Comparing the Clinical and Laboratory Features of Remitting Seronegative Symmetrical Synovitis with Pitting Edema and Seronegative Rheumatoid Arthritis: Stage 1

In seronegative arthritis with extremity edema, the differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (SNRA) is difficult. We compared the clinical characteristics of RS3PE and SNRA and those of such patients with and without malignancies. We retrospectively examined patients diagnosed with RS3PE (McCarty criteria) and SNRA at our hospital in 2007–2020. Malignancy was diagnosed within 2 years before or after RS3PE or SNRA diagnosis. Overall, 24 RS3PE and 124 SNRA patients were enrolled. The mean ages were 79.0 and 66.5 years, and men comprised 54.2% and 37.1% of RS3PE and SNRA patients, respectively. RS3PE patients had higher inflammation levels (p < 0.01) and more incidences of malignancy (p < 0.01). Matching for age and sex, RS3PE patients had higher inflammation levels (p < 0.01) and more incidences of malignancy (p = 0.02). Overall, odds ratios (ORs) for malignancy were higher for older age (OR 1.06, p = 0.04), male sex (OR 4.34, p = 0.02), RS3PE patients (OR 4.83, p = 0.01), and patients with extremity edema (OR 4.83, p = 0.01). RS3PE patients had higher inflammation levels and associated factors of malignancy than SNRA patients. Patients who are older, male, with extremity edema, or with RS3PE should be screened for malignancies.

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Comparing the Clinical and Laboratory Features of Remitting Seronegative Symmetrical Synovitis with Pitting Edema and Seronegative Rheumatoid Arthritis

Journal of Clinical Medicine ◽

10.3390/jcm10051116 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1116

Author(s):

Misako Higashida-Konishi ◽

Keisuke Izumi ◽

Satoshi Hama ◽

Hiroshi Takei ◽

Hisaji Oshima ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Associated Factors ◽

Clinical Characteristics ◽

Older Age ◽

Seronegative Arthritis ◽

Odds Ratios ◽

Laboratory Features ◽

Male Sex ◽

Pitting Edema ◽

Age And Sex

In seronegative arthritis with extremity edema, it is difficult to differentiate between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (SNRA). We compared the clinical characteristics of RS3PE and SNRA in patients with and without malignancies. We retrospectively examined patients diagnosed with RS3PE (McCarty criteria) and SNRA at our hospital in 2007–2020. Malignancy was diagnosed within 2 years before or after RS3PE or SNRA diagnosis. Overall, 24 RS3PE and 124 SNRA patients were enrolled. The median ages were 79.5 and 68.5 years, and men comprised 54.2% and 37.1% of RS3PE and SNRA patients, respectively. RS3PE patients had higher inflammation levels (p = 0.004) and more incidences of malignancy (p = 0.034). Matching for age and sex, RS3PE patients had higher inflammation levels (p = 0.021) and more incidences of malignancy (p = 0.005). Overall, odds ratios (ORs) for malignancy were higher for older age (OR 1.06, p = 0.037), male sex (OR 4.34, p = 0.007), RS3PE patients (OR 4.83, p = 0.034), and patients with extremity edema (OR 4.83, p = 0.034). Inflammation levels and associated factors of malignancy were higher in RS3PE patients than in SNRA patients. Patients who are older, male, with extremity edema, or had RS3PE should be screened for malignancies.

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FRI0488 CLINICAL AND LABORATORY FEATURES OF PATIENTS WITH REMITTING SERONEGATIVE SYMMETRICAL SYNOVITIS WITH PITTING EDEMA COMPARED TO PATIENTS WITH SERONEGATIVE RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5871 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 842-843

Author(s):

M. Higashida-Konishi ◽

K. Izumi ◽

S. Hama ◽

Y. Hayashi ◽

Y. Okano ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Secondary Analysis ◽

Sudden Onset ◽

Finger Joints ◽

Before And After ◽

History Of ◽

Rs3pe Syndrome ◽

The Mean ◽

Old Females ◽

Pitting Edema

Background:In the case of seronegative arthritis, it was difficult to make a differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (seronegative RA) because the distribution of affected joints was similar and the patients with RS3PE or seronegative RA may have edema.Objectives:To compare the clinical characteristics of RS3PE and seronegative RAMethods:We retrospectively examine consecutive patients diagnosed with RS3PE or seronegative RA in our hospital from 2007 to 2019. Patients in whom both ACPA and RF were negative were included. The patients with RS3PE met the criteria of McCarty et al.: (1) pitting edema of the dorsum of both hands and both feet, (2) sudden onset of polyarthritis, (3) seronegative for ACPA and RF. (4)no radiologically evident erosions developed. The patients with seronegative RA met the EULAR/ACR 2010 criteria. The patients who were diagnosed with RS3PE at first and then diagnosed with seronegative RA afterward were included in seronegative RA group. The first analysis was performed on the affected joints, CRP, ESR, Hb, LDH, edema, the history of malignancy 2 years before and after the diagnosis, treatment, and the history of infection requiring hospitalization after the start of treatment. The affected joints were shoulders, elbows, wrists, finger joints (the MCP, and PIP joints), hips, knees, ankles, and toe joints (the MTP and PIP joints). The secondary analysis was performed on the above evaluations with a propensity score (PS) matching for age.Results:In the first analysis, 20 patients with RS3PE and 122 patients with seronegative RA were enrolled. The mean ages (RS3PE, seronegative RA) were 81.1, 67.4 years old. Females were 60.0%, 63.1%. The mean observation period was 25.4, 63.6 months. The proportion of affected joints were shoulders (25.0%, 42.6%), elbows (10.0%, 29.5%: p=0.06), wrists (85.0%, 73.8%), finger joints (80.0%, 95.1%: p=0.01), hips (0%, 9.8%), knees (40.0%, 37.7%), ankles (65.0%, 39.3%: p=0.03) and toe joints (40.0%, 32.8%). Edema at diganosis was observed in 100%, 17.21% (p <0.0001). The mean levels of the following blood tests at diagnosis were noted: CRP, 9.0 and 4.8 mg/dL (p=0.02); ESR, 87.6 and 60.7 mm/1h (p=0.003); Hb, 10.4 and 11.8 mg/dl (p=0.001); LDH, 198.3 and 177.9 U/L (p = 0.12); MMP-3, 742.5 and 633.8 ng/mL (p = 0.14). The proportion of patients with high LDH levels (>222 U/L) was 13.6% and 9.0% (p=0.0269). The proportion of patients having the history of malignancy was 20.0%, 8.2% (p=0.10). The patient treated with prednisolone as the initial treatment was 100% and 41.0%; the mean dose was 14.3 and 9.9 mg/d. After the start of treatment, the proportion of infection requiring hospitalization was 20.0 and 3.28% (p=0.002).In the secondary analysis with PS, 17 patients with RS3PE and 17 patients with seronegative RA were enrolled. The mean ages were 80.4, 78.9 years old. Females were 52.9, 76.4%. The affected joints with difference were elbows (11.8, 35.3%: p=0.10), wrists (82.4, 100%: p=0.06), and finger joints (82.4, 100%: p=0.06). The mean levels of Hb at diagnosis was 10.4, 11.4 mg/dL (p=0.01). The proportion of patients having the history of malignancy was 23.5% and 0% (p=0.03). After the start of treatment, the proportion of infection requiring hospitalization was 23.5% and 0% (p=0.03).Conclusion:When the ankles are affected and edema is observed, RS3PE is more likely than seronegative RA. RS3PE had higher levels of CRP, ESR, and LDH. The proportion of anemia was higher in RS3PE. The proportions of infection requiring hospitalization and the history of malignancy were higher in RS3PE.References:[1]McCarty DJ, O’Duffy JD et al. Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE Syndrome). JAMA 1985; 254: 2763–2767. DOI:10.1001/jama.1985.03360190069027Disclosure of Interests:Misako Higashida-Konishi: None declared, Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Satoshi Hama: None declared, Yutaro Hayashi: None declared, Yutaka Okano: None declared, Hisaji Oshima: None declared

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POS0588 USUAL INTERSTITIAL PNEUMONIA DURING RHEUMATOID ARTHRITIS: PREVALENCE AND ASSOCIATED FACTORS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4178 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 526.3-527

Author(s):

C. Daldoul ◽

N. El Amri ◽

A. Guiga ◽

S. Laataoui ◽

K. Baccouche ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Associated Factors ◽

Disease Duration ◽

Usual Interstitial Pneumonia ◽

Mediastinal Lymphadenopathy ◽

Lung Involvement ◽

Exertional Dyspnea ◽

Rheumatoid Nodules ◽

The Mean ◽

Male Sex

Background:Lung involvement is the second common extraarticular manifestation of rheumatoid arthritis (RA). Its prevalence varies widely according to the screening tool used and it could reach up to 80% of patients. This lung disease can affect all the lung compartments. However, interstitial lung disease during RA needs a particular attention due to the increased morbidity and usual interstitial pneumonia (UIP) pattern especially due to its higher rate of mortality.Objectives:To determine the frequency and associated factors of UIP among RA patientsMethods:This was a retrospective study conducted at the Rheumatology department of Farhat Hached University Hospital from 2005 to 2020. We included all RA patients who had undergone high-resolution computed tomography (HRCT) scans of the lung. Demographic data, disease characteristics, pulmonary function tests (PFT) and drugs intake were collected at the time of the realization of the HRCT. UIP pattern and NON-UIP patterns were based on HRCT results. Khi-2 and T-student tests were used in the univariate analysis. Binary logistic regression was used in the multivariate analysis. Statistical significance level was set at 5%.Results:Fifty-nine patients with RA patients having HRCT of the lung were identified among them 27.1% (16) were male. The mean age of the patients was 60.27± 11.3 years; the mean disease duration was 7.16 ± 2.9 years and current or previous smoking habits were recorded in 18.8% (11) of our population with a median. Secondary Sjogren’s syndrome and cutaneous rheumatoid nodules were documented in 33.9% (20) and 10.17% (6) respectively. RA was erosive in 81.5% (48) of our population. The median tender joint count and the median swollen joint count were 10 and 4 respectively. The mean erythrocyte sedimentation rate (ESR) and the mean C-reactive protein (CRP) were 49±20.31 mm and 32±14.07 mg/dl respectively. The mean disease activity score (DAS 28 ESR) was 5.49±1.66. The median rheumatoid factor and Anti-CCP levels were 260UI/ml and 68 UI/ml respectively. Exertional dyspnea (stage 2 or higher) was present in 42.37% (25) and inspiratory crackles were found in 22.4% (13) of our patients. PFT revealed a restrictive ventilatory defect, an obstructive pattern and a mixed pattern were found in 20.3% (12), 13.6 (8) and 3.4% (2) respectively. The mean DLCO value was 70±24.6%. According to HRCT results, parenchymal involvement was found in 83.1% (49) of our patients and among them, we documented UIP pattern in 18 (36.73%), Non Specific Interstitial Pneumonia (NSIP) in 14.28% (7), unclassifiable fibrosis in 14.29 (7), organizing pneumonia in 2% (1) and isolated pulmonary nodules in 32.6% (16). Pleural effusion was found in 5.1% (3) and airways disease in 15.3% (9). Mediastinal lymphadenopathy was found in 15.25% (9). Abnormalities on HRCT lead to a change in treatment in 30.5% (18) of our patients. Compared to the group with a non-UIP pattern, male sex was significantly associated with UIP pattern on HRCT (47.4% vs. 17.5%, p=0.016). UIP pattern was significantly associated with smoking (37.5% vs. 9.4% p=0.022, Unadjusted OR=5.88, 95%IC=[1.217-27.634]), with cutaneous rheumatoid nodules (31.3% vs.3.4%, p=0.017, Unadjusted OR=12.72, 95IC=[1.331-121.658]) and with the presence of lymphadenopathy on HRCT (41.2% vs. 6.5%, p=0.004, Unadjusted OR=10.15, 95%IC=[1.803-57.140]). There was no significant difference between the two groups regarding age (p=0.454), disease duration (p=0.126), DAS28 (p=0.447), anti-CCP level (p=0.454). After multivariate analysis, male sex (Adjusted OR=11.58, 95%IC=[1.622-82.67] p=0.015), Presence of lymphadenopathy on HRCT (Adjusted OR=10.53, 95%IC=[1.146-96.87], p=0.037) and exertional dyspnea (Adjusted OR=6.43, 95%IC=[1.036-40.011], p=0.046) were independently associated with UIP pattern.Conclusion:UIP was present in 36.73% and it was the most prevalent pattern of lung involvement in RA. It was associated with male sex, mediastinal lymphadenopathy and exertional dyspnea.Disclosure of Interests:None declared

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FRI0077 THE PREVALENCE OF DEPRESSION AND ANXIETY IN PATIENTS WITH RHEUMATOID AND PSORIATIC ARTHRITIS AND ITS CONTRIBUTORY FACTORS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5127 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 615.2-616

Author(s):

S. Selvadurai ◽

L. Mohamed Nor ◽

N. I. Redzuan ◽

L. Mohd Isa ◽

N. S. Shahril

Keyword(s):

Rheumatoid Arthritis ◽

Psoriatic Arthritis ◽

Disease Activity ◽

Associated Factors ◽

Depression Scale ◽

Disease Assessment ◽

Joint Involvement ◽

Depression And Anxiety ◽

Prevalence Rates ◽

The Mean

Background:Rheumatoid Arthritis (RA) and Psoriatic arthritis (PsA) are both chronic, progressive inflammatory arthritis that can cause significant disability and morbidity. Depression in RA has been associated with higher levels of disease activity, pain, fatigue, work disability, lower treatment compliance and increased suicidal risk and mortality [1]. PsA patients suffer from psoriasis and joint involvement; hence have greater odds of depression by 2.1 times compared with RA [2].Objectives:To compare the prevalence rates of depression and anxiety and its associated factors between RA and PsA patients in Hospital Putrajaya.Methods:A cross sectional survey using the Hospital Anxiety and Depression Scale (HADS) questionnaire were distributed to 300 patients who attended rheumatology outpatient clinic from February – April 2019. The HADS was categorized into 3 groups based on their scores 0-7 (Normal); 8-10 (Borderline); and 11-21 (Abnormal). Data on patient demographics and components of disease assessment scores were recorded. Disease activity was assessed using DAS 28-CRP for all patients. Additional evaluation using Bath Ankylosing Spondylitis Disease Activity Score (BASDAI) and body surface area (BSA) were done for PsA patients. P value of < 0.05 was taken as significant.Results:In total, 205 RA and 73 PsA patients were eligible for analysis. Majority of the patients were female, Malay and married for both groups. The mean age group for RA and PsA were 56.2 ± 11.9 years and 51.0 ± 14.6 years. The mean duration of disease for RA were 8 ± 10 years; while for PsA were 6 ± 11 years. The prevalence rates of depression and anxiety for RA were 8.3% and 13.7%; and PsA were 9.6% and 17.8% respectively. Borderline scores for depression occurred in 16.1% of RA patients and 12.3% for PsA. Twenty percent of RA patients (n=41) and twenty-four percent of PsA patients (n=18) scored borderline for anxiety. The significant positive correlations with depression and anxiety in RA include high disease activity scores (r = 0.27; r = 0.31), number of tender joints (r = 0.26; r = 0.24) and pain (r = 0.29; r = 0.27). Higher number of swollen joints significantly correlated with depression (r = 0.16) but not with anxiety. RA patients with Ischaemic Heart Disease (IHD) ± heart failure have higher depression scores (p < 0.05). As for PsA group, high BASDAI score (anxiety: r = 0.34, depression: r = 0.26) and psoriasis involving head and neck region (p < 0.05) were significant associated factors. Age was inversely correlated with anxiety in the PsA group.Conclusion:There is higher prevalence of anxiety in both RA and PsA as compared to depression. Higher disease activity scores were associated with depression and anxiety in both RA and PsA with axial involvement.References:[1]Faith Matcham et al. “Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study” BMC Musculoskeletal Disorders (2016) 17:155.[2]Sinnathurai et al. “Comorbids in psoriatic arthritis and rheumatoid arthritis”. July 2018. Internal Medicine Journal.Available fromhttps://doi.org/10.1111/imj.14046[3]RA Rahim et al. “ Self-reported symptoms of depression, anxiety and stress among patients with Rheumatoid Arthritis in a Malaysian rheumatology centre – prevalence and correlates”. Med J Malaysia Vol 73 No 4 August 2018Disclosure of Interests:None declared

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Association between clinical characteristics and laboratory findings with outcome of hospitalized COVID-19 patients, a report from northeast of Iran

10.1101/2021.01.23.21250359 ◽

2021 ◽

Author(s):

Sahar Sobhani ◽

Reihaneh Aryan ◽

Elham Kalantari ◽

Salman Soltani ◽

Nafise Malek ◽

...

Keyword(s):

Chest Pain ◽

Medical Records ◽

Clinical Characteristics ◽

C Reactive Protein ◽

Laboratory Findings ◽

Reactive Protein ◽

Level Of Consciousness ◽

Laboratory Features ◽

Duration Of Hospitalization ◽

Male Sex

AbstractCoronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza hospital, northeast of Iran. Clinical and laboratory features were evaluated among survivors and non-survivors. The correlation between variables and duration of hospitalization and admission to the Intensive Care Unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived (p = 0.017). It was also related to a shorter stay in the hospital (p = 0.032) as opposed to patients who experienced chest pain (p = 0.033). Decreased levels of consciousness and dyspnea were statistically more frequent in non-survivors (p = 0.003 and p = 0.011, respectively). Baseline white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in non-survivors (p < 0.001). Patients with higher WBC and CRP levels were more likely to be admitted to ICU (p = 0.009 and p = 0.001, respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.

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Uncovering Lymphatic Transport Abnormalities in Patients with Primary Lipedema

Journal of Reconstructive Microsurgery ◽

10.1055/s-0039-1697904 ◽

2019 ◽

Vol 36 (02) ◽

pp. 136-141 ◽

Cited By ~ 4

Author(s):

Daniel J. Gould ◽

Bassim El-Sabawi ◽

Pedram Goel ◽

Ido Badash ◽

Patrick Colletti ◽

...

Keyword(s):

Body Mass Index ◽

Clinical Characteristics ◽

Lymphatic Transport ◽

Lymphatic Flow ◽

Patient Demographics ◽

Severe Stage ◽

Included Patient ◽

Stage 4 ◽

The Mean ◽

Stage 1

Abstract Background Although lipedema is often clinically distinguished from lymphedema, there is considerable overlap between the two entities. The purpose of this study was to evaluate lymphoscintigraphic findings in patients with lipedema to better characterize lymphatic flow in this patient population. Methods Patients with lipedema receiving lymphoscintigraphy between January 2015 and October 2017 were included. Patient demographics, clinical characteristics, and lymphoscintigraphic findings were extracted. Klienhan's transport index (TI) was utilized to assess lymphatic flow in patient's lower extremities (LEs).Scores ranged from 0 to 45, with values > 10 denoting pathologic lymphatic transport. Results A total of 19 total patients with lipedema underwent lymphoscintigraphic evaluation. Mean age was 54.8 years and mean body mass index was 35.9 kg/m2. Severity of lipedema was classified as stage 1 in five patients (26.3%), stage 2 in four patients (21.1%), stage 3 in four patients (21.1%), and stage 4 in six patients (31.6%). The mean TI for all extremities was 12.5; 24 (63.2%) LEs had a pathologic TI, including 7 LEs with stage 1 (29.2%), 3 LEs with stage 2 (12.5%), 6 LEs with stage 3 (25.0%), and 8 LEs with stage 4 lipedema (33.3%). The mean TI was significantly greater for extremities with severe (stage 3/4) lipedema than those with mild or moderate (stage 1/2) lipedema (15.1 vs. 9.7, p = 0.049). Mean difference in TI scores between each LE for individual patients was 6.43 (standard deviation +7.96). Conclusion Our results suggest that patients with lipedema have impaired lymphatic transport, and more severe lipedema may be associated with greater lymphatic transport abnormalities.

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Clinical Characteristics and Prognostic Analysis of Pregnancy-Related Acute Kidney Injury

10.21203/rs.3.rs-1074697/v1 ◽

2021 ◽

Author(s):

Minjie Hu ◽

Haidong Huang ◽

Xuantong Dai ◽

Fujun Lin ◽

Junfeng Shi ◽

...

Keyword(s):

Renal Function ◽

Pregnancy Outcomes ◽

Clinical Characteristics ◽

Causes Of Death ◽

Kidney Injury ◽

Infant Outcomes ◽

Acute Fatty Liver ◽

The Mean ◽

Stage 1 ◽

Maternal And Infant Outcomes

Abstract Objective: To investigate the clinical characteristics and prognosis of pregnancy-related acute kidney injury (PR-AKI) and provide a basis for improving maternal and infant outcomes. Methods: Seventy pregnant women admitted to the surgical intensive care unit of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to December 2020 were included; 31 were screened out according to KDIGO-AKI criteria. We retrospectively analyzed their clinical characteristics and prognosis and analyzed risk factors for different pregnancy outcomes with logistic regression analysis. Results: A total of 31 PR-AKI patients were enrolled. The mean age of onset was 30.08±0.63 years, and the mean gestational age was 33.02±7.64 weeks. Six cases (19.45%) were in stage 1, six cases (19.35%) were in stage 2, and 19 cases (61.29%) were in stage 3. The continuous renal replacement therapy (CRRT) group comprised 13 cases (41.94%): one (7.69%) in stage 1, one (7.69%) in stage 2, and 11 (84.62%) in stage 3. The non-CRRT group comprised 18 cases (58.06%): five (27.78%) in stage 1, five (27.78%) in stage 2, and eight (44.44%) in stage 3. The mean time of commencing renal replacement therapy was 2.08±1.26 days after admission, and the serum creatinine (SCr) level at the beginning of treatment was 352.68±196.58 μmol/L. Renal function recovered completely in 18 cases (58.06%), comprising four (22.22%) in the CRRT group and 14 (77.78%) in the non-CRRT group, and three cases of partial renal function recovery occurred in the CRRT group. Eventually, seven patients (22.58%) died, of whom four (57.14%) were in the non-CRRT group, and all were in stage 3. The causes of death were postpartum hemorrhage, septic shock, and acute fatty liver during pregnancy. Three patients (42.86%) died in the non-CRRT group: two in stage 3 and one case in stage 1. The causes of death were severe preeclampsia and acute fatty liver during pregnancy. Multi-factor logistic regression analysis showed that gestational weeks (OR=0.456, P=0.023), platelet count (OR=0.989, P=0.02), hemoglobin (OR=1.017, P=0.022), and uric acid (OR=1.017, P=0.022) were associated risk factors for maternal adverse pregnancy outcomes of PR-AKI (P<0.05). Conclusions: The incidence of PR-AKI is high, the outcomes of maternal renal function are better, and the proportion of adverse fetal outcomes is higher. CRRT can effectively improve the prognosis of patients with PR-AKI, stabilize the internal environment, and affect hemodynamics slightly. It is currently one of the main ways to treat severe PR-AKI. Maternal and infant outcomes are related to the severity of PR-AKI.

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Association between Clinical Characteristics and Laboratory Findings with Outcome of Hospitalized COVID-19 Patients: A Report from Northeast Iran

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2021/5552138 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Sahar Sobhani ◽

Reihaneh Aryan ◽

Elham Kalantari ◽

Salman Soltani ◽

Nafise Malek ◽

...

Keyword(s):

Chest Pain ◽

Clinical Characteristics ◽

Laboratory Findings ◽

Reactive Protein ◽

Level Of Consciousness ◽

Laboratory Features ◽

Duration Of Hospitalization ◽

Male Sex ◽

Wbc Count ◽

Northeast Iran

Coronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza Hospital, northeast Iran. Clinical and laboratory features were evaluated among survivors and nonsurvivors. The correlation between variables and duration of hospitalization and admission to the intensive care unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived ( p = 0.017 ). It was also related to a shorter stay in the hospital ( p = 0.032 ) as opposed to patients who experienced chest pain ( p = 0.033 ). Decreased levels of consciousness and dyspnea were statistically more frequent in nonsurvivors ( p = 0.003 and p = 0.011 , respectively). Baseline white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in nonsurvivors ( p < 0.001 ). Patients with higher WBC and CRP levels were more likely to be admitted to ICU ( p = 0.009 and p = 0.001 , respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.

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Papilledema in children with hydrocephalus: incidence and associated factors

Journal of Neurosurgery Pediatrics ◽

10.3171/2017.2.peds16561 ◽

2017 ◽

Vol 19 (6) ◽

pp. 627-631 ◽

Cited By ~ 6

Author(s):

Haeng Jin Lee ◽

Ji Hoon Phi ◽

Seung-Ki Kim ◽

Kyu-Chang Wang ◽

Seong-Joon Kim

Keyword(s):

Congenital Anomaly ◽

Brain Tumor ◽

Intracranial Pressure ◽

Associated Factors ◽

Shunt Surgery ◽

Ventricular Drainage ◽

Younger Patients ◽

Factors Associated ◽

The Mean ◽

Age And Sex

OBJECTIVEThe aim of this study was to report the incidence of and the factors associated with papilledema in children with hydrocephalus.METHODSPatients younger than 15 years of age who had been diagnosed with hydrocephalus and treated by extra-ventricular drainage or ventriculoperitoneal shunt surgery between 2005 and 2015 were retrospectively reviewed. Factors including patient age and sex, etiology of hydrocephalus, duration of signs or symptoms, intracranial pressure (ICP), and presence of papilledema were evaluated.RESULTSForty-six patients, whose mean age was 6.3 ± 4.7 years, were included in the study. The 19 patients without papilledema had a mean age of 2.7 ± 2.7 years, and the 27 patients with papilledema had a mean age of 8.8 ± 4.2 years (p < 0.001). The mean ICP was 19.9 ± 10.0 cm H2O among those without papilledema and 33.3 ± 9.1 cm H2O among those with papilledema (p < 0.001). The mean duration of signs or symptoms was 3.0 ± 4.6 months in the patients without papilledema and 3.4 ± 3.9 months in those with papilledema (p = 0.704). The patients with papilledema were older and presented with higher ICP than those without. The causes of hydrocephalus were tumor (59%), congenital anomaly (19%), hemorrhage (13%), and infection (9%).CONCLUSIONSPapilledema was more common in patients who were older, who had higher ICP, and whose hydrocephalus had been induced by brain tumor. However, since papilledema was absent in 41% of the children with hydrocephalus, papilledema's absence does not ensure the absence of hydrocephalus, especially in younger patients.

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Epidemiology of musculoskeletal symptoms, rheumatologic disorders, and disability in the Zoroastrian population in Yazd, Iran: a WHO-ILAR COPCORD study (stage 1)

BMC Rheumatology ◽

10.1186/s41927-021-00214-2 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Ali Dehghan ◽

Hossein Soleimani Salehabadi ◽

Ahmadreza Jamshidi ◽

Zohre Kamali ◽

Mojgan Mali ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Musculoskeletal Symptoms ◽

Treatment Programs ◽

Cluster Sampling ◽

Musculoskeletal Complaints ◽

Rheumatologic Diseases ◽

The Mean ◽

University Level ◽

Stage 1 ◽

The City

Abstract Background The purpose of this study was to determine the prevalence of musculoskeletal complaints, rheumatologic diseases, and disability among the Zoroastrian population in Iran. Methods The city of Yazd, in central Iran was selected for this study, with the highest population of Zoroastrians in Iran. Subjects were selected by cluster sampling of 9 neighborhoods populated with Zoroastrians. Subjects ≥15 years old were interviewed by trained interviewers in their houses. The validated Farsi translation of Community Oriented Program for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) was used for this study. Subjects with musculoskeletal complaints (pain, stiffness and/or swelling) were examined by a rheumatologist. Laboratory tests and radiographic exams were performed when deemed necessary. Results Two-thousand subjects were interviewed during a 12-month period, of which 956 were male, and 1044 were female. The mean age was 41.1 ± 18.3 years (95%CI: 40.3–41.9). 36.9% of the subjects had university-level education. In the 7 days prior to the interview, 27.6% of the subjects had musculoskeletal complaints, with the knee, dorsolumbar spine, and shoulder being the most common sites of complaints. The most common rheumatologic diagnoses were osteoarthritis (21.5%) and low back pain (10.3%). Rheumatoid arthritis was diagnosed in 1.2% of the subjects. Conclusions The epidemiology of musculoskeletal complaints and rheumatologic disorders was inconsistent with previous COPCORD studies in Iran, with a lower prevalence of musculoskeletal complaints in general, lower rates of Behçet and lupus, and a higher prevalence of rheumatoid arthritis. The findings of this study can be for development of better prevention, screening, and treatment programs for the vulnerable population of Zoroastrians in Iran.

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