scholarly journals LOOP, a cross-sectional, observational study investigating the clinical specialty setting as a determinant of disease management in psoriatic arthritis: Subgroup analysis results from Japan

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245954
Author(s):  
Masato Okada ◽  
Sarina Kurimoto ◽  
Fabiana Ganz ◽  
Wolf-Henning Boehncke

Background Psoriatic arthritis (PsA) is a progressive erosive joint disorder that causes functional impairment; therefore, early diagnosis and management are essential. This study evaluated the association between clinical specialty and the time to management in patients with PsA in Japan. Methods This was a subgroup analysis of a cross-sectional, multicenter, observational study that was conducted in 17 countries outside the United States, including 17 sites at 8 institutions in Japan, from June 2016 to October 2017. Data from consecutive patients (age ≥18 years) with a suspected or established diagnosis of PsA on a routine visit to a participating rheumatology/orthopedic or dermatology clinic in Japan were analyzed. The primary endpoints were time from onset of inflammatory musculoskeletal symptoms to PsA diagnosis, PsA diagnosis to first conventional synthetic disease-modifying antirheumatic drug (csDMARD), PsA diagnosis to first biologic DMARD (bDMARD), and first csDMARD to first bDMARD. Results Of 109 patients with a confirmed diagnosis of PsA, 39.4% (n = 43) and 60.6% (n = 66) were recruited by rheumatologists/orthopedists and dermatologists, respectively. Most patients were prescribed tumor necrosis factor inhibitors (58.7%) or methotrexate (56.0%). The mean duration from symptom onset to PsA diagnosis was significantly longer (p = 0.044) for patients treated by rheumatologists/orthopedists (70.6 months) than those treated by dermatologists (30.1 months). In the rheumatology/orthopedic and dermatology settings, the mean time from PsA diagnosis to first csDMARD administration was −0.9 and −2.9 months, and from PsA diagnosis to first bDMARD 21.4 and 14.9 months, respectively. The mean duration from administration of first csDMARD to first bDMARD was comparable in the rheumatology/orthopedic (31.8 months) and dermatology (31.5 months) settings. Conclusions Treatment approach was slightly different between rheumatology/orthopedic and dermatology setting in clinical practice in Japan, suggesting that an integrated dermo-rheumatologic approach can optimize the management of patients with PsA.

2021 ◽  
Vol 8 (12) ◽  
pp. 1799
Author(s):  
Momammed Mustafizur Rahman ◽  
Shabnam Imam ◽  
Sayedatun Nessa ◽  
A. K. M. Maruf Raza ◽  
Farida Arjuman ◽  
...  

Background: This cross- sectional observational study was carried out with an aim to look for microsatellite instability (MSI) status in colorectal carcinoma and their association with different histomorphological patterns and biological behavior of colorectal carcinoma.Methods: This cross-sectional observational study was done in the Department of Pathology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh during September 2014 to October 2015. A total of 39 surgically resected sample of colorectal carcinoma were included. Consent from each patient was taken. The samples were histopathologically evaluated according to the standard protocol. The statistical analyses were done using Statistical packages for social sciences (SPSS 15) for Windows.Results: A total of 39 cases of colorectal carcinoma were included in this study. Majority of the patients (55.5%) was in 6th decade in MSI and 29.1% were MSI absent group. The mean age was found 47.67±10.97 years in present group and 47.84±14.26 years in absent group. The difference was not statistically significant (p>0.05). TNM stage with MSI was observed. The mean CEA level was 100.74±103.66 and 60.43±91.72. The mean Hb was 9.72±1.99 % and 9.92±2.17, the range was 7.2-12.2 and 4.6-13.4 among the groups. The mean difference was not statistically significant (p>0.05). Ulcerated was 3 (33.3%) and 19 (64.5%). Stage 3 tumor was 4 (44.4%) and 16 (51.6%). Grade 2 tumor was 5 (55.6%) and 17 (58.0%).Conclusions: For the first time in Bangladesh, this study was undertaken to evaluate the microsatellite instability (MSI) status in colorectal cancer tissue and their association with different histomorphological patterns of colorectal carcinoma.   


2021 ◽  
Author(s):  
Megan Fuerst ◽  
Kaitlin Schrote ◽  
Bharti Garg ◽  
Maria Rodriguez

Abstract Objective This study sought to determine if there was a difference in the months of oral contraception prescribed by physicians living in U.S. states with a 12-month supply policy compared to physicians in states without a policy. Methods We conducted an exploratory descriptive study using a convenience sample of Obstetrics & Gynecology resident physicians (n=275) in the United States. Standard bivariate analyses were used to compare the difference between groups. Results Few physicians in both groups (3.8% with a policy and 1.4% without a policy) routinely prescribed a 12-month supply of contraception. The mean coverage prescribed by providers in states with and without a policy was 2.81 and 2.07 months (p<0.05). Conclusions The majority of physicians were unaware of 12-month contraceptive supply policies and unable to correctly write a prescription for 12-months of contraception, regardless of whether they lived in a state with a 12-month contraceptive supply policy. Physician education may be needed to effectively implement 12-month contraceptive supply policies.


2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Berliana Irianti ◽  
Ermawati Ermawati ◽  
Arni Amir

Abstrak Penyebab dismenore belum semuanya diketahui, ada dugaan peningkatan proses peroksida lipid yang akan mengaktivasi mediator inflamasi pada endometrium yang menimbulkan rasa nyeri haid (dismenore). Tujuan penelitian ini adalah menentukan perbedaan kadar malondialdehide dan tromboksan B 2  pada dismenore dan tanpa dismenore. Studi observasional ini menggunakan desain potong lintang komparatif. Subjek penelitian terdiri dari dua kelompok yaitu 23 remaja dismenore dan 23 remaja tanpa dismenore dengan waktu penelitian dari Juni sampai Juli 2014. Analisis sampel dilakukan di Laboratorium Biomedik dan Biokimia Universitas Andalas Padang. Pemeriksaan kadartromboksan B 2  menggunakan metode ELISA dan kadar malondialdehide menggunakan metode Asam Thiobarbiturat (TBA). Hasil penelitian diperoleh bahwa rerata kadar malondialdehid pada remaja dengan dismenore yaitu 2,60±0,63 µmol/ml, rerata remaja tanpa dismenore 1,98±0,12 µmol/ml dengan probabilitas p<0,05 (0,000), sedangkan reratakadar Tromboksan B 2  pada remaja dengan dismenore 20,043±9,56 ng/ml, rerata remaja tanpa dismenore 19,222±10,79 ng/ml, dengan probabilitas p>0,05 (0,786). Kesimpulan penelitian ini adalah terdapat perbedaan yang signifikan rerata kadar malondialdehid pada remaja dengan dismenore dan tanpa dismenore dan tidak terdapatperbedaan signifikan pada kadar tromboksan B 2 pada remaja dengan dismenore dan tanpa dismenore.Kata kunci: remaja, dismenore, malondialdehide, tromboksan B2 Abstract The precise cause of dysmenorrhea is still unclear, there may be increased lipid peroxidation process will activate the inflammatory mediators at endometrium that cause menstrual cramps (dysmenorrhea). The objective of this study was to determine the difference of malondialdehyde levels and thromboxane B 2  levels in dysmenorrhea and without dysmenorrhea. It was an observational study with comparative cross-sectional design. The subjects consisted of two groups, they are 23 adolescent with dysmenorrhea and 23 adolescents without dysmenorrhea, done in Juny -July 2014. Sample analysis was conducted in Laboratory of Biochemistry and Biomedical Laboratory of Andalas University Padang. The examination of Thromboxane B 2  levels used ELISA and the examination of malondialdehyde levels used a Thiobarbituric acid method. The results showed the mean of malondialdehyde levels in adolescents withdysmenorrhea was 2.60±0.63 µmol/ml, the mean level in adolescent without dysmenorrhea was 1.98±0.12 µmol/ml with probability p<0.05 (0.000), while the mean levels of thromboxane B 2  in adolescents with dysmenorrhea was 20.043±9.56 ng/ml, the mean level in adolescent without dysmenorrhea was 19.222±10.79 ng/ml, with probabilityp>0.05 (0.786). It can be concluded that there is a significant difference in the mean of malondialdehyde levels between adolescents with dysmenorrhea and without dysmenorrhea and there is no significant differences in thromboxane B 2 level between adolescents with dysmenorrhea and without dysmenorrheaKeywords: adolescent, dysmenorrhea, malondialdehyde, thromboxane B2


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049389
Author(s):  
Clare L Atzema ◽  
Ivona Mostarac ◽  
Dana Button ◽  
Peter C Austin ◽  
Arshia P Javidan ◽  
...  

ObjectivesDuring the COVID-19 pandemic wearing a mask in public has been recommended in some settings and mandated in others. How often this advice is followed, how well, and whether it inadvertently leads to more disease transmission opportunities due to a combination of improper use and physical distancing lapses is unknown.DesignCross-sectional observational study performed in June–August 2020.SettingEleven outdoor and indoor public settings (some with mandated mask use, some without) each in Toronto, Ontario, and in Portland, Oregon.ParticipantsAll passers-by in the study settings.Outcome measuresMask use, incorrect mask use, and number of breaches (ie, coming within 2 m of someone else where both parties were not properly masked).ResultsWe observed 36 808 persons, the majority of whom were estimated to be aged 31–65 years (49%). Two-thirds (66.7%) were wearing a mask and 13.6% of mask-wearers wore them incorrectly. Mandatory mask-use settings were overwhelmingly associated with mask use (adjusted OR 79.2; 95% CI 47.4 to 135.1). Younger age, male sex, Torontonians, and public transit or airport settings (vs in a store) were associated with lower adjusted odds of wearing a mask. Mandatory mask-use settings were associated with lower adjusted odds of mask error (OR 0.30; 95% CI 0.14 to 0.73), along with female sex and Portland subjects. Subjects aged 81+ years (vs 31–65 years) and those on public transit and at the airport (vs stores) had higher odds of mask errors. Mask-wearers had a large reduction in adjusted mean number of breaches (rate ratio (RR) 0.19; 95% CI 0.17 to 0.20). The 81+ age group had the largest association with breaches (RR 7.77; 95% CI 5.32 to 11.34).ConclusionsMandatory mask use was associated with a large increase in mask-wearing. Despite 14% of them wearing their masks incorrectly, mask users had a large reduction in the mean number of breaches (disease transmission opportunities). The elderly and transit users may warrant public health interventions aimed at improving mask use.


2020 ◽  
Author(s):  
Nawal Al kaabi ◽  
Asma Al Nuaimi ◽  
Mariam Al Harbi ◽  
Jehad Abdalla ◽  
Tehmina Khan ◽  
...  

Abstract Background: SARS‐CoV‐2 was first reported in December 2019. The severity of COVID-19 infection ranges from being asymptomatic to severe infection leading to death. The aim of the study is to describe the clinical characteristics and outcomes of hospitalized COVID-19 patients within the largest government healthcare facilities in the Emirate of Abu Dhabi, the capital of UAE. Methods: This paper is a retrospective cross-sectional study of all patients admitted to Abu Dhabi Healthcare services facilities (SEHA) between the period of March 1st until May 31st with a laboratory-confirmed test of SARS-CoV2, known as Coronavirus disease (COVID19). Variation in characteristics, comorbidities, laboratory values, length of hospital stay, treatment received and outcomes were examined. Data was collected from electronic health records available at SEHA health information system.Results: There were 9390 patients included; patients were divided into severe and non-severe groups. 721 (7.68%) patients required intensive care while the remaining majority (92.32 %) were mild-moderate cases. The mean age (41.8 years) is less than the mean age reported globally. Our population had a male predominance and variable representation of different nationalities. Three major comorbidities were noted, hypertension, diabetes mellitus and chronic kidney disease. The laboratory tests that were significantly different between the severe and the non-severe groups were LDH, Ferritin, CRP, neutrophil count, IL6 and creatinine level. The major antiviral therapies the patients have received were a combination of hydroxychloroquine and favipiravir. The overall in hospital mortality was 1.63% while severe group mortality rate was 19.56 %. The Death rate in the adults younger than 30 years was noted to be higher compared to elderly patients above 60 years, 2.3% and 0.9 % respectively. Conclusion: our analysis suggests that Abu Dhabi had a relatively low morbidity and mortality rate and a high recovery rate compared to published rates in China, Italy and The United States. The demographic of the population is younger and has an international representation. The country had the highest testing rate in relation to the population volume. We believe the early identification and younger demographic had affected the favorable comparative outcome in general with early identification of cases leading to a lower mortality rate.


Sign in / Sign up

Export Citation Format

Share Document