scholarly journals Significance of descriptive symptoms and signs and clinical parameters as predictors of neuropathic cancer pain

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0252781
Author(s):  
Sun Kyung Baek ◽  
Sang Won Shin ◽  
Su-Jin Koh ◽  
Jung Han Kim ◽  
Hyo Jung Kim ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Disease Duration ◽  
Young Patients ◽  
Stage Iv ◽  
Clinical Predictors ◽  
Cross Sectional ◽  
Korean Patients ◽  
History Of ◽  
Stage Iv Cancer ◽  
Symptoms And Signs

Purpose Evaluation of symptoms and signs for the management of neuropathic cancer pain (NCP) is challenging. This study aimed to identify clinical predictors of NCP and symptoms and signs most relevant of those in Korean patients. Methods This nationwide, descriptive, cross-sectional, multicenter, observational study included 2,003 cancer patients aged ≥20 years who reported a visual analog scale (VAS) score ≥1 for pain and provided informed consent for participation. The Douleur Neuropathic (DN4) questionnaire (score ≥4) was used to determine symptoms and signs as well as the presence of NCP. Results The prevalence of NCP was associated with age <65 years [OR, 1.57; 95% CI, 1.270–1.934], disease duration >6 months (OR, 1.57; 95% CI, 1.232–2.012), stage IV cancer (OR, 0.75; 95% CI, 0.593–0.955), history of chemotherapy (OR, 1.74; 95% CI, 1.225–2.472), and moderate-to-severe cancer pain (OR, 2.05; 95% CI, 1.671–2.524) after multivariate analysis. The most common descriptive symptoms of NCP were tingling, electric shock, and pins and needles. For NCP patients in the presence or absence of the clinical predictors, pins and needles (p = 0.001) and painful cold (p<0.001) symptoms were significantly frequent in patients with moderate-to-severe pain. Tingling, numbness, and touch hypoesthesia (p = 0.022, 0.033, 0.024, respectively) were more frequent in those with longer cancer duration and hyperesthesia (p = 0.024) was more frequent in young patients. Conclusion Age <65 years, disease duration >6 months, stage IV cancer, history of chemotherapy, and moderate-to-severe cancer pain, were identified as predictors of NCP. Some symptoms and signs of NCP were associated with these predictors. Further studies are warranted on the pathogenesis and management of NCP with respect to the symptoms and signs, and factors associated with pain severity in Korean patients.

scholarly journals Comparison of Clinical Features in HLA-B27 Positive and Negative Patients With Axial Spondyloarthritis: Results From a Cohort of 4,131 Patients

2020 ◽  
Vol 7 ◽  
Author(s):  
Shangzhu Zhang ◽  
Yanhong Wang ◽  
Linyi Peng ◽  
Jinmei Su ◽  
Xiaofeng Zeng ◽  
...  
Keyword(s):  
Delay Time ◽  
Disease Duration ◽  
Axial Spondyloarthritis ◽  
Diagnosis Delay ◽  
Hla B27 ◽  
Biologic Treatment ◽  
Cross Sectional ◽  
Younger Age ◽  
History Of ◽  
Family Aggregation

Objective: The aim of our study was to assess the influence of the HLA-B27 status on axial spondyloarthritis (axSpA) in the largest cohort in China.Methods: An observational, cross-sectional, and analytic study of axSpA patients from the China axSpA database was performed. Demographic and clinical data were compared in terms of the HLA-B27 status. Univariate and multivariate analyses were performed to identify variables related to HLA-B27 presence.Results: We enrolled 4,131 patients in this study; of those, 36,95 (89.4%) were HLA-B27 positive. In the multivariate analysis, male gender (p &lt; 0.001), younger age (p &lt; 0.001), a disease duration of more than 3 years (p &lt; 0.001), a family history of SpA (p &lt; 0.001), uveitis (p &lt; 0.001), ASDAS-CRP (p &lt; 0.001), and biologic treatment (p &lt; 0.001) were the main variables that were independently related to HLA-B27 presence, whereas a diagnosis delay time &gt;36 months (p &lt; 0.001) and psoriasis (p &lt; 0.001) were independently related to HLA-B27 absence.Conclusion: In Chinese axial SpA patients, presence of HLA-B27 is associated with the male sex, younger age, longer disease duration, greater family aggregation, and higher frequency of uveitis; absence of HLA-B27 is associated with longer diagnosis delay time and higher frequency of psoriasis.

scholarly journals Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0124329 ◽  
Author(s):  
Johnny Kao ◽  
Kenneth D. Gold ◽  
Gina Zarrili ◽  
Emily Copel ◽  
Andrew J. Silverman ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Stage Iv ◽  
Clinical Predictors ◽  
Stage Iv Cancer

scholarly journals Analysis of two groups of young patients with breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Matheus de Paula Solino ◽  
Mariana Soares Cardoso ◽  
Marcelo Antonini
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Screening Method ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Cross Sectional ◽  
Hormonal Receptors ◽  
Significant Difference ◽  
History Of

Introduction: Breast cancer is the main type of cancer and the main cause of death by cancer among women worldwide. For Brazil, the National Cancer Institute José Alencar Gomes da Silva (Instituto Nacional de Câncer José Alencar Gomes da Silva – INCA) estimated that breast cancer would be responsible for 29.5% of new cancer cases and 16.2% of cancer deaths in 2019. The incidence of breast cancer in young women has grown worldwide: in developing countries, 25% of breast cancer cases occur in women under 40 years of age. In young women, breast cancer has more aggressive characteristics and is diagnosed later. Mammography is the best screening method, however, it is only started at 40. Objective: To analyze the clinical, pathological, and treatment characteristics among patients with breast cancer diagnosed up to 40 years old and between 41 and 45 years old. Methods: Observational and cross-sectional study, which evaluated patients diagnosed with breast cancer until the age of 45 and who underwent surgical treatment at the Hospital do Servidor Público Estadual between October, 2013 and October, 2017. Data were collected from medical records and patients were divided into two groups: Group 01, up to 40 years old and Group 02, from 41 to 45 years old. Variables were collected regarding age at diagnosis, menarche, number of deliveries, body mass index (BMI), comorbidities, family history of breast cancer, initial clinical staging, type of biopsy, type of histological biopsy result, type of treatment, and surgical results. The variables were analyzed statistically. Results: Fifty patients aged between 29 and 45 years old were evaluated. There was no statistically significant difference in clinical characteristics. Group 02 presented more tumors with hormonal receptors, more cases of axillary emptying after compromised sentinel lymph node, and lower rates of radiotherapy. Conclusion: Young patients aged 41-45 years old present more tumors with hormonal receptors, greater involvement of microscopically locoregional lymph nodes, and less treatment with radiotherapy than young patients under 40 years of age.

scholarly journals A clinico-epidemiological study of polymorphic light eruption in a tertiary care centre in Salem: a region of South India

2017 ◽  
Vol 3 (1) ◽  
pp. 113
Author(s):  
Eby Chacko ◽  
Seethalakshmi Ganga Vellaisamy ◽  
Kannan Gopalan ◽  
Govindarajan Nanjappachetty
Keyword(s):  
Tertiary Care ◽  
Positive Family History ◽  
Study Data ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Polymorphic Light Eruption ◽  
Plaque Type ◽  
History Of ◽  
Study Population ◽  
Symptoms And Signs

<p><strong> </strong><strong>Introduction: </strong>Polymorphic light eruption (PMLE) is an acquired photodermatosis characterized by a polymorphic eruption ranging from papulovesicular lesions to large plaques. The prevalence of PMLE varies from 5% to 15% in various studies across the world and<strong> </strong>in India it is 0.56%.</p><p><strong>Objective: </strong>The present study was conducted to study the clinical pattern and to assess the epidemiological aspects of polymorphic light eruption.</p><p><strong>Material and Method: </strong>A cross sectional prospective study was conducted in Dermatology OPD between April 2015 and June 2016. A total of 100 patients with symptoms and signs of PMLE were included in the study. Data were coded and analyzed.</p><p><strong>Results:</strong> Majority of the cases in our study were in the age group of 21 - 30 years (36%). It was more common in females (82%) when compared with males (18%). Occupation of most of the patients (29%) was farmers in our study population. Positive family history of PMLE was seen in 11% of the study population. The commonest form was the papular type (46%) and the second most common type was plaque type (17%). Regarding the distribution of lesions, about  51%  of  our study subjects had polymorphic lesions confined to only one area of their body mostly forearm (25%) followed by face (12%).</p><p><strong>Conclusion:</strong> The prevalence of PMLE was 1.34% in our study population. Pruritus was the presenting complaint in most of the cases and the rash was mainly seen in areas exposed to sunlight.</p>

scholarly journals Correction: Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0132748 ◽  
Author(s):  
Johnny Kao ◽  
Kenneth D. Gold ◽  
Gina Zarrili ◽  
Emily Copel ◽  
Andrew J. Silverman ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Stage Iv ◽  
Clinical Predictors ◽  
Stage Iv Cancer

scholarly journals Correction: Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0130511
Author(s):  
Johnny Kao ◽  
Kenneth D. Gold ◽  
Gina Zarrili ◽  
Emily Copel ◽  
Andrew J. Silverman ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Stage Iv ◽  
Clinical Predictors ◽  
Stage Iv Cancer

scholarly journals Serum biomarkers in patients suspected of transient ischaemic attack in primary care: a diagnostic accuracy study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031774 ◽  
Author(s):  
Louis Servaas Dolmans ◽  
Frans Rutten ◽  
Marie-Louise E L Bartelink ◽  
Ewoud J van Dijk ◽  
Paul J Nederkoorn ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Blood Sample ◽  
Diagnostic Value ◽  
Minor Stroke ◽  
Clinical Predictors ◽  
Accuracy Study ◽  
History Of ◽  
Ischaemic Attack ◽  
Symptoms And Signs

ObjectiveThe diagnosis of transient ischaemic attack (TIA) based on symptoms and signs can be challenging and would greatly benefit from a rapid serum biomarker of brain ischaemia. We aimed to quantify the added diagnostic value of serum biomarkers in patients suspected of TIA beyond symptoms and signs.MethodsThis is a cross-sectional diagnostic accuracy study with a 6-month follow-up period. Participants were patients suspected of TIA by the general practitioner (GP) in whom a blood sample could be collected within 72 hours from symptom onset. A research nurse visited the participant for the blood sample and a standardised interview. The GP referred participants to the regional TIA service. An expert panel of three neurologists classified cases as TIA, minor stroke or any other diagnosis, based on all available diagnostic information including the GP’s and neurologist’s correspondence and the follow-up period. We used multivariable logistic regression analyses to quantify the diagnostic accuracy of clinical predictors and the improvement of accuracy by seven biomarkers (NR2, NR2 antibodies, PARK7, NDKA, UFD1, B-FABP and H-FABP).Results206 patients suspected of TIA participated, of whom 126 (61.2%) were diagnosed with TIA (n=104) or minor stroke (n=22) by the expert panel. The median time from symptom onset to the blood sample collection was 48.0 (IQR 28.3–56.8) hours. None of the seven biomarkers had discriminative value in the diagnosis of TIA, with C-statistics ranging from 0.45 to 0.58. The final multivariable model (C-statistic 0.83 (0.78–0.89)) consisted of eight clinical predictors of TIA/minor stroke: increasing age, a history of coronary artery disease, sudden onset of symptoms, occurrence of symptoms in full intensity, dysarthria, no history of migraine, absence of loss of consciousness and absence of headache. Addition of the individual biomarkers did not further increase the C-statistics.ConclusionsCurrently available blood biomarkers have no added diagnostic value in suspected TIA.Trial registration numberNCT01954329

scholarly journals FRI0533 SMOKING AS A PREDICTIVE FACTOR FOR SPONDYLOARTHRITIS RELATED UVEITIS: RESULTS FROM A SINGLE CENTRE CROSS-SECTIONAL STUDY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 866.2-866
Author(s):  
E. Costa ◽  
D. Almeida ◽  
M. Cerqueira ◽  
J. Redondo Costa ◽  
A. R. Ribeiro ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Disease Duration ◽  
Axial Spondyloarthritis ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Hla B27 ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Cross Sectional Studies

Background:Although spondyloarthritis (SpA) is primarily a musculoskeletal condition, ocular involvement is an important clinical feature and contributes to the burden of disease. Acute anterior uveitis (AAU) is classically described as the most frequent extra-articular manifestation of SpA and in some cases the first clinical presentation. The prevalence of AAU varies according to the subtype of SpA. In a systematic literature review, the mean prevalence of AAU was 32.7% and a positive association between HLA-B27 positivity, axial SpA, male sex and uveitis has been reported (1). More recently, some cross-sectional studies have described lower odds of spondyloarthritis-related uveitis (SpA-U) in smokers than in patients who are ex smokers or never smokers (2). Predictors of SpA-U are poorly defined in literature and the influence of smoking status remains controversial.Objectives:To analyse the factors associated with uveitis in SpA patients in a Tertiary Rheumatology Center.Methods:An observational cross-sectional study was performed including patients fulfilling the ASAS criteria for axial SpA with a follow-up visit between January and June 2019. Clinical patients’ charts were reviewed and the following variables were considered: age, gender, history of uveitis (confirmed by ophthalmologist observation), number of AAU episodes, smoking status (never smoker or ever smoker), HLA-B27, disease duration, disease involvement (exclusively axial or axial and peripheral), history of enthesitis and syndesmophytes. History of AAU and associated variables were determined in this subset of patients.Statistical analysis was performed with logistic regression model. P value <.05 was defined as statistically significant.Results:The study included 164 patients (62.3% men) with median age of 44.0 years (IQR 37 to 54) and a median disease duration of 14.6 years (IQR 9.28 to 20.32). SpA diagnosis was ankylosing spondylitis in 70.7% cases and the remaining were non-radiographic axial SpA. HLA-B27 was positive in 84.8%, 31.1% of patients were ever smokers and 21% had both axial and peripheral joint involvement. Twenty four percent of patients had at least one AAU episode. Recurrence of uveitis occurred in 70% of patients. Ever smoking (OR=2.256; 95%CI [1.077-4.276]; p<.05) and syndesmophytes (OR=2.125; 95%CI [1.009-4.475]; p<.05) showed a statistically significant association with uveitis in univariated logistic regression. Althougth not statistically significant, a trend to association was found between smoking and recurrence of AAU (OR=2.235; 95%ICI [.973-5.135], p=.058). In multivariated logistic regression only ever smoking was independently associated with uveitis (OR=2.542; 95%CI [1.007-6.420]; p<.05). We did not find association between presence of uveitis and gender, age, disease duration, disease involvement, HLA-B27 positivity and enthesitis.Conclusion:Contrary to few cross-sectional studies showing a possible protective effect of smoking in SpA-U, and in line with new data from Zhaoet al(3), we report a statistically significant independent association between history of smoking and uveitis. Nevertheless, we emphasize the need of more studies to confirm these findings.References:[1] Zeboulon N, et al. Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Annals of Rheumatic Diseases 2008;67:955.[2] Zhao S, et al. Associations between smoking and extra-axial manifestations and disease severity in axial spondyloarthritis: results from the BSR Biologics Register for Ankylosing Spondylitis (BSRBR-AS). Rheumatology 2018;69.[3] Zhao S, et al. Smoking does not protect patients with axial spondyloarthritis from attacks of uveitis. Annals of Rheumatic Diseases 2019;78(9).Disclosure of Interests:None declared

scholarly journals Distribution of comorbidities in spondyloarthritis with regard to the phenotype and psoriasis: data from the ASAS-COMOSPA study

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110452
Author(s):  
M. Ángeles Puche-Larrubia ◽  
Lourdes Ladehesa-Pineda ◽  
Pilar Font-Ugalde ◽  
Alejandro Escudero-Contreras ◽  
Anna Moltó ◽  
...  
Keyword(s):  
Bone Metabolism ◽  
Fixed Effects ◽  
Disease Duration ◽  
Random Effect ◽  
National Society ◽  
Lower Prevalence ◽  
Framingham Score ◽  
Cross Sectional ◽  
History Of

Introduction: The aim of the study was to compare the prevalence of comorbidities between patients with axial and peripheral phenotypes and to evaluate the role of psoriasis in such comorbidities. Methods: Patients from the cross-sectional Assessment in SpondyloArthritis Inter-national Society (ASAS)-COMOSPA study were classified as having either the axial (presence of sacroiliitis on X-ray or MRI) or peripheral phenotype (absence of sacroiliitis AND presence of peripheral involvement). Patients with each phenotype were divided into two groups depending on the presence or history of psoriasis. Pair-wise comparisons among the four groups (axial/peripheral phenotype with/without psoriasis) were conducted through univariate logistic regressions and generalized linear mixed models using disease duration and sex as fixed effects and country as random effect. Results: A total of 3291 patients were included in this analysis. The peripheral involvement with psoriasis phenotype showed the highest prevalence of hypertension (44.9%), dyslipidaemia (34%) and diabetes (8.8%), while the axial involvement without psoriasis phenotype exhibited the lowest prevalence of dyslipidaemia (14.2%), diabetes (4.1%) and stroke (0.9%). Among patients with psoriasis, the axial phenotype showed a significantly lower prevalence of hypertension (OR: 0.51, 95% CI: 0.35–0.75) and lower prevalence of Framingham score ⩾15 (OR: 0.57, 95% CI: 0.38–0.85) than patients with peripheral involvement after adjusting for disease duration, sex and country. Among patients with the axial phenotype, patients with psoriasis showed a higher prevalence of hypertension (OR 1.76, 1.40–2.20), dyslipidaemia (OR: 1.99, 95% CI: 1.56–2.53), diabetes (OR: 2.05, 95% CI: 1.39–3.02) and Framingham score ⩾15 (OR: 2.00, 95% CI: 1.57–2.55) than non-psoriatic patients. No differences were found across groups concerning bone metabolism disorders. Conclusion: Both the peripheral phenotype and psoriasis are independently associated with an increased prevalence of cardiovascular risk factors. No differences were found for bone metabolism disorders.

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