Sedimentation Rate Research Articles

Real-world effectiveness and retention rate of upadacitinib in patients with rheumatoid arthritis: results from a multicentre study

Abstract This study evaluates upadacitinib (UPA) effectiveness and drug retention rate (DRR) in patients with rheumatoid arthritis (RA). Multicentre prospective observational study. Consecutive patients with RA receiving UPA were evaluated at 0, 3, 6, 12, 18, and 24 months of treatment. Key outcomes included UPA DRR and changes in clinical and serological measures over time. The study included 215 patients (72.6% female sex, mean age 60.1 ± 11.7 years). The DRR of UPA was 91.6% (95% CI 88.0–95.4%) at 6 months, 84.6% (95% CI 79.8–89.7%) at 12 months, 80.3% (95% CI 75.0–86.0%) at 18 months and 80% (95% CI 75.0–86.0%) at 24 months. UPA DRR was similar between monotherapy and methotrexate combination (p = 0.47), and across different treatment lines (p = 0.58). A statistically significant improvement from baseline was observed over 24 months considering erythrocyte sedimentation rate, C-reactive protein (CRP), Health Assessment Questionnaire (HAQ), Disease Activity Score (DAS)28-CRP, Physician’s (Ph) and Patient’s (Pt) Global Assessment (GA), Visual Analogue Scale (VAS) Pain, Simplified and Clinical Disease Activity Index (SDAI and CDAI) (p < 0.00 for all of them). Patients discontinuing UPA were more likely to be male (p = 0.02), with a longer disease duration (p = 0.03), higher baseline values of VAS Pain (p < 0.00), PtGA (p < 0.00), PhGA (p < 0.00), CDAI (p < 0.00), SDAI (p < 0.00) and corticosteroid dosage (p = 0.04). This study confirms UPA effectiveness in managing RA in the real-world practice, demonstrating sustained drug retention and improvements in clinical and laboratory measures over time. Also, UPA could be a valuable option for patients with multi-refractory RA and when monotherapy is preferred.

Mortality Risk Prediction in Patients With Antimelanoma Differentiation-Associated, Gene 5 Antibody-Positive, Dermatomyositis-Associated Interstitial Lung Disease: Algorithm Development and Validation.

Patients with antimelanoma differentiation-associated gene 5 antibody-positive dermatomyositis-associated interstitial lung disease (anti-MDA5+DM-ILD) are susceptible to rapidly progressive interstitial lung disease (RP-ILD) and have a high risk of mortality. There is an urgent need for a reliable prediction model, accessible via an easy-to-use web-based tool, to evaluate the risk of death. This study aimed to develop and validate a risk prediction model of 3-month mortality using machine learning (ML) in a large multicenter cohort of patients with anti-MDA5+DM-ILD in China. In total, 609 consecutive patients with anti-MDA5+DM-ILD were retrospectively enrolled from 6 hospitals across China. Patient demographics and laboratory and clinical parameters were collected on admission. The primary endpoint was 3-month mortality due to all causes. Six ML algorithms (Extreme Gradient Boosting [XGBoost], logistic regression (LR), Light Gradient Boosting Machine [LightGBM], random forest [RF], support vector machine [SVM], and k-nearest neighbor [KNN]) were applied to construct and evaluate the model. After applying inclusion and exclusion criteria, 509 (83.6%) of the 609 patients were included in our study, divided into a training cohort (n=203, 39.9%), an internal validation cohort (n=51, 10%), and 2 external validation cohorts (n=92, 18.1%, and n=163, 32%). ML identified 8 important variables as critical for model construction: RP-ILD, erythrocyte sedimentation rate (ESR), serum albumin (ALB) level, age, C-reactive protein (CRP) level, aspartate aminotransferase (AST) level, lactate dehydrogenase (LDH) level, and the neutrophil-to-lymphocyte ratio (NLR). LR was chosen as the best algorithm for model construction, and the model demonstrated excellent performance, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.866, a sensitivity of 84.8%, and a specificity of 84.4% on the validation data set and an AUC of 0.90, a sensitivity of 85.0%, and a specificity of 83.9% on the training data set. Calibration curves and decision curve analysis (DCA) confirmed the model's accuracy and clinical applicability. Moreover, the model showed strong predictive performance in the external validation cohorts (cohort 1: AUC=0.836, 95% CI 0.754-0.916; cohort 2: AUC=0.915, 95% CI 0.871-0.959), indicating good generalizability. This model was integrated into a web-based tool to predict the 3-month mortality for patients with anti-MDA5+DM-ILD. We successfully developed a robust clinical prediction model and an accompanying web tool to estimate the 3-month mortality risk for patients with anti-MDA5+DM-ILD.

Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study

Abstract Background Tubercular lymphadenitis (TBLN) is the most common extrapulmonary tuberculosis (EPTB) followed by tubercular pleural effusion (TPE). The bacteriological confirmation to diagnose EPTB is more difficult due to its paucibacillary nature often leading to delay or misdiagnosis. The role of the CBNAAT test for the diagnosis of EPTB is highly variable among different populations. Hence, the aim of the present study was to evaluate the role of CBNAAT in the diagnosis of EPTB in a tertiary care center in north India. Methods This was a cross-sectional study conducted in the 100 stable patients of EPTB (55 TPE and 45 TBLN) who came to the Respiratory Medicine Department in MMMC&H, Solan, India. The total duration of the study was eighteen months from April 2021 to September 2022. Fine needle aspirate and pleural fluid samples were collected from all suspected TPE and TBLN patients respectively and were subjected to CBNAAT investigation. All other recommended investigations used for diagnosis of TBLN and TPE were also performed including ZN stain, FNAC, biochemical analysis of pleural fluid, Mantoux test, radiological imaging, and other routine investigations. The data analysis was done using SPSS version 20 software. Results Out of 100 patients of EPTB, 55 were TPE, and 45 were TBLN patients. The positivity of CBNAAT was higher in TBLN patients (57.8%) as compared to TPE (23.7%) patients. The correlation between CBNAAT and ZN stain was statistically significant in both TBLN (p = 0.008) and TPE (p = 0.001) patients. The correlation of CBNAAT with FNAC, duration of illness, erythrocyte sedimentation rate (ESR), and Mantoux were all statistically significant (p < 0.05). Conclusion Our study finding showed higher positivity of CBNAAT in the TBLN as compared to that in patients of TPE. The positivity of CBNAAT in the TBLN patients was higher in pus and cheesy FNAC samples, Mantoux-positive patients, and those with high ESR value.

Circulating cell-free DNA as a potential biomarker for prediction of disease activity and prognosis among Egyptian rheumatoid arthritis patients.

Cell-free DNA (cfDNA) has emerged as a potential biomarker for assessing disease activity and prognosis in rheumatoid arthritis (RA). However, the association between cfDNA levels and the established RA markers of inflammation and disease severity remains unclear. The current study aimed to detect plasma levels of cfDNA in patients with RA and to investigate their association with RA activity indicators (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), disease activity score-28 (DAS28)), prognostic markers (rheumatoid factor (RF), anticitrullinated protein antibodies (ACPA)), and the musculoskeletal ultrasonographic (US7) scores. This controlled cross-sectional study included 108 RA patients and 108 healthy controls. Plasma levels of cfDNA were quantified by real-time PCR using ALU repeats. Levels of ESR, CRP, RF, and ACPA were measured using routine laboratory assays. Synovial inflammation and joint damage evaluation was performed using the US7 scoring system. Plasma levels of cfDNA were higher in RA patients than controls (P < 0.001) and significantly increased with higher DAS28 scores among all RA activity groups. Also, cfDNA levels were significantly positively correlated with ESR, CRP, RF, and ACPA levels (P-values <0.001). Regarding US7, cfDNA was significantly positively correlated with synovitis and erosion scores (P-values <0.05) but did not correlate significantly with tenosynovitis scores (P-values >0.05). In addition, plasma cfDNA was significantly higher in seropositive RA patients than in seronegative patients (P = 0.007). The odds ratio for cfDNA as a risk factor for erosions was 2.254. This study revealed that cfDNA levels are elevated in RA patients and positively associated with disease activity indicators and prognosis markers. Further research is warranted to validate these findings in larger cohorts and explore the clinical implications of cfDNA measurement in RA management.

Impact of climate and human-induced fire on the Dongyuan Lake, Southern Taiwan during the last 1850 cal years BP

Impact of climate and human-induced fire on the Dongyuan Lake, Southern Taiwan during the last 1850 cal years BP

The Application of the Vesikari and Modified Vesikari Severity Scores in Complicated Pediatric Gastroenteritis of Viral Origin: An Observational Study

Background/Objectives: Viral gastroenteritis can have a potentially fatal outcome at young ages and the recognition of severe cases could be aided by clinically derived severity scores. Methods: This observational study intended to conduct a comparative assessment of the utility of the Vesikari and modified Vesikari score in the evaluation of viral gastroenteritis severity and for the possible prediction of the dehydration degree. A total number of 113 children diagnosed with gastroenteritis were retrospectively enrolled and divided based on viral etiology into group 1 (34 children with unknown viral etiology), group 2 (60 children with rotavirus) and group 3 (19 children with adenovirus). Results: The highest mean Vesikari and modified Vesikari scores were found in group 2 (p&lt;0.01; p=0.01). A significant increase in liver enzymes was also identified in patients infected with rotavirus. The highest mean diarrhea, vomiting duration and body temperature were found in group 3 (p&lt;0.01; p&lt;0.01; p=0.02), as well as the highest mean inflammatory markers, such as C-reactive protein (CRP; p=0.01) and the erythrocyte sedimentation rate (p&lt;0.01). Significant linear associations were found between pH, bicarbonate level, base excess and the Vesikari scores, whereas urea, CRP and aspartate aminotransferase levels were associated with both severity scores. ROC curve analysis revealed a significant correlation between the Vesikari scores and dehydration degree (p&lt;0.01), with numeric cut-off values of 11.5 being proposed for the differentiation between mild and moderate gastroenteritis and 13.5 for the distinction between moderate and severe gastroenteritis. Conclusions: Both severity scores are useful in clinical settings, but more studies enrolling populations with various enteral infections could provide more insight into their etiology-based performance and reflection of paraclinical changes.

A Study on the Clinico-serological Features of Nail Psoriasis.

Nail psoriasis is a relatively unexplored clinical feature in the Indian population. Its correlation with cutaneous, musculoskeletal, and serological manifestations was analyzed. This study included 45 patients with clinically evident nail psoriasis. Clinical characteristics, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Nail Psoriasis Quality of Life Index 10 (NPQ10) scores and serological markers, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), and Rheumatoid Arthritis factor (RA factor) were documented, calculated, and assessed to study their correlation. Mean age was 35.36 ± 13.26 years. Mean NAPSI and NPQ10 were 41.96 ± 29.38 and 5.44 ± 5.31, respectively. Common nail findings were onycholysis (80%), subungual hyperkeratosis (75.5%), and pitting (62.2%). Joint involvement was seen in 31.11% of patients. Positive associations of NAPSI with duration of illness (P < 0.001, β = 0.57) and PASI scores (P < 0.001, β = 0.56) were observed. NPQ10 demonstrated associations with NAPSI (P < 0.001, β = 0.83) and PASI (P = 0.001, β = 0.83). Elevated ESR and CRP levels were associated with higher NAPSI scores (P < 0.001, β = 0.55, and P = 0.003, β = 0.43, respectively). Furthermore, duration of illness, NAPSI, and NPQ10 scores were positively correlated with joint involvement (P < 0.05). A strong correlation between nail psoriasis severity, disease duration, skin involvement, and nail-specific quality of life was observed. Furthermore, severe nail psoriasis was linked to a higher likelihood of joint involvement and elevated serological markers. These findings emphasize the importance of integrated treatment strategies for affected patients.

Prediction potential of serum sulfatide levels at diagnosis for end-stage kidney disease progression in ANCA-associated vasculitis.

The aim was to investigate the ability of serum sulfatide levels at diagnosis to reflect the cross-sectional activity and further longitudinally predict the occurrence of end-stage kidney disease (ESKD) during the follow-up period in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV), regardless of kidney involvement at diagnosis. This study included 67 patients first diagnosed with AAV with available clinical data, including Birmingham Vasculitis Activity Score (BVAS), erythrocyte sedimentation rate, C-reactive protein, and blood samples at diagnosis. Serum sulfatide levels were assessed using stored serum samples at the time of diagnosis. The median age of the 67 patients (40.3% men and 59.7% women) was 61.0 years. During follow-up, 10 (14.9%) patients progressed to ESKD, and 4 (6.0%) died. Serum sulfatide levels significantly correlated with Five-Factor Score (r = -0.242), erythrocyte sedimentation rate (r = -0.315), and renal manifestation of the BVAS items (r = -0.296), but not BVAS at diagnosis. The cutoff of serum sulfatide levels at diagnosis for ESKD progression was 332.5 pg/mL. However, no significant cutoff of serum sulfatide levels for all-cause mortality was obtained. Patients with serum sulfatide levels ≤ 332.5 pg/mL at diagnosis exhibited both significantly higher frequency of ESKD progression (22.7% vs 0%, P = .012) and lower ESKD-free survival rate than those without (P = .011). This study highlighted the clinical usefulness of measuring serum sulfatide levels at the time of diagnosis as a biomarker to predict ESKD progression in patients with AAV regardless of kidney involvement at diagnosis.

The ability of C-reactive protein-albumin ratio to predict disease activity in ulcerative colitis.

Ulcerative colitis (UC) is an incurable disease represented by relapse and remission. Noninvasive biomarkers are required to predict disease activation. This study aimed to identify noninvasive biomarkers, such as the c-reactive protein-albumin (CRP/ALB) ratio, platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR), that might forecast disease activation in UC. This retrospective study included 443 participants: 192 patients with active UC, 166 in remission, and 85healthy controls. Mayo Endoscopic Subscore was employed to assess endoscopic disease activity. Serum CRP, erythrocyte sedimentation rate (ESR), ALB levels, and complete blood count characteristics were documented. Three ratios of inflammation-related indicators were identified as CRP/ALB, PLR, and NLR. A positive correlation was found between ESR, CRP, neutrophil count, platelet count, levels of CRP/ALB, PLR, NLR, and endoscopic activity. The CRP/ALB ratio demonstrated more efficacy than the NLR and PLR in differentiating the UC patients from the controls (p = 0.007, p = 0.003, respectively) and the active group from the remission group (p < 0.001, p < 0.001, respectively). Regression analysis revealed that the CRP/ALB was significantly able to distinguish active UC from the remission group and the controls (p < 0.001, p < 0.001, respectively). The CRP/ALB ratio could be useful as an independent predictive biomarker for disease activity in UC.

Analysis of Erosion Rate and Sedimentation Rate at Batujai Dam sing USLE and MUSLE Methods

Analysis of Erosion Rate and Sedimentation Rate at Batujai Dam sing USLE and MUSLE Methods

Discrepancies in Temporal Artery Biopsy Positivity Rate Among White and Black Patients Suspected of Having Giant Cell Arteritis.

Our hypothesis is that biopsy-positive giant cell arteritis (GCA) is infrequent among Black patients. To evaluate this, we compared the temporal artery biopsy (TAB) positivity rates among White and Black patients. This is a case-control study review from all patients who underwent TAB at our institution from 2012 until 2021. The main study outcome was the TAB positivity rate. The main independent variable was race/ethnicity. Clinical and demographic features of patients undergoing TAB were compared between those with positive and negative biopsies with t tests, Wilcoxon rank sum test, χ2 test, or Fisher exact test where appropriate. A multiple logistic regression with Firth correction was performed with factors found to be significant in bivariate analysis to evaluate for independent associations with a positive biopsy. Three hundred eighty-five patients who underwent TAB for suspected GCA were included (290 White, 95 Black). Mean sedimentation rate was higher in Black patients, but otherwise, both groups had similar demographic and clinical characteristics. Positivity rate of TAB in White patients was 20.3% and 8.4% in Black patients. White race was associated with higher likelihood of TAB positivity compared with Black race (odds ratio, 3.47). Patients with positive TAB were more likely to have jaw claudication, constitutional symptoms, and higher inflammatory markers. Other factors significant in the logistic regression model included age, and inversely with decreased visual acuity. Our study results support the hypothesis that there is a discrepancy in the frequency of biopsy-confirmed GCA in patients referred for TAB, with Black patients having lower rates than their White counterparts.

Postoperative fever following surgery for oral cancer: Incidence, risk factors, and the formulation of a machine learning-based predictive model.

Postoperative fever (POF) is a common occurrence in patients undergoing major surgery, presenting challenges and burdens for both patients and surgeons yet. This study endeavors to examine the incidence, identify risk factors, and establish a machine learning-based predictive model for POF following surgery of oral cancer. A total of seven hundred and twenty-seven consecutive patients undergoing radical resection of oral cancer were retrospectively investigated. The analysis encompassed 34 parameters, incorporating demographic and clinical characteristics, biochemical and hematological assay results, surgical-related data, hospitalization costs and stay in hospital. Six machine learning models were compared by the area under the receiver operating characteristic curve (AUC). The best-performing models were selected for further analyze, including feature importance evaluation and nomogram analysis, identifying key POF risk factors, and establish a comprehensive prediction model. A total of 466 patients with surgery for oral cancer met the criteria, with an average age of (54.2 ± 11.1) years, including an POF group (n = 197) and a non-POF group (n = 269). The fever group has greater hospitalization costs, longer lengths of stay, and higher infection biochemical indicators (leucocyte ratio and erythrocyte sedimentation rate). Furthermore, Among the 6 machine learning models, logistic regression models performed best, with the higher AUC and accuracy. In univariate and multivariate logistic analysis showed that age, sex, reoperation, Charlson Comorbidity Index score (CCI), leukocyte, bleeding and blood transfusion were independent risk factors for POF of patients following surgery in oral cancer. Then seven variables were selected to establish the nomogram for predict the probability of POF by nomogram algorithm. Postoperative fever patients following radical resection of oral cancer have greater burden. Machine learning algorithms can be effectively used to identify potential risk factors of POF, which may enhance individualized treatment plans in oral cancer patient during perioperative period.

Clinical features of pediatric spinal tuberculosis at tertiary general hospital

Spinal Tuberculosis is a secondary tuberculosis due to hematogenous spread from the primary infection site (lungs) caused by the bacteria Mycobacterium tuberculosis and is chronic-destructive in nature which attacks the spine. Manifestations in the form of deformity can also be cosmetically disturbing and will certainly reduce the sufferer's quality of life. The diagnosis of Spinal Tuberculosis is difficult and it commonly presents at an advanced stage. This retrospective study was performed at tertiary general hospital to identify the demographic and presenting clinical features of pediatric Spinal Tuberculosis population. Based on demographic characteristics, it was found that majority patients were female (59.34%) and in the range of 13-18 years old (52.75%). Based on diagnostic characteristics, it was found that majority of the lesions involved the thoracic spine (72.52%), majority of Kyphotic Angle in the range of 0-40 degrees (32.97%), more patients with vertebral collapse damage levels, types of deformity changes, complications of spinal stenosis, the main complaint is back pain and usually followed by weakness in the legs, and the most common patient laboratory results are increased WBC (White Blood Cells), decreased Hgb (Hemoglobin), and increased ESR (Erythrocyte Sedimentation Rate).

Renal cell carcinoma: epidemiology, risk factors and clinicopathological profile

Background: The incidence of renal cell carcinoma (RCC) is increasing worldwide. The aims of this study were to describe epidemiological data, risk factors, clinicopathological characteristics of RCC. Methods: This cross-sectional descriptive study was carried out at the department of Urology, BIRDEM General Hospital from Janaury 2013 to July 2023. All radiological characteristics and fine needle aspiration (FNA) positive RCC cases were included and othere renal tumor such as angiolipoma, renal cyst, renal tuberculosis were excluded. Results: A total 200 RCC patients were included in the study. The mean age at presentation was 52.28 years and male (74%) were predominant. Most of the patients (66%) were asymptomatic, smoking (62%) was the most common modifiable risk factor, 50% patients had hypertension. In 54% cases right kidney was involved. Raised erythrocyte sedimentation rate was the most common (60%) paraneoplastic feature. The most common histopathologic type of renal tumour was clear cell carcinoma (70%), followed by papillary (20%) and chromophobe (6%) carcinoma; 66% of the patients presented at Robsing Stage II and 20% cases diagnosed as stage III. Conclusion: It had been observed that RCC mostly occurred in young male patient at right kidney with fewer symptomatic detection. Tobacco smoking were the most common modifiable risk factor. Diagnosis were made at advance stage of the disease. BIRDEM Med J 2025; 15(1): 16-21

Prognostic value of biohumoral markers and echocardiography images in infective endocarditis

Abstract Introduction The incidence of infective endocarditis (IE) has risen due to an increasing at-risk population and improved diagnosis through the widespread use of imaging techniques. With the surge in COVID-19 cases during the pandemic, there have been more frequent reports of patients being diagnosed with IE, likely due to factors such as immunosuppressive therapies and the use of central venous or urinary catheters. Purpose To analyze the prognostic value of biohumoral markers and valvular impairement assessed by echocardiography. Methods We conducted a retrospective observational study involving 29 patients diagnosed with IE who were admitted to our department in 2021. During hospitalization, we monitored and analyzed various biological parameters, including blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum creatinine and blood cultures. We also interpreted findings from transthoracic and transesophageal echocardiography. Results Most patients were presented with signs of inflammatory syndrome: leukocytosis upon admission in 22 patients (75.8%), elevated CRP in 28 patients (96.5%), ESR in 27 patients (93.1%), and procalcitonin in 6 patients (20.6%). Our analysis also included biomarker parameters with prognostic significance in IE: anemia was present in 22 patients (75.8%), while thrombocytopenia was observed in 11 patients (37.9%). Renal impairment was noted in 11 patients (37.9%). Among the pathogens identified Staphylococcus spp. was detected in 11 patients (37.93%), Streptococcus spp. in 5 patients (17.24%), Enterococcus spp. in 2 patients (6.89%), Acinetobacter spp. in 1 patient (3.44%), and Escherichia coli in 1 patient (3.44%). A notable proportion of cases (31.03% - 9 patients) had negative blood cultures, contrasting with findings from other registries. Vegetations were predominantly localized on the aortic valve in 15 patients (51.72%), followed by the mitral valve in 6 patients (20.68%). Less common locations included prosthetic heart valves in 5 patients (17.24%) and the tricuspid valve in 3 patients (10.34%). Among valvular complications, valve abscesses were most frequently observed in 6 patients (20.6%), followed by valve ruptures in 5 patients (17.2%), and valvular pseudoaneurysms in 2 patients (6.8%). Conclusions CRP was the most sensitive inflammation marker for assessing infection severity, while the most relevant prognostic biomarkers were hemoglobin, platelet count, and serum creatinine. Diagnosing this condition required complex analyses, as a significant percentage of patients presented with negative blood cultures. Staphylococcus spp. was the most identified microorganism. The most frequent infection sites were the native aortic valve, followed by the native mitral valve. The most common local complications included valve abscesses and valve ruptures.

P-734. Clinical Characteristics and Outcomes of Respiratory Viral Infections in the Endemic Era: A Comparative Study of COVID-19, Influenza, and RSV

Abstract Background On May 5, 2023, the World Health Organization declared the end of the public health emergency for COVID-19, marking the transition into the endemic era. In the endemic situation, there is limited data on the epidemiological of respiratory virus infections. This study aimed to compare the epidemiology and clinical outcomes of three representative respiratory viral infections (COVID-19, influenza and RSV).Table 1.Baseline characteristics of influenza, COVID-19, and RSV.Data are presented as the mean±SD or No (%).HTN, Hypertension; DM, Diabetes Mellitus; COPD, Chronic Obstructive Pulmonary Disease; TB, Tuberculosis; HIV, Human Immunodeficiency Virus; OPD, Outpatient Department; ER, Emergency Room; WBC, White Blood Cell; AST, Aspartate Aminotransferase; ALT, Alanine Aminotransferase; LDH, Lactate Dehydrogenase; CPK, Creatine Phosphokinase; proBNP, Pro-Brain Natriuretic Peptide; ESR, Erythrocyte Sedimentation Rate; CRP, C-Reactive Protein; CXR, Chest X-Ray* P &amp;lt; 0.05 Methods We conducted a multi-center, retrospective cohort study utilizing Hospital-based Influenza Morbidity and Mortality (HIMM) surveillance data from 1 September 2022 to 31 August 2023. We included laboratory-confirmed cases of COVID-19, influenza and RSV among hospitalized patients aged≥19. Clinical and laboratory data were collected from electronic medical records at each participating hospital. Demographic characteristics and clinical outcomes (pneumonia, ARDS, ICU admission and mortality) were compared among three virus groups, and the risk of severe infection was evaluated by underlying chronic medical conditions.Table 2.Comparison of outcomes among influenza, COVID-19, and RSV.Data are presented as the No (%).ICU, Intensive Care Unit; ARDS, Acute Respiratory Distress Syndrome* P &amp;lt; 0.05 Results During the study period, 1,850 laboratory-confirmed cases of COVID-19, 98 of influenza, and 63 of RSV were included in the analysis. When comparing the three virus groups, significant differences were observed in the rates of fever, cough, sputum, and dyspnea among them. Pneumonia was more common in the RSV group (65.6%) compared to the others (42.9% with influenza and 34.4% with COVID-19; p&amp;lt; 0.01) with significantly higher levels of erythrocyte sedimentation rate and C-reactive protein. In the COVID-19 group, the odds ratio for pneumonia increased to 1.46 (95% CI, 1.03-2.08) in the moderate-risk group with one chronic medical condition and to 1.54 (95% CI, 1.06-2.23) in the moderate-risk group with two chronic medical conditions, while showing an increase of 1.37 (95% CI, 0.90-1.93) in the high-risk group. ICU admission showed a similar trend with higher rate the moderate-risk groups. In comparison, the mortality rate was higher the high-risk group compared to the moderate-risk group (13.3% vs. 9.0%, p=0.066).Table 3.Risk assessment of pneumonia, ICU admission and mortality based on each underlying medical condition.ICU, Intensive Care Unit; OR, Odds Ratio; CI, Confidence Interval; DM, Diabetes Mellitus; COPD, Chronic Obstructive Pulmonary Disease; TB, Tuberculosis; HIV, Human Immunodeficiency Virus* P &amp;lt; 0.05 Conclusion Among hospitalized patients, pneumonia was more frequently identified in RSV-infected patients compared to those with COVID-19 or influenza. The risk of pneumonia development increased by underlying medical conditions.Table 4.Odds ratio of pneumonia, ICU admission and mortality based on risk group.ICU, Intensive Care Unit; OR, Odds Ratio; CI, Confidence Interval* P &amp;lt; 0.05 Disclosures All Authors: No reported disclosures

P-73. Pyogenic And Brucellar Spondylodiscitis: Comparative Analysis Of Clinical, Laboratory, And Evolutionary Features

Abstract Background Spondylodiscitis is an infection of the vertebral and the intervertebral disc. The clinical presentation varies according to the underlying etiology. We aimed to compare the clinical, laboratory and evolutionary features between pyogenic and brucellar spondylodiscitis. Methods We conducted a retrospective study including patients hospitalized in the infectious disease department for pyogenic or brucellar spondylodiscitis between 1998 and 2022. Results We encountered 44 cases of brucellar spondylodiscitis (BS) (50.6%) and 43 cases of pyogenic spondylodiscitis (PS) (49.4%). Patients with PS were significantly older (60±16 years vs 50±16 years; p=0.007). A rural origin was significantly more frequent among BS patients (88.6% vs 55.8%; p=0.001). While motor deficit was significantly more frequent among PS patients (33.3% vs 11.4%; p=0.014), nights sweats were significantly more frequent among BS patients (72.7% vs 25.6%; p&amp;lt; 0.001). As to gender, fever and back pain, no significant difference was noted. The lumbar spine was the most affected site among BS group (74.4%) and PS group (72.1%), with no significant difference (p=0.8). Laboratory investigations including white blood cells count (11153±4952/mm3 vs 6719±2910/mm3; p&amp;lt; 0.001), erythrocyte sedimentation rate (84±31mm/h vs 50±33mm/h; p&amp;lt; 0.001) and C-reactive protein levels (108±87mg/l vs 32±28mg/l; p&amp;lt; 0.001) were significantly higher among PS group. Surgical treatment was indicated in 9.3% of PS cases and in 2.3% of BS cases, with no significant difference (p=0.3). Two patients with PS were dead (4.6%). Sequelae were noted among PS cases (41.9%) and BS cases (38.6%), with no significant difference (p=0.7). Conclusion Although PS patients were older, presented more frequently with motor deficit and had higher inflammatory markers, the disease evolution was similar in comparison with BS patients. Disclosures All Authors: No reported disclosures

P-70. Outcome of Gram-Negative Periprosthetic Joint Infection after Primary and Revision Total Hip and Knee Arthroplasty

Abstract Background Gram-negative bacteria (GNB) account for 5-23% of all periprosthetic joint infections (PJI), following total knee or hip arthroplasties (TKA, THA). Literature on the management of Gram-negative PJI is limited. This study aimed to describe our experience with the presentation, management, and outcomes of Gram-negative PJI.Table 1:Baseline characteristics (N = 126 cases)Data are N (%) unless otherwise specified. Abbreviations: BMT; Bone-marrow transplant, CCI; Charlson comorbidity index, CPPD; Calcium pyrophosphate crystal deposition, CRP; C-reactive protein, DMARDs; Disease-modifying antirheumatic drugs, ESR; Erythrocyte sedimentation rate, GERD; Gastroesophageal reflux disease, IQR; Inter-quartile range, PJI; prosthetic joint infection, SD; Standard deviation, TNF; Tumor necrotic factor, WBC; white blood cell Methods A retrospective review of our infected institutional total joint registry from 2012-2023 identified 125 patients with 126 GNB PJI (60 THA and 66 TKA) according to MSIS criteria for PJI. Seventy-two cases (57%) of GNB PJI in this series were classified as acute based on the duration of symptoms of less than 4 weeks. Treatment failure was defined as reoperation for any reason, persistent infection, or reinfection post-surgery. Baseline demographics, presenting symptoms, microbiological data, and treatment outcomes were reviewed.Table 2:Therapies (N = 126 joints)Data are N (%) unless otherwise specified. Abbreviations: DAIR; Debridement, antibiotics, and implant retention, IQR; Inter-quartile range Results For baseline demographics, see Table 1. Notably, 10% of patients included in the study were immunosuppressed. Fifty-five cases (43.6%) had a history of revision prior to the diagnosis of PJI, including 44 cases with history of prior PJI. Pseudomonas aeruginosa was the most commonly isolated pathogen (31.7%). Wound drainage was associated with polymicrobial growth (40.8%). Debridement, antibiotics, and implant retention (DAIR) was utilized in 42 cases with 9.8% failure rate. History of revision arthroplasty, chronic PJI and the presence of sinus tract were associated with higher odds of reoperation within 1 year. Eighty-four cases underwent resection arthroplasty (RA), 73 had antimicrobial spacer, of those, 60 patients completed two-stage revision (TSR). At the time of reimplantation, 45/60 (75%) of cases had negative cultures (Table 2). The overall failure rate in resection group failure rate was 45.2%. Wound drainage was associated with higher odds of reoperation in this group (Table 3). The Failure rate in this cohort was 33%. Fluoroquinolones had a 90% susceptibility rate but were used infrequently for chronic suppression (25%).Table 3:Predictor factors with reoperation for any reason within 1 yearData are N (%) unless otherwise specified.Abbreviations: DAIR; Debridement, antibiotics, and implant retention, PJI; Prosthetic joint infection Conclusion Pseudomonas aeruginosa was the predominant pathogen in GNB PJI, with a high failure rate observed in the resection group. History of revision arthroplasty, chronic PJI, sinus tracts and wound drainage were associated with increased risk of reoperation within 1 year.Figure 1:Distribution of failure events across the study Disclosures Nicholas Bedard, MD, Stryker: Advisor/Consultant

P-1285. Particularities Of Non-Osteoarticular Brucellosis In Comparaison With Osteoarticular Cases

Abstract Background Osteoarticular (OA) brucellosis represent the most frequently described form of the sub-acute brucellosis. We aimed to study the clinical, laboratory and evolutionary features of non-osteoarticular (NOA) brucellosis in comparaison with OA cases. Methods We conducted a retrospective study including all patients hospitalized in the infectious disease department for sub-acute brucellosis between 1995 and 2022. Standard agglutination test titer &amp;gt; 1/160 and/or positive blood cultures to Brucella spp confirmed the diagnosis of brucellosis. Results We encountered 108 cases among which 30 cases had NOA brucellosis (27.8%). In total, NOA cases included neurobrucellosis (60%), Brucella endocarditis (23.3%) and genitourinary brucellosis (16.7%). Patients with NOA were significantly younger (30[21-44] years vs 52[37-60] years; p&amp;lt; 0.001). Vomiting (30% vs 2.6% ; p&amp;lt; 0.001) and nausea (16.7% vs 3.8%; p=0.036) were significantly more frequent among NOA cases, while night sweats (46.7% vs 70.5%; p=0.021) was significantly less frequent among NOA cases. Fever (86.7% vs 80.8%; p =0.471), weight loss (24.1% vs 38.5%; p= 0.166), myalgia (13.3% vs 23.1%; p=0.26) and asthenia (53.3% vs 44.9%; p=0.43) were noted among NOA and OA cases. Hepatomegaly was significantly more frequent among NOA cases (13.3% vs 2.6% ; p=0.049). A negative C-reactive protein (67.9% vs 24.2%; p&amp;lt; 0.001) and a normal erythrocyte sedimentation rate (75% vs 50.7%; p=0.027) were significantly more frequent among NOA cases. Leucopenia (6.7% vs 7.8%; p=1), thrombopenia (13.3% vs 6.4%; p=0.244) and hepatic cytolysis (6.7% vs 10.3%; p=0.723) were noted among NOA and OA cases. Treatment duration was significantly shorter among NOA cases (4[3-6] months vs 6[4-9] months; p&amp;lt; 0.001). Sequelae were significantly less frequent among NOA cases (3.3% vs 20.8%; p=0.37). A favorable disease evolution (83.3% vs 90.9%; p=0.311) and relapse (3.3% vs 9.1%; p=0.437) were noted among NOA and OA cases. Conclusion Clinical presentation of NOA brucellosis included vomiting and nausea more frequently, the presence of hepatomegaly and the absence of inflammatory markers, among younger patients. The treatment duration was significantly shorter in comparaison with OA brucellosis cases. Disclosures All Authors: No reported disclosures

P-75. Factors Predicting Sequelae After Treatment Of Spondylodiscitis

Abstract Background The outcome of spondylodiscitis, a serious infection of the intervertebral disc(s) and/or adjacent vertebrae, might be invalidating with the occurrence of sequelae. We aimed to study factors predicting sequelae after treatment of spondylodiscitis. Methods We conducted a retrospective study including all patients hospitalized in the infectious diseases department for spondylodiscitis between 2000 and 2022. Tubercular, brucellar and pyogenic spondylodiscitis were included in the study. Results We encountered 173 cases, among whom 78 had sequelae (45.1%). No significant difference was noted concerning the age of patients with (54[37-62] years) or without (57[41-67] years) sequelae (p=0.155). Tubercular spondylodiscitis was significantly associated with sequelae (52.6% vs 36.8% ; p=0.038). Anorexia (49.4% vs 31.2% ; p=0.016) and night sweats (57.9% vs 41.9% ; p=0.039) were significantly noted among patients with sequelae. Fever (53.8% vs 64.2% ; p=0.167), back pain (97.4% vs 93.5% ; p=0.295) and asthenia (53.2% vs 44.1% ; p=0.234) were the revealing symptoms among cases with or without sequelae. An accelerated erythrocyte sedimentation rate was noted more frequently among patients with sequelae (90.5% vs 76.5% ; p=0.018). Elevated C-reactive protein level (21.7% vs 20.7% ; p=0.873) and leukocytosis (23.1% vs 24.2% ; p=0.861) were noted among cases with or without sequelae. Treatment duration was significantly longer among patients with sequelae (11[6-15] months vs 7[4-12] months ; p=0.021). Percutaneous abscess drainage was significantly more frequent among patients with sequelae (17.1% vs 6.5% ; p=0.029). Surgery was indicated among patients with or without sequelae (14.3% vs 7.4%), with no significant difference (p=0.141). Conclusion The presence of anorexia, night sweats and an accelerated erythrocyte sedimentation rate, especially among tubercular spondylodiscitis cases, were predictor factors of sequelae after treatment. Such patients require a regular follow-up and an adequate treatment duration in order to reduce sequelae. Disclosures All Authors: No reported disclosures