Recurrent (or episodic) fever of unknown origin (FUO) as a variant subgroup of classical FUO: A French multicentre retrospective study of 170 patients.

BACKGROUND: Recurrent FUO (fever of unknown origin) is a rare subtype of FUO for which diagnostic procedures are ill-defined and outcome data are lacking. METHODS: We performed a retrospective multicentre study of patients with recurrent FUO between 1995 and 2018. By multivariate analysis, we identified epidemiological, clinical and prognostic variables independently associated with final diagnosis and mortality. RESULTS: Of 170 patients, 74 (44%) had a final diagnosis. Being ≥ 65 years of age (OR = 5.2; p < 0.001), contributory history (OR = 10.4; p < 0.001), and abnormal clinical examination (OR = 4.0; p = 0.015) independently increased the likelihood of reaching a diagnosis, whereas lymph node and/or spleen enlargement decreased it (OR = 0.2; p = 0.004). The overall prognosis was good; 58% of patients recovered (70% of those with a diagnosis). Twelve (7%) patients died; patients without a diagnosis had a fatality rate of 2%. Being ≥ 65 years of age (OR = 41.3; p < 0.001) and presence of skin signs (OR = 9.5; p = 0.005) significantly increased the risk of death. CONCLUSION: This study extends the known yield of recurrent FUO and highlights the importance of repeated complete clinical examinations to discover potential diagnostic clues during follow-up. Moreover, their overall prognosis is excellent.

[The dynamics of addictions in students and possibilities of reflecting it in psychorehabilitative programs]. / Dinamika addiktivnykh rasstroistv u studentov i vozmozhnosti ee otrazheniia v programmakh po psikhoprofilaktike.

Objective. To study the dynamics of different indicators of addiction in a student population over the last decade (2002-2012), to find the factors predicting addiction and to develop recommendations for the correction of rehabilitative programs. Material and methods. Authors examined 578 students of different faculties in 2002 and 568 students in 2012. Patients were stratified by a pattern of addictive behaviour. In addition, it was used psychological method and self-rated stress response as well as the causes of alcoholism and drug addiction. Results. A comparison of the results for 2002 and 2012 demonstrated the increase in percent of drug addiction compared to alcoholism, the increase in the number of women with drug addiction, but not with alcoholism, significant changes in motivation of using alcohol and drugs and comorbidity with anxiety, depression and stress reactivity. Conclusion. The results indicate the necessity of the renovation of rehabilitation programs.

[Ethnoterritorial heterogeneity of alcohol dependence formation in the native population of Siberia].

Clinical-dynamic parameters of heterogeneity of alcohol dependence in 155 tuvinian and russian patients with lucid and psychotic forms of the disease have been studied. A highly progressive form of alcoholism with late onset of systematic consumption of alcohol has been identified in tuvinians as compared with russians. The formation of withdrawal syndrome occurs at later age than in russians (37.7 and 29.6 years; p=0.00004), but its development is more rapid - in average 2-2.5 years of systematic alcohol consumption. Psychotic forms of alcoholism are more frequent in tuvinians with the earlier onset of systematic consumption of alcohol and manifestation of basic disease syndromes (by 7 and 5 years, respectively) than in those with lucid alcoholism. In conclusion, treatment and rehabilitation of patients of different ethnic groups should be based on clinical and social features of the disease.