Mckenziegould9889

Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population are limited.

To delineate the adverse factors associated with outcomes of COVID-19 patients ≥75 years of age.

Retrospective cohort study.

Patients were classified into mild/moderate, severe/very severe and critical disease (intubated) based on oxygen requirements. The primary outcome was in-hospital mortality.

A total of 355 patients aged ≥75 years hospitalized with COVID-19 between 19 March and 25 April 2020 were included.Mean age was 84.3 years. One-third of the patients developed critical disease. Mean length of stay was 7.10 days. Vasopressors were required in 27%, with the highest frequency in the critical disease group (74.1%). Overall mortality was 57.2%, with a significant difference between severity groups (mild/moderate disease 17.4%, severe/very severe disease 71.3%, critical disease 94.9%, P < 0.001).Increased age, dementia, and severe/very severe and critical disease groups were independently associated with increased odds for mortality while diarrhea was associated with decreased odds for mortality (OR 0.12, 95% CI 0.02-0.60, P < 0.05). None of the cardiovascular comorbidities were significantly associated with mortality.

Age and dementia are associated with increased odds for mortality in patients ≥75 years of age hospitalized with COVID-19. Those who require intubation have the greatest odds for mortality. Diarrhea as a presenting symptom was associated with lower odds for mortality.

Age and dementia are associated with increased odds for mortality in patients ≥75 years of age hospitalized with COVID-19. Those who require intubation have the greatest odds for mortality. Diarrhea as a presenting symptom was associated with lower odds for mortality.

Heterogeneity of systemic lupus erythematosus (SLE) patients in clinical trials remains a challenge for developing new therapies. This study used a combinatorial analysis of four molecular biomarkers to define key sources of heterogeneity.

Combinations of IFN(high/low), anti-dsDNA(+/-), C3 and C4(low/normal) were used to subset n = 1747 patients from two randomized phase 3 trials. A dichotomous classification scheme defined SLE(+) as IFNhigh, anti-dsDNA(+), C3(low) and/or C4(low). SLE(-) required all of the following IFNlow, anti-dsDNA(-), C3(normal) and C4(normal). Additional analyses subset the data further by IFN, anti-dsDNA and complement.

The trials enrolled n = 2262 patients of which n = 1747 patients had data for IFN, anti-dsDNA, C3 and C4 at baseline. There were n = 247 patients in the SLE(-) population and n = 1500 patients in the SLE(+) population. The SLE(-) population had more mucocutaneous and musculoskeletal disease at baseline, while SLE(+) had more hematologic, renal and vascular involveals and identifying subsets of patients for analysis.The limited heritability of human lifespans suggests an important role for gene-environment (GxE) interactions across the lifespan (T), from gametes to geronts. Multi-level GxExT interactions of aging phenotypes are conceptualized in the Gero-Exposome as Exogenous and Endogenous domains. Stochastic variations in the Endogenous domain contribute to the diversity of aging phenotypes, shown for the diversity of inbred Caenorhabditis elegans lifespans in the same culture environment, and for variegated gene expression of somatic cells in nematodes and mammals. selleck These phenotypic complexities can be analyzed as three-way interactions of gene, environment, and stochastic variations, the Tripartite Phenotype of Aging. Single cell analyses provide tools to explore this broadening frontier of biogerontology.

Studies have reported the development of moderate and severe de novo spondyloarthritis (SpA) associated disease under vedolizumab (VDZ) treatment for inflammatory bowel disease (IBD). Herein, we report a case series that developed severe enthesitis under VDZ therapy from a cohort of 90 treated cases.

In a single Italian IBD Unit, where 90 cases were on VDZ therapy, we identified 11 cases that developed severe enthesitis. The onset of disease in relationship to VDZ initiation, clinical and sonographic imaging features, outcomes including therapy switches were described.

11 cases, including 8 prior anti-TNF failures, with new onset entheseal pathology were identified (Multifocal (n = 4), unifocal (n = 6), enthesitis/synovitis/dactylitis (n = 1). The mean duration to symptoms was 46 weeks (range 6-119), mean CRP was 5.1 mg/dl and the majority were HLA-B27 negative and showed good clinical response for gut disease. Clinical features and Ultrasound showed severe enthesitis including PD change in 7 patients.All patients were initially treated with NSAIDs, 5 patients underwent local steroid injections. At 12 months 5/7 cases continued VDZ and 2 were switched to Ustekinumab. At 12 months follow-up of 7 cases, 5 patients were in clinical remission and 2 patients had mild enthesitis with minimal increase of PD signal. Also 4/7 severe patients developed marked post-inflammatory entheseal calcifications.

A predominant isolated severe enthesitis pattern of SpA may develop under VDZ therapy with severe disease in 8% of cases. Most cases continued VDZ therapy.

A predominant isolated severe enthesitis pattern of SpA may develop under VDZ therapy with severe disease in 8% of cases. Most cases continued VDZ therapy.

The recombinant zoster vaccine had over 90% efficacy in preventing herpes zoster in clinical trials. However, its effectiveness outside of a clinical trial setting has not been investigated. This study aimed to assess the effectiveness of the recombinant zoster vaccine in general practice.

A de-identified administrative claims database, the OptumLabs ® Data Warehouse, was used to conduct this retrospective cohort study to assess the effectiveness of the recombinant zoster vaccine against herpes zoster in non-immunocompromised, vaccine age-eligible individuals enrolled in the database for ≥365 days.

A total of 4 769 819 adults were included in this study, with 173 745 (3.6%) adults receiving two valid doses of the recombinant zoster vaccine. The incidence rate of herpes zoster was 258.8 (95% CI 230.0 to 289.4) cases per 100 000 person-years in vaccinated persons compared to 893.1 (95% CI 886.2 to 900.0) in unvaccinated. Recombinant zoster vaccine effectiveness was 85.5% (95% CI 83.5% to 87.3%) overall, with an effectiveness of 86.