Rate of Proven Rheumatic Diseases in a Large Collective of Referrals to an Outpatient Rheumatology Clinic under Routine Conditions

The prognostic significance of early diagnosis and therapeutic intervention in inflammatory rheumatic diseases has been well documented. However, a shortage of rheumatologists often impedes this approach in clinical practice. Therefore, it is of importance to identify those patients referred for diagnosis who would benefit most from a specialist's care. We applied a telephone-based triage for appointment allocation during routine care. This retrospective, monocentric analysis evaluated the efficacy of our triage to identify patients with rheumatic disease with special regard to initial appointment category (elective, early arthritis clinic (EAC), or emergency appointment). Of the 1,782 patients assessed, 718 (40.3%) presented with an inflammatory rheumatic disease, and there were significant discrepancies between the appointment categories: elective 26.2%, EAC 49.2% ( P < 0.001) and emergency appointment 56.6% ( P < 0.001). We found that 61.2% of patients were allocated to the correct diagnostic category (inflammatory or noninflammatory) solely based on the telephone-based triage and 67.1% based on the combination of triage and C-reactive protein (CRP) count.

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Comorbidities of rheumatic disease

10.1093/med/9780199642489.003.0032 ◽

2013 ◽

Cited By ~ 1

Author(s):

Tuulikki Sokka ◽

Kari Puolakka ◽

Carl Turesson

Keyword(s):

Rheumatic Disease ◽

Rheumatic Diseases ◽

Health Professionals ◽

Physical Inactivity ◽

Organ Damage ◽

Inflammatory Rheumatic Diseases ◽

Rheumatology Clinic ◽

Cholesterol Levels ◽

Lifestyle Choices ◽

The Impact

All other diseases that coexist with a disease of interest are called comorbidities. Comorbidities in inflammatory rheumatic diseases may be associated with persistent inflammatory activity or disease-related organ damage, or may be related to medications. Lifestyle choices such as smoking or physical inactivity contribute to comorbidity. Patients with rheumatic diseases meet health professionals regularly and are more often tested for osteoporosis or cholesterol levels than individuals without rheumatic disease, which may contribute to a higher prevalence of some comorbidities. Comorbidities can also be unrelated to rheumatic diseases or their treatments. In this chapter, we discuss the impact of comorbidities to the patient. We emphasize the importance to review and manage comorbidities in usual daily rheumatology clinic, to improve outcomes of patients with rheumatic diseases.

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Comorbidities of rheumatic disease

10.1093/med/9780199642489.003.0032_update_001 ◽

2015 ◽

Author(s):

Tuulikki Sokka ◽

Kari Puolakka ◽

Carl Turesson

Keyword(s):

Rheumatic Disease ◽

Rheumatic Diseases ◽

Health Professionals ◽

Physical Inactivity ◽

Organ Damage ◽

Inflammatory Rheumatic Diseases ◽

Rheumatology Clinic ◽

Cholesterol Levels ◽

Lifestyle Choices ◽

The Impact

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Comorbidities of rheumatic disease

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0032_update_002 ◽

2013 ◽

pp. 243-250

Author(s):

Tuulikki Sokka ◽

Kari Puolakka ◽

Carl Turesson

Keyword(s):

Rheumatic Disease ◽

Rheumatic Diseases ◽

Health Professionals ◽

Organ Damage ◽

Inflammatory Rheumatic Diseases ◽

Rheumatology Clinic ◽

Cholesterol Levels ◽

Lifestyle Choices ◽

The Impact ◽

Index Disease

All other diseases that coexist with a disease of interest are called comorbidities. Comorbidities in inflammatory rheumatic diseases may be associated with persistent inflammatory activity or disease-related organ damage, or may be related to medications. Lifestyle choices such as smoking or physical inactivity contribute to comorbidity. Patients with rheumatic diseases meet health professionals regularly and are more often tested for osteoporosis or cholesterol levels than individuals without rheumatic disease, which may contribute to a higher prevalence of some comorbidities. Comorbidities can also be unrelated to rheumatic diseases or their treatments. The concept of ‘multimorbidity’ is being used increasingly, shifting the focus from the index disease to two or more chronic diseases that exist in the same individual. In this chapter, we discuss the impact of multi/comorbidities. We emphasize the importance to review and manage comorbidities in usual daily rheumatology clinic, to improve outcomes of patients with rheumatic diseases.

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Prognostic Significance of Perioperative C-Reactive Protein in Resected Non-Small Cell Lung Cancer

Seminars in Thoracic and Cardiovascular Surgery ◽

10.1053/j.semtcvs.2020.03.019 ◽

2020 ◽

Vol 32 (4) ◽

pp. 1046-1055 ◽

Cited By ~ 1

Author(s):

Satoru Okada ◽

Masanori Shimomura ◽

Hiroaki Tsunezuka ◽

Satoshi Teramukai ◽

Shunta Ishihara ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Prognostic Significance ◽

Small Cell ◽

C Reactive Protein ◽

Small Cell Lung ◽

Reactive Protein

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Implementation of C-reactive protein point of care testing to improve antibiotic targeting in respiratory illness in Vietnamese primary care (ICAT): a study protocol for a cluster randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-040977 ◽

2020 ◽

Vol 10 (12) ◽

pp. e040977

Author(s):

Nga Thi Thuy Do ◽

Rachel Claire Greer ◽

Yoel Lubell ◽

Sabine Dittrich ◽

Maida Vandendorpe ◽

...

Keyword(s):

Primary Care ◽

Antibiotic Prescription ◽

Point Of Care ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Antibiotic Use ◽

Routine Care ◽

C Reactive Protein ◽

Reactive Protein ◽

Randomised Controlled

IntroductionC-reactive protein (CRP), a biomarker of infection, has been used widely in high-income settings to guide antibiotic treatment in patients presenting with respiratory illnesses in primary care. Recent trials in low- and middle-income countries showed that CRP testing could safely reduce antibiotic use in patients with non-severe acute respiratory infections (ARIs) and fever in primary care. The studies, however, were conducted in a research-oriented context, with research staff closely monitoring healthcare behaviour thus potentially influencing healthcare workers’ prescribing practices. For policy-makers to consider wide-scale roll-out, a pragmatic implementation study of the impact of CRP point of care (POC) testing in routine care is needed.Methods and analysisA pragmatic, cluster-randomised controlled trial, with two study arms, consisting of 24 commune health centres (CHC) in the intervention arm (provision of CRP tests with additional healthcare worker guidance) and 24 facilities acting as controls (routine care). Comparison between the treatment arms will be through logistic regression, with the treatment assignment as a fixed effect, and the CHC as a random effect. With 48 clusters, an average of 10 consultations per facility per week will result in approximately 520 over 1 year, and 24 960 in total (12 480 per arm). We will be able to detect a reduction of 12% to 23% or more in immediate antibiotic prescription as a result of the CRP POC intervention. The primary endpoint is the proportion of patient consultations for ARI resulting in immediate antibiotic prescription. Secondary endpoints include the proportion of all patients receiving an antibiotic prescription regardless of ARI diagnosis, frequency of re-consultation, subsequent antibiotic use when antibiotics are not prescribed, referral and hospitalisation.Ethics and disseminationThe study protocol was approved by the Oxford University Tropical Research Ethics Committee (OxTREC, Reference: 53–18), and the ethical committee of the National Hospital for Tropical Diseases in Vietnam (Reference:07/HDDD-NDTW/2019). Results from this study will be disseminated via meetings with stakeholders, conferences and publications in peer-reviewed journals. Authorship and reporting of this work will follow international guidelines.Trial registration detailsNCT03855215; Pre-results.

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Diagnostic Value and Prognostic Significance of Pleural C-Reactive Protein in Lung Cancer Patients with Malignant Pleural Effusions

Yonsei Medical Journal ◽

10.3349/ymj.2013.54.2.396 ◽

2013 ◽

Vol 54 (2) ◽

pp. 396 ◽

Cited By ~ 2

Author(s):

Do-Sim Park ◽

Dong Kim ◽

Ki-Eun Hwang ◽

Yu-Ri Hwang ◽

Chul Park ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Prognostic Significance ◽

Diagnostic Value ◽

Pleural Effusions ◽

C Reactive Protein ◽

Lung Cancer Patients ◽

Malignant Pleural Effusions ◽

Reactive Protein

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Prognostic value of C-reactive protein/albumin ratio in renal cell carcinoma: a systematic review and meta-analysis

10.21203/rs.2.17584/v1 ◽

2019 ◽

Author(s):

hualin song ◽

Peng xiang ◽

Zhifu liu ◽

shuai hu ◽

Jie Jin

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Meta Analysis ◽

Prognostic Significance ◽

Clinicopathological Features ◽

C Reactive Protein ◽

Poor Overall Survival ◽

Albumin Ratio ◽

Reactive Protein

Abstract Background: There are a mass of studies declared the prognostic significance of C-reactive protein/albumin ratio (CRP/Alb) in renal cell carcinoma (RCC). Nevertheless, these works are controversial. In our study, we investigate the expression of CRP/Alb in RCC and its role in prognosis and clinicopathological features. Methods: The PubMed, Embase and Cochrane databases were searched systematically for correlative articles published before August 1, 2019. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined according to eligible studies. And we use fixed and random effects models to calculate on the basis of heterogeneity. Results: Six relevant studies were identified in this study, 1959 participants included in total. Our results showed that CRP/Alb was related to poor overall survival (HR=1.86, 95% CI: 1.56-2.21). In addition, CRP/Alb was also associated with tumor stage (OR=3.29, 95% CI: 1.66-6.50), lymph node involvement (OR=3.76, 95% CI: 2.57-5.51), metastasis (OR=5.69, 95% CI: 2.40-13.51), Fuhrman nuclear grade (OR=4.21, 95% CI: 3.14-5.64), pTNM (OR=4.34, 95% CI: 1.94-9.70) and tumor size (WMD=2.26, 95% CI: 1.86–2.67). However, CRP/Alb was not associated with necrosis. Conclusion: Our study illustrates that the higher CRP/Alb expression was correlated with poorer prognosis and more advanced clinicopathological features in RCC patients. High CRP/Alb expression may act as a valuable predictive biomarker for poor prognosis in RCC patients.

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