AB0442 CLINICAL FEATURES OF POLYMYOSITIS AND DERMATOMYOSITIS PATIENTS WITH SEVERE DYSPHAGIA

Background:Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases characterized by proximal myositis. Dysphagia has been reported to develop in 35 to 62% of PM/DM patients and known as poor prognosis factor.Objectives:The purpose of this study is to determine the clinical characteristics of PM/DM patients who present with deglutition disorder.Methods:Consecutive patients with PM/DM who visited National Hospital Organization Tokyo Medical Center between April 2010 and January 2021 are included in this study. We compared clinical features between the patients with and without dysphagia. The diagnosis of dysphagia was based on videofluorography swallow study, and dysphagia requiring gastrostomy was defined as severe dysphagia. The clinical characteristics compared in this study were following: age of onset, levels of serum creatine kinase (CK) and lactate dehydrogenase(LDH), sense of dysphagia, manual muscle test (MMT) score, and complication of malignancy or interstitial pneumonia.Results:A total of 73 patients with PM/DM were identified. Among them, 12 patients were diagnosed with dysphagia, and 5 patients developed severe dysphagia. Patients with dysphagia had the following characteristics compared to patients without dysphagia: higher levels of serum LDH (833.7 ± 500.1 U/L vs 471.9 ± 321.0 U/L, p = 0.0088), higher levels of serum CK at initial examination (6070.3 ± 7184.8 IU/L vs 1534.7 ± 2978.8 IU/L, p = 0.0086) and more frequent sense of dysphagia (90.9% vs 10.6%, p< 0.0001), lower MMT score(3.18 ± 1.07 vs 4.31 ± 0.75, p = 0.0017). In addition to those, patients with severe dysphagia presented older age of onset (mean age 69.4 ± 12.0 vs 51.7 ± 14.8, p = 0.014), more frequent complication of malignancy (80.0% vs 14.8%, p= 0.0048) and less frequent complication of interstitial pneumonia (0.0% vs 55.5%, p= 0.023).Conclusion:These results indicate that dysphagia develops frequently in PM/DM patients with higher levels of serum LDH or CK, sense of dysphagia and low MMT score. Among them, patients with elderly onset or malignancy are at risk for sever dysphagia, and should be treated carefully.Disclosure of Interests:None declared.

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Prevalence, clinical features and treatment pattern of patients with concurrent diagnoses of rheumatoid arthritis and psoriatic disease: results of a 14-year retrospective study in a tertiary referral center

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622319847900 ◽

2019 ◽

Vol 10 ◽

pp. 204062231984790

Author(s):

Kai-Lung Chen ◽

Hsien-Yi Chiu ◽

Jui-Hsiang Lin ◽

Jian-De Ye ◽

Yi-Hsuan Cho ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Features ◽

Age Of Onset ◽

Medical Center ◽

Skin Lesions ◽

Tertiary Referral ◽

Female Ratio ◽

Tertiary Referral Center ◽

Referral Center ◽

Psoriatic Disease

Background: Multiple comorbidities, including rheumatoid arthritis (RA), have been reported to be associated with psoriasis. Objective: This study aimed to determine the prevalence and the clinical features of RA among patients with psoriasis in a tertiary referral center. Methods: Between January 2000 and December 2013, all patients coded with psoriatic disease (ICD-9 CM 696.0 OR ICD-9 CM696.1) and RA (ICD-9 CM 714.0) in a tertiary medical center were enrolled. Results: There were 10,844 patients and 9073 patients with psoriatic disease and RA identified by diagnostic codes, respectively. Among patients with psoriasis, 111 patients had claim-based diagnosis of RA (1.02%). By reviewing medical records and telephone interview or clinic visits, 25 of the 111 patients (0.23%) was identified unequivocally as having concurrent RA. Among them, 17 (68%) were female and 16 (64%) patients developed arthritis prior to the onset of psoriasis with a mean lag of 6.3 years (1–19 years); 8 (32%) had psoriasis skin lesions prior to the onset of arthritis with a mean lag of 6.9 years (3–20 years); 1 (4%) had skin lesions and arthritis in the same time; 17 (68%) patients also fulfilled the CASPAR classification criteria for psoriatic arthritis. The mean age of onset for arthritis was 49.6 years old. Conclusions: The prevalence of RA in psoriasis might be overestimated in some previous studies using claimed database. Patients with concurrent RA and psoriasis showed a comparable age of onset and male to female ratio, but had more axial involvements compared to patients without psoriasis.

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Etiologies and Clinical Characteristics of Patients with Macular Hole: A 8-Years Single-Center Retrospective Study

10.21203/rs.3.rs-969062/v1 ◽

2021 ◽

Author(s):

Huifang Yue ◽

Chenyu Liu ◽

Yunda Zhang ◽

Lijuan Zhang ◽

Zhao Gao ◽

...

Keyword(s):

Retrospective Study ◽

Correlation Analysis ◽

Macular Hole ◽

Clinical Features ◽

Clinical Characteristics ◽

Age Of Onset ◽

Related Factors ◽

Multivariate Correlation ◽

Younger Age ◽

Multivariate Correlation Analysis

Abstract Background: To investigate the etiologies and clinical characteristics of full-thickness macular hole (FTMH) patients at Shanxi eye hospital of North China. Methods: Patients diagnosed with FTMH and treated with surgery from 2012 to 2020 were included, and the etiologies and clinical features of different types of MHs were analysed in the 8-years cross sectional retrospective study. Multivariate correlation analysis was used to predict the related factors affecting baseline vision.Results: A total of 752 cases (776 eyes) were analysed. The top three causes of MH were idiopathic (IMH, 64.4%), myopic (MMH, 21.1%) and traumatic (TMH, 3.7%). Among these three causes’ groups, there were significant differences in sex distribution, age, and baseline BCVA. Female was predominated in IMH and MMH, while it was the opposite in TMH. The age of onset in IMH was older than MMH and TMH. The baseline Logarithm of the Minimum Angle of Resolution (logMAR) best-corrected visual acuity (BCVA) in IMH (Z=8.9, p<0.001) and Others group (Z=4.0, p<0.001) were significantly better than in MMH. In IMH, female patients had younger age, shorter axial length, and poorer baseline BCVA than male, while in MMH there were no significant differences between sexes. Multivariate correlation analysis showed that the smaller hole diameter of IMH, MMH without retinal detachment and younger age in TMH, may resulted in better baseline BCVA. Conclusions: The most common etiologies in MH were idiopathic, myopic and traumatic, which contributed to the different clinical features. Female was more common in IMH and MMH, and patients with MMH were 6.5 years earlier than IMH in onset. Therefore earlier monitoring fundus for female and people with high myopia is helpful for early detection and timely treatment.

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Clinical and epidemicological characteristics of acute rinosinusite by medical document recommended by multidisciplinary polyclinics

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2018-2-24 ◽

2018 ◽

pp. 24-31

Author(s):

Al Hariri Mahmoud Jomaa ◽

S Semenenko ◽

A Semenenko ◽

Sergey Zaikov

Keyword(s):

Statistical Analysis ◽

Medical Care ◽

Disease Duration ◽

Inflammatory Diseases ◽

Medical Center ◽

Duration Of Treatment ◽

Acute Rhinosinusitis ◽

Diagnostic Center ◽

Gender And Age ◽

Clinical Variant

Introduction. Despite the world practice, the problem of inflammatory diseases of the paranasal sinuses is still relevant and has an important social meaning. Despite the fact that rhinosinusitis is one of the most common diseases, the reisvery little accurate data on its epidemiology. Therefore, our goal was to conduct a clinical epidemiological analysis with the establishment of the role of rhinosinusitis in the structure of requests for medical care in multidisciplinary polyclinics. Materials and methods. The data on the prevalence of various forms of sinusitis in the structure of ambulatory-polyclinic patients in the period 2011-2015 have been studied. In patients with acute rhinosinusitis, the following parameters were analyzed: gender and age of patients, duration, clinical variant of the disease, duration of treatment. Results. A clinical and statistical analysis of medical aid appeals at the level of the multidisciplinary outpatient clinic of the Vinnytsia City Clinical Hospital of ambulatory care and the Communal Medical Center "City Medical and Diagnostic Center" of Vinnytsia during 2011-2015. A statistical analysis based on the criterion approach included 896 patients with rinosunsitis. The following parameters have been analyzed: gender and age of patients, duration, clinical variant of the disease, duration of treatment. The conducted researches indicate that in the structure of appeals to the otolaryngologist rhinosinusitis is dominated by acute rhinosinusitis, the frequency of which remained relatively stable for five consecutive years: 133 cases - in 2011, 143 in 2012, 168 in 2013, 150 and 151 in 2014 and 2015, respectively. Among ambulatory polyclinic patients with different clinical variants of sinusitis prevailing persons of young working age. In general, patients with acute bacterial rhinosinusitis in the age group up to 60 years old make up 90.6%, which emphasizes the socioeconomic significance of this pathology. The frequency of treatment with rhinosinusitis is dominated by maxillary sinus lesions. The median duration of treatment was greatest in the case of hemi-sinusitis and polysynytes – 11.27±3.69 and 11.23±3.99 days, respectively, and the lowest in patients with frontal lobe was 9.48±3,76 days (p=0.032). A reduction in the mean duration of treatment for patients during the last three years of observation was observed (p<0.001). Conclusions: The study of the main clinical and epidemiological indicators of rhinosinusitis in the Ukrainian population can be the basis for the in for medplanning of medical care and social activities for this category of otolaryngological patients.

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Ketamine Treatment in Depression: A Systematic Review of Clinical Characteristics Predicting Symptom Improvement

Current Topics in Medicinal Chemistry ◽

10.2174/1568026620666200423094423 ◽

2020 ◽

Vol 20 (15) ◽

pp. 1398-1414 ◽

Cited By ~ 2

Author(s):

Darby J.E. Lowe ◽

Daniel J. Müller ◽

Tony P. George

Keyword(s):

Clinical Features ◽

Clinical Characteristics ◽

Bipolar Depression ◽

Antidepressant Effect ◽

Future Research ◽

Symptom Improvement ◽

Randomized Controlled ◽

Treatment Of Depression ◽

Future Direction

Ketamine has been shown to be efficacious for the treatment of depression, specifically among individuals who do not respond to first-line treatments. There is still, however, a lack of clarity surrounding the clinical features and response periods across samples that respond to ketamine. This paper systematically reviews published randomized controlled trials that investigate ketamine as an antidepressant intervention in both unipolar and bipolar depression to determine the specific clinical features of the samples across different efficacy periods. Moreover, similarities and differences in clinical characteristics associated with acute versus longer-term drug response are discussed. Similarities across all samples suggest that the population that responds to ketamine’s antidepressant effect has experienced chronic, long-term depression, approaching ketamine treatment as a “last resort”. Moreover, differences between these groups suggest future research to investigate the potential of stronger efficacy towards depression in the context of bipolar disorder compared to major depression, and in participants who undergo antidepressant washout before ketamine administration. From these findings, suggestions for the future direction of ketamine research for depression are formed.

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Acute Colonic Diverticulitis: Diagnostic Evidence, Demographic and Clinical Features in ree Practice Settings

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.234.acdd ◽

2014 ◽

Vol 23 (4) ◽

pp. 379-386 ◽

Cited By ~ 6

Author(s):

Rajan Iyer ◽

George F. Longstreth ◽

Li-Hao Chu ◽

Wansu Chen ◽

Linnette Yen ◽

...

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Clinical Features ◽

Clinical Characteristics ◽

Past History ◽

Colonic Diverticulitis ◽

Co Morbidity ◽

Objective Evidence ◽

Multiple Variables ◽

Acute Colonic Diverticulitis

Background & Aims: Diverticulitis is often diagnosed in outpatients, yet little evidence exists on diagnostic evidence and demographic/clinical features in various practice settings. We assessed variation in clinical characteristics and diagnostic evidence in inpatients, outpatients, and emergency department cases and effects of demographic and clinical variables on presentation features.Methods: In a retrospective cohort study of 1749 patients in an integrated health care system, we compared presenting features and computed tomography findings by practice setting and assessed independent effects of demographic and clinical factors on presenting features.Results: Inpatients were older and more often underweight/normal weight and lacked a diverticulitis past history and had more comorbidities than other patients. Outpatients were most often Hispanic/Latino. The classical triad (abdominal pain, fever, leukocytosis) occurred in 78 (38.6%) inpatients, 29 (5.2%) outpatients and 34 (10.7%) emergency department cases. Computed tomography was performed on 196 (94.4%) inpatients, 110 (9.2%) outpatients and 296 (87.6%) emergency department cases and was diagnostic in 153 (78.6%) inpatients, 62 (56.4%) outpatients and 243 (82.1%) emergency department cases. Multiple variables affected presenting features. Notably, female sex had lower odds for the presence of the triad features (odds ratio [95% CI], 0.65 [0.45-0.94], P<0.05) and increased odds of vomiting (1.78 [1.26-2.53], P<0.01). Patients in age group 56 to 65 and 66 or older had decreased odds of fever (0.67 [0.46-0.98], P<0.05) and 0.46 [0.26-0.81], P<0.01), respectively, while ≥1 co-morbidity increased the odds of observing the triad (1.88 [1.26-2.81], P<0.01).Conclusion: There was little objective evidence for physician-diagnosed diverticulitis in most outpatients. Demographic and clinical characteristics vary among settings and independently affect presenting features.Abbreviations: AD: acute colonic diverticulitis; BMI: body mass index; CT: computed tomography; ED: emergency department; IBS: irritable bowel syndrome; ICD-9-CM: International Classification of Diseases, 9th Revision, Clinical Modification; IP: inpatient; KPSC: Kaiser Permanente Southern California; OP: outpatient.

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Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

BMC Geriatrics ◽

10.1186/s12877-021-02261-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sunny Singhal ◽

Pramod Kumar ◽

Sumitabh Singh ◽

Srishti Saha ◽

Aparajit Ballav Dey

Keyword(s):

Systematic Review ◽

Older Adults ◽

Critically Ill ◽

Clinical Features ◽

Older Patients ◽

Clinical Characteristics ◽

Meta Analysis ◽

Severe Infection ◽

Factors Affecting ◽

Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

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Clinical characteristics of inpatients with coronavirus disease 2019 (COVID-19) in Sichuan province

BMC Infectious Diseases ◽

10.1186/s12879-021-05825-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wen Wang ◽

Lei Chen ◽

Qiao He ◽

Mingqi Wang ◽

Mei Liu ◽

...

Keyword(s):

Mechanical Ventilation ◽

Clinical Features ◽

Medical Records ◽

Clinical Characteristics ◽

Sichuan Province ◽

Chest Ct ◽

Shortness Of Breath ◽

Course Of Disease ◽

West China ◽

Radiologic Abnormality

Abstract Background The outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients. Methods Patients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared. Results Of the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P < 0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046). Conclusions The symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.

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Toxoplasma gondii Infection and Clinical Characteristics of Patients With Schizophrenia: A Systematic Review and Meta-analysis

Schizophrenia Bulletin Open ◽

10.1093/schizbullopen/sgaa042 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Arjen L Sutterland ◽

David A Mounir ◽

Juul J Ribbens ◽

Bouke Kuiper ◽

Tom van Gool ◽

...

Keyword(s):

Systematic Review ◽

Toxoplasma Gondii ◽

Publication Bias ◽

Clinical Characteristics ◽

Negative Symptoms ◽

Age Of Onset ◽

Meta Analysis ◽

Random Effects Models ◽

Duration Of Illness ◽

Toxoplasma Gondii Infection

Abstract Schizophrenia is associated with an increased prevalence of IgG antibodies against Toxoplasma gondii (T. gondii seropositivity), whereby the infection seems to precede the disorder. However, it remains unclear whether a T. gondii infection affects clinical characteristics of schizophrenia. Therefore, a systematic review and meta-analysis was conducted following PRISMA guidelines examining the association between T. gondii seropositivity and severity of total, positive, or negative symptoms or age of onset in schizophrenia. PubMed, Embase, and PsycInfo were systematically searched up to June 23, 2019 (PROSPERO #CRD42018087766). Random-effects models were used for analysis. Furthermore, the influence of potential moderators was analyzed. Indications for publication bias were examined. From a total of 934 reports, 13 studies were included. No overall effect on severity of total, positive, or negative symptoms was found. However, in patients with a shorter duration of illness T. gondii seropositivity was associated with more severe positive symptoms (standardized mean difference [SMD] = 0.32; P < .001). Similar but smaller effects were seen for total symptoms, while it was absent for negative symptoms. Additionally, a significantly higher age of onset was found in those with T. gondii seropositivity (1.8 y, P = .015), although this last finding was probably influenced by publication bias and study quality. Taken together, these findings indicate that T. gondii infection has a modest effect on the severity of positive and total symptoms in schizophrenia among those in the early stages of the disorder. This supports the hypothesis that T. gondii infection is causally related to schizophrenia, although more research remains necessary.

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Clinical Features Of Patients With Acute And Subacute Interstitial Pneumonia

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a2939 ◽

2010 ◽

Author(s):

Makiko Anzai ◽

Yasutsugu Fukushima ◽

Hirokuni Hirata ◽

Naruo Yoshida ◽

Kuniyoshi Kamiya ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Clinical Features

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Multiple sclerosis in Kenya: Demographic and clinical characteristics of a registry cohort

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/20552173211022782 ◽

2021 ◽

Vol 7 (2) ◽

pp. 205521732110227

Author(s):

Imran Jamal ◽

Jasmit Shah ◽

Peter Mativo ◽

Juzar Hooker ◽

Mitchell Wallin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Symptom Onset ◽

Clinical Characteristics ◽

Age Of Onset ◽

Sub Saharan Africa ◽

University Hospital ◽

Tertiary Referral Hospital ◽

Female Ratio ◽

Sub Saharan ◽

Neuro Imaging

Background Multiple Sclerosis (MS) is the leading cause of non-traumatic neurological disability in young adults. There is limited literature regarding the burden of MS in sub-Saharan Africa (SSA). Objective To describe the demographic and clinical characteristics of patients with MS (PwMS) presenting to a tertiary referral hospital in Nairobi. Methods We conducted a retrospective descriptive study for PwMS presenting to Aga Khan University Hospital, Nairobi from 2008–2018. Results 99 cases met the diagnostic criteria for MS with a male to female ratio of 1:4. Majority (68.7%) of PwMS were indigenous Africans with a mean age of onset of 30.7 years. Mean duration from symptom onset to first neuro-imaging was 5.04 years. Only 33% of patients had sensory symptoms at onset whereas 54.5% had vitamin D deficiency/insufficiency. Majority (79.5%) had relapsing remitting MS (RRMS) and 56.6% were initiated on disease modifying therapy (DMT). Only 21.2% of patients on DMT were non-compliant. Patients with RRMS were more likely to be initiated on DMT at our hospital (p < 0.001). Conclusion Clinical characteristics of these patients largely resemble those of other SSA cohorts and African American patients. There was a delay between symptom onset and neuroimaging. There were also issues with DMT compliance.

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