scholarly journals Effect of COVID-19 Pandemic on Anxiety in Rheumatology Patients Taking Immunosuppressive Drugs

Author(s):  
Tugba Izci Duran ◽  
Seyyid Bilal Acikgoz ◽  
Cemal Gurbuz ◽  
Aysegul Ucar ◽  
Gokhan Yavuzbilge ◽  
...  

Abstract Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a public health emergency that is causing international concern. Patients with medical comorbidities are more likely to be infected and have a worse prognosis. The purpose of this study was to determine the prevalence of anxiety due to COVID-19 pandemic in patients with rheumatic and musculoskeletal diseases (RMDs) who used immunosuppressive drugs during the initial stage of the COVID-19 pandemic and to identify the risk and protective factors that cause anxiety.Methods: A total of 145 patients with RMDs aged ≥18 years who used regular immunosuppressive drugs and 95 healthy controls were included in the study. An anonymous survey comprising questions regarding the COVID-19 pandemic was used, and the Beck anxiety inventory (BAI) was used to measure the anxiety levels of participants. Additional information was collected such as demographic data, current RMDs, immunosuppressive drugs used, information and concerns about COVID-19, and the source of information about COVID-19.Results: About 42.1% patients reported that the epidemic caused concern due to the drug they were using, and 33.8% rated their concerns as moderate and severe. The BAI scores of patients and healthy controls were 4 (0-52) and 3 (0-18) respectively. According to the BAI scores, 16.5% patients had moderate to severe anxiety symptoms; and comparison of the groups showed that the anxiety level of the patient group was significantly higher (38.6% vs. 18.9%, p=0.001). Female had more anxiety symptoms in both groups (p<0.005). In addition, anxiety was lower in patients with higher education levels (p=0.039).Conclusion: It should be ensured that patients in the high-risk group are not provided false information, the patients are individually informed, and they trust the treatment team. Providing online or smartphone-based psychoeducation and psychological interventions may be considered for these patients with high anxiety levels.

2020 ◽  
Author(s):  
Tugba Izci Duran ◽  
Seyyid Bilal Acikgoz ◽  
Cemal Gurbuz ◽  
Aysegul Ucar ◽  
Gokhan Yavuzbilge ◽  
...  

Abstract Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a public health emergency that is causing international concern. Patients with medical comorbidities are more likely to be infected and have a worse prognosis. The purpose of this study was to determine the prevalence of anxiety due to COVID-19 pandemic in patients with rheumatic and musculoskeletal diseases (RMDs) who used immunosuppressive drugs during the initial stage of the COVID-19 pandemic and to identify the risk and protective factors that cause anxiety.Methods: A total of 145 patients with RMDs aged ≥18 years who used regular immunosuppressive drugs and 95 healthy controls were included in the study. An anonymous survey comprising questions regarding the COVID-19 pandemic was used, and the Beck anxiety inventory (BAI) was used to measure the anxiety levels of participants. Additional information was collected such as demographic data, current RMDs, immunosuppressive drugs used, information and concerns about COVID-19, and the source of information about COVID-19.Results: About 42.1% patients reported that the epidemic caused concern due to the drug they were using, and 33.8% rated their concerns as moderate and severe. The BAI scores of patients and healthy controls were 4 (0-52) and 3 (0-18) respectively. According to the BAI scores, 16.5% patients had moderate to severe anxiety symptoms; and comparison of the groups showed that the anxiety level of the patient group was significantly higher (38.6% vs. 18.9%, p=0.001). Female had more anxiety symptoms in both groups (p<0.005). In addition, anxiety was lower in patients with higher education levels (p=0.039).Conclusion: It should be ensured that patients in the high-risk group are not provided false information, the patients are individually informed, and they trust the treatment team. Providing online or smartphone-based psychoeducation and psychological interventions may be considered for these patients with high anxiety levels.


2021 ◽  
Author(s):  
Nilson Silva ◽  
Anderson Sousa Martins da Silva ◽  
Lucas Pequeno Galvao ◽  
Julio Torales ◽  
Antonio Ventriglio ◽  
...  

Background Depression and anxiety are common and disabling mental disorders worldwide. It has been described a high prevalence of these disorders among health professionals. Aim This study aimed to investigate the association between occupation and depressive/anxiety symptoms, education levels, among professionals from a Brazilian General Hospital in need of mental health treatment. Methods This is a longitudinal twelve-years retrospective study, involving health professionals. Socio-demographic data were collected as well as two standardized scales for depression and anxiety symptoms. Results Data from 506 employees needing a mental health intervention have been described: mean age was 34.6 years, 46.2% of them worked in the administrative sector, 35.0% were nursing assistants, 7.5% were nursing technicians, 6.7% were nurses, and 4.5% reported other occupations. According to the ICD-10 criteria, the rates of diagnosis of depressive disorders and anxiety disorders were 60.9% and 37%, respectively. Conclusions The rate of depression and anxiety is higher among health professionals than the general population. Thus, specific programs of prevention based on resilience, continuing education and health promotion are needed.


1996 ◽  
Vol 15 (3) ◽  
pp. 241-259 ◽  
Author(s):  
Kathy Lynn Schuh

This study looked at characteristics of the classroom environment and their relationship to reduction of computer anxiety in students taking college computer proficiency courses. The College and University Lecture Classroom Environment Inventory was developed for this study as a means to assess the classroom environment. Pre- and posttest data were utilized to assess computer anxiety levels as well as gather additional information about the classroom environment and provide demographic data for comparison with computer anxiety. Weak correlations were found between students' change in computer anxiety and students' perceptions of the classroom environment. Significant differences were found in changes of computer anxiety among students who indicated that they had sought or received assistance from the instructor and those who indicated that the instructor had said or done something during the semester to alleviate their fears and apprehension about working on a computer.


Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 974
Author(s):  
Hayfa Sharif ◽  
Caroline L. Hoad ◽  
Nichola Abrehart ◽  
Penny A. Gowland ◽  
Robin C. Spiller ◽  
...  

Background: Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations. Objectives: (1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT). Methods: Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7–18 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT. Results: Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243–384 mL) for the FC group than for the healthy controls of 227 mL (180–263 mL). The largest increase between patients and controls was in the sigmoid colon–rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005). Conclusions: This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eman H. Ibrahim ◽  
Mostafa G. Aly ◽  
Gerhard Opelz ◽  
Christian Morath ◽  
Martin Zeier ◽  
...  

Abstract Background The Identification of B cell subsets with regulatory functions might open the way to new therapeutic strategies in the field of transplantation, which aim to reduce the dose of immunosuppressive drugs and prolong the graft survival. CD25 was proposed as a marker of a B-cell subset with an immunosuppressive action termed Bregs. The effect of CD19 + CD25 + Bregs on graft function in renal transplant recipients has not yet been elucidated. We investigated a potential impact of CD19 + CD25 + Bregs on renal graft function as well as a possible interaction of CD19 + CD25 + Bregs with peripheral Tregs in healthy controls, end-stage kidney disease patients (ESKD), and renal transplant recipients. Moreover, we aimed to investigate the association of CD19 + CD25 + Bregs with serum IL-10, TGF-ß1, and IFN-γ in the same study groups. Method Thirty-one healthy controls, ninety renal transplant recipients, and eighteen ESKD patients were enrolled. We evaluated the CD19 + CD25 + Bregs and Treg absolute counts. Next, we investigated CD19 + CD25 + Bregs as predictors of good graft function in multiple regression and ROC analyses. Finally, we evaluated the association between CD19 + CD25+ Bregs and serum IL-10, TGF-ß, and IFN-γ. Results ESKD patients and renal transplant recipients showed lower counts of CD19 + CD25+ Bregs compared to healthy controls (p < 0.001). Higher CD19 + CD25+ Breg counts were independently associated with a better GFR in renal transplant recipients (unstandardized B coefficient = 9, p = 0.02). In these patients, higher CD19 + CD25+ Bregs were independently associated with higher Treg counts (unstandardized B = 2.8, p = 0.004). In ROC analysis, cut-offs for CD19 + CD25 + Breg counts and serum TGF-ß1 of 0.12 cell/μl and 19,635.4 pg/ml, respectively, were shown to provide a good sensitivity and specificity in identifying GFR ≥ 30 ml/min (AUC = 0.67, sensitivity 77%, specificity 43%; AUC = 0.65, sensitivity 81%, specificity 50%, respectively). Finally, a significant positive association between CD19 + CD25+ Bregs and TGF-ß1 was shown in renal transplant recipients (r = 0.255, p = 0.015). Conclusions Our findings indicate that higher counts of CD19 + CD25+ Bregs are independently associated with better renal function and higher absolute Treg counts in renal transplant recipients.


2010 ◽  
Vol 37 (12) ◽  
pp. 2452-2461 ◽  
Author(s):  
LIE DAI ◽  
LANG-JING ZHU ◽  
DONG-HUI ZHENG ◽  
YING-QIAN MO ◽  
XIU-NING WEI ◽  
...  

Objective.To determine serum glucose-6-phosphate isomerase (GPI) concentrations in patients with rheumatoid arthritis (RA), and to test whether they correlate with objective measures of disease activity.Methods.Sera from 116 patients with RA, 69 patients with non-RA rheumatic diseases, and 101 healthy controls were analyzed. Levels of soluble serum GPI were measured by ELISA. Histological disease activity was determined with the synovitis score in synovial needle biopsies from 58 of the 116 patients with RA. Thirty-one of the 58 synovium samples were stained for CD68, CD3, CD20, CD38, CD79a, and CD34 by immunohistochemistry. Demographic data were collected, as well as serological and clinical variables that indicate RA disease activity, for Spearman correlation analysis.Results.Serum GPI level correlated positively with the synovitis score (r = 0.278, p = 0.034). Significantly higher soluble GPI levels were detected in the RA sera compared with sera from healthy controls and the non-RA disease controls (2.25 ± 2.82 vs 0.03 ± 0.05 and 0.19 ± 0.57 μg/ml, respectively; p < 0.0001). The rate of serum GPI positivity was significantly higher in the RA patients than in the non-RA disease controls (64.7% vs 10.1%; p < 0.0001). Spearman analysis showed no significant correlation between serum GPI level and Disease Activity Score in 28 joints at baseline. After initiation of antirheumatic treatments, GPI levels decreased significantly (2.81 ± 3.12 vs 1.44 ± 2.09 μg/ml; p = 0.016), paralleling improvement of the disease activity indices.Conclusion.Elevated serum GPI may be involved in the synovitis of RA and may prove useful as a serum marker for disease activity of RA.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rizwan Qaisar ◽  
Asima Karim ◽  
Tahir Muhammad ◽  
Islam Shah ◽  
Javaidullah Khan

AbstractLoss of muscle mass and strength with aging, termed sarcopenia is accelerated in several comorbidities including chronic heart failure (CHF) and chronic obstructive pulmonary diseases (COPD). However, the effective circulating biomarkers to accurately diagnose and assess sarcopenia are not known. We recruited male healthy controls and patients with CHF and COPD (n = 81–87/group), aged 55–74 years. Sarcopenia was clinically identified based on hand-grip strength, appendicular skeletal muscle index and physical capacity as recommended by the European working group for sarcopenia. The serum levels of amino-terminal pro-peptide of type-III procollagen, c-terminal agrin fragment-22, osteonectin, irisin, fatty acid-binding protein-3 and macrophage migration inhibitory factor were significantly different between healthy controls and patients with CHF and COPD. Risk scores for individual biomarkers were calculated by logistic regressions and combined into a cumulative risk score. The median cutoff value of 3.86 was used to divide subjects into high- and low-risk groups for sarcopenia with the area under the curve of 0.793 (95% CI = 0.738–0.845, p < 0.001). A significantly higher incidence of clinical sarcopenia was found in high-risk group. Taken together, the battery of biomarkers can be an effective tool in the early diagnosis and assessment of sarcopenia.


2010 ◽  
Vol 13 (8) ◽  
pp. 1170-1177 ◽  
Author(s):  
Megan E Grimstvedt ◽  
Kathleen Woolf ◽  
Brandy-Joe Milliron ◽  
Melinda M Manore

AbstractObjectiveTo assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.DesignCross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7·11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann–Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.SettingArizona, USA.SubjectsOlder (≥ 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).ResultsThere were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0·02), total fruit (cups; P = 0·05), whole grains (oz; P = 0·004), oil (g; P = 0·05) and total HEI score (P = 0·04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = −0·20, P = 0·04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0·02), fibre (g; P = 0·01) and vitamin C (mg; P = 0·04).ConclusionsThis is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.


RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000743 ◽  
Author(s):  
Abhishek Abhishek ◽  
Annamaria Iagnocco ◽  
J W J Bijlsma ◽  
Michael Doherty ◽  
Frédéric Lioté

ObjectivesTo survey the undergraduate rheumatic and musculoskeletal diseases (RMDs) curriculum content in a sample of medical schools across Europe.MethodsThe undergraduate musculoskeletal diseases and disability curriculum of University of Nottingham, UK, was used as a template to develop a questionnaire on curriculum content. The questionnaire elicited binary (yes/no) responses and included the option to provide additional information as free text. The survey was mailed to members of the European League Against Rheumatism (EULAR) School of Rheumatology (Undergraduate Classroom) and to EULAR Standing Committee on Education and Training members in January 2017, with a reminder in February 2017.ResultsResponses were received from 21 schools belonging to 11 countries. Assessment of gait, hyperalgesic tender site response and hypermobility were not included in many curricula. Similarly, interpretation of investigations undertaken on synovial fluid was taught in only 16 schools. While disease-modifying anti-rheumatic drugs and biological agents, and urate-lowering treatment were included in the curricula of 20 and 21 institutions, respectively, only curricula from 18 schools included core non-pharmacological interventions. Osteoarthritis, gout, rheumatoid arthritis, spondyloarthropathy, polymyalgia rheumatica and lupus were included in the curriculum of all institutions. However, common RMDs such as calcium pyrophosphate deposition, fibromyalgia, giant cell arteritis and bone and joint infection were included in 19 curricula.ConclusionThis survey highlights areas of similarities and differences in undergraduate curricula across Europe. It is hoped that the results of this survey will catalyse the development and agreement of a minimum core European Curriculum for undergraduate education in RMDs.


Author(s):  
Vibha Joshi ◽  
Nitin Kumar Joshi ◽  
Komal Bajaj

Background: As various dental procedures can transmit HIV, rapid HIV oral testing facilities in dental settings could play a major role in prevention of HIV infection. Being most popular HIV testing methods worldwide, the rapid HIV oral test is not available in India and its level of acceptance in Indian dental settings is unexplored. This study conducted with the objective to assess patient’s knowledge about HIV and their willingness toward rapid HIV oral testing in dental settings.Methods: This cross-sectional study was conducted in two dental clinics selected from two different largest mixed socioeconomic housing societies of Jodhpur respectively. A semi structured questionnaire consisting of demographics, respondent’s general knowledge towards AIDS/HIV infection, willingness towards HIV rapid oral test was developed for data collection. Standard descriptive statistics were calculated and comparisons between demographic data and willingness to get tested in dental setting, awareness for HIV etc. were analyzed.Results: Total of 473 age-eligible patients were surveyed out of which 214 were males. The difference about the knowledge of HIV/AIDS between two groups of education levels (p<0.05) was statistically significant and almost 82% of these respondents were willing to have HIV oral rapid saliva testing as a part of regular dental appointment.Conclusions: It can be concluded that dental patient generally are willing for HIV rapid oral testing, but additional studies are needed to explore relevant policy implications.


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