Machine learning-based remission prediction in rheumatoid arthritis patients treated with biologic disease-modifying anti-rheumatic drugs: findings from the Kuwait rheumatic disease registry.

Background: Rheumatoid arthritis (RA) is a common condition treated with biological disease-modifying anti-rheumatic medicines (bDMARDs). However, many patients exhibit resistance, necessitating the use of machine learning models to predict remissions in patients treated with bDMARDs, thereby reducing healthcare costs and minimizing negative effects.

Objective: The study aims to develop machine learning models using data from the Kuwait Registry for Rheumatic Diseases (KRRD) to identify clinical characteristics predictive of remission in RA patients treated with biologics.

Association of psoriasis with allergic multimorbidity of asthma, rhinitis, and eczema among adolescents: a cross-sectional study.

Background: Associations between psoriasis and allergic diseases (asthma, rhinitis, and eczema) in children have been reported in a limited number of studies, and the association between psoriasis and multimorbidity (co-occurrence) of allergic diseases remains unclear. Hence, this study aimed to assess the association between psoriasis and the co-occurrence of asthma, rhinitis, and eczema in adolescents.

Methods: This school-based cross-sectional study enrolled adolescents (n = 3,864) aged 11-14 years.

Adherence to the Mediterranean diet is associated with a reduced DAS28 index among patients with rheumatoid arthritis: Case study from KRRD.

Background: Rheumatoid arthritis (RA) is a chronic, autoimmune disease that mostly affects the synovial joints. It has been hypothesized that dietary and other environmental and lifestyle factors contribute to the development of RA and its severity.

Objective: The present study aims to measure the effect of the Mediterranean diet (MedDiet) on the disease activity scores (DAS28) among patients with RA.

Rheumatologic Aspects of the COVID-19 Pandemic: A Practical Resource for Physicians in Kuwait and the Gulf region as Recommended by the Kuwait Association of Rheumatology.

The Kuwait Association of Rheumatology members met thrice in April 2020 to quickly address and support local practitioners treating rheumatic disease in Kuwait and the Gulf region during the coronavirus disease 2019 (COVID-19) pandemic. Because patients with rheumatic and musculoskeletal disease (RMD) may need treatment modifications during the COVID-19 pandemic, we voted online for the general guidance needed by local practitioners. In this review, we have addressed patients' vulnerability with rheumatic disease and issues associated with their optimum management.

Debriefing: A Tool to Enhance Education and Practice in NICU.

Debriefing, a facilitator-guided reflection of an educational experience or critical incident, is an important tool in improving the safety and quality of practice in the NICU. Unlike feedback, which is often a one-way discussion, debriefing is a purposeful, 2-way reflective discussion which is based on experiential learning theory. The purpose of this article is to review the theoretical basis of debriefing and describe styles and tools for debriefing that can be applied in the NICU.

Noninvasive High-Frequency Oscillatory Ventilation: A Retrospective Chart Review.

Objective: This study aimed to review the feasibility of nasal high-frequency oscillatory ventilation (NHFOV) in preventing reintubation in preterm infants.

Study Design: This is a retrospective cohort study of all premature newborn infants placed on NHFOV in a single-center neonatal intensive care unit.

Results: Twenty-seven patients (birth weight: 765 ± 186 g, gestational age: 28 ± 2 weeks) were commenced on NHFOV on 32 occasions.

Accessibility to biologics and its impact on disease activity and quality of life in patients with rheumatoid arthritis in Kuwait.

Objective: Biologics are indicated in rheumatoid arthritis (RA) in case of persistent high disease activity despite conventional disease-modifying anti-rheumatic drugs (cDMARDs) or patients with contraindications to cDMARDs or poor prognostic factors. The purpose of this study was to compare the prescription rates of biologics in Kuwaiti and non-Kuwaiti patients and to assess whether this had an impact on disease activity and quality of life in RA patients.

Methods: Data were extracted from the Kuwait Registry for Rheumatic Diseases.

The treatment journey for patients with axial spondyloarthritis in North Africa and the Middle East: From diagnosis to management.

The management of axial spondyloarthritis (axSpA) is challenging worldwide, and the particular challenges shared by North Africa and the Middle East are mainly related to early diagnosis and standardized management. We believe there are several reasons for these challenges, including: (a) limited awareness of the disease manifestations and prevalence in the region among physicians; (b) the concept of nonradiographic axSpA, while accepted with some difficulty by the rheumatology community, may not be well understood by the referring primary care physicians; (c) access to, and training in magnetic resonance imaging varies greatly between countries in the North Africa and Middle East region, and this may have a large impact on early diagnosis; (d) country-specific treatment guidelines are unavailable; and (e) economic and cultural factors influence patients' attempts to seek and continue treatment. In this review, we will discuss the prevalence of axSpA in North Africa and the Middle East, as well as the challenges to diagnose and treat patients in this region.

Recommendation for the Management of Spondyloarthritis Patients in Kuwait.

Objective: In 2016, ASAS and EULAR made joint recommendations for the management of patients with spondyloarthritis. Although Global and European perspectives are important, they cannot accurately reflect the situation for all patients in all countries and regions. As such, the group worked to tailor the existing international recommendations to suit the specific demographic needs of local populations in the Gulf region, with a specific focus on Kuwait.

Psoriasis Among Adolescents in Kuwait and the Role of Siblings, Breastfeeding, and Household Cat and Secondhand Smoke Exposure: A Cross-Sectional Study.

Introduction: Globally, the epidemiology of psoriasis is poorly understood, and most countries lack essential epidemiologic data regarding disease burden and its determinants. This study sought to estimate the prevalence of psoriasis among adolescents in Kuwait and assess its association with different risk factors, including obesity, sibship size, breastfeeding, and exposure to household secondhand smoke (SHS) and pets.

Methods: Schoolchildren aged 11-14 years (n = 3864) were enrolled in a cross-sectional study.

Rhinoconjunctivitis among Adolescents in Kuwait and Associated Risk Factors: A Cross-Sectional Study.

Rhinoconjunctivitis is a public health problem that causes major illness and disability worldwide. Epidemiological studies intended to determine the burden of rhinoconjunctivitis in Kuwait are limited. Hence, this study sought to estimate the prevalence of rhinoconjunctivitis among adolescents in Kuwait and explore its association with different risk factors.

Kuwait association of rheumatology 2018 treatment recommendations for patients with rheumatoid arthritis.

The Kuwait Association of Rheumatology (KAR) aimed to develop a set of recommendations for the treatment of patients with rheumatoid arthritis (RA), tailored to the unique patient population and healthcare system of Kuwait. Each recommendation was developed based on expert opinion and evaluation of clinical practice guidelines from other international and national rheumatology societies. Online surveys were conducted to collate feedback on each KAR member's level of agreement (LoA) with definitions of disease-/treatment-related terms used and the draft recommendations.

Integrated evaluation of hemodynamics: a novel approach for the assessment and management of preterm infants with compromised systemic circulation.

Objective: To establish normal reference values for tissue oxygen delivery and consumption in preterm infants and demonstrate the usefulness of the integrated evaluation of hemodynamics (IEH) in preterm infants with compromised systemic circulation (CSC).

Methods: This study included 32 stable preterm infants and 6 infants (selected cases) who underwent IEH. IEH is a multimodal approach which integrates clinical parameters: data obtained from near-infrared spectroscopy (NIRS) and targeted neonatal echocardiography (TNE).

Kuwait Recommendations on Vaccine Use in People with Inflammatory Rheumatic Diseases.

People with IRD are at increased risk of infection, and in 2011 EULAR made general recommendations for vaccination in these patients. Global and European perspectives are important, but they cannot accurately reflect the individual situations of patients in different countries and regions. Based on our clinical experience and opinions, we have sought to tailor the original EULAR recommendations to include advice for vaccination with new agents approved in the intervening years-including the new class of targeted synthetic disease-modifying antirheumatic drugs.

Serum S100A12 and temporomandibular joint magnetic resonance imaging in juvenile idiopathic arthritis Egyptian patients: a case control study.

This study aimed to measure serum levels of the proinflammatory protein S100A12, investigate clinical as well as contrast enhanced magnetic resonance imaging findings of temporomandibular joint inflammation among juvenile idiopathic arthritis patients and to find out the correlation between each of them, moreover with different disease parameters as temporomandibular joint inflammation may occur without clinical manifestations; it is in need for thorough evaluation and S100A12 may be a future anti-inflammatory treatment in JIA. Twenty patients with Juvenile Idiopathic Arthritis (JIA) and 10 healthy control subjects underwent measurement of S100A12 serum concentrations by sandwich ELISA. Temporomandibular Joints (TMJs); clinical and post contrast Magnetic Resonance Imaging (MRI) examinations were performed.

Can tumor necrosis factor inhibitors be safely used in pregnancy?

Objective: We review available safety data for use of currently approved tumor necrosis factor (TNF) inhibitors during pregnancy and lactation and suggest guidelines for use of these agents among women of reproductive age. Method. Although regulatory agencies encourage the inclusion of pregnant women and those of child-bearing age in randomized controlled trials, pregnant and lactating women have universally been excluded from studies because of unknown or potential risks to the fetus.

Improved survival in psoriatic arthritis with calendar time.

Objective: To determine whether there has been a change in mortality rates over the last 3 decades in patients with psoriatic arthritis (PsA) whose cases were followed prospectively.

Methods: Patients receiving followup care according to a standard protocol at the University of Toronto PsA Clinic between 1978 and 2004 were included. Information on patient deaths was collected prospectively.

Outcomes in patients with active lupus nephritis requiring immunosuppressives who never received cyclophosphamide.

Objective: To assess outcomes in patients with lupus nephritis treated with immunosuppressives compared to those treated with cyclophosphamide in a cohort study and in a matched cohort study.

Methods: Patients with active renal disease treated with immunosuppressive/cytotoxic medications were selected from the University of Toronto Lupus Clinic database. Five outcomes were evaluated: all-cause mortality, renal failure, reversal of active renal disease, relapse of active renal disease, and toxicity.