What is the Prevalence of Peri-Implantitis? A Systematic Review and Meta-Analysis

Background: Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times, and use of probing depth on prevalence rate.Methods: Following electronic and manual searches of the literature published from January 2005 to December 2020, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study.Results: Prevalence of peri-implantitis was 19.6% (95% CI, 15.25-24.75) at the patient-level, and 12.39% (95% CI, 9.46-15.43) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data.Conclusion: The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.

A Delphi consensus to advance on a Clinical Case Definition for Post COVID-19 condition: A WHO protocol

Background: While most people developing COVID-19 recover quickly and completely, a proportion of those infected with SARS-CoV-2 develop persistent symptoms, which can be disabling. After establishing the interim nomenclature for Post COVID-19 condition, there is a need to establish a clinical case definition to be used by all parties in all settings. Of the many definitions available to date, none is universal and the WHO has engaged in formally defining the Post COVID-19 condition based on existing evidence and by means of the most robust methodology. A key element for success is to engage patients and advocacy groups in this exercise.The objective of the study “Delphi consensus to advance on a Clinical Case Definition for Post COVID-19 condition” is to determine the domains, variables and values (thresholds) for inclusion into a clinical case definition for Post COVID-19 condition, using a Delphi consensus methodology. Methods: This study is a prospective, Delphi consensus-seeking exercise, mixed, iterative survey of internal and external experts, patients and other stakeholders. Panelists (individual participants who will fill the online survey in) will fulfil the criteria of balanced representativity of all WHO regions, age and gender balance, specialty diversity, and patients.We aim to sample approximately 100 panelists for this Delphi task, and the COMET Initiative DelphiManager software will be used. DelphiManager is a web-based system designed to facilitate the building and management of Delphi surveys.From an initial, comprehensive list of 14 domains identified, 10 have been selected, some of them with a number of sub-domains. It is envisaged that panelists will reach consensus after two Delphi rounds. The questionnaire with all agreed domains/variables will be followed by a series of questions relating to these variables with eventual values/thresholds (Appendix 2). Registration of panelists and the actual Delphi questionnaire are accessible via this link https://delphimanager.liv.ac.uk/DefiningPostCOVID/Delphi‘Consensus’ will be obtained on a question if 70% or more of the responses fall within the same response on a 9-point Likert scale. ‘Disagreement’ will occur if 35% or more of responses fall in both of the two extreme ranges of possible options on the Likert scale. All other combinations of panel answers will be considered ‘partial agreement’. Discussion: Establishing a satisfactory clinical case definition of Post COVID-19 condition is needed to enable systematic investigations of the incidence, duration and pathogenesis of Post COVID-19 condition, and to eventually develop effective treatments and successful management strategies and care pathways. This working clinical case definition may change as new evidence emerges, data are pooled and our understanding of the consequences of COVID-19 develops further.

Palindromic Rheumatism: Just a Pre-rheumatoid Stage or Something Else?

Palindromic rheumatism (PR), a unique clinical entity, has a characteristic clinical presentation with a relapsing/remitting course. It is established that most patients with PR evolve to chronic disease, of which rheumatoid arthritis (RA) is by far the most common. The relationship between PR and RA is unclear, with similarities and differences between the two, and not all patients evolve to RA in the long-term. Therefore, PR is clearly a pre-RA stage for most, but not all, patients. Autoimmunity plays a substantial role in PR, with the same characteristic autoantibody profile observed in RA, although with some differences in the immune response repertoire. Autoinflammation may also be relevant in some cases of PR. Prognostic factors for RA progression are identified but their exact predictive value is not clear. There are several unmet needs in PR, such as the diagnostic criteria and clinical case definition, the pathogenic mechanisms involved in the unusual clinical course, and the evolution to RA, and our understanding of the therapeutic strategy that could best avoid progression to persistent and potentially destructive arthritis.

Assessment of Lymphocytosis in Patients with Pertussis in the Amhara Regional State, Ethiopia

Background: Pertussis is a severe and prolonged coughing disease caused by Bordetella pertussis. In 2014, an estimated 24.1 million pertussis cases, resulting in 160,700 deaths were reported worldwide. The aim of this study was to assess lymphocytosis in patients with pertussis in the Amhara Regional State, Ethiopia.Methods: An institution-based cross-sectional study was conducted among pertussis patients who met the clinical case definition for pertussis in the Amhara Regional State, Ethiopia. The study was conducted from July 2018 to February 2019 and nasopharyngeal swabs were collected from 321 participants, and samples were analyzed using real-time PCR. Blood specimens were collected from 321 study participant and total lymphocyte count was conducted using fully automated haematology analyzer.Results: One hundred nine study participants were positive for Bordetella species. Lymphocytosis was found in 15/109 (13.8%) of the PCR confirmed pertussis patients. Of those 15 PCR confirmed participants, 53.3% had lymphocytosis grading ‘high’ (>51%) followed by 20% ‘moderately high’ (>70%) and 26.7% had ‘very high’ (>85%). Amongst participants with lymphocytosis and PCR confirmed pertussis, 11/15 (73.3%) were less than 1 year old.Conclusions: This study revealed the importance of lymphocyte count in the diagnosis of pertussis. Thus, in combination with other laboratory tests, incorporation of lymphocyte count in pertussis suspected patients is recommended.