Documenting Disability History in Western Pennsylvania

ABSTRACT Disability history is everyone's history. However, existing archival literature on disability focuses almost exclusively on issues of accessibility. Relatively little has been written on the challenges and opportunities present in strengthening disability history representation in archives. The author uses their experience as a contractor for a regional nonprofit to explore the nature of working with community members to strengthen disability history representation in archives and proposes documentation strategy as an ideal framework for such collaborations.

A Comprehensive Clinical Description of Pediatric SARS-CoV-2 Infection in Western Pennsylvania

Objective: We sought to characterize clinical presentation and healthcare utilization for pediatric COVID-19 in Western Pennsylvania (PA). Methods: We established and analyzed a registry of pediatric COVID-19 in Western PA that includes cases in patients <22 years of age cared for by the pediatric quaternary medical center in the area and its associated pediatric primary care network from March 11 through August 20, 2020. Results: Our cohort included 424 pediatric COVID-19 cases (mean age 12.5 years, 47.4% female); 65% reported exposure and 79% presented with symptoms. The most common initial healthcare contact was through telehealth (45%). Most cases were followed as outpatients, but twenty-two patients (4.5%) were hospitalized: 19 with acute COVID-19 disease, and three for multisystem inflammatory syndrome of children (MIS-C). Admitted patients were younger (p<0.001) and more likely to have pre-existing conditions (p<0.001). Black/Hispanic patients were 5.8 times more likely to be hospitalized than white patients (p=0.012). Five patients (1.2%) were admitted to the PICU, including all three MIS-C cases; two required BiPAP and one mechanical ventilation. All patients survived. Conclusions: We provide a comprehensive snapshot of pediatric COVID-19 disease in an area with low to moderate incidence. In this cohort, COVID-19 was generally a mild disease; however, ~5% of children were hospitalized. Pediatric patients can be critically ill with this infection, including those presenting with MIS-C.

Clinical subgroup clustering analysis in a systemic lupus erythematosus cohort from Western Pennsylvania

ObjectiveSystemic lupus erythematosus (SLE) is a complex heterogenous autoimmune disease that can affect multiple organs. We performed clinical clustering analysis to describe a lupus cohort from the University of Pittsburgh Medical Center.MethodsA total of 724 patients who met the ACR classification criteria for SLE were included in this study. Clustering was performed using the ACR classification criteria and the partitioning around medoid method. Correlation analysis was performed using the Spearman’s Rho test.ResultsPatients with SLE in our cohort identify 3 district clinical disease subsets. Patients in Cluster 1 were significantly more likely to develop renal and hematologic involvement, and had overrepresentation in African-American and male lupus patients. Clusters 2 and 3 identified a milder disease, with a significantly less likelihood of organ complications. Patients in Cluster 2 are characterized by malar rash and photosensitivity, while patients in Cluster 3 are characterized by oral ulcers which is present in ∼90% of patients within this cluster. The presence of photosensitivity or oral ulcers appears to be protective against the development of lupus nephritis in our cohort.ConclusionsWe describe a large cohort of SLE from Western Pennsylvania and identify 3 distinct clinical disease subgroups. Clustering analysis might help to better manage and predict disease complications in heterogenous diseases like lupus.