The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR''s

Muscle Analyzer System: Exploring Correlation Between Novel Microwave Resonator and Ultrasound-based Tissue Information in the Thigh

A microwave sensor to safely measure quality of muscle tissue for diagnosis and screening of diseases and medical conditions characterized by fat infiltration in muscle is presented. Fat infiltration in muscle may be seen by a lower dielectric constant of muscle at microwave frequencies corresponding to the large contrast between fat and muscle tissues. A planar resonator based on a bandstop filter and optimized to noninvasively interrogate muscle in the thigh on tissue quality is proposed. Currently, a study based on clinical trials is carried out, and, here, we present a preliminary correlation between skin and fat thicknesses and rectus femoris cross sectional area (CSA) measured with ultrasound and the proposed sensor's resonance frequency. CST simulations based on the ultrasound information guide the analysis. We see that although there are signs of a potential correlation between CSA and resonance, skin and fat variability is still an issue to overcome

Muscle Analyzer System: Exploring Correlation Between Novel Microwave Resonator and Ultrasound-based Tissue Information in the Thigh

A microwave sensor to safely measure quality of muscle tissue for diagnosis and screening of diseases and medical conditions characterized by fat infiltration in muscle is presented. Fat infiltration in muscle may be seen by a lower dielectric constant of muscle at microwave frequencies corresponding to the large contrast between fat and muscle tissues. A planar resonator based on a bandstop filter and optimized to noninvasively interrogate muscle in the thigh on tissue quality is proposed. Currently, a study based on clinical trials is carried out, and, here, we present a preliminary correlation between skin and fat thicknesses and rectus femoris cross sectional area (CSA) measured with ultrasound and the proposed sensor's resonance frequency. CST simulations based on the ultrasound information guide the analysis. We see that although there are signs of a potential correlation between CSA and resonance, skin and fat variability is still an issue to overcome

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients