scholarly journals First-year follow-up of children with chronic nonbacterial osteomyelitis—an analysis of the German National Pediatric Rheumatologic Database from 2009 to 2018

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Christiane Reiser ◽  
Jens Klotsche ◽  
Anton Hospach ◽  
Rainer Berendes ◽  
Anja Schnabel ◽  
...  

Abstract Objective To assess the first-year features of patients with chronic nonbacterial osteomyelitis (CNO). Methods Patients with a diagnosis of CNO, disease duration of under 13 months, and first registration in the German National Pediatric Rheumatologic Database (NPRD) between 2009 and 2018 were included in this cross-sectional analysis. Results Of 774 documented patients, 62.8% were female, and all patients had a median age of 11 years. The most affected clinical sites were the tibia (29.7%), pelvis (28.0%), and femur (27.8%). HLA-B27 was positive in 48 of 314 analyzed patients (15.3%). In 406 patients, an X-ray was performed at the first visit; X-ray results showed osteosclerosis/−lysis in 34.0% and hyperostosis in 14.5% of the patients. MRI scans (focal and whole-body scans) were performed in 648 patients, and 81.5% showed a positive TIRM/STIR signal. A total of 84.7% of the patients were administered nonsteroidal anti-inflammatory drugs, 9.6% were administered oral glucocorticoids, 10.8% were administered disease-modifying anti-rheumatic drugs (DMARDs), and 6.1% were administered bisphosphonates. An evaluation of the patient’s questionnaire showed an overall well-being (NRS 0–10) of 2.0. The PedCNO disease “activity” score revealed a 70% improvement in variables in 43% of patients in the initial 1-year follow-up. Copresentation with diagnostic criteria of pediatric enthesitis-related arthritis was rare. Conclusion To our knowledge, the NPRD cohort seemed to be the largest cohort of children and adolescents suffering from CNO worldwide. Most patients were treated effectively with NSAIDs, and only a small group of patients was administered additional medication. The patient-defined measures of disease activity had a moderate impact on patients’ daily lives. Trial registration Not applicable.

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.


Author(s):  
Martina Pecoraro ◽  
Stefano Cipollari ◽  
Livia Marchitelli ◽  
Emanuele Messina ◽  
Maurizio Del Monte ◽  
...  

Abstract Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.


2009 ◽  
Vol 15 (7) ◽  
pp. 848-853 ◽  
Author(s):  
J Río ◽  
J Castilló ◽  
A Rovira ◽  
M Tintoré ◽  
J Sastre-Garriga ◽  
...  

Background and objective Several criteria for treatment response to interferon beta (IFNβ) have been proposed, although there is no consensus among different investigators. Hence, the aim of this study was to investigate magnetic resonance imaging (MRI) and clinical predictors of response during the first 12 months of therapy. Methods This is a prospective and longitudinal study of relapsing-remitting multiple sclerosis (RRMS) patients treated with IFNβ. Patients were classified based on the presence of new lesions on MRI, relapses, confirmed disability increase, or combinations of all these variables after 1 year of therapy. Regression analysis was performed in order to identify variables of response after a follow-up of 3 years. Results We included 222 RRMS patients. The logistic model demonstrated that only the combination of new active lesions on MRI with the presence of relapses (OR 4.4; 95% CI 1.6–12.5) or disability progression (Odds Ratio (OR) 7.1; 95% Confidence Interval (CI) 1.6–33.9), or both (OR 6.5; 95% CI 1.9–23.4) achieved significant values to identify those patients with a poor outcome. Conclusions In RRMS patients treated with IFNβ, the combination of measures of disease activity and the presence of new active lesions on MRI may have a prognostic value for identifying patients with disease activity in the second and third year of therapy.


2021 ◽  
Author(s):  
Aidos K. Bolatov

Abstract The study aimed to investigate the relationships between academic motivation and the psychological well-being of 1st-year medical students during the COVID-19 pandemic. The total number of respondents in the cross-sectional study was 273. Intrinsic motivation was positively correlated with fear of COVID-19 and negatively correlated with psychological collapse and negative changes in quality of life due to the COVID-19. Extrinsic motivation positively associated with fear of COVID-19. Amotivation positively correlated with psychological collapse and negative changes in quality of life. In conclusion, COVID-19-related changes in quality of life and psychological destruction were predictors of academic motivation among 1st-year medical students.


2021 ◽  
Vol 8 (3) ◽  
pp. 49-55
Author(s):  
Shiv Kumar R ◽  
Puli SK ◽  
P. Kishan ◽  
Sanjay ND ◽  
Pusukuri Sphurthi ◽  
...  

Background: The development of an ideal doctor-patient relationship requires empathy. Empathetic conversation aids in the formation of an open and trusting equation between doctor and patient. Furthermore, this leads to accurate diagnoses and more compliance to the advised treatment. In this manner, empathy helps in overall recovery of the patient and improves global functioning and generalised well-being. This study aims to make note of the fluctuation in empathy levels during medical education. Studies done in various countries have found factors such as curriculum, clinical rotations timing and gender to progressively influences empathy levels in students throughout their medical training. The recent trend of violence against healthcare professionals in India calls for an urgent action into the gap between doctors and patients communication. Empathy towards patients and attendants will reduce such untoward events. In this current context, we should improve empathy levels among the training doctors. As a first step, we should assess various factors affecting empathy among health care professionals. Method: This cross sectional study was done among undergraduates of a rural medical college in Northern Telangana during the time period of October to December 2019. Their empathy levels were assessed using Jefferson’s Scale for Empathy- Student version (JSE-S). Result: Of the 470 students surveyed, 227 were males and 243 females. Female students were having higher empathy among first year and second years (p<0.001). Empathy levels seem to decline from first year to second year following which the mean empathy remains similar throughout the remaining years in students of both sexes. There is no significant relation between mean empathy scores and choice of future speciality (p>0.05). Conclusion: Female undergraduate students are found to be more empathetic than their male counterparts. A fall in empathy scores from the first to second year of MBBS is seen, which is when students enter their clinical rotations. Targeted intervention at this time may go a long way in the creation of a new generation of more empathetic physicians. Hence, there is a need for evaluation of teaching and learning techniques in medical education. Further, there is a call for more research into the determinants of decline in empathy amongst medical professionals.


2004 ◽  
Vol 287 (5) ◽  
pp. E842-E847 ◽  
Author(s):  
Marie-Pierre St-Onge ◽  
ZiMian Wang ◽  
Mary Horlick ◽  
Jack Wang ◽  
Steven B. Heymsfield

Dual-energy X-ray absorptiometry (DEXA) provides a measure of lean soft tissue (LST). LST hydration, often assumed to be constant, is relevant to several aspects of DEXA body composition estimates. The aims of this study were to develop a theoretical model of LST total body water (TBW) content and to examine hydration effects with empirically derived model coefficients and then to experimentally test the model's prediction that, in healthy adults, LST hydration is not constant but varies as a function of extra- and intracellular water distribution (E/I). The initial phase involved TBW/LST model development and application with empirically derived model coefficients. Model predictions were then tested in a cross-sectional study of 215 healthy adults. LST was measured by DEXA, extracellular water (ECW) by NaBr dilution, intracellular water (ICW) by whole body 40K counting, and TBW by 2H2O dilution. TBW estimates, calculated as ECW + ICW, were highly correlated with ( r = 0.97, SEE = 2.1 kg, P < 0.001) and showed no significant bias compared with TBW measured by 2H2O. Model-predicted TBW/LST was almost identical to experimentally derived values (means ± SD) in the total group (0.767 vs. 0.764 ± 0.028). LST hydration was significantly correlated with E/I (total group, r = 0.30, SEE = 0.027, P < 0.001). Although E/I increased with age (men, r = 0.48; women, r = 0.37; both P < 0.001), the association between TBW/LST and age was nonsignificant. Hydration of the DEXA-derived LST compartment is thus not constant but varies predictably with ECW and ICW distribution. This observation has implications for the accuracy of body fat measurements by DEXA and the use of TBW as a means of checking DEXA system calibration.


2020 ◽  
Vol 85 (3) ◽  
pp. 257-262
Author(s):  
Joseph Nelson Siewe Fodjo ◽  
Edlaine Faria de Moura Villela ◽  
Stijn Van Hees ◽  
Thalia Tibério dos Santos ◽  
Pieter Vanholder ◽  
...  

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elizabeth Stratton ◽  
Michael J. Player ◽  
Ariane Dahlheimer ◽  
Isabella Choi ◽  
Nicholas Glozier

PurposeDiscrimination and bullying contribute to mental ill-health in the workplace. At face value, they would seem linked but are often dealt with by different legislations. Workplace studies generally focus on bullying and population studies on discrimination. The authors aimed to evaluate the prevalence and relationship of discrimination and bullying in a male-dominated workforce, associated factors and relative impact on mental ill-health.Design/methodology/approachAn online cohort survey was conducted amongst employees of an Australian mining company, measuring discrimination, bullying, demographics and workplace and health factors over two months. Cross-sectional and prospective analyses assessed the prevalence of each, their association and their effects on depression and anxiety.FindingsA total of 580 employees (82% male) participated. There was no association between workplace bullying (n = 56, 9.7%) and discrimination (n = 160, 27.6%). Discrimination, but not bullying, was associated with higher depression, anxiety and suicidal ideation and lower well-being and resilience. After controlling for demographic, workplace and health and well-being factors, depression had the main effect on discrimination ß = 0.39, p = 0.003. Discrimination predicted an increase in depression scores at follow-up F (1, 129) = 4.88, p = 0.029.Originality/valueIn this male-dominated industry, discrimination was more prevalent than bullying. Discrimination, but not bullying, was associated with poorer mental health both cross sectionally and prospectively. Supporting the need to assess and manage discrimination and bullying in the workplace independently and the need for interventions to reduce a broader range of adverse interpersonal behaviours.


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