scholarly journals Rate of Infection in Rheumatoid Arthritis Patients

2014 ◽  
Vol 4 (1) ◽  
pp. 15-21
Author(s):  
Aisha A. Al Ghamdi ◽  
Suzan M. Attar
Keyword(s):  
Rheumatoid Arthritis ◽  
University Hospital ◽  
Inflammatory Disorder ◽  
Risk Of Infection ◽  
Kingdom Of Saudi Arabia ◽  
Steroid Use ◽  
Increased Risk ◽  
King Abdulaziz University ◽  
Associated Risk Factors ◽  
Common Infections

Objectives: Rheumatoid arthritis is an autoimmune inflammatory disorder associated with increased risk of infection. The aim of this study was to evaluate infections frequency in rheumatoid arthritis patients and to report the independent associated risk factors. Methods: Rheumatoid arthritis patients (n = 200) were retrospectively reviewed at King Abdulaziz University Hospital Jeddah, Kingdom of Saudi Arabia from January 2008 to December 2010. The rate and predictors of infection were evaluated. Results: The frequency of infection in rheumatoid arthritis patients was (36%). The most common infections were pneumonia, bacteremia and urinary tract infection occurring in 18%, 12%, and 10%, respectively. The strongest and significant predictors for infection were cardiovascular disease (OR = 8.87), renal impairment (OR = 7.12), and steroid use (OR = 1.67). Conclusions: Infection rate in rheumatoid arthritis patients was high but lower than other studies. Comorbid illnesses (renal and cardiovascular diseases) and steroids in rheumatoid arthritis patients predisposed them to develop infections that may necessitate hospitalization. Comorbid illnesses should be managed early and steroids to be used cautiously in order to reduce infection risk among rheumatoid arthritis patients.

scholarly journals Rate of Infection in Rheumatoid Arthritis Patients

2014 ◽  
Vol 4 (1) ◽  
pp. 15-21
Author(s):  
Aisha A. Al Ghamdi ◽  
Suzan M. Attar
Keyword(s):  
Rheumatoid Arthritis ◽  
University Hospital ◽  
Inflammatory Disorder ◽  
Risk Of Infection ◽  
Kingdom Of Saudi Arabia ◽  
Steroid Use ◽  
Increased Risk ◽  
King Abdulaziz University ◽  
Associated Risk Factors ◽  
Common Infections

Objectives: Rheumatoid arthritis is an autoimmune inflammatory disorder associated with increased risk of infection. The aim of this study was to evaluate infections frequency in rheumatoid arthritis patients and to report the independent associated risk factors. Methods: Rheumatoid arthritis patients (n = 200) were retrospectively reviewed at King Abdulaziz University Hospital Jeddah, Kingdom of Saudi Arabia from January 2008 to December 2010. The rate and predictors of infection were evaluated. Results: The frequency of infection in rheumatoid arthritis patients was (36%). The most common infections were pneumonia, bacteremia and urinary tract infection occurring in 18%, 12%, and 10%, respectively. The strongest and significant predictors for infection were cardiovascular disease (OR = 8.87), renal impairment (OR = 7.12), and steroid use (OR = 1.67). Conclusions: Infection rate in rheumatoid arthritis patients was high but lower than other studies. Comorbid illnesses (renal and cardiovascular diseases) and steroids in rheumatoid arthritis patients predisposed them to develop infections that may necessitate hospitalization. Comorbid illnesses should be managed early and steroids to be used cautiously in order to reduce infection risk among rheumatoid arthritis patients.

Risk of infection following colonoscopy and sigmoidoscopy in symptomatic patients

Endoscopy ◽  
2017 ◽  
Vol 49 (08) ◽  
pp. 754-764 ◽  
Author(s):  
Jiun-Nong Lin ◽  
Chang-Bi Wang ◽  
Chih-Hui Yang ◽  
Chung-Hsu Lai ◽  
Hsi-Hsun Lin
Keyword(s):  
Health Insurance ◽  
Retrospective Study ◽  
Confidence Interval ◽  
National Health Insurance ◽  
Control Group ◽  
Research Database ◽  
Concordance Index ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Common Infections

Abstract Background and study aims Previous studies describing the incidence of infection after colonoscopy and sigmoidoscopy are limited. The aim of this study was to determine the incidence of infection, and to propose a nomogram to predict the probability of infection following colonoscopy and sigmoidoscopy in symptomatic patients. Patients and methods A nationwide retrospective study was conducted by analyzing the National Health Insurance Research Database of Taiwan. The incidence of infection within 30 days after colonoscopy and sigmoidoscopy was assessed and compared with a control group matched at a ratio of 1:1 based on age, sex, and the date of examination. Results  In all, 112 543 patients who underwent colonoscopy or sigmoidoscopy and 112 543 matched patients who did not undergo these procedures were included. The overall incidence of infection within 30 days after colonoscopy and sigmoidoscopy was 0.37 %, which was significantly higher than that of the control group (0.04 %; P < 0.001). Diverticulitis, peritonitis, and appendicitis were the most common infections. Patients who underwent colonoscopy or sigmoidoscopy had a 9.38-fold risk of infection (95 % confidence interval, 6.81 – 12.93; P < 0.001) compared with the control group. The predicted infection-free rates of the nomogram were closely aligned with the actual infection-free rates, with a bootstrapping concordance index of 0.763. Conclusions Colonoscopy and sigmoidoscopy are associated with an increased risk of infection, which may occur after these procedures. Our nomogram may provide clinicians with an easy tool to evaluate the risk of infection after colonoscopy and sigmoidoscopy in symptomatic patients.

scholarly journals Occurrence of Serious Infection in Patients with Rheumatoid Arthritis Treated with Biologics and Denosumab Observed in a Clinical Setting

2017 ◽  
Vol 45 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Arthur N. Lau ◽  
Matthew Wong-Pack ◽  
Rod Rodjanapiches ◽  
George Ioannidis ◽  
Sally Wade ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Opportunistic Infection ◽  
Opportunistic Infections ◽  
Biologic Agent ◽  
Risk Of Infection ◽  
Group 4 ◽  
Concurrent Use ◽  
Serious Infection ◽  
Increased Risk ◽  
Group 3

Objective.Previous studies combining biologic disease-modifying antirheumatic drugs (bDMARD) to treat rheumatoid arthritis (RA) have shown an increased risk of infection. However, the risk of infection with concurrent use of denosumab, a biologic agent for the treatment of osteoporosis, and a bDMARD remains unclear. Here, we evaluated the incidence of serious and opportunistic infections in patients treated concurrently with denosumab and a bDMARD and patients treated with a bDMARD alone.Methods.A chart review of patients with RA from 2 Canadian rheumatology practices between July 1, 2010, and July 31, 2014, identified 2 groups of patients: those taking denosumab and a bDMARD concurrently (concurrent group) and those taking only a bDMARD (biologic-alone group). Patients were followed from the time of initiation of denosumab, or a matched index date for the biologic-alone group, to the end of the study or loss to followup. Instances of serious or opportunistic infections were recorded.Results.A total of 308 patients (n = 102 for the concurrent group and n = 206 for the biologic-alone group) were evaluated. Within the concurrent group, 3 serious infection events occurred. Within the biologic-alone group, 4 serious infection events and 1 opportunistic infection event occurred. In both groups, all patients with serious or opportunistic infection recovered, and there were no instances of death during the study period.Conclusion.This study demonstrated a low occurrence of serious and opportunistic infections in patients with RA taking bDMARD, including patients with concurrent denosumab use.

scholarly journals COVID-19 and Sarcoidosis, Readiness for Vaccination: Challenges and Opportunities

2021 ◽  
Vol 8 ◽  
Author(s):  
Michael Manansala ◽  
Amit Chopra ◽  
Robert P. Baughman ◽  
Richard Novak ◽  
Elyse E. Lower ◽  
...  
Keyword(s):  
Clinical Decision ◽  
Inflammatory Disorder ◽  
Efficacy And Safety ◽  
Risk Of Infection ◽  
Decision Algorithm ◽  
Chronic Inflammatory Disorder ◽  
Immune Mediated ◽  
Immunosuppressive Medications ◽  
Increased Risk ◽  
Challenges And Opportunities

Sarcoidosis is an immune mediated chronic inflammatory disorder that is best characterized by non-caseating granulomas found in one or more affected organs. The COVID-19 pandemic poses a challenge for clinicians caring for sarcoidosis patients who may be at increased risk of infection compared to the general population. With the recent availability of COVID-19 vaccines, it is expected that clinicians raise questions regarding efficacy and safety in sarcoidosis. However, studies examining safety and efficacy of vaccines in sarcoidosis are lacking. In this review, we examine the current literature regarding vaccination in immunocompromised populations and apply them to sarcoidosis patients. The available literature suggests that vaccines are safe and effective in patients with autoimmune disorders and in those taking immunosuppressive medications. We strongly recommend the administration of COVID-19 vaccines in patients with sarcoidosis. We also present a clinical decision algorithm to provide guidance on vaccination of sarcoidosis patients against COVID-19.

scholarly journals High Anemia Prevalence in Korean Older Adults, an Advent Healthcare Problem: 2007-2016 KNHANES

2020 ◽  
Author(s):  
Hee won Chueh ◽  
Hye Lim Jung ◽  
Ye Jee Shim ◽  
Hyoung Soo Choi ◽  
Jin Yeong Han
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Multivariate Analyses ◽  
University Hospital ◽  
Categorical Variables ◽  
High Morbidity ◽  
Older Individuals ◽  
Female Sex ◽  
Korean Adults ◽  
Increased Risk

Abstract BACKGROUND: Anemia is associated with high morbidity and mortality in older people. However, the prevalence and characteristics of anemia in older individuals are not fully understood, and national data on these aspects in older Korean adults are lacking. This study aimed to evaluate the prevalence and characteristics of anemia in older adults using data from the Korea National Health and Nutrition Examination Survey (KNHANES), which is a nationwide cross-sectional epidemiological study conducted by the Korean Ministry of Health and Welfare.METHODS: Data from a total of 62,825 participants of the 2007-2016 KNHANES were compiled and analyzed to investigate differences in participant characteristics and potential risk factors for anemia. Differences in clinical characteristics of participants were compared across subgroups using the chi-square test for categorical variables and independent t-test for continuous variables. Univariate and multivariate analyses using logistic regression were performed to identify related clinical factors.RESULTS: The prevalence of anemia was higher in the population aged ≥ 65 years than in the younger population. Anemia was also more prevalent among females than among males, but this difference was not significant in people aged >85 years. Being underweight, receiving a social allowance, living alone, and having comorbidities such as hypertension, rheumatoid arthritis, diabetes mellitus (DM), cancer, and chronic renal failure (CRF) were more common among older adults with anemia than among the population without anemia. In univariate and multivariate analyses, older age, female sex, underweight, and presence of comorbidities including rheumatoid arthritis, DM, cancer, and CRF were associated with an increased risk of anemia.CONCLUSIONS: This study revealed that age, female sex, underweight, and the presence of comorbidities such as rheumatoid arthritis, DM, cancer, and CRF were associated with an increased risk of anemia in older Korean adults. Further study on causal relationships between anemia and other variables in the older population is necessary.Trial registration: KNHANES has been approved by the KCDC Research Ethics Review Committee, annually since 2007 (2007-02CON-04-P, 2008-05EXP-01-C, 2009-01CON-03-2C, 2010-02CON-21-C, 2011-02CON-06-C, 2012-01EXP-01-2C, 2013-07CON-03-4C, 2013-12EXP-03-5C, 2015-01-02-6C). Ethical approval of this study was obtained through the Institutional Review Board of Dong-A University Hospital (DAUHIRB-EXP-20-035).

scholarly journals Growth patterns and associated risk factors of congenital malformations in twins

2020 ◽  
Author(s):  
Ettore Piro ◽  
Ingrid Anne Mandy Schierz ◽  
Gregorio Serra ◽  
Giuseppe Puccio ◽  
Mario Giuffrè ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Twin Pair ◽  
Heart Defects ◽  
Growth Patterns ◽  
University Hospital ◽  
Parental Age ◽  
Increased Risk ◽  
Associated Risk Factors ◽  
The University ◽  
Twin Pregnancies

Abstract Background: The rate of twinning continues to increase due to the combined effect of a rise in parental age and increased use of assisted reproductive technology. The risk of congenital anomalies in twins is higher than in singletons, but it is less well reported in relation to growth patterns. We focused to the auxological outcome of twin pregnancies when one or both of twins are affected by one or more malformations. Methods: We conducted a retrospective observational study reviewing the clinical charts of twins admitted in the period between January 2003 and December 2018 at the University Hospital of Palermo. The associations between malformations and anthropometric variables at birth were analyzed by comparison within each twin pair and regarding each variable as ordered difference between the two twins. Results: We studied data of 488 neonates (52% females) from 244 pregnancies. The rate of major congenital anomalies was 11%, affecting significantly the smaller twin (p = .00018; Odds ratio 3.21; 95% CI 1.65 6.59). Malformation class distribution was as following: genitourinary (24%), gastrointestinal (20%), cardiovascular (18.5%), musculoskeletal (11%), central nervous system (9%), syndromic (9%), ocular (5.5%) and diaphragmatic hernia (2%). The most predictive value, the Birthweight (BW) difference mean ratio in malformed versus not malformed neonates (-0.31 vs 0.02; p= .0016) was distributed equally lower than zero in all malformed twins, except for those with congenital heart defects ( p= .0000083). Microcephaly (head circumference <2 standard deviation, SD) was present in 3% of symmetrically smaller twin, and severe microcephaly (<3 SD) was present in 0.6%. We found that an intertwin BW discordance of 18% or greater identified 50% of neonates with microcephaly, but only 11% of malformed twins. Conclusions: In case of one twin with a BW <10 th centile, a concomitant intertwin BW discordance ≥18% could reveal an increased risk for microcephaly but not for malformation. Lower values of BW, Ponderal index, Body mass index but above all negative value of BW difference mean ratio are associated with malformations in twin pairs.

Risk and other factors associated with toxoplasmosis and toxocariasis in pregnant women from southern Brazil

2016 ◽  
Vol 91 (5) ◽  
pp. 534-538 ◽  
Author(s):  
P.C. Santos ◽  
P.L. Telmo ◽  
L.M. Lehmann ◽  
G.T. Mattos ◽  
G.B. Klafke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Total Population ◽  
University Hospital ◽  
Risk Of Infection ◽  
Southern Brazil ◽  
Factors Associated ◽  
Modes Of Transmission ◽  
Increased Risk ◽  
Serology Test

AbstractToxoplasmosis causes complications during pregnancy that have serious effects on fetal development. Thus far, toxocariasis has been reported to spread only via vertical transmission. Nonetheless, the population of pregnant women is also exposed to this infection. Co-infection with both Toxoplasma gondii and Toxocara spp. has been reported in children, but there are no reports of co-infection in the population of pregnant women. The aim of this study was to determine the prevalence of co-infection with T. gondii and Toxocara spp. in pregnant women at a university hospital in southern Brazil, and to identify the risk factors associated with infection by both parasites. Two hundred pregnant women were tested for the presence of anti-T. gondii and anti-Toxocara spp. antibodies and were asked to complete an epidemiological questionnaire. In this study, the co-infection rate observed in the total population of pregnant women was 8%. In addition, women with a positive result for a serology test for Toxocara spp. were at increased risk of infection by T. gondii (P = 0.019). Co-infection with both parasites in pregnant women was associated with low birth weights in neonates. The similar modes of transmission of both parasites could explain the co-infection. Only a few previous studies have investigated this phenomenon. The findings of the present study emphasize the importance of serological diagnosis during prenatal care and further research in this area to identify risk factors associated with this co-infection, and the possible implications of this co-infection during pregnancy and on the health of newborns.

scholarly journals Considerations for improving quality of care of patients with rheumatoid arthritis and associated comorbidities

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001211 ◽  
Author(s):  
Tore K Kvien ◽  
Alejandro Balsa ◽  
Neil Betteridge ◽  
Maya H Buch ◽  
Patrick Durez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Primary Care ◽  
Good Practice ◽  
Research Literature ◽  
Inflammatory Disorder ◽  
Management Support ◽  
Patient Registries ◽  
Self Monitoring ◽  
Increased Risk ◽  
Delays In Diagnosis

ObjectiveRheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder with a global prevalence of approximately 0.5–1%. Patients with RA are at an increased risk of developing comorbidities (eg, cardiovascular disease, pulmonary disease, diabetes and depression). Despite this, there are limited recommendations for the management and implementation of associated comorbidities. This study aimed to identify good practice interventions in the care of RA and associated comorbidities.MethodsA combination of primary research (180+ interviews with specialists across 12 European rheumatology centres) and secondary research (literature review of existing publications and guidelines/recommendations) were used to identify challenges in management and corresponding good practice interventions. Findings were prioritised and reviewed by a group of 18 rheumatology experts including rheumatologists, comorbidity experts, a patient representative and a highly specialised nurse.ResultsChallenges throughout the patient pathway (including delays in diagnosis and referral, shortage of rheumatologists, limited awareness of primary care professionals) and 18 good practice interventions were identified in the study. The expert group segmented and prioritised interventions according to three distinct stages of the disease: (1) suspected RA, (2) recent diagnosis of RA and (3) established RA. Examples of good practice interventions included enabling self-management (self-monitoring and disease management support, for example, lifestyle adaptations); early arthritis clinic; rapid access to care (online referral, triage, ultrasound-guided diagnosis); dedicated comorbidity specialists; enhanced communication with primary care (hotline, education sessions); and integrating patient registries into daily clinical practice.ConclusionLearning from implementation of good practice interventions in centres across Europe provides an opportunity to more widely improved care for patients with RA and associated comorbidities.

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