scholarly journals Juvenile Spondyloarthritis: focus on uveitis.

2020 ◽  
Author(s):  
Achille Marino ◽  
Pamela F. Weiss ◽  
Timothy G. Brandon ◽  
Melissa Ann Lerman
Keyword(s):  
Hla B27 ◽  
Limited Data ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Distinctive Features ◽  
Entire Cohort ◽  
Ocular Symptoms ◽  
Inflammatory Bowel ◽  
Juvenile Spondyloarthritis

Abstract Background Juvenile spondyloarthritis (JSpA) represents a group of inflammatory arthritides with several distinctive features (enthesitis, involvement of spine and sacroiliac joint, HLA-B27 association and development of uveitis). There are limited data on the course of uveitis in children with JSpA. This study aims to estimate the prevalence of uveitis and to look at the presence of HLA-B27 in relation to uveitis occurrence and ocular symptoms in a cohort of JSpA patients. Findings This is a cross sectional/retrospective study involving patients with JSpA followed in a tertiary referral hospital. Two hundred twenty-three patients were enrolled in the study. The prevalent diagnosis was enthesitis-related arthritis (ERA) (62%) followed by juvenile psoriatic arthritis (PsA), undifferentiated arthritis (UA), and the arthropathies associated with inflammatory bowel disease (IBD-A) (18%, 13%, 12%, respectively). Uveitis was reported in twenty-four patients (11%) of the JSpA cohort (JSpA-U). ERA patients had the highest uveitis prevalence (ERA-U) (13%) with similar prevalences in UA, PsA (7%) and in IBD-A (7% each). The prevalence of HLA-B27 positivity was 45% amongst JSpA-U (N=22), with fewer than half of patients with ERA-U HLA-B27 positive (44%). The overall prevalence of symptomatic uveitis was 79%. Neither the likelihood of uveitis, nor of symptomatic uveitis, varied by HLA-B27 status either in the entire cohort nor in those with ERA. Conclusions About one-tenth of patients developed uveitis, the majority of which was symptomatic. Fewer than half of the patients with uveitis were HLA-B27 positive. HLA-B27 status was not statistically associated with either the development of uveitis or symptomaticity of uveitis.

scholarly journals Juvenile Spondyloarthritis: focus on uveitis.

2020 ◽  
Author(s):  
Achille Marino ◽  
Pamela F. Weiss ◽  
Timothy G. Brandon ◽  
Melissa Ann Lerman
Keyword(s):  
Hla B27 ◽  
Limited Data ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Distinctive Features ◽  
Entire Cohort ◽  
Ocular Symptoms ◽  
Inflammatory Bowel ◽  
Juvenile Spondyloarthritis

Abstract Background Juvenile spondyloarthritis (JSpA) represents a group of inflammatory arthritides with several distinctive features (enthesitis, involvement of spine and sacroiliac joint, HLA-B27 association and development of uveitis). There are limited data on the course of uveitis in children with JSpA. This study aims to estimate the prevalence of uveitis and to look at the presence of HLA-B27 in relation to uveitis occurrence and ocular symptoms in a cohort of JSpA patients.Findings This is a cross sectional/retrospective study involving patients with JSpA followed in a tertiary referral hospital. Two hundred twenty-three patients were enrolled in the study. The prevalent diagnosis was enthesitis-related arthritis (ERA) (62%) followed by juvenile psoriatic arthritis (PsA), undifferentiated arthritis (UA), and the arthropathies associated with inflammatory bowel disease (IBD-A) (18%, 14%, 6%, respectively). Uveitis was reported in twenty-four patients (11%) of the JSpA cohort (JSpA-U). ERA patients had the highest uveitis prevalence (ERA-U) (13%) with similar prevalences in UA, PsA and in IBD-A (7% each). The prevalence of HLA-B27 positivity was similar amongst the entire JSpA-U cohort (N=22, 45%) and those with ERA-U (N=8, 44%). The overall prevalence of symptomatic uveitis was 79%. Neither the likelihood of uveitis, nor of symptomatic uveitis, varied by HLA-B27 status either in the entire cohort nor in those with ERA.Conclusions About one-tenth of patients developed uveitis, the majority of which was symptomatic. Fewer than half of the patients with uveitis were HLA-B27 positive. HLA-B27 status was not statistically associated with either the development of uveitis or symptomaticity of uveitis.

scholarly journals Juvenile Spondyloarthritis: focus on uveitis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Achille Marino ◽  
Pamela F. Weiss ◽  
Timothy G. Brandon ◽  
Melissa A. Lerman
Keyword(s):  
Hla B27 ◽  
Limited Data ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Distinctive Features ◽  
Entire Cohort ◽  
Ocular Symptoms ◽  
Inflammatory Bowel ◽  
Juvenile Spondyloarthritis

Abstract Background Juvenile spondyloarthritis (JSpA) represents a group of inflammatory arthritides with several distinctive features (enthesitis, involvement of spine and sacroiliac joint, HLA-B27 association and development of uveitis). There are limited data on the course of uveitis in children with JSpA. This study aims to estimate the prevalence of uveitis and to look at the presence of HLA-B27 in relation to uveitis occurrence and ocular symptoms in a cohort of JSpA patients. Findings This is a cross sectional/retrospective study involving patients with JSpA followed in a tertiary referral hospital. Two hundred twenty-three patients were enrolled in the study. The prevalent diagnosis was enthesitis-related arthritis (ERA) (62%) followed by juvenile psoriatic arthritis (PsA), undifferentiated arthritis (UA), and the arthropathies associated with inflammatory bowel disease (IBD-A) (18, 14, 6%, respectively). Uveitis was reported in twenty-four patients (11%) of the JSpA cohort (JSpA-U). ERA patients had the highest uveitis prevalence (ERA-U) (13%) with similar prevalences in UA, PsA and in IBD-A (7% each). The prevalence of HLA-B27 positivity was similar amongst the entire JSpA-U cohort (N = 22, 45%) and those with ERA-U (N = 8, 44%). The overall prevalence of symptomatic uveitis was 79%. Neither the likelihood of uveitis, nor of symptomatic uveitis, varied by HLA-B27 status either in the entire cohort nor in those with ERA. Conclusions About one-tenth of patients developed uveitis, the majority of which was symptomatic. Fewer than half of the patients with uveitis were HLA-B27 positive. HLA-B27 status was not statistically associated with either the development of uveitis or symptomaticity of uveitis.

scholarly journals Antibiotic Prescription Patterns for Hospitalized Children Under 12 Years in a Tertiary Referral Teaching Hospital, Kerman, Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gholamreza Sepehri ◽  
Mahnaz Amiri ◽  
Ali Hosseininasab
Keyword(s):  
Antibiotic Prescription ◽  
Resistance Rate ◽  
Microbial Culture ◽  
Hospitalized Children ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Prescription Patterns ◽  
Tract Infections ◽  
Selection Of

Background: Inappropriate prescriptions of antibiotics in children is common in most parts of the world. Objectives: This study was performed to evaluate antibiotic prescription patterns and the rational use of antibiotics in hospitalized children in a tertiary referral hospital in Kerman, Iran. Methods: This prospective cross-sectional study evaluated prescription patterns of antibiotics for hospitalized children under 12 years old for six months from October 1, 2017, to March 31, 2018. Demographic information, including age, sex, most commonly-prescribed drug classes, name of antibiotic, duration and route of administration, diagnosis, and results of microbial culture and duration of hospitalization were recorded. Results: Most antibiotics were administered by parenteral route. The major infections for which antibiotics were prescribed were febrile seizures (34.4%), upper respiratory infections (25.5%), pyrexia with unknown origin (17.6%), and urinary tract infections (14.8%). Ceftriaxone, clindamycin, and vancomycin were the most frequently prescribed antibiotics. The selection of 84% of antibiotics was on an empirical basis. Ampicillin (83.9%) and clindamycin (81.0%) showed the highest resistance rate, followed by ceftriaxone (33.0%) and vancomycin (32.0%). Conclusions: Our results showed inappropriate use of antibiotics in hospitalized children. A relatively high resistance rate to prescribed antibiotics for children indicates that the selection of high-cost antibiotics, including ceftriaxone, vancomycin, and meropenem should be based on antimicrobial sensitivity tests.

Clinical factors associated with work disability in epilepsy: A cross-sectional study at a tertiary referral hospital

2021 ◽  
Vol 124 ◽  
pp. 108310
Author(s):  
Gea Mireia ◽  
Grau-López Lara ◽  
Jiménez Marta ◽  
Hernández-Stahl Marina ◽  
Fumanal Alejandra ◽  
...  
Keyword(s):  
Work Disability ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Clinical Factors ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Factors Associated

scholarly journals Do geography and ethnicity play a role in juvenile Spondyloarthritis? A multi-center binational retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Nassem Ghantous ◽  
Merav Heshin-Bekenstein ◽  
Kimberly Dequattro ◽  
Yaniv Lakovsky ◽  
Amir Moshe Hendel ◽  
...  
Keyword(s):  
Pediatric Rheumatology ◽  
The United States ◽  
Inflammatory Back Pain ◽  
Hla B27 ◽  
Cross Sectional ◽  
Joint Tenderness ◽  
The Us ◽  
Axial Disease ◽  
Juvenile Spondyloarthritis ◽  
Juvenile Ankylosing Spondylitis

Abstract Background Observations among Israeli pediatric rheumatologists reveal that pediatric Juvenile Spondyloarthritis (JSpA) may present differently compared to patients from the United States (US). This study is aimed to compare the demographic and clinical variables of Israeli and US JSpA patients upon presentation. Methods We performed a retrospective, cross-sectional, multicenter comparison of JSpA patients among 3 large Israeli pediatric rheumatology centers and a large US pediatric rheumatology center. Patients with diagnosis of Juvenile Ankylosing Spondylitis (JAS) and/or Enthesitis-related Arthritis (ERA) were included. The demographic, clinical and radiologic features were compared. Results Overall 87 patients were included (39 Israeli, 48 US patients). Upon presentation, inflammatory back pain, sacroiliac joint tenderness and abnormal modified Schober test, were significantly more prevalent among Israeli patients (59% vs. 35.4, 48.7% vs. 16.7, and 41.2% vs. 21.5%, respectively, all p < 0.05), whereas peripheral arthritis and enthesitis were significantly more prevalent among US patients (43.6% vs. 91.7 and 7.7% vs. 39.6% in Israeli patients vs. US patients, p < 0.05). In addition, 96.7% of the Israeli patients versus 29.7% of the US patients demonstrated sacroiliitis on MRI (p < 0.001, N = 67). Less than one-third of the Israeli patients (32%) were HLA-B27 positive vs. 66.7% of US patients (p = 0.007). Conclusion Israeli children with JSpA presented almost exclusively with axial disease compared to US patients who were more likely to present with peripheral symptoms. HLA B27 prevalence was significantly lower in the Israeli cohort compared to the US cohort. Further studies are needed to unravel the genetic and possibly environmental factors associated with these findings.

scholarly journals A Retrospective Study on Snakebite Victims in a Tertiary Referral Center

2016 ◽  
Vol 10 (3) ◽  
pp. 47-50
Author(s):  
Nasim Zamani ◽  
◽  
Leila Modir-Fallah Rad ◽  
Kambiz Soltaninejad ◽  
Shahin Shadnia ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Tertiary Referral Center

Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. Methods: In this retrospective, cross-sectional study in Loghman Hakim Hospital Poisoning Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a four-year period from March 2007 to March 2011. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Results: Seventy cases (58 males, 12 females) were evaluated. Most of the cases (79%) were older than 20 year old. The most common bite site was upper extremity (67%). Most of the patients were admitted within 5 h after the snakebite. The most common local and systemic manifestations were swelling (90%), pain (81.4%), nausea and vomiting (24.3%). Leukocytosis (35.7%) and thrombocytopenia (25.7%) were the most common laboratory abnormalities. Most of the patients (97.1%) were treated with antivenom. Fifty percent of the patients only received 3-5 vials of antivenom. The mortality rate was 1.4%. Necrosis of the toes and compartment syndrome were the only serious complications. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

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