Clinical and Demographic Characteristics of Erosion-free and Erosion-present Status in Psoriatic Arthritis in a Cohort Study

2016 ◽  
Vol 43 (6) ◽  
pp. 1057-1062 ◽  
Author(s):  
Zahi Touma ◽  
Arane Thavaneswaran ◽  
Vinod Chandran ◽  
Fawnda Pellett ◽  
Richard J. Cook ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Regression Models ◽  
Cox Regression ◽  
Erosive Disease ◽  
Radiographic Findings ◽  
Logistic Regression Models ◽  
Younger Age ◽  
The Mean ◽  
Time Varying Covariates ◽  
Mean Time

Objective.Psoriatic arthritis (PsA) has been recognized as a severe erosive disease. However, some patients do not develop erosions. We aimed to determine the prevalence, characteristics, and predictors of erosion-free patients (EFP) as compared with erosion-present patients (EPP) among patients with PsA followed prospectively.Methods.This is a retrospective analysis conducted on patients from the Toronto PsA cohort. Patients with at least 10 years of followup and radiographs were analyzed. Radiographs were scored with the modified Steinbrocker method. Baseline (first visit to clinic) characteristics were used to predict the development of erosions with logistic regression models. To examine the effect of time-varying covariates, Cox regression models were fit for the time to development of erosions from baseline.Results.Among 290 patients, 12.4% were EFP and 87.6% were EPP over the study period. The mean time to development of erosion in the EPP over the course of followup was 6.8 ± 6.1 years. EFP were diagnosed with psoriasis at a younger age compared with EPP. In both models, actively inflamed joints and clinically damaged joints were predictive of the development of erosion, whereas a longer duration of psoriasis at baseline decreased the odds of developing erosion. EPP had a higher percentage of unemployment as compared with EFP at baseline and followup visits.Conclusion.Among patients with PsA followed for at least 10 years, 12.4% never develop erosions. The clinical and radiographic findings can ultimately assist in the stratification of a patient’s prognosis regarding the development of erosions.

scholarly journals The updated Charlson comorbidity index is a useful predictor of mortality in patients with Staphylococcus aureus bacteraemia

2018 ◽  
Vol 146 (16) ◽  
pp. 2122-2130 ◽  
Author(s):  
H. G. Ternavasio-de la Vega ◽  
F. Castaño-Romero ◽  
S. Ragozzino ◽  
R. Sánchez González ◽  
M. P. Vaquero-Herrero ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Charlson Comorbidity Index ◽  
Regression Models ◽  
Model Fit ◽  
Logistic Regression Models ◽  
Relevant Variables ◽  
Comorbidity Index ◽  
The Mean ◽  
Related Mortality ◽  
Better Than

AbstractThe objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.

Progression of coal workers’ pneumoconiosis absent further exposure

2020 ◽  
Vol 77 (11) ◽  
pp. 748-751
Author(s):  
Kirsten S Almberg ◽  
Lee S Friedman ◽  
Cecile S Rose ◽  
Leonard H T Go ◽  
Robert A Cohen
Keyword(s):  
Disease Progression ◽  
Regression Models ◽  
Medical Surveillance ◽  
Coal Miners ◽  
Radiographic Evidence ◽  
Logistic Regression Models ◽  
Younger Age ◽  
History Of ◽  
Coal Workers Pneumoconiosis ◽  
Coal Workers

ObjectivesThe natural history of coal workers’ pneumoconiosis (CWP) after cessation of exposure remains poorly understood.MethodsWe characterised the development of and progression to radiographic progressive massive fibrosis (PMF) among former US coal miners who applied for US federal benefits at least two times between 1 January 2000 and 31 December 2013. International Labour Office classifications of chest radiographs (CXRs) were used to determine initial and subsequent disease severity. Multivariable logistic regression models were used to identify major predictors of disease progression.ResultsA total of 3351 former miners applying for benefits without evidence of PMF at the time of their initial evaluation had subsequent CXRs. On average, these miners were 59.7 years of age and had 22 years of coal mine employment. At the time of their first CXR, 46.7% of miners had evidence of simple CWP. At the time of their last CXR, 111 miners (3.3%) had radiographic evidence of PMF. Nearly half of all miners who progressed to PMF did so in 5 years or less. Main predictors of progression included younger age and severity of simple CWP at the time of initial CXR.ConclusionsThis study provides further evidence that radiographic CWP may develop and/or progress absent further exposure, even among miners with no evidence of radiographic pneumoconiosis after leaving the industry. Former miners should undergo regular medical surveillance because of the risk for disease progression.

Retrospective Diagnosis of Dementia Using an Informant Interview Based on the Brief Cognitive Rating Scale

1998 ◽  
Vol 10 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Kenneth Rockwood ◽  
Kellee Howard ◽  
Vince Salazar Thomas ◽  
Laurie Mallery ◽  
Christopher Macknight ◽  
...  
Keyword(s):  
Regression Models ◽  
Rating Scale ◽  
Tissue Bank ◽  
Mixed Dementia ◽  
Severe Dementia ◽  
Retrospective Diagnosis ◽  
Logistic Regression Models ◽  
Diagnosis Of Dementia ◽  
The Mean ◽  
Expert Physician

The accuracy of a dementia diagnosis by specialist physicians, as verified at an autopsy, is greater than 90% in many series. Donations of brains to the Maritime Brain Tissue Bank (MBTB) by individuals who did not have expert dementia diagnoses before death led us to investigate whether clinical features could also be detected retrospectively. Informants for 36 individuals whose brains were in the MBTB (18 women, mean age = 79 years; pathologic diagnoses: 75% Alzheimer's disease [AD]; 8.4% vascular or mixed dementia) were interviewed by specialist physicians using a semistructured retrospective interview based on the Brief Cognitive Rating Scale (BCRS) (range = 1 [no impairment] to 7 [terminal dementia]). The mean duration of dementia was 8.5 ± 12.8 years based on proxy reports, and most cases suggested severe dementia—(stage 6 [severe] or 7 [terminal])—on the retrospective BCRS (RetroBCRS) before death. A score of 4 or more on the RetroBCRS had 100% sensitivity and specificity in detecting dementia. The RetroBCRS score correlated moderately with duration (.51). In linear and logistic regression models adjusted for age and sex, RetroBCRS staging helped explain 93% of the variation in duration. The accuracy of the retrospective diagnosis of the cause of dementia, compared with autopsy, was 92%. The RetroBCRS used by an expert physician with a reliable informant is a valid method of detecting dementia and determining whether AD was present.

scholarly journals A Longitudinal Study of Lameness Incidence and Association with Animal-Based Welfare Measures in Dairy Cows

2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Mohammed Babatunde Sadiq ◽  
Siti Zubaidah Ramanoon ◽  
Wan Mastura Shaik Mossadeq ◽  
Rozaihan Mansor ◽  
Sharifah Salmah Syed-Hussain
Keyword(s):  
Dairy Cows ◽  
Body Condition ◽  
Regression Models ◽  
Management Practices ◽  
Cox Regression ◽  
Body Condition Score ◽  
Logistic Regression Models ◽  
Condition Score ◽  
Claw Lesions ◽  
Welfare Measures

The objective of this study was to investigate time to lameness event, prevalence of claw lesions, and their associations with animal-based welfare measures (ABWMs) in dairy cows. A total of 120 non-lame lactating cows (n = 30 each from four intensive dairy farms) having no claw lesion were enrolled in the study. The cow-level enrollment criteria included good body condition score (BCS), normal hock condition score, absence of body injuries, and normal claw length. Information on cows’ parity, milk yield, and previous lameness event (PLE) were recorded. The cows were observed twice monthly (every 2 weeks) for locomotion scores (LS), and ABWMs, whereas claw lesions were recorded upon onset of lameness and at the end of the observation period. Cows were considered lame when 2 consecutive LS = 3, or any assessment with score 4. Cox regression models were used to investigate lameness incidence and the association with ABWMs, while association between the latter and claw horn lesions (CHL) prevalence were analyzed using logistic regression models. Twenty-four percent (29/120) of the cows were lame during the study period. Lameness risk was associated with PLE (Hazard ratio; HR = 7.4; 95% CI 2.4-23.0), presence of overgrown claw (HR = 3.7; 95% CI 1.1-12.6) and low BCS pre-lame (HR = 4.5; 95% CI 1.3-16.6). Amongst the cows affected with claw lesions, 68.4% (37/44) were lame and CHL were predominant (75.4%) compared to infectious claw lesions (24.7%). Cows with lower BCS (< 3.0) (OR = 5.7; 95% CI 1.6- 20.4) and those with PLE (OR = 7.2; 95% CI = 2.1-24.7) were more likely to have CHL. Management practices such as maintaining cows’ body condition, improved care for those with history of lameness, and proper claw trimming could assist farmers to reduce lameness incidence in the studied herds.

scholarly journals Predictors and Conversion Rate of Clinically Isolated Syndrome to Clinically Definite Multiple Sclerosis: A Follow-up Study in Patients Living in the Southern Part of Iran

2020 ◽  
Vol 6 (1) ◽  
pp. 9-15
Author(s):  
Sadegh Izadi ◽  
◽  
Meysam Ahmadi ◽  
Maryam Poursadeghfard ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Conversion Rate ◽  
Regression Models ◽  
Cox Regression ◽  
Clinical Course ◽  
Clinically Isolated Syndrome ◽  
Definite Multiple Sclerosis ◽  
Clinically Definite Multiple Sclerosis ◽  
The Mean

Background: Clinical course of Clinically Isolated Syndrome (CIS) is variable, and identifying patients who will eventually develop Multiple Sclerosis (MS) is essential. Objectives: To assess the conversion rate of CIS to Clinically Definite Multiple Sclerosis (CDMS) and its predictors in southern Iran. Materials & Methods: A total of 143 CIS patients registered to Fars Multiple Sclerosis Society (FMSS) were enrolled in the study from 2006 until 2012, and all of them were followed for 5 years. Also, their demographic and MRI data were recorded. The obtained data were analyzed by univariate and multivariable Cox regression models in SPSS v. 17. P<0.05 was considered statistically significant. Results: About 26.6% of patients progressed to MS after a mean duration of 3.4±1.1 years. The conversion rate was 27.6% in patients presented with optic neuritis, and 25.6% in patients presented with spinal cord problems. Although it was not statistically significant (P=0.23), the mean age of the patients who converted to MS was lower at the onset of the presentation (27.6 vs. 29.4 years). In patients who had 3 or more MRI lesions, the conversion rate was 49.2%; however, it was only 9.8% in subjects who had fewer than 3 lesions (OR=8.95, 95% CI=3.69–21.7, P <0.001). Women had higher conversion rate though it was not statistically significant (OR=2.09, 95% CI=0.57–7.64, P=0.26). Conclusion: Our results supported this supposition that the number of MRI lesions at baseline can be used as a predictor of CIS conversion to MS.

scholarly journals Risk Factors for Patient–Ventilator Asynchrony and Its Impact on Clinical Outcomes: Analytics Based on Deep Learning Algorithm

2020 ◽  
Vol 7 ◽  
Author(s):  
Huiqing Ge ◽  
Kailiang Duan ◽  
Jimei Wang ◽  
Liuqing Jiang ◽  
Lingwei Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tidal Volume ◽  
Clinical Outcomes ◽  
Regression Models ◽  
Negative Binomial ◽  
Cox Regression ◽  
Plateau Pressure ◽  
Care Hospital ◽  
Time Varying ◽  
Time Varying Covariates

Background and objectives: Patient–ventilator asynchronies (PVAs) are common in mechanically ventilated patients. However, the epidemiology of PVAs and its impact on clinical outcome remains controversial. The current study aims to evaluate the epidemiology and risk factors of PVAs and their impact on clinical outcomes using big data analytics.Methods: The study was conducted in a tertiary care hospital; all patients with mechanical ventilation from June to December 2019 were included for analysis. Negative binomial regression and distributed lag non-linear models (DLNM) were used to explore risk factors for PVAs. PVAs were included as a time-varying covariate into Cox regression models to investigate its influence on the hazard of mortality and ventilator-associated events (VAEs).Results: A total of 146 patients involving 50,124 h and 51,451,138 respiratory cycles were analyzed. The overall mortality rate was 15.6%. Double triggering was less likely to occur during day hours (RR: 0.88; 95% CI: 0.85–0.90; p &lt; 0.001) and occurred most frequently in pressure control ventilation (PCV) mode (median: 3; IQR: 1–9 per hour). Ineffective effort was more likely to occur during day time (RR: 1.09; 95% CI: 1.05–1.13; p &lt; 0.001), and occurred most frequently in PSV mode (median: 8; IQR: 2–29 per hour). The effect of sedatives and analgesics showed temporal patterns in DLNM. PVAs were not associated mortality and VAE in Cox regression models with time-varying covariates.Conclusions: Our study showed that counts of PVAs were significantly influenced by time of the day, ventilation mode, ventilation settings (e.g., tidal volume and plateau pressure), and sedatives and analgesics. However, PVAs were not associated with the hazard of VAE or mortality after adjusting for protective ventilation strategies such as tidal volume, plateau pressure, and positive end expiratory pressure (PEEP).

scholarly journals Psychosocial difficulties and treatment retention in inpatient detoxification programmes

2021 ◽  
pp. 145507252110212
Author(s):  
Jonna Levola ◽  
Arno Aranko ◽  
Tuuli Pitkänen
Keyword(s):  
Regression Models ◽  
Addiction Treatment ◽  
Real Life ◽  
Treatment Retention ◽  
Logistic Regression Models ◽  
Cognitive Difficulties ◽  
Polysubstance Use ◽  
Real Life Data ◽  
Younger Age ◽  
Psychosocial Difficulties

Aims: Treatment retention is associated with addiction treatment outcomes. Research regarding predictors of retention at inpatient detoxification treatment is limited. The aim of this study was to investigate whether psychosocial difficulties (PSDs) are associated with treatment retention among Finnish inpatients undergoing detoxification treatment. Design: This register-based study included real-life data on detoxification treatment episodes ( n = 2,752) between February of 2016 and May of 2019 from several inpatient treatment units in Finland. The PARADISE24fin instrument was used to assess PSDs. Socio-demographic and substance use related variables, as well as PSDs, were analysed with regard to treatment retention. Multiple logistic regression models were used to identify predictors of treatment incompletion. Results: Of the 2,752 detoxification treatment episodes, 80.3% ( n = 2,209) were completed. Men and women differed with regard to the variables associated with treatment retention. After adjusting for confounders, younger age (≤ 35 years), being less educated (≤ 9 years), being unemployed, using opioids, polysubstance use and more severe dependence were associated with treatment incompletion. Overall severity of PSDs (PARADISE24fin mean score) became non-significant after adjusting for confounders. However, having more severe cognitive difficulties was significantly associated with treatment incompletion, while more severe difficulties in daily activities was associated with treatment completion. Conclusions: Special attention should be paid to younger individuals with opioid and/or polysubstance use, as well as those with cognitive difficulties, in order to retain people in treatment.

scholarly journals Impact of lymphopenia on survival for elderly patients with glioblastoma: A secondary analysis of the CCTG CE.6 (EORTC 26062-22061, TROG03.01) randomized clinical trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2547-2547
Author(s):  
Andrew Jehyun Song ◽  
Keyue Ding ◽  
Normand Laperriere ◽  
James R. Perry ◽  
Warren P. Mason ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Regression Models ◽  
Cox Regression ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Extent Of Resection ◽  
Logistic Regression Models ◽  
Short Course ◽  
Grade 3 ◽  
The Impact

2547 Background: Lymphopenia (LMP) may lead to worse outcomes for patients with glioblastoma (GBM). This study is a secondary analysis of the CCTG CE.6 trial evaluating the impact of chemotherapy and radiation on LMP, as well as the association of LMP with overall survival. Methods: CCTG clinical trial CE.6 randomized elderly GBM patients (≥ 65 yrs) to short course radiation alone (RT) or short course radiation with temozolomide (RT + TMZ). In this study LMP (mild-mod: grade 1-2; severe: grade 3-4) was defined per CTCAE v3.0 criteria, and measured at baseline, 1 wk and 4 wks post-RT. Pre-selected key factors for the analysis included age, sex, ECOG, extent of resection, MGMT methylation, MMSE, and steroid use. Multinomial logistic regression models were used to identify factors associated with LMP and multivariable Cox regression models were used to study effect of LMP on survival. Results: A total of 562 patients were included for analysis (281 RT vs 281 RT+TMZ). At baseline, both arms (RT vs RT+TMZ) had similar rates of mild-mod (21.4% vs 21.4%) and severe (3.2% vs 2.9%) LMP. The 1 wk post-RT LMP rates were also similar (p = 0.25). However, RT+TMZ pts were more likely to develop both mild-mod LMP (18.2% vs 27.9%) and severe LMP (1.8% vs 9.3%) [p < 0.001] at 4 wks post-RT. Developing mild-mod and severe LMP post-RT were both associated with baseline LMP (p < 0.001) and RT+TMZ (p < 0.001). Severe LMP at 4 wks post-RT was also associated with biopsy only (p < 0.02). After adjusting for confounding factors, 4 wks post-RT LMP was not significantly associated with PFS or OS regardless of severity. However, baseline LMP (HR 1.3) was significantly associated with worse OS (HR: 1.30, 95% C.I.: 1.05-1.62, p = 0.02), regardless of MGMT status. Other factors significantly associated with worse outcome included: males (HR 1.41), biopsy only (HR 1.59), and lower MMSE (HR 1.03). Conclusions: Short course RT alone does not lead to LMP after treatment. Development of LMP post-RT is associated with addition of TMZ and baseline LMP. However, only baseline LMP is associated with worse OS regardless of MGMT status. This may be considered as a prognostic biomarker for elderly GBM patients and warrants further validation. Clinical trial information: NCT00482677 .

Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis

2018 ◽  
Vol 89 (12) ◽  
pp. 1272-1278 ◽  
Author(s):  
Doriana Landi ◽  
Paolo Ragonese ◽  
Luca Prosperini ◽  
Viviana Nociti ◽  
Shalom Haggiag ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Models ◽  
Disease Modifying Drugs ◽  
Elective Abortion ◽  
Relapsing Remitting ◽  
Conception Date ◽  
The Mean ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Mean Time

ObjectiveTo investigate clinical and radiological outcomes of women with relapsing-remitting multiple sclerosis (RRMS) undergoing abortion.MethodsAn independent, multicentre retrospective study was conducted collecting data from eight Italian MS centres. We compared the preconception and postabortion annualised relapse rate (ARR) and number of Gadolinium enhancing (Gd+) lesions, by analyses of covariance. Variables associated with postabortion clinical and MRI activity were investigated using Poisson regression models; each abortion was considered as a statistical unit.ResultsFrom 1995 to 2017, we observed 188 abortions (17 elective) in 153 women with RRMS. Abortions occurred after a mean time of 9.5 (4.4) weeks from estimated conception date. In 86 events out of 188, conception happened during treatment with disease modifying drugs. The mean postabortion ARR (0.63±0.74) was significantly increased (p=0.037) compared with the preconception year (0.50±0.71) as well as the postabortion mean number of new Gd+ lesions (0.77±1.40 vs 0.39±1.04; p=0.004). Higher likelihood of relapses was predicted by higher preconception ARR, discontinuation of preconception treatment and elective abortion; the occurrence of new Gd+ lesions was associated with higher preconception number of active lesions, discontinuation of preconception treatment, shorter length of pregnancy maintenance and elective abortion.ConclusionsAbortion was associated with clinical and radiological inflammatory rebound remarkably in the first 12 months postevent. Deregulated proinflammatory processes arising at the early stages of pregnancy might play a role both in MS reactivation and abortion. Women with MS should be counselled about these risks of abortion and followed up accordingly.

scholarly journals Impact of peer review on discussion of study limitations and strength of claims in randomized trial reports: a before and after study

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Kerem Keserlioglu ◽  
Halil Kilicoglu ◽  
Gerben ter Riet
Keyword(s):  
Logistic Regression ◽  
Peer Review ◽  
Regression Models ◽  
Randomized Trials ◽  
Median Number ◽  
Logistic Regression Models ◽  
Before And After ◽  
The Mean ◽  
Before And After Study ◽  
Manuscript Publication

Abstract Background In their research reports, scientists are expected to discuss limitations that their studies have. Previous research showed that often, such discussion is absent. Also, many journals emphasize the importance of avoiding overstatement of claims. We wanted to see to what extent editorial handling and peer review affects self-acknowledgment of limitations and hedging of claims. Methods Using software that automatically detects limitation-acknowledging sentences and calculates the level of hedging in sentences, we compared the submitted manuscripts and their ultimate publications of all randomized trials published in 2015 in 27 BioMed Central (BMC) journals and BMJ Open. We used mixed linear and logistic regression models, accounting for clustering of manuscript-publication pairs within journals, to quantify before-after changes in the mean numbers of limitation-acknowledging sentences, in the probability that a manuscript with zero self-acknowledged limitations ended up as a publication with at least one and in hedging scores. Results Four hundred forty-six manuscript-publication pairs were analyzed. The median number of manuscripts per journal was 10.5 (interquartile range 6–18). The average number of distinct limitation sentences increased by 1.39 (95% CI 1.09–1.76), from 2.48 in manuscripts to 3.87 in publications. Two hundred two manuscripts (45.3%) did not mention any limitations. Sixty-three (31%, 95% CI 25–38) of these mentioned at least one after peer review. Changes in mean hedging scores were negligible. Conclusions Our findings support the idea that editorial handling and peer review lead to more self-acknowledgment of study limitations, but not to changes in linguistic nuance.

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