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  • 1
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    Online Resource
    Comparison of clinical features between patients with anti-synthetase syndrome and dermatomyositis: results from the MYONET registry
    Oxford University Press (OUP) ; 2023
    In:  Rheumatology ( 2023-09-12)
    Details
    In: Rheumatology, Oxford University Press (OUP), ( 2023-09-12)
    Abstract: To compare clinical characteristics, including the frequency of cutaneous, extramuscular manifestations and malignancy, between adults with anti-synthetase syndrome (ASyS) and DM. Methods Using data regarding adults from the MYONET registry, a cohort of DM patients with anti-Mi2/-TIF1γ/-NXP2/-SAE/-MDA5 autoantibodies, and a cohort of ASyS patients with anti-tRNA synthetase autoantibodies (anti-Jo1/-PL7/-PL12/-OJ/-EJ/-Zo/-KS) were identified. Patients with DM sine dermatitis or with discordant dual autoantibody specificities were excluded. Sub-cohorts of patients with ASyS with or without skin involvement were defined based on presence of DM-type rashes (heliotrope rash, Gottron’s papules/sign, violaceous rash, shawl sign, V-sign, erythroderma, and/or periorbital rash). Results In total 1054 patients were included (DM, n = 405; ASyS, n = 649). In the ASyS cohort, 31% (n = 203) had DM-type skin involvement (ASyS-DMskin). A higher frequency of extramuscular manifestations, including Mechanic’s hands, Raynaud’s phenomenon, arthritis, interstitial lung disease and cardiac involvement differentiated ASyS-DMskin from DM (all P  & lt; 0.001), whereas higher frequency of any of four DM-type rashes—heliotrope rash (n = 248, 61% vs n = 90, 44%), violaceous rash (n = 166, 41% vs n = 57, 9%), V-sign (n = 124, 31% vs n = 28, 4%), and shawl sign (n = 133, 33% vs n = 18, 3%)—differentiated DM from ASyS-DMskin (all P  & lt; 0.005). Cancer-associated myositis (CAM) was more frequent in DM (n = 67, 17%) compared with ASyS (n = 21, 3%) and ASyS-DMskin (n = 7, 3%) cohorts (both P  & lt; 0.001). Conclusion DM-type rashes are frequent in patients with ASyS; however, distinct clinical manifestations differentiate these patients from classical DM. Skin involvement in ASyS does not necessitate increased malignancy surveillance. These findings will inform future ASyS classification criteria and patient management.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/kead481
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1474143-X
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  • 2
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    P230 Feasibility study of mobile phone photography as a possible outcome measure of systemic sclerosis-related digital ulcers
    Oxford University Press (OUP) ; 2022
    In:  Rheumatology Vol. 61, No. Supplement_1 ( 2022-04-23)
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 61, No. Supplement_1 ( 2022-04-23)
    Abstract: Digital ulcers cause pain and disability in patients with systemic sclerosis (SSc). They are often used as outcome measures in clinical trials; however, trials have been hampered by a lack of reliable outcome measures of healing. Photographic monitoring of digital ulcers using smartphones could overcome this difficulty. Our objective was to assess the feasibility of patients collecting mobile-phone images of their digital ‘lesions’ as a first step in a programme of research to develop a smartphone-based outcome measure. Methods An imaging protocol was developed with input from a patient representative group. Patients with SSc-related digital lesions were recruited and instructed to photograph one or more finger lesions each day over 30 days using their smartphone, at the same time each day. Instructions on how to take the photographs were given either face-to-face or remotely. An adhesive dot, placed adjacent to the lesion(s), provided a 1cm reference scale to help extract accurate measurements. Images were uploaded by each patient to a secure Dropbox folder. Image quality was assessed using six criteria: blurriness, shadow, uniform lighting, dot location, dot angle, and central positioning of the lesion. After image collection, patients were asked to complete a feedback questionnaire, with most questions on a scale of 1 (very easy) to 10 (very difficult). Results Twelve patients (10 female, age 37 to 72 years, disease duration 1 to 27 years) returned 331 photographs of 19 lesions (maximum three lesions per patient). Each patient sent a median of 30 photographs (IQR 14 to 33), with a median of 15 photographs per lesion (IQR 2 to 31). Of the 331 photographs, 24 were ‘duplicates’ taken on the same day, meaning that there were 263 ‘missing’ photographs (i.e., 570 photographs would have been taken if 19 lesions had been photographed every day). Image quality results included the following: 255 (77%) of photographs were sufficiently in focus; 268 (81%) had some shadow; lighting was even in 55 (17%); dot location was acceptable in 231 (70%); dot angle was ideal in 107 (32%); the lesion was centred in 254 (77%). Patient feedback showed 9/10 responses would be willing to record images at least 1-3 times per week, and the overall patient experience taking photographs was good, with a median rating of 3 (IQR 3 to 4). Conclusion Capturing photographs of digital lesions with a smartphone was feasible for most patients. They were able to take photographs in focus and with lesions central in the image. Support will be required to improve lighting, shadow, and dot positioning while minimising discomfort. These encouraging results will inform the next research phase to develop a smartphone app for monitoring finger lesions. Disclosure A.K. Davison: None. H. Patrick: None. P. New: None. G. Dinsdale: None. V.P. Taxiarchi: None. W.G. Dixon: None. A. Vail: None. A.K. Murray: None. M. Dickinson: None. C. Taylor: None. A.L. Herrick: None.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/keac133.229
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1474143-X
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  • 3
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    Online Resource
    Risk of Injury in Royal Air Force Training: Does Sex Really Matter?
    Oxford University Press (OUP) ; 2018
    In:  Military Medicine ( 2018-08-21)
    Details
    In: Military Medicine, Oxford University Press (OUP), ( 2018-08-21)
    Type of Medium: Online Resource
    ISSN: 0026-4075 , 1930-613X
    URL: Article
    DOI: 10.1093/milmed/usy177
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2130577-8
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  • 4
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    Feasibility study of mobile phone photography as a possible outcome measure of systemic sclerosis-related digital lesions
    Oxford University Press (OUP) ; 2022
    In:  Rheumatology Advances in Practice Vol. 6, No. 3 ( 2022-09-06)
    Details
    In: Rheumatology Advances in Practice, Oxford University Press (OUP), Vol. 6, No. 3 ( 2022-09-06)
    Abstract: Clinical trials assessing systemic sclerosis (SSc)-related digital ulcers have been hampered by a lack of reliable outcome measures of healing. Our objective was to assess the feasibility of patients collecting high-quality mobile phone images of their digital lesions as a first step in developing a smartphone-based outcome measure. Methods Patients with SSc-related digital (finger) lesions photographed one or more lesions each day for 30 days using their smartphone and uploaded the images to a secure Dropbox folder. Image quality was assessed using six criteria: blurriness, shadow, uniformity of lighting, dot location, dot angle and central positioning of the lesion. Patients completed a feedback questionnaire. Results Twelve patients returned 332 photographs of 18 lesions. Each patient sent a median of 29.5 photographs [interquartile range (IQR) 15–33.5], with a median of 15 photographs per lesion (IQR 6–32). Twenty-two photographs were duplicates. Of the remaining 310 images, 256 (77%) were sufficiently in focus; 268 (81%) had some shadow; lighting was even in 56 (17%); dot location was acceptable in 233 (70%); dot angle was ideal in 107 (32%); and the lesion was centred in 255 (77%). Patient feedback suggested that 6 of 10 would be willing to record images daily in future studies, and 9 of 10 at least one to three times per week. Conclusion Taking smartphone photographs of digital lesions was feasible for most patients, with most lesions in focus and central in the image. These promising results will inform the next research phase (to develop a smartphone monitoring application incorporating photographs and symptom tracking).
    Type of Medium: Online Resource
    ISSN: 2514-1775
    URL: Article
    DOI: 10.1093/rap/rkac105
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2899298-2
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  • 5
    Online Resource
    Online Resource
    Current Epidemiology and Clinical Features of Cryptococcus Infection in Patients Without Human Immunodeficiency Virus: A Multicenter Study in 46 Hospitals in Australia and New Zealand
    Oxford University Press (OUP) ; 2023
    In:  Clinical Infectious Diseases Vol. 77, No. 7 ( 2023-10-05), p. 976-986
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 77, No. 7 ( 2023-10-05), p. 976-986
    Abstract: Patients without human immunodeficiency virus (HIV) are increasingly recognized as being at risk for cryptococcosis. Knowledge of characteristics of cryptococcosis in these patients remains incomplete. Methods We conducted a retrospective study of cryptococcosis in 46 Australian and New Zealand hospitals to compare its frequency in patients with and without HIV and describe its characteristics in patients without HIV. Patients with cryptococcosis between January 2015 and December 2019 were included. Results Of 475 patients with cryptococcosis, 90% were without HIV (426 of 475) with marked predominance in both Cryptococcus neoformans (88.7%) and Cryptococcus gattii cases (94.3%). Most patients without HIV (60.8%) had a known immunocompromising condition: cancer (n = 91), organ transplantation (n = 81), or other immunocompromising condition (n = 97). Cryptococcosis presented as incidental imaging findings in 16.4% of patients (70 of 426). The serum cryptococcal antigen test was positive in 85.1% of tested patients (319 of 375); high titers independently predicted risk of central nervous system involvement. Lumbar puncture was performed in 167 patients to screen for asymptomatic meningitis, with a positivity rate of 13.2% where meningitis could have been predicted by a high serum cryptococcal antigen titer and/or fungemia in 95% of evaluable cases. One-year all-cause mortality was 20.9% in patients without HIV and 21.7% in patients with HIV (P = .89). Conclusions Ninety percent of cryptococcosis cases occurred in patients without HIV (89% and 94% for C. neoformans and C. gattii, respectively). Emerging patient risk groups were evident. A high level of awareness is warranted to diagnose cryptococcosis in patients without HIV.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/ciad321
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2002229-3
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  • 6
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    Online Resource
    Anal Dysplasia in Human Immunodeficiency Virus-Infected Men Who Have Sex With Men With Sexually Acquired Early Hepatitis C Virus Infection
    Oxford University Press (OUP) ; 2019
    In:  Open Forum Infectious Diseases Vol. 6, No. 11 ( 2019-11-01)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 6, No. 11 ( 2019-11-01)
    Abstract: Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of anorectal infection with high-risk human papillomavirus and subsequent high-grade squamous intraepithelial lesions (HSIL), the putative precursor to anal cancer. Recently, an epidemic of sexually transmitted hepatitis C virus (HCV) has emerged that shares this anorectal route of transmission. We hypothesized that the prevalence of anal HSIL would be high in HIV-infected MSM with sexually acquired early HCV infection. Methods High-resolution anoscopy (HRA) findings from a cohort of HIV-infected MSM with sexually acquired early HCV infection were compared with HRA findings from a contemporary cohort of HIV-infected MSM without HCV infection who underwent HRA due to abnormal anal cytology found during routine screening. Results Sixty HIV-infected MSM with sexually acquired early HCV infection and the comparator group of 1150 HIV-infected MSM with abnormal anal cytology but without HCV underwent HRA. The HIV-infected MSM with sexually acquired early HCV had higher CD4 counts compared with the comparator group (656 and 541 cells/μL, respectively; P = .02). Despite this, the prevalence of anal dysplasia was as high among MSM with early HCV as in the comparator group of MSM with abnormal cytology (47 [78%] and 941 [82%] , respectively; P = .50), as was the proportion with HSIL (25 [42%] and 379 [33%] , respectively; P = .17). Conclusions The prevalence of anal dysplasia in HIV-infected MSM with sexually acquired early HCV infection was as high as that of HIV-infected MSM with abnormal anal cytology. These findings suggest that primary screening with HRA may be warranted for HIV-infected MSM with early HCV.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofz339
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2757767-3
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