RESUMO
Background: Bullous pemphigoid is the most common subepidermal autoimmune blistering disease. Till now, the reported prognostic factors in bullous pemphigoid vary considerably. Aims: The purpose of this study was to determine the overall survival rate and prognostic factors in bullous pemphigoid. Methods: We conducted a retrospective cohort study on newly diagnosed bullous pemphigoid patients between July 2001 and November 2019 in a referral unit for autoimmune blistering skin diseases in Romania. Results: One hundred forty-eight patients were included in the study. The Kaplan–Meier overall survival rates at 1, 3, 5 and 10 years were respectively 74.2% (95% confidence interval, 67.5–81.6%), 53.4% (45.7–62.2%), 43.6% (35.9–53%) and 31.3% (23.5–41.7%). The median follow-up among survivors was 48 months (interquartile range: 11–150). Ninety (60.8%) patients died during the follow-up period; of them, 38 (42.2%) had active disease at the time of death. Advanced age, neurological diseases, valvular heart disease, malignancies, use of statins, skin infections and extensive cutaneous involvement were linked to poorer outcomes, while the use of topical corticosteroids was associated with increased overall survival. Limitations: This study lacks a control cohort to validate the obtained results. It was conducted in a retrospective manner in a single centre. In addition, indirect immunofluorescence microscopy was not performed in all patients. Conclusion: Beyond ageing and neurological comorbidities, the prognosis of bullous pemphigoid patients was significantly influenced by the presence of skin infections, valvular heart disease, use of statins and extensive cutaneous involvement. Topical corticosteroid treatment was associated with increased survival in these patients
RESUMO
ABSTRACT Introduction: Functional gastrointestinal disorders (FGIDs) are the most common disorders in the general population. These disorders can overlap, decreasing the quality of life. Objective: We analyzed the prevalence of functional esophageal disorders (FED) and irritable bowel disease (IBS), and their overlapping and associated factors in musicians and athletes. Methods: A cross-sectional study was conducted using FGID and associated factors questionnaires administered to four groups: instrumentalists, singers, athletes, and a control group of healthy volunteers. Results: Of the 161 subjects, 62 (38.51%) had only FED, 76 (47.2%) had only IBS, and 23 (14.29%) had FED-IBS overlap. Subjects with FED-IBS overlap had more severe symptoms of IBS, especially hard and lumpy stools and constipation, compared to those with IBS alone. IBS subtype was more frequent in the overlap group, while not specified IBS type was less frequent. Regarding FED, we found that subjects with FED-IBS overlap had more functional heartburn and less functional dysphagia symptoms. There was a higher risk of overlap in instrumentalists and smokers. Conclusions: FED and IBS are frequently encountered in musicians and athletes. Subjects with FED-IBS overlap presented more frequent and severe symptoms. Instrumentalists and smokers are at higher risk of overlap. Level of Evidence IV; Case series.
RESUMO Introdução: Os distúrbios gastrintestinais funcionais (DGIF) são os mais comuns na população em geral. Esses distúrbios podem se sobrepor, diminuindo a qualidade de vida. Objetivo: Analisamos a prevalência dos distúrbios funcionais esofágicos (DFE) e da síndrome do intestino irritável (SII), sua sobreposição e os fatores associados em músicos e esportistas. Métodos: Realizou-se um estudo transversal por meio de questionários sobre DGIF e fatores associados, administrados a quatro grupos: instrumentistas, cantores, esportistas e um grupo controle de voluntários saudáveis. Resultados: Dos 161 indivíduos, 62 (38,51%) tinham só DFE, 76 (47,2%) tinham só SII e 23 (14,29%) tinham sobreposição de DFE e SII. Os indivíduos com sobreposição de DFE e SII tinham sintomas mais intensos de SII, especialmente fezes duras e encaroçadas e constipação em comparação com os que tinham só SII. O subtipo SII foi mais frequente no grupo de sobreposição, enquanto o tipo SII indefinido foi menos frequente. Quanto ao DFE, verificamos que os indivíduos com sobreposição DFE-SII tinham mais sintomas de azia funcional e menos de disfagia funcional. Houve maior risco de sobreposição em instrumentistas e fumantes. Conclusões: DFE e SII são frequentes em músicos e esportistas. Os indivíduos com sobreposição de DFE e SII apresentaram sintomas mais frequentes e mais severos. Os instrumentistas e os fumantes têm maior risco de sobreposição. Nível de Evidência IV; Série de casos.
RESUMEN Introducción: Los trastornos gastrointestinales funcionales (TGIF) son los más comunes en la población en general. Estos trastornos pueden sobreponerse, disminuyendo la calidad de vida. Objetivo: Analizamos la prevalencia de los trastornos funcionales esofágicos (TFE) y del síndrome del colon irritable (SCI), su superposición y los factores asociados en músicos y deportistas. Métodos: Se realizó un estudio transversal por medio de cuestionarios sobre TGIF y factores asociados, administrados a cuatro grupos: instrumentistas, cantantes, deportistas y un grupo control de voluntarios sanos. Resultados: De los 161 sujetos, 62 (38,51%) tenían sólo TFE, 76 (47,2%) tenían sólo SCI y 23 (14,29%) tenían superposición de TFE e SCI. Los individuos con superposición de TFE y SCI tenían síntomas más intensos de SCI, especialmente heces duras y grumosas y estreñimiento en comparación con los que tenían sólo SCI.. El subtipo SCI fue más frecuente en el grupo de superposición, mientras que el tipo de SCI no especificado resultó menos frecuente. En cuanto al TFE, verificamos que los sujetos con superposición TFE-SCI tenían más síntomas de pirosis funcional y menos de disfagia funcional. Hubo mayor riesgo de superposición en instrumentistas y fumadores. Conclusiones: TFE y SCI son frecuentes en músicos y deportistas. Los sujetos con superposición de TFE y SCI presentaron síntomas más frecuentes y más severos. Los instrumentistas y los fumadores tienen mayor riesgo de superposición. Nivel de Evidencia IV; Serie de casos.