scholarly journals Predictive Factors of the Responses to Treatment of Mycoplasma pneumoniae Pneumonia

2021 ◽  
Vol 10 (6) ◽  
pp. 1154
Author(s):  
Eun Lee ◽  
Yun Young Lee
Keyword(s):  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Predictive Factors ◽  
Respiratory Virus ◽  
Clinical Laboratory ◽  
Poor Response ◽  
Response To Treatment ◽  
Slow Response ◽  
Response Group ◽  
Time Of Admission

The prevalence of refractory Mycoplasma pneumoniae (MP) pneumonia is increasing. The present study aimed to identify the predictive factors of responses to treatment of MP pneumonia in children. A total of 149 children were diagnosed with MP pneumonia, of whom 56 were included in the good response group, 75 children in the slow response group, and 18 children in no response or progression group. Data on the clinical, laboratory, and radiologic features were retrospectively obtained through medical chart reviews. The severity of pneumonia, based on the extent of pneumonic lesions on chest x-ray (adjusted odds ratio (aOR), 10.573; 95% confidence intervals (CIs), 2.303−48.543), and lactate dehydrogenase (LDH) levels (aOR, 1.002; 95% CIs, 1.000–1.004) at the time of admission were associated with slow response to treatment of MP pneumonia. Pleural effusion (aOR, 5.127; 95% CIs, 1.404–18.727), respiratory virus co-infection (aOR, 4.354; 95% CIs, 1.374–13.800), and higher LDH levels (aOR, 1.005; 95% CIs, 1.002–1.007) as well as MP-specific IgM titer (aOR, 1.309; 95% CIs, 1.095–1.564) were associated with no response or progression of MP pneumonia. The area under the curve for the prediction of no or poor response in MP pneumonia using pleural effusion, respiratory virus co-infection, LDH levels, and MP-specific IgM titer at the time of admission was 0.8547. This study identified the predictive factors of responses to treatment of MP pneumonia in children, which would be helpful in establishing a therapeutic plan and predicting the clinical course of MP pneumonia in children.

scholarly journals Clinical Significance of Pleural Effusion in Mycoplasma pneumoniae Pneumonia in Children

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1075
Author(s):  
Seo-Hee Kim ◽  
Eun Lee ◽  
Eun-Song Song ◽  
Yun-Young Lee
Keyword(s):  
Pleural Effusion ◽  
Clinical Significance ◽  
Mycoplasma Pneumoniae ◽  
Clinical Laboratory ◽  
Clinical Course ◽  
Severe Pneumonia ◽  
Poor Response ◽  
Tertiary Hospital ◽  
Reactive Protein ◽  
Poor Treatment

The clinical significance of pleural effusion in Mycoplasma pneumoniae (MP) pneumonia in children has not yet been elucidated. Herein, we investigated the clinical implications of pleural effusion in children with MP pneumonia. Overall, 150 children with MP pneumonia transferred to a tertiary hospital were enrolled in this study. Information on their clinical, laboratory, and radiological features was retrospectively obtained from medical chart reviews. In total, 24 (16.0%) children had pleural effusion at the time of admission. The duration of fever and length of hospitalization were significantly longer in the pleural effusion group than in the non-pleural effusion group. A significantly higher proportion of individuals in the pleural effusion group had a poor response to stepwise treatment for MP pneumonia. The mean C-reactive protein, lactate dehydrogenase, and aspartate aminotransferase levels were significantly higher in the pleural effusion group than in the non-pleural effusion group at admission. The prevalence of severe pneumonia, defined on the basis of the extent of pneumonic lesions on chest radiography, was higher in the pleural effusion group than in the non-pleural effusion group. However, there was no significant intergroup difference in the proportion of macrolide-resistant MP cases or respiratory viral coinfections. The presence of pleural effusion in children with MP pneumonia indicated a more severe clinical course and poor treatment response. The results of the present study would help in the creation of a therapeutic plan and prediction of the clinical course of MP pneumonia in children.

Predicting and Evaluating Treatment Response: Evidence Toward Protracted Response Patterns for Severely Impacted Students With Dyslexia

2021 ◽  
pp. 002221942110476
Author(s):  
Anna E. Middleton ◽  
Emily A. Farris ◽  
Jeremiah J. Ring ◽  
Timothy N. Odegard
Keyword(s):  
Poor Response ◽  
Response To Treatment ◽  
Individual Response ◽  
Response Patterns ◽  
Far Transfer ◽  
Hyperactivity Disorder ◽  
Reading Abilities ◽  
And Gender ◽  
Response Group ◽  
Tier 3

Great strides have been made in the development of effective methods of instruction for children with dyslexia. However, individual response to treatment varies, and weaknesses persist for some students with dyslexia despite otherwise effective instruction. Continued efforts are needed to support the prospective identification of poor response, particularly in routine intervention settings. The current study addressed whether indicators of dyslexia risk as outlined by hybrid diagnostic models predict response in children who received Tier 3 dyslexia intervention in their schools. The program’s efficacy has been previously documented in remediating reading abilities in children with dyslexia. Data were examined from 115 elementary-aged children who received routine Tier 3 dyslexia intervention in their schools. Logistic regression revealed powerful effects of preintervention fluency and gender in predicting response, with weaker effects of decoding and rapid naming. Attention-deficit/hyperactivity disorder status also played a role in predicting response. Phonological awareness and listening-reading comprehension discrepancy did not predict response. Profile analyses indicated near- and far-transfer of skill for the adequate response group, whereas growth in the poor response group was limited to near-transfer. Findings support a continuum of severity that may be associated with less robust growth and generalization over the course of the intervention.

Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

2020 ◽  
Vol 41 (6) ◽  
pp. 436-441 ◽  
Author(s):  
Daniel A. Rosloff ◽  
Kunal Patel ◽  
Paul J. Feustel ◽  
Jocelyn Celestin
Keyword(s):  
Diagnostic Criteria ◽  
Statistical Significance ◽  
Case Series ◽  
Poor Response ◽  
Response To Treatment ◽  
Fisher Exact Test ◽  
Subjective Symptoms ◽  
Significant Difference ◽  
Physical Findings ◽  
Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study

2021 ◽  
pp. 1-6
Author(s):  
Ediz Vuruskan ◽  
Hakan Ercil ◽  
Umut Unal ◽  
Ergun Alma ◽  
Hakan Anil ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Partial Response ◽  
Medical Treatment ◽  
Predictive Factors ◽  
Treatment Success ◽  
Complete Response ◽  
Response To Treatment ◽  
Factors Affecting ◽  
Success Of Treatment ◽  
Functioning Kidney

<b><i>Introduction:</i></b> The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. <b><i>Methods:</i></b> Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. <b><i>Results:</i></b> Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (<i>p</i> = 0.071, <i>p</i> = 0.973, respectively), but the increase in age and hypertension duration (<i>p</i> = 0.030 and <i>p</i> &#x3c; 0.001, respectively) and the presence of metabolic syndrome (<i>p</i> = 0.002) significantly decreased the complete response rates. <b><i>Conclusions:</i></b> Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.

scholarly journals AB1119 U9: A NOVEL CLINICALLY ORIENTED ULTRASONOGRAPHIC SCALE AS A USEFUL MARKER FOR MONITORING THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS (MULTI CENTERS STUDY)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.2-1849
Author(s):  
M. A. Mortada ◽  
H. Eitta ◽  
R. Elmallah ◽  
A. Radwan ◽  
A. Elsaman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Laboratory ◽  
Pearson Correlation ◽  
Response To Treatment ◽  
P Value ◽  
Clinical Parameters ◽  
Biologic Dmards ◽  
Das 28 ◽  
Significant Difference

Background:Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA, which affects many joints and tendons in different presentations. In previous study (1) U9 score was proven to be correlated with disease activity parameters.Objectives:To determine whether US assessment using U9 score is useful for monitoring response to treatment for RA or not?Methods:A prospective, multicenter study were conducted in period from July 2019 to December 2019. All recruited RA patients were subjected to: Disease activity assessment by clinical disease activity indices (CDAI and DAS28 ESR). Functional status assessment by (HAQ) and ultrasonographic assessment using U9 score which include 8 joints (bilateral wrists,2ndMCP,3RDMCP and knees) plus most clinically affected joint or tendon (one joint or one tendon). Most clinically affected joints from 48 joints. Any affected tendons could be choosing. All targeted joints were evaluated according to EULAR guidlines and by EULAR/ OMERACT combined score (0-3). Targeted tendons were scored (0-3).All patients received their treatment (biologic and non biologic DMARDs) according to the decision of the treating physicians. No specific therapy is needed. CDAI and DAS28 ESR, HAQ and U9 score were repeated after 3 months to detect the response to change after receiving the therapy.Results:One hundred and forty patients (23.6% were male) with mean age 39.26±11.30 were recruited from 4 tertiary referral university hospitals.There was a significant difference (<0.001) between the first and second visits as regards clinical, laboratory and ultrasonographic parameters. DAS 28 decreased form (5.29±1.21) to (3.95±0.99), ESR decreased from (42.12±15.24) to (26.84±12.32), HAQ2 improved from (0.652±0.350) to (0.510±0.237) and U9 total US score decreased from (13.56±5.18) to (8.02±4.28).There was significant correlation between U9 ultrasonographic score and clinical parameters at both visits (table 1).Table 1.correlation between U9 ultrasonographic score and clinical parameters.U9 at 1stvisitU9 at 2ndvisitDAS-28Pearson Correlation(P value)0.806<0.0010.790<0.001CDAIPearson Correlation(P value)0.787<0.0010.773<0.001HAQPearson Correlation(P value)0.431<0.0010.317<0.001We found that the most suitable cut-off value of U9 score to predict high disease activity was 11.5 (sensitivity 85.7% and specificity 80.6%), cut off value for moderate disease activity was 5.5(sensitivity 83.2% and specificity 88%) and cut off value for low disease activity was 3.5 (sensitivity of 83.3% and specificity 57.1%). These results are summarized in the following table:Conclusion:U9 ultrasonographic score is very useful method for evaluating the monitoring the response of treatment.References:[1]Mortada, et al. Annals of the Rheumatic Diseases 2019;78:1009.Disclosure of Interests:None declared

scholarly journals Modified Rio Score with Platform Therapy Predicts Treatment Success with Fingolimod and Natalizumab in Relapsing-Remitting Multiple Sclerosis Patients

2021 ◽  
Vol 10 (9) ◽  
pp. 1830
Author(s):  
Anna Jamroz-Wiśniewska ◽  
Radosław Zajdel ◽  
Agnieszka Słowik ◽  
Monika Marona ◽  
Marcin Wnuk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Success ◽  
Prospective Trial ◽  
Poor Response ◽  
Response To Treatment ◽  
First Year ◽  
Second Line ◽  
Second Line Therapy ◽  
Line Therapy ◽  
Multiple Sclerosis Patients

Background: Reliable markers of disease outcomes in multiple sclerosis (MS) would help to predict the response to treatment in patients treated with high efficacy drugs. No evidence of disease activity (NEDA) has become a treatment goal whereas the modified Rio score (MRS) predicts future suboptimal responders to treatment. The aim of our study was to identify factors that would predict poor response to treatment with natalizumab and fingolimod. Methods: In the multicenter prospective trial, 336 subjects were enrolled, initiating therapy with natalizumab (n = 135) or fingolimod (n = 201). Data on relapse rate, the expanded disability status scale, and MRI results were collected, and MRS was estimated. Results: NEDA-3 after the first year of therapy was 73.9% for natalizumab and 54.8% for fingolimod (p < 0.0001). Patients with MRS = 0 in the last year on platform therapy had the best NEDA-3 (71%) and patients with MRS = 3 had the worst NEDA-3 (41%) in the first year of treatment with the second-line therapy. Conclusion: We conclude that switching to the second-line therapy should occur earlier to enable better results for patients treated with natalizumab or fingolimod. The outcome on both drugs is better with better neurological conditions and lower MRS of the patient on the platform therapy.

Diffusion kurtosis imaging assessment of the response to radiotherapy in a VX2 bone tumor model: an animal study

2021 ◽  
pp. 028418512198951
Author(s):  
Jia Guo ◽  
Cheng Dong ◽  
Zengjie Wu ◽  
Weikai Sun ◽  
Xiaoli Li ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Tumor Cell ◽  
Bone Tumors ◽  
Tumor Model ◽  
Poor Response ◽  
Early Response ◽  
Diffusion Kurtosis Imaging ◽  
Malignant Bone Tumors ◽  
Response Group ◽  
Diffusion Kurtosis

Background Neoadjuvant radiotherapy plays a vital role in the treatment of malignant bone tumors, and non-invasive imaging methods are needed to evaluate the response to treatment. Purpose To assess the value of diffusion kurtosis imaging (DKI) for monitoring early response to radiotherapy in malignant bone tumors. Material and Methods Treatment response was evaluated in a rabbit VX2 bone tumor model (n = 35) using magnetic resonance imaging (MRI), DKI, and histopathologic examinations. Subjects were divided into three groups: pre-treatment, post-treatment, and control groups. The post-treatment group was subclassified into good response and poor response groups according to the results of histopathologic examination. Apparent diffusion coefficient (ADC) and DKI parameters (mean diffusion coefficient [MD] and mean kurtosis [MK]) were recorded. The relationship between ADC, DKI parameters, and histopathologic changes after radiotherapy was determined using Pearson’s correlation coefficient. The diagnostic performance of these parameters was assessed using receiver operating characteristic analysis. Results MD in the good response group was higher after treatment than before treatment ( P < 0.001) and higher than that in the poor response group ( P = 0.009). MD was highly correlated with tumor cell density and apoptosis rate (r = −0.771, P < 0.001 and r = 0.625, P < 0.001, respectively). MD was superior to other parameters for determining the curative effect of radiotherapy, with a sensitivity of 75.0%, specificity of 100.0%, and area under the curve of 0.917 ( P < 0.001). Conclusion The correlations between MD, tumor cell density, and apoptosis suggest that MD could be useful for assessing the early response to radiotherapy in rabbit VX2 malignant bone tumors.

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