Discovery of Arthritis in Psoriasis Patients for Early Rheumatological Referral (DAPPER): Protocol for a Longitudinal Observational Study

Background One in three patients with psoriasis will develop psoriatic arthritis (PsA). If left untreated, this can lead to pain, impaired function, and irreversible joint damage. Timely recognition and referral to a rheumatologist are therefore key. However, current methods used to screen patients with psoriasis for those who might benefit from referral to a rheumatologist are not performing well enough. Objective The Discovery of Arthritis in Psoriasis Patients for Early Rheumatological Referral (DAPPER) study is designed to determine the prevalence of PsA in a psoriasis population and to find parameters that can be used to develop a new or enhance an existing instrument for a rheumatological referral. Methods DAPPER is a longitudinal observational study with a 1-year follow-up. Patients with psoriasis (N=300) who are treated at an outpatient dermatological clinic will be screened extensively for signs and symptoms of PsA by a trained rheumatologist. If there is clinical suspicion of PsA and the patient is not yet treated by a rheumatologist, referral to the Department of Rheumatology will follow for confirmation of the diagnosis and further care. After 1 year, data on changes in quality of life and PsA and psoriasis disease activity will be collected from the referred patients. The screening visit will be used to gather demographical and medical data, which can later be used to develop the aforementioned screening instrument. Results Inclusion started in June 2019 and finished in June 2021. Follow-up with newly discovered patients with PsA is ongoing. Conclusions The DAPPER study is specifically designed to improve the detection of existing PsA in a dermatologic outpatient setting. Although internal validity will be tested, external validity will have to be checked using a second validation cohort. To predict the development of PsA in the future, longitudinal/prospective data collection is required and will be performed in a follow-up study (DAPPER-i). Trial Registration Dutch Trial Register NTR7604; https://www.trialregister.nl/trial/7397 International Registered Report Identifier (IRRID) DERR1-10.2196/31647

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Discovery of Arthritis in Psoriasis Patients for Early Rheumatological Referral (DAPPER): Protocol for a Longitudinal Observational Study (Preprint)

10.2196/preprints.31647 ◽

2021 ◽

Author(s):

Tamara W van Hal ◽

Juul MPA Van den Reek ◽

Hans MM Groenewoud ◽

Marcel C Pasch ◽

Frank HJ Van den Hoogen ◽

...

Keyword(s):

Observational Study ◽

Validation Cohort ◽

Joint Damage ◽

Internal Validity ◽

Signs And Symptoms ◽

Outpatient Setting ◽

Prospective Data ◽

Longitudinal Observational Study

BACKGROUND One in three patients with psoriasis will develop psoriatic arthritis (PsA). If left untreated, this can lead to pain, impaired function, and irreversible joint damage. Timely recognition and referral to a rheumatologist are therefore key. However, current methods used to screen patients with psoriasis for those who might benefit from referral to a rheumatologist are not performing well enough. OBJECTIVE The Discovery of Arthritis in Psoriasis Patients for Early Rheumatological Referral (DAPPER) study is designed to determine the prevalence of PsA in a psoriasis population and to find parameters that can be used to develop a new or enhance an existing instrument for a rheumatological referral. METHODS DAPPER is a longitudinal observational study with a 1-year follow-up. Patients with psoriasis (N=300) who are treated at an outpatient dermatological clinic will be screened extensively for signs and symptoms of PsA by a trained rheumatologist. If there is clinical suspicion of PsA and the patient is not yet treated by a rheumatologist, referral to the Department of Rheumatology will follow for confirmation of the diagnosis and further care. After 1 year, data on changes in quality of life and PsA and psoriasis disease activity will be collected from the referred patients. The screening visit will be used to gather demographical and medical data, which can later be used to develop the aforementioned screening instrument. RESULTS Inclusion started in June 2019 and finished in June 2021. Follow-up with newly discovered patients with PsA is ongoing. CONCLUSIONS The DAPPER study is specifically designed to improve the detection of existing PsA in a dermatologic outpatient setting. Although internal validity will be tested, external validity will have to be checked using a second validation cohort. To predict the development of PsA in the future, longitudinal/prospective data collection is required and will be performed in a follow-up study (DAPPER-i). CLINICALTRIAL Dutch Trial Register NTR7604; https://www.trialregister.nl/trial/7397 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/31647

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A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v1i1.3631 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Praveenkumar H. Bagali ◽

A. S. Prashanth

Keyword(s):

Medical Science ◽

Frozen Shoulder ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Animal Kingdom ◽

Shoulder Joints ◽

Group A ◽

Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

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The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study

BMC Family Practice ◽

10.1186/s12875-021-01471-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ingmar Schäfer ◽

Heike Hansen ◽

Agata Menzel ◽

Marion Eisele ◽

Daniel Tajdar ◽

...

Keyword(s):

Primary Care ◽

Observational Study ◽

Rural Areas ◽

Longitudinal Observational Study ◽

Multivariable Analyses ◽

Gastrointestinal Complaints ◽

Urban And Rural Areas ◽

Quota Sampling ◽

Primary Care Practices

Abstract Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.

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Characteristics Predicting the Outcome in Individuals with Diabetic Foot Ulcerations

Journal of the American Podiatric Medical Association ◽

10.7547/15-070 ◽

2017 ◽

Vol 107 (3) ◽

pp. 180-191 ◽

Cited By ~ 2

Author(s):

Lourdes Vella ◽

Cynthia Formosa

Keyword(s):

Ulcer Healing ◽

Diabetic Foot ◽

Health Care Professionals ◽

Hemoglobin A1c ◽

Foot Ulcer ◽

Patient Characteristics ◽

Outpatient Setting ◽

Foot Complications

Background: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. Methods: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up for a maximum of 1 year. Results: After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics. Seventy-seven percent of ulcers had healed and 23% had not healed. Independent predictors of nonhealing were ulcer stage (P = .003), presence of biofilm (P = .020), and ulcer depth (P = .028). Although this study demonstrated that the baseline hemoglobin A1c reading at the start of the study was not a significant predictor of foot ulcer outcome (P = .603, resolved versus amputated), on further statistical analyses, when hemoglobin A1c was compared with the time taken for complete ulcer healing (n = 77), it proved to be significant (P = .009). Conclusions: The factors influencing healing are ulcer stage, presence of biofilm, and ulcer depth. These findings have important implications for clinical practice, especially in an outpatient setting. Prediction of outcome may be helpful for health-care professionals in individualizing and optimizing clinical assessment and management of patients. Identification of determinants of outcome could result in improved health outcomes, improved quality of life, and fewer diabetes-related foot complications.

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Health-related quality of life in patients after lumbar disc surgery: a longitudinal observational study

Quality of Life Research ◽

10.1007/s11136-007-9255-8 ◽

2007 ◽

Vol 16 (9) ◽

pp. 1453-1460 ◽

Cited By ~ 13

Author(s):

Dirk Heider ◽

Katharina Kitze ◽

Margrit Zieger ◽

Steffi G. Riedel-Heller ◽

Matthias C. Angermeyer

Keyword(s):

Quality Of Life ◽

Observational Study ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Health Related Quality ◽

Longitudinal Observational Study ◽

Disc Surgery ◽

Related Quality ◽

Health Related

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Clinical Evolution and Quality of Life in Clinically Based COPD Chronic Bronchitic and Emphysematous Phenotypes: Results from the 1-Year Follow-Up of the STORICO Italian Observational Study

International Journal of Chronic Obstructive Pulmonary Disease ◽

10.2147/copd.s310428 ◽

2021 ◽

Vol Volume 16 ◽

pp. 2133-2148

Author(s):

Francesco Blasi ◽

Raffaele Antonelli Incalzi ◽

Giorgio Walter Canonica ◽

Pietro Schino ◽

Giuseppina Cuttitta ◽

...

Keyword(s):

Quality Of Life ◽

Observational Study ◽

Clinical Evolution

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Murcia atrial fibrillation project II: protocol for a prospective observational study in patients with atrial fibrillation

BMJ Open ◽

10.1136/bmjopen-2019-033712 ◽

2019 ◽

Vol 9 (12) ◽

pp. e033712

Author(s):

José Miguel Rivera-Caravaca ◽

Francisco Marín ◽

María Asunción Esteve-Pastor ◽

Josefa Gálvez ◽

Gregory Y.H. Lip ◽

...

Keyword(s):

Atrial Fibrillation ◽

Observational Study ◽

Heart Valves ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Real Life ◽

Poor Quality ◽

Prosthetic Heart Valves

IntroductionAtrial fibrillation (AF) is characterised by a high stroke risk. Vitamin K antagonists (VKAs) are the most commonly used oral anticoagulants (OACs) in Spain, but their efficacy and safety depend on the time in therapeutic range of International Normalized Ratio (INR) 2.0–3.0 over 65%–70%. Unfortunately, the difficulties of maintaining an optimal level of anticoagulation and the complications of VKAs (particularly haemorrhagic ones), frequently lead to cessation of this therapy, which has been associated with higher risk of adverse events (AEs), including ischaemic stroke. Our aims are as follows: (1) to evaluate the quality of oral anticoagulation with VKAs, the prevalence of poor quality of anticoagulation, and to identify factors predisposing to poor quality anticoagulation; and (2) to identify patients who will stop OAC and to investigate what factors influence the decision of OAC withdrawal.Methods and analysisProspective observational cohort study including outpatients newly diagnosed with AF and naïve for OACs from July 2016 to June 2018 in an anticoagulation clinic. Patients with prosthetic heart valves, rheumatic mitral valves or valvular AF will be excluded. Follow-up will extend for up to 3 years. During this period, the INR results and changes in the anticoagulant therapy will be recorded, as well as all AEs, or any other information that would be relevant to the proper conduct of research.Ethics and disseminationAll patients were informed about the nature and purpose of the study, and the protocol was approved by the Ethics Committee of Hospital General Universitario Morales Meseguer (reference: EST:20/16). This is an observational study focusing on ‘real life’ practice and therefore all treatments and follow-up will be performed in accordance to the routine clinical practice with no specific interventions or visits. The results of our study will be disseminated by presentations at national and international meetings, and publications in peer-reviewed journals.

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