Notes

Have we accomplished improvement throughout tocolytic therapy?--results of a retrospective cohort review inside a tertiary university or college healthcare facility.
Peripheral muscle and tendon changes after stroke can influence the functional outcome of patients. The aim of this systematic review was to summarize the evidence of ultrasonographic changes in morphological muscle and tendon properties of the spastic hemiparetic lower leg in patients with first ever stroke.

A systematic search was conducted through PubMed, Embase, Scopus, Cinahl, Cochrane Library, and manual searches from inception until 1st of May 2020. Observational case control or cohort studies were included. Risk of bias was evaluated by using the Newcastle-Ottawa Quality Assessment Scale. Outcome parameters of interest included muscle thickness, muscle and tendon length, fascicle length, pennation angle and echo-intensity.

Nine studies investigated outcome parameters beyond one-month after stroke. We are unable to make a comprehensive statement. Nevertheless, there are some arguments for reduced muscle thickness and reduced fascicle length of the hemiplegic, spastic leg.

Despite the fact that objective assessment by ultrasonography holds promise for diagnosis and follow-up of spastic hemiparesis after stroke, more evidence is needed to determine how changes in morphological muscle and tendon properties are related to muscle weakness, severity of spasticity and compensation strategies such as disuse or overuse in longitudinal studies starting early after stroke.
Despite the fact that objective assessment by ultrasonography holds promise for diagnosis and follow-up of spastic hemiparesis after stroke, more evidence is needed to determine how changes in morphological muscle and tendon properties are related to muscle weakness, severity of spasticity and compensation strategies such as disuse or overuse in longitudinal studies starting early after stroke.
Impaired upper limb functionality and dexterity are common in people with multiple sclerosis (PwMS) and lead to increased dependency and reduced quality of life.

To Compare the ability of the Manual Abilites Measure 36 (MAM-36) and the Abilhand questionnaire to recognize an involvement of the upper limbs in PwMS, and to compare their results with those of other patient reported outcomes (PRO) evaluating disability, functional independence, symptoms of anxiety and depression, fatigue and quality of life.

Observational study.

Outpatient.

51 PwMS (mean age 56,31 years, age range 33-82 years, 72,5% females).

For each patient were collected MAM-36, Abilhand questionnaire, expanded disability status scale (EDSS), Functional Independence measure (FIM), Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS) and Life Satisfaction Index (LSI).

A strong correlation between MAM-36 and the Abilhand questionnaire (Spearman r 0.79; p<0.0001) were found. We obtained a significant correlation between MAM-36 and EDSS (Spearman r -0.5; p= 0.0002), FIM (Spearman r 0.55; p<0.0001); we did not observe a correlation with MFIS (Spearman r -0.33; p 0.02); moreover we found a similar trend between Abilhand and EDSS (Spearman r -0.47; p= 0.0005), FIM (Spearman r 0.61; p<0.0001), MFIS (Spearman r -0.41; p 0.002).

In PwMS the assessment of upper limbs is fundamental since it closely related to the level of disability of the person. Both MAM-36 and Abilhand Questionnaire are equally able to detect upper limb dysfunctions in PwMS.

Both MAM-36 and Abilhand can be used for upper limbs evaluation, within a multidimensional approach that seems to be the best way to evaluate PwMS.
Both MAM-36 and Abilhand can be used for upper limbs evaluation, within a multidimensional approach that seems to be the best way to evaluate PwMS.
Low-risk status in pulmonary arterial hypertension (PAH) predicts better survival. The present study aimed to describe changes in risk status and treatment approaches over multiple clinical assessments in PAH, taking age and comorbidity burden into consideration.

The study included incident patients from the Swedish PAH registry, diagnosed with PAH in 2008-2019. Group A (n=340) were ≤75years old with <3 comorbidities. Group B (n=163) were >75years old with ≥3 comorbidities. Assessments occurred at baseline, first-year (Y1) and third-year (Y3) follow-ups. The study used an explorative and descriptive approach. Group A median age was 65years, 70% were female, and 46% had no comorbidities at baseline. Baseline risk assessment yielded low (23%), intermediate (66%), and high risk (11%). Among patients at low, intermediate, or high risk at baseline, 51%, 18%, and 13%, respectively, were at low risk at Y3. At baseline, monotherapy was the most common therapy among low (68%) and intermediate groups (60%), while dual therapy was the most common among high risk (69%). In patients assessed as low, intermediate, or high risk at Y1, 66%, 12%, and 0% were at low risk at Y3, respectively. https://www.selleckchem.com/products/Erlotinib-Hydrochloride.html Of patients at intermediate or high risk at Y1, 35% received monotherapy and 13% received triple therapy. In low-risk patients at Y1, monotherapy (40%) and dual therapy (43%) were evenly distributed. Group B median age was 77years, 50% were female, and 44% had ≥3 comorbidities at baseline. At baseline, 8% were at low, 80% at intermediate, and 12% at high risk. Monotherapy was the most common therapy (62%) in Group B at baseline. Few patients maintained or reached low risk at follow-ups.

Most patients with PAH did not meet low-risk criteria during the 3year follow-up. The first year from diagnosis seems important in defining the longitudinal risk status.
Most patients with PAH did not meet low-risk criteria during the 3 year follow-up. The first year from diagnosis seems important in defining the longitudinal risk status.
Patients with systemic autoimmune rheumatic diseases (ARDs) continue to be concerned about risks of severe coronavirus disease 2019 (COVID-19) outcomes. This study was undertaken to evaluate the risks of severe outcomes in COVID-19 patients with systemic ARDs compared to COVID-19 patients without systemic ARDs.

Using a large multicenter electronic health record network, we conducted a comparative cohort study of patients with systemic ARDs diagnosed as having COVID-19 (identified by diagnostic code or positive molecular test result) compared to patients with COVID-19 who did not have systemic ARDs, matched for age, sex, race/ethnicity, and body mass index (primary matched model) and additionally matched for comorbidities and health care utilization (extended matched model). Thirty-day outcomes were assessed, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation, acute renal failure requiring renal replacement therapy, ischemic stroke, venous thromboembolism, and death.

We initially identified 2,379 COVID-19 patients with systemic ARDs (mean age 58 years; 79% female) and 142,750 comparators (mean age 47 years; 54% female).
My Website: https://www.selleckchem.com/products/Erlotinib-Hydrochloride.html