POS0538 RELATIONSHIP BETWEEN HINDFOOT DEFORMITIES AND ULTRASOUND TENOSYNOVITIS IN RHEUMATOID ARTHRITIS

Background:Rheumatoid arthritis (RA) is an inflammatory disease that frequently affects the joints and soft tissues of the feet. Tibialis posterior tenosynovitis has a reported prevalence between 13 and 64% in RA. The condition is associated with a progressive flat foot deformity and significant gait disability. However, few studies have investigated the relationship between foot deformities and the involvement of tendons. Recently, ultrasonography (US) has been reported as the gold standard for the investigation of tendons.Objectives:This study aimed to assess the relationship between hindfoot deformities and US tenosynovitis in RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. For each patient, a podoscope examination of both feet was performed by a rheumatologist. A radiologist experienced in musculoskeletal imaging performed a US examination using a Philips HD11 device with a high-frequency linear transducer. The assessed lesions were synovitis of the tibiotalar, talonavicular, and subtalar joints, and tenosynovitis of tibialis anterior (TA), extensor hallucis longus (EHL), extensor digitorum longus (EDL), tibialis posterior (TP), flexor digitorum longus (FDL), flexor hallucis longus (FHL), fibularis brevis (FB) and fibularis longus (FL) tendons. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler/grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in respectively 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Podoscope examination revealed pes planus valgus (PPV) in 55.6% of cases and pes cavus varus (PCV) in 18.5% of cases. US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. In the anterior compartment, tenosynovitis of TA was noted in 5.6% of cases, of EHL in 1.9% of cases, and EDL in 9.3% of cases. In the medial compartment, tenosynovitis of TP was found in 22.2% of cases, of FDL in 5.6% of cases, and FHL in 0% of cases. In the lateral compartment, tenosynovitis of FB and FL was found in 25% and 11.1% of cases respectively.An association between PPV and synovitis of the tibiotalar joint (p<0.001) and the subtalar joint (p=0.007) was found. An association was also noted with FL tenosynovitis (p=0.045) but not with the other assessed tendons.No association was noted between PCV and synovitis or tenosynovitis of the assessed structures.Conclusion:PPV was frequent among RA patients. This condition was associated with tibiotalar and subtalar synovitis and FL tenosynovitis. It is important to detect and correct foot deformities in order to ensure optimal control of the disease.Disclosure of Interests:None declared

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POS0548 OPTIMAL ASSESSMENT OF THE RHEUMATOID ARTHRITIS ANKLE AND HINDFOOT: A COMPARATIVE STUDY BETWEEN CLINICAL EXAMINATION AND ULTRASONOGRAPHY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2720 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 508.2-509

Author(s):

K. Maatallah ◽

H. Boussaa ◽

H. Riahi ◽

H. Ferjani ◽

M. Habechi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Examination ◽

Demographic Data ◽

Power Doppler ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Therapeutic Decisions ◽

The Mean ◽

Foot Disease

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared

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The relation between cardiovascular affection and erosive articular changes in patients with rheumatoid arthritis

QJM ◽

10.1093/qjmed/hcaa064.004 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M M H Hassabelnabi ◽

N Y Assaf ◽

H F Zidan ◽

G M M Abushanab

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Risk ◽

Power Doppler ◽

Premenopausal Women ◽

Joint Disease ◽

P Value ◽

Physical Medicine ◽

Bone Erosions ◽

The Mean

Abstract Background rheumatoid arthritis is currently regarded as independent cardiovascular risk factor. Accelerated atherosclerosis considered as an extra-articular manifestation of RA that occurs as a result of interaction between traditional CV risk factors and inflammatory activity of joint disease. Both atherosclerosis and RA have in common inflammatory mediators. Objectives the presented study aimed to find the relation between cardiovascular affection and erosive articular changes in RA. Subjects and Methods The presented study included 40 patients’ men and premenopausal women that were diagnosed with rheumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis recruited from the physical Medicine, Rheumatology, and Rehabilitation outpatient clinics of Ain Shams University, patients underwent laboratory investigation, carotid duplex, musculoskeletal ultrasound and echocardiography. Results Among 40 RA patients, 16 (40%) had erosions in both hands and 24 (60%) without erosion with no statistically significance difference between both sides of hand and feet, only 3 patients (7.5%) had active erosion exhibited by power Doppler. The presence of erosion positively correlated with the mean CIMT (p-value < 0.001) with mean 0.827±0.149, The presence of carotid plaques as a marker of advanced atherosclerosis showed statistically significant value with erosions (p = 0.001). There was positive relation between erosions with disease duration (p-value < 0.001), and negatively with DAS-28 (p = 0.083). Out of 33 patients with positive RF, 16 patients had erosions with statistically significant value (p = 0.017). Conclusion Since the presence of bone erosions was highly associated with higher mean CIMT, consequently, we recommend that when finding bone erosions in rheumatoid arthritis patient, good monitoring should be given to cardiovascular risk factors with early and proper treatment to limit the progression of erosions and protect against atherosclerosis and its complications.

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AB0171 ACHILLES ENTHESITIS AND PLANTAR FASCIITIS IN RHEUMATOID ARTHRITIS PATIENTS: IMPACT OF BODY MASS INDEX

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3194 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1112.1-1112

Author(s):

K. Maatallah ◽

H. Boussaa ◽

H. Riahi ◽

H. Ferjani ◽

M. Habechi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Achilles Tendon ◽

Clinical Data ◽

Plantar Fasciitis ◽

Structural Damage ◽

Doppler Signal ◽

Foot Deformities ◽

P Value ◽

Plantar Aponeurosis ◽

The Mean

Background:Enthesitis is known as a hallmark of spondyloarthitis. However, the growing use of ultrasonography (US) increased our opportunity to encounter enthesitis in rheumatoid arthritis (RA). The involvement of Achilles tendon and the plantar fascia is not rare in RA patients.Objectives:The aims of this study were to determine the prevalence of Achilles enthesitis and plantar fasciitis in RA patients, and to identify association with clinical data.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic and clinical data were collected. Three groups were defined according to the BMI: normal (BMI<25kg/m2), overweight (BMI≥25kg/m2) and obese (BMI≥30kg/m2). US examination of Achilles tendon and plantar aponeurosis was performed by a blinded radiologist experienced in musculoskeletal US using a Philips HD11 device with a high-frequency linear transducer. Enthesitis was defined as hypoechoic and/or thickened insertion of the tendon close to the bone (within 2 mm from the bony cortex) which exhibits Doppler signal if active and that may show erosions, enthesophytes or calcifications as sign of structural damage. A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].The mean BMI was 27.7±5.4 kg/m2 [18.3-45.8]. Obesity was noted in 22.7 % of patients and overweight in 45.5% of patients. Clinical examination revealed pes planus valgus (PPV) in 55.6% of cases and pes cavus varus (PCV) in 18.5% of cases.Heel US revealed Achilles enthesitis in 79.6% of cases. The following elementary lesions were noted in the enthesis: thickness (24.1%), hypoechogenicity (37%), erosions (9.3%), enthésophytes (75.9%), and Doppler signal (3.7%). Plantar fasciitis was noted in 81.5% of cases. The following elementary lesions were found in the insertion of plantar aponeurosis: thickness (75.9%), hypoechogenicity (77.8%), erosions (16.7%), enthesophytes (13%), calcifications (1.9%), and Doppler signal (1.9%).An association was noted between BMI and Achilles enthesitis (p=0.002). This association was not found with plantar fasciitis (p=0.224).Achilles enthesitis was also associated with PCV (p=0.007) while plantar fasciitis was associated with PPV (p=0.039).Conclusion:Achilles enthesitis and plantar fasciitis are common in RA patients. These lesions seem to be associated with BMI and foot deformities rather than the inflammatory process.Disclosure of Interests:None declared

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

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6064 ◽

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

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POS1465-HPR THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND SLEEP IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.641 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1017.2-1018

Author(s):

N. Kelly ◽

E. Hawkins ◽

H. O’leary ◽

K. Quinn ◽

G. Murphy ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Sleep Quality ◽

Sedentary Behavior ◽

Disease Duration ◽

Cross Sectional Study ◽

P Value ◽

Poor Sleep ◽

Cross Sectional ◽

The Relationship

Background:Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory condition that affects 0.5% of the adult population worldwide (1). Sedentary behavior (SB) is any waking behavior characterized by an energy expenditure of ≤1.5 METs (metabolic equivalent) and a sitting or reclining posture, e.g. computer use (2) and has a negative impact on health in the RA population (3). Sleep is an important health behavior, but sleep quality is an issue for people living with RA (4, 5). Poor sleep quality is associated with low levels of physical activity in RA (4) however the association between SB and sleep in people who have RA has not been examined previously.Objectives:The aim of this study was to investigate the relationship between SB and sleep in people who have RA.Methods:A cross-sectional study was conducted. Patients were recruited from rheumatology clinics in a large acute public hospital serving a mix of urban and rural populations. Inclusion criteria were diagnosis of RA by a rheumatologist according to the American College of Rheumatology criteria age ≥ 18 and ≤ 80 years; ability to mobilize independently or aided by a stick; and to understand written and spoken English. Demographic data on age, gender, disease duration and medication were recorded. Pain and fatigue were measured by the Visual Analogue Scale (VAS), anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index. SB was measured using the ActivPAL4™ activity monitor, over a 7-day wear period. Descriptive statistics were calculated to describe participant characteristics. Relationships between clinical characteristics and SB were examined using Pearson’s correlation coefficients and regression analyses.Results:N=76 participants enrolled in the study with valid data provided by N=72 participants. Mean age of participants was 61.5years (SD10.6) and the majority 63% (n = 47) were female. Participant mean disease duration was 17.8years (SD10.9). Mean SB time was 533.7 (SD100.1) minutes (8.9 hours per day/59.9% of waking hours). Mean sleep quality score was 7.2 (SD5.0) (Table 1). Correlation analysis and regression analysis found no significant correlation between sleep quality and SB variables. Regression analysis demonstrated positive statistical associations for SB time and body mass index (p-value=0.03846, R2 = 0.05143), SB time and pain VAS (p-value=0.009261, R2 = 0.07987), SB time and HADS (p-value = 0.009721, R2 = 0.08097) and SB time and HADSD (p-value = 0.01932, R2 = 0.0643).Conclusion:We found high levels of sedentary behavior and poor sleep quality in people who have RA, however no statistically significant relationship was found in this study. Future research should further explore the complex associations between sedentary behavior and sleep quality in people who have RA.References:[1]Carmona L, et al. Rheumatoid arthritis. Best Pract Res Clin Rheumatol 2010;24:733–745.[2]Anon. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab = Physiol Appl Nutr Metab 2012;37:540–542.[3]Fenton, S.A.M. et al. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18, 131 (2017).[4]McKenna S, et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int. 2018 May;38(5):845-853.[5]Grabovac, I., et al. 2018. Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity. Journal of clinical medicine, 7(10)336.Table 1.Sleep quality in people who have RASleep variableBed Time N(%) before 10pm13(18%) 10pm-12pm43 (60%) after 12pm16 (22%)Hours Sleep mean(SD)6.56 (1.54)Fall Asleep minutes mean(SD)33.3(27.7)Night Waking N(%)45(63%)Self-Rate Sleep mean(SD)2.74 (0.90)Hours Sleep mean(SD)6.56 (1.54)Disclosure of Interests:None declared

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AB0101 THE IMPACT OF TIME SPAN TO ACHIEVE BOOLEAN REMISSION FOR MAINTAINING DISEASE ACTIVITY AFTER ACQUISITION IN RHEUMATOID ARTHRITIS PATIENT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.297 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1079.1-1079

Author(s):

I. Yoshii

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Remission Rate ◽

Mean Value ◽

Time Span ◽

Mean Values ◽

The Mean ◽

The Relationship

Background:Boolean remission criteria is one most popular and stringent criteria in treating patient with rheumatoid arthritis (RA), because it may guarantees a stable clinical course after attaining remission.Objectives:Impact of time span from initiation to achieving Boolean remission on maintaining disease activity, daily activities, and quality of life after attaining Boolean remission was investigated from daily clinical practice data.Methods:685 patients with RA since August 2010 under the T2T strategy were treated. They were monitored for their TJC, SJC, PGA, EGA, CRP, and disease activity indices such as CDAI, SDAI, DAS28, and Boolean criteria at every visit. HAQ-DI score, pain score using visual analog scale (PS-VAS), and EQ-5D were also monitored, and the quality of life score (QOLS) calculated from EQ-5D was determined at every visit from the time of diagnosis (baseline).Of 685 patients, 465 patients had achieved Boolean remission >1 times, and were consecutively followed up for >3 years. These patients were enrolled in the study. Time span from the first visit to first Boolean remission was calculated. The relationship between the time span and each of background parameters, and the relationship between the time span and each of the mean values of the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at the first Boolean remission and thereafter was evaluated statistically.Patients were subsequently divided into the G ≤ 6 and G > 6 groups based on the achievement of first Boolean remission within two groups: time span G ≤ 6 months and G > 6 months. The two groups were compared with regard to the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at first visit and at the time of first Boolean remission, and the mean values of these parameters after remission were evaluated statistically. Moreover, changes of these parameters and the mean Boolean remission rate after the first remission, and SDAI remission rate at the first Boolean remission to thereafter were compared between the two groups statistically.Results:Out of 465 patients, females comprised 343 (73.7%), and the mean age was 67.8 years (range, from 21–95 years). The mean disease duration at first visit was 6.1 years (range, from 1 months–45 years). The mean follow up length was 88.1 months (range: 36–122 months; median: 85 months) and mean time span from the first visit to the first Boolean remission was 8.1 months. The mean SDAI score, HAQ score, PS-VAS, and the QOLS at first visit were 13.3, 0.467, 33.2, and 0.834, respectively. Among the study parameters, PS-VAS and QOLS were significantly correlated with the time span. For parameters at the first Boolean remission, HAQ-DI score, PS-VAS, and QOLS demonstrated significant correlation with the time span, whereas SDAI, HAQ-DI score, PS-VAS, SHS, and QOLS after the Boolean remission demonstrated significant correlation with the time span.The comparison between the G ≤ 6 and the G > 6 groups revealed that the disease duration, HAQ score, and PS-VAS at baseline in the G > 6 were significantly higher than that in the G ≤ 6 group, and QOLS in the G ≤ 6 group was significantly higher than that in the G > 6 group at baseline. Similarly, the HAQ score and PS-VAS at the first Boolean remission in the G > 6 group were significantly higher than that in the G ≤ 6 group, whereas QOLS in the G ≤ 6 group demonstrated no significant difference compared with that in the G > 6 group.The mean value of the SDAI score after the first Boolean remission in the G > 6 group was significantly higher than that in the G ≤ 6 group. Similarly, the SDAI score, HAQ score, and PS-VAS after the first Boolean remission in the G > 6 group were also significantly higher than those in the G ≤ 6 group, and the mean value of the QOLS in the G ≤ 6 group were significantly higher than that in the G > 6 group. The Boolean remission rate and SDAI remission rate after the first Boolean remission were significantly higher in the G ≤ 6 group than those in the G > 6 group.Conclusion:Attaining Boolean remission ≤ 6 months for RA has significant benefit for more stable disease control, that leads good maintenance of ADL.Disclosure of Interests:None declared

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A study of Madrid sonographicenthesis score Index (MASEI) versus spondyloarthritis research consortium of Canada (SPARCC) in the assessment of early enthesopathy among psoriatic skin patient

QJM ◽

10.1093/qjmed/hcab116.008 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Nehal M Zytoon ◽

Nadia S Abd El Bar ◽

Mona G El Husseiny ◽

Reem M El-mallah ◽

Nermin H El-Gharbawy

Keyword(s):

Clinical Examination ◽

Power Doppler ◽

Musculoskeletal Ultrasound ◽

Psoriatic Skin ◽

P Value ◽

Early Assessment ◽

Significant Difference ◽

The Mean ◽

Research Consortium ◽

Score Index

Abstract Objective To compare between Sonographic Madrid score index (MASEI) versus Spondyloarthritis research consortium of canada (SPARCC) for early assessment of enthesopathy among psoriatic skin patients. Patients and Methods This study included fifty psoriatic skin patients. All underwent history, laboratory investigation, clinical examination using SPARCC score, Psoriasis Area and Severity Index (PASI) and musculoskeletal ultrasound using MASEI score with power Doppler (PD) bilaterally for assessment of enthesitis. Results The mean age of fifty patients was 42.00 ± 10.923 years, disease duration of 11.110 ±7.402 and BMI of 29.356 ± 3.753. The mean PASI was 12.950±8.044. SPARCC score was positive in 10 out of 50 patients (20%).MASEI score was positive in 20 out of 50 patients (40%) with 10 out of 50 patients had power Doppler signals. Highly statistically significant difference between MASEI and SPARCC score( pvalue <0.001). Highly statistically significant positive correlation was observed between PASI score and MASEI(r = 0.498, p-value <0.001). Conclusion musculoskeletal ultrasound is useful for early detection of enthesitis and to be a sensitive tool in detecting of enthesitis and subclinical enthesitis that can be missed during routine clinical examination.

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SAT0090 EFFECTS OF ADHERENCE TO MEDITERRANEAN DIET ON RHEUMATOID ARTHRITIS IMPACT OF DISEASE (RAID) SCORE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2338 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 979.1-979

Author(s):

F. Ingegnoli ◽

I. Scotti ◽

T. Schioppo ◽

T. Ubiali ◽

G. Marano ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mediterranean Diet ◽

Functional Disability ◽

Regression Coefficient ◽

Well Being ◽

P Value ◽

Food Groups ◽

Single Item ◽

And Coping ◽

The Relationship

Background:Mediterranean diet (MD) is a well-balanced, nutritionally adequate and potentially anti-inflammatory diet that encompasses all food groups. Presently, there are conflicting data about the benefits of MD in rheumatoid arthritis (RA). Not enough evidence support a role of MD in the prevention and treatment of RA, and a modest impact of MD on laboratory parameters has been described. Greater effect on subjective aspects of the disease such as joint pain, morning stiffness, and fatigue was reported.Objectives:To investigate whether the adherence to MD affects RA perception as measured by Rheumatoid Arthritis Impact of Disease (RAID) score.Methods:Consecutive patients <65 years with RA attending our outpatient clinic were enrolled in this cross-sectional study. For each patient we collected: 1) RAID that consists of 7 single-item domains (pain, functional disability, fatigue, sleep, physical well-being, emotional well-being and coping), each rated by patients on an 11-point numerical rating scale from 0 (best) to 10 (worst) [1], and 2) MD score, a self-reported questionnaire that evaluates the adherence to MD through the consumption of 11 food groups, ranging from 0 (no adherence) to 55 (high adherence) [2]. Univariate analysis was performed using MD score as independent variable. Moreover, to evaluate the adjusted relationship between the single item of RAID and MD score, a multiple regression model was used.Results:205 RA patients were enrolled: median age at visit 53 (q1-q3: 44-59) years, female 80.5 %. The median MD and RAID score were 35 (q1-q3: 32-39) and 2.42 (q1-q3: 0.63-4.51) respectively.RAID total score had a statistically significant negative relationship with MD score (regression coefficient -0.08; p-value=0.016). Concerning the single RAID items, a statistically significant negative association was found for pain (regression coefficient -0.08; p-value=0.025), functional disability (regression coefficient -0.13; p-value<0.001), sleep (regression coefficient -0.08; p-value=0.041), physical well-being (regression coefficient -0.08; p-value=0.027) and coping (regression coefficient -0.11; p-value=0.008).Multiple regression analysis to evaluate the relationship between significant RAID items and MD score did not show any statistical significance as all items are strongly related to each other.Conclusion:To our knowledge, this is the first study addressing the relationship between the adherence to MD and the perception of RA impact. A better MD adherence was associated with lower self-reported composite total RAID score as well as lower pain, functional disability, sleep, physical well-being and coping. The effect of MD adherence on overall RAID is relevant but, at the same time, a prominent effect of one single item on the others could not be documented. This study confirmed the importance of non-pharmacological interventions, such as diet, in RA management.References:[1] Gossec L, et al. Ann Rheum Dis 2011;70(6):935-42.[2] Panagiotakos DB, et al. Nutr Metab Cardiovasc Dis 2006;16(8):559-68.Disclosure of Interests:Francesca Ingegnoli: None declared, Isabella Scotti: None declared, Tommaso Schioppo: None declared, Tania Ubiali: None declared, Giuseppe Marano: None declared, Patrizia Boracchi: None declared, Orazio De Lucia: None declared, Antonella Murgo: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

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Fetal Fibronectin (fFN) on the Imminent Premature Parturition in Correlation with Incidence of Preterm Labor

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v4i1.65 ◽

2016 ◽

Author(s):

Kusnarman Keman ◽

Prasetyorini Nugrahanti ◽

Ni Wayan Supriany

Keyword(s):

Pregnant Women ◽

Preterm Labor ◽

Obstet Gynecol ◽

Obstetrics And Gynecology ◽

P Value ◽

Fetal Fibronectin ◽

Preterm Group ◽

The Mean ◽

Relationship Of ◽

The Relationship

Objective: To determine the relationship of fFn levels in cervicovaginal discharge of pregnant women who experience imminent premature parturition with the incidence of preterm labor. Method: The study was carried out with Analytic Observational Prospective Cohort using cervicovaginal discharge of pregnant women that experienced imminent premature parturition taken from the delivery room of Obstetrics and Gynecology department dr. Saiful Anwar Hospital, Malang as well as Bangil Hospital and Ngudi Waluyo Wlingi Hospital. Statistical analysis was performed using the Shapiro-Wilk test and comparison test used independent samples t test for normal data, Mann-Whitney test if not. All analysis used SPSS for Windows 19.0 software. Result: Thirty two patient samples was examined, 14 patients (43.75%) were primigravida and 18 patients (52.56%) is multigravida. 17 of these patients (53.13%) experienced aterm labor and 15 patients (46.87%) experienced preterm labor. Mann-Whitney test of the mean fFN levels between the aterm group (13.01 ± 7.57 ng/ml) and the preterm group (56.29 ± 27.77 ng/ml) showed a significant difference (p-value = 0.000 > 0.05). Moreover, Spearman’s Rho correlation test also showed a strong correlation between fFN level and incidence of preterm labor (R = 0.797, p < 0.05). Conclusion: fFN levels is significantly increase in cervicovaginal discharge from pregnant women with imminent premature parturition who experience preterm labor than pregnant women who experience aterm labor. Therefore, this result suggests that fFN has potential ability to become useful modality in preterm labor diagnosis. [Indones J Obstet Gynecol 2016; 1: 8-14] Keywords: cervicovaginal discharge, fFN, imminent premature parturition, preterm labor

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Severe Perinatal Asphyxia and Risk of Neonatal Jaundice at a Tertiary Hospital in Northern Nigeria

Asian Journal of Pediatric Research ◽

10.9734/ajpr/2021/v5i330176 ◽

2021 ◽

pp. 17-22

Author(s):

I. A. Imoudu ◽

M. O. Yusuf ◽

A. T. Aro ◽

P. E. Akpabio ◽

Z. M. Waziri

Keyword(s):

Medical Records ◽

Neonatal Jaundice ◽

Serum Bilirubin ◽

Perinatal Asphyxia ◽

Tertiary Hospital ◽

P Value ◽

Community Based ◽

Special Care Baby Unit ◽

The Mean ◽

The Relationship

Background: The risk factors of neonatal jaundice are largely known, yet there is little agreement on the association between it and perinatal asphyxia. Aim: To investigate the association between severe perinatal asphyxia (SPA) and the risk of clinical jaundice (NNJ) among neonates managed at the Federal Medical Centre, Azare, Nigeria. Methodology: Case control design was employed. Medical records of 315 babies managed at the special care baby unit from 1st January, 2011 to 31st December, 2018 were analysed. The exposure of interest was SPA and the outcome was jaundice. Logistic regression was applied to demonstrate the relationship between neonatal jaundice and SPA. Relative risk was provided as odds ratio and 95% confidence interval. Results: Sixty-three cases and 252 controls were enrolled in the study. The mean age of the cases (4.39) and that of the controls (4.95 ) did not differ significantly (t= -0.52, P= 0.30). One hundred and fifty-six (61.9%) of the controls were males while 34 (54.0%) of the cases were females. For 59 (93.7%) of the cases treatment for jaundice was done with phototherapy and 1.6% required exchange blood transfusion. SPA significantly reduced the risk of developing NNJ (adjusted OR = 0.27, P-value ˂ 0.01). Conclusion: We demonstrated a significantly reduced risk of developing neonatal jaundice with prior exposure to severe perinatal asphyxia. Prospective multicenter and community based studies correlated with serum bilirubin levels are recommended.

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