scholarly journals Prophylaxis for Pneumocystis pneumonia in patients with rheumatoid arthritis treated with biologics, based on risk factors found in a retrospective study

2014 ◽  
Vol 16 (1) ◽  
pp. R43 ◽  
Author(s):  
Takayuki Katsuyama ◽  
Kazuyoshi Saito ◽  
Satoshi Kubo ◽  
Masao Nawata ◽  
Yoshiya Tanaka
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Retrospective Study ◽  
Pneumocystis Pneumonia

scholarly journals SAT0047 RISK FACTORS FOR THE POSTOPERATIVE DELAYED WOUND HEALING IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH A BIOLOGICAL AGENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 954.3-954
Author(s):  
S. Okita ◽  
H. Ishikawa ◽  
A. Abe ◽  
S. Ito ◽  
A. Murasawa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Wound Healing ◽  
Retrospective Study ◽  
Nutritional Status ◽  
Disease Activity ◽  
Disease Duration ◽  
Foot And Ankle ◽  
Delayed Wound Healing ◽  
Chugai Pharmaceutical

Background:It has been suggested that perioperative use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients carries risks for the surgical-site infection and the delayed wound healing (DWH); however, the risk of DWH with perioperative use of bDMARDs has not reached a general consensus.Objectives:This retrospective study aimed to investigate the risk factors associated with DWH after orthopedic surgery in RA patients treated with bDMARDs.Methods:We reviewed medical records of 277 orthopedic procedures for 188 RA patients treated with bDMARDs between from 2014 to 2017 in Niigata Rheumatic Center. As preoperative nutritional status assessment, we evaluated body mass index (BMI), prognostic nutritional index (PNI), and CONtrolling NUTritional status (CONUT). In addition, we evaluated DAS28-CRP, DAS28-ESR, face scale for pain, global health (GH), and Health Assessment Questionnaire-Disability Index (HAQ-DI) to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factor for DWH.Results:The major characteristics of the patients in 277 procedures were mean age of 63.2 years old and mean disease duration of 18.2 years. Surgical site were hand and wrist (145 procedures), foot and ankle (76), hip and knee (31), elbow and shoulder (24), and spine (1). Seventy-four patients were treated with tocilizumab, 62 with etanercept, 55 with golimumab, 49 with abatacept, 16 with infliximab, 15 with adalimumab, and 6 with certolizumab. According to nutritional assessment in PNI and CONUT, 63% (n=175) and 47% (n=130) were normal nourished patients, respectively.In 277 procedures, DWH were identified in 24 patients (8.6%). The following variables were significant in the univariate analyses: disease duration (OR 1.053; 95% CI 1.010–1.099; p=0.016), foot and ankle surgery (OR 7.091; 95% CI 2.130–23.603; p=0.001), tocilizumab (OR 0.286; 95% CI 0.093–0.881; p=0.029) (Table 1). These variables were entered into a multivariate model, and it was revealed that pre-operative use of tocilizumab (OR 0.265; 95% CI 0.074–0.953; p=0.042) and procedures in the foot and ankle (OR 6.915; 95% CI 1.914–24.976; p=0.003) were associated with an increased risk of DWH (Table 1).Conclusion:As previous study on tocilizumab described, the current retrospective study suggested that pre-operative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH. Pre-operative disease activity and nutritional status were not independent risk factors for an increase in the prevalence of DWH.References:[1] Momohara S, Hashimoto J, Tsuboi H et al. Analysis of perioperative clinical features and complications after orthopaedic surgery in rheumatoid arthritis patients treated with tocilizumab in a real-world setting: Results from the multicentre tocilizumab in perioperative period (TOPP) study. Modern rheumatology. 2013, 23: 440-9.Disclosure of Interests:Shunji Okita: None declared, Hajime Ishikawa: None declared, Asami Abe: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Akira Murasawa: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Toshifumi Ozaki: None declared

scholarly journals Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Atsushi Hashimoto ◽  
Shiori Suto ◽  
Kouichiro Horie ◽  
Hidefumi Fukuda ◽  
Shinichi Nogi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Respiratory Tract Infections ◽  
Multivariate Logistic Regression Analysis ◽  
Japanese Patients ◽  
Pneumocystis Pneumonia ◽  
Male Sex ◽  
The Individual ◽  
Tract Infections ◽  
Significant Factors

Objective. Rheumatoid arthritis (RA) may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH) including pneumocystis pneumonia (PCP) in patients with RA. Methods. We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA. Multivariate logistic regression analysis was applied to calculate adjusted odds ratios (ORs) for factors associated with the occurrence of IRH. Results. In a total of 9210 patient-years (2688 patients), there were 373 IRH (3.7/100 patient-years). Respiratory tract infections were most frequent (n=154, and additionally 16 PCP), followed by urinary tract infections (n=50). Significant factors for PCP included higher age (≥70 years; OR 3.5), male sex (6.6), underlying lung disease (3.0), use of corticosteroids (4.8), and use of biologics (5.4). Use of methotrexate (5.7) was positively associated with PCP but negatively with total infections (0.7). Additionally, functional disorders and higher RA disease activity were also related to total infections. Conclusions. Risk factors for infection should be taken into account when deciding treatment for the individual RA patient.

Cardiovascular Risk in Rheumatoid Arthritis and Mechanistic Links: From Pathophysiology to Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 431-446 ◽  
Author(s):  
George E. Fragoulis ◽  
Ismini Panayotidis ◽  
Elena Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Cvd Risk ◽  
The Past ◽  
Increased Risk ◽  
Cv Disease ◽  
Obesity Hypertension ◽  
Inflammatory Burden

Rheumatoid arthritis (RA) is an autoimmune inflammatory arthritis. Inflammation, however, can spread beyond the joints to involve other organs. During the past few years, it has been well recognized that RA associates with increased risk for cardiovascular (CV) disease (CVD) compared with the general population. This seems to be due not only to the increased occurrence in RA of classical CVD risk factors and comorbidities like smoking, obesity, hypertension, diabetes, metabolic syndrome, and others but also to the inflammatory burden that RA itself carries. This is not unexpected given the strong links between inflammation and atherosclerosis and CVD. It has been shown that inflammatory cytokines which are present in abundance in RA play a significant role in every step of plaque formation and rupture. Most of the therapeutic regimes used in RA treatment seem to offer significant benefits to that end. However, more studies are needed to clarify the effect of these drugs on various parameters, including the lipid profile. Of note, although pharmacological intervention significantly helps reduce the inflammatory burden and therefore the CVD risk, control of the so-called classical risk factors is equally important. Herein, we review the current evidence for the underlying pathogenic mechanisms linking inflammation with CVD in the context of RA and reflect on the possible impact of treatments used in RA.

Effect of Dietary Education on Cardiovascular risk Factors in Rheumatoid Arthritis Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Statistical Tests ◽  
Intervention Group ◽  
Serum Levels ◽  
Control Group ◽  
Dietary Education

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

Prevalence of anaemia and it's associated risk factors among under five children at Mukinge Missions Hospital in Kasempa District: Retrospective Study (Preprint)

2019 ◽  
Author(s):  
Lloyd Sampa
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Mean Corpuscular Volume ◽  
Sub Saharan Africa ◽  
Corpuscular Volume ◽  
Under Five ◽  
Under Five Children ◽  
Mission Hospital ◽  
Associated Risk Factors ◽  
Prevalence Of Anemia

BACKGROUND Anemia is a worldwide major problem known to affect people throughout the world. It has an adverse effect on both the social and economic development. The worldwide prevalence of anemia is 9% in developed nations. The global estimate indicates that 293.1 million of children under five years, approximately 43%, are anaemic worldwide and 28.5% of these children are found in sub Saharan Africa. In Zambia specifically Kasempa, no documented studies on prevalence have been done. Despite iron supplementation being given to pregnant women and the availability of blood transfusion. The burden of the disease remains high as determined by high mortality and morbidity. This study aims at determining the prevalence of anemia and the associated risk factors among under-five children at Mukinge Mission Hospital in Kasempa District. Knowledge of prevalence and the associated risk factors of anaemia will enhance early detection and timely management. OBJECTIVE 1.To determine the hemoglobin status of anaemia by its severity among anaemic under-five children admitted at Mukinge Mission Hospital. 2.To assess the association of anaemia with Malaria among under-five children admitted at Mukinge Mission Hospital. METHODS This was a retrospective study review of under-five children that were diagnosed and managed of Anemia at Mukinge Missions Hospital, over the period of period of 2015, 2017 and 2018. .Data of the variables of interest was extracted and analyzed using SPSS. RESULTS A sample population of 52 children was included in our study. The majority of the children were females 28 (53.8 %) and 24 (46.2 %) were Males. It was found that moderate and severe anaemia was 17.3% and 82.7 % respectively. Additionally, Majority of the anaemic children (75%) had Normocytic anaemia. The Pearson Chi square test revealed no statistical relationship between the variables; Malaria (p=0.58), Age (P=0.82), Gender (P=0.91). CONCLUSIONS According to our study, 39 (75%) had normal mean corpuscular volume which could suggest chronic diseases and sickle cell anemia. 11 (21.2%) had a low mean corpuscular volume indicating Microcytic anemia which could suggest diseases such as iron deficiency and thalassemia among many other causes. However, we were unable to determine the specific cause of anemia.

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