticoid treatment, of these, 23 patients (65.7%) received treatment with DMARDs. Methotrexato (47.8%) and Ciclophosphamide (43.5%) are the most used. 12.8% (5) of patients received treatment with biological therapy 2 patients received treatment with Rituximab (already retired) and 3 patients maintained the treatment with Tocilizumab. (The characteristics of the patients are in table 1).About the course of disease, 47.8% of patients have achieved clinical remission, 43.6% have a chronic course, and only 3 patients have presented relapse of disease.Conclusion:The results of our study are consistent with what is published in the literature. The average age of presentation is higher than in other series (48 ±12 years), this is because all patients are European and Caucasian. There is still not much experience on biological treatment in patients diagnosed with sarcoidosis, however the use of Rituximab, AntiTNFs and Tocilizumab has been described, presenting a good clinical response and with few adverse effects, as has been observed in our patients.Disclosure of Interests:None declared


Author(s):  
Jegathesan T. ◽  
Camilla J. Stewart ◽  
Pei Y. Tong ◽  
Wee L. Lam ◽  
Vaikunthan Rajaratnam

Abstract Introduction Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations. Materials and Methods Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren–Lawrence (K-L) score. Chi-square test, Fisher’s exact test, or Student’s t-test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints. Results A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant (p = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population. Conclusion Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Filip Lundström ◽  
Erik Odhagen ◽  
Fredrik Alm ◽  
Claes Hemlin ◽  
Pia Nerfeldt ◽  
...  

Abstract Background The ambition of the National Tonsil Surgery Register in Sweden (NTSRS) is to improve otorhinolaryngological care by monitoring trends in the clinical practices, complications, and outcomes of tonsil surgery. The NTSRS collects data from both surgeons and patients and provides the participating clinics with daily updated data on a publicly available website. On the website, national and local results can be compared and monitored. The use of NTSRS data necessitates that the data is valid, but the NTSRS has not yet been validated. With approximately half of the registered patients responding to the postoperative questionnaires, an analysis of responders and non-responders is also necessary. The aim of this study was to assess the criterion validity of NTSRS data. Another aim was to compare the characteristics and rates of complications between postoperative questionnaire responders and non-responders. Methods Data in the NTSRS were compared with data in electronic medical records. The 200 most recent surgeries, up to 31 Dec 2019, in each of 11 surgical units were included. Criterion validity was analysed in terms of observed agreement, Cohens kappa, Gwet’s AC1, and positive and negative agreement. The sign test was used to analyse systematic differences between the NTSRS and the medical records. Comparisons of rates between groups were made with Fisher’s exact test, the chi-square test, and Fisher’s non-parametric permutation test. Results A total of 1991 registrations were included in the study. All variables showed very high observed agreement ranging from 0.91 to 1.00, and all variables had AC1 values corresponding to almost perfect agreement. The analysis of questionnaire responders and non-responders showed no statistically significant differences regarding age, indication, or type of surgery. The proportion of women was higher in the responder group. The rate of reoperation due to bleeding was higher in the responder group, but there were no differences regarding other complications. Conclusions The results of this study show that data in the NTSRS have criterion validity. The NTSRS is thus well suited for monitoring the clinical practices and outcomes of tonsil surgery. The quality of the data also implies that the registry can be used in both clinical improvement projects and research.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S412-S412
Author(s):  
Vansha Singh ◽  
Philip Yune ◽  
Rehana Rasul ◽  
Rebecca Schwartz ◽  
Negin Niknam ◽  
...  

Abstract Background GI PCR can detect 22 pathogens (bacteria, parasites and viruses) from a single stool sample. Stool cultures are labor intensive and only target the most common diarrheal pathogens (such as Campylobacter, E. coli and a few parasites). We hypothesized that implementation of GI PCR would result in decreased LOS and lower antibiotic use. Methods This retrospective study utilized data from review of electronic medical records and included patients aged &gt; 18 years old who were admitted with diarrhea over a 3-year period from 2016 to 2019. LOS and antibiotic use data was collected for patients who had GI PCR from 2017–2019 (GIP arm) and compared with data from patients who had stool cultures from 2016–2017 (SC arm). Differences were assessed using Chi-square or Fisher’s exact test for categorical variables and the Mann Whitney Rank Sum test for continuous variables. Results The analysis included a total of 338 patients, 225 (66.6%) in the GI PCR arm and 113 (33.4%) in the SC arm. A significantly higher proportion of patients in the GIP arm had a positive result compared with the SC arm (26.2% vs. 9.7%, P &lt; .0001; Table 1). Table 2 shows the most frequently isolated organisms. Median LOS was 6 days (IQR: 4–13) for the GIP arm and 5 days (IQR: 3–7) for the SC arm (p=.060); 8 patients in the GIP arm had average LOS of 75 days due to comorbidities and disposition issues. However, within the GIP arm, median LOS was much shorter for patients detected with viruses by PCR vs. those with non-viral pathogens (3.5 days (IQR: 3-7) vs. 6 days (3-12)) There was no difference in antibiotic use between the GIP and SC arms (84.9% vs. 84.1%, P=.844). Patients in GIP arm were more commonly given Piperacillin-tazobactam and Carbapenems, whereas patients in the SC arm received metronidazole more often. Within the GIP arm, antibiotic use was lower among patients detected with viruses vs. those detected with non-viral pathogens (73.1% vs. 81.8%). Table 1 Table 2 Conclusion LOS was longer in patients in GIP arm vs SC arm, which may have been influenced by the presence of outliers in the GIP arm. No differences in antibiotic use was observed between the two groups. However, within the GIP arm, detection of viruses by GI PCR significantly shortened LOS and lowered antibiotic use. Disclosures All Authors: No reported disclosures


2013 ◽  
Vol 31 (4) ◽  
pp. 459-465
Author(s):  
Rafael Fabiano M. Rosa ◽  
Melina Vaz Sarmento ◽  
Janaina Borges Polli ◽  
Daniela de Paoli Groff ◽  
Patrícia Petry ◽  
...  

OBJECTIVE: To describe gestational, perinatal and family findings of patients with Patau syndrome (PS). METHODS: The study enrolled patients with PS consecutively evaluated during 38 years in a Clinical Genetics Service of a pediatric referral hospital in Southern Brazil. The clinical data and the results of cytogenetic analysis were collected from the medical records. For statistical analysis, the two-tailed Fisher's exact test and the chi-square test with Yates' correction were used, being significant p<0.05. RESULTS: The sample was composed of 27 patients, 63% were male, with a median age of nine days at the first evaluation. Full trisomy of chromosome 13 was the main cytogenetic finding (74%). Only six patients were submitted to obstetric ultrasound and none had prenatal diagnosis of PS. The patients' demographic characteristics, compared to born alive infants in the same Brazilian state showed a higher frequency of: mothers with 35 years old or more (37.5%); multiparous mothers (92.6%); vaginal delivery (77%); preterm birth (34.6%); birth weight <2500g (33.3%), and Apgar scores <7 in the 1st (75%) and in the 5th minute (42.9%). About half of them (53%) died during the first month of life. CONCLUSIONS: The understanding of the PS patients' gestational, perinatal and family findings has important implications, especially on the decision about the actions to be taken in relation to the management of these patients.


2020 ◽  
Author(s):  
Marzieh Araban ◽  
Mahmood Karimy ◽  
Mehdi Mesri ◽  
Bahram Armoon ◽  
Hamid Reza Koohestani ◽  
...  

Abstract BackgroundNew Coronavirus disease (COVID-19) is the main pathogens that primarily target the human respiratory organization, represents a public health emergency and global concern. The present study aimed to investigate the epidemiological, clinical characteristics of coronavirus-infected disease (COVID-19) in Saveh city, of Iran, in 2020.MethodIn this descriptive-analytical research, 1142 patients suspected of having coronavirus, participated. Data collection was performed using interviews, inserting information into the researcher-made questionnaires, and using the information in patients' medical records. Data were analyzed by SPSS 21 using Chi-square, independent sample t tests, Fisher's Exact Test, and regression analysis.Resultsmultivariate logistic regression models revealed that among clinical symptoms and patents characteristics, some variables were significant predictors of death: Intubation (OR = 8.82; 95% CI: (5.15-15.63), PO2 rate (OR = 2.48; 95% CI: (1.51-4.08), Diabetes (OR = 1.88; 95% CI: (1.00-3.54), Shortness of breath (OR = 1.70; 95% CI: (1.02-2.82). Almost half of the patients (48.3%) had a history of chronic disease, cardiovascular disease (CVD) (12.8%), diabetes (11.6%), and high blood pressure (9.7%) were the primary chronic disease among patients.ConclusionConsidering the results of the study, designing and implementing targeting and tailoring health education programs for all groups of the community and especially for susceptible people such as elderly and patients with chronic disease, are highly recommended. All in all, risk communication programs regarding COVID-19 might be a priority for responsible agencies.


1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.


Sign in / Sign up

Export Citation Format

Share Document