Characterization of the Clinical and Laboratory Features of Primary and Secondary Antiphospholipid Syndrome in a Cohort of Egyptian Patients

2020 ◽  
Vol 16 (4) ◽  
pp. 304-310 ◽  
Author(s):  
Geilan Abd el-Moniem ◽  
Kamal El-Garf ◽  
Nesreen Sobhy ◽  
Sally Elmaghraby
Keyword(s):  
Antiphospholipid Syndrome ◽  
Age At Onset ◽  
Disease Onset ◽  
P Value ◽  
Significant Difference ◽  
Egyptian Patients ◽  
Laboratory Features ◽  
Systemic Manifestations ◽  
Males And Females

Objective: To study the clinical and laboratory features of Antiphospholipid Syndrome (APS) in a cohort of Egyptian patients and compare between primary and secondary type on the basis of clinical and immunological pattern. Patients and Methods: We reviewed the medical records of 148 antiphospholipid syndrome patients following in Rheumatology and Rehabilitation department, Cairo University. Clinical and immunological data were recorded; subsequently, our patients were compared based on the type of APS, patient’s age and sex. Results: The cohort consisted of 148 patients, 135 females (91.2%) and 13 males (8.8%). The mean age at onset was 23.6 ±7.66 years. 28.4% of patients had primary while, 71.6% of patients had secondary APS. : Patients with secondary APS presented more frequently with the following manifestations compared to patients with primary APS: systemic manifestations (56.6% versus 4.8%, P-value: 0.00), venous thrombosis (41.5% versus 19%, P-value: 0.009), cutaneous vasculitis (19.8% versus 4.8%, P-value: 0.023), thrombocytopenia (37.7% versus 11.9%, P-value: 0.002) and hemolytic anemia (28.3% versus 4.8%, P-value: 0.002). On the other hand, total obstetric manifestations were more common in primary APS (92.5% versus 75%, P-value: 0.007). : Juvenile onset APS presented more frequently with systemic (68.8%, p-value: 0.02), neurological (62.5%, p-value: 0.01) and renal manifestations (31.3%, p-value: 0.005). No statistically significant difference was found between males and females in our cohort. Conclusion: APS has broad spectrum manifestations, which may vary according to the patient’s age at disease onset and association with other diseases. Further more, different ethnicities may show different presentations.

scholarly journals AB0669 PARTICULARITIES OF TUNISIAN FEMALE AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1629.2-1629
Author(s):  
K. Ben Abdelghani ◽  
Y. Gzam ◽  
A. Fazaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Age At Onset ◽  
Disease Onset ◽  
Disease Activity Index ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean

Background:Axial spondyloarthritis (ax-SpA) is a chronic rheumatic disease that mainly affects men. However, the female form of ax-SpA remains insufficiently studied.Objectives:The aim of this study was to determine the clinical characteristics, the disease activity and the functional impact of female ax-SpA in comparison with male ax-SpA.Methods:This is a retrospective study including patients diagnosed with ax-SpA fulfilling the criteria of the Assessment of SpondyloArthritis international Society (ASAS) 2009.Clinical parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) were compared between groups of female and male ax-SpA.Results:Two hundred ax-SpA patients were included with 31% of female (n=62) and a mean age of 43,3 ± 11,2 years.The mean age at onset of symptoms was 31,8 ± 8,9 years for women and 25,3 ± 9,1 years for men (p <0,0001). The mean age at diagnosis was 36,4 ± 9,6 years for women and 31,7 ± 10,4 years for men (p = 0,003). Ax-SpA with juvenile onset was noted in 1,7% of women and 12,1% of men (p = 0,02). Male ax-SpA were significantly more smokers (46.8% vs 5.4%; p <0.001). The mean duration of morning stiffness was 11,3 ± 9,2 minutes for women versus 21,6 ± 19,3 minutes for men (p = 0,005).The mean ESR was 42,4 ± 29,8 mm for women and 28,3 ± 23,4 mm for men (p = 0,001). Radiographic sacroiliitis was present in 69,3% of women versus 84,7% of men (p = 0,01). The use of anti-TNF alpha was less frequent in women (29% vs 48,5%; p = 0,01).Our study didn’t found a statistically significant difference in peripheral manifestations, extraarticular manifestations, CRP, BASDAI and BASFI between the two groups.Conclusion:Female ax-SpA seems to have a better prognosis than male with older age in disease onset, less inflammation, less radiographic sacroiliitis and less use of biological treatments.References:[1]Rusman T, et al. Curr Rheumatol Rep. 2018; 20(6).[2]Siar N, et al. Curr Rheumatol Rev. 2019;Disclosure of Interests:None declared

scholarly journals Prevalence of Hepatitis C Virus in the Population of Albania for the Period 2007-2010

2014 ◽  
Vol 2 (3) ◽  
pp. 525-528 ◽  
Author(s):  
Hysaj Vila Brunilda ◽  
Shundi Lila ◽  
Abazaj Erjona ◽  
Bino Silva ◽  
Rexha Tefta
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Age Groups ◽  
Viral Disease ◽  
Hcv Infection ◽  
University Hospital ◽  
P Value ◽  
Hcv Rna ◽  
Significant Difference ◽  
Males And Females

BACKGROUND: Hepatitis C is a blood-borne, infectious, viral disease that is caused by a hepatotropic virus called Hepatitis C virus (HCV).AIM: The aim of this study is to determine the prevalence of active HCV infection (HCV–RNA) in the cases that were anti-HCV positive.MATERIAL AND METHODS: Plasma of 301 high-risk for HCV infection consecutive from University Hospital Centre “Mother Theresa” Tirana-Albania, during January 2007 to December 2010 was included in this study. To identify the presence of HCV RNA, the samples were examined by Cobas Amplicor HCV test (qualitative method).RESULTS: From 301 samples analyzed in total, 214 of them resulted positive for the presence of HCV-RNA's, corresponding to a prevalence of 71.1%, with 95% CI interval [65.8 - 75.9] for value of χ2 = 52.7 p value <0.0001. Divide by the sex 56% were males and 44% females, with statistically significant difference between them for value χ2 =4306 p value=0.0380. Among the age groups the highest prevalence was observed in the age groups > 25 years with a significant difference with other age groups for p value <0.001.CONCLUSION: Among tested samples, 71.1 % were confirmed to be positive for HCV –RNA infections. The prevalence of male was highest compared to female. For males and females infected the prevalence was highest in the age group of > 25 years.

scholarly journals Validation of distinct pathogenic patterns in a cohort of membranoproliferative glomerulonephritis patients by cluster analysis

2019 ◽  
Vol 13 (2) ◽  
pp. 225-234
Author(s):  
Nóra Garam ◽  
Zoltán Prohászka ◽  
Ágnes Szilágyi ◽  
Christof Aigner ◽  
Alice Schmidt ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Membranoproliferative Glomerulonephritis ◽  
Late Onset ◽  
Age At Onset ◽  
Disease Onset ◽  
Membrane Attack Complex ◽  
Hierarchical Cluster ◽  
Nephritic Syndrome ◽  
Significant Difference ◽  
High Prevalence

Abstract Background A novel data-driven cluster analysis identified distinct pathogenic patterns in C3-glomerulopathies and immune complex-mediated membranoproliferative glomerulonephritis. Our aim was to replicate these observations in an independent cohort and elucidate disease pathophysiology with detailed analysis of functional complement markers. Methods A total of 92 patients with clinical, histological, complement and genetic data were involved in the study, and hierarchical cluster analysis was done by Ward method, where four clusters were generated. Results High levels of sC5b-9 (soluble membrane attack complex), low serum C3 levels and young age at onset (13 years) were characteristic for Cluster 1 with a high prevalence of likely pathogenic variations (LPVs) and C3 nephritic factor, whereas for Cluster 2—which is not reliable because of the small number of cases—strong immunoglobulin G staining, low C3 levels and high prevalence of nephritic syndrome at disease onset were observed. Low plasma sC5b-9 levels, decreased C3 levels and high prevalence of LPV and sclerotic glomeruli were present in Cluster 3, and patients with late onset of the disease (median: 39.5 years) and near-normal C3 levels in Cluster 4. A significant difference was observed in the incidence of end-stage renal disease during follow-up between the different clusters. Patients in Clusters 3–4 had worse renal survival than patients in Clusters 1–2. Conclusions Our results confirm the main findings of the original cluster analysis and indicate that the observed, distinct pathogenic patterns are replicated in our cohort. Further investigations are necessary to analyse the distinct biological and pathogenic processes in these patient groups.

Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity

2014 ◽  
Vol 112 (10) ◽  
pp. 727-735 ◽  
Author(s):  
Elisa Salvan ◽  
Teresa Del Ross ◽  
Maria Gerosa ◽  
Laura Andreoli ◽  
Aldo Maina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Conventional Therapy ◽  
Treatment Strategies ◽  
P Value ◽  
Pregnancy Failure ◽  
Significant Difference ◽  
Antibody Positivity

SummaryPrevious thrombosis, diagnosis of systemic lupus erythematosus (SLE) and triple antiphospholipid (aPL) antibody positivity have recently been found to be independent factors associated to pregnancy failure during conventional therapy in women with antiphospholipid syndrome (APS). This study aimed to assess the effect of various treatment strategies on pregnancy outcomes in women with APS and the risk factors for pregnancy failure. One hundred ninety-six pregnancies of 156 patients diagnosed with APS were analysed: 118 (60.2%) of these had previous thrombosis, 81 (41.3%) were diagnosed with SLE, and 107 (54.6%) had triple aPL positivity. One hundred seventy-five (89.3%) were treated with conventional therapies (low-dose aspirin [LDA] or prophylactic doses of heparin + LDA or therapeutic doses of heparin + LDA), while 21 (10.7%) were prescribed other treatments in addition to conventional therapy. The pregnancies were classified into seven risk profiles depending on the patients’ risk factors – thrombosis, SLE, and triple aPL positivity – and their single, double or triple combinations. It was possible to find significant difference in outcomes correlated to treatments only in the thrombosis plus triple aPL positivity subset, and logistic regression analysis showed that additional treatments were the only independent factor associated to a favourable pregnancy outcome (odds ratio=9.7, 95% confidence interval= 1.1–88.9, p-value<0.05). On the basis of this retrospective study, we found that APS pregnant patients with thrombosis and triple aPL positivity treated with additional therapy had a significant higher livebirth rate with respect to those receiving conventional therapy alone.

scholarly journals Hemispheric Coherence Analysis of Wide Band EEG Signals for Characterization of Post-Stroke Patients with Dementia

2021 ◽  
Vol 38 (4) ◽  
pp. 985-992
Author(s):  
Sugondo Hadiyoso ◽  
Hasballah Zakaria ◽  
Paulus Anam Ong ◽  
Tati Latifah E.R. Mengko
Keyword(s):  
Quantitative Analysis ◽  
Wide Band ◽  
P Value ◽  
Coherence Analysis ◽  
Stroke Survivors ◽  
Eeg Signals ◽  
Stroke Patients ◽  
Post Stroke ◽  
Significant Difference

Post-stroke dementia (PSD) is a type of vascular dementia (VaD) that might be occurred in post-stroke patients. Memory, language and behavior tests can be used for the analysis of cognitive impairment caused by PSD. Often a supporting clinical examination such as an electroencephalogram (EEG) is used to support the diagnosis or analyze the characteristic changes that occur in the brain. Conventional analysis or visual inspection of EEG signals can be very difficult, since the nature of the signal tends to be non-stationer. Therefore, this study proposes a quantitative analysis for the characterization of EEG signals in stroke survivors with dementia. It is thought that it has different characteristics with the normal subject so that this study can be used as a reference in supporting dementia detection in post-stroke survivors. The quantitative analysis used in this study is coherence analysis. Coherence analysis was performed on EEG signals recorded from six poststroke patients with dementia and then compared with ten normal healthy subjects. Analysis of coherence between brain areas includes inter and intra-hemispheric coherence. Validation was carried out by using the independent t-test where the confidence level was 95%, indicating that the p-value <0.05 had a significant difference. The test results show that in general the coherence of the electrode pairs in patients with dementia is lower than in the normal healthy group. It is notably, i) In interhemispheric, the C3-C4, T3-T4, and T5-T6 pairs generate significant differences, ii) the highest decrease in intrahemispheric coherence was found in C3-T5 with p = 0.0005. The coherence study presented in this paper is expected to be used for early detection of PSD in the future.

scholarly journals A Preliminary Clinical Study on 100 Egyptian Psoriatic Patients

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Metabolic Syndrome ◽  
Severe Disease ◽  
Pustular Psoriasis ◽  
Clinical Aspects ◽  
Juvenile Onset ◽  
Immune Mediated ◽  
Significant Difference ◽  
Egyptian Patients ◽  
Pasi Score

Background: Psoriasis is a chronic, immune-mediated, inflammatory condition frequently seen in the clinical practice with a reported prevalence of 0.6 to 4.8 percent in the general population. However, data on psoriasis in Egypt are scarce. So, our aim was to investigate the clinical characterization of psoriasis in 100 Egyptian patients. Method: One hundred Egyptian psoriasis patients were enrolled in this study. A detailed questionnaire was filled including demographic and clinical aspects of the disease. Some laboratory tests were done to search for associated diseases like diabetes, metabolic syndrome and hepatitis C virus (HCV) and to correlate them with the disease severity. The collected data were analyzed by SPSS version 17. Results: Thirty seven patients were diagnosed with juvenile-onset psoriasis. There was no significant difference between the mean PASI score for adult versus juvenile onset psoriasis. Pustular psoriasis affected 15% of the patients including children and infants. Metabolic syndrome was absent in juvenile onset psoriatic patients and wasn’t associated with a significantly higher PASI score in the adults affected. PASI score was significantly high in the HCV positive and the hypertensive patients. Conclusion: Although the study sample is quite small to reach definite judgments on psoriasis in Egypt, yet we noticed that early onset psoriasis is quite a common and challenging disease. Metabolic syndrome is not common in the studied children with psoriasis. Pustular psoriasis is a common entity even in children and infants. HCV is associated with a severe disease and might be an inducing factor for psoriasis.

FEMALES HAVE EARLIER DISEASE ONSET THAN MALES AMONG HLA-CW6 POSITIVE PSORIASIS PATIENTS

2021 ◽  
pp. 1-2
Author(s):  
Akhilesh Behra
Keyword(s):  
Age Of Onset ◽  
Care Center ◽  
Tertiary Care ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Male And Female ◽  
Female Patients ◽  
Males And Females

Background- Psoriasis is a chronic inammatory relapsing skin disorder. Environmental and genetic factors play an important role in the development of disease. HLA-Cw6 most strongly associated with disease. There is also a difference in HLA-Cw6 positivity in respect to gender, which affect occurrence of disease in males and females. Aims & Objectives- This study was aimed to determine the association of HLA-Cw6 positive and negative psoriasis individuals had any signicant differences in respect to disease onset among male and female Materials & Methods- An Institute based Cross sectional study was done in a tertiary care center in eastern India. All patients attending skin OPD were included in the study. Detailed history and blood samples were collected from patients. HLA-Cw6 typing has done by sequence-specic PCR method. Results- HLA-Cw6 positive female patients had a signicantly early age of onset than male patients (p value-0.009334) (20.88 vs. 27.91yr), while HLA-Cw6 negative patients did not show any signicant difference of age of onset between male and female ( p value- 0.406905) Conclusion- Although men are more commonly affected than female, HLA-Cw6 positive psoriasis female patients show earlier disease onset. This results show that genetic variations in terms of HLA-Cw6 are reected in the age of onset among males and females.

Causes of delayed diagnosis of multiple sclerosis in egypt

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Tohamy ◽  
M S Swelam ◽  
D M Abdelgawad ◽  
H A Aref
Keyword(s):  
Multiple Sclerosis ◽  
Age At Onset ◽  
Disease Onset ◽  
Diagnostic Delay ◽  
Delayed Diagnosis ◽  
P Value ◽  
Common Source ◽  
University Hospitals ◽  
Phone Calls ◽  
Diagnostic Delays

Abstract © 2018 Institute of Psychiatry, Ain Shams University Copyright r 2018 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited. Background MS is an inflammatory and neurodegenerative disease. Early inflammatory activity might have a profound impact on the risk of developing early disability, and might be a risk factor for early transition into the progressive phase of the illness. However, there are a number of barriers implementing early MS diagnosis and treatment as the patients may delay consulting a physician about their neurological symptoms or may be reluctant to start DMT. Objective The aim of this study is to highlight the causes of delayed diagnosis of multiple sclerosis in Egypt to shorten the time of diagnosis and improve the prognosis for patients with MS. Patients and Methods Retrospective descriptive study .500 Patients coming to multiple sclerosis unit at Ain Shams University hospitals with delayed diagnosis of MS for more than 2 years had been screened. A questionnaire could be applied on 320 patients out of 500. Contacting (direct and via phone calls) the patients for evaluating the causes of delayed diagnosis of MS was done. Results In this study we found number of significant factors adversely affected a timely diagnosis including the age at onset finding that those younger at onset of MS (vs. older) experienced diagnostic delays (P-value = 0.005) and denial of symptoms which was a leading cause for delayed time to first doctor consultation and delayed diagnosis of MS (P-value =0.009). Also there was a correlation between types of MS and delayed diagnosis as we found that PPMS versus RRMS had delayed diagnosis for more than 2 years. Meanwhile, sensory symptoms at onset of the disease were associated with longer diagnostic delay. Although the first specialties the patients visit were ophthalmology and orthopedic services, that the most common Source of referral to a neurologist was suggestion by family and media. Conclusion multiple causes significantly affect time to diagnosis of MS including age at onset of the disease, denial of symptoms sensorial symptoms at the disease onset and referral delay from other specialties.

Long-term follow-up of antiphospholipid syndrome: real-life experience from a single center

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1050-1059
Author(s):  
Rosa Serrano ◽  
Guillermo J Pons-Estel ◽  
Gerard Espinosa ◽  
Rosana M. Quintana ◽  
Joan C Reverter ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Life Experience ◽  
Disease Onset ◽  
Real Life ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Single Center ◽  
Live Births ◽  
Laboratory Features ◽  
Long Term Follow Up

Objective The objective of this paper is to assess the prevalence of the main clinical manifestations and laboratory features at disease onset and during the ensuing 10 years of a large cohort of patients with antiphospholipid syndrome (APS) from a single center. Methods The study included all consecutive APS patients followed longitudinally in our center from 2003 to 2013. Descriptive statistics for demographics, clinical and laboratory features and mortality were performed. Results A total of 160 patients were included. Most of them, 128 (78.8%), were women and the mean (SD) age at diagnosis was 39.1 (14.0) years. The majority of them, 104 (65.0%), had primary APS, 36 (22.5%) had APS associated with systemic lupus erythematous, and 20 (12.5%) had APS associated with other autoimmune disease. During the study period, thrombotic events occurred in 27 (16.9%) patients, the most common being strokes, nonbacterial thrombotic endocarditis and deep venous thrombosis. Regarding obstetric morbidity, 18 women (14.3%) became pregnant and 90% of pregnancies succeeded in having live births. The most common obstetric complication was early pregnancy loss (15% of pregnancies). Prematurity (11.1% of live births) and intrauterine growth restriction (5.6% of live births) were the most frequent fetal morbidities. Ten (6.3%) patients died and the most frequent causes of death were severe thrombosis, hemorrhage, and cancer. Three (0.9%) cases of catastrophic APS occurred. The survival probability at 10 years was 93.8%. Conclusions Patients with APS develop significant morbidity and mortality despite current treatment. It is imperative to identify prognostic factors and therapeutic measures to prevent these complications.

Lack of gender differences in familial schizophrenia

1997 ◽  
Vol 14 (4) ◽  
pp. 128-131
Author(s):  
Bernadette M Murphy ◽  
John G Burke ◽  
Joseph C Bray ◽  
Dermot Walsh ◽  
Kenneth S Kendler
Keyword(s):  
Gender Differences ◽  
Clinical Features ◽  
Negative Symptoms ◽  
Age At Onset ◽  
Gender Effects ◽  
Final Sample ◽  
Significant Difference ◽  
Schizophrenic Patients ◽  
Males And Females ◽  
The Difference

AbstractObjective: Gender appears to have a significant impact on the prevalence, age at onset, symptoms and outcome of schizophrenia. This study examines gender effects in a population of familial schizophrenic patients in Ireland.Method: Families with two or more siblings suffering from schizophrenia, as defined by DSM-III-R were ascertained in Ireland. The final sample comprised 169 siblings from 80 families. Siblings were interviewed using the Structured Clinical Interview for DSM-III-R (SCID), the Scale for the Assessment of Negative Symptoms (SANS) and the Strauss-Carpenter Levels of Functioning Scale. The difference between males and females for various clinical features were calculated.Result: There was a marked excess of affected males (65% male and 35% female). When the excess of male subjects was taken into account there was no significant excess of same-sex as compared to opposite-sex pairs. There were no significant difference between males and females for age at onset, age at first admission, symptoms or level of outcome.Conclusion: The excess of males and the lack of gender differences for clinical features found in this study may, in part, be due to the narrow diagnostic criteria used. Alternatively, at least some of these findings may be specific to this Irish sample. Further research is a need to see if these findings can be replicated in other countries.

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