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The trend of PI at the screening phase, while the PI and VAS pain score were not affected by the treatment, is consistent with the reports that a higher PI is related to more severe primary dysmenorrhoea [29] [30], and both PI and VAS pain score are the highest in the first day of menstruation cycle [30].
Indoor detonations tend to cause more severe primary blast injuries than do open air, outdoor bombings.
In HCA- KpBSI, underlying diseases were more severe, primary bacteremia and peritonitis were more common and resistance to antimicrobials was more frequent than in CA- KpBSI.
Patients who did not respond to the post-operative questionnaire tended to have more severe primary conditions and a poorer pre-operative quality of life.
For lower penetrance disorders, inferences need to be more cautious and both depressive and substance use disorders fall into this category - i.e. cases known to secondary care may reflect more severe primary disorders, comorbidity, environmental disadvantage or referral biases.
The less common but more severe primary pneumonic form develops after inhalation of the bacteria; pneumonic tularemia can be difficult to diagnose because the respiratory signs and symptoms may be minimal or absent and, when present, are often nonspecific.
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Secondary MDS tends to be much more severe than primary MDS.
Bone loss can be more severe in primary adrenal disease compared to CD.
Secondary RP is a frequent finding in autoimmune rheumatic diseases, especially in systemic sclerosis (SSc), and is often more severe than primary RP [ 2].
While the manifestations in the infant are generally considered to be more severe in primary infections, fetal death and severe neonatal illness have been described following congenital infection in seropositive mothers [ 59].
Disease severity is thought to be a consequence of the raised viral titre and the resulting pathology (whether mediated directly by the virus itself or by immune responses, cellular or otherwise) is therefore correspondingly more severe than that in primary infection.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com