scholarly journals P051 Symptoms of COVID-19 and anxiety levels in adult patients receiving b-and ts-DMARDS using an online reporting system

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
May Nwe Lwin ◽  
Christopher Holroyd ◽  
Dinny Wallis ◽  
Saul Faust ◽  
Hans De Graaf ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Joint Pain ◽  
Connective Tissue Diseases ◽  
Anxiety Score ◽  
Online Portal ◽  
Inflammatory Conditions ◽  
Advanced Therapy ◽  
Number Of Patients ◽  
Patient Reported ◽  
Anxiety Levels

Abstract Background/Aims  The coronavirus disease-2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for over 120,000 UK deaths. Those with chronic inflammatory conditions or receiving immunosuppressive medications are at higher risk of COVID-19 than the general population. As a result, rheumatology patients taking b- or ts-DMARDs were advised to shield. We planned to observe COVID-19 related symptoms and anxiety levels reported by rheumatology patients during the pandemic. Methods  From April 2020, 1,004 rheumatology patients from an advanced therapy database were invited to participate in the adult ImmunoCOVID study to collect daily symptoms (fever, cough, shortness of breath (SOB), sore throat, blocked nose, red-eye, headache, fatigue, joint pain, muscle pain, chills, nausea, diarrhoea and vomiting, loss of senses) and anxiety level using an online portal. Loss of senses were not recorded until week 7 as these were not officially recognized at the pandemic onset. Results  153 patients (rheumatoid arthritis, n = 75, psoriatic arthritis, n = 28, Axial spondyloarthropathy, n = 24, systemic lupus erythematosus, n = 2 and other connective tissue diseases, n = 24) consented and participated. By week 25, 142 patients remained. Among those, 36.57% (±6.09%) (average (±SD)) reported no symptoms over the 25 week period. The main symptoms reported were joint pain (mean=47.94%) followed by fatigue (27.17%). Few patients reported fever (0.94%), cough (8.34%), SOB (4.53%), or loss of senses (1.11%) with more symptoms reported during the first 8 weeks (April/May 2020) and another increase in September/October 2020. The anxiety score (pragmatic 10-point scale) mean (±SD) was 5.60 (±0.34) and remained elevated throughout the study though higher when lockdown began. Conclusion  During the first peak of SARS-CoV-2, the number of patients reporting COVID-19 symptoms appeared high and was associated with high levels of anxiety. As only a small number have been swab-tested, this may suggest that larger numbers of untested individuals have had COVID-19 with mild symptoms. Features of inflammatory rheumatic illnesses may mimic COVID-19 symptoms and create diagnostic difficulty (joint pain and fatigue) whilst anxiety may lead to over-reporting of symptoms in the absence of infection. The key symptoms of fever, cough and SOB were less common and may be most reliable. Disclosure  M. Lwin: None. C. Holroyd: None. D. Wallis: None. S. Faust: None. H. De Graaf: None. C.J. Edwards: Honoraria; Abbvie, Biogen, BMS, Celgene, Fresenius, GSK, Janssen, Lilly, Mundipharma, Pfizer, Roche, Sanofi, UCB. Member of speakers’ bureau; Abbvie, Biogen, BMS, Celgene, Janssen, Lilly, Sanofi, Pfizer, Roche. Grants/research support; Abbvie, Biogen, Pfizer. P051 Table 1:patient reported symptoms and anxiety score from immunoCOVID studyWeek & (number of participants)Fever (%)Cough (%)SOB (%)Joint pain (%)Fatigue (%)Loss of senses (%)No symptoms (%)Tested (n)Test positive (n)Anxiety score1 (26)3.857.6911.5446.1530.77NA30.77006.312 (42)2.3311.639.3052.3834.88NA28.57005.833 (69)1.4514.494.3552.1737.68NA23.19415.884 (92)1.0911.966.5254.3531.52NA27.17206.225 (110)0.0011.716.3145.9533.33NA30.00006.156 (108)0.0010.193.7050.0026.85NA34.26205.747 (119)0.8410.084.2049.5828.57NA34.45205.938 (120)0.007.505.0051.6734.170.8329.17305.629 (124)0.817.263.2352.4229.840.8136.29405.6410 (118)0.008.473.3948.3129.660.8534.75205.2811 (116)0.858.476.7849.1529.661.6933.62305.6512 (131)0.006.114.5856.4926.720.7635.11205.4513 (110)0.916.362.7350.0029.091.8242.73105.4414 (121)0.837.442.4847.1125.620.8339.67805.2815 (100)1.007.003.0046.0023.001.0041.00405.4816 (114)0.887.893.5139.4725.441.7542.98905.2717 (105)0.008.573.8144.7622.860.9543.81425.1018 (107)0.006.543.7443.9319.630.9343.93405.3019 (99)0.005.052.0240.4019.191.0145.45505.0820 (110)0.914.552.7350.9124.550.9139.09NA0Missing data21 (106)0.946.602.8350.0020.750.9439.62405.2822 (104)2.889.626.7349.0430.770.9635.58305.5023 (106)1.897.553.7742.4526.420.9436.79805.8924 (108)0.938.332.7844.4422.220.9341.67605.6125 (94)1.067.454.2641.4915.962.1344.68605.49Average0.948.344.5347.9427.171.1136.575.60SD0.972.312.254.395.350.426.090.34Weekly data are the average of daily reported symptoms and anxiety levels.

scholarly journals Spectrum of Rheumatological Disorders: A Clinic-based Study

2014 ◽  
Vol 15 (1) ◽  
pp. 23-27 ◽  
Author(s):  
AKM Shaheen Ahmed ◽  
Muhammad Abdur Rahim ◽  
Pratik Dewan ◽  
Hasna Fahmima Haque ◽  
Reshad Falah Nazim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Rheumatology Clinic ◽  
Clinical Criteria ◽  
Inflammatory Conditions ◽  
Number Of Patients ◽  
Soft Tissue Rheumatism ◽  
Spine Diseases ◽  
Prevalent Disease

Objectives: To assess the prevalence and distribution of rheumatic diseases at rheumatology clinic in a tertiary level hospital. Methods: This retrospective study was done at rheumatology clinic of BIRDEM from July 2009 to December 2012. Diagnoses were reached by using clinical criteria supplemented by necessary investigations. Results: Total number of patients was 772 with female predominance (F:M ratio of 1.3:1). Mean age was 46.9 (range 13-83) years. Majority (85.9%) were in 3rd to 6th decades. Degenerative diseases (49.9%) were most common, followed by inflammatory conditions (33.5%), soft tissue rheumatism (7%), metabolic bone disease (4.8%) and connective tissue diseases (2.5%). Rheumatoid arthritis (27.7%) was the most prevalent disease, followed by osteoarthritis of knees (26.2%) and lumber spines (23.4). Tendinitis, osteoporosis, fibromyalgia and systemic lupus erythematosus prevailed in 5.6%, 4.8%, 1.4% and 1.3% cases respectively. Common comorbidities were diabetes mellitus (87.9%),  hypertension (22.2%), ischaemic heart disease (12.4%), dyslipidaemia (10.1%), fatty liver (7.9%), chronic kidney disease (6.9%) and hypothyroidism (4.5%). Commonly prescribed medications were non-steroidal anti-inflammatory drugs (93%), disease modifying anti-rheumatic drugs (28.9%) and prednisolone (10.6%). Physiotherapy was required in 13.3% cases. In 56.6% cases various combination of treatment was required. In 12% patients receiving methotrexate, adverse effects occurred.Conclusion: Degenerative joint and spine diseases were more common but as an individual disease rheumatoid arthritis was the most prevalent condition.DOI: http://dx.doi.org/10.3329/jom.v15i1.19855 J Medicine 2014; 15: 23-27

scholarly journals Evaluation of Dot Immunoblot for identification of antibodies to Extractable nuclear antigen

2011 ◽  
Vol 5 (1) ◽  
pp. 12-15
Author(s):  
Sadia Sharmin ◽  
Sharmee Ahmed ◽  
Humayun Sattar ◽  
Ahmed Abu Saleh ◽  
Shirin Tarafdar
Keyword(s):  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Simultaneous Detection ◽  
Connective Tissue Diseases ◽  
Cross Sectional Study ◽  
Connective Tissue Disorder ◽  
Nuclear Antigen ◽  
Dot Blot ◽  
Cross Sectional ◽  
Number Of Patients

This cross sectional study was done from January 2009 to June 2010 in Microbiology department of Dhaka Medical Collage. The study was designed to evaluate the advantages and reliability of dot immunoblot (DB) for identification of antibodies to extractable nuclear antigens (anti-ENA) in autoimmune connective tissue disorder (CTD). Sera from systemic lupus erythematosus patients (n = 37), systemic sclerosis patients (n = 13), rheumatoid arthritis patients(n=11), mixed connective tissue disease patients (n=6), polymyositis patients (n=7), and sjogren’s syndrome (n=2)were tested for antinuclear antibody (ANA) by Indirect Immunofluorescence (IIF) on HEp-2 cell and analyzed for the presence of antibodies to RNP, Sm, SSA, SSB, Scl-70, and Jo-1 (anti-ENAs) by dot immunoblot and ELISA. Out of 76sera of autoimmune connective tissue diseases 35 (46.05%) samples were found to be positive by DB and 33 (43.4%)were positive by ELISA. The dot blot assay exhibited 100% sensitivity for SSA, SSB, Scl-70 antibodies and for RNP the sensitivity was 90%; specificity was over 98% for these 4 ENA antibodies. Multiple reactivities were also found in a substantial number of patients sera. No serum was positive for anti-Sm and anti-Jo-1.Healthy controls also revealed no positive reactivity for anti-ENA by DB and ELISA. In conclusion, the dot immunoblot is a valid method for the detection of specific autoantibodies in autoimmune connective tissue disorder. Its most notable advantages are simultaneous detection of several autoantibodies in the same serum and its lower cost.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15815 Bangladesh J Med Microbiol 2011; 05 (01): 12-15

scholarly journals Leisure Activities for Patients with Diffuse Connective Tissue Diseases

2021 ◽  
Vol 3 (3) ◽  
pp. 70-76
Author(s):  
Marielle Fornazzaro Nascimento ◽  
Paulo Eduardo Neves Ferreira Velho ◽  
Raphaela Espanha Corrêa ◽  
Rute Estanislava Tolocka
Keyword(s):  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Leisure Activities ◽  
Connective Tissue Diseases ◽  
The Elderly ◽  
Physical Activities ◽  
Patient Reported ◽  
The University ◽  
Open Question

Leisure is everyone right, regardless of the clinical condition of each individual. The quality of life (QoL) of patients with dermatoses has been related to the practice of leisure activities (PLA); however, little is known about this practice in these patients. This study aimed to verify the PLA in patients with Diffuse Connective Tissue Diseases (DCTD). This is a descriptive, qualitative, and quantitative field study with patients seen at the Dermatology Outpatient Clinic (Hospital de Clínicas) of the University of Campinas (UNICAMP), São Paulo, Brazil.  A form was used, containing closed questions about the sociodemographic and clinical profiles, and an open question about leisure. The responses were categorized according to the classification of leisure cultural content. Descriptive statistics, construction of a crosstable and the Mann-Whitney and Kruskal-Wallis tests were used. Data from 62 patients were collected, who aged between 19.4 and 75.3 years (average of 49.32±12.55 years). Among the patients, 80.6% were female and 70.9% were diagnosed with Cutaneous or Systemic Lupus Erythematosus (LE). The most practiced leisure activities were those related to manual and virtual content, mentioned by 24.6% of the patients. Another 18.0% reported preferring to stay at home or sleep (other activities), and no patient reported physical-sports or tourist leisure practices. The PLAs were little varied, showing 75.8% of the patients taking only one type of content related to these practices and 12.9% not carrying out any leisure activities. The elderly were the ones who most reported manual and virtual activities. An association was found between the variety of leisure content practiced and literacy level. Illiterate patients were those who least reported activities related to leisure, when compared to those who completed elementary school (X² = 24.686; p= 0.035). Before diagnosis, 56.5% of the patients performed physical activities, of which 27.4% could be classified as physical-sports leisure. After the disease development, only 19.7% of them maintained physical activities, and, of all the activities practiced by them, only 9.7% could be considered as leisure activities, but none as physical-sports leisure. Thus, it appears that leisure practices among patients with DCTD are scarce and little varied, which interferes with their QoL. The orientation and practice of these activities are necessary so that they can make choices and vary the types of activities practiced. Likewise, more studies, which can support actions that encourage and enable the leisure practices of these patients, play an important role.

scholarly journals THU0253 FATIGUE AND PAIN REMAIN PROMINENT AND IMPACTFUL IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): A CROSS-SECTIONAL SURVEY OF SLE PATIENTS IN THE UNITED STATES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 353.2-354
Author(s):  
J. Birt ◽  
M. Hadi ◽  
N. Sargalo ◽  
E. Brookes ◽  
P. Swinburn ◽  
...  
Keyword(s):  
United States ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Joint Pain ◽  
Disease Burden ◽  
Joint Stiffness ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Patient Reported ◽  
The Mean

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory condition impacting multiple organ systems.1,2SLE affects approximately 1.5 million Americans, disproportionately females of reproductive age, and is more prevalent in non-Caucasian populations.3Fatigue and pain are some of the most prominent symptoms of SLE, contributing to the heavy disease burden and disruption to daily life.4This study aimed to further understand the burden of SLE. Lilly worked with the Lupus Foundation of America (LFA) and Evidera to develop the SLE-UPDATE (Understanding Preferences, Disease Activity and Treatment Expectations) survey.Objectives:To understand the patient-perceived symptom burden of SLE, in particular pain and fatigue, within the current landscape of therapeutic options. This study also focused on current treatment patterns in SLE patients.Methods:This was a cross-sectional, non-interventional, online survey study conducted in partnership with the LFA. English-speaking United States patients aged ≥18 years with a self-reported diagnosis of SLE completed the survey following online screening and informed consent. Descriptive data are presented by means (standard deviation [SD]) for continuous measures, and frequency (n, %) for dichotomous measures. Demographic, clinical, and patient-reported outcomes were collected including the FACIT-Fatigue (range 0-52, higher scores indicate less fatigue), Pain Numerical Rating Scale (NRS) (0 [none] to 10 [worst imaginable]), Worst Joint Pain NRS (0 [none] to 10 [worst imaginable]), and the LupusPRO, a validated, lupus-specific quality of life (QoL) instrument (range 0-100, higher scores indicate better QoL).Results:A total of 500 patients with SLE completed the survey. Patients were predominantly female (75%), white/Caucasian (76%), with a mean age of 42.6 years and mean disease duration of 11.1 years.Most patients with SLE rated their overall condition as either good (38%) or fair (31%), with 8% rating poor and 7% excellent. Current non-biologic prescription medication use included: antimalarials 42%, corticosteroids 33%, immunosuppressants 33%, nonsteroidal anti-inflammatory drugs (NSAID) 32%, other analgesics 15% and 10% were using tofacitinib. Biologic therapies were being used by only 19%, including intravenous (IV) Benlysta (37%),subcutaneous(SC) Benlysta (25%), rituximab (17%), and 22% were using other biologics. Fatigue was the most commonly reported symptom (69%), with 40% of patients ranking fatigue as their most bothersome SLE symptom. Forty eight percent of patients with current fatigue rated the severity as moderate and 33% as severe. The mean (SD) FACIT-Fatigue score was 22.9 (12.0). The next most commonly reported symptoms were joint stiffness (57%), sleep problems (55%), joint pain/swelling (53%), and muscle pain (52%). Sixty percent of patients reported experiencing pain all or most of the time over the past seven days. A total of 30% of patients with current joint pain/swelling rated it as severe, and 24% of patients with current joint stiffness rated it as severe. The mean scores for Worst pain NRS and Worst Joint Pain NRS were both 5.8 out of 10.The LupusPRO domains indicated by respondents as the most impacted by SLE were Emotional Health, Pain/Vitality, and Lupus Medications.Conclusion:Fatigue, followed by pain and joint stiffness, were the most common patient-reported symptoms contributing to the overall SLE disease burden. Further research could highlight the efforts required to address the inadequacies in treatment and management of pain and fatigue in this patient population.Disclosure of Interests:Julie Birt Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Monica Hadi: None declared, Nashmel Sargalo: None declared, Ella Brookes: None declared, Paul Swinburn: None declared, Leslie Hanrahan: None declared, Karin Tse: None declared, Natalia Bello Vega Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Kirstin Griffing Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Maria Silk Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Laure Delbecque Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Diane L Kamen Consultant of: Consulted on SLE survey development for Lilly and consulted on SLE trial protocol development for EMD Serono in 2019

Correlation Between Serological Makers and Immunofluorescence Deposits i n Kidney Tissue of Patients with Lupus Nephritis

2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Haider S Al-Hadad ◽  
Aqeel Abbas Matrood ◽  
Maha Abdalrasool Almukhtar ◽  
Haider Jabur Kehiosh ◽  
Riyadh Muhi Al-Saegh
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Pearson Correlation ◽  
Standard Procedure ◽  
Kidney Tissue ◽  
P Value ◽  
American College Of Rheumatology ◽  
Immune Deposits ◽  
Number Of Patients

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease. Few biomarkers for SLE have been validated and widely accepted for the laboratory follow-up of inflammatory activity. In SLE patients, with lupus nephritis (LN), complement activation leads to fluctuation of serum C3 and C4 that are frequently used as clinicalm biomarker of disease activity in SLE. Patients and Methods: In this study the number of patients were 37, seven patients were excluded for incomplete data collection, 28 were females ,2 were males. The duration of the study is two years from 2015 to 2017. Patients were considered to have SLE and LN according to American College of Rheumatology (ACR) criteria, and International Society of Nephrology/ Renal Pathology Society (ISN/RPS). All patients were evaluated withm clinical presentation, laboratory investigations. Our patients underwent kidney biopsy according to standard procedure by Kerstin Amann, and their tissue specimens were studied in the laboratory with light microscope (LM) and immunofluorescence microscope reagents. The relationship between the serological markers and immunofluorescence deposits in kidney biopsy of all patients were studied using the statistical analysis of Pearson correlation and single table student's T test. A P value 0.05 was considered statistically significant. Results: The granular pattern of IF deposits was present in all LN patients, and in more than two third of patients these IF deposits presented in glomerular, tubular, and mesangium sites. While less than one third of patients had IF deposits in the mesangium only. There was no statistically significant correlation between serum ANA, anti-dsDNA, and IF deposits of different types. There was significant correlation between serum C3 and C4 hypocomplementemia and IgG immune deposits in kidney biopsy, and there was significant relationship between serum C3 hypocomplementemia and full house immunofluorescence (FHIF) deposits inm kidney biopsy.Conclusions:Immunofluorescence deposits is mainly granular pattern in LN patients. There was no significant association between serum ANA, anti-dsDNA, and immune deposits in kidney tissue. Immunofluorescence deposits of IgG type correlates significantly with serum C3 and C4 hypocomplemetemia, and these immune deposits in association with low complement levels correlates with LN flare. There was significant correlation between C3 hypocomplementemia and FHIF.

scholarly journals Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go

2019 ◽  
Vol 8 (4) ◽  
pp. 555 ◽  
Author(s):  
Cátia Caneiras ◽  
Cristina Jácome ◽  
Sagrario Mayoralas-Alises ◽  
José Ramon Calvo ◽  
João Almeida Fonseca ◽  
...  
Keyword(s):  
Clinical Research ◽  
Patient Experience ◽  
Clinical Care ◽  
Research Priorities ◽  
Specific Patient ◽  
Quality Healthcare ◽  
Body Of Knowledge ◽  
Number Of Patients ◽  
Patient Reported ◽  
System Sustainability

The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.

scholarly journals Is Biofeedback through an Intra-Aural Device an Effective Method to Treat Bruxism? Case Series and Initial Experience

2020 ◽  
Vol 18 (1) ◽  
pp. 51
Author(s):  
Kira Pfeiffer ◽  
Thaqif El Khassawna ◽  
Deeksha Malhan ◽  
Christine Langer ◽  
Barbara Sommer ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Positive Impact ◽  
Case Series ◽  
Physiological Status ◽  
Initial Experience ◽  
Ear Canal ◽  
Number Of Patients ◽  
Patient Reported ◽  
Unpleasant Feeling ◽  
Ear Canals

Biofeedback was reported as an effective concept for bruxism treatment, through increasing patient’s awareness of the habit. During bruxing both ear canals become tighter, therefore, an in-ear device can provide biofeedback. The in-ear device is fitted to the ear canal in physiological status, during bruxing the ear-canal tightens resulting in stress on the canal walls and unpleasant feeling. Subsequently, patients stop their bruxing habit. The aim of this study is to provide first clinical evidence that in-ear devices have a positive impact on relieving bruxism in patients. Despite the low number of patients, this early study was designed as a controlled prospective study. The trial included seven female patients with a median age of 47.3 years (23–64 years). Only two patients implemented their devices for eight and seven months, respectively. One patient reported a relief in her symptoms, like headaches and pain intensity during the night, by 50% after three month and 80% after six months. Despite the limited number of participants, the study reflects a potential of Intra-aural devices as effective biofeedback devices in treating bruxism.

scholarly journals Which patient-reported outcomes do rheumatology patients find important to track digitally? A real-world longitudinal study in ArthritisPower

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
W. Benjamin Nowell ◽  
Kelly Gavigan ◽  
Carol L. Kannowski ◽  
Zhihong Cai ◽  
Theresa Hunter ◽  
...  
Keyword(s):  
Physical Function ◽  
Lupus Erythematosus ◽  
Patient Reported Outcomes ◽  
Treatment Effectiveness ◽  
Time Window ◽  
Joint Stiffness ◽  
Summary Score ◽  
Longitudinal Tracking ◽  
Patient Reported

Abstract Background Patient-reported outcomes (PROs) are increasingly used to track symptoms and to assess disease activity, quality of life, and treatment effectiveness. It is therefore important to understand which PROs patients with rheumatic and musculoskeletal disease consider most important to track for disease management. Methods Adult US patients within the ArthritisPower registry with ankylosing spondylitis, fibromyalgia syndrome, osteoarthritis, osteoporosis, psoriatic arthritis, rheumatoid arthritis, and systemic lupus erythematosus were invited to select between 3 and 10 PRO symptom measures they felt were important to digitally track for their condition via the ArthritisPower app. Over the next 3 months, participants (pts) were given the option to continue tracking their previously selected measures or to remove/add measures at 3 subsequent monthly time points (month [m] 1, m2, m3). At m3, pts prioritized up to 5 measures. Measures were rank-ordered, summed, and weighted based on pts rating to produce a summary score for each PRO measure. Results Among pts who completed initial selection of PRO assessments at baseline (N = 253), 140 pts confirmed or changed PRO selections across m1–3 within the specified monthly time window (28 days ± 7). PROs ranked as most important for tracking were PROMIS Fatigue, Physical Function, Pain Intensity, Pain Interference, Duration of Morning Joint Stiffness, and Sleep Disturbance. Patient’s preferences regarding the importance of these PROs were stable over time. Conclusion The symptoms that rheumatology patients prioritized for longitudinal tracking using a smartphone app were fatigue, physical function, pain, and morning joint stiffness.

scholarly journals AB0713 EVALUATION OF THE EFFECTIVENESS OF LASER THERAPY IN THE TREATMENT OF RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1388.1-1388
Author(s):  
N. Zhuravleva ◽  
L. Karzakova ◽  
S. Kudryashov ◽  
E. Petrova
Keyword(s):  
Rheumatoid Arthritis ◽  
Laser Therapy ◽  
Medical Therapy ◽  
Joint Pain ◽  
Morning Stiffness ◽  
Activity Index ◽  
Clinical Indicators ◽  
On Demand ◽  
Number Of Patients ◽  
Basic Medical

Background:Despite the fact that the introduction of biological disease-modifying antirheumatic medicines (bDMARDs) and the early start of treatment for rheumatoid arthritis (RA) can effectively stop the inflammatory process in RA, a fairly large number of patients continue to experience joint pain [1]. It is assumed that in some cases, joint pain in patients with RA is not associated with the inflammation, so it requires consideration of the possibility of using alternative strategies for the treatment of RA.Objectives:The aim of the research is to study the effectiveness of laser therapy in the treatment of RA.Methods:114 patients with RA aged from 32 to 53 years have been monitored for 6 months. There were 82 women (71.9 %) and 32 men (28.1%) among them. The patients were randomly divided into 2 groups. The first group of patients (57 people) received basic medical therapy with methotrexate 15 mg intramuscularly once a week and nonsteroidal anti-inflammatory medicines (NSAIDs) on demand. The dose of methotrexate was selected taking into account the disease activity index DAS 28. The second group of patients (57 people) received basic medical therapy with methotrexate 15 mg intramuscularly once a week and NSAIDs on demand. In addition, the cutaneous low-intensity laser irradiation of the joints was added along the projection of the joint gap in a pulse mode with a wavelength of 0.89 microns. The pulse frequency is 80-1500 Hz, the pulse power is 5 W, the exposure time in the field is 1-2 minutes and the total radiation time per session is no more than 10 minutes [2]. The course of treatment consisted of 10 procedures (the device “Milta F-8 RD”, Russia, Moscow). The course of laser therapy was repeated after 4 weeks. To assess clinical indicators, patients were examined using the SF-36 questionnaire before treatment and 6 months after the start of treatment.Results:The survey after 6 months revealed the significant decrease in the severity of pain on the VAS from the initial average indicator 4.5±0.2 to 3.69±0.2 points (p<0.01) and morning stiffness from 60±5 to 40.8±4 minutes (p<0.01). In the first group, the dynamics of clinical indicators were not statistically significant: the intensity of pain decreased from 4.6±0.2 to 4.2±0.3 points (p>0.05) and the duration of morning stiffness reduced from 62±7 to 58.6±6 minutes (p>0.05). In the second group the decrease in the need for NSAIDs was observed in 21 patients, while in the first group the same was observed only in 10 patients (px2 = 0.020).Conclusion:Laser therapy in the treatment of patients with RA enabled to decrease the frequency of the need for NSAIDs and reduce morning stiffness. We recommend using laser therapy in patients with RA at the second radiological stage as an addition to basic therapy.References:[1]Altawil R et al. Arthritis Care Res (Hoboken). 2016; 68(8): 1061-1068.[2]Burger M et al. Physiother Theory Pract. 2017; 33(3): 184-197.Disclosure of Interests:None declared

scholarly journals Epidemiology of Secondary Warm Autoimmune Haemolytic Anaemia—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1244
Author(s):  
Stinne Tranekær ◽  
Dennis Lund Hansen ◽  
Henrik Frederiksen
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Underlying Disease ◽  
Age At Diagnosis ◽  
Autoimmune Haemolytic Anaemia ◽  
Sex Distribution ◽  
Number Of Patients ◽  
Study Results ◽  
Full Text Review

Background: Warm autoimmune haemolytic anaemia (wAIHA) is a haemolytic disorder, most commonly seen among adults and is classified as either primary or secondary to an underlying disease. We describe the age and sex distribution and the proportion of secondary wAIHA. Method: We retrieved 2635 published articles, screened abstracts and titles, and identified 27 articles eligible for full-text review. From these studies, we extracted data regarding number of patients, sex distribution, age at diagnosis, number of patients with secondary wAIHA, and whether the patients were diagnosed through local or referral centres. All data were weighted according to the number of included patients in each study. Results: 27 studies including a total of 4311 patients with wAIHA, of which 66% were females, were included. The median age at diagnosis was 68.7 years, however, wAIHA affected all ages. The mean proportion of secondary wAIHA was 49%, most frequently secondary to systemic lupus erythematosus. The proportions of secondary wAIHA reported from primary vs. referral centres were 35% vs. 59%, respectively. Conclusion: This review consolidates previously reported gender distribution. The higher proportion of secondary wAIHA in referral centres suggests that the most severely affected patients are disproportionally more frequent in such facilities.

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