Registry-based Cross-sectional Study Research Articles

Years of Life Lost Due to Complete Suicide in Iran: A National Registry-Based Study.

Suicide was the fourth leading cause of death among individuals aged 15 to 29 years worldwide in 2019, highlighting its significant impact on young people. Iran's suicide-related mortality rate was 5.1 per 100000 population in the same year, which is lower than the global average. This study aimed to estimate the years of life lost (YLLs) due to complete suicide in Iran. Study Design: A registry-based cross-sectional study. The data on complete suicide cases used in this study were obtained from the national suicide registry of the Iranian Forensic Medicine Organization (FMO) that was registered between March 21, 2016 and March 20, 2020. The total number of YLL due to premature death by suicide over the four-year period was 611068 years (15.97 per 1000 persons) in males, 286847 years (7.65 per 1000 persons) in females, and 897915 years (11.86 per 1000 persons) for both genders. Moreover, the age group of 15-29 years experienced the highest YLL attributed to suicide. Furthermore, the study revealed an increasing trend of YLL due to suicide among individuals aged 30-44. These findings highlight the significant impact of suicide on the loss of potential years of life in Iran. The study indicates that the young and productive age groups of 15-29 and 30-44 years are particularly affected, with the highest YLL due to complete suicide. The study provides valuable insights for designing targeted and evidence-based suicide prevention programs that can reduce the burden of suicide in Iran, particularly among young and middle-aged adults.

War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia

The war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented. To assess the association of the war with the utilization of health care services for patients with chronic diseases. Of 135 primary health care facilities, a registry-based cross-sectional study was conducted on 44 rural and semiurban facilities of Tigray. Data on health services utilization were extracted for patients with tuberculosis, HIV, diabetes, hypertension, and psychiatric disorders in the prewar period (September 1, to October 31, 2020) and during the first phase of the war period (November 4, 2020, to June 30, 2021). Records on the number of follow-up, laboratory tests, and patients undergoing treatment of the aforementioned chronic diseases were counted during the prewar and war periods. Of 4645 records of patients with chronic diseases undergoing treatment during the prewar period, 998 records (21%) indicated having treatment during the war period. Compared with the prewar period, 59 of 180 individuals (33%; 95% CI, 26%-40%) had tuberculosis, 522 of 2211 (24%; 95% CI, 22%-26%) had HIV, 228 of 1195 (19%; 95% CI, 17%-21%) had hypertension, 123 of 632 (20%; 95% CI, 16%-22%) had psychiatric disorders, and 66 of 427 (15%; 95% CI, 12%-18%) had type 2 diabetes records, which revealed continued treatment during the war period. Of 174 records of patients with type 1 diabetes in the prewar period, at 2 to 3 months into the war, the numbers dropped to 10 with 94% decline compared with prewar observations. This study found that the war in Tigray has resulted in critical health care service disruption and high loss to follow-up for patients with chronic disease, likely leading to increased morbidity and mortality. Local, national, and global policymakers must understand the extent and impact of the service disruption and urge their efforts toward restoration of those services.

The incidence and prevalence of crude and familial multiple sclerosis in Tehran, Iran in 2021.

Our registry-based cross-sectional study covered 27,508 PwMS in Tehran with a point incidence rate and prevalence of 7.87 and 194.62 per 100,000 in 2021, respectively. We found that the incidence and prevalence of MS in Tehran are still on an upward trend which requires general attention and measures to overcome. The proportion of men with a family history of MS was significantly higher. Whilst IMSS deals with economic difficulties, it continues to collect new PwMS to reach regional-level coverage in Tehran for better MS care services.

Impact and burden of sickle cell disease in critically ill obstetric patients in a high dependency unit in Sierra Leone—a registry based evaluation

IntroductionSickle cell disease (SCD) in pregnancy is associated with worse maternal and neonatal outcomes. There is limited available data describing the burden and outcomes of critically ill obstetric patients affected by SCD in low-income settings.ObjectivesWe aimed to define SCD burden and impact on mortality in critically-ill obstetric patients admitted to an urban referral hospital in Sierra Leone. We hypothesized that SCD burden is high and independently associated with increased mortality.MethodsWe performed a registry-based cross-sectional study from March 2020 to December 2021 in the high-dependency unit (HDU) of Princess Christian Maternity Hospital PCMH, Freetown. Primary endpoints were the proportion of patients identified in the SCD group and HDU mortality. Secondary endpoints included frequency of maternal direct obstetric complications (MDOCs) and the maternal early obstetric warning score (MEOWS).ResultsOut of a total of 497 patients, 25 (5.5%) qualified to be included in the SCD group. MEOWS on admission was not different between patients with and without SCD and SCD patients had also less frequently reported MDOCs. Yet, crude HDU mortality in the SCD group was 36%, compared to 9.5% in the non SCD group (P < 0.01), with an independent association between SCD group exposure and mortality when accounting for severity on admission (hazard ratio 3.40; 95%CI 1.57—7.39; P = 0.002). Patients with SCD had a tendency to longer HDU length of stay.ConclusionsOne out of twenty patients accessing a HDU in Sierra Leone fulfilled criteria for SCD. Despite comparable severity on admission, mortality in SCD patients was four times higher than patients without SCD. Optimization of intermediate and intensive care for this group of patients should be prioritized in low-resource settings with high maternal mortality.

Epidemiological parameters of multiple sclerosis in Chaharmahal and Bakhtiari Province, Iran.

Background: Multiple sclerosis (MS) is a neurological disease with a high burden and disability. There are reports of various medications' side effects on patients with MS. The aim of the study is to determine the characteristics and medicine usage distribution among patients with MS in Chaharmahal and Bakhtiari Province in Iran. Methods: This registry-based cross-sectional study was performed among MS cases in Chaharmahal and Bakhtiari Province. The epidemiological data were collected from the nationwide MS registry of Iran (NMSRI) from 2019 to 2022. The information collected included age, sex, family history, type of MS, age at MS onset and diagnosis, MS symptoms, physical condition, and history of medication use. All tests were performed at a significance level of 0.05 using SPSS software. Results: A total of 416 patients included in this study. Among them, 325 individuals (78%) were women with mean ± standard deviation (SD) of age of 37.35 ± 8.51 years. No significant difference was observed between men and women in terms of age, type of MS disease, family history of MS, and physical condition (P > 0.05). The results showed that the Expanded Disability Status Scale (EDSS) score in female patients (1.41) was different from the EDSS score in male patients (1.77) (P < 0.05). Most of the patients often used interferon beta (IFN-β). Conclusion: The results provided new insight into the epidemiology and medicine patterns of patients with MS in Chaharmahal and Bakhtiari Province. The epidemiological situation of MS in this province is similar to other parts of Iran. Planning according to national programs is suggested for the management and control of MS.

GLYCAEMIC CONTROL AMONG SAUDI PATIENTS WITH TYPE 2 DIABETES MELLITUS AT FIRST TIME REGISTRY IN RAQEB RECORDS FROM 2018-2022

Background:Diabetes Mellitus (DM) is a major risk factor for many complications and glycaemic control prevents and delays such complications. The Raqeb registry aims toimprove diabetic patientscontrol of their diabetes by giving them glucometers. Objective:This study aims to determine the prevalence of type 2 diabetes (T2DM) glycaemic control in all regions of Saudi Arabia using Raqeb data, as well as outline the factors associated with uncontrolled T2DM. Methods:This paper conducted a registry-based cross-sectional study among all patients with T2DM who registered in Raqeb from October 16, 2018, to July 17, 2022. According to the American Diabetes Association, for non-pregnant adults, HbA1c can be used to assess glycaemic control according to the HbA1c target of &lt; 7% (control DM) and ≥7 (uncontrolled DM). To identify glycaemic control determinants, the present study used multivariate logistic regression analysis, while SPSS v26 software was used for data entry and analysis. Results: In the study, the mean level of HbA1c of the patients was 8.4 (SD1.7) and approximately 86% of the patients had uncontrolled diabetes mellitus (HbA1c ≥ 7%). Multivariate analysis revealed that being over 45 years old, using hypoglycaemic agents (OHA) and insulin, being followed up in a diabetic centre and being from the Western, Southern or Northern regions were all significant predictors of poor glycaemic control. Meanwhile, the female gender and OHA treatment were linked to a lower risk of poor glycaemic control. Conclusion:Using data from Saudi Arabias Raqeb registry of T2DM patients, this different level of care database analysis over a five-year period revealed uncontrolled DM. An increased risk of uncontrolled DM in T2DM patients was seen in those over the age of 45 years and patients using OHA and insulin treatment, as well as people from the Western, Southern or Northern regions of Saudi Arabia.

Delta of Egypt Atrial Fibrillation Registry Phase Two

Background: Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia found in clinical practice. The assessed frequency of AF in adults is between 2% and 4%, with greater incidence and frequency rates in developed nations [1,2]. AF prevalence increases with advancing age, and with some cardiac and non-cardiac disorders, also it may exist in the absence of any conditions [2]. We aimed to determine case characteristics, practice patterns, management strategies and outcomes of atrial fibrillation in the delta area of Egypt.&#x0D; Methods: This registry-based cross-sectional study included 1000 atrial fibrillation patients (with any AF patterns) who were allowed to enter ER in cardiac centers and hospitals in middle Delta of Egypt from April 2020 to March 2021.&#x0D; Results: 267 patients (26.7%) were unstable. Heart failure, hypertension, and coronary disease were still prevalent comorbidities in our AF dataset, where hypertension accounts for over 50% of all AF cases. Rheumatic valvular heart disorder was a major underlying disease for the development of AF, still about 25.5% by echocardiography. Lone AF still high 20.6%. CHA2DS2VASc score ≥2 is 83.5%. A high proportion of cases were treated with pharmaceuticals for rate control nearly 52.7% of the cases and nearly 30.3% of the cases were given pharmacological medications for the cardioversion to the sinus rhythm and a small proportion of the cases were given electrical cardioversion nearly 7%.&#x0D; Conclusions: Coronary disease, hypertension, and heart failure were still usual comorbidities in AF. Rheumatic valvular heart disease is still about 25.5% of the total registry. Amiodarone is the most prevalent antiarrhythmic medications (AAD) used. lone AF still high 20.6%. minimal use of novel oral anticoagulant (OAC).

P431 Factors related to higher level of physical activity in Swedish cystic fibrosis-patients – a registry-based cross sectional study

P431 Factors related to higher level of physical activity in Swedish cystic fibrosis-patients – a registry-based cross sectional study

Estimated frequency of instrumented vaginal delivery in Colombia between 2015 and 2019. Population registry-based cross-sectional study

To assess the frequency of instrumented delivery in Colombia and by regions between 2015 and 2019. Cross-sectional study based on population registries. Records of women with a gestational age of more than 28 weeks and vaginal delivery were included. Consecutive sampling was used. The information was taken from live birth certificates of the National Administrative Department of Statistics (DANE). Sociodemographic and clinical variables were described. The frequency of instrumented deliveries was calculated and described by year and by department. Overall, 3,224,218 live birth records were included. Of these 1,719,405 (53.33 %) were vaginal deliveries and 1,468,726 (45.55 %) were cesarean births. At a national level, the frequency of instrumented deliveries between 2015 and 2019 was 36,087 births (1.11 %); Antioquia and Bogotá, D.C. were the places with the highest occurrence, with 16,201 (4.5 %) and 13,686 (2.52 %), respectively. The occurrence of instrumented vaginal delivery in Colombia is the lowest and tends to diminish. Training of healthcare professionals in this approach during labor must not be abandoned, particularly in Obstetrics and Gynecology training programs. Further studies should be conducted to determine whether the increased adequate use of this technique could contribute to a lower rate of cesarean sections, and also to describe the clinical setting in which its use is safe for both the mother and the fetus. Prospective studies are required to identify the causes leading to the lower use of this obstetric tool as well as the risks and benefits in terms of maternal and perinatal outcomes.

Coronary calcium score in the initial evaluation of suspected coronary artery disease

ObjectiveWe evaluated coronary artery calcium (CAC) scoring as an initial diagnostic tool in outpatients and in patients presenting at the emergency department due to suspected coronary artery disease (CAD).Methods10 857...

Associations between social integration, participation and productivity loss among persons with chronic pain: a registry based cross sectional study

PurposeTo examine associations between factors of social inclusion and participation and productivity loss in employed persons with chronic pain, assessed for an interprofessional pain rehabilitation programme. We hypothesized that factors of social inclusion and participation and work related social factors are significantly associated with productivity when experiencing chronic pain and we expected a moderate effect.MethodsCross-sectional study using data collected prospectively in an interprofessional patient registry for chronic pain. The primary end point was productivity loss, measured with the iMTA Productivity Costs Questionnaire. We included data from 161 individuals. To be included, persons had to be 18 years old or older, in paid work, and had to have a medical diagnosis of chronic pain syndrome with actual or potential tissue damage. In addition, participants had to have indicators of significant impairments in psychosocial functions.ResultsLinear regression analysis showed that a highly stressful professional situation, frequent problems regarding the compatibility of the family and job and not being Swiss were associated with a significantly higher total productivity loss. Similar results were found for productivity loss in paid work. However, problems concerning the compatibility of the family and job did not reach the significance level for productivity loss in paid work.ConclusionThe results of this study underscore the importance of factors of social inclusion and participation for interprofessional rehabilitation programmes to manage chronic pain especially when focussing on productivity loss.

Prevalence of Lung Cancer in Al Najaf Governorate Registered in Middle Euphrates Oncology Center during 2019 and 2020

Background: Lung cancer is a disease in which cells in the lung grow out of control and may spread to lymph nodes or other organs in the body such as the brain. Cancer from other organs also may spread to the lungs. The chance that a man will develop lung cancer in his lifetime is about 1 in 15; for a woman, the risk is about 1 in 17. These numbers include both people who smoke and those who don't smoke. Worldwide; prevalence of the lung cancer was decreased in the last decade.&#x0D; Objectives: To determine the prevalence of lung cancer in Al Nagaf Governorate during 2019 and 2020&#x0D; Patients and Methods:&#x0D; A Registry-based cross sectional study was conducted at middle Euphrates oncology center in Al Najaf city from October 2021 to February 2022. data was collected from this center and from the Iraqi National Cancer Registry (INCR) annual reports. Independent t test (Mean±SD) and X2 test was used, P value at &lt; 0.05 was significant. Results: In 2019; there were 98 (53.60%) patients diagnosed with lung CA, while in 2020, there were 85 (46.40%) patients. 59 (32.20%) patients were within age 60-69 years and 59 (32.20%) patients were within age 70-79 years. There were 125 (68.3%) males and 58 (31.7%) females, 138 (75.40%) smokers, and 59 (32.20%) patients were overweight. 103 (56.3%) patients diagnosed with SCC, 43 (23.5%) with adenocarcinoma, 32 (17.5%) with small cell CA. Cancer metastasis found among 108 (59%) patients. bone in 35 (19.1%) patients and to the Liver in 30 (16.4%) patients. Prevalence of Lung CA in 2019 was 6.5/105 (in males 8.72/105 and 4.25/105 in females). During 2020; there were 59 males and 26 females. Prevalence of Lung CA was 5.5/105 (in males 6.7/105 and 3.4/105 in females). Small cell CA was significantly associated with patients aged 60-69 years, smokers, diagnosis with biopsy, metastasis to the supraclavicular LN, and metastasis to the liver (P&lt;0.05).&#x0D; Conclusions: Prevalence of lung CA in 2019 was higher than that in 2020. Males were dominant in lung CA. Metastasis was found among more than half of patients; bone and liver were the most common metastasized organs. The most common types of cancer were Squamous Cell CA, adenocarcinoma, and Small Cell CA.

Clinical pattern and drug-related problems among colorectal cancer patients at oncology center in Ethiopia: A hospital-based study.

Objective:Despite the fact that cancer patients are highly susceptible to drug-related problems due to the effects of cytotoxic agents, data are limited due to a lack of studies on those patients. Hence, we aimed to investigate drug-related problems among patients diagnosed with colorectal cancer.Method:A registry-based cross-sectional study was conducted on colorectal cancer patients at the Felege Hiwot Comprehensive Specialized Hospital. Socio-demographic and disease-related characteristics, treatment regimens, and drug-related problems were recorded by reviewing medical records. Standard guidelines, protocols, and databases were used to evaluate the occurrence of drug-related problems and the severity of adverse drug reactions. For the analysis, Stata version 16/MP for Windows was used. Logistic regression analysis was employed to investigate the potential-associated factors of drug-related problems. A p-value ⩽ 0.05 was used to declare the statistical significance of each independent variable.Results:A total of 150 colorectal cancer patients were included, with a mean age of 51.4 ± 13.8 years. About 30% and 41.3% had stage II and stage III cancers, respectively. About three-quarters (73.8%) of the patients were given 5-fluorouracil-based combination regimens. The prevalence of drug-related problems was found to be 48.7%, with a mean of 2.12 ± 0.93 drug-related problems. In the Felege Hiwot Comprehensive Specialized Hospital, drug–drug interactions and adverse drug reactions were the most prevalent drug-related problems, which accounted for 50 (32.7%) and 49 (32%) cases, respectively. Being elderly (>50 years old) (p = 0.013), having co-morbidity (p = 0.001), and being on five or more medications (p = 0.002) were independent predictors of drug-related problems.Conclusion:Fluorouracil-based chemotherapy was the most frequently used treatment regimen. Almost, half of the colorectal cancer patients had one or more drug-related problems. About one-third of patients had adverse drug reactions and drug–drug interactions. Furthermore, age, co-morbidity status, and the number of medications used were significantly associated with drug-related problems. Clinical pharmacy services should be implemented to optimize drug therapy because the majority of colorectal cancer patients have one or more drug-related problems.

POSC189 A Patient Registry-Based Cross-Sectional Study of the Burden and Management of Comorbid Psoriatic Arthritis (PsA) in Patients with Systemic Lupus Erythematosus (SLE)

Coexistence of PsA and SLE is considered rare. Given the potential for phototherapy or drug-induced exacerbation of SLE, or worsening psoriasis with some biologic treatments, this study sought to better understand the burden of real-world comorbidities critical to optimizing patient outcomes. The OM1 SLE Registry (OM1;Boston, MA) follows 46,900+ SLE patients in the U.S. managed by rheumatologists longitudinally w/deep clinical data, including laboratory, patient-reported and disease activity information, and linked claims, starting from 2013. Index date was set by the first encounter w/SLE diagnosis code and ≥18 months of baseline available. Comorbidities were defined by ≥2 outpatient diagnosis codes ≥30 days apart or one inpatient diagnosis code prior to index. Obesity was defined as BMI≥30 kg/m2. Medications were identified by prescriptions, administrations or fills. RAPID3 (Routine Assessment of Patient Index Data 3) at index was also explored. Study included 44,186 patients (92% female, mean age 51 years) from the OM1 SLE Registry, 703 (1.4%) of whom had documented PsA. Patients with co-morbid PsA were slightly older, with higher proportion male (12% vs. 8%), white (68% vs. 56%) and non-Hispanic (69% vs. 64%) patients. Patients with PsA were more likely to be obese (50% vs. 40%). Mean joint-related disease activity was moderate (mean RAPID-3=4) across patients. Proportion with other autoimmune conditions were similar. Recent treatment w/systemic steroids, methotrexate, leflunomide and TNFa and IL-17 or IL12/23 inhibitors was more common in SLE-PsA patients. Hydroxychloroquine was less commonly used in PsA patients (31% vs. 42%). Managing T-cell and B-cell-driven conditions simultaneously poses a clinical challenge, attempting to balance treating cutaneous and joint-related manifestations with exacerbating disease flares. Clinical development and availability of therapies with other mechanisms of action may provide important alternatives. Since clinical trials typically exclude many comorbid conditions, real-world data regarding these complex phenotypes provide important insights into tailored treatment strategies.

Clinical, Laboratory, and Ultrasound Related Diagnoses of Thyroid Disorders: Using a Family Medicine Center Data to Assess Thyroiditis and Thyroid Nodules in the Eastern Province of Saudi Arabia.

Introduction/Objectives:The prevalence of thyroid disorders is high in Saudi Arabia. Among the disorders, goiter and thyroiditis are the most common and have unique ultrasound (US) features, underscoring the need for US screening for thyroid pathologies. This study aimed to determine the prevalence of thyroiditis and thyroid nodules in patients attending the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University.Methods:This registry-based cross-sectional study analyzed laboratory and US data from 240 patients who attended the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University from January 2020 to December 2021. Abnormalities of the thyroid gland were categorized according to laboratory and US data. Associations between different types of thyroid pathology and clinical and laboratory findings were assessed using appropriate statistical methods.Results:The majority of participants were Saudi women. The prevalence of thyroiditis in the study population was 43%. Approximately 25% of these patients had more than 1 nodule, and fine-needle aspiration biopsy showed that most nodules were benign. Most nodules were found in clinically euthyroid patients. Thyroiditis might be associated with abnormal thyroid function.Conclusions:Thyroiditis and thyroid nodules were common in our cohort. Vitamin D deficiency, other autoimmune diseases, and a family history of thyroid disorders were associated with thyroiditis and thyroid nodules. US is useful for identifying the type of thyroid disease.

General and COVID-19-Related Mortality by Pre-Existing Chronic Conditions and Care Setting during 2020 in Emilia-Romagna Region, Italy.

In 2020, the number of deaths increased in Italy, mainly because of the COVID-19 pandemic; mortality was among the highest in Europe, with a clear heterogeneity among regions and socio-demographic strata. The present work aims to describe trends in mortality and to quantify excess mortality variability over time and in relation to demographics, pre-existent chronic conditions and care setting of the Emilia-Romagna region (Northern Italy). This is a registry-based cross-sectional study comparing the 2020 observed mortality with figures of the previous five years by age, sex, month, place of death, and chronicity. It includes 300,094 deaths in those 18 years of age and above resident in the Emilia-Romagna region. Excess deaths were higher during the first pandemic wave, particularly among men and in March. Age-adjusted risk was similar among both men and women (Mortality Rate Ratio 1.15; IC95% 1.14–1.16). It was higher among females aged 75+ years and varied between sub-periods. Excluding COVID-19 related deaths, differences in the risk of dying estimates tended to disappear. Metabolic and neuropsychiatric diseases were more prevalent among those that deceased in 2020 compared to the deaths that occurred in 2015–2019 and therefore can be confirmed as elements of increased frailty, such as being in long-term care facilities or private homes as the place of death. Understanding the impact of the pandemic on mortality considering frailties is relevant in a changing scenario.

Outcomes and Risk Factors Associated With SARS-CoV-2 Infection in a North American Registry of Patients With Multiple Sclerosis

Emergence of SARS-CoV-2 causing COVID-19 prompted the need to gather information on clinical outcomes and risk factors associated with morbidity and mortality in patients with multiple sclerosis (MS) and concomitant SARS-CoV-2 infections. To examine outcomes and risk factors associated with COVID-19 clinical severity in a large, diverse cohort of North American patients with MS. This analysis used deidentified, cross-sectional data on patients with MS and SARS-CoV-2 infection reported by health care professionals in North American academic and community practices between April 1, 2020, and December 12, 2020, in the COVID-19 Infections in MS Registry. Health care professionals were asked to report patients after a minimum of 7 days from initial symptom onset and after sufficient time had passed to observe the COVID-19 disease course through resolution of acute illness or death. Data collection began April 1, 2020, and is ongoing. Laboratory-positive SARS-CoV-2 infection or highly suspected COVID-19. Clinical outcome with 4 levels of increasing severity: not hospitalized, hospitalization only, admission to the intensive care unit and/or required ventilator support, and death. Of 1626 patients, most had laboratory-positive SARS-CoV-2 infection (1345 [82.7%]), were female (1202 [74.0%]), and had relapsing-remitting MS (1255 [80.4%]). A total of 996 patients (61.5%) were non-Hispanic White, 337 (20.8%) were Black, and 190 (11.7%) were Hispanic/Latinx. The mean (SD) age was 47.7 (13.2) years, and 797 (49.5%) had 1 or more comorbidity. The overall mortality rate was 3.3% (95% CI, 2.5%-4.3%). Ambulatory disability and older age were each independently associated with increased odds of all clinical severity levels compared with those not hospitalized after adjusting for other risk factors (nonambulatory: hospitalization only, odds ratio [OR], 2.8 [95% CI, 1.6-4.8]; intensive care unit/required ventilator support, OR, 3.5 [95% CI, 1.6-7.8]; death, OR, 25.4 [95% CI, 9.3-69.1]; age [every 10 years]: hospitalization only, OR, 1.3 [95% CI, 1.1-1.6]; intensive care unit/required ventilator support, OR, 1.3 [95% CI, 0.99-1.7]; death, OR, 1.8 [95% CI, 1.2-2.6]). In this registry-based cross-sectional study, increased disability was independently associated with worse clinical severity including death from COVID-19. Other risk factors for worse outcomes included older age, Black race, cardiovascular comorbidities, and recent treatment with corticosteroids. Knowledge of these risk factors may improve the treatment of patients with MS and COVID-19 by helping clinicians identify patients requiring more intense monitoring or COVID-19 treatment.

Ageing and the natural history of dry eye disease: A prospective registry-based cross-sectional study

PurposeTo investigate the impact of ageing on ocular surface parameters, and empirically determine optimal prognostic cut-off ages for clinical markers of dry eye disease, aqueous tear deficiency, and meibomian gland dysfunction. MethodsA total of 1331 community residents (785 females, 546 males; mean ± SD age, 38 ± 19 years) were recruited in a prospective registry-based cross-sectional study. Dry eye symptomology, ocular surface characteristics, and tear film quality were evaluated for each participant within a single clinical session, in accordance with the global consensus recommendations of the TFOS DEWS II reports. ResultsMultivariate regression analysis demonstrated positive associations between ageing and clinical markers of dry eye disease (all p ≤ 0.001). The Youden-optimal prognostic cut-off ages for signs of meibomian gland dysfunction occurred during the third decade of life (24–29 years); the optimal predictive ages for lid wiper epitheliopathy, tear film instability, hyperosmolarity, and dry eye symptoms occurred during the fourth decade of life (31–38 years); while the optimal prognostic thresholds for signs of aqueous tear deficiency and ocular surface staining occurred in the fifth and sixth decades of life (46–52 years). ConclusionsAdvancing age is a significant risk factor for dry eye disease, which represents a growing public health concern with the ageing population worldwide. Signs of meibomian gland dysfunction appeared earlier in the natural history of disease progression, and the brief delay prior to the development of other clinical dry eye signs might represent a window of opportunity for preventative interventions in the young adult age group.

Hidradenitis Suppurativa in Sweden: A Registry-Based Cross-Sectional Study of 13,538 Patients

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition with nodules and fistula formation and scarring. It is a debilitating disease with a severe negative impact on quality of life. There is a need for increased knowledge about the social and lifestyle characteristics of patients with HS in general, and pregnant women in particular. Objectives: The aims of this study were to investigate and describe social characteristics and comorbidity in all HS patients in Sweden as well as to study the prevalence of lifestyle factors associated with negative impact on health and pregnancy in Swedish pregnant women with HS. Methods: A registry-based cross-sectional study was performed by record linkage between Swedish registers covering the entire population. A cohort of 13,538 HS patients diagnosed with HS in specialised care during the years 2001–2014 and a subgroup of 1,368 HS patients who had undergone pregnancy during 2010–2015 were defined and described. Aggregated public data on the entire Swedish population and all pregnancies in 2014 were described for reference. Results: The HS population had an average age of 44 years on December 31, 2014. The prevalence of HS was 0.14%. In comparison to the Swedish reference population the HS patients were more often women, unmarried (36 vs. 44% married), and had lower education (68 vs. 82% with an upper-secondary school degree or higher) and lower income (39 vs. 16% made SEK <100,000 a year). Comorbidity was 3% for inflammatory bowel disease and 8% for type 2 diabetes. The subgroup analysis showed high prevalence of overweight, obesity, and smoking in pregnant women with HS. Conclusions: The results from this comprehensive characterisation of Swedish HS patients may be used to improve preventive measures, information, and care for this vulnerable group.

The reasons for colposcopy and histopathological outcomes in referral patients to Ayatollah Mosavi Hospital of Zanjan (2012–2017)

Objectives: The present study aimed at assessing the prevalence of cervical cancer and premalignant lesions of the cervix in patient referred to colposcopy unit in Zanjan, and to determine what extent colposcopy is conducted based on the scientific indications. Materials and Methods: In this registry-based cross-sectional study, all women who were referred to the Colposcopy unit of Zanjan Ayatollah-Mousavi Hospital to undergo colposcopy during 2012–2017 were studied. The required data were collected from the registered medical records in the Pathology Department of the hospital. The Bethesda System Terminology was used for classifying premalignant cervical lesions. Results: In the present study, the most common abnormal clinical signs were abnormal vaginal bleeding, whereas atypical squamous cells of undetermined significance (39.5%) remained the most common abnormal Pap smear test result. The clinical appearance of the cervix in 104 patients (62.3%) showed cervical erosion. The results of colposcopy showed some signs of inflammation in all patients. Out of these patients, 5.4% were reported with acute inflammation, and 39.5% with chronic inflammation. Conclusions: It can be concluded that the patients' referral for a colposcopy must be based on the scientific indications and unnecessary colposcopy should be avoided.