36 research outputs found
Identifying the Research Extent of Medical Tourism in the World and the Components of Attracting Medical Tourists in Iran
No full textIdentifying the Research Extent of Medical Tourism in the World and the Components of Attracting Medical Tourists in Iran
Mohammad Dehghani Mahmoudabadi1, Iravan Masoudi Asl*2,
Soad Mahfoozpour3, Somayeh Hessam4
1Department of Health Services Management, Science & Research Branch, Islamic Azad University, Tehran, Iran.
Corresponding author: Tel: 09209901218, email: [email protected]
Corrigendum notice: In the above article, which was published in the Volume 31, Issue of 8,Year 2023, the correspounding author has been changed
The Libyan Arabic version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR)
No full textThe Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Libyan Arabic language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data, and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach’s alpha, interscale correlations, test–retest reliability, and construct validity (convergent and discriminant validity). A total of 100 JIA patients (22.0% systemic, 26.0% oligoarticular, 25.0% RF negative polyarthritis, and 27.0% other categories) and 100 healthy children, were enrolled in a paediatric rheumatology centre. The JAMAR components discriminated well healthy subjects from JIA patients. Notably, there is no significant difference between the healthy subjects and their affected peers in the school-related problems variable. All JAMAR components revealed satisfactory psychometric performances. In conclusion, the Libyan Arabic version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research
Corpus oral, lecture, parole préparée, parole spontanée
No full textCe corpus audio est enregistré dans une classe de maternelle de 32 enfants par un enregistreur Zoom. l'enregistrement est constitué de deux parties, dans la première partie la maîtresse réalise la tâche de lecture d'une histoire et dans la deuxième elle raconte l'histoire sans support écrit. Les transcriptions sont faites sous Praat avec des fichiers Textgrid
Anakinra treatment for systemic onset juvenile idiopathic arthritis in Libyan Children
No full textSystemic onset juvenile idiopathic arthritis (SoJIA) is a rare inflammatory disorder. It is the severest form of juvenile idiopathic arthritis, and complications occur most commonly in this type. Non-responsiveness to standard therapy with corticosteroids and disease-modifying antirheumatic drugs is not uncommon. Interleukin-1 beta (Il-1β) has been shown to be a main contributor to the pathogenesis of SoJIA. Anakinra, a recombinant Il-1β receptor antagonist, was shown to be effective in small cohorts of therapy-resistant adult and pediatric still's patients. This study aimed to evaluate the real-world efficacy, steroid-sparing effect, and safety profile of anakinra in patients with SoJIA at a tertiary care center in Libya. A retrospective case series was conducted on patients with SoJIA treated with anakinra at the Tripoli Children's Hospital between 2010 and 2017. Data on demographic characteristics, disease activity, corticosteroid dosage, concomitant medications, and adverse events were collected at baseline and at 1-, 3-, 6-, and 12-month post-treatment. 13 patients were treated with anakinra with a mean age of 9.4±4.6 years at anakinra initiation and a female-to-male ratio of 2: 1. All patients were on corticosteroids and 92.3% on methotrexate at treatment initiation. The proportion of patients achieving inactive disease (Jadas 10=0) increased over time. A marked steroid-sparing effect was observed: the number of patients requiring high-dose steroids (>0.5 mg/kg/day) decreased from 100% at baseline to 7.6% at 12 months, and 53.8% successfully discontinued corticosteroids entirely. All patients experienced injection site reaction, and macrophage activation syndrome occurred in 15.4% as a side effect after treatment initiation. But no severe infections or fatalities occurred. Reasons for discontinuation included remission (46.1%), drug unavailability (23.0%), inefficacy (15.3%), and side effects (15.3%). Anakinra demonstrated significant efficacy in inducing rapid disease control and reducing corticosteroid dependence in patients with refractory SoJIA, with a manageable safety profile
Tocilizumab effectiveness in paediatric non-infectious uveitis: data from the International AIDA Network Registries on ocular inflammatory disorders
No full textTo describe tocilizumab (TCZ) effectiveness in 15 children with refractory non-infectious uveitis. Reported outcomes are the number of relapses before and after treatment, steroid-sparing effect and drug retention rate. Macular oedema, fluorangiographic findings and ocular complications are also reported. The mean number of ocular relapses significantly decreased from 314 per 100 eyes/year to 106 per 100 eyes/year (p=0.016). A significant steroid-sparing effect was detected (p=0.037). TCZ drug survival was 77.4% at 6 months, followed by 61.9% at 12, 24 and 36 months of follow-up. Macular oedema and retinal vasculitis resolved in all affected eyes
Development of the paediatric society of the African league against rheumatism (PAFLAR) JIA registry and clinical profile of JIA in Africa from the PAFLAR JIA registry
No full textImaging findings in patients with axial spondyloarthritis presenting with recurrent fever attacks: data from the international AIDA network spondyloarthritis registry
No full textSpondyloarthritis (SpA) is a group of immuno-mediated diseases likely caused by a complex interaction between autoimmune and autoinflammatory immunological mechanisms, where a febrile clinical presentation can be an early manifestation. This retrospective study aims to assess the prevalence of inflammatory involvement of the sacroiliac joints (SIJs), pelvis, and lumbosacral spine in patients with axial-SpA and recurrent febrile presentation. MR examinations of 57 patients fulfilling the axial-SpA according to ASAS criteria and presenting with febrile symptoms were evaluated, compared to 30 patients with axial-SpA and no febrile symptoms. 20/57 patients in the axial-SpA group with recurrent fevers underwent a US examination of the SIJs. Structural damage and inflammatory alterations of the SIJs were highly prevalent in both groups. In patients with febrile syndrome, bone marrow edema (78.9%) and erosions (85.9%) were the most prevalent findings in the SIJs; SPARCC score was significantly higher in patients with typical axial-SpA onset (BME: 20.1 ± 12.28 vs. 6.15 ± 3.21; erosions: 22.16 ± 8.13 vs. 6.60 ± 3.08; p = 0.01). Among pelvic enthesitis, enthesitis of the pubic symphysis showed a significant difference in prevalence (p < 0.001). Significant differences were found for the prevalence of vertebral body corner sclerosis (p = 0.01), zygapophyseal capsulitis (p = 0.005), and interspinous enthesitis (p = 0.006). No significant correlation was found between ultrasound findings and MR inflammatory changes (p > 0.05). SIJs and spinal inflammatory alterations and pelvis enthesitis were highly prevalent in axial-SpA patients with and without recurrent fever. Enthesitis of the pubic symphysis, vertebral body corner sclerosis, zygapophyseal capsulitis, and interspinous enthesitis showed a significant difference in frequency between axial-SpA patients with and without fever attacks
Determinants of Discordance Between Criteria for Inactive Disease and Low Disease Activity in Juvenile Idiopathic Arthritis
No full textObjective
To assess concordance among criteria for inactive disease (ID) and low disease activity (LDA) in juvenile idiopathic arthritis (JIA) and to seek factors driving discordance.
Methods
The frequency of fulfillment of existing criteria was evaluated in information on 10,186 patients extracted from 3 cross-sectional data sets. Patients were divided up according to the functional phenotypes of oligoarthritis and polyarthritis. Concordance between criteria was examined using weighted Venn diagrams. The role of each individual component in explaining discordance between criteria was assessed by calculating the absolute number and percentage of instances in which the component was responsible for discrepancy between definitions.
Results
Criteria for ID were met by 28.6–41.1% of patients with oligoarthritis and by 24.0–33.4% of patients with polyarthritis. Criteria for LDA were met by 44.8–62.4% of patients with oligoarthritis and by 44.6–50.4% of patients with polyarthritis. There was a 57.9–62.3% overlap between criteria for ID and a 67.9–85% overlap between criteria for LDA. Parent and physician global assessments and acute-phase reactants were responsible for the majority of instances of discordance among criteria for ID (8.7–15.5%, 10.0–12.3%, and 10.8–17.3%, respectively).
Conclusion
We found fair concordance between criteria for ID and LDA in JIA, with the main drivers of discordance for ID being physician and parent global assessments and acute-phase reactants. This observation highlights the need for further studies aimed to evaluate the impact of subjective physician and parent perception of disease remission and of laboratory measures of inflammatory activity on the definition of ID
Promising selective MAO-B inhibition by sesamin, a lignan from Zanthoxylum flavum stems
No full text© 2020 The Author(s) Monoamine oxidase inhibition is an important therapeutic approach for various neurodegenerative disorders. Reversible MAO inhibitors selectively targeting only one isoform possess substantial merit in terms of safety, efficacy, and side effect profile. This study aimed to isolate the secondary metabolites of Zanthoxylum flavum stems and evaluate their recombinant human MAO inhibition, antimicrobial, and antiprotozoal activities. As a result, fourteen compounds were isolated and identified (nine of them were reported from Z. flavum for the first time). Compound 3 (sesamin) exhibited potent selective MAO-B inhibition (IC50 value of 1.45 ± 0.05 µM) which reported herein for the first time. Compound 2 showed selective MAO-A inhibition activity, compound 5 exhibited good trypanocidal activity, and compound 7 displayed moderate antibacterial activity. The promising MAO-B inhibitory activity of sesamin provoked us to further explore the kinetic properties, the binding mode, and the underlying mechanism of MAO-B inhibition by this lignan. This detailed investigation substantiated a reversible binding and mixed MAO-B catalytic function inhibition via sesamin (Ki: 0.473 ± 0.076 μM). Selectivity and reversibility of sesamin on MAO-B provide exciting prerequisites for further in vivo investigation to confirm its therapeutic potentiality
Worldwide evaluation of Clinical Practice Strategies (CliPS) for lung involvement in Still's disease within the JIR-CliPS network: a COST action
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