POS0950 ARE THERE GENDER DIFFERENCES IN AXIAL SPONDYLOARTHRITIS: DATA FROM A PORTUGUESE SPONDYLOARTHRITIS COHORT

Background:Historically, axial spondyloarthritis (particularly ankylosing spondylitis) was considered a men’s disease and has been under-recognized in women.Emerging evidence reveals gender differences in patophysiology, disease presentation and therapeutic efficacy.Objectives:To determine if there are differences between genders in a Portuguese cohort of patients with axSpA as regards clinical manifestations, disease activity, functional capacity, patient related outcomes and radiographic findings.Methods:Patients with ≥18 years fulfilling the ASAS- Assessment of Spondyloarthritis International Society classification criteria for axSpA and registered in the electronic national database- Reuma.pt were included in a multicentric cross-sectional study. Sociodemographic data, clinical features and radiographic findings were collected from the first record in Reuma.pt. These variables were compared between genders using Mann-Whitney test and Chi-Square test. Variables with a significant association with group variable (gender) were considered in the multiple variable analysis to adjust the gender effect on the outcome variables.Results:A total of 1995 patients were included, 1114 (55.9%) men and 881 (44.1%) women. Men had a lower median age at onset of disease (25.1 vs 28.4, p=0.000) and median age at diagnosis (26.9 vs 30.4, p=0.000) and were more frequently smokers (32.1% vs 15.7%, p=0.000). Comparing to women, men had worse BASMI scores (4.0 vs 3.4, p=0.000), higher levels of CPR (10.5 vs 6.9, p=0.000) and were more often HLA-B27 positive (67.8% vs 54%, p=0.000). In univariable analysis, sacroiliitis on radiograph or/and MRI (95.5% vs 91.7%, p=0.04) was more common in men, however that wasn’t confirmed in multivariable analysis.In contrast, women more frequently had more inflammatory bowel disease (8.8% vs 4.9%, p=0,004), higher levels of ESR (25.0 vs 21.0, p=0.003) and worse PROs- BASDAI (5.7 vs 4.5, p=0.000), PGA (60.0 vs 55.0, p=0.000) and fatigue (6.2 vs 5.4, p=0,000).Conclusion:Physicians must be aware of differences between genders in axial spondyloarthritis because this can result in less underdiagnosis and misdiagnosis, allow optimization of treatment strategies, and decrease overall disease burden in women with axSpA patients.References:[1]Rusman T, van Vollenhoven RF, van der Horst-Bruinsma IE. Gender Differences in Axial Spondyloarthritis: Women Are Not So Lucky. Curr Rheumatol Rep. 2018;20(6):35.[2]Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort. Arthritis Care Res (Hoboken). 2013;65(9):1482-9.Disclosure of Interests:None declared

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Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽

10.1177/09612033211014253 ◽

2021 ◽

pp. 096120332110142

Author(s):

Tamer A Gheita ◽

Rasha Abdel Noor ◽

Esam Abualfadl ◽

Osama S Abousehly ◽

Iman I El-Gazzar ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Age Of Onset ◽

Wide Spectrum ◽

Age At Onset ◽

Disease Onset ◽

Clinical Manifestations ◽

Population Based ◽

Systemic Lupus ◽

Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

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Oromandibular Dystonia: A Clinical Examination of 2,020 Cases

Frontiers in Neurology ◽

10.3389/fneur.2021.700714 ◽

2021 ◽

Vol 12 ◽

Author(s):

Laura M. Scorr ◽

Stewart A. Factor ◽

Sahyli Perez Parra ◽

Rachel Kaye ◽

Randal C. Paniello ◽

...

Keyword(s):

Clinical Features ◽

Age At Onset ◽

Treatment Strategies ◽

Oromandibular Dystonia ◽

Cross Sectional ◽

Psychiatric Disturbances ◽

Segmental Dystonia ◽

Expert Center ◽

Sectional Analysis ◽

Botulinum Toxin Injections

Objective: The goal of this study is to better characterize the phenotypic heterogeneity of oromandibular dystonia (OMD) for the purpose of facilitating early diagnosis.Methods: First, we provide a comprehensive summary of the literature encompassing 1,121 cases. Next, we describe the clinical features of 727 OMD subjects enrolled by the Dystonia Coalition (DC), an international multicenter cohort. Finally, we summarize clinical features and treatment outcomes from cross-sectional analysis of 172 OMD subjects from two expert centers.Results: In all cohorts, typical age at onset was in the 50s and 70% of cases were female. The Dystonia Coalition cohort revealed perioral musculature was involved most commonly (85%), followed by jaw (61%) and tongue (17%). OMD more commonly appeared as part of a segmental dystonia (43%), and less commonly focal (39%) or generalized (10%). OMD was found to be associated with impaired quality of life, independent of disease severity. On average, social anxiety (LSA score: 33 ± 28) was more common than depression (BDI II score: 9.7 ± 7.8). In the expert center cohorts, botulinum toxin injections improved symptom severity by more than 50% in ~80% of subjects, regardless of etiology.Conclusions: This comprehensive description of OMD cases has revealed novel insights into the most common OMD phenotypes, pattern of dystonia distribution, associated psychiatric disturbances, and effect on QoL. We hope these findings will improve clinical recognition to aid in timely diagnosis and inform treatment strategies.

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The Dark Side of Healthy Eating: Links between Orthorexic Eating and Mental Health

Nutrients ◽

10.3390/nu12123662 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3662

Author(s):

Jana Strahler

Keyword(s):

Mental Health ◽

Gender Differences ◽

Healthy Eating ◽

Treatment Strategies ◽

Dark Side ◽

Dimensional Structure ◽

Targeted Prevention ◽

Negative Consequences ◽

Cross Sectional ◽

Significant Impairment

Orthorexia nervosa (OrNe) describes a behavior where eating overly healthy develops into an obsession leading to significant impairment and stress. Initial studies support a bi-dimensional structure of orthorexic eating with one dimension healthy orthorexia (HeOr, interest in healthy eating), which can be distinguished from the dimension OrNe. The present study pursued the goals to examine the negative consequences of OrNe on mental health, whether HeOr buffers these effects, and the role of gender. Data from two cross-sectional online surveys were combined (study 1 n = 385, 310 women; study 2 n = 398, 265 women; mean age: 28.9 ± 12.0 year) both generating data on psychological wellbeing, life satisfaction, stress, anxiety, and depressive symptoms in relation to OrNe and HeOr (Teruel Orthorexia Scale). By means of correlation and moderation analyses, OrNe was shown to be associated with poorer mental health, especially in the female sample. In terms of HeOr, clear gender differences appeared. There were no meaningful correlations in women. In men, however, HeOr correlated with better mental health. Further, the link between OrNe and poorer mental health was mitigated when there were high HeOr levels. Present findings support the hypotheses that OrNe is associated with pathological consequences and that HeOr may act as a buffer for these consequences. Gender differences in the clinical manifestation of orthorexic eating confirm previous knowledge and have important implications for targeted prevention and treatment strategies.

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Proprotein Convertase Subtilisin/Kexin Type 9 in the Inflammation-Related Dyslipidemia of Patients with Axial Spondyloarthritis is Related to Disease Activity.

10.21203/rs.3.rs-21063/v1 ◽

2020 ◽

Author(s):

Laura de Armas-Rillo ◽

Juan Carlos Quevedo-Abeledo ◽

Antonia de Vera-González ◽

Alejandra González-Delgado ◽

José A. García-Dopico ◽

...

Keyword(s):

Cardiovascular Risk ◽

Disease Activity ◽

Lipid Profile ◽

Axial Spondyloarthritis ◽

Cholesterol Metabolism ◽

Multivariable Analysis ◽

Serum Levels ◽

Proprotein Convertase ◽

Cross Sectional ◽

Lipid Panel

Abstract Introduction: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a serine protease that regulates cholesterol metabolism through low-density lipoprotein receptor degradation and that has been linked to cardiovascular risk. The purpose of the present study was to examine whether PCSK9 levels are related to both abnormalities in the lipid profile and the development of severe atherosclerosis that often occurs in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study that encompassed 545 individuals; 299 patients with axSpA and 246 statin use-matched controls. PCSK9, lipoproteins serum concentrations and standard lipid profiles were analyzed in patients and controls. Carotid intima-media thickness (cIMT) and carotid plaques were assessed in patients. A multivariable analysis, adjusted for standard cardiovascular risk factors, was performed to evaluate the influence of PCSK9 on axSpA related dyslipidemia and subclinical carotid atherosclerosis.Results: Most lipid panel parameters (total cholesterol, HDL- and LDL-cholesterol, lipoprotein (a) and apoliprotein A1) were significantly lower in axSpA patients than controls. PCSK9 serum levels (beta coef. -44 [95%CI -60- -27] ng/dl, p=0.000) were also downregulated in axSpA patients after fully multivariate adjustment, including other lipid profile-related molecules modifications that the disease generates. Unadjusted higher levels of PCSK9 were associated with carotid plaque in axSpA patients (beta coef. 27 [95%CI 9-45], p=0.003). ASDAS-CRP was found to be independently and significantly related to PCSK9 (beta coef. 10 [95%CI 1-18] ng/dl, p=0.023) after analyzing fully adjusted models that took age, sex, and the rest of lipid profile molecules into account. Whereas patients taking prednisone showed higher serum levels of PCSK9 (55 [95%CI 24-8]) ng/ml, p=0.001), those under anti-TNF alpha therapies exhibited lower levels (beta coef. -26 [95%CI -43- -9], p=0.003).Conclusion: PCSK9 is downregulated in patients with axSpA. Disease activity is positive and significantly related to PSCK9. Anti-TNF-therapy yields reduction in PCSK9 serum levels.

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Perceived Voice Disorders in Older Adults and Impact on Social Interactions

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00059 ◽

2021 ◽

pp. 1-8

Author(s):

Connie K. Porcaro ◽

Clare Singer ◽

Boris Djokic ◽

Ali A. Danesh ◽

Ruth Tappen ◽

...

Keyword(s):

Older Adults ◽

Social Interactions ◽

Social Engagement ◽

Leisure Activities ◽

Treatment Strategies ◽

Voice Disorders ◽

Community Dwelling ◽

Vocal Performance ◽

Older Individuals ◽

Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

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THE CLINICAL, LABORATORY MANIFESTATIONS AND HISTOPATHOLOGY IN NEPHROTIC PATIENTS WITH LUPUS NEPHRITIS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.2.9 ◽

2018 ◽

pp. 52-58

Author(s):

Le Thuan Nguyen ◽

Bui Bao Hoang

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Nephritis ◽

Lupus Erythematosus ◽

Clinical Laboratory ◽

Activity Index ◽

Clinical Manifestations ◽

Systemic Lupus ◽

Cross Sectional ◽

Organ Systems ◽

Tubulointerstitial Lesions

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical

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Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.05.10937 ◽

2020 ◽

Vol 103 (5) ◽

pp. 465-471

Keyword(s):

Clinical Manifestations ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

Sectional Study ◽

Close Attention ◽

Cross Sectional ◽

Factors Associated ◽

Present Cross Sectional Study ◽

Important Health ◽

Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

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Using Naïve Bayes Algorithm to Estimate the Response to Drug in Lung Cancer Patients

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207322666190125151624 ◽

2019 ◽

Vol 21 (10) ◽

pp. 734-748 ◽

Cited By ~ 2

Author(s):

Baoling Guo ◽

Qiuxiang Zheng

Keyword(s):

Lung Cancer ◽

Side Effects ◽

Cancer Patients ◽

Drug Response ◽

Treatment Options ◽

Clinical Manifestations ◽

Treatment Strategies ◽

Cancer Resistance ◽

Lung Cancer Patients ◽

Bayes Algorithm

Aim and Objective: Lung cancer is a highly heterogeneous cancer, due to the significant differences in molecular levels, resulting in different clinical manifestations of lung cancer patients there is a big difference. Including disease characterization, drug response, the risk of recurrence, survival, etc. Method: Clinical patients with lung cancer do not have yet particularly effective treatment options, while patients with lung cancer resistance not only delayed the treatment cycle but also caused strong side effects. Therefore, if we can sum up the abnormalities of functional level from the molecular level, we can scientifically and effectively evaluate the patients' sensitivity to treatment and make the personalized treatment strategies to avoid the side effects caused by over-treatment and improve the prognosis. Result & Conclusion: According to the different sensitivities of lung cancer patients to drug response, this study screened out genes that were significantly associated with drug resistance. The bayes model was used to assess patient resistance.

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Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

Current Pediatric Reviews ◽

10.2174/1573396316666200116093753 ◽

2020 ◽

Vol 16 (3) ◽

pp. 241-247

Author(s):

Atifete Ramosaj-Morina ◽

Alije Keka-Sylaj ◽

Arbana Baloku Zejnullahu ◽

Lidvana Spahiu ◽

Virgjina Hasbahta ◽

...

Keyword(s):

Celiac Disease ◽

Disease Onset ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Dominant Mode ◽

Primary School Children ◽

Cross Sectional ◽

Classical Form ◽

Wide Range ◽

The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

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Comparison of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondyltis from a Single Rheumatology Hospital in Morocco

Current Rheumatology Reviews ◽

10.2174/1573397115666190222195923 ◽

2020 ◽

Vol 16 (3) ◽

pp. 240-244 ◽

Cited By ~ 2

Author(s):

Nessrine Akasbi ◽

Siar Nihad ◽

Zoukal Sofia ◽

El Kohen Khadija ◽

Harzy Taoufik

Keyword(s):

Disease Burden ◽

Axial Spondyloarthritis ◽

Univariate Analysis ◽

Cross Sectional Study ◽

Low Back ◽

New Classification ◽

Cross Sectional ◽

Asas Criteria ◽

History Of ◽

High Level

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.

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