Increased Risk of Hypertension Associated with Spondyloarthritis Disease Duration: Results from the ASAS-COMOSPA Study

Objective.Spondyloarthritis (SpA) is associated with a number of cardiovascular (CV) comorbidities. We examined the association of SpA disease duration and delay in diagnosis with CV-related conditions.Methods.Using data from the COMOSPA study, the associations between SpA disease duration and CV-related conditions were evaluated in univariable and multivariable logistic regression models. Each model examined 1 CV-related factor as dependent and “SpA disease duration” as a predictor, adjusted for relevant confounders.Results.Data from 3923 subjects (median SpA disease duration 5.1 yrs, interquartile range 1.3–11.8 yrs) were available for analysis. The main CV-related conditions were hypertension (HTN; 22.4%), ischemic heart disease (2.6%), stroke (1.3%), and diabetes mellitus (5.5%). HTN was associated with SpA disease duration in both univariable and multivariable analysis, with an OR of 1.129 (95% CI 1.072–1.189; p < 0.001) for each 5-year increase in SpA disease duration. Other factors associated with HTN were age, male sex, current body mass index, ever steroid therapy, and ever synthetic disease-modifying antirheumatic drug therapy, but not nonsteroidal antiinflammatory drugs (NSAID). In subgroup analysis, the strongest association of HTN and disease duration was seen in subjects with the axial-only SpA phenotype (OR 1.202, 95% CI 1.053–1.372) but not in those with peripheral-only SpA (OR 0.902, 95% CI 0.760–1.070). The other CV conditions were not associated with SpA disease duration.Conclusion.Duration of SpA disease in the ASAS-COMOSPA cohort is associated with higher odds of HTN, particularly in those with axial disease, but not with other CV-related conditions. The association with HTN does not appear to be related to NSAID exposure.

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Impact of Diabetes and Disease Duration on Work Status Among U.S. Older Adults

Journal of Aging and Health ◽

10.1177/0898264318822897 ◽

2019 ◽

Vol 32 (5-6) ◽

pp. 432-440 ◽

Cited By ~ 4

Author(s):

Miriam Mutambudzi ◽

Cesar Gonzalez Gonzalez ◽

Rebecca Wong

Keyword(s):

Older Adults ◽

Disease Duration ◽

Multinomial Logistic Regression ◽

Relative Risk Ratio ◽

Work Status ◽

Workplace Interventions ◽

Logistic Regression Models ◽

Increased Risk ◽

Using Data ◽

Retirement Study

Objectives: To examine the effects of diabetes and disease duration on work status over a 9-year period. Method: Multinomial logistic regression models examined the probability of retirement and disability impeding work, using data from the Health and Retirement Study ( n = 5,576). Results: Among participants who had retired in 2012, almost 14% had incident diabetes (4.91 mean years with diabetes, 95% confidence interval [CI] = [4.67, 5.15]). Approximately 22% of participants who reported a disability impeded labor force participation had prevalent diabetes (17.1 mean years with diabetes, 95%CI = [16.41, 17.71]). Only prevalent diabetes that indicated longer disease duration was associated with disability (relative risk ratio [RRR] = 1.83, 95% CI = [1.30, 2.57]). There was evidence of effect modification among Hispanics only ( p = .02). Discussion: Diabetes increased risk of exiting the workforce due to disability, and mean disease duration was associated with changes. Disease management and workplace interventions may enable older adults to continue being productive should they choose to remain in the workforce.

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Factors Associated with Celecoxib and Rofecoxib Utilization

Annals of Pharmacotherapy ◽

10.1345/aph.1e298 ◽

2005 ◽

Vol 39 (4) ◽

pp. 597-602 ◽

Cited By ~ 11

Author(s):

Nigel SB Rawson ◽

Parivash Nourjah ◽

Stella C Grosser ◽

David J Graham

Keyword(s):

Cardiovascular Disease ◽

Disease Burden ◽

Multiple Logistic Regression Analysis ◽

Underlying Disease ◽

Nonsteroidal Antiinflammatory Drugs ◽

Nonselective Nsaid ◽

Antiinflammatory Drugs ◽

The Past ◽

Increased Risk ◽

Cox 2

BACKGROUND: The cyclooxygenase-2 (COX-2) selective nonsteroidal antiinflammatory drugs (NSAIDs) celecoxib and rofecoxib (before its removal) are marketed as having fewer gastrointestinal (GI)-related complications than nonselective NSAIDs. However, adverse reaction data suggest that the use of COX-2 selective NSAIDs is associated with clinically significant GI events. OBJECTIVE: To assess whether patients receiving celecoxib and rofecoxib have a greater underlying disease burden than patients prescribed nonselective NSAIDs. METHODS: The study population consisted of members of 11 health plans, aged >34 years, with a pharmacy claim for celecoxib or rofecoxib or a nonselective NSAID dispensed between February 1, 1999, and July 31, 2001, who had been continuously enrolled for >364 days before the dispensing date. Celecoxib and rofecoxib patients were randomly selected without replacement from a pool of eligible users in each of the 30 months. Nonselective NSAID users were randomly chosen without replacement within each month on a 2:1 ratio to cases; they could be chosen in more than one month. Univariate analyses comparing 9000 cases and 18 000 controls were performed, followed by a multiple logistic regression analysis conditioned on time. RESULTS: Increasing age, treatment by a rheumatologist or an orthopedic specialist, treatment with a high number of different medications in the past year, treatment with oral corticosteroids in the past year, and having had a previous GI bleed increased the likelihood of receiving celecoxib or rofecoxib, whereas treatment with a high number of nonselective NSAID prescriptions in the past year decreased it. Treatment with a high number of different medications was a predictor of increased prevalence of underlying diabetes mellitus and cardiovascular disease. CONCLUSIONS: Patients having a greater underlying disease burden were more likely to receive COX-2 selective NSAIDs than nonselective ones. Paradoxically, patients at higher risk for cardiovascular disease were channeled toward treatment with COX-2 selective NSAIDs, many of which may confer an increased risk of acute myocardial infarction and other adverse cardiovascular outcomes.

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The Minimum Clinically Important Improvement and Patient-acceptable Symptom State in the BASDAI and BASFI for Patients with Ankylosing Spondylitis

The Journal of Rheumatology ◽

10.3899/jrheum.151244 ◽

2016 ◽

Vol 43 (9) ◽

pp. 1680-1686 ◽

Cited By ~ 15

Author(s):

Milla Johanna Kviatkovsky ◽

Sofia Ramiro ◽

Robert Landewé ◽

Maxime Dougados ◽

Florence Tubach ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Disease Duration ◽

Activity Index ◽

Disease Activity Index ◽

Nonsteroidal Antiinflammatory Drugs ◽

Cumulative Distribution ◽

Antiinflammatory Drugs ◽

Important Improvement ◽

Patient Acceptable Symptom State ◽

Active Disease

Objective.To establish cutoffs for the minimum clinically important improvement (MCII) and the patient-acceptable symptom state (PASS) for the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with ankylosing spondylitis (AS).Methods.Patients with AS who started nonsteroidal antiinflammatory drugs were included. After 4 weeks, the PASS and the MCII were defined using external anchor questions (for the PASS, patients considering their condition of AS over the prior 48 h as “acceptable” forever; and for the MCII, those reporting moderate or slightly important improvement). Consistency of the MCII and PASS were tested according to HLA-B27 status, presence/absence of SpA extraarticular manifestations, age, sex, disease duration, and baseline BASDAI/BASFI score. The 75th percentile of the cumulative distribution was used to determine the MCII and PASS.Results.In total, 283 patients from a multinational cohort were included. Overall cutoffs for the PASS were 4.1 in the BASDAI and 3.8 in the BASFI. Cutoffs for the MCII were 0.7 and 0.4 for the BASDAI and BASFI, respectively. Subgroup analyses revealed that disease duration and baseline BASDAI/BASFI were significantly associated with the PASS and MCII. In a subanalysis limited to patients with active disease (baseline BASDAI ≥ 4), the MCII was 1.1 for the BASDAI and 0.6 for the BASFI.Conclusion.The conceptual viability of the PASS for the BASDAI is questionable because levels approach those required for the start of biological therapy. Because the MCII is less variable than the PASS, we propose its exclusive use, with cutoffs of 1.1/0.6 for the BASDAI/BASFI in patients with active disease. Because these values are based on a subset of the study population, we recommend confirmation in larger studies focused on patients with baseline BASDAI ≥ 4.

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Updated Guidelines for the Management of Axial Disease in Psoriatic Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.140877 ◽

2014 ◽

Vol 41 (11) ◽

pp. 2286-2289 ◽

Cited By ~ 20

Author(s):

Peter Nash ◽

Ennio Lubrano ◽

Alberto Cauli ◽

William J. Taylor ◽

Ignazio Olivieri ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Axial Spondyloarthritis ◽

Nonsteroidal Antiinflammatory Drugs ◽

Therapeutic Interventions ◽

Limited Data ◽

Spinal Disease ◽

Antiinflammatory Drugs ◽

Axial Disease ◽

Traditional Therapies ◽

Axial Involvement

Axial involvement in patients with psoriatic arthritis (PsA) remains common and can be defined in terms of spinal disease alone or in combination with peripheral manifestations. Diagnosis is based upon inflammatory spinal symptoms or the presence of radiological sacroiliitis and other radiographic signs of spondylitis, or by criteria for axial spondyloarthritis (SpA) defined by ASAS (Assessment of SpondyloArthritis International Society). Although recent data are scarce for efficacy of traditional therapies for axial disease (e.g., nonsteroidal antiinflammatory drugs, methotrexate, etc.), limited data are available for targeted biologics and novel agents. We identify and evaluate the efficacy of therapeutic interventions for treatment of axial disease in PsA. This review is an update of the axial PsA section of the treatment recommendations project by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

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Droughts, cyclones, and intimate partner violence: A disastrous mix for Indian women

10.1101/2020.06.29.20142893 ◽

2020 ◽

Author(s):

Ayushi Rai ◽

Anupam Joya Sharma ◽

Malavika A. Subramanyam

Keyword(s):

Intimate Partner Violence ◽

Natural Disasters ◽

Partner Violence ◽

Family Health ◽

Rapid Onset ◽

Intimate Partner ◽

Logistic Regression Models ◽

Increased Risk ◽

Using Data ◽

The Impact

AbstractIndia has reported a high prevalence of Intimate Partner Violence (IPV) against women over the years. Previous Western research have found an increased IPV risk among women in the aftermath of natural disasters, underscoring the need for such studies in India. We could not locate any study focusing on the impact of slow-onset versus rapid-onset disasters, which might have differing impacts on the vulnerable, especially on the incidence of IPV in India. Using data on ever-married women from the National Family Health Survey-4, we investigated the association of residing in districts exposed to a drought (N=31,045), and separately, to two cyclones (N=8469), with three forms of self-reported IPV against women (emotional, physical, and sexual). Survey-adjusted logistic regression models showed that exposure to cyclone was positively associated with emotional IPV (AOR: 1.59, CI: 1.20, 2.10) after adjusting for sociodemographic covariates. Although not statistically significant, exposure to cyclone was also positively associated with physical and sexual IPV, and drought with physical IPV. However, we did not find an association of drought with emotional and sexual violence. Notably, we corroborated previous findings that women from wealthier households, educated, and whose husbands had no history of alcohol consumption, were less likely to experience any form of IPV independent of the influence of other factors. These results highlight the potential increased risk of IPV following natural disasters. In a patriarchal society such as India vulnerable to climate-change, these sobering results highlight the need to prepare for the social disasters that might accompany natural disasters.

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Consumption of ultra-processed foods is associated with abdominal obesity in rotating shift workers

10.21203/rs.3.rs-1074710/v1 ◽

2021 ◽

Author(s):

Luiz Antônio Alves de Menezes Júnior ◽

Virgínia Capistrano Fajardo ◽

Jonathas Assis de Oliveira ◽

George Luiz Lins Machado-Coelho ◽

Fausto Aloísio Pedrosa Pimenta ◽

...

Keyword(s):

Abdominal Obesity ◽

Multivariable Analysis ◽

Saturated Fat ◽

Cross Sectional Study ◽

Processed Foods ◽

Cross Sectional ◽

Shift Workers ◽

Logistic Regression Models ◽

Body Adiposity ◽

Increased Risk

Abstract Background and aims: Higher intake of ultra-processed foods might be associated with an increased risk of obesity. Our objective was to evaluate the consumption of ultra-processed foods and their association with nutrient intake and excess body adiposity in shift workers.Design: Cross-sectional study conducted in 2016 with 238 male rotating shift workers. Dietary data is obtained by the 24-hour recall and classified according to processing by the NOVA classification system. Body adiposity indicators assessed were waist circumference and body mass index. Logistic regression models were built and adjusted for sociodemographic, lifestyle, and dietary variables.Results: Ultra-processed foods represented on average 22.3% of the total caloric value of the individuals' food consumption, with a maximum value of 66.9%. Participants with the highest tercile of ultra-processed foods consumed more carbohydrate (57%), protein (35%), total fat (96%), saturated fat (79%), cholesterol (68%), and sodium (44%) intake compared to the first tercile (p < 0.001). The most frequencies of ultra-processed foods consumed were bread (81.0%), followed by cookies (45.9%), sweetened beverages (45.7%), processed meats (46.8%), and margarine (46.8%). In multivariable analysis, the highest consumption of ultra-processed foods had 183% higher odds of abdominal obesity (OR = 2.83, 95%CI 1.29-6.22), compared with the lowest consumption. Conclusion: Ultra-processed foods are important contributors to the energy intake of these workers, and higher consumption of ultra-processed foods was associated with abdominal obesity.

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Neighbourhood characteristics at birth and positive and negative psychotic symptoms in adolescence: findings from the ALSPAC birth cohort

10.31234/osf.io/nmh9y ◽

2018 ◽

Author(s):

Francesca Solmi ◽

Glyn Lewis ◽

James Bowes Kirkbride

Keyword(s):

Negative Symptoms ◽

Sensitivity Analyses ◽

Risk Scores ◽

Psychotic Symptoms ◽

Logistic Regression Models ◽

White Ethnicity ◽

Parents And Children ◽

Increased Risk ◽

Using Data ◽

Multivariable Adjustment

Objective: Urban birth is associated with risk of non-affective psychoses. While emerging evidence suggests that this association is also apparent for subclinical positive psychotic phenomena in the general population, few studies have considered which specific aspects of the urban environment predict risk, or whether these factors also increase the likelihood of negative symptoms. Method: Using data from the Avon Longitudinal Study of Parents and Children, linked to census geographical indicators, we examined whether population density, deprivation, inequality, and social fragmentation at birth were associated with negative and positive psychotic symptoms at age 16 and 18 years, respectively. We used logistic regression models, controlling for child’s ethnicity, maternal age, education, marital status, social class, depressive symptoms, other neighbourhood exposures, and, in sensitivity analyses, polygenic risk scores (PRS) for schizophrenia in a sub-sample of children of white ethnicity (N=10,283). Results: Amongst 11,879 adolescents, those born in the most densely populated tertile had greater odds of reporting positive psychotic experiences, after multivariable adjustment (odds ratio (OR): 1.57, 95% confidence intervals (CI): 1.14 – 2.17). Adolescents born in the most socially fragmented neighbourhoods had greater odds of negative symptoms, after multivariable adjustment (OR: 1.43, 95%CI: 1.06 – 1.85). These associations were not confounded by schizophrenia PRS. There was no evidence of any other associations. Discussion: Birth into more densely populated and socially fragmented environments increased risk of positive and negative psychotic phenomena in adolescence. Our findings suggest that different forms of neighbourhood social adversity impinge on different psychopathophysiologies associated with the clinical expression of psychosis.

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A Cyclooxygenase-2 Inhibitor Impairs Ligament Healing in the Rat

The American Journal of Sports Medicine ◽

10.1177/03635465010290062101 ◽

2001 ◽

Vol 29 (6) ◽

pp. 801-805 ◽

Cited By ~ 78

Author(s):

Christopher L. Elder ◽

Laurence E. Dahners ◽

Paul S. Weinhold

Keyword(s):

Medial Collateral Ligament ◽

Soft Tissues ◽

Nonsteroidal Antiinflammatory Drugs ◽

Cyclooxygenase 2 ◽

Ligament Injuries ◽

Collateral Ligament ◽

Antiinflammatory Drugs ◽

Increased Risk ◽

Ligament Healing ◽

Specific Inhibitors

Celecoxib was the first of a new class of nonsteroidal antiinflammatory drugs, the cyclooxygenase-2 (COX-2) specific inhibitors, marketed as having the same antiinflammatory efficacy as other nonsteroidal antiinflammatory drugs without their increased risk of gastrointestinal ulceration. Among the widest uses of nonsteroidal antiinflammatory drugs is in the treatment of acute soft tissue injuries. Although the benefits of celecoxib have been shown when used for rheumatoid arthritis and osteoarthritis, we are unaware of any studies concerning its effect on soft tissues. We used the surgically incised medial collateral ligament of male Sprague-Dawley rats as an experimental model for acute ligament injuries to investigate the effects of celecoxib on ligament healing. Fifty rats underwent surgical transection of the right medial collateral ligament. Postoperatively, half were given celecoxib for the first 6 days of recovery, the other half were not. The animals were sacrificed 14 days after the operation, and both the injured and uninjured medial collateral ligaments were mechanically tested to failure in tension. Celecoxib-treated/injured ligaments were found to have a 32% lower load to failure than untreated/ injured ligaments. The results of this study do not support use of cyclooxygenase-2 specific inhibitors in the treatment of ligament injuries.

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Ibuprofen-Induced Aseptic Meningitis in Rheumatoid Arthritis

Annals of Pharmacotherapy ◽

10.1177/106002809703100911 ◽

1997 ◽

Vol 31 (9) ◽

pp. 1009-1011 ◽

Cited By ~ 18

Author(s):

Amy C Horn ◽

Steven W Jarrett

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Aseptic Meningitis ◽

Lupus Erythematosus ◽

Nonsteroidal Antiinflammatory Drugs ◽

Systemic Lupus ◽

Antiinflammatory Drugs ◽

Stiff Neck ◽

Laboratory Findings ◽

Increased Risk

Objective To report a case of aseptic meningitis related to ibuprofen ingestion. Case Summary We discuss the case of a 56-year-old white man with a history of rheumatoid arthritis and hypertension who became confused, nauseated, and began to vomit within 2 hours of the ingestion of ibuprofen. A diagnosis of ibuprofen-induced aseptic meningitis was made based on the patient's physical and laboratory findings, the quick onset and resolution of symptoms, and his medical history. Discussion Ibuprofen-induced aseptic meningitis has been most frequently reported in patients with systemic lupus erythematosus. However, there have been reports of this reaction in patients with other underlying disease states. Various nonsteroidal antiinflammatory drugs have been reported to cause this reaction, but ibuprofen is the most common offending agent. A drug-related cause should be considered in any patient who presents with typical meningitis symptoms, such as fever, headache, and stiff neck, that occur within hours of ingesting a drug. Conclusions Although persons with systemic lupus erythematosus appear to have an increased risk for this type of reaction, the development of signs and symptoms in other patients warrants the consideration of nonsteroidal antiinflammatory drugs as the cause of aseptic meningitis.

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Intraoperative Nerve Monitoring in Thyroidectomies for Malignancy: Does it Matter?

The American Surgeon ◽

10.1177/0003134821991967 ◽

2021 ◽

pp. 000313482199196

Author(s):

Shravan Leonard-Murali ◽

Tommy Ivanics ◽

Hassan Nasser ◽

Amy Tang ◽

Michael C. Singer

Keyword(s):

Subgroup Analysis ◽

Multivariable Analysis ◽

Improvement Program ◽

Data Set ◽

Nerve Monitoring ◽

Logistic Regression Models ◽

Increased Risk ◽

Complications Of Thyroidectomy ◽

Intraoperative Nerve Monitoring ◽

The Impact

Background Recurrent laryngeal nerve (RLN) injury and postoperative hypocalcemia are potential complications of thyroidectomy, particularly in malignancy. Intraoperative nerve monitoring (IONM) remains controversial. We sought to evaluate the impact of IONM on these complications using a national data set. Methods The American College of Surgeons National Surgical Quality Improvement Program thyroidectomy-targeted data set was queried for patients who underwent thyroidectomies from 2016 to 2017. Patients were grouped according to IONM use. Logistic regression models were constructed to evaluate associations of variables with 30-day hypocalcemic events (HCEs) and RLN injury. Associations were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). A subgroup analysis was performed of patients with malignancy. Results A total of 9527 patients were identified; 5969 (62.7%) underwent thyroidectomy with IONM and 3558 (37.3%) without. By multivariable analysis, IONM had protective associations with HCE (OR = .81, 95% CI = .68-.96; P = .013) and RLN injury (OR = .83, 95% CI = .69-.98; P = .033). Malignancy increased risk of HCE (OR = 1.21, 95% CI=1.01-1.45; P = .038) and RLN injury (OR = 1.22, 95% CI = 1.02-1.46; P = .034). A large proportion (5943/9527, 62.4%) of patients had malignancy; 3646 (61.3%) underwent thyroidectomy with IONM and 2297 (38.7%) without. In the subgroup analysis, IONM had stronger protective associations with HCE (OR = .73, 95% CI = .60-.90; P = .003) and RLN injury (OR = .76, 95% CI = .62-.94; P = .012). Discussion Malignancy was associated with increased risk of HCE and RLN injury. Intraoperative nerve monitoring had a protective association with HCE and RLN injury, both overall, and in the malignant subgroup. Intraoperative nerve monitoring was correlated with improved thyroidectomy outcomes, especially if the indication was malignancy. This warrants further study to clarify cause and effect.

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