DESCRIPTION OF CLINICAL JOINT MANIFESTATION OF HYPOVITAMINOSIS D PATIENTS AT RHEUMATOLOGY OUTPATIENT CLINIC OF DR. HASAN SADIKIN GENERAL HOSPITAL IN WEST JAVA INDONESIA 2012 -2015

2016 ◽  
Author(s):  
Sumartini Dewi
Keyword(s):  
General Hospital ◽  
Outpatient Clinic ◽  
Hypovitaminosis D ◽  
West Java ◽  
Rheumatology Outpatient

scholarly journals AB0702 PITFALLS IN THE DIAGNOSIS OF COVID-19 – EXPERIENCES FROM A RHEUMATOLOGY OUTPATIENT CLINIC

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1383.2-1383
Author(s):  
S. G. Werner ◽  
H. E. Langer ◽  
P. Höhenrieder ◽  
R. Chatelain
Keyword(s):  
Outpatient Clinic ◽  
Virus Disease ◽  
Disease Onset ◽  
Signs And Symptoms ◽  
Contact Tracing ◽  
Igg Antibodies ◽  
Antibody Testing ◽  
Antibody Titers ◽  
Rheumatology Outpatient

Background:PCR (Polymerase Chain Reaction) is generally considered the gold standard for confirming the diagnosis in the early stages of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. However, in our rheumatology outpatient clinic we observed a significant discrepancy between clinical evidence of COVID-19 and PCR results.Objectives:Aim of this retrospective study was to analyze the significance of PCR and serologic tests in the diagnosis of COVID-19 (Corona Virus Disease 2019) in a cohort of patients with rheumatic diseases.Methods:Between March 2020 and January 2021, 35 patients with a history of established COVID-19 or typical signs and symptoms were identified on the occasion of a routine rheumatology follow-up examination in our institution. Previous diagnostic work-up in external facilities (results of PCR or antibody testing, imaging) was documented. Antibody ELISA-tests (IgG, IgA, IgM, Euroimmun) were performed in patients reporting typical signs and symptoms of COVID-19 in the past.Results:PCR diagnostics had been performed in 15/35 patients (43%), in 13/35 (39%) at the onset of the first symptoms, in 2 subjects only 2 months later. PCR was positive in 7/13 (54%) of those tested early, but negative in the two patients tested later. In 29/35 patients (83%) SARS-CoV-2-ELISA tests were performed on the occasion of the routine rheumatologic examination (interval between first symptoms and testing on average 98 days, median86, range 4-283 days). In two of the initially negative individuals the second PCR was positive. ELISA tests were positive in all patients. SARS-CoV-2 IgM antibodies were positive in only two patients (however 55 and 71 days after disease onset), n=8/29 (28%) IgG only, n=9/29 (31%) IgG and IgA, n=12/29 (41%) IgA only. In these subjects, IgG antibodies did not develop even in the further course. Antibody titers were in part very high, but in part also very low (only just above the normal value), so even low titers were diagnostic obviously. In all patients with negative PCR, ELISA was positive and retrospectively led to confirmation of the diagnosis. Only in 13/35 patients (37%) diagnosis had been made with the onset of the first symptoms or in the course of clinically manifest disease and had led to appropriate quarantine measures and contact tracing by the health authorities. In contrast, in the majority of patients (63%), the diagnosis of COVID-19 infection was only made retrospectively on the occasion of a routine rheumatologic follow-up. However, 5 of these 22 patients (23%) had quarantined themselves during the symptomatic phase. Titer histories were available from 12 patients. The titer became negative in 7 patients, after a mean of 188 days (median 202, min 51, max 296 days), and remained positive in 5 individuals (mean 190 days, median 191, min 122, max 260 days). The change of the titer was independent of disease severity or antirheumatic therapy.Conclusion:The results suggest that the importance of PCR in the diagnosis of COVID-19 may be overestimated. Therefore, antibody testing for SARS-CoV-2 should be performed in cases of clinical suspicion and negative PCR. In antibody diagnostics, special features were observed compared to other viruses, in particular, in some patients only low antibody titers or the absence of seroconversion with lack of development of IgG antibodies. Normalization of antibody titers in some patients supports the recommendation to vaccinate even after expired COVID-19 disease.Disclosure of Interests:None declared

An Outpatient Survey of Antidepressant Prescription Habits

1986 ◽  
Vol 20 (4) ◽  
pp. 487-491 ◽  
Author(s):  
Geoffrey D. Schrader ◽  
Andrew Gibbs ◽  
Robert G. Harcourt
Keyword(s):  
General Hospital ◽  
Outpatient Clinic ◽  
Depressive Disorders ◽  
Low Doses ◽  
Neurotic Disorders ◽  
Psychiatric Outpatient ◽  
Antidepressant Prescription ◽  
Psychiatric Outpatient Clinic

A review of case notes of patients attending a general hospital psychiatric outpatient clinic revealed that 75% of patients with depressive disorders and 38% of patients with neurotic disorders were prescribed antidepressants. Antidepressants were often prescribed for long periods in low doses and in combination with benzodiazepines. There was less polypharmacy, however, with more sedating antidepressants. The results indicate that clinical prescription habits for antidepressants may still be at some variance with recommendations from the literature.

The use of TNF Blockers in the Rheumatology Outpatient Clinic, Doha, Qatar

2009 ◽  
Vol 2009 (1) ◽  
Author(s):  
S. Al Emadi ◽  
H. Sarakbi ◽  
M. Hammodeh
Keyword(s):  
Outpatient Clinic ◽  
Tnf Blockers ◽  
Rheumatology Outpatient

scholarly journals Specialist interventions at the rheumatology outpatient clinic

Rheumatology ◽  
2007 ◽  
Vol 46 (12) ◽  
pp. 1859-1860 ◽  
Author(s):  
M. Wray ◽  
G.D. Wright
Keyword(s):  
Outpatient Clinic ◽  
Rheumatology Outpatient

Prolonged, widespread, disabling musculoskeletal pain of adolescents among referrals to the Pediatric Rheumatology Outpatient Clinic from the Päijät-Häme Hospital District in southern Finland

2018 ◽  
Vol 18 (4) ◽  
pp. 621-628
Author(s):  
Heini Pohjankoski ◽  
Maiju Hietanen ◽  
Leena Leppänen ◽  
Heli Vilen ◽  
Hannu Kautiainen ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Outpatient Clinic ◽  
Pediatric Rheumatology ◽  
Functional Disability ◽  
Screening Tool ◽  
Screening Tools ◽  
Rapid Screening ◽  
Hospital District ◽  
Pain Patients ◽  
Rheumatology Outpatient

Abstract Background and aims Musculoskeletal pain among adolescents is a problem for the patients and their families and has economic consequences for society. The aim of this study is to determine the incidence of prolonged disabling musculoskeletal pain of adolescents among referrals to a pediatric rheumatology outpatient clinic and describe the patient material. The second aim is to find proper screening tools which identifies patients with a risk of pain chronification and to test whether our patients fit the Pediatric Pain Screening Tool (PPST) stratification according to Simons et al. Methods We selected adolescent patients with disabling, prolonged, musculoskeletal pain and calculated the incidence. Furthermore, after the patient collection, we adjusted our pain patients to PPST. Results The incidence of prolonged musculoskeletal pain patients at our clinic was 42/100,000 patient years (pyrs) (age 13–18; 95% CI: 29–60) during years 2010–2015. A nine-item screening tool by Simons et al. proves to be valid for our patient group and helps to identify those patients who need early, prompt treatment. The functional risk stratification by Simons et al. correlates with our patients’ functional disability. Conclusions and implications In order to prevent disability and to target intervention, it is necessary to have proper and rapid screening tools to find the appropriate patients in time.

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