scholarly journals OP0146 TENOSYNOVITIS, SYNOVIAL HYPERTROPHY AND FEET BURSITIS ARE USEFUL ULTRASOUND BIOMARKERS FOR PREDICTING ARTHRITIS DEVELOPMENT IN A POPULATION AT-RISK FOR RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 87.2-87
Author(s):  
Y. Kisten ◽  
A. Circiumaru ◽  
M. Loberg ◽  
N. Vivar-Pomiano ◽  
A. Antovic ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
At Risk ◽  
Musculoskeletal Complaints ◽  
Population At Risk ◽  
Synovial Hypertrophy ◽  
Extensor Carpi Ulnaris ◽  
Chi Squared ◽  
Good Potential ◽  
Study Participants ◽  
Mtp Joints

Background:Musculoskeletal ultrasound (MSUS) evaluation of individuals at risk for developing rheumatoid arthritis (RA) having Anti-Citrullinated Protein Antibody (ACPA) positivity and musculoskeletal complaints, may play an important role in the very early detection of RA.Objectives:We aimed to identify which ultrasound markers could predict arthritis development.Methods:Individuals with musculoskeletal complaints with a positive anti-CCP2 test were referred to the rheumatology department for a detailed clinical (68 joint count) and MSUS examination of the hands, feet and any symptomatic joints. Only those without clinical and/or MSUS detected arthritis were included in the RISK RA prospective cohort and followed-up over 3 years/ or until arthritis onset. Using EULAR-OMERACT guidelines1, MSUS markers for synovial hypertrophy (SH) and hyperemia (Doppler activity) were documented for each visit. Finger and wrist tendons were screened for any signs of tenosynovitis (TS), and between metatarsal joints for bursitis. Association of MSUS biomarkers with arthritis development was tested (comparing proportions) using Chi-Squared or Fisher’s exact tests.Results:288 individuals were included from January 2014 to October 2019 (79% female, 35% RF positive, median age 48 years: IQR: 36-58). Within a median of 38 months (IQR: 1-72) since recruitment, 84 individuals (28%) developed an arthritis diagnosis.Prior to obtaining any diagnosis (at inclusion and/or follow-up visit), 95 of the 288 individuals (33%) had at least one type of MSUS anatomical modification present (around the tendons, joint synovium and/or within bursal cavities), and 56% (53/95) of these individuals eventually developed arthritis. Of the remaining 193 that did not present with any obvious MSUS changes, 16% progressed towards arthritis development.The presence of tenosynovitis was detected in 64 of 288 individuals scanned prior to diagnosis and were more frequent in those developing arthritis (44%, 37/84) as compared to those with TS not developing arthritis (13%, 27/204), p<0.0001. The extensor carpi ulnaris wrist tendons were mostly involved. Sonographic changes within the synovium were noted in 11% (32/288) of all individuals, mostly affecting the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints. There was a higher incidence of synovial hypertrophy detected in those developing arthritis (22%, 18/24), as compared to those that remained arthritis free (7%, 14/204), p<0.0001. The MCP joints with synovial hypertrophy were more prone to arthritis development as compared to the MTP’s. Furthermore, we observed a higher frequency of bursitis between the MTP joints in individuals developing arthritis, as compared to individuals having a bursitis who did not develop arthritis (13%, 11/84 versus 7%, 14/204, p=0.009).Conclusion:Ultrasound biomarkers such as tenosynovitis of the extensor carpi ulnaris, synovial hypertrophy of the MCP joints and feet bursitis have good potential to predict arthritis development in a population at-risk for rheumatoid arthritis.References:[1]Maria-Antonietta D’Agostino et al. RMD Open 2017;3:e 000428Acknowledgements:All study participants and patients, including researchers that are part of the multidisciplinary laboratory, clinical and academic teams of the RISK RA study group, as well as all assisting this research in one form or the other are greatly acknowledged.Disclosure of Interests:None declared

scholarly journals Demographic Seasonality

2019 ◽  
Vol 22 (03) ◽  
pp. 187-194 ◽  
Author(s):  
Johan Fellman
Keyword(s):  
At Risk ◽  
Goodness Of Fit ◽  
Extreme Values ◽  
Demographic Data ◽  
Climatic Conditions ◽  
Data Sets ◽  
Test Statistic ◽  
Population At Risk ◽  
Chi Squared ◽  
Number Of Births

AbstractThe seasonality of demographic data has been of great interest. It depends mainly on the climatic conditions, and the findings may vary from study to study. Commonly, the studies are based on monthly data. The population at risk plays a central role. For births or deaths over short periods, the population at risk is proportional to the lengths of the months. Hence, one must analyze the number of births (and deaths) per day. If one studies the seasonality of multiple maternities, the population at risk is the total monthly number of confinements and the number of multiple maternities in a given month must be compared with the monthly number of all maternities. Consequently, when one considers the monthly rates of multiple maternities, the monthly number of births is eliminated and one obtains an unaffected seasonality measure of the rates. In general, comparisons between the seasonality of different data sets presuppose standardization of the data to indices with common means, mainly 100. If one assumes seasonality as ‘non-flatness’ throughout a year, a chi-squared test would be an option, but this test calculates only the heterogeneity and the same test statistic can be obtained for data sets with extreme values occurring in consecutive months or in separate months. Hence, chi-squared tests for seasonality are weak because of this arbitrariness and cannot be considered a model test. When seasonal models are applied, one must pay special attention to how well the applied model fits the data. If the goodness of fit is poor, nonsignificant models obtained can erroneously lead to statements that the seasonality is slight, although the observed seasonal fluctuations are marked. In this study, we investigate how the application of seasonal models can be applied to different demographic variables.

scholarly journals Studies of the Seasonal Pattern of Multiple Maternities

2017 ◽  
Vol 20 (3) ◽  
pp. 250-256 ◽  
Author(s):  
Johan Fellman
Keyword(s):  
At Risk ◽  
Seasonal Variation ◽  
Goodness Of Fit ◽  
Seasonal Pattern ◽  
Population Data ◽  
Seasonal Fluctuations ◽  
Population At Risk ◽  
Chi Squared ◽  
Birth Data ◽  
Number Of Births

The seasonality of population data has been of great interest in demographic studies. When seasonality is analyzed, the population at risk plays a central role. In a study of the monthly number of births and deaths, the population at risk is the product of the size of the population and the length of the month. Usually, the population can be assumed to be constant, and consequently, the population at risk is proportional to the length of the month. Hence, the number of cases per day has to be analyzed. If one studies the seasonal variation in twin or multiple maternities, the population at risk is the total number of monthly confinements, and the study should be based on the rates of the multiple maternities. Consequently, if one considers monthly twinning rates, the monthly number of birth data is eliminated and one obtains an unaffected seasonality measure of the twin maternities. The strength of the seasonality is measured by a chi-squared test or by the standard deviation. When seasonal models are applied, one must pay special attention to how well the model fits the data. If the goodness of fit is poor, it can erroneously result in a statement that the seasonality is slight, although the observed seasonal fluctuations are marked.

scholarly journals Frequency of depression in patients with rheumatoid arthritis.

2020 ◽  
Vol 27 (03) ◽  
pp. 646-650
Author(s):  
Owais Kareem ◽  
Hafiz Shafique Ahmad ◽  
Bushra Ijaz ◽  
Shiza Altaf
Keyword(s):  
Rheumatoid Arthritis ◽  
Service Use ◽  
Treatment Compliance ◽  
Sampling Technique ◽  
Pain Clinic ◽  
Optimal Care ◽  
Cross Sectional ◽  
Chi Squared ◽  
Poor Outcomes ◽  
Study Participants

Co morbid depression in rheumatoid arthritis is associated with higher levels of disease activity, pain, fatigue, work disability, health service use and lower treatment compliance. Objectives: To determine the frequency of depression among patients with rheumatoid arthritis. Study Design: Cross sectional, descriptive study. Setting: Pain clinic, Outpatient department, Nishtar Hospital, Multan. Period: Eight months from 10-11-2015 to 10-06-2016. Material & Methods: The total 174 patients with rheumatoid arthritis were enrolled through the non-probability consecutive sampling technique. Results pertaining to rates were reported as frequencies and percentages. Pearson chi squared test was applied to identify the significant associations between study variables. Results: Among the total 174; (100%) study participants, depression was noted in 116; (66.7%) of participants. Forty-three (24.7%) of study participants were males and 131; (75.3%) were females. Calculated mean age of participants was 48.47 ± 8.09 years. Statistically significant associations of depression were noted with duration, treatment and symptom of rheumatoid arthritis. Conclusion: A high frequency of the depression was noted among patients with rheumatoid arthritis, which was associated with poor outcomes of rheumatoid arthritis. This suggests that the optimal care of rheumatoid arthritis should include detection and management of depression.

Penyelidikan KLB keracunan makanan acara ruwahan di desa Mulo, Gunung Kidul provinsi DIY

2018 ◽  
pp. 1
Author(s):  
Mur Prasetyaningrum ◽  
Z. Chomariyah ◽  
Trisno Agung Wibowo
Keyword(s):  
At Risk ◽  
Total Population ◽  
Total Coliform ◽  
Case Control ◽  
P Value ◽  
Common Source ◽  
Population At Risk ◽  
E Coli

Tujuan: Studi ini untuk mengetahui gambaran KLB keracunan pangan yang terjadi di desa Mulo menurut deskripsi epidemiologi, faktor risiko dan penyebab KLB keracunan makanan. Metode: Studi ini menggunakan studi analitik case control, dimana kasus adalah orang yang mengalami sakit pada tanggal 7 - 8 Mei 2017, tinggal di desa Mulo dan mengkonsumsi makanan olahan dari bapak S dan K. Instrument menggunakan kuesioner. Hasil: KLB terjadi di Desa Mulo RT 5 dan 6 dengan jumlah kasus sebanyak 18 orang dari total population at risk 112 orang dengan gejala utama diare (100%), mual (72,2%), demam (66,6%), pusing (66,6%) dan muntah (50%). Dari diagnosa banding menurut gejala, masa inkubasi dan agent penyebab keracunan, kecurigaan kontaminasi bakteri mengarah pada E. Coli (ETEC). Masa inkubasi 1-16 jam (rata-rata 9 jam) dan common source curve. Penyaji makanan ada dua (pak K dan pak S). Dari perhitungan AR, berdasarkan sumber makanan mengarah pada makanan dari pak S (AR=42,8%). Bedasarkan menu, perhitungan OR dan CI 95 % jenis makanan yang dicurigai sebagai penyebab KLB adalah urap/gudangan (OR=4,33; p value0,0071) dan sayur lombok (OR=6,31; p value 0,0071). Sampel yang didapatkan adalah sampel air bersih, feses, dan muntahan penderita, sampel makanan tidak didapatkan karena keterlambatan informasi dari masyarakat. Hasil laboratorium, Total Coliform sampel air bersih melebihi ambang batas, sampel feses dan muntahan mengandung bakteri Klebsiella pneumonia.Simpulan: Terdapat 3 (tiga) faktor yang diduga sebagai penyebab keracunan pada warga Desa Mulo yaitu air bersih untuk mengolah makanan tercemar bakteri patogen, pengolahan makanan tidak hygienis dan penyajian makanan pada suhu ruang lebih dari 1 jam.

scholarly journals EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis

2021 ◽  
pp. annrheumdis-2021-220884
Author(s):  
Kulveer Mankia ◽  
Heidi J Siddle ◽  
Andreas Kerschbaumer ◽  
Deshire Alpizar Rodriguez ◽  
Anca Irinel Catrina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
At Risk ◽  
Clinical Trials ◽  
Observational Studies ◽  
Task Force ◽  
Musculoskeletal Symptoms ◽  
Subclinical Inflammation ◽  
Consensus Statements ◽  
Clinical Arthritis

BackgroundDespite growing interest, there is no guidance or consensus on how to conduct clinical trials and observational studies in populations at risk of rheumatoid arthritis (RA).MethodsAn European League Against Rheumatism (EULAR) task force formulated four research questions to be addressed by systematic literature review (SLR). The SLR results informed consensus statements. One overarching principle, 10 points to consider (PTC) and a research agenda were proposed. Task force members rated their level of agreement (1–10) for each PTC.ResultsEpidemiological and demographic characteristics should be measured in all clinical trials and studies in at-risk individuals. Different at-risk populations, identified according to clinical presentation, were defined: asymptomatic, musculoskeletal symptoms without arthritis and early clinical arthritis. Study end-points should include the development of subclinical inflammation on imaging, clinical arthritis, RA and subsequent achievement of arthritis remission. Risk factors should be assessed at baseline and re-evaluated where appropriate; they include genetic markers and autoantibody profiling and additionally clinical symptoms and subclinical inflammation on imaging in those with symptoms and/or clinical arthritis. Trials should address the effect of the intervention on risk factors, as well as progression to clinical arthritis or RA. In patients with early clinical arthritis, pharmacological intervention has the potential to prevent RA development. Participants’ knowledge of their RA risk may inform their decision to participate; information should be provided using an individually tailored approach.ConclusionThese consensus statements provide data-driven guidance for rheumatologists, health professionals and investigators conducting clinical trials and observational studies in individuals at risk of RA.

scholarly journals POS0517 A LONGITUDINAL STUDY OF SARCOPENIA, LOCOMOTIVE SYNDROME, AND FRAILTY IN PATIENTS WITH RHEUMATOID ARTHRITIS: FROM THE CHIKARA STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 492.2-492
Author(s):  
K. Mandai ◽  
M. Tada ◽  
Y. Yamada ◽  
T. Koike ◽  
T. Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Multivariate Logistic Regression Analysis ◽  
Locomotive Syndrome ◽  
Chi Squared ◽  
Higher Doses ◽  
Rheumatoid Arthritis Data ◽  
Onset Rate ◽  
New Onset

Background:Rheumatoid arthritis (RA) patients have a high frequency of sarcopenia, and they commonly have reduced physical function. We previously reported that the prevalence of sarcopenia was 28%, that of frailty was 18.9%, and that of pre-frailty was 38.9% in RA patients1,2, and 13.2% of RA patients developed sarcopenia within a year 3.Objectives:To investigate the risk factors for new onset of sarcopenia, locomotive syndrome, and frailty in patients with RA and the course of each disease.Methods:Two-year follow-up data from the rural group of the prospective, observational CHIKARA study were used. Sarcopenia was diagnosed using the criteria of the Asian Working Group for Sarcopenia 2014, locomotive syndrome was diagnosed using locomotive 5, and frailty was diagnosed using the basic checklist. New onset of the disease over the 2-year follow-up period was studied, excluding cases that had the disease at baseline. Improvement was defined as cases with disease at baseline that no longer met the diagnostic criteria after 2 years. Differences in the characteristics of each disease were tested using the Chi-squared test and the paired t-test.Results:The 81 patients with RA (82.7% female) had mean age 66.9±11.5 years, mean DAS28-ESR 2.9±1.2, methotrexate use in 81.5% (with a dose of 9.9±2.7 mg/week), and glucocorticoid (GC) use in 22.2% (with a dose of 3.1±1.7 mg/week). The baseline prevalence was 44.4% for sarcopenia, 35.8% for locomotive syndrome, and 25.9% for frailty, and the new onset rate was 4.4% for sarcopenia, 15.4% for locomotive syndrome, and 13.3% for frailty. Of the patients with each disease at baseline, 36.1% had sarcopenia, 20.7% had locomotive syndrome, and 33.3% had frailty, and of those with each disease at 2 years, 36.1% had sarcopenia, 20.7% had locomotive syndrome, and 33.3% had frailty. The new onset sarcopenia and locomotive syndrome groups had significantly higher rates of GC use (p=0.036, p=0.007, paired t-test) and significantly higher doses (p=0.01, p=0.001, paired t-test) than the groups without new onset sarcopenia and locomotive syndrome. High baseline disease activity was an independent predictor of new onset of locomotive syndrome on multivariate logistic regression analysis (OR=3.21, p=0.015).Conclusion:The new onset rates at 2 years were 4.4% for sarcopenia, 15.4% for locomotive syndrome, and 13.3% for frailty. In the new onset sarcopenia and locomotive syndrome groups, both GC use and dosage were significantly higher.References:[1]Tada M, et al. Matrix metalloprotease 3 is associated with sarcopenia in rheumatoid arthritis - results from the CHIKARA study. Int J Rheum Dis. 2018 Nov;21(11):1962-1969.[2]Tada M, et al. Correlation between frailty and disease activity in patients with rheumatoid arthritis: Data from the CHIKARA study. Geriatr Gerontol Int. 2019 Dec;19(12):1220-1225.[3]Yamada Y, et al. Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Clin Rheumatol. 2020 Jun;39(6):1757-1764.Disclosure of Interests:None declared

scholarly journals AB0189 ASSESSMENT OF POWER DOPPLER SYNOVITIS IN RHEUMATOID ARTHRITIS PATIENTS WITH CLINICAL REMISSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1394.2-1394
Author(s):  
R. Fakhfakh ◽  
N. El Amri ◽  
K. Baccouche ◽  
H. Zeglaoui ◽  
E. Bouajina
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Capacity ◽  
Clinical Remission ◽  
Power Doppler ◽  
Health Assessment ◽  
Disease Flare ◽  
Synovial Hypertrophy ◽  
The Mean ◽  
Grade 3 ◽  
Subclinical Synovitis

Background:Ultrasound-detected synovitis, mainly synovial Doppler signal, has shown predictive value in relation to radiographic damage progression and disease flare or relapse in rheumatoid arthritis (RA) patients with clinical remission.Objectives:The aim of the study was to analyze the correlation between power Doppler scores and clinical/laboratory and radiographic data in clinical remission RA patients.Methods:Cross-sectional study including patients with RA in clinical remission defined by: DAS28ESR ≤ 2.6, without disease flare or changes in therapy in the previous 6 months. Each patient underwent ultrasound: B-mode and PD assessments of 36 joints and 20 tendons in the Rheumatology Department over a period of 6 month. Synovitis and tenosynovitis were defined and scored according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT). Radiological measurements included the modified Sharp/van der Heijde method (SHS). Functional capacity was assessed by the Health Assessment Questionnaire (HAQ).Results:Thirty two patients were enrolled, the mean age was 53.7±13.4 and 75% were female. The mean disease duration was 15 years ± 8.8. Subclinical synovitis were the most frequent in wrist (56.3%), 2ndmetacarpophalangeal joints (28.1%) and 2ndmetatarsophalangeal joints (29%). The mean subclinical synovitis/ tenosynovitis numbers was 4±3.1 per patient. Synovial hypertrophy and B mode tenosynovitis were detected in 93.8%: 71.3% had a grade = 2 and 9.8% had a grade= 3. Total B mode score was correlated only with the SHS score in the feet (r: 0.4, p: 0.03). PD signal was detected in 62.5% of patients: 37.5% had a grade =2 and 9.4% had a grade= 3. Total PD score was correlated with DAS28 (r:0.42, p:0.02), the SHS score in the hands (r:0.39, p:0.03) and in the feet (r:0.5, p:0.007), synovial hypertrophy (r:0.6, p:0.0001) and HAQ (r:0.32, p:0.06). No correlation was found with CDAI, SDAI, swollen joint counts, tender joint counts, patient global health assessment, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and anti-cyclic citrullinated peptide, biologic treatment.Conclusion:Synovial hypertrophy and PD signal were frequent in RA remission. PD signal was associated with RA activity, radiologic damage and functional capacity.References:[1]Yan Geng & Jingjing Han & Xuerong Deng and al. Presence of power Doppler synovitis in rheumatoid arthritis patients with synthetic and/or biological disease-modifying anti-rheumatic drug-induced clinical remission: experience from a Chinese cohort. Clinical Rheumatology 2014. DOI 10.1007/s10067-014-2634-yDisclosure of Interests:None declared

scholarly journals Temporomandibular disorders in patients with early rheumatoid arthritis and at-risk individuals in the Dutch population: a cross-sectional study

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001485
Author(s):  
Johanna M Kroese ◽  
Catherine M C Volgenant ◽  
Wim Crielaard ◽  
Bruno Loos ◽  
Dirkjan van Schaardenburg ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
At Risk ◽  
Early Rheumatoid Arthritis ◽  
Temporomandibular Disorders ◽  
Self Report ◽  
Joint Disease ◽  
Control Group ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Pain Diagnosis

ObjectiveTo evaluate the prevalence of temporomandibular disorders (TMD) in patients with early rheumatoid arthritis (ERA) and individuals at-risk of RA.Methods150 participants were recruited in three groups (50 per group): (1) patients with ERA (2010 EULAR criteria) (2) at-risk individuals and (3) healthy controls. All participants were tested for seropositivity of rheumatoid factor and anticitrullinated protein antibodies. A possible TMD diagnosis was determined according to the standardised and validated diagnostic criteria for TMD (DC/TMD) in five categories: myalgia, arthralgia, articular disc displacement, degenerative joint disease and headache attributed to TMD. Results were tested for the prevalence of TMD (all categories combined) and TMD pain (myalgia and/or arthralgia). To investigate a possible role for bruxism, a probable sleep and/or awake bruxism diagnosis was determined based on self-report and several clinical features.ResultsThe prevalence of any TMD diagnosis did not differ between the three groups. However, at-risk individuals more often had a TMD-pain diagnosis than healthy controls (p=0.046). No such difference was found between the ERA group and the control group. However, within the ERA group, seronegative patients had a TMD-pain diagnosis more often than seropositive patients (4/12 (33%) vs 3/38 (8%), p=0.048). Participants with a TMD-pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD-pain diagnosis.ConclusionThe prevalence of TMD pain is increased in individuals at-risk of RA and seronegative ERA patients, and is associated with bruxism signs and symptoms. These results suggest that health professionals should be alert to TMD pain in these groups.

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