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2. Outcomes of COVID-19 in people with rheumatic and musculoskeletal disease in Ireland over the first 2 years of the pandemic

Author

Conway, Richard, Nikiphorou, Elena, Demetriou, Christiana A., Low, Candice, Leamy, Kelly, Ryan, John G., Kavanagh, Ronan, Fraser, Alexander D., Carey, John J., O’Connell, Paul, Flood, Rachael M., Mullan, Ronan H., Kane, David J., Stafford, Frances, Robinson, Philip C., Liew, Jean W., Grainger, Rebecca, and McCarthy, Geraldine M.

Published
2023
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3. Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study

Author

Dahou, Brahim, Gómez, Gimena, Roberts, Karen, Baez, Roberto M, Castro Coello, Vanessa V, Haye Salinas, María J, Maldonado, Federico N, Reyes, Alvaro A, Alle, Gelsomina, Tanten, Romina, Maldonado Ficco, Hernán, Nieto, Romina, Gobbi, Carla, Tissera, Yohana, Pisoni, Cecilia, Paula, Alba, Albiero, Juan A, Schmid, Maria M, Cosatti, Micaela, Gamba, Maria J, Leandro, Carlevaris, Cusa, María A, German, Noelia, Bellomio, Veronica, Takashima, Lorena, Pera, Mariana, Cogo, Karina, Gálvez Elkin, Maria S, Medina, María A, Savio, Veronica, Rojas Tessel, Romina, Alamino, Rodolfo P, Werner, Marina L, Ornella, Sofía, Casalla, Luciana, de la Vega, Maria, Severina, María, García, Mercedes, Gonzalez Lucero, Luciana, Romeo, Cecilia, Moyano, Sebastián, Barbich, Tatiana, Bertoli, Ana, Baños, Andrea, Petruzzelli, Sandra, Matellan, Carla, Conti, Silvana, Lazaro, Maria A, Rodriguez Gil, Gustavo F, Risueño, Fabian, Quaglia, Maria I, Scafati, Julia, Cuchiaro, Natalia L, Rebak, Jonathan E, Pineda, Susana I, Calvo, María E, Picco, Eugenia, Yanzi, Josefina G, Maid, Pablo, Guaglianone, Debora, Morbiducci, Julieta S, Porta, Sabrina, Herscovich, Natalia, Velasco Zamora, José L, Kisluk, Boris, Castaños Menescardi, Maria S, Gallo, Rosana, Martire, María V, Maldini, Carla, Goizueta, Cecilia, de la Vega Fernandez, Sabrina S, Aeschlimann, Carolina, Subils, Gisela, Rath, Eva, Piette, Yves, Devinck, Mieke, Maeyaert, Bea, Machado Ribeiro, Francinne, Euzebio Ribeiro, Sandra L, Pinheiro, Marcelo, Ibáñez, Sebastián, Chassin Trubert, Anne-Marie, Dong, Lingli, Cajas, Lui, Barešić, Marko, Anić, Branimir, Ćulo, Melanie-Ivana, Pavelić, Tea A, Stranski, Kristina K, Karanovic, Boris, Vencovsky, Jiri, Píchová, Marta, Filkova, Maria, Hamoud, Hesham, Vassilopoulos, Dimitrios, Guzman Melgar, Gabriela M, So, Ho, Király, Márta, Vojdanian, Mahdi, Balbir Gurman, Alexandra, Abutiban, Fatemah, Zepa, Julija, Bulina, Inita, Bukauskiene, Loreta, Zazueta Montiel, Beatriz E, Castillo Ortiz, Angel A, Zamora Tehozol, Erick, Vega Morales, David, Cervántes Rosete, Diana, Martín Nares, Eduardo, Rodriguez Reyna, Tatiana S, Rull Gabayet, Marina, Alpízar Rodríguez, Deshiré, Irazoque, Fedra, Jimenez, Xochitl, Geurts van Bon, Lenny, Zijlstra, Theo, Hoekstra, Monique, Al Adhoubi, Nasra, Salim, Babur, Giraldo, Enrique, Salinas, Ariel, Ugarte Gil, Manuel, Nowakowski, Jarosław, Conway, Richard, Flood, Rachael, McCarthy, Geraldine, Felea, Ioana, Filipescu, Ileana, Rednic, Simona, Groseanu, Laura, Tamas, Maria M, Mlynarikova, Vanda, Skamlova, Martina, Zlnay, Martin, Mičeková, Dagmar, Capova, Lubica, Macejova, Zelmira, Šteňová, Emőke, Raffayova, Helena, Belakova, Gabriela, Strakova, Eva, Senčarová, Marieta, Žlnayová, Soňa, Sabová, Anna, Spisakova, Daniela, Oetterová, Mária, Lukacova, Olga, Bakosova, Martina, Hocevar, Alojzija, de la Torre Rubio, Natalia, Alegre Sancho, Juan J, Corteguera Coro, Montserrat, Cobeta Garcia, Juan C, Torres Martin, Maria C, Campos, Jose, Gomez Puerta, Jose A, Yardimci, Gozd K, Akar, Servet, Icacan, Ozan C, ÇELİK, Selda, Vasylets, Viktoriia, Yeoh, Su-Ann, Vandevelde, Claire, Dunt, Sasha, Leeder, Jane, Macphie, Elizabeth, Salerno, Rosaria, Graver, Christine, Williams, Katie, O'Reilly, Sheila, Devine, Kirsty, Tyler, Jennifer, Warner, Elizabeth, Pilcher, James, Patel, Samir, Nikiphorou, Elena, Chadwick, Laura, Jones, Caroline M, Harrison, Beverley, Thornton, Lucy, O'Kane, Diana, Fusi, Lucia, Low, Audrey, Horton, Sarah, Jatwani, Shraddha, Baig, Sara, Bajwa, Hammad, Berglund, Vernon, Dahle, Angela, Dorman, Walter, Hargrove, Jody, Hilton, Maren, Lebedoff, Nicholas, Leonard, Susan, Morgan, Jennifer, Pfeifer, Emily, Skemp, Archibald, Wilson, Jeffrey, Wolff, Anne, Cepeda, Eduardo, Todd, Derrick, Hare, Denise, Calabrese, Cassandra, Adams, Christopher, Khosroshahi, Arezou, Kilian, Adam, White, Douglas, Winter, Melanie, Fields, Theodore, Siegel, Caroline, Daver, Nicole, Harvey, Melissa, Kramer, Neil, Lamore, Concetta, Hogarty, Suneya, Yeter, Karen, Siddique, Faizah, Ban, Byung, Tanner, Tamar, Ruderman, Eric, Davis, William, Quinet, Robert, Scopelitis, Evangeline, Toribio, Karen, Webb Detiege, Tameka, Zakem, Jerald, Abbass, Khurram, Kepecs, Gilbert, Miranda, Lilliam, Guma, Michael, Haikal, Ammar, Mody, Sushama, Mueller, Daric, Jayatilleke, Arundathi, Zell, JoAnn, Bays, Alison, Dao, Kathryn, Ezzati, Fatemeh, Parks, Deborah, Karp, David, Quiceno, Guillermo, Izadi, Zara, Gianfrancesco, Milena A, Schmajuk, Gabriela, Jacobsohn, Lindsay, Katz, Patricia, Rush, Stephanie, Ja, Clairissa, Taylor, Tiffany, Shidara, Kie, Danila, Maria I, Wysham, Katherine D, Strangfeld, Anja, Mateus, Elsa F, Hyrich, Kimme L, Gossec, Laure, Carmona, Loreto, Lawson-Tovey, Saskia, Kearsley-Fleet, Lianne, Schaefer, Martin, Al-Emadi, Samar, Sparks, Jeffrey A, Hsu, Tiffany Y-T, Patel, Naomi J, Wise, Leanna, Gilbert, Emily, Duarte-García, Alí, Valenzuela-Almada, Maria O, Ugarte-Gil, Manuel F, Ljung, Lotta, Scirè, Carlo A, Carrara, Greta, Hachulla, Eric, Richez, Christophe, Cacoub, Patrice, Thomas, Thierry, Santos, Maria J, Bernardes, Miguel, Hasseli, Rebecca, Regierer, Anne, Schulze-Koops, Hendrik, Müller-Ladner, Ulf, Pons-Estel, Guillermo, Nieto, Romina E, Pisoni, Cecilia N, Tissera, Yohana S, Xavier, Ricardo, Lopes Marques, Claudia D, Pileggi, Gecilmara C S, Robinson, Philip C, Machado, Pedro M, Sirotich, Emily, Liew, Jean W, Hausmann, Jonathan S, Sufka, Paul, Grainger, Rebecca, Bhana, Suleman, Gore-Massy, Monique, Wallace, Zachary S, and Yazdany, Jinoos

Published
2022
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4. Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study

Author

Dahou, Brahim, Rath, Eva, Piette, Yves, Devinck, Mieke, Maeyaert, Bea, Machado Ribeiro, Francinne, Euzebio Ribeiro, Sandra Lucia, Pinheiro, Marcelo, Quintana, Rosana, Gómez, Gimena, Roberts, Karen, Baez, Roberto Miguel, Castro Coello, Vanessa, Haye Salinas, María J., Maldonado, Federico Nicolas, Reyes Torres, Alvaro Andres, Alle, Gelsomina, Tanten, Romina, Maldonado Ficco, Hernán, Nieto, Romina, Gobbi, Carla, Tissera, Yohana, Pisoni, Cecilia, Paula, Alba, Albiero, Juan Alejandro, Schmid, Maria Marcela, Cosatti, Micaela, Gamba, Maria Julieta, Leandro, Carlevaris, Cusa, María Alejandra, German, Noelia, Bellomio, Veronica, Takashima, Lorena, Pera, Mariana, Cogo, Karina, Gálvez Elkin, Maria Soledad, Medina, María Alejandra, Savio, Veronica, Rojas Tessel, Ivana Romina, Perez Alamino, Rodolfo, Werner, Marina Laura, Ornella, Sofía, Casalla, Luciana, de la Vega, Maria, Severina, María, García, Mercedes, Gonzalez Lucero, Luciana, Romeo, Cecilia, Moyano, Sebastián, Barbich, Tatiana, Bertoli, Ana, Baños, Andrea, Petruzzelli, Sandra, Matellan, Carla, Conti, Silvana, Lazaro, Ma. Alicia, Rodriguez Gil, Gustavo Fabián, Risueño, Fabian, Quaglia, Maria Isabel, Scafati, Julia, Cuchiaro, Natalia Lili, Rebak, Jonathan Eliseo, Pineda, Susana Isabel, Calvo, María Elena, Picco, Eugenia, Gallino Yanzi, Josefina, Maid, Pablo, Guaglianone, Debora, Morbiducci, Julieta Silvana, Porta, Sabrina, Herscovich, Natalia, Velasco Zamora, José Luis, Kisluk, Boris, Castaños Menescardi, Maria Sol, Gallo, Rosana, Martire, María Victoria, Maldini, Carla, Goizueta, Cecilia, de la Vega Fernandez, Sabrina Solange, Aeschlimann, Carolina, Subils, Gisela, Ibáñez, Sebastián, Chassin-Trubert, Anne-Marie, Dong, Lingli, Cajas, Lui, Barešic, Marko, Anic, Branimir, Culo, Melanie-Ivana, Pavelic, Tea Ahel, Kovacevic Stranski, Kristina, Karanovic, Boris, Vencovsky, Jiri, Píchová, Marta, Filkova, Maria, Hamoud, Hesham, Vassilopoulos, Dimitrios, Guzman Melgar, Gabriela Maria, So, Ho, Király, Márta, Vojdanian, Mahdi, Balbir-Gurman, Alexandra, Abutiban, Fatemah, Zepa, Julija, Bulina, Inita, Bukauskiene, Loreta, Zaueta, Beatriz, Castillo Ortiz, Angel Alejandro, Zamora Tehozol, Erick, Vega, David, Cervántes Rosete, Diana, Martín Nares, Eduardo, Rodriguez-Reyna, Tatiana Sofia, Rull Gabayet, Marina, Alpízar-Rodríguez, Deshiré, Irazoque, Fedra, Jimenez, Xochitl, Geurts-van Bon, Lenny, Zijlstra, Theo, Hoekstra, Monique, Al-Adhoubi, Nasra, Salim, Babur, Giraldo, Enrique, Salinas, Ariel, Ugarte-Gil, Manuel, Nowakowski, Jaroslaw, Al-Emadi, Samar, Conway, Richard, Flood, Rachael, McCarthy, Geraldine, Felea, Ioana, Filipescu, Ileana, Rednic, Simona, Groseanu, Laura, Tamas, Maria Magdelena, Mlynarikova, Vanda, Skamlova, Martina, Zlnay, Martin, Miceková, Dagmar, Capova, Lubica, Macejova, Zelmira, Štenová, Emoke, Raffayova, Helena, Belakova, Gabriela, Strakova, Eva, Sencarová, Marieta, Žlnayová, Sona, Anna Sabová, Anna, Spisakova, Daniela, Oetterová, Mária, Lukacova, Olga, Bakosova, Martina, Hocevar, Alojzija, de la Torre-Rubio, Natalia, Alegre Sancho, Juan José, Corteguera Coro, Montserrat, Cobeta Garcia, Juan Carlos, Torres Martin, Maria Carmen, Campos, Jose, Gomez Puerta, Jose A, Yardimci, Gozd Kubra, Akar, Servet, Icacan, Ozan Cemal, Çelik, Selda, Vasylets, Viktoriia, Yeoh, Su-Ann, Vandevelde, Claire, Dunt, Sasha, Leeder, Jane, Macphie, Elizabeth, Salerno, Rosaria, Graver, Christine, Williams, Katie, O'Reilly, Sheila, Devine, Kirsty, Tyler, Jennifer, Warner, Elizabeth, Pilcher, James, Patel, Samir, Nikiphorou, Elena, Chadwick, Laura, Jones, Caroline Mulvaney, Harrison, Beverley, Thornton, Lucy, O'Kane, Diana, Fusi, Lucia, Low, Audrey, Horton, Sarah, Jatwani, Shraddha, Baig, Sara, Bajwa, Hammad, Berglund, Vernon, Dahle, Angela, Dorman, Walter, Hargrove, Jody, Hilton, Maren, Lebedoff, Nicholas, Leonard, Susan, Morgan, Jennifer, Pfeifer, Emily, Skemp, Archibald, Wilson, Jeffrey, Wolff, Anne, Cepeda, Eduardo, D'Silva, Kristin, Hsu, Tiffany, Patel, Naomi, Sparks, Jeffrey, Todd, Derrick, Wallace, Zachary, Hare, Denise, Calabrese, Cassandra, Adams, Christopher, Khosroshahi, Arezou, Kilian, Adam, White, Douglas, Winter, Melanie, Fields, Theodore, Siegel, Caroline, Daver, Nicole, Harvey, Melissa, Kramer, Neil, Lamore, Concetta, Hogarty, Suneya, Yeter, Karen, Wise, Leanna, Siddique, Faizah, Ban, Byung, Tanner, Tamar, Ruderman, Eric, Davis, William, Quinet, Robert, Scopelitis, Evangeline, Toribio Toribio, Karen, Webb-Detiege, Tameka, Zakem, Jerald, Abbass, Khurram, Kepecs, Gilbert, Miranda, Lilliam, Guma, Michael, Haikal, Ammar, Mody, Sushama, Mueller, Daric, Jayatilleke, Arundathi, Zell, JoAnn, Bays, Alison, Dao, Kathryn, Fatemeh, Ezzati, Parks, Deborah, Karp, David, Quiceno, Guillermo, Sattui, Sebastian E, Putman, Michael S, Seet, Andrea M, Gianfrancesco, Milena A, Beins, Kaley, Hill, Catherine, Liew, David, Mackie, Sarah L, Mehta, Puja, Neill, Lorna, Gomez, Gimena, Salinas, Maria Isabel Haye, Mariz, Henrique Ataide, de Sousa Studart, Samia Araujo, Araujo, Nafice Costa, Knight, Ann, Rozza, Davide, Quartuccio, Luca, Samson, Maxime, Bally, Stéphane, Maria, Alexandre TJ, Chazerain, Pascal, Hasseli, Rebecca, Müller-Ladner, Ulf, Hoyer, Bimba F, Voll, Reinhard, Torres, Rita Pinheiro, Luis, Mariana, Ribeirio, Sandra Lucia Euzebio, Sparks, Jeffrey A, Hsu, Tiffany Y-T, D’Silva, Kristin M, Patel, Naomi J, Gilbert, Emily, Almada, Maria Valenzuela, Duarte-García, Alí, Jacobsohn, Lindsay, Izadi, Zara, Strangfeld, Anja, Mateus, Elsa F, Hyrich, Kimme L, Gossec, Laure, Carmona, Loreto, Lawson-Tovey, Saskia, Kearsley-Fleet, Lianne, Schaefer, Martin, Sirotich, Emily, Hausmann, Jonathan S, Sufka, Paul, Bhana, Suleman, Liew, Jean W, Grainger, Rebecca, Machado, Pedro M, Wallace, Zachary S, Yazdany, Jinoos, and Robinson, Philip C

Published
2021
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5. Effect of Immunosuppression on the Immune Response to SARS-CoV-2 Infection and Vaccination.

Author

Leacy, Emma J., Teh, Jia Wei, O'Rourke, Aoife M., Brady, Gareth, Gargan, Siobhan, Conlon, Niall, Scott, Jennifer, Dunne, Jean, Phelan, Thomas, Griffin, Matthew D., Power, Julie, Mooney, Aoife, Naughton, Aifric, Kiersey, Rachel, Gardiner, Mary, O'Brien, Caroline, Mullan, Ronan, Flood, Rachael, Clarkson, Michael, and Townsend, Liam

Subjects
T cells, SARS-CoV-2, IMMUNE response
Abstract

Immunosuppressive treatment in patients with rheumatic diseases can maintain disease remission but also increase risk of infection. Their response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is frequently blunted. In this study we evaluated the effect of immunosuppression exposure on humoral and T cell immune responses to SARS-CoV-2 infection and vaccination in two distinct cohorts of patients; one during acute SARS-CoV-2 infection and 3 months later during convalescence, and another prior to SARS-CoV-2 vaccination, with follow up sampling 6 weeks after vaccination. Results were compared between rituximab-exposed (in previous 6 months), immunosuppression-exposed (in previous 3 months), and non-immunosuppressed groups. The immune cell phenotype was defined by flow cytometry and ELISA. Antigen specific T cell responses were estimated using a whole blood stimulation interferon-γ release assay. A focused post-vaccine assessment of rituximab-treated patients using high dimensional spectral cytometry was conducted. Acute SARS-CoV-2 infection was characterised by T cell lymphopenia, and a reduction in NK cells and naïve CD4 and CD8 cells, without any significant differences between immunosuppressed and non-immunosuppressed patient groups. Conversely, activated CD4 and CD8 cell counts increased in non-immunosuppressed patients with acute SARS-CoV-2 infection but this response was blunted in the presence of immunosuppression. In rituximab-treated patients, antigen-specific T cell responses were preserved in SARS-CoV-2 vaccination, but patients were unable to mount an appropriate humoral response. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Temporal trends in COVID-19 outcomes in people with rheumatic diseases in Ireland: data from the COVID-19 Global Rheumatology Alliance registry.

Author

Conway, Richard, Nikiphorou, Elena, Demetriou, Christiana A, Low, Candice, Leamy, Kelly, Ryan, John G, Kavanagh, Ronan, Fraser, Alexander D, Carey, John J, O'Connell, Paul, Flood, Rachael M, Mullan, Ronan H, Kane, David J, Ambrose, Nicola, Stafford, Frances, Robinson, Philip C, Liew, Jean W, Grainger, Rebecca, McCarthy, Geraldine M, and Alliance, the COVID-19 Global Rheumatology

Subjects
EVALUATION of medical care, OBESITY, HUMAN research subjects, MORTALITY, FISHER exact test, INFORMED consent (Medical law), MATHEMATICAL variables, HOSPITAL care, CHI-squared test, DESCRIPTIVE statistics, RHEUMATISM, SMOKING, SOCIODEMOGRAPHIC factors, LOGISTIC regression analysis, DATA analysis software, COVID-19 pandemic, GOUT
Abstract

Objectives Although evidence is accumulating globally, data on outcomes in rheumatic disease and COVID-19 in Ireland are limited. We used data from the COVID-19 Global Rheumatology Alliance (C19-GRA) to describe time-varying COVID-19 outcomes for people with rheumatic disease in Ireland. Methods Data entered into the C19-GRA provider registry from Ireland between 24 March 2020 and 9 July 2021 were analysed. Differences in the likelihood of hospitalization and mortality according to demographic and clinical variables were investigated using Chi-squared test or Fisher's exact test, as appropriate. Trends in odds of hospitalization and mortality over time were investigated using logistic regression with the time period as a categorical variable. Results Of 212 cases included, 59.4% were female and median age was 58.0 years (range 13–96). Of the 212 cases, 92 (43%) were hospitalized and 22 (10.4%) died. Increasing age, a diagnosis of gout, ever smoking, glucocorticoid use, having comorbidities and specific comorbidities of cancer, cardiovascular and pulmonary disease were more common in those hospitalized. A diagnosis of inflammatory arthritis, csDMARD and/or b/tsDMARD use were less frequent in those hospitalized. Increasing age, a diagnosis of gout, ever smoking, having comorbidities and specific comorbidities of obesity, cardiovascular and pulmonary disease were more common in those who died. Odds of hospitalization or mortality did not change over time. Conclusion No temporal trend was observed in either COVID-19-related hospitalization or mortality outcomes for people with rheumatic disease in Ireland. [ABSTRACT FROM AUTHOR]

Published
2022
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7. COVID-19 in Pregnant Women With Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance.

Author

Bermas, Bonnie L., Gianfrancesco, Milena, Tanner, Helen L., Seet, Andrea M., Aguiar, Mathia C., Al Adhoubi, Nasra K., Al Emadi, Samar, Cunha, Bernardo M., Flood, Rachael, Kusevich, Daria A., McCarthy, Eoghan M., Patel, Naomi J., Ruderman, Eric M., Sattui, Sebastian E., Sciascia, Savino, Siddique, Faizah, Valenzuela-Almada, Maria O., Wise, Leanna M., Worthing, Angus B., and Zell, JoAnn

Published
2022
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8. Predictors of hospitalization in patients with rheumatic disease and COVID-19 in Ireland: data from the COVID-19 global rheumatology alliance registry.

Author

Conway, Richard, Nikiphorou, Elena, Demetriou, Christiana A, Low, Candice, Leamy, Kelly, Ryan, John G, Kavanagh, Ronan, Fraser, Alexander D, Carey, John J, O'Connell, Paul, Flood, Rachael M, Mullan, Ronan H, Kane, David J, Robinson, Philip C, Liew, Jean W, Grainger, Rebecca, McCarthy, Geraldine M, and Alliance, for the COVID-19 Global Rheumatology

Subjects
HOSPITAL care, RHEUMATISM, COVID-19 pandemic
Abstract

Objectives Given the limited data regarding the risk of hospitalization in patients with rheumatic disease and coronavirus disease 2019 (COVID-19) in Ireland, we used the COVID-19 Global Rheumatology Alliance (GRA) registry data to study outcomes and their predictors. The primary objective was to explore potential predictors of hospitalization. Methods We examined data on patients and their disease-related characteristics entered in the COVID-19 GRA provider registry from Ireland (from 24 March 2020 to 31 August 2020). Multivariable logistic regression was used to assess the association of demographic and clinical characteristics with hospitalization. Results Of 105 patients, 47 (45.6%) were hospitalized and 10 (9.5%) died. Multivariable logistic regression analysis showed that age [odds ratio (OR) = 1.06, 95% CI 1.01, 1.10], number of co-morbidities (OR = 1.93, 95% CI 1.11, 3.35) and glucocorticoid use (OR = 15.01, 95% CI 1.77, 127.16) were significantly associated with hospitalization. A diagnosis of inflammatory arthritis was associated with lower odds of hospitalization (OR = 0.09, 95% CI 0.02, 0.32). Conclusion Increasing age, co-morbidity burden and glucocorticoid use were associated with hospitalization, whereas a diagnosis of inflammatory arthritis was associated with lower odds of hospitalization. [ABSTRACT FROM AUTHOR]

Published
2021
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12. The information age.

Author

Flood, Rachael

Abstract

This article reports that patients need access to information which is current and accurate, after all, its the patient who suffer from the effects of an ill-informed choice. Although some patients seek health related information on pharmacies, many turn first to friends, the media or the Internet. More advice is now available from a number of sources, some reputable, some not. If a patient choose a reputable source does it provide the right information in the correct context. Choosing the right information is not the only important factor. The timing of when we receive information can also affect how one absorb, interpret and remember it.

Published
2004

13. Evolution of ultrasound in giant cell arteritis.

Author

Kirby C, Flood R, Mullan R, Murphy G, and Kane D

Abstract

Ultrasound (US) is being increasingly used to diagnose Giant Cell Arteritis (GCA). The traditional diagnostic Gold Standard has been temporal artery biopsy (TAB), but this is expensive, invasive, has a false-negative rate as high as 60% and has little impact on clinical decision-making. A non-compressible halo with a thickened intima-media complex (IMC) is the sonographic hallmark of GCA. The superficial temporal arteries (STA) and axillary arteries (AA) are the most consistently inflamed arteries sonographically and imaging protocols for evaluating suspected GCA should include at least these two arterial territories. Studies evaluating temporal artery ultrasound (TAUS) have varied considerably in size and methodology with results showing wide discrepancies in sensitivity (9-100%), specificity (66-100%), positive predictive value (36-100%) and negative predictive value (33-100%). Bilateral halos increase sensitivity as does the incorporation of pre-test probability, while prior corticosteroid use decreases sensitivity. Quantifying sonographic vasculitis using Halo Counts and Halo Scores can predict disease extent/severity, risk of specific complications and likelihood of treatment response. Regression of the Halo sign has been observed from as little as 2 days to as late as 7 months after initiation of immunosuppressive treatment and occurs at different rates in STAs than AAs. US is more sensitive than TAB and has comparable sensitivity to MRI and PET/CT. It is time-efficient, cost-effective and allows for the implementation of fast-track GCA clinics which substantially mitigate the risk of irreversible blindness. Algorithms incorporating combinations of imaging modalities can achieve a 100% sensitivity and specificity for a diagnosis of GCA. US should be a standard first line investigation in routine clinical care of patients with suspected GCA with TAB reserved only for those having had a normal US in the context of a high pre-test probability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kirby, Flood, Mullan, Murphy and Kane.)

Published
2022
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