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You searched for subject:(Paediatric Rheumatology). Showing records 1 – 3 of 3 total matches.

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University of Cape Town

1. Okong'o, Lawrence Owino. Demographic and clinical characteristics of children with juvenile dermatomyositis in Cape Town.

Degree: Image, Division of Rheumatology, 2015, University of Cape Town

Study rationale: Juvenile dermatomyositis (JDM) is a rare idiopathic inflammatory myopathy of childhood with an incidence of 1.9-3.2 per million. The aetiology of JDM is uncertain but may result from immune dysregulation triggered by environmental factors in genetically susceptible children. The demographic and clinical characteristics of JDM may thus differ by race and geographic regions. Few studies have described the characteristics of JDM patients from Africa. There is need for further studies for better understanding of the epidemiology, clinical characteristics and outcome of patients with JDM from the continent. Methods: We conducted a retrospective observational study to determine clinical characteristics and outcomes of patients satisfying the Bohan and Peter criteria for probable JDM seen between 2004-2013 in Red Cross, Groote Schuur and Tygerberg hospitals in Cape Town. Data was analyzed using R version 3.1.0 (2014-04-10). Results: Twenty-five cases were identified: 16 female and 9 male. Thirteen (52%) of the cases were of indigenous African, eleven (44%) mixed and one (4%) European ancestry. The median ages at disease onset and diagnosis were 6.75 (range 2.0-9.7) and 7.9 (range 3.4-9.75) years respectively. Muscle weakness and characteristic cutaneous manifestations occurred in all the 25 patients while 24 had elevated muscle enzymes. All the patients received corticosteroids, seventeen (73.9%) received methotrexate and four received rituximab. Eleven patients had calcinosis during the disease course [median follow up period of 50 (range 0.5-159) months]. The mortality was 2/25 (8%) while only 40% of the patients had clinically inactive disease by PRINTO criteria. There was no difference in racial distribution (p-value = 1), age at disease onset (p-value = 0.87) and disease duration prior to treatment initiation (p -value = 0.75) between patients who had clinically active and inactive disease. Discussion: The demographic characteristics of children with JDM were similar to that from most other regions of the world with female predominance and similar age at onset. The median delay in diagnosis (4 months) was not longer than that reported in most other studies. However, some children had prolonged delay of up to 7 years due to misdiagnosis that denied them appropriate treatment in a timely manner. Majority (60%) of the patients also remained with clinically active disease, which put them at risk of further disease complications including calcinosis. Even though the mortality rate was low (8%) this was still more than double that reported in most recent large studies especially from the resource rich countries. Conclusions: Long-term follow up of JDM patients is advisable since majority of patients seem to have clinically active disease many years after disease onset despite treatment. Formulation and use of appropriate treatment guidelines and protocols may aid in the early diagnosis and appropriate management for optimum outcomes. Advisors/Committee Members: Scott, Christiaan (advisor).

Subjects/Keywords: Paediatric Rheumatology

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Okong'o, L. O. (2015). Demographic and clinical characteristics of children with juvenile dermatomyositis in Cape Town. (Thesis). University of Cape Town. Retrieved from http://hdl.handle.net/11427/15680

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Okong'o, Lawrence Owino. “Demographic and clinical characteristics of children with juvenile dermatomyositis in Cape Town.” 2015. Thesis, University of Cape Town. Accessed October 20, 2020. http://hdl.handle.net/11427/15680.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Okong'o, Lawrence Owino. “Demographic and clinical characteristics of children with juvenile dermatomyositis in Cape Town.” 2015. Web. 20 Oct 2020.

Vancouver:

Okong'o LO. Demographic and clinical characteristics of children with juvenile dermatomyositis in Cape Town. [Internet] [Thesis]. University of Cape Town; 2015. [cited 2020 Oct 20]. Available from: http://hdl.handle.net/11427/15680.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Okong'o LO. Demographic and clinical characteristics of children with juvenile dermatomyositis in Cape Town. [Thesis]. University of Cape Town; 2015. Available from: http://hdl.handle.net/11427/15680

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation


University of Manchester

2. Shoop-Worrall, Stephanie Joanna. Can We Predict Remission in Children with Juvenile Idiopathic Arthritis?.

Degree: 2018, University of Manchester

Background: Long-term consequences of active disease in juvenile idiopathic arthritis (JIA) include persistent pain, disability and potential joint replacement surgery. The aims of treatment are therefore clinically inactive disease (CID) and, ideally, sustained disease remission. This thesis set out to understand CID and remission in JIA: how they are defined, how commonly they are achieved, long-term outcomes following their achievement and whether they are associated with factors early in disease. Methods: The setting for this thesis was the UK Childhood Arthritis Prospective Study (CAPS), the largest multicentre, prospective inception cohort of JIA globally. Children and young people (CYP) were selected for each paper based on their dates of recruitment and categories of disease. At one year following initial presentation to paediatric rheumatology, CYP were classified as to whether they had fulfilled published criteria for CID. Initial analyses explored whether different definitions for CID identified the same groups of CYP. Outcomes to five years were then compared between those achieving all, some or none of the criteria for CID using multivariable, multilevel logistic (absence of limited joints), linear (quality of life) and zero-inflated negative binomial (functional ability) regression models. Finally, risk factors for remission (CID maintained over two annual follow-ups) were explored using multivariable logistic regression models. Throughout, multiple imputation under various assumptions was implemented for missing data. Results: The majority of CYP in CAPS were female (65%) and had oligoarthritis (50%). Median age at initial presentation was eight years (IQR 4, 12). At one year, fewer than 50% of CYP had achieved CID according to published definitions. There was poor overlap (44%) between groups of CYP identified by two validated definitions, whose main difference was the inclusion or exclusion of patient-reported wellbeing. The odds of no limited joints in the long-term did not differ between CYP fulfilling either definition of CID. However, CYP who achieved CID on scores which included wellbeing had superior long-term function (OR for no disability: 2.5, 95% CI 1.8, 3.5) and quality of life (β: 3.9, 95% CI 1.6, 6.2) to those who either did not achieve CID or only achieved it using inflammatory criteria (i.e. had persistent symptoms despite the absence of inflammation). Finally, there were few factors at initial presentation which were associated with remission. However, greater improvements in both physician and patient-reported variables over the first year following initial presentation were associated with higher odds of remission in the first three years. Conclusions: The disease burden in JIA remains high with over 50% of CYP not achieving CID within the first year of disease. Current definitions of CID available for use in clinical practice as potential treatment targets do not classify the same groups of CYP and are associated with different long-term outcomes. Further study is required to… Advisors/Committee Members: THOMSON, WENDY W, VERSTAPPEN, SUZANNE S, Hyrich, Kimme, Thomson, Wendy, Verstappen, Suzanne.

Subjects/Keywords: Juvenile idiopathic arthritis; Remission; Epidemiology; Health Outcomes; Paediatric Rheumatology

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Shoop-Worrall, S. J. (2018). Can We Predict Remission in Children with Juvenile Idiopathic Arthritis?. (Doctoral Dissertation). University of Manchester. Retrieved from http://www.manchester.ac.uk/escholar/uk-ac-man-scw:317341

Chicago Manual of Style (16th Edition):

Shoop-Worrall, Stephanie Joanna. “Can We Predict Remission in Children with Juvenile Idiopathic Arthritis?.” 2018. Doctoral Dissertation, University of Manchester. Accessed October 20, 2020. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:317341.

MLA Handbook (7th Edition):

Shoop-Worrall, Stephanie Joanna. “Can We Predict Remission in Children with Juvenile Idiopathic Arthritis?.” 2018. Web. 20 Oct 2020.

Vancouver:

Shoop-Worrall SJ. Can We Predict Remission in Children with Juvenile Idiopathic Arthritis?. [Internet] [Doctoral dissertation]. University of Manchester; 2018. [cited 2020 Oct 20]. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:317341.

Council of Science Editors:

Shoop-Worrall SJ. Can We Predict Remission in Children with Juvenile Idiopathic Arthritis?. [Doctoral Dissertation]. University of Manchester; 2018. Available from: http://www.manchester.ac.uk/escholar/uk-ac-man-scw:317341


University of Manchester

3. Shoop-Worrall, Stephanie. Can we predict remission in children with juvenile idiopathic arthritis?.

Degree: PhD, 2018, University of Manchester

Background: Long-term consequences of active disease in juvenile idiopathic arthritis (JIA) include persistent pain, disability and potential joint replacement surgery. The aims of treatment are therefore clinically inactive disease (CID) and, ideally, sustained disease remission. This thesis set out to understand CID and remission in JIA: how they are defined, how commonly they are achieved, long-term outcomes following their achievement and whether they are associated with factors early in disease. Methods: The setting for this thesis was the UK Childhood Arthritis Prospective Study (CAPS), the largest multicentre, prospective inception cohort of JIA globally. Children and young people (CYP) were selected for each paper based on their dates of recruitment and categories of disease. At one year following initial presentation to paediatric rheumatology, CYP were classified as to whether they had fulfilled published criteria for CID. Initial analyses explored whether different definitions for CID identified the same groups of CYP. Outcomes to five years were then compared between those achieving all, some or none of the criteria for CID using multivariable, multilevel logistic (absence of limited joints), linear (quality of life) and zero-inflated negative binomial (functional ability) regression models. Finally, risk factors for remission (CID maintained over two annual follow-ups) were explored using multivariable logistic regression models. Throughout, multiple imputation under various assumptions was implemented for missing data. Results: The majority of CYP in CAPS were female (65%) and had oligoarthritis (50%). Median age at initial presentation was eight years (IQR 4, 12). At one year, fewer than 50% of CYP had achieved CID according to published definitions. There was poor overlap (44%) between groups of CYP identified by two validated definitions, whose main difference was the inclusion or exclusion of patient-reported wellbeing. The odds of no limited joints in the long-term did not differ between CYP fulfilling either definition of CID. However, CYP who achieved CID on scores which included wellbeing had superior long-term function (OR for no disability: 2.5, 95% CI 1.8, 3.5) and quality of life (β: 3.9, 95% CI 1.6, 6.2) to those who either did not achieve CID or only achieved it using inflammatory criteria (i.e. had persistent symptoms despite the absence of inflammation). Finally, there were few factors at initial presentation which were associated with remission. However, greater improvements in both physician and patient-reported variables over the first year following initial presentation were associated with higher odds of remission in the first three years. Conclusions: The disease burden in JIA remains high with over 50% of CYP not achieving CID within the first year of disease. Current definitions of CID available for use in clinical practice as potential treatment targets do not classify the same groups of CYP and are associated with different long-term outcomes. Further study is required to…

Subjects/Keywords: Juvenile idiopathic arthritis; Remission; Epidemiology; Health Outcomes; Paediatric Rheumatology

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Shoop-Worrall, S. (2018). Can we predict remission in children with juvenile idiopathic arthritis?. (Doctoral Dissertation). University of Manchester. Retrieved from https://www.research.manchester.ac.uk/portal/en/theses/can-we-predict-remission-in-children-with-juvenile-idiopathic-arthritis(8ebddea8-a3e4-45e9-8653-c7921de65760).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.799278

Chicago Manual of Style (16th Edition):

Shoop-Worrall, Stephanie. “Can we predict remission in children with juvenile idiopathic arthritis?.” 2018. Doctoral Dissertation, University of Manchester. Accessed October 20, 2020. https://www.research.manchester.ac.uk/portal/en/theses/can-we-predict-remission-in-children-with-juvenile-idiopathic-arthritis(8ebddea8-a3e4-45e9-8653-c7921de65760).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.799278.

MLA Handbook (7th Edition):

Shoop-Worrall, Stephanie. “Can we predict remission in children with juvenile idiopathic arthritis?.” 2018. Web. 20 Oct 2020.

Vancouver:

Shoop-Worrall S. Can we predict remission in children with juvenile idiopathic arthritis?. [Internet] [Doctoral dissertation]. University of Manchester; 2018. [cited 2020 Oct 20]. Available from: https://www.research.manchester.ac.uk/portal/en/theses/can-we-predict-remission-in-children-with-juvenile-idiopathic-arthritis(8ebddea8-a3e4-45e9-8653-c7921de65760).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.799278.

Council of Science Editors:

Shoop-Worrall S. Can we predict remission in children with juvenile idiopathic arthritis?. [Doctoral Dissertation]. University of Manchester; 2018. Available from: https://www.research.manchester.ac.uk/portal/en/theses/can-we-predict-remission-in-children-with-juvenile-idiopathic-arthritis(8ebddea8-a3e4-45e9-8653-c7921de65760).html ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.799278

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