Assessment of preterm and low birth weight infants by prechtl analysis

“General movements”, spontan hareketlerin en sık ve en karmaşık paterni olarak bilinir. Bu spesifik paternlerin kalitesindeki ve şeklindeki değişiklikler, infantlarda gelişebilecek nörolojik disfonksiyonlar için önemli bir belirteçtir. Çalışmamızın amacı, düşük doğum ağırlığı ve preterm doğum öyküsü olan bebeklerin video çekimlerini inceleyerek, Prechtl analizi ile hareket paternlerini belirlemek ve sonuçların, kranial ultrasonografi sonuçlarıyla uyumlarını araştırmaktır. Kesitsel retrospektif araştırmamıza; preterm (<37 hafta) ve düşük doğum ağırlığı (<2500gr ) ile doğum öyküsü olan 64 bebek dahil edildi. Olgular prematürite ve doğum ağırlığı düzeylerine göre gruplandırıldı. Video kayıtları incelenen bebekler “general movements” değerlendirme sonuçlarına göre iki gruba ayrıldı. Tüm video değerlendirmeleri normal olan olgular ve ilk video kayıtlarında anormal patern görülmesine rağmen takip eden kayıtlarda normal patern saptanan olgular “normal” grubu, ilk ve devam eden video kayıtlarında anormal patern gözlenen olgular ise “anormal” grubu oluşturdu. Olguların 57’si (%89.1) “normal”, 7’si (%10.9) “anormal” gruptaydı. Kranial ultrasonografi sonuçlarına göre ise olguların 9’u (%14.1) “anormal”, 55’i (%85.9) “normal” olarak belirlendi. İstatistiksel analiz sonucunda, “general movements” analiz sonuçları ile kranial ultrasonografi sonuçları arasında mükemmel derecede (kappa= 0.857) uyum saptandı. Anormal “general movements” sonuçlarının prematürite ve doğum ağırlığı düzeylerine göre dağılımına bakıldı ve istatistiksel olarak anlamlı fark saptanmadı. Çalışma sonucunda, “general movements” değerlendirmesinin, riskli bebeklerin uzun dönem takip edilmesine ve gerektiğinde erken dönem rehabilitasyona yönlendirilerek, bu bebeklerde gelişebilecek nörogelişimsel bozuklukların neden olacağı engelliliklerin azaltılmasına yarar sağlayacağı kanısındayız."General movements" are the most common and complex pattern of spontaneous movements. Changes in the quality and character of these patterns; is a predictor of neurological dysfunction in infants. We aimed to evaluate the video records of preterm (<37 weeks) and low birth weight (<2500 gr) infants with Prechtl analysis and to investigate the correlation with the results of cranial ultrasonography. 64 infants were included in our crosssectional retrospective study. The cases were grouped according to the level of prematurity, birth weight and Prechtl analysis. The "normal" group consisted of cases in which all video evaluations and patterns were observed normal in the follow-up records even though the first video records had abnormal pattern. The cases with an abnormal pattern in the first and continuing video records constituted the "abnormal" group. The normal and abnormal cases were found 57 (89.1%) and 7 (10.9%), respectively. The same distribution according to cranial ultrasonography were found 55 (85.9%) and 9 (14.1%) respectively. A significant excellent correlation (kappa = 0.857) was found between the results of the "general movements" analysis and the results of the cranial ultrasonography. The distribution of abnormal "general movements" results according to the level of prematurity and birth weight were no statistically significant different. The assessment of "general movements" can help long-term follow-up of high-risk infants and reduce the disabilities caused by neurodevelopmental disorders by directing to early rehabilitation if necessary

COVID-19 Among Patients With Inflammatory Rheumatic Diseases

Backgroun

Comparing DAPSA, DAPSA28 and DAS28-CRP in patients with psoriatic arthritis initiating a first TNF-inhibitor across nine European countries.

Objectives: Since 66/68 joint counts are not always performed in routine care, we aimed to determine which of a. the modified 28‐joint disease activity index for psoriatic arthritis (DAPSA28), or b. 28‐joint disease activity score with C‐reactive protein (DAS28‐CRP) should be preferred for monitoring disease activity in psoriatic arthritis (PsA), when the original DAPSA (66/68 joints) is not available. Methods: Prospectively collected real‐world data of European bio‐naïve PsA patients initiating a first tumor necrosis factor inhibitor (TNFi) were pooled. Remission and response status were evaluated at 6 months by: remission; DAPSA≤4, DAPSA28≤4, DAS28‐CRP<2.6, response; 75% improvement for DAPSA and DAPSA28, and combined EULAR good/moderate responses for DAS28‐CRP. Logistic regression analyses on multiple imputed data were used to identify baseline predictors. Results: Remission and response cohorts included 3,159 and 1,866 patients, respectively. Six‐month proportions achieving remission/response were: DAPSA: 27%/44%, DAPSA28: 28%/44% and DAS28‐CRP: 59%/80%. Of 14 possible baseline predictors, 11 predicted both DAPSA and DAPSA28 remission, (eight of which also predicted their response, indicated by*): longer disease duration*, male sex* and higher CRP* were positive, while older age*, higher body mass index*, patient fatigue* and global, physician global, health assessment questionnaire score*, tender and swollen* joint counts were negative predictors. Eight and five of these predicted DAS28‐CRP remission and response, respectively. Conclusion: In patients with PsA, DAPSA28 should be preferred over DAS28‐CRP as a substitute for DAPSA when 66/68 joint counts are not available, due to the large overlap in remission and response status and in predictors between DAPSA and DAPSA28

Unveiling cancer risk in ANCA-associated vasculitis: result from the Turkish Vasculitis Study Group (TRVaS)

To investigate cancer incidence in patients with ANCA-associated vasculitis (AAV), compare it with the age/sex-specific cancer risk of the Turkish population, and explore independent risk factors associated with cancer. This multicenter, incidence case–control study was conducted using the TRVaS registry. AAV patients without cancer history before AAV diagnosis were included. Demographic and AAV-related data of patients with and without an incident cancer were compared. Standardized cancer incidence rates were calculated using age-/sex-specific 2017 Turkish National Cancer Registry data for cancers (excluding non-melanoma skin cancers). Cox regression was performed to find factors related to incident cancers in AAV patients. Of 461 AAV patients (236 [51.2%] male), 19 had incident cancers after 2022.8 patient-years follow-up. Median (IQR) disease duration was 3.4 (5.5) years, and 58 (12.6%) patients died [7 with cancer and one without cancer (log-rank, p = 0.04)]. Cancer-diagnosed patients were older, mostly male, and more likely to have anti-PR3-ANCA positivity. The cumulative cyclophosphamide dose was similar in patients with and without cancer. Overall cancer risk in AAV was 2.1 (SIR) ((1.3–3.2), p = 0.004); lung and head-neck [primary target sites for AAV] cancers were the most common. In Cox regression, male sex and ≥ 60 years of age at AAV diagnosis were associated with increased cancer risk, while receiving rituximab was associated with decreased cancer risk. Cancer risk was 2.1 times higher in AAV patients than the age-/sex-specific cancer risk of the Turkish population population, despite a high rate of rituximab use and lower dose of cyclophosphamide doses. Vigilance in cancer screening for AAV patients covering lung, genitourinary, and head–neck regions, particularly in males and the elderly, is vital