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1.
BMC Med Genet ; 21(1): 27, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-32039712

RESUMO

BACKGROUND: Stickler syndrome is the most common genetic cause of rhegmatogenous retinal detachment (RRD) in children, and has a high risk of blindness. Type I (STL1) is the most common subtype, caused by COL2A1 mutations. This study aims to analyze the mutation spectrum of COL2A1 and further elucidate the genotype-phenotype relationships in the East Asian populations with STL1, which is poorly studied at present. METHODS: By searching MEDLINE, Web of Science, CNKI, Wanfang Data, HGMD and Clinvar, all publications associated with STL1 were collected. Then, they were carefully screened to obtain all reported STL1-related variants in COL2A1 and clinical features in East Asian patients with STL1. RESULTS: There were 274 COL2A1 variants identified in 999 patients with STL1 from 466 unrelated families, and more than half of them were truncation mutations. Of the 107 STL1 patients reported in the East Asian population, it was found that patients with truncation mutations had milder systemic phenotypes, whereas patients with splicing mutations had severer phenotypes. In addition, several recurrent variants (c.3106C > T, c.1833 + 1G > A, c.2710C > T and c.1693C > T) were found. CONCLUSIONS: Genotype-phenotype correlations should certainly be studied carefully, contributed to making personalized follow-up plans and predicting prognosis of this disorder. Genome editing holds great potential for treating inherited diseases caused by pathogenic mutations. In this study, several recurrent variants were found, providing potential candidate targets for genetic manipulation in the future.


Assuntos
Artrite/genética , Doenças do Tecido Conjuntivo/genética , Análise Mutacional de DNA , Perda Auditiva Neurossensorial/genética , Mutação/genética , Descolamento Retiniano/genética , Artrite/epidemiologia , Artrite/patologia , Doenças do Tecido Conjuntivo/epidemiologia , Doenças do Tecido Conjuntivo/patologia , Oftalmopatias Hereditárias , Estudos de Associação Genética , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Neurossensorial/patologia , Humanos , Fenótipo , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/patologia
3.
Orthop Clin North Am ; 51(1): 77-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739882

RESUMO

Scapholunate ligament injuries are common and can lead to a predictable pattern of arthritis (scaphoid lunate advanced collapse wrist) if unrecognized or untreated. This article describes the relevant anatomy, biomechanics, and classification system, and provides an up-to-date literature-based review of treatment options, including acute repair and various reconstruction techniques. It also helps guide surgeons in making decisions regarding a systematic treatment algorithm for these injuries.


Assuntos
Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Traumatismos do Punho/complicações , Artrite/epidemiologia , Artrite/etiologia , Fenômenos Biomecânicos , Articulações do Carpo/lesões , Articulações do Carpo/patologia , Articulações do Carpo/cirurgia , Humanos , Ligamentos Articulares/anatomia & histologia , Osso Semilunar/lesões , Osso Semilunar/patologia , Osso Semilunar/cirurgia , Radiografia/métodos , Amplitude de Movimento Articular , Osso Escafoide/lesões , Osso Escafoide/patologia , Osso Escafoide/cirurgia , Resultado do Tratamento , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/cirurgia , Articulação do Punho/patologia , Articulação do Punho/cirurgia
4.
J S Afr Vet Assoc ; 90(0): e1-e5, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31793309

RESUMO

Infectious arthritis or tenosynovitis in broiler and breeder chickens results in major loss of productivity because of reduced growth and downgrading at processing plants. The most common causative agents of avian infectious arthritis are the bacterium Mycoplasma synoviae and avian reoviruses (ARVs) (family Reoviridae, genus Orthoreovirus). In this study, we evaluated the occurrence of these two pathogens in arthritis or tenosynovitis lesions of broilers and breeder flocks in southern Brazil using molecular detection. Tissue sections from tibiotarsal joints with visible lesions from 719 broilers and 505 breeders were analysed using pathogen-specific polymerase chain reaction (PCR) assays. In breeders, 41.2% (n = 296) of lesions were positive for M. synoviae, 26.4% (n = 190) were positive for ARV, while co-infection was present in 12.2% (n = 88) of the samples. In broilers, 20.8% (n = 105) of lesions were positive for M. synoviae, 11.9% (n = 60) for ARV and 7.7% (n = 39) of these cases were positive for both pathogens. Post-mortem examination revealed lesions with varying degrees of gross pathological severity. Histopathological examination showed intense, diffuse lymphohistiocytic inflammatory infiltrates with heterophil accumulation, primarily in the synovial capsule and digital flexor tendon, in all samples. Improved strategies for early detection and control of these major avian pathogens are highly desirable for preventing the spread of infection and reducing economic losses in the poultry industry.


Assuntos
Artrite/veterinária , Infecções por Mycoplasma/veterinária , Doenças das Aves Domésticas/microbiologia , Infecções por Reoviridae/veterinária , Tenossinovite/veterinária , Animais , Artrite/epidemiologia , Artrite/microbiologia , Artrite/patologia , Autopsia/veterinária , Brasil , Galinhas , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/patologia , Mycoplasma synoviae/isolamento & purificação , Orthoreovirus Aviário/isolamento & purificação , Reação em Cadeia da Polimerase/veterinária , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/virologia , Infecções por Reoviridae/epidemiologia , Infecções por Reoviridae/patologia , Tenossinovite/epidemiologia , Tenossinovite/microbiologia , Tenossinovite/patologia
5.
J Vet Intern Med ; 33(5): 2096-2104, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31444996

RESUMO

BACKGROUND: Rapidly progressive glomerulonephritis has been described in dogs that seroreact to Borrelia burgdorferi, but no studies have compared clinicopathologic differences in Lyme-seroreactive dogs with protein-losing nephropathy (PLN) versus dogs with Borrelia-seronegative PLN. HYPOTHESIS/OBJECTIVES: Dogs with Borrelia C6 antigen-seroreactive PLN have distinct clinicopathologic findings when compared to dogs with Borrelia seronegative PLN. ANIMALS: Forty dogs with PLN and Borrelia C6 antigen seroreactivity and 78 C6-seronegative temporally matched dogs with PLN. METHODS: Retrospective prevalence case-control study. Clinical information was retrieved from records of dogs examined at the University of California, Davis, Veterinary Medical Teaching Hospital. Histopathologic findings in renal tissue procured by biopsy or necropsy of dogs with PLN were reviewed. RESULTS: Retrievers and retriever mixes were overrepresented in seroreactive dogs (P < .001). Seroreactive dogs were more likely to have thrombocytopenia (P < .001), azotemia (P = .002), hyperphosphatemia (P < .001), anemia (P < .001), and neutrophilia (P = .003). Hematuria, glucosuria, and pyuria despite negative urine culture were more likely in seroreactive dogs (all P ≤ .002). Histopathologic findings were consistent with immune-complex glomerulonephritis in 16 of 16 case dogs and 7 of 23 control dogs (P = 006). Prevalence of polyarthritis was not different between groups (P = .17). CONCLUSIONS AND CLINICAL IMPORTANCE: C6 seroreactivity in dogs with PLN is associated with a clinicopathologically distinct syndrome when compared with other types of PLN. Early recognition of this syndrome has the potential to improve outcomes through specific aggressive and early treatment.


Assuntos
Borrelia/imunologia , Doenças do Cão/microbiologia , Nefropatias/veterinária , Doença de Lyme/veterinária , Animais , Antígenos de Bactérias/sangue , Artrite/epidemiologia , Artrite/veterinária , Estudos de Casos e Controles , Doenças do Cão/imunologia , Cães , Nefropatias/imunologia , Nefropatias/microbiologia , Nefropatias/patologia , Doença de Lyme/imunologia , Doença de Lyme/patologia , Estudos Retrospectivos
6.
Environ Pollut ; 253: 1030-1037, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31434180

RESUMO

OBJECTIVES: Evaluate the relationship between arthritis diagnosis in those over 50 and exposure to extreme air pollution in utero or infancy (<1 year of age). METHODS: Compare rates of arthritis diagnosis between groups that experienced differential air pollution exposure in early-life due to quasi-random variation in birth location and date relative to the 1952 Great Smog in London. We use regression-estimated difference-in-differences analyses based on English Longitudinal Study of Aging (ELSA) data. RESULTS: In the 2816 respondent sample, aged 51-62, the arthritis diagnosis rate is 22.8%, with 16.4% reporting osteoarthritis and 4.6% reporting rheumatoid arthritis. We estimate that exposure to the Great Smog in infancy increases the arthritis diagnosis rate by 23.4 percentage points (95% CI: 1.97 to 44.8). Decomposing these results by type of arthritis reveals that the rheumatoid arthritis diagnosis rate increases due to infant exposure are larger and more significant than those for osteoarthritis: 14.9 percentage points (95% CI: 0.495 to 29.4) versus 9.5 percentage points (95% CI: -11.9 to 30.8). In utero exposure is not associated with significant increases in arthritis diagnosis rates. CONCLUSIONS: Our results are the first to link early-life air pollution exposure to later-life arthritis diagnoses, and suggest a particularly strong link for RA. These findings are consistent with those of shorter-term, correlational studies, and indicate that health effects of air pollution exposure can span decades and extend beyond cardiopulmonary systems.


Assuntos
Poluição do Ar/estatística & dados numéricos , Artrite/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Feminino , Humanos , Lactente , Londres/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Material Particulado/análise , Análise de Regressão , Smog/análise
7.
Diabetes Metab Syndr ; 13(5): 2897-2905, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31425954

RESUMO

BACKGROUND AND OBJECTIVE: Although obesity is a heterogeneous disease, little is known regarding chronic medical conditions (CMCs) that defines variability in obese populations. The characterization of obese populations using CMCs rather than categorization using BMI alone can advance understanding of obesity. The aims of this study are to phenotype obesity in a large representative sample of non-Hispanic White (NHW), non-Hispanic Black (NHB) and Mexican American (MA) obese adults using CMCs, and assess relationship between resulting phenotypes and self-rated health (SRH). METHODS: Sex-specific two-step cluster analysis was used to phenotype obese participants (n = 12,547) to CMC-based clusters. The prevalence of CMCs and lifestyle risk factors in each cluster was assessed. Sex and race/ethnic specific association between cluster membership and SRH was determined using odds ratio (OR) from logistic regression analysis. RESULTS: Distinct subgroups of obese men and women were observed: moderate dyslipidemic healthy young obese men, hypertensive-dyslipidemic middle-age obese men, hypertensive young obese men, hypertensive-dyslipidemic-asthmatic middle-age obese men, and syndemic elderly obese men, healthy young obese women, hypertensive-dyslipidemic middle-age obese women, dyslipidemic young adult obese women, syndemic middle-age obese women, and syndemic elderly obese women. Participants in the more CMCs symptomatic clusters reported high rates of behavioral risk factors and showed significantly greater odds of poor SRH than participants in the less symptomatic clusters. Compared to obese persons who are asymptomatic for CMCs, syndemic elderly obese and women men had much higher increased ORs for poor SRH with values of 3.88 [95% CI = 2.41-6.26], 3.96 [95% CI = 1.86-8.30] and 7.25 [95% CI = 2.41-9.6] for NHW, NHB and MA men, respectively. The corresponding ORs for women are 4.08 [95% CI = 2.71-6.14], 4.01 [95% CI = 2.40-6.69], and 2.62 [95% CI = 1.32-5.19], respectively. CONCLUSION: Obesity treatment and intervention should consider heterogeneity within obese persons and pay greater attention to obesity related co-morbidities and metabolic manifestations.


Assuntos
Doença Crônica/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Obesidade/classificação , Obesidade/fisiopatologia , Fenótipo , Adulto , Idoso , Artrite/epidemiologia , Asma/epidemiologia , Análise por Conglomerados , Estudos Transversais , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Seguimentos , Cardiopatias/epidemiologia , Humanos , Hipertensão/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia
8.
Orthop Clin North Am ; 50(4): 539-548, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31466669

RESUMO

End-stage ankle arthritis has a significant effect on function and quality of life. Total ankle arthroplasty continues to emerge as a safe and effective treatment of ankle arthritis. Ankle arthroplasty preserves motion at the ankle joint, while still achieving the primary goal of pain relief. With encouraging outcomes and improved implant longevity, there has been significant improvement on the results of first-generation implants. Further high-quality studies are required to clarify outcomes post ankle arthroplasty. This article reviews the latest data from national registries and the wider literature to evaluate the current status with outcomes of modern total ankle replacements.


Assuntos
Artrite/epidemiologia , Artrite/cirurgia , Artroplastia de Substituição do Tornozelo/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Substituição do Tornozelo/instrumentação , Austrália/epidemiologia , Humanos , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Noruega/epidemiologia , Medidas de Resultados Relatados pelo Paciente , Desenho de Prótese , Falha de Prótese , Sistema de Registros , Suécia/epidemiologia , Resultado do Tratamento , Reino Unido/epidemiologia , Adulto Jovem
9.
PLoS Negl Trop Dis ; 13(8): e0007702, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31465453

RESUMO

Polyarthritis and rash caused by Sindbis virus (SINV), was first recognised in northern Europe about 50 years ago and is known as Ockelbo disease in Sweden and Pogosta disease in Finland. This mosquito-borne virus occurs mainly in tropical and sub-tropical countries, and in northern Europe it is suggested to cause regularly reoccurring outbreaks. Here a seven-year cycle of SINV outbreaks has been referred to in scientific papers, although the hypothesis is based solely on reported human cases. In the search for a more objective outbreak signal, we evaluated mosquito abundance and SINV prevalence in vector mosquitoes from an endemic area in central Sweden. Vector mosquitoes collected in the River Dalälven floodplains during the years before, during, and after the hypothesised 2002 outbreak year were assayed for virus on cell culture. Obtained isolates were partially sequenced, and the nucleotide sequences analysed using Bayesian maximum clade credibility and median joining network analysis. Only one SINV strain was recovered in 2001, and 4 strains in 2003, while 15 strains were recovered in 2002 with significantly increased infection rates in both the enzootic and the bridge-vectors. In 2002, the Maximum Likelihood Estimated infection rates were 10.0/1000 in the enzootic vectors Culex torrentium/pipiens, and 0.62/1000 in the bridge-vector Aedes cinereus, compared to 4.9/1000 and 0.0/1000 in 2001 and 0.0/1000 and 0.32/1000 in 2003 Sequence analysis showed that all isolates belonged to the SINV genotype I (SINV-I). The genetic analysis revealed local maintenance of four SINV-I clades in the River Dalälven floodplains over the years. Our findings suggest that increased SINV-I prevalence in vector mosquitoes constitutes the most valuable outbreak marker for further scrutinising the hypothesized seven-year cycle of SINV-I outbreaks and the mechanisms behind.


Assuntos
Aedes/virologia , Infecções por Alphavirus/epidemiologia , Artrite/epidemiologia , Culex/virologia , Surtos de Doenças , Mosquitos Vetores/virologia , Vírus Sindbis/isolamento & purificação , Aedes/crescimento & desenvolvimento , Infecções por Alphavirus/virologia , Animais , Artrite/virologia , Culex/crescimento & desenvolvimento , Feminino , Genótipo , Humanos , Mosquitos Vetores/crescimento & desenvolvimento , Prevalência , Vírus Sindbis/classificação , Vírus Sindbis/genética , Suécia/epidemiologia
10.
Int J Rheum Dis ; 22(9): 1686-1694, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31328410

RESUMO

AIM: Inflammatory joint diseases (IJDs) are chronic arthritis, but frequently present with co-morbidities of other organs and systems, which is known as extra-articular manifestations (EAMs). It is still unclear which clinical characteristics or bio-markers can predict the development of EAMs. The aim of this study was to estimate the proportion of EAMs in southern Chinese patients with IJDs and to explore the risk factors. METHODS: This was a retrospective cohort study of a total 1135 IJDs patients, including 788 rheumatoid arthritis (RA) patients, 307 ankylosing spondylitis (AS) patients and 40 psoriatic arthritis (PsA) patients. Demographic data, disease characteristics, laboratory blood tests, medical imaging, and the presence of EAMs were recorded. RESULTS: We found 459 (40.44%) patients presented with EAMs: 30.84% had cardiovascular involvement, 7.67% had pulmonary involvement, 5.29% had osteoporosis/low bone mineral density, 2.29% had ocular, 0.79% had gastrointestinal and 0.26% had renal involvements. Multivariate logistic regression showed older age (odds ratio [OR] 1.06, P < .001) and higher anti-cyclic citrullinated peptide antibody (anti-CCP) levels (OR 1.003, P = .019) were independent risks of EAMs in RA patients. In the AS group, older age (OR 1.07, P < .001) and higher disease activity (OR 3.24-7.42, both P < .05), were independent risks of EAMs. In the PsA group, longer disease duration (OR 1.01, P = .036) and higher disease activity (OR 1.15, P = .004) were univariate associated factors. CONCLUSION: These results suggested the high prevalence of EAMs, and it is important to regularly screen for EAMs, as they influence treatment decisions and impact on patients' quality of life.


Assuntos
Artrite Psoriásica/epidemiologia , Artrite/epidemiologia , Doenças Cardiovasculares/epidemiologia , Pneumopatias/epidemiologia , Espondilite Anquilosante/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Artrite/diagnóstico , Artrite Psoriásica/diagnóstico , Doenças Cardiovasculares/diagnóstico , China/epidemiologia , Progressão da Doença , Oftalmopatias/diagnóstico , Oftalmopatias/epidemiologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Incidência , Nefropatias/diagnóstico , Nefropatias/epidemiologia , Pneumopatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Espondilite Anquilosante/diagnóstico , Adulto Jovem
11.
Poult Sci ; 98(11): 5321-5329, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31222278

RESUMO

In recent years, emerging avian reovirus (ARV) strains causing viral arthritis have become a challenge to the worldwide chicken industry, and were responsible for significant economic losses. In this study, we characterized emerging variant ARV strains and examined their genetic relationship and pathogenicity variation with reference strains. A total of 18 emerging variant ARV strains were isolated from tendon and capsular synovial fluid of broiler chickens with clinical cases of arthritis/tenosynovitis at commercial farms in China. Comparative analysis based on σC sequence showed that 4/18 isolates were in the same cluster (Cluster 1) as vaccine strains (S1133), whereas 14 of 18 isolates were in Clusters 2, 3, and 6. The field isolates shared a rather low identity (38.1 to 81.9%) with S1133 in Cluster 1, especially for those from Cluster 6 (38.1 to 67.2%). A higher ARV isolation rate was observed in chicken embryos (47/61) compared to cell culture (37/61) through PCR with a detection primer. A total of 3 isolates were selected to infect specific-pathogen-free (SPF) chickens, showing that the tested isolates, especially that from Cluster 6, displayed greater pathogenicity than S1133 strain, characterized by higher incidence. These findings suggest that the virulence of Chinese ARVs has been increasing rapidly in recent years, and the vaccine need to be updated correspondingly.


Assuntos
Galinhas , Orthoreovirus Aviário/genética , Orthoreovirus Aviário/patogenicidade , Doenças das Aves Domésticas/epidemiologia , Infecções por Reoviridae/veterinária , Animais , Artrite/epidemiologia , Artrite/veterinária , Artrite/virologia , China/epidemiologia , Incidência , Filogenia , Doenças das Aves Domésticas/virologia , Prevalência , Infecções por Reoviridae/epidemiologia , Infecções por Reoviridae/virologia , Organismos Livres de Patógenos Específicos , Virulência
12.
Geriatr Gerontol Int ; 19(8): 798-803, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31237103

RESUMO

AIM: The identification of risk factors associated with comorbidities and physical fitness might provide pathways for planning therapeutic targets for future falls prevention. Results from large datasets that examined falls risk factors in Asia have been limited. The aim of the present study was to identify the risk factors for falls by pooling data consisting of medical history, physical performance and self-rated health from two large Malaysian epidemiological studies. METHODS: Matching variables from the Towards Useful Aging and Malaysian Elders Longitudinal Research datasets related to falls, physical performance and determinants of falls were identified and pooled for analysis. The Timed Up and Go test and dominant handgrip strength tests were used as physical performance measures. Falls were self-reported, and functional status was assessed using activities of daily living. RESULTS: Data of 3935 participants, mean age 68.9 ± 6.8 years, 2127 (54.0%) women and 1807 (46.0%) men were extracted for analyses. In an adjusted model, independent risk factors for falls from this cohort studies were diabetes (OR 1.258), arthritis (OR 1.366), urinary incontinence (OR 1.346), poor self-rated health (OR 1.293), higher body mass index (OR 1.029) and lower handgrip strength (OR 1.234). CONCLUSIONS: Although the risk factors that emerged from our analyses were similar to available studies among older adults, the Timed Up and Go test did not appear as one of the risk factors in the present study that included middle-aged adults. Our findings will require confirmation in a prospective study. Geriatr Gerontol Int 2019; 19: 798-803.


Assuntos
Acidentes por Quedas , Atividades Cotidianas , Artrite/epidemiologia , Diabetes Mellitus/epidemiologia , Sobrepeso , Incontinência Urinária/epidemiologia , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Índice de Massa Corporal , Comorbidade , Correlação de Dados , Autoavaliação Diagnóstica , Feminino , Força da Mão , Humanos , Vida Independente/estatística & dados numéricos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Desempenho Físico Funcional , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco
13.
Laeknabladid ; 105(6): 267-275, 2019 06.
Artigo em Islandês | MEDLINE | ID: mdl-31192789

RESUMO

ntroduction: To collect nationwide data in Iceland on pregnancy and its outcomes among female patients with active inflammatory arthritides we linked two registers, the ICEBIO register and the Icelandic Medical Birth Register. METHODS: We used multivariate analysis to evaluate the risk of preterm birth, Caesarean section, low Apgar score at 5-minutes and low birth weight among females with inflammatory arthritis (rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS)) in comparison with healthy controls matched on age and parity. We also investigated pregnancies before and after the diagnosis of respective rheumatic disease and especially in respect to treatment with TNFα inhibitors (TNFi). RESULTS: In the end of 2016, 723 female patients were registered in ICEBIO as they had received treatment with TNFi due to inflammatory arthritis. Of those, 412 women had given birth to 801 children, whereof 597 were delivered before confirmed diagnosis of the mother and 53 were delivered after the start of the TNFi treatment. Relative risk of Caesarean section among these female with various arthritis conditions were 1.47 (95% CI: 1.19-1.82; p < 0,001) compared to controls and was highest in the group with PsA or 2.06 (1.41-3.02; p<0,001). We did not find increased risk of preterm delivery or low Apgar score. Patients with inflammatory arthritis had lower risk of children with low birth weight or 0.37 compared to healthy controls (95% CI: 0.36-0.37; p < 0.05). Due to low numbers of deliveries after the initiation of TNFi therapy (n=53) we were not able to perform any analysis for that group. CONCLUSION: Icelandic female patients with inflammatory arthritis are at an increased risk of Caesarean section in comparison to healthy controls. However, their newborns are in good condition and healthy at birth. Analysis of the impact of treatment with TNFi on pregnancy is not yet possible due to limited data.


Assuntos
Artrite/tratamento farmacológico , Cesárea , /uso terapêutico , Índice de Apgar , Artrite/diagnóstico , Artrite/epidemiologia , Peso ao Nascer , Estudos de Casos e Controles , Feminino , Humanos , Islândia/epidemiologia , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Resultado da Gravidez , Sistema de Registros , Medição de Risco , Fatores de Risco , /efeitos adversos
14.
Cien Saude Colet ; 24(5): 1845-1852, 2019 May 30.
Artigo em Português | MEDLINE | ID: mdl-31166517

RESUMO

This cross-sectional study was based on a probabilistic sample of 597 community-dwelling elderly people living in Belo Horizonte. Theaim was to assess which chronic conditions are independently associated with ongoing employment among elderly people. It was conducted to assess the isolated effect of each one. The multivariate analysis was based on Poisson regression models with robust variance, adjusted by sex, age, schooling, retirement and chronic conditions. Arthritis (or rheumatism) was the only chronic condition with independent and statistic significant association with ongoing employment, even after adjustment for other chronic conditions: older people with medical diagnosis of arthritis have lower odds of being in the labor market (Fully adjusted Prevalence ratio [PR] = 0.54; CI 95%: 0.35-0.85). Moreover, our results showed that gender modifies this association, with a lower propensity among females (PR=0.45; CI 95%: 0.25-0.84). Our results highlight the importance of health promotion among workers, mostly arthritis prevention and management among women.


Assuntos
Artrite/epidemiologia , Emprego/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil , Doença Crônica/epidemiologia , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Prevalência , Fatores Sexuais
15.
J Am Acad Orthop Surg ; 27(12): 444-450, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31170098

RESUMO

INTRODUCTION: This investigation compares the outcomes of proximal interphalangeal (PIP) arthroplasty in patients older than and younger than 60 years. METHODS: Overall, 299 consecutive, primary PIP arthroplasties were performed over a 14-year period, including 126 arthroplasties performed in patients younger than 60 years. In younger patients group, a higher rate of posttraumatic and inflammatory arthritis was observed. RESULTS: In patients younger than 60 years, 32 (25%) revision surgeries occurred. Risk of revision surgery was associated with younger age. The 10-year implant survival rate was 72% for the patients younger than 60 years versus 86% for those older than 60 years. Silicone implants decreased the risk of revision surgery, although it was increased in posttraumatic arthritis. The most common complication in young patients was dislocation (n = 21). At a mean follow-up of 6.4 years, pain levels had significantly improved in patients younger than 60 years, and PIP range of motion and pinch strength were maintained. However, older patients had improved PIP motion compared with younger patients. CONCLUSIONS: Younger age leads higher revision rates after PIP arthroplasty, particularly in the posttraumatic setting. LEVEL OF EVIDENCE: Therapeutic, level III.


Assuntos
Artroplastia de Substituição de Dedo , Articulações dos Dedos/cirurgia , Falanges dos Dedos da Mão/cirurgia , Adulto , Fatores Etários , Artrite/epidemiologia , Artrite/etiologia , Feminino , Traumatismos dos Dedos/complicações , Traumatismos dos Dedos/cirurgia , Humanos , Prótese Articular , Masculino , Pessoa de Meia-Idade , Falha de Prótese , Amplitude de Movimento Articular , Reoperação/estatística & dados numéricos , Risco , Fatores de Tempo , Resultado do Tratamento
16.
Womens Health Issues ; 29 Suppl 1: S39-S46, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31253241

RESUMO

BACKGROUND: The health of women Gulf War (deployed) and Gulf Era (nondeployed) veterans is understudied; although most studies examining the health effects of deployment to the Gulf War adjust for gender in multivariate analyses, gender-specific prevalence and effect measures are not routinely reported. The National Academy of Medicine recommended that the Department of Veterans Affairs assess gender-specific health conditions in large cohort studies of Gulf War veterans. METHODS: Data from this study come from the follow-up study of a national cohort of Gulf War and Gulf Era veterans. This study was conducted between 2012 and 2014, and was the second follow-up of a population-based cohort of Gulf War and Gulf Era veterans that began in 1995. Measures included self-reported medical conditions and frequency of doctor visits as well as validated screening instruments for mental health conditions. RESULTS: Overall, female veterans (both Gulf War and Era) reported poorer health than their male counterparts as measured by the prevalence of self-reported disease. The top five prevalent conditions in both Gulf War and Gulf Era veterans were migraine, hypertension, major depressive disorder, arthritis, and dermatitis. Female Gulf War veterans were found to have a higher prevalence of disease than male Gulf Era veterans. CONCLUSIONS: Women veterans, particularly deployed veterans, from this era have significant medical needs that may justify increased outreach from the Department of Veterans Affairs. Our findings highlight the importance of asking about military service, particularly for women veterans, in the clinical setting, both in the Department of Veterans Affairs and in the private sector.


Assuntos
Disparidades nos Níveis de Saúde , Nível de Saúde , Vigilância da População/métodos , Veteranos/estatística & dados numéricos , Adolescente , Adulto , Artrite/epidemiologia , Estudos de Coortes , Transtorno Depressivo Maior/epidemiologia , Dermatite/epidemiologia , Feminino , Seguimentos , Guerra do Golfo , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Prevalência , Autorrelato , Distribuição por Sexo , Estados Unidos/epidemiologia , Veteranos/psicologia , Adulto Jovem
17.
Anaerobe ; 59: 54-60, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31075312

RESUMO

Prosthetic joint infections (PJIs) are rare but feared complications following joint replacement surgery. Cutibacterium acnes is a skin commensal that is best known for its role in acne vulgaris but can also cause invasive infections such as PJIs. Some phylotypes might be associated with specific diseases, and recently, a plasmid was detected that might harbour important virulence genes. In this study, we characterized C. acnes isolates from 63 patients with PJIs (n = 140 isolates) and from the skin of 56 healthy individuals (n = 56 isolates), using molecular methods to determine the phylotype and investigate the presence of the plasmid. Single-locus sequence typing and a polymerase chain reaction designed to detect the plasmid were performed on all 196 isolates. No statistically significant differences in sequence types were seen between the two study groups indicating that the C. acnes that causes PJIs originates from the patients own normal skin microbiota. Of the 27 patients with multiple tissue samples, 19 displayed the same sequence types among all their samples. Single-locus sequence typing identified different genotypes among consecutive C. acnes isolates from four patients with recurrent infections. The plasmid was found among 17 isolates distributed in both groups, indicating that it might not be a marker for virulence regarding PJIs. Patients presenting multiple sequence types in tissue samples may represent contamination or a true polyclonal infection due to C. acnes.


Assuntos
Artrite/microbiologia , Portador Sadio/microbiologia , Genótipo , Infecções por Bactérias Gram-Positivas/microbiologia , Propionibacterium acnes/classificação , Propionibacterium acnes/genética , Infecções Relacionadas à Prótese/microbiologia , Artrite/epidemiologia , Humanos , Epidemiologia Molecular , Tipagem Molecular , Plasmídeos/análise , Reação em Cadeia da Polimerase , Propionibacterium acnes/isolamento & purificação , Infecções Relacionadas à Prótese/epidemiologia , Análise de Sequência de DNA
18.
BMC Health Serv Res ; 19(1): 313, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31096989

RESUMO

BACKGROUND: Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patterns across conditions/disciplines. These comparisons are further complicated by the impact of using different study designs, multimorbidity definitions and data sources. The aim of this paper is to share insights on multimorbidity and associated health services use and costs by reflecting on the common patterns across 3 parallel studies in distinct disease cohorts (diabetes, dementia, and stroke) that used the same study design and were conducted in the same health jurisdiction over the same time period. METHODS: We present findings that lend to broader Insights regarding multimorbidity based on the relationship between comorbidity and health service use and costs seen across three distinct disease cohorts. These cohorts were originally created using multiple linked administrative databases to identify community-dwelling residents of Ontario, Canada with one of diabetes, dementia, or stroke in 2008 and each was followed for health service use and associated costs. RESULTS: We identified 376,434 indviduals wtih diabetes, 95,399 wtih dementia, and 29,671 with stroke. Four broad insights were identified from considering the similarity in comorbidity, utilization and cost patterns across the three cohorts: 1) the most prevalent comorbidity types were hypertension and arthritis, which accounted for over 75% of comorbidity in each cohort; 2) overall utilization increased consistently with the number of comorbidities, with the vast majority of services attributed to comorbidity rather than the index conditions; 3) the biggest driver of costs for those with lower levels of comorbidity was community-based care, e.g., home care, GP visits, but at higher levels of comorbidity the driver was acute care services; 4) service-specific comorbidity and age patterns were consistent across the three cohorts. CONCLUSIONS: Despite the differences in population demographics and prevalence of the three index conditions, there are common patterns with respect to comorbidity, utilization, and costs. These common patterns may illustrate underlying needs of people with multimorbidity that are often obscured in literature that is still single disease-focused.


Assuntos
Demência/epidemiologia , Diabetes Mellitus/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Multimorbidade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Artrite/epidemiologia , Comorbidade , Demência/economia , Diabetes Mellitus/economia , Feminino , Serviços de Saúde/economia , Humanos , Hipertensão/epidemiologia , Masculino , Ontário/epidemiologia , Prevalência , Projetos de Pesquisa , Acidente Vascular Cerebral/economia
19.
MMWR Morb Mortal Wkly Rep ; 68(17): 381-387, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31048678

RESUMO

An estimated 54.4 million (approximately one in four) U.S. adults have doctor-diagnosed arthritis (arthritis) (1). Severe joint pain and physical inactivity are common among adults with arthritis and are linked to adverse mental and physical health effects and limitations (2,3). CDC analyzed 2017 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate current state-specific prevalence of arthritis and, among adults with arthritis, the prevalences of severe joint pain and physical inactivity. In 2017, the median age-standardized state prevalence of arthritis among adults aged ≥18 years was 22.8% (range = 15.7% [District of Columbia] to 34.6% [West Virginia]) and was generally highest in Appalachia and Lower Mississippi Valley regions.* Among adults with arthritis, age-standardized, state-specific prevalences of both severe joint pain (median = 30.3%; range = 20.8% [Colorado] to 45.2% [Mississippi]) and physical inactivity (median = 33.7%; range = 23.2% [Colorado] to 44.4% [Kentucky]) were highest in southeastern states. Physical inactivity prevalence among those with severe joint pain (47.0%) was higher than that among those with moderate (31.8%) or no/mild joint pain (22.6%). Self-management strategies such as maintaining a healthy weight or being physically active can reduce arthritis pain and prevent or delay arthritis-related disability. Evidence-based physical activity and self-management education programs are available that can improve quality of life among adults with arthritis.


Assuntos
Artralgia/epidemiologia , Artrite/epidemiologia , Comportamento Sedentário , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
20.
J Hosp Infect ; 103(1): 69-77, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31054936

RESUMO

BACKGROUND: A growing body of evidence associates malnutrition with several adverse outcomes. AIM: To investigate the link between malnutrition with surgical site and periprosthetic joint infections (SSIs and PJIs) following total knee and hip arthroplasty (TKA and THA) through a comprehensive meta-analysis of observational studies. METHODS: A systematic search was conducted on PubMed and Scopus databases through December 2018, and recent proceedings of major orthopaedic meetings. Data from eligible studies were extracted and synthesized; pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. FINDINGS: Seven publications were included, reporting eight independent cohort studies with >250,000 subjects. SSIs and PJIs were more likely to develop in malnourished patients (OR: 2.49; 95% CI: 2.13-2.90; and 3.62; 2.33-5.64, respectively). The association of SSI with malnutrition was evident both after TKA (2.42; 1.94-3.02) and after THA (2.66; 1.64-4.30). Similarly, PJI was associated with malnutrition after TKA (2.55; 1.10-5.91) and after THA (3.10; 1.84-5.25). Finally, PJI correlated with malnutrition both after primary arthroplasty (3.58; 1.82-7.03) and revision arthroplasty (3.96; 2.47-6.33). The subgroup analysis by study setting confirmed the relationship between PJI and malnutrition in hospital (6.02; 3.07-11.81) and population-based (2.80; 1.76-4.44) studies. CONCLUSION: Malnutrition is associated with PJIs and SSIs after total joint arthroplasty. Further high-quality research is warranted to confirm or refute these findings.


Assuntos
Artrite/epidemiologia , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Desnutrição/complicações , Infecções Relacionadas à Prótese/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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