Woodwest4789
The human microbiome has attracted attention for its potential utility in precision medicine. Increasingly, more researchers are recognizing changes in intestinal microbiome can upset the balance between pro- and anti-inflammatory factors of host immune system, potentially contributing to arthritis immunopathogenesis. Patients who develop rheumatoid arthritis from undifferentiated arthritis can face multiple irreversible joint lesions and even deformities. Strategies for identifying undifferentiated arthritis patients who have a tendency to develop rheumatoid arthritis and interventions to prevent rheumatoid arthritis development are urgently needed. Intestinal microbiome dysbiosis and shifts in the miRNA profile affect undifferentiated arthritis progression, and may play an important role in rheumatoid arthritis pathophysiologic process via stimulating inflammatory cytokines and disturbing host and microbial metabolic functions. However, a causal relationship between microbiome-miRNA interactions and rheumatoid arthritis development from undifferentiated arthritis has not been uncovered yet. Changes in the intestinal microbiome and miRNA profiles of undifferentiated arthritis patients with different disease outcomes should be studied together to uncover the role of the intestinal microbiome in rheumatoid arthritis development and to identify potential prognostic indicators of rheumatoid arthritis in undifferentiated arthritis patients. Herein, we discuss the possibility of microbiome-miRNA interactions contributing to rheumatoid arthritis development and describe the gaps in knowledge regarding their influence on undifferentiated arthritis prognosis that should be addressed by future studies.This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases and identify the risk factors associated with severe COVID-19 pneumonia. This was a retrospective study in a tertiary care center conducted through the period between March 2020 and November 2020 and included all adult patients with rheumatic diseases who tested positive on the COVID-19 polymerase chain reaction (PCR) test. We assessed the patients' demographic data, history of rheumatic disease, COVID-19 symptoms and experimental treatment, if any, their disease course, and outcome. In all, 47 patients were included, and most were females. The commonest rheumatic diseases were rheumatoid arthritis (53.2%), followed by systemic lupus erythematosus (21.3%), and psoriatic arthritis (10.6%). Methotrexate and hydroxychloroquine were the most commonly used disease-modifying anti-rheumatic drugs in 36.1% and 25.5%, respectively. Out of 47 patients, 48.9% required hospitalization with a median hospital stay of 7 days. Severe COVID-19 pneumonia, defined as clinical signs of pneumonia plus one of the following respiratory rate > 30 bpm, severe respiratory distress, or oxygen saturation less then 90% in room air was observed in 19.1% of the patients, and one patient died. We found that elderly patients with a mean age of 65.3 years were more likely to develop severe COVID-19 pneumonia and that was statistically significant. Our study showed that elderly patients with a mean age of 65 years and having rheumatic diseases had an increased risk of hospital admission and development of severe COVID-19 pneumonia.
Cerebrovascular complications are commonly observed in children with tuberculous meningitis. We aimed to determine which clinical factors were associated with stroke at admission in children with tuberculous meningitis and, in children stroke-free at admission, which factors were associated with development of stroke on treatment.
We analysed a cohort of 474 children diagnosed with 'definite' and 'probable' tuberculous meningitis, with prospectively collected data, at Tygerberg Hospital, Cape Town, South Africa from 1985 to 2005. We considered either hemiparesis or radiological arterial ischemic infarction as evidence of stroke.
At admission, 339 (71.5%) children presented with stroke. Features associated with stroke at admission included age <3 years (odds ratio (OR) 3.70; 95% confidence interval (CI) 2.44-5.63; p < 0.01), convulsions (OR 2.25; 95% CI 1.46-3.45; p < 0.01) and hydrocephalus (OR 1.63; 95% CI 1.05-2.53; p = 0.03). In the group of children without stroke at admission (n = 135), 33 (24.4%) developed stroke by 1 month. Similar factors predicted stroke and included age <3 years (OR 2.60; 95% CI 1.17-5.80; p = 0.02), convulsions (OR 2.25; 95% CI 1.46-3.45; p < 0.01), CSF cell count <10 or >500/L (OR 3.12; 95% CI 1.03-9.43; p = 0.04) and hydrocephalus (OR 2.99; 95% CI 1.30-6.89; p = 0.01).
A large proportion of children with tuberculous meningitis present with stroke at admission. Of those with no evidence of stroke at admission, a quarter develop stroke by 1 month, suggesting that there could be a brief window in which to give preventive therapy.
A large proportion of children with tuberculous meningitis present with stroke at admission. Of those with no evidence of stroke at admission, a quarter develop stroke by 1 month, suggesting that there could be a brief window in which to give preventive therapy.
This study aimed to investigate the effect of ultrasound-diagnosed adenomyosis on assisted pregnancy outcomes, i.e., in vitro fertilization-embryo transfer (IVF-ET).
This was a retrospective cohort study of 18,568 women who had received their first frozen-thawed ET cycle in Center of Reproductive Medicine, Children's Hospital of Shanxi and Women Health Center of Shanxi and the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital from January 2014 to May 2019. A total of 5,087 patients met the inclusion and exclusion criteria, and they were divided into two groups adenomyosis with tubal factor infertility (study group, n = 193) and only tubal factor infertility (control group, n = 4894). After a 11 propensity score match (caliper value = 0.005), 360 cases were matched in the end.
There was no statistical difference in the embryo implantation rate, clinical pregnancy rate, or multiple pregnancy rate between the two groups (28.4% vs. MD-224 cost 31.7%, 42.2% vs. 42.8%, and 11.7% vs. 12.8%, respectively; P > 0.