scholarly journals Prophylactic effects of hydroxychloroquine on the incidence of COVID-19 in patients with rheumatic arthritis: an observational cohort study

2021 ◽  
Vol 7 (2) ◽  
pp. e29-e29
Author(s):  
Zohre Naderi ◽  
Bahar Sadeghi ◽  
Ziba Farajzadegan ◽  
Ramin Sami ◽  
Mansour Salesi ◽  
...  
Keyword(s):  
Clinical Importance ◽  
Phone Call ◽  
Systemic Autoimmune Disease ◽  
Rheumatic Arthritis ◽  
Academic Hospitals ◽  
Observational Cohort ◽  
Steady State Levels ◽  
Severity Of The Disease ◽  
Substantial Morbidity ◽  
Rheumatic Patients

Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune disease with substantial morbidity and mortality. Anti-malarial drugs like hydroxychloroquine are indicated in several rheumatic diseases such as RA. Some reports have suggested hydroxychloroquine for prevention of COVID-19. Objectives: Whether hydroxychloroquine has prophylactic effects for COVID-19 in rheumatic patients. Patients and Methods: In this multicenter cohort-based observational study the preventive effect of hydroxychloroquine regarding the incidence and severity of COVID-19 was investigated in patients with RA who referred to rheumatology clinics of academic hospitals of Isfahan between April and July 2020 and already have been treated with hydroxychloroquine for more than three months. Around 215 patients with RA and current use of hydroxychloroquine were recruited and followed for three months. Patients’ information was gathered using the medical record or by phone call. Results: The incidence of COVID-19 in this selected sample was 4.2% (n=9). Only one in nine patients needed hospitalization, without need for intubation or ICU care. Symptoms including dry cough, headache, body pain, malaise, dyspnea, fever, sore throat, chills, and chest pain, were reported to be statistically higher in COVID-19+ group. Conclusion: In contrast to the mortality rate in the general population of Isfahan, Iran (4.8% - until June 2020), no mortality has been reported in these patients. Therefore, it seems that the use of hydroxychloroquine has been able to reduce the incidence and severity of the disease after reaching steady-state levels. This finding has clinical importance, especially for rheumatic patients using immunomodulatory drugs.

scholarly journals Propéptido natriurético tipo B N-terminal en adultos mayores ecuatorianos

2020 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Rubí Eliana Bermello Zamora ◽  
Yury Jordano Sanclemente Núñez ◽  
Ivón Howland Álvarez
Keyword(s):  
Heart Failure ◽  
Healthcare Expenditure ◽  
Clinical Manifestations ◽  
Clinical Importance ◽  
The Elderly ◽  
Comprehensive Health Care ◽  
Palabras Clave ◽  
Insuficiencia Cardiaca ◽  
Comprehensive Health ◽  
Severity Of The Disease

  La insuficiencia cardiaca (IC) es un trastorno progresivo y letal que constituye la primera causa de ingreso hospitalario en las personas mayores de 65 años. Se ha demostrado la utilidad del NT-proBNP para su diagnóstico; sin embargo, los valores de estos marcadores difieren según las características de los pacientes y la severidad de la enfermedad. El objetivo de este estudio consistió en determinar la utilidad de la medición de NT-proBNP para diagnosticar el riesgo de padecer IC en adultos mayores. Se realizaron análisis de NT-proBNP, creatinina, urea, hemoglobina, glucosa y sodio en 47 muestras sanguíneas de pacientes de un centro gerontológico de Manabí en el periodo octubre a diciembre 2017. Se analizaron los valores y la posible asociación a otras enfermedades. Se compararon los valores de variables demográficas, analíticas y clínicas. Se analizaron las manifestaciones clínicas y antecedentes patológicos personales asociados al riesgo de IC. El valor NT-proBNP se asoció con la presencia de anemia, creatinina mayor de 2 mg/dL e hiponatremia. La edad media de los pacientes fue de 79 años, de predominio masculino, con comorbilidad asociada y cierto grado de dependencia, aunque la edad no fue un factor que influyó en la probabilidad de tener elevación en el valor plasmático de NT-proBNP y por lo tanto del riesgo latente de padecer o no IC. El valor de NT-proBNP mostró ser un analito complementario de gran importancia clínica para la evaluación y el cuidado integral de salud del anciano.   Palabras clave: NT-proBNP, insuficiencia cardiaca, adultos mayores.   Abstract Heart failure (HF) is a progressive and lethal disorder that constitutes the first cause of hospital admission in people over 65 years of age and represents just over 2% of national healthcare expenditure. The usefulness of NT-proBNP for its diagnosis has been demonstrated, however, the values of these markers differ according to the characteristics of the patients and the severity of the disease. The objective of this study is to determine the NT-proBNP usefullness to diagnose risk of HF in older adults. NT-proBNP, creatinine, urea, hemoglobin, glucose and sodium were analyzed in 47 blood samples of patients from the gerontological center from October to December 2017. The values and the possible association to other diseases were analyzed. The values of demographic, analytical and clinical variables were compared. The clinical manifestations and personal pathological background associated with the risk of HF were analyzed. The NT-proBNP value was associated with the presence of anemia, creatinine greater than 2 mg/dL and hyponatremia. The average age of the patients was 79 years, predominantly male, with associated comorbidity and a certain degree of dependence, although age was not a factor that influenced the probability of having an elevated plasma NT-proBNP value and therefore both of the latent risk of suffering or not IC. The value of NT-proBNP was shown to be a complementary analyte of great clinical importance for the evaluation and comprehensive health care of the elderly.   Keywords: NT-proBNP, heart failure, elderly.

scholarly journals Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19

2020 ◽  
Vol 99 (11) ◽  
pp. 1239-1244 ◽  
Author(s):  
R. Liu ◽  
S. Yi ◽  
J. Zhang ◽  
Z. Lv ◽  
C. Zhu ◽  
...  
Keyword(s):  
Viral Load ◽  
Quantitative Polymerase Chain Reaction ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Global Pandemic ◽  
Observational Cohort ◽  
Polymerase Chain ◽  
Underlying Diseases ◽  
Temporal Profiles ◽  
Substantial Morbidity

Coronavirus disease 2019 (COVID-19) has caused a global pandemic associated with substantial morbidity and mortality. Nasopharyngeal swabs and sputum samples are generally collected for serial viral load screening of respiratory contagions, but temporal profiles of these samples are not completely clear in patients with COVID-19. We performed an observational cohort study at Renmin Hospital of Wuhan University, which involved 31 patients with confirmed COVID-19 with or without underlying diseases. We obtained samples from each patient, and serial viral load was measured by real-time quantitative polymerase chain reaction. We found that the viral load in the sputum was inclined to be higher than samples obtained from the nasopharyngeal swab at disease presentation. Moreover, the viral load in the sputum decreased more slowly over time than in the nasopharyngeal group as the disease progressed. Interestingly, even when samples in the nasopharyngeal swab turned negative, it was commonly observed that patients with underlying diseases, especially hypertension and diabetes, remained positive for COVID-19 and required a longer period for the sputum samples to turn negative. These combined findings emphasize the importance of tracking sputum samples even in patients with negative tests from nasopharyngeal swabs, especially for those with underlying conditions. In conclusion, this work reinforces the importance of sputum samples for SARS-CoV-2 detection to minimize transmission of COVID-19 within the community.

scholarly journals Trajectories of Biological Values and Vital Parameters: An Observational Cohort Study of Adult Patients with Sickle Cell Disease Hospitalized for a Non-Complicated Vaso-Occlusive Crisis

2019 ◽  
Vol 8 (9) ◽  
pp. 1502
Author(s):  
Veil ◽  
Bussy ◽  
Looten ◽  
Arlet ◽  
Pouchot ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Observational Cohort Study ◽  
Cell Disease ◽  
Cell Counts ◽  
Observational Cohort ◽  
Steady State Levels ◽  
White Blood Cell Counts ◽  
Vital Parameters

Hospital admission of patients with sickle-cell disease (SCD) presenting with a vaso-occlusive crisis (VOC) can be justified by pain refractory to usual outpatient care and/or the occurrence of a complication. Yet, the trajectories of vital parameters and standard biomarkers throughout a non-complicated VOC has not been established. In this observational cohort study, we describe the course of routine parameters throughout 329 hospital stays for non-complicated VOC. We used a new spline-based approach to study and visualize non-specific time-dependent variables extracted from the hospital clinical data warehouse. We identified distinct trends during the VOC for hemoglobin level, leukocytes count, C-Reactive Protein (CRP) level and temperature. Hemoglobin decreased after admission and rarely returned to steady state levels before discharge. White blood cell counts were elevated at admission before immediately decreasing, whereas eosinophils increased slowly throughout the first five days of the stay. In over 95% of non-complicated VOC-related stays, the CRP value was below 100 mg/L within the first day following admission and above normal after 48 hours, and the temperature was below 38 °C throughout the entire stay. Knowing the typical trajectories of these routine parameters during non-complicated VOC may urge the clinicians to be more vigilant in case of deviation from these patterns.

scholarly journals AB0656 SARS-CoV-2 INFECTION IN PATIENTS WITH RHEUMATIC DISEASE: A TERTIARY SINGLE-CENTER EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1360.2-1360
Author(s):  
A. Halbac ◽  
B. Balan ◽  
C. Tamas ◽  
M. M. Tamas ◽  
I. Felea ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Rheumatic Disease ◽  
Connective Tissue Disease ◽  
Gastrointestinal Symptoms ◽  
Polymerase Chain Reaction Test ◽  
Tnf Alpha ◽  
Systemic Autoimmune Disease ◽  
Positive Polymerase Chain Reaction ◽  
Increased Risk ◽  
Rheumatic Patients

Background:In the context of the coronavirus (SARS-CoV-2) pandemic, several studies looked at the relation between rheumatic disease and SARS-CoV-2. It remains unclear whether these patients are at increased risk of developing more severe cases of coronavirus disease (COVID-19) or not.Objectives:The objective of this descriptive study is to report the characteristics and outcomes of rheumatic patients that had a history of confirmed SARS-CoV-2 infection. Findings have also been compared to some of the existing publications on COVID-19 in these patients.Methods:Between November 17, 2020 and January 18, 2021, a single-centre observational study was conducted in the rheumatology department of the Emergency Clinical County Hospital and the University of Medicine and Pharmacy “Iuliu Hatieganu” in Cluj-Napoca, Romania. The sample consisted of 62 rheumatic patients with a positive polymerase chain reaction test from nasopharyngeal/oral swab. Data on both systemic autoimmune disease and COVID-19 was collected using a survey, by means of telephone or in the outpatient clinic setting. Data on the patient rheumatologic condition was also collected from the electronic health records available within our departmentResults:62 patients were included, with 85.48% females and 14.51% males, and a median age of 52 years (SD +/- 14).The most frequent comorbidities were high blood pressure (HBP) 46.77%, dyslipidaemia 19.35%, liver disease 17.74%, and interstitial lung disease (ILD) 12.90%. Recurrent COVID-19 symptoms included: cough (62%), fever (46,77%), anosmia (46.77%), ageusia (30.64%), headache (29.03%), gastrointestinal symptoms (27.41%) and myalgia (25.80%).Out of the entire 62 sample, 41 patients had an inflammatory arthritis (IA) diagnosis, with the most frequent being rheumatoid arthritis (RA) - 68.29%, followed by ankylosing spondylitis - 21.95%, psoriatic arthritis - 7.31% and 2.43% with Still disease. Only 10 patients suffered from connective tissue disease (CTD): 3 systemic lupus erythematosus, 2 poli/dermatomyositis, 2 Sjogren syndrome (SjS), 2 mixed connective tissue disease, 1 systemic sclerosis (SSc). Another 10 patients had overlapping syndromes with the most frequent (40%) overlap between RA and SSc. One patient had osteoarthritis.49 patients followed a treatment with conventional synthetic disease-modifying anti-rheumatic drugs with 51.2% of them being treated with Methotrexate.14 of our patients received glucocorticoids (GC), but no relation between the GC dose and COVID-19 severity could be observed. Only 3 patients with doses greater than 10mg/day were present in the cohort and 2 developed mild while 1 developed an asymptomatic COVID-19 course.22 patients had received biological treatment. Anti TNF alpha medication was administered to 13 of these, and mostly consisted of Adalimumab, Etanercept and Golimumab. The anti TNF alpha patients were asymptomatic or had mild forms of COVID-19 (93.30%).8 cases had ILD: 3 RA patients, 3 overlapping syndromes, 1 SSc and 1 SjS. The median age was 59,5 years (SD +/- 10). 25% exhibited severe, 37,5% moderate, 25% mild and 12.5% asymptomatic COVID-19.The COVID-19 severity in our sample was as follows: 12.90% of the patients were asymptomatic, 59.67% exhibited a mild form, 19.35% a moderate one, and out of the 8.06% with a severe case of COVID-19, 1 patient died. The median age in the severe cases of COVID-19 was 66 years (SD +/- 12) and HBP was the most common comorbidity.Conclusion:Most patients in this sample were either asymptomatic or had a mild COVID-19 evolution. Although the research design has multiple limitations, rheumatic pathology does not seem to be a higher risk factor for severe COVID-19 than other associated comorbidities. With that in mind, ILD patients should be closely monitored as even in on our limited sample size a worse evolution of COVID-19 has been observed. Biological treatments, especially anti TNF alpha might help in reducing the severity of COVID-19, but this outcome could have been associated in our sample with other factors like lower median age and less comorbidities.Disclosure of Interests:None declared.

Continuing Trauma: The Unmet Needs of Trauma Patients in the Postacute Care Setting

2017 ◽  
Vol 83 (11) ◽  
pp. 1308-1314 ◽  
Author(s):  
Samir M. Fakhry ◽  
Pamela L. Ferguson ◽  
Jama L. Olsen ◽  
Jennifer J. Haughney ◽  
Heidi S. Resnick ◽  
...  
Keyword(s):  
Care Setting ◽  
Modern Technology ◽  
Phone Call ◽  
Trauma Patients ◽  
Communication Preferences ◽  
Observational Cohort ◽  
Postacute Care ◽  
Emotional Recovery ◽  
Injured Patients ◽  
To Receive

Trauma care has traditionally focused on prehospital and hospital settings, yet many injured patients report emotional distress in the postacute care setting, which is known to impair recovery. The objective of this study was to assess postdischarge emotional recovery and communication preferences. An observational cohort of 100 adult patients from our Level 1 Trauma Center was surveyed one to two months postdischarge. Among those employed preinjury, 44 per cent had not returned to work. Nearly half screened positive for emotional issues (posttraumatic stress disorder, depression, and/or psychological distress); of these, only 35 per cent considered getting professional help and only 10 per cent received help. The barrier most cited (58%) was cost; 42 per cent did not know how or where to get help. Most participants responded “no” or “I don't know” when asked if they had received information about coping with negative emotions after injury and how to seek help from a doctor to address these emotions. Two-thirds preferred to receive such information via phone call from a health care provider or by text. Eighty-nine per cent owned a cellphone. Our trauma systems are failing to provide comprehensive care or look at the ultimate outcomes of our patients, yet modern technology could provide needed resources to patients in novel ways.

scholarly journals Cell Biology in Rheumatoid Arthritis

2020 ◽  
Vol 10 (3-s) ◽  
pp. 348-357
Author(s):  
Lukeshwari Sahu ◽  
S. Prakash Rao ◽  
Mahendra Verma ◽  
Akhilesh Kumar ◽  
Rajendra Sahu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cell Population ◽  
Cell Biology ◽  
Immune Cell ◽  
Critical Role ◽  
Autoimmune Disorder ◽  
Systemic Autoimmune Disease ◽  
Rheumatic Arthritis ◽  
Dendrite Cell ◽  
Normal Human

Rheumatoid arthritis (RA) is a systemic autoimmune disease, which affects about 0.33 to 2.65% of the population. In RA Synovium contain various type of immune cell. In which only one cell population cannot cause rheumatoid arthritis that requires more than one cell population. In normal condition, they act as a switch (active or inactive the cell signaling). It controls cell growth, proliferation or metastasizes. In an autoimmune disorder such as rheumatoid arthritis, the immune system mistakenly attacks and destroys the body's cells and tissues. Mostly cells are present in limited numbers in normal human synovium, but in rheumatoid arthritis and other inflammatory joint diseases, this population can expand to constitute 5-20% or more of all synovial cells. Recent investigations in a murine model have demonstrated that cells can have a critical role in the generation of inflammation within the joint. Keyword: Cell Biology in rheumatic arthritis; Dendrite cell; T-cell; Mast cell; Fibroblastic cell; Macrophages cell.

Abstract 18025: Systematic Screening is Necessary to Detect Post-operative Thrombosis and Evaluate Risk in Children Undergoing Cardiac Surgery: A Prospective Observational Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Cedric Manlhiot ◽  
Leonardo R Brandao ◽  
Helen M Holtby ◽  
V. Ben Sivarajan ◽  
Jennifer L Russell ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Prospective Observational Study ◽  
Pediatric Patients ◽  
Clinical Importance ◽  
Poor Performance ◽  
Systematic Screening ◽  
Vascular Ultrasound ◽  
Post Operation ◽  
Observational Cohort ◽  
Postoperative Thrombosis

Introduction: Postoperative thrombosis in children undergoing cardiac surgery with cardiopulmonary bypass (CPB) is a frequent, under-diagnosed and clinically detrimental complication. Methods: Pediatric patients were prospectively enrolled before surgery with CPB in an observational cohort study. Children <1 year old and cyanotic patients were oversampled. All subjects had serial lab assessment of hemostatic status and standardized vascular ultrasound for surveillance of post-operative thrombosis. Eligible non-enrolled patients were retrospectively reviewed as concurrent controls without study surveillance. All imaging findings underwent blinded adjudication to confirm the presence and clinical importance of identified thrombi. Results: Of 400 enrolled patients (54% males, 55% <1 year, 25% cyanotic), 398 (99%) completed the study, and 339 (85%) had protocol vascular ultrasound prior to or within 1 week of hospital discharge. Post-operative thrombosis was diagnosed in 99 study patients (25%) vs. 10% of the 1,019 control patients (p<0.001). Clinical evaluation alone missed 59% of all postoperative thrombi and 20% of clinically important thrombi. Multivariable factors associated with higher odds of postoperative thrombosis in study patients included 4 factors reflective of reduced heparin sensitivity and/or anticoagulation levels during CPB (Table). Postoperative thrombosis was associated with longer ICU stay (5 vs. 2 days, p=0.008), longer hospital stay (6 vs. 10 days, p<0.001), increased odds of reintervention or post-operation ECMO (OR: 2.7, p=0.005) and mortality (OR: 5.9, p=0.002). Conclusions: Given the poor performance of relying on clinical suspicion for detecting post-operative thrombosis, children <1 year old undergoing surgery with CPB should be systematically screened for thrombosis post-operatively. Individualization of thromboprophylaxis should consider both preoperative clinical factors and heparin sensitivity.

scholarly journals Progressive multifocal leukoencephalopathy

2019 ◽  
Vol 6 (6) ◽  
pp. e618 ◽  
Author(s):  
Pria Anand ◽  
Gladia C. Hotan ◽  
Andre Vogel ◽  
Nagagopal Venna ◽  
Farrah J. Mateen
Keyword(s):  
Risk Factors ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Symptom Onset ◽  
Clinical Course ◽  
Jc Virus ◽  
Definite Diagnosis ◽  
Common Risk Factor ◽  
Academic Hospitals ◽  
Observational Cohort

ObjectiveTo characterize the risk factors, clinical course, and treatment of patients with progressive multifocal leukoencephalopathy (PML) diagnosed and followed over a 25-year epoch at 2 academic hospitals.MethodsPatients with a definite diagnosis of PML were identified by positive CSF PCR for JC virus or histopathology between January 1, 1994, and January 1, 2019. Demographic and PML-specific variables were recorded on symptomatic presentation and at follow-up, including risk factors, clinical outcome, neuroimaging findings, and modified Rankin Scale (mRS) score at last follow-up.ResultsThere were 91 patients with confirmed PML. HIV infection was the most common risk factor, identified in 49% (n = 45). Other frequent risk factors included lymphoma, leukemia, or myelodysplasia, identified in 31% of patients (n = 28); exposure to chemotherapeutic medications (30%, n = 27); and exposure to monoclonal antibody therapies (19%, n = 17). Thirty percent of the cohort was alive at the time of censoring, with a median mRS of 2 points, indicating slight disability at last follow-up. Median survival following PML diagnosis in HIV-infected patients was longer than in HIV-uninfected patients (1,992 vs 101 days, p = 0.024). Forty patients survived more than 1 year after PML symptom onset, of whom 24 were HIV infected (60%). Thirteen patients survived more than 10 years after PML symptom onset, all HIV infected, of the 59 patients diagnosed before June 1, 2009, and eligible for 10-year survivor status (22%).ConclusionsWe add to the limited literature on PML by reporting its epidemiology in a large observational cohort. These parameters may be useful for future clinical trials that measure survival and clinical outcomes.

scholarly journals Candidemia among Iranian Patients with Severe COVID-19 Admitted to ICUs

2021 ◽  
Vol 7 (4) ◽  
pp. 280
Author(s):  
Amir Arastehfar ◽  
Tahmineh Shaban ◽  
Hossein Zarrinfar ◽  
Maryam Roudbary ◽  
Mona Ghazanfari ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Clinical Importance ◽  
Rapid Diagnosis ◽  
Rhodotorula Mucilaginosa ◽  
Chain Reaction ◽  
Timely Initiation ◽  
Polymerase Chain ◽  
Severity Of The Disease ◽  
Iranian Patients

As a novel risk factor, COVID-19 has led to an increase in the incidence of candidemia and an elevated mortality rate. Despite being of clinical importance, there is a lack of data regarding COVID-19-associated candidemia (CAC) among Iranian patients. Therefore, in this retrospective study, we assessed CAC epidemiology in the intensive care units (ICUs) of two COVID-19 centers in Mashhad, Iran, from early November 2020 to late January 2021. Yeast isolates from patients’ blood were identified by 21-plex polymerase chain reaction (PCR) and sequencing, then subjected to antifungal susceptibility testing according to the CLSI M27-A3 protocol. Among 1988 patients with COVID-19 admitted to ICUs, seven had fungemia (7/1988; 0.03%), among whom six had CAC. The mortality of the limited CAC cases was high and greatly exceeded that of patients with COVID-19 but without candidemia (100% (6/6) vs. 22.7% (452/1988)). In total, nine yeast isolates were collected from patients with fungemia: five Candida albicans, three C. glabrata, and one Rhodotorula mucilaginosa. Half of the patients infected with C. albicans (2/4) were refractory to both azoles and echinocandins. The high mortality of patients with CAC, despite antifungal therapy, reflects the severity of the disease in these patients and underscores the importance of rapid diagnosis and timely initiation of antifungal treatment.

scholarly journals The Effect of Follow ups with Weekly Phone Calls on the Outcome and Quality of Life Among the Patients with Rheumatoid Arthritis

2021 ◽  
Vol 10 (3) ◽  
pp. 104-107
Author(s):  
Anusheh Haghighi ◽  
Maryam Dibadin ◽  
Alireza Farahani ◽  
Mohammad Amin Abbasi ◽  
Mohsen Arabi
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Therapeutic Process ◽  
Intervention Group ◽  
Phone Call ◽  
Control Group ◽  
Phone Calls ◽  
Das 28 ◽  
Severity Of The Disease

Background: The present study aimed at evaluating the effect of weekly phone calls on treatment outcomes and quality of life among a group of Iranian patients with rheumatoid arthritis (RA). Materials and Methods: In this randomized clinical trial study, 60 patients aged 15-85 with RA were randomly assigned to intervention and control groups. The intervention group, in addition to a monthly assessment on a weekly basis, received a full 3-month follow-up telephone conversation in order to follow the correct and regular use of the drug and respond to the patients’ questions. The control group was only evaluated routinely. Finally, the severity of the disease activity (based on DAS-28) and the quality of life (based on the SF-12 questionnaire) were evaluated after three months. Results: After three months from the onset of intervention, a significant reduction was observed in the number of tender joints, mean erythrocyte sedimentation rate (ESR), and total score of DAS-28 in the intervention group compared to the control group. In addition, after three months of treatment, the quality of life for the intervention group improved significantly more than that of the control group. Conclusion: A weekly phone call with the patients suffering from RA with the purpose to guide the therapeutic process and respond to the patients’ questions could positively improve the severity of the disease along with the quality of life among the patients.

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