scholarly journals POS1179 POST COVID ARTHRITIS; REACTIVE ARTHRITIS OR RHEUMATIC DISEASE FLARE OR BOTH

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 871.1-871
Author(s):  
F. Fayed ◽  
E. Abdelkarim
Keyword(s):  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Reactive Arthritis ◽  
Viral Infections ◽  
Past History ◽  
Musculoskeletal Symptoms ◽  
Oral Nsaid ◽  
History Of ◽  
A Prospective Study ◽  
New Onset

Background:Reactive arthritis (ReA) is an emerging arthritis after viral infection especially respiratory and gastrointestinal related viruses. In 2020, SARS-COV2 virus is sweeping worldwide with diverse symptoms and prolonged post-Covid manifestations in which are arthralgia and myalgia are frequently present for days and even months. Interestedly, arthritis in covid era is a part of ReA or a flare of autoimmune disease, it is challenging.(1)Objectives:Our objective was to determine the frequency of musculoskeletal symptoms with SARS-COV2 virus and after recovery as well as its relation to autoimmune diseases flares.Methods:A Prospective study was done on 241 patients who admitted to the Rheumatology clinic from March 2020 to January 2021, complaining from new onset of musculoskeletal symptoms. Detailed history, Examination of systems including Musculoskeletal, laboratory investigation, past history of existing rheumatic disease, and history of infection with covid 19.Results:Among 241 patients with median age 34.4, 36.92% had an existing Rheumatic disease while 63.08% are not. Moreover, 39% of patients had a post history with covid 19 within weeks. The most frequent Musculoskeletal symptoms are myalgia (74.56%), arthralgia (69.36%), and arthritis (10.78%). Furthermore, ReA (Post covid arthritis) accounted (2.07%) especially monoarthritis of Ankle (68.75%) while rheumatic diseases flares (24.48%) as well as new onset rheumatic diseases (39.68%). (p ≤0.001) patients of ReA improved on NSAID and intrarticular injection of glucocorticosteroid.Conclusion:Covid 19 is one of environmental triggers for development of rheumatic disease as well as reactive arthritis post viral infections. ReA is commonly affected the Ankle joint mainly monoarthritis and had improved on oral NSAID and intrarticular injection of Glucocorticosteroid.References:[1]Schett, G., Manger, B., Simon, D. et al. COVID-19 revisiting inflammatory pathways of arthritis. Nat Rev Rheumatol16, 465–470 (2020).Disclosure of Interests:None declared.

scholarly journals SAT0589 RISK FOR PSYCHIATRIC HOSPITALIZATION FOLLOWING A RHEUMA-RELATED HOSPITALIZATION: RESULTS FROM A CZECH NATIONWIDE, COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1253.2-1254
Author(s):  
T. Formánek ◽  
K. Mladá ◽  
M. Husakova
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Ankylosing Spondylitis ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Psychiatric Hospitalization ◽  
Population Based ◽  
Index Hospitalization ◽  
Increased Risk ◽  
History Of

Background:Cohort studies using nationwide health registers have shown an increased risk for affective and anxiety disorders in people with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) (1-3). Moreover, a nationwide cohort study demonstrated an increased risk for mental disorders in people with rheumatic diseases (4).Objectives:We aimed to investigate the risk for psychiatric hospitalization following a hospitalization for rheumatic disease.Methods:Using data from the Czech nationwide register of all-cause hospitalizations, we obtained 4 971 individuals hospitalized (index hospitalization) between 2004 and 2012 for rheumatic diseases - RA, spondyloarthritis (including AS, psoriatic arthritis and undifferentiated spondyloarthritis), systemic lupus erythematosus and systemic sclerodermia, with no history of psychiatric and rheuma-related hospitalization in the previous 10 years from the index hospitalization. On these individuals, we randomly matched (on age, gender and year of index hospitalization) controls that were hospitalized in the same time period for a non-rheumatic disease and have no history of psychiatric and rheumatic hospitalization in the last 10 years from their index hospitalization, in the ratio of 1:5. We employed conditional logistic regression for assessing the risk for psychiatric hospitalization in the subsequent 3 years from the index hospitalization. To strengthen our results, we repeated the matching step 100 times and run the analysis on each resulting dataset separately, and pooled the results. The findings are expressed as odds ratios (OR) with 95% confidence intervals (95% CI).Results:We identified an elevated risk for psychiatric (OR = 1.34, 95% CI = 1; 1.78) and for affective disorders (OR = 2.19, 95% CI = 1.17; 4.1) in people hospitalized for rheumatic diseases. We did not find a statistically significant association with organic, psychotic and anxiety disorders.Conclusion:There is an increased risk for experiencing a psychiatric disorder in the period of 3 years after a rheuma-related hospitalization.References:[1]Shen C-C, Hu L-Y, Yang AC, Kuo BI-T, Chiang Y-Y, Tsai S-J. Risk of Psychiatric Disorders following Ankylosing Spondylitis: A Nationwide Population-based Retrospective Cohort Study. The Journal of Rheumatology. 2016;43(3).[2]Park J-S, Jang H-D, Hong J-Y, Park Y-S, Han K, Suh S-W, et al. Impact of ankylosing spondylitis on depression: a nationwide cohort study. Scientific Reports. 2019;9(1):6736.[3]Hsu C-C, Chen S-C, Liu C-J, Lu T, Shen C-C, Hu Y-W, et al. Rheumatoid Arthritis and the Risk of Bipolar Disorder: A Nationwide Population-Based Study. PLOS ONE. 2014;9(9).[4]Sundquist K, Li X, Hemminki K, Sundquist J. Subsequent Risk of Hospitalization for Neuropsychiatric Disorders in Patients With Rheumatic Diseases: A Nationwide Study From Sweden. Archives of General Psychiatry. 2008;65(5):501-7.Acknowledgments:Supported by the project (Ministry of Health Czech Republic) for conceptual development of research organization 00023728 (Institute of Rheumatology).Disclosure of Interests:Tomáš Formánek: None declared, Karolina Mladá: None declared, Marketa Husakova Speakers bureau: Novartis

scholarly journals P733 Past history of bariatric surgery associated with increased risk of new onset inflammatory bowel disease

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S455-S456 ◽  
Author(s):  
R. Ungaro ◽  
H. Chang ◽  
L. Roque Ramos ◽  
R. Fausel ◽  
J. Torres ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Past History ◽  
Increased Risk ◽  
History Of ◽  
Inflammatory Bowel ◽  
New Onset

scholarly journals EP09 COVID-19 and rheumatic disease clinical characteristics and outcomes of rheumatic disease patients hospitalised with COVID-19: a single centre experience

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Myrto Cheila ◽  
Ali Elrashid ◽  
Nicola Erb ◽  
Karen Douglas ◽  
Christos Koutsianas
Keyword(s):  
Case Report ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Clinical Characteristics ◽  
Fatal Outcome ◽  
Previous History ◽  
True Incidence ◽  
Viral Spread ◽  
Increased Risk ◽  
History Of

Abstract Case report - Introduction There is limited evidence on the outcomes of COVID-19 in patients with rheumatic diseases. Since severe COVID-19 is characterised by hyperinflammation, the effects of a pre-existing inflammatory state and immunomodulatory treatments on the disease’s course are of great interest. Even though patients in this group are perceived of being at higher risk for severe disease, most of the relevant observational studies have had controversial results. We aimed to investigate the clinical characteristics and outcomes of patients with a history of rheumatic disease and COVID-19 related admission in our centre. Case report - Case description We conducted a retrospective observational study of COVID-19 RT-PCR positive admissions of patients coded as having rheumatic disease in the Dudley Group NHS Foundation Trust between April 1st and June 24th, 2020. Data were extracted from the patient clinical notes and electronic medical records and were captured and analysed on MS Excel. Among 613 COVID-19 related admissions, 19 (3.1%) patients were coded as having comorbid rheumatic disease. 8 cases were excluded from further analysis as, upon records review, they had osteoarthritis or a history of gout. Thus, the true incidence of comorbid rheumatic disease among COVID-19 related hospitalisations was even lower at 11/613 (1.8%). The mean age of the patients was 80.5 ± 8.06 years, 9/11 (81.8%) were female and 8/11 (73%) were Caucasian. In the vast majority the diagnosis was that of Rheumatoid Arthritis (9/11, 81.8%), while one patient had Polymyalgia Rheumatica and another Systemic Lupus Erythematosus. Only a quarter of the patients had moderate (2, 18%) or high (1, 9%) disease activity on their most recent outpatient visit. In terms of antirheumatic medication, 5 (45%) patients were on regular Prednisolone (20% <5mg, 80% 5-10mg), 8 (72%) were on cs DMARDs and only 1 (9%) on bDMARDs. A substantial proportion of the patient cohort also suffered with other comorbidities. 8/11 (72.7%) patients had arterial hypertension, 5 (45.4%) had a history of cardiovascular disease, 3 (27.3%) obesity (BMI 30+), 3 (27.3%) previous history of cancer, 2 (18.2%) COPD, 2 (18.2%) CKD, 1 (9%) Interstitial lung disease, 1 (9%) Diabetes, 1 (9%) Cerebrovascular disease and 1 (9%) immunodeficiency. During their admission, 7 (63.6%) patients required supplemental oxygen therapy. Unfortunately, 5/11 (45.5%) patients had a fatal outcome. Case report - Discussion In our cohort, the percentage of patients with rheumatic diseases among inpatients with confirmed COVID-19 infection was low (∼1.8%). Potential explanations for this observation could be a beneficial effect of concomitant antirheumatic treatment (steroids and/or DMARDs) in controlling hyperinflammation, but also rheumatic disease patients’ increased risk awareness and thus increased compliance with viral spread mitigation measures (‘shielding’) as per Government guidelines. We also note the low rate of biologic DMARD use with only 1 (9%) inpatient having received Rituximab for RA. Case report - Key learning points The incidence of rheumatic disease among COVID-19 related admissions in our centre was exceptionally low. Per recently published reports from worldwide registries, older age and multiple comorbidities appear to drive the risk for hospitalisation, need for oxygen supplementation and fatal outcome. Better understanding of the effect of DMARDs on COVID-19 severity requires further investigation, perhaps with SARS-CoV-2 antibody studies, but our observations appear to be reassuring.

Zika virus (ZIKV) infection related with immune thrombocytopenic purpura (ITP) exacerbation and antinuclear antibody positivity

Lupus ◽  
2016 ◽  
Vol 26 (8) ◽  
pp. 890-892 ◽  
Author(s):  
A F Zea-Vera ◽  
B Parra
Keyword(s):  
Zika Virus ◽  
Antinuclear Antibody ◽  
Immune Thrombocytopenia ◽  
Viral Infections ◽  
Past History ◽  
Disease Onset ◽  
Zikv Infection ◽  
Antibody Positivity ◽  
History Of ◽  
Genomic Regions

A 30-year-old Colombian woman with past history of immune thrombocytopenia (ITP) presented to the emergency room with two days of global headache, arthralgia, myalgia, and low level fever and generalized erythematous rash. Platelets dropped to 9 × 109/L (fourth day of symptoms) without hemorrhagic manifestations but recovered to 30 × 109/L in 24 hours (fifth day). Dengue virus infection, as well as other viral infections, was ruled out. Zika virus (ZIKV) was evaluated in serum and urine samples by real-time reverse-transcriptase polymerase chain reaction (genomic regions within E protein and NS2b protein). Urine sample was positive and serum sample negative for ZIKV, confirming a recent ZIKV infection with urinary tract virus excretion at 7th day after disease onset. To our knowledge this is the first description of a case of severe immune thrombocytopenia exacerbation and antinuclear antibody positivity induced by ZIKV infection.

The Morbidity of Non-Operative Treatment of Possible Appendicitis

1968 ◽  
Vol 13 (3) ◽  
pp. 68-71 ◽  
Author(s):  
J. G. R. Howie
Keyword(s):  
Retrospective Study ◽  
Prospective Study ◽  
Operative Treatment ◽  
Past History ◽  
Main Criterion ◽  
Favourable Prognosis ◽  
History Of ◽  
A Prospective Study

No attempt has previously been made to assess the morbidity of non-operative treatment of possible appendicitis. This paper uses the need for appendicectomy at a later date as the main criterion of morbidity. On the basis of a prospective study of 209 patients and a retrospective study of 1,284 patients, it appears that about 25 per cent of patients admitted to hospital with possible appendicitis but not operated on, require appendicectomy at a later date. In addition, only some 57 per cent of patients treated non-operatively do not again have pain. The presence of a past history of similar pain appears to prejudice unfavourably the results of non-operative treatment. Patients who return quickly to work and are not allowed to think that they have had appendicitis are the most likely to have a favourable prognosis.

Headache Following Carotid Endarterectomy: A Prospective Study

Cephalalgia ◽  
1992 ◽  
Vol 12 (6) ◽  
pp. 380-382 ◽  
Author(s):  
Alain Djacoba Tehindrazanarivelo ◽  
Gina Lutz ◽  
Christian Petitjean ◽  
Marie-Germaine Bousser
Keyword(s):  
Prospective Study ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Past History ◽  
Cerebral Hyperperfusion Syndrome ◽  
Temporal Profile ◽  
Cerebral Hyperperfusion ◽  
History Of ◽  
Ihs Criteria ◽  
A Prospective Study

The occurrence of headache in the 28 days following surgery was studied in 50 consecutive patients (14F and 36M, mean aged 70 years) who underwent carotid endarterectomy for atheromatous carotid stenosis. Thirty-one patients (62%) reported headache. Headache occurred in the first five days after surgery in 87% of cases. Its characteristics and temporal profile were highly variable but it was mostly bilateral (74%), mild or moderate (78%), requiring no treatment (77%). No correlation was found between the occurrence of headache and degree of stenosis, intraoperative characteristics and past history of headache. In none of our patients was severe ipsilateral headache, cerebral hyperperfusion syndrome, or cluster-like hemicrania encountered and only five patients met the IHS criteria for post-endarterectomy headache. Post-endarterectomy headache is frequent when specifically looked for and is therefore not a single entity. The present IHS criteria are unsatisfactory and should be modified accordingly.

scholarly journals Clinical outcomes of ectopic pregnancy

2017 ◽  
Vol 6 (10) ◽  
pp. 4277
Author(s):  
Roopa Malik ◽  
Shaveta Jain ◽  
Nirmala Duhan ◽  
Daya Sirohiwal
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Past History ◽  
Management Strategies ◽  
Emergency Laparotomy ◽  
Mortality And Morbidity ◽  
History Of ◽  
Ectopic Pregnancies ◽  
A Prospective Study

Background: Ectopic pregnancy (EP) is a life threatening gynaecological emergency, and a significant cause of maternal mortality and morbidity worldwide. Aim of this study was to determine and evaluate the incidence, clinical presentation, risk factors, management strategies and outcome of the patients with EP.Methods: This was a prospective study of all cases of ectopic pregnancies admitted and managed at PGIMS Rohtak over a period of 1 year. All patients admitted through accident and emergency unit as well as the gynaecology clinic that were managed in gynaecological ward were included in the study. The diagnosis of EP was made by history, clinical examination, urinary pregnancy test and ultrasound examination. Patients were managed as per hospital protocol and relevant data on age, parity, clinical presentation, risk factors, management and findings at laparotomy, and the outcome of treatment were collected.Results: The incidence of ectopic pregnancy in this study was 1.056%. The mean age of the patients was 27±3 years. Of the 102 ectopic pregnancies, 86 (84.31%) were ruptured ectopic pregnancies, while 16 (15.68%) were unruptured ectopic pregnancies. The commonest clinical complaint was abdominal pain (97 of 102, 95.09%) History of previous abortion (induced or spontaneous) was the commonest risk factor (92 of 102, 90.19%) followed by past history of pelvic inflammatory disease (56 of 102, 54.90%). History of tubal surgery was present in 27 of 102 patients (26.47%). commonest surgical procedure done was emergency laparotomy followed by salpingectomy (67 of 102, 65.68%).Conclusions: EP is an important cause of maternal morbidity and mortality in early pregnancy and has remained a reproductive health challenge. Early diagnosis and treatment can improve reproductive outcomes. 

scholarly journals Assessment of epidemiological factors and clinical profiles of cerebral infarction cases in tertiary health center in southern Maharashtra and hence evaluating computed tomography as its diagnostic modality: a prospective study

2017 ◽  
Vol 5 (12) ◽  
pp. 5376
Author(s):  
Nitin Jadhav ◽  
Vikram Rode
Keyword(s):  
Computed Tomography ◽  
Cerebral Infarction ◽  
Prospective Study ◽  
Past History ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Epidemiological Factors ◽  
Healthcare Needs ◽  
History Of ◽  
A Prospective Study

Background: Cerebrovascular accidents are one of the leading causes of death in developed countries. The advent of CT in early 1970s greatly facilitated the diagnosis and management of stroke. The present study aims at assessing epidemiological factors and clinical presentation of cerebral infarction cases and hence to evaluate computed tomography as a diagnostic tool for cerebral infarction.Methods: A prospective study was carried out among cases of Cerebral infarction. Every patient was interviewed personally, and detailed history was taken followed by clinical, systemic and neurological examination. Results were analysed comparing clinical diagnosis, sites of lesions, nature of lesions and CT scan findings.Results: Cases showed male predominance with 69% cases and 31% were females. 19% cases presented with headache, 17% with convulsions and 9% with vomiting. Upon eliciting past history of cases, we found that 48% were known cases of hypertension, 23% were having past history of cerebrovascular episodes, 20% cases were smokers and tobacco chewers whereas 15% were known cases of diabetes mellitus.Conclusions: Currently India is facing double burden of communicable and non-communicable diseases, and now a day’s cases of non-communicable diseases have started increasing, following iceberg phenomenon. So, diagnosing these conditions in its initial stage and halting the disease progress will be the priority. The present study recommends a comprehensive model for non-communicable disease prevention and control based on current healthcare needs and disease scenario.

Depression and Previous Alcoholism in the Elderly

1991 ◽  
Vol 158 (1) ◽  
pp. 72-75 ◽  
Author(s):  
Brian L. Cook ◽  
George Winokur ◽  
Michael J. Garvey ◽  
Vickie Beach
Keyword(s):  
Risk Factor ◽  
Elderly Population ◽  
Bipolar Depression ◽  
Past History ◽  
Previous History ◽  
The Elderly ◽  
Response To Treatment ◽  
History Of ◽  
A Prospective Study

A prospective study of male in-patients over 55 years old who met Feighner criteria for non-bipolar depression was performed to determine if a previous history of alcoholism significantly influenced treatment or response to treatment. Among 58 subjects with complete follow-up information, the 16 who had a history of alcoholism had a presentation at index which differed from that of the non-alcoholics, and on follow-up they clearly had more chronic illness. This elderly sample with alcoholism resembles ‘neurotic-reactive’ depressives described in younger samples, and supports a past history of alcoholism as being a risk factor for chronicity of depression on follow-up in the elderly population.

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