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Objectives: To characterize the clinical features and outcomes of childhood-onset primary Sjögren's syndrome (pSS). Methods: Patients less than 18 years old who were diagnosed with pSS by paediatric rheumatologists were included, and all patients were applied the 2002 American-European Consensus Group (ACEG) criteria, the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for pSS, or the 1999 proposed juvenile pSS criteria. The electronic medical records of patients with pSS from 2013 to 2020 were collected and analysed. Results: Thirty-nine patients were included. Of them, 27 (69.2%), 38 (97.4%) and 35 (89.7%) patients fulfilled the AECG criteria, ACR/EULAR criteria and proposed juvenile pSS criteria, respectively. The female:male ratio was 3.9:1. The median ages at first signs or symptoms and at diagnosis were 9.2 (4.7, 14.5) years and 10.9 (6.3, 15.0) years, respectively. The main clinical manifestations were rash or purpura (20, 51.3%), followed by fever (12, 30.8%), glandular enlargement/recurrent parotitis (10, 25.6%), and dry mouth and/or dry eyes (9, 23.1%). Twenty-eight (56.4%) patients had systemic damage, the most common of which was haematological involvement (14, 35.9%), followed by hepatic (13, 33.3%) and renal involvement (8, 20.5%). Thirty-eight (97.4%) patients underwent labial minor salivary gland biopsy, and all exhibited focal lymphocytic sialadenitis. All patients had a global ESSDAI score ≥ 1 at diagnosis, and the median total score at diagnosis was 8 (2, 31). Thirty-six (92.3%) patients were followed up for a median time of 23.6 (7.9, 79.5) months, and three patients developed systemic lupus erythematosus (SLE) at follow-up times of 13.3, 38.8 and 63.8 months. Conclusions: The presentation of childhood-onset pSS is atypical, and extraglandular manifestations and systemic involvement are more common than in adult-onset pSS. Labial salivary gland biopsy is vital for patients with probable pSS. Some patients may develop SLE over time. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the prevalence and influencing factors of symptomatic dry eye disease (DED) in Chinese coal workers. Methods: The prevalence of symptomatic DED in coal workers was investigated by using the questionnaire of Ocular Surface Disease Index (OSDI) and the influencing factors were explored. Results: The prevalence of symptomatic DED was 50.7% in coal workers. Of the influencing factors of symptomatic DED, the level of dust exposure had an odds ratio (OR) of 1.26, the time of dust exposure had an OR of 1.02, and the age had an OR of 1.03. Conclusion: There was a high morbidity of symptomatic DED among coal workers and the level and the time of dust exposure and the age of coal workers had important effects. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the testing methods used to detect fungal pathogens as well as the pathogenic profiles and drug susceptibility among fungal isolates from ocular sources collected in a tertiary eye hospital. Methods: The laboratory test records of patients with suspected ocular fungal infection from January 2010 to December 2019 at a tertiary eye care center in southern China were retrospectively evaluated. The isolated pathogens identified by smear examination and culture combined with microscopy were analyzed. For 2017– 2019 fungal isolates, their antifungal susceptibilities to four antifungal agents were evaluated. Results: A total of 22,233 specimens (16,315 for culture and 5918 for direct smear examination) from 16,209 individuals were assessed, and 3317 specimens (2169 for culture and 1148 for smear examination) from 2395 patients had confirmed fungal infection. The mean age of patients was 50.6± 14.2 years and 63.4% were male. The positive rate of smear examination was 19.4% and significantly higher than 13.3% of fungal culture (p< 0.001). Of 5812 patients who were simultaneously examined for culture and smear staining, 897 (15.43%) had positive findings for fungi. Among the 2420 positive findings, 2138 (88.3%) were from the cornea, and 133 (5.5%) were from intraocular samples. Fusarium spp. (40.5%) and Aspergillus spp. (22.0%) were the major fungal genera among the molds, whereas Candida spp. (4.6%) constituted the major yeast. Fusarium spp. had a lower antifungal susceptibility than Aspergillus spp. against voriconazole and amphotericin. And yeast spp. had the highest susceptibility to caspofungin. Conclusion: This study provided a 10-year assessment of fungi in ocular infections in southern China, giving support to epidemiological understanding and guiding empiric antimicrobial therapy. [ABSTRACT FROM AUTHOR]