scholarly journals Differentiation of PSRA due to Group A and due to Nongroup A Streptococci in Patients with Early Arthritis and Elevated Antisteptolysin-O at Presentation

2009 ◽  
Vol 2009 ◽  
pp. 1-7
Author(s):  
T. L. Th. A. Jansen

A study was performed of consecutive patients presenting to a Dutch early arthritis clinic with a primary suggested diagnosis of reactive arthritis due to streptococci between April 1998 and January 2003, in a well-defined reference population consisting of 600 000 inhabitants. At 1 year after presentation out of 45 acute arthritis patients with initially an elevated antistreptolysin-O and without an alternative rheumatic diagnosis only 9 patients (20%) were not diagnosed as PSRA; 16 cases (36%) were due to NGAS, 20 cases (44%) due to GAS. The estimate of the annual incidence rate of PSRA in the Netherlands during the study was 1.26 per 100 000: 0.70 GAS-related. A diagnostic set of criteria was formulated based on the original Ayoub&Ahmed criteria by adding a serological criterium ASO/antiDNaseB ratio <1.4 and excluding a clinical criterium on chronicity/recurrency of arthritis: likelihood ratio for a positive test 7.9 [95% confidence interval (95%CI: 2.7–22.7)], for a negative test 0.06 [95%CI: 0.009–0.39].

2018 ◽  
Vol 23 (16) ◽  
Author(s):  
Mirjam J Knol ◽  
Wilhelmina LM Ruijs ◽  
Laura Antonise-Kamp ◽  
Hester E de Melker ◽  
Arie van der Ende

The annual incidence rate of serogroup W invasive meningococcal disease in the Netherlands increased from < 0.05/100,000 (n < 10) before 2015 to 0.5/100,000 (n = 80) in 2017. Most isolates (94%) belong to clonal complex 11. The incidence rate is highest among  < 5 year-olds and 15–24 year-olds. The case fatality rate was 12% (17/138) in 2015–2017. From May 2018, MenACWY vaccination replaces MenC vaccination at age 14 months and from October 2018, 13–14 year-olds are offered MenACWY vaccination.


Cephalalgia ◽  
2021 ◽  
pp. 033310242110485
Author(s):  
Wouter I Schievink ◽  
M Marcel Maya ◽  
Franklin G Moser ◽  
Paul Simon ◽  
Miriam Nuño

Background Spontaneous intracranial hypotension is diagnosed with an increasing frequency, but epidemiologic data are scarce. The aim of this study was to determine the incidence rate of spontaneous intracranial hypotension in a defined population. Methods Using a prospectively maintained registry, all patients with spontaneous intracranial hypotension residing in Beverly Hills, California, evaluated at our Medical Center between 2006 and 2020 were identified in this population-based incidence study. Our Medical Center is a quaternary referral center for spontaneous intracranial hypotension and is located within 1.5 miles from downtown Beverly Hills. Results A total of 19 patients with spontaneous intracranial hypotension were identified. There were 12 women and seven men with a mean age of 54.5 years (range, 28 to 88 years). The average annual incidence rate for all ages was 3.7 per 100,000 population (95% confidence interval [CI]: 2.0 to 5.3), 4.3 per 100,000 for women (95% CI, 1.9 to 6.7) and 2.9 per 100,000 population for men (95% CI, 0.8 to 5.1). Conclusion This study, for the first time, provides incidence rates for spontaneous intracranial hypotension in a defined population.


Author(s):  
L. Derks ◽  
◽  
S. Houterman ◽  
G. S. C. Geuzebroek ◽  
P. van der Harst ◽  
...  

Abstract Background In multiple studies, the potential relationship between daylight saving time (DST) and the occurrence of acute myocardial infarction (MI) has been investigated, with mixed results. Using the Dutch Percutaneous Coronary Intervention (PCI) registry facilitated by the Netherlands Heart Registration, we investigated whether the transitions to and from DST interact with the incidence rate of PCI for acute MI. Methods We assessed changes in hospital admissions for patients with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) undergoing PCI between 1 January 2015 and 31 December 2018. We compared the incidence rate of PCI procedures during the first 3 or 7 days after the transition with that during a control period (2 weeks before transition plus second week after transition). Incidence rate ratio (IRR) was calculated using Poisson regression. Potential gender differences were also investigated. Results A total of 80,970 PCI procedures for STEMI or NSTEMI were performed. No difference in incidence rate a week after the transition to DST in spring was observed for STEMI (IRR 0.95, 95% confidence interval (CI) 0.87–1.03) or NSTEMI (IRR 1.04, 95% CI 0.96–1.12). After the transition from DST in autumn, the IRR was also comparable with the control period (STEMI: 1.03, 95% CI 0.95–1.12, and NSTEMI: 0.98, 95% CI 0.91–1.06). Observing the first 3 days after each transition yielded similar results. Gender-specific results were comparable. Conclusion Based on data from a large, nationwide registry, there was no correlation between the transition to or from DST and a change in the incidence rate of PCI for acute MI.


BMJ ◽  
2021 ◽  
pp. n49
Author(s):  
Jeffrey J Perry ◽  
Marco L A Sivilotti ◽  
Marcel Émond ◽  
Ian G Stiell ◽  
Grant Stotts ◽  
...  

Abstract Objective To validate the previously derived Canadian TIA Score to stratify subsequent stroke risk in a new cohort of emergency department patients with transient ischaemic attack. Design Prospective cohort study. Setting 13 Canadian emergency departments over five years. Participants 7607 consecutively enrolled adult patients attending the emergency department with transient ischaemic attack or minor stroke. Main outcome measures The primary outcome was subsequent stroke or carotid endarterectomy/carotid artery stenting within seven days. The secondary outcome was subsequent stroke within seven days (with or without carotid endarterectomy/carotid artery stenting). Telephone follow-up used the validated Questionnaire for Verifying Stroke Free Status at seven and 90 days. All outcomes were adjudicated by panels of three stroke experts, blinded to the index emergency department visit. Results Of the 7607 patients, 108 (1.4%) had a subsequent stroke within seven days, 83 (1.1%) had carotid endarterectomy/carotid artery stenting within seven days, and nine had both. The Canadian TIA Score stratified the risk of stroke, carotid endarterectomy/carotid artery stenting, or both within seven days as low (risk ≤0.5%; interval likelihood ratio 0.20, 95% confidence interval 0.09 to 0.44), medium (risk 2.3%; interval likelihood ratio 0.94, 0.85 to 1.04), and high (risk 5.9% interval likelihood ratio 2.56, 2.02 to 3.25) more accurately (area under the curve 0.70, 95% confidence interval 0.66 to 0.73) than did the ABCD2 (0.60, 0.55 to 0.64) or ABCD2i (0.64, 0.59 to 0.68). Results were similar for subsequent stroke regardless of carotid endarterectomy/carotid artery stenting within seven days. Conclusion The Canadian TIA Score stratifies patients’ seven day risk for stroke, with or without carotid endarterectomy/carotid artery stenting, and is now ready for clinical use. Incorporating this validated risk estimate into management plans should improve early decision making at the index emergency visit regarding benefits of hospital admission, timing of investigations, and prioritisation of specialist referral.


2000 ◽  
Vol 181 (2) ◽  
pp. 631-638 ◽  
Author(s):  
Ellen M. Mascini ◽  
Margriet Jansze ◽  
Joop F. P. Schellekens ◽  
James M. Musser ◽  
Joop A. J. Faber ◽  
...  

2018 ◽  
Vol 129 (2) ◽  
pp. 490-497
Author(s):  
Hidetoshi Matsukawa ◽  
Hiroyasu Kamiyama ◽  
Toshiyuki Tsuboi ◽  
Kosumo Noda ◽  
Nakao Ota ◽  
...  

OBJECTIVEOnly a few previous studies have investigated subarachnoid hemorrhage (SAH) after surgical treatment in patients with unruptured intracranial aneurysms (UIAs). Given the improvement in long-term outcomes of embolization, more extensive data are needed concerning the true rupture rates after microsurgery in order to provide reliable information for treatment decisions. The purpose of this study was to investigate the incidence of and risk factors for postoperative SAH in patients with surgically treated UIAs.METHODSData from 702 consecutive patients harboring 852 surgically treated UIAs were evaluated. Surgical treatments included neck clipping (complete or incomplete), coating/wrapping, trapping, proximal occlusion, and bypass surgery. Clippable UIAs were defined as UIAs treated by complete neck clipping. The annual incidence of postoperative SAH and risk factors for SAH were studied using Kaplan-Meier survival analysis and Cox proportional hazards regression models.RESULTSThe patients’ median age was 64 years (interquartile range [IQR] 56–71 years). Of 852 UIAs, 767 were clippable and 85 were not. The mean duration of follow-up was 731 days (SD 380 days). During 1708 aneurysm years, there were 4 episodes of SAH, giving an overall average annual incidence rate of 0.23% (95% CI 0.12%–0.59%) and an average annual incidence rate of 0.065% (95% CI 0.0017%–0.37%) for clippable UIAs (1 episode of SAH, 1552 aneurysm-years). Basilar artery location (adjusted hazard ratio [HR] 23, 95% CI 2.0–255, p = 0.0012) and unclippable UIA status (adjusted HR 15, 95% CI 1.1–215, p = 0.046) were significantly related to postoperative SAH. An excellent outcome (modified Rankin Scale score of 0 or 1) was achieved in 816 (95.7%) of 852 cases overall and in 748 (98%) of 767 clippable UIAs at 12 months.CONCLUSIONSIn this large case series, microsurgical treatment of UIAs was found to be safe and effective. Aneurysm location and unclippable morphologies were related to postoperative SAH in patients with surgically treated UIAs.


Zootaxa ◽  
2012 ◽  
Vol 3207 (1) ◽  
pp. 40
Author(s):  
NHI THI PHAM ◽  
GAVIN R. BROAD ◽  
RIKIO MATSUMOTO ◽  
WOLFGANG BÖHME

Six new Acrodactyla species are described and illustrated from Vietnam based on the Ichneumonidae collection depositedat the Netherlands Centre for Biodiversity, Naturalis, Netherlands and the Osaka Museum of Natural History, Japan: A.maiphuquyi sp. nov., A. elongata sp. nov., A. shawi sp. nov and A. tami sp. nov. collected from Lao Cai Province at anelevation of 1,700–2,320 m a.s.l; A. lachryma sp. nov. collected from Chu Mom Ray NP, Kon Tum Province at an eleva-tion of 700–900 m a.s.l; and A. phuthoensis sp. nov. collected from Xuan Son NP, Phu Tho Province at an elevation of350–400 m a.s.l. Acrodactyla maiphuquyi sp. nov., A. elongata sp. nov. and A. tami sp. nov. belong to the degener group; A. lachryma sp. nov., A. phuthoensis sp. nov. and A. shawi sp. nov. belong to the quadrisculpta group.


2019 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
K. M. Kurbonov ◽  
E. G. Simonova ◽  
N. N. Filatov

The aim of this work was to study modern manifestations of seasonal brucellosis among the population of the Republic of Tajikistan. The materials and methods: of the study were the official statistics, as well as the results of previously performed studies on the risk assessment of the incidence in population. A retrospective epidemiological analysis of annual incidence rate for the period from 1997 to 2016 was conducted, depending on the most significant social and environmental risk factors. Results. The article shows the impact on the annual incidence rate of socio-economic transformations, including the privatization of collective livestock farms, accompanied by the massive movement of farm animals to private ownership, the loss of practice in animal breeding, and changes in environmental and climatic conditions. Against the background of the intensification of sheep breeding, there is a tendency in seasonality smoothing and shifting the maximum levels of population incidence of brucellosis to the spring season. Conclusion. The modern features of seasonal manifestation of brucellosis infection in the Republic of Tajikistan make it necessary to apply a differentiated approach to planning and conducting preventive measures in various areas of the country.


Author(s):  
Milou Ohm ◽  
Susan J M Hahné ◽  
Arie van der Ende ◽  
Elizabeth A M Sanders ◽  
Guy A M Berbers ◽  
...  

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.


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