scholarly journals AB0474 THE USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) IN WOMEN WITH ANKYLOSING SPONDYLITIS (AS) DURING PREGNANCY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1264.2-1265
Author(s):  
O. Krichevskaya ◽  
T. Dubinina ◽  
E. Ilinykh ◽  
S. Glukhova ◽  
A. Demina
Keyword(s):  
New York ◽  
Back Pain ◽  
Nsaid Therapy ◽  
International Studies ◽  
Average Daily Dose ◽  
Time Data ◽  
The Third ◽  
Increased Risk ◽  
Daily Dose ◽  
Adherence To Therapy

Background:NSAIDs remain the first-line drugs in treatment of AS. During pregnancy, COX-2 non-selective NSAIDs are allowed for intake up to 32 weeks, but the question of the dose-dependent effect of NSAIDs on fetal organogenesis in the 1st trimester and on fetal kidney function and the increased risk of bleeding in childbirth when taken in the second half of pregnancy continues to be discussed. At the same time, data on the effectiveness of NSAIDs, including their low and medium doses, during pregnancy are extremely small.Objectives:to describe the frequency of using NSAIDs during pregnancy, to determine relationship between the dose of NSAIDs, adherence to therapy with the activity of AS.Methods:50 pregnancies were followed in 49 pregnant women with confirmed AS (modified New York criteria, 1984). The average age of the pts was 31.6 ± 4.9 years, the duration of the disease was 134.4 ± 85.8 months. The visits were conducted at 10-11, 20-21, and 31-32 weeks of pregnancy. The BASDAI in the month of conception and in the trimesters (trim.) of pregnancy was: 1,4[0,6; 3,3]; 2,3[1,2; 4,4]; 2,8[1,4; 4,2] and 2,2[1,6; 4,0], respectively. The level of nocturnal back pain according to the NRS in the first, second and third trim. was: 3.2±2.0; 5.4±2.5 and 5.2±2.6, respectively. The drug of choice was ibuprofen at a maximum daily dose of 1200 mg, its withdrawal - no later than 32 weeks of pregnancy.Adherence to NSAID therapy was defined as the ratio of the actual dose taken to the prescribed dose; an indicator of less than 80% was regarded as non-adherence to therapy. The total dose of NSAIDs was determined by the NSAID intake index (M. Dougados, 2001). The” actual daily dose” of ibuprofen was the sum of the doses of ibuprofen taken, divided by the number of actual days of taking the drug. The “average daily dose” was defined as the sum of the ibuprofen doses taken, divided by the number of days in the trimester.Results:At the time of conception and in the first, second and third trim. of pregnancy, NSAIDs were taken 23 (46%), 20 (40%), 30 (60%) and 21 (43.8%) women, respectively. The NSAID intake index, the actual and average daily dose of ibuprofen are shown in the Table 1.month of conceptiontrim. 1trim. 2trim. 3the actual daily dose, mg-700[425; 800]800[400; 1000]750[400; 1200]the average daily dose, mg-158[87,9; 307,7]355,1[138,5; 685,7]580[320; 1200]NSAIDs intake index28,6 [16,7; 50]5,8 [2,9; 11,8]15,5 [4,7; 30,9]24,4 [9,5; 50]The index of NSAID intake in the first trim. was lower than before pregnancy and in the second half of gestation (p<0.05 compared to the month of conception, II and III trim.). The average daily dose of ibuprofen was also lower in the first trim. than in the second and third trim. (p<0.05), while the actual daily dose in the second trim. was higher than in the first and third trim. (p<0.05 in all cases).There was no correlation between BASDAI AS activity, the level of nocturnal pain and the ibuprofen intake index, likewise the fact of NSAID withdrawal throughout pregnancy. In addition, there were no differences in BASDAI levels and back pain in women with a subjective need for NSAIDs, who did and did’t take ibuprofen.50% of women were committed to NSAID therapy in the first trim., 43.5% in the second trim., and 67.4% in the third trim. In pts with non-adherence to NSAID therapy, the BASDAI level was higher than in those who followed the recommendations of the rheumatologist throughout pregnancy: in the first trim. – 3.8[3.4; 4.7] and 1.7[0.8; 2.2]; in the second trim. - 3[2.3; 4.6] and 1.4[0.8; 2.7]; in the third trim. - 3.1[2.1; 4.0] and 1.7[1.1; 4.0], p<0.05 in all cases. However, women with adherence > 80% were initially less active and NSAIDs were prescribed “on demand”, which increased their compliance.Conclusion:intake of ibuprofen in low doses does not affect the activity of AS. Due to the ongoing discussion about the effect of NSAIDs on neonatal outcomes, further international studies are required for development an optimal treatment regimen during pregnancy with a possible extension of the indications for the appointment of TNF inhibitors (BASDAI<4).Disclosure of Interests:None declared.

scholarly journals Back pain in pregnant women attending an antenatal clinic in KwaZulu-Natal, South Africa

2021 ◽  
Vol 26 ◽  
Author(s):  
Carmen Hawker ◽  
Laura O'Connor ◽  
Poovendhree Reddy ◽  
Firoza Haffejee ◽  
Maureen N. Sibiya ◽  
...  
Keyword(s):  
Back Pain ◽  
Pregnant Women ◽  
South African ◽  
Negative Impact ◽  
Resource Poor Setting ◽  
Antenatal Visit ◽  
International Studies ◽  
Third Trimester ◽  
The Third ◽  
Kwazulu Natal

Background: Back pain is not uncommon in pregnant women, but it is often under-reported and can be disabling. International studies report a high prevalence of back pain, especially in the last trimester. Little is known about the prevalence of back pain in South African pregnant women.Aim: To determine the prevalence and risk factors of back pain in a cohort of pregnant womenSetting: Public primary healthcare clinics and the eThekwini municipality of KwaZulu-Natal (KZN), South AfricaMethods: A descriptive cohort design was used to survey pregnant women (n = 303) over the course of their pregnancy. Data were collected at the first antenatal visit and again in the third trimester. Participants gave consent and ethical clearance was obtained from an institutional research ethics committee, from the eThekwini Health District and KZN Provincial Department of Health.Results: The respondents were young Black African women (mean age of 25.8 (± 6.0), who were mostly unemployed (70.7%), and resided in a resource poor setting. Back pain prevalence at the first antenatal visit and the third trimester was 12.4% (n = 35) and 10.9% (n = 5), respectively. This condition was associated with carrying water and residing in a hostel or an employee’s property. Being single was associated with less risk for developing back pain.Conclusion: The prevalence of back pain was low in this cohort of women, yet it resulted in a negative impact on the women’s ability to cope with daily life.Contribution: This is one of the first studies to describe back pain in a South African pregnant population.

Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Crisis ◽  
2009 ◽  
Vol 30 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Stephanie De Munck ◽  
Gwendolyn Portzky ◽  
Kees Van Heeringen
Keyword(s):  
Young Adults ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Epidemiological Studies ◽  
Adolescents And Young Adults ◽  
University Hospital ◽  
International Studies ◽  
Suicide Attempters ◽  
Increased Risk ◽  
Epidemiological Trends

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

Optimizing adherence to therapy in patients with non-specific back pain

2016 ◽  
Vol 18 (9) ◽  
pp. 147-150 ◽  
Author(s):  
M.N. Dadasheva ◽  
◽  
N.Yu. Taranenko ◽  
Keyword(s):  
Back Pain ◽  
Adherence To Therapy

Interpersonal Violence and Substance Use Among Female Sexual Minorities

2019 ◽  
Author(s):  
Cort M. Dorn-Medeiros ◽  
Cass Dykeman ◽  
Timothy Bergquist
Keyword(s):  
New York ◽  
Tobacco Use ◽  
Interpersonal Violence ◽  
Sexual Minorities ◽  
Sample Population ◽  
Life Outcomes ◽  
City Community ◽  
Increased Risk ◽  
Significant Difference ◽  
Community Health Survey

This archived data study used results from the New York City Community Health Survey to explore the relationship between interpersonal violence among female sexual minorities (FSM) and their levels of alcohol and tobacco use. A total of 92 FSM were included in the sample population. There was a significant difference in the mean number of alcoholic drinks consumed between FSM who reported past experience of interpersonal violence and those who did not. No difference was found in levels of tobacco use between FSM who reported interpersonal violence and those who did not. Results of the present study support current research indicating FSM may be at increased risk for elevated alcohol use and respective negative life outcomes related to the experience of interpersonal violence.

Issues Surrounding the Development of the Neo-Nazi Scene in East Berlin

2000 ◽  
Vol 33 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Eric Brothers
Keyword(s):  
New York ◽  
German Democratic Republic ◽  
Democratic Republic ◽  
Third Reich ◽  
Communist Regime ◽  
The Political ◽  
Social Culture ◽  
East Berlin ◽  
The Third ◽  
The Third Reich

The rise of neo-Nazism in the capital of the former German Democratic Republic (GDR) was not inspired by a desire to recreate Hitler's Reich, but by youthful rebellion against the political and social culture of the GDR's Communist regime. This is detailed in Fuehrer-Ex: Memoirs of a Former Neo-Naxi by Ingo Hasselbach with Tom Reiss (Random House, New York, 1996). This movement, however, eventually worked towards returning Germany to its former 'glory' under the Third Reich under the guidance of 'professional' Nazis.

scholarly journals COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Alvin J. X. Lee ◽  
Karin Purshouse
Keyword(s):  
Risk Factors ◽  
Performance Status ◽  
Poor Performance ◽  
Cancer Registries ◽  
Adverse Outcomes ◽  
Smoking History ◽  
Poor Performance Status ◽  
International Studies ◽  
Patients With Cancer ◽  
Increased Risk

AbstractThe SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT—chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.

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