1
|
Mody GM, Tikly M, Hajjaj-Hassouni N. Editorial: Global excellence in rheumatology: Africa. Front Med (Lausanne) 2023; 10:1201020. [PMID: 37188087 PMCID: PMC10175767 DOI: 10.3389/fmed.2023.1201020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Girish M. Mody
- Department of Rheumatology, University of KwaZulu-Natal, Durban, South Africa
- *Correspondence: Girish M. Mody
| | - Mohammed Tikly
- Division of Rheumatology, University of the Witwatersrand, Johannesburg, South Africa
| | | |
Collapse
|
2
|
Eljoumani T, Rkain H, Zahrae TF, Imane B, Kenza H, Redouane A, Bahloul S, Rahma H, Farih S, Samya E, Kronbi F, Alami N, Tahiri L, Hajjaj-Hassouni N, Allali F. Quels sont les facteurs liés au vécu douloureux des patients atteints de rhumatisme inflammatoire chronique pendant la pandémie de la COVID-19 ? Rev Rhum Ed Fr 2022. [PMCID: PMC9758741 DOI: 10.1016/j.rhum.2022.10.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction La pandémie de Coronavirus a entraîné de nombreuses conséquences sur le bien-être, l’accès aux soins et le maintien thérapeutique chez les patients atteints de maladies chroniques. L’objectif de cette étude est d’évaluer l’impact du confinement sur le vécu douloureux des patients atteints de rhumatisme inflammatoire chronique (RIC) et les éventuels facteurs associés. Patients et méthodes Une étude transversale a été menée auprès de patients atteints de RIC à l’aide d’un questionnaire en ligne fournissant les caractéristiques des patients et de leur maladie et la douleur globale qu’ils avaient ressentie avant et pendant la période de confinement, en utilisant l’échelle visuelle analogique (EVA). Système d’analyse statistique IBM SPSS Statistics V20.0.0 a été utilisé pour analyser les données de l’étude. Nous avons effectué une analyse univariée puis multivariée pour rechercher les facteurs liés à la perception de la douleur pendant le confinement. Les valeurs qualitatives ont été analysées par le test du Chi2. Les valeurs quantitatives ont été analysées par le test de Student lorsque les mesures étaient normalement distribuées ou par un test non paramétrique (Mann-Whitney U) lorsque les mesures n’étaient pas normalement distribuées (le test de Kolmogorov-Smirnov a été utilisé pour tester la normalité). Résultats Parmi les 350 patients ayant répondu au questionnaire, la polyarthrite rhumatoïde représentait 62,3 %, la spondylarthropathie 34,3 % et le RIC indifférenciée 3,4 %. La douleur causée par le RIC pendant le confinement a été rapportée par 79,1 % des patients. L’EVA de la douleur a augmenté de manière significative pendant la pandémie (4,6 ± 2,8 et 5,4 ± 3 avant et pendant le confinement ; p < 0,001). En analyse multivariée, les facteurs impliqués dans la douleur étaient l’impact négatif du Coronavirus sur l’accès aux soins rhumatologiques, la mauvaise observance thérapeutique, la qualité du sommeil perturbée et l’impact psychologique négatif. Discussion Cette étude montre les difficultés rencontrées par les patients pour assurer un suivi régulier auprès de leurs rhumatologues et la forte prévalence de l’arrêt des traitements. L’expérience de la douleur pendant la pandémie serait déterminée par des facteurs liés aux patients eux-mêmes et à l’interruption du suivi de leur RIC. La plupart des patients ont réclamé des difficultés à consulter leur rhumatologue pour plusieurs raisons : les problèmes de transport et la crainte de contracter le Coronavirus sur le chemin de l’hôpital et une peur générale d’attraper la COVID-19 à l’hôpital même. Ce constat est alarmant et laisse craindre des poussées de RIC plus fréquentes en période post-pandémique. Conclusion L’enquête a montré que cette pandémie a augmenté l’expérience douloureuse chez les patients ayant un RIC. Les facteurs influençant le vécu douloureux doivent être pris en compte pour aider les patients à faire face à leurs RIC et à cette crise sanitaire mondiale.
Collapse
Affiliation(s)
- T. Eljoumani
- Rhumatologie B, hôpital Al-Ayachi, rue Al-Ayachi, Salé, Maroc,Auteur correspondant
| | - H. Rkain
- Rhumatologie B, hôpital Al-Ayachi, rue Al-Ayachi, Salé, Maroc
| | | | - B. Imane
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - H. Kenza
- École internationale de santé publique, université Mohammed VI des sciences de la santé, Casablanca, Maroc
| | - A. Redouane
- Laboratoire de biostatistique, recherche clinique et épidémiologie, faculté de médecine et de pharmacie de Rabat, Rabat, Maroc
| | - S. Bahloul
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - H. Rahma
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - S. Farih
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - E. Samya
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - F. Kronbi
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - N. Alami
- Rhumatologie b, hôpital Al-Ayachi, Salé, Maroc
| | - L. Tahiri
- Service de rhumatologie, CHU d’Ibn-Sina, hôpital El-Ayachi, Salé, Maroc
| | | | - F. Allali
- Rhumatologie, CHU d’Ibn-Sina, hôpital El-Ayachi, Rabat-Salé, Maroc
| |
Collapse
|
3
|
Afilal S, Rkain H, Allaoui A, Fellous S, Berkchi JM, Taik FZ, Aachari I, Tahiri L, Alami N, Ennibi O, Hajjaj-Hassouni N, Allali F. Oral Hygiene Status in Rheumatoid Arthritis Patients and Related Factors. Mediterr J Rheumatol 2021; 32:249-255. [PMID: 34964029 PMCID: PMC8693299 DOI: 10.31138/mjr.32.3.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives To evaluate oral hygiene status in Rheumatoid arthritis (RA) patients, to analyse possible related factors, and to investigate the role of the rheumatologist in information about importance of adequate oral hygiene status in RA patients. Methods A cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 ± 11.7 years). For each patient, we recorded oral symptoms, oral hygiene status and role of rheumatologist in information on the oral hygiene status. Factors associated with regular brushing (≥2/day) were also analysed. Results Median disease duration was 8 years (4;2). Dental pain was reported by 74% of patients and bleeding by 51% of them. Regular brushing was noted in 45% of patients. The use of a correct brushing method was noted in 14% of cases. Two patients reported visiting a dentist regularly. Information explaining that poor oral hygiene has a negative impact on RA was delivered by rheumatologist to 11 patients. Regular brushing of teeth was recommended by rheumatologist to 8 patients and 10 patients were advised by their rheumatologist to consult a dentist. Regular brushing was more important in women (48,3% vs 18,2%; p=0.05) and in the literate patients (57,6 vs 31,2%, p<0.01). No association was found between regular brushing, Disease Activity Score 28 (DAS28) and health Assessment Questionnaire (HAQ). Conclusion This study illustrates bad oral hygiene status in RA patients, which seems more important in men and illiterate patients. It also highlights poor information given by the rheumatologist.
Collapse
Affiliation(s)
- Saloua Afilal
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Hanan Rkain
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.,Laboratory of Physiology, Physiology team of Exercise and Autonomic Nervous System, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Afaf Allaoui
- Periodontology Department, Faculty of Dentistry, Mohammed V University, Rabat, Morocco
| | - Safaa Fellous
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Jihad Moulay Berkchi
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Fatima Zahrae Taik
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Ilham Aachari
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Latifa Tahiri
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Nada Alami
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - OumKeltoum Ennibi
- Periodontology Department, Faculty of Dentistry, Mohammed V University, Rabat, Morocco
| | | | - Fadoua Allali
- Rheumatology B Department, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| |
Collapse
|
4
|
López-Medina C, Chevret S, Molto A, Sieper J, Duruöz T, Kiltz U, Elzorkany B, Hajjaj-Hassouni N, Burgos-Vargas R, Maldonado-Cocco J, Ziade N, Gavali M, Navarro-Compan V, Luo SF, Biglia A, Tae-Jong K, Kishimoto M, Pimentel-Santos FM, Gu J, Muntean L, van Gaalen FA, Geher P, Magrey M, Ibáñez-Vodnizza SE, Bautista-Molano W, Maksymowych W, Machado PM, Landewé R, van der Heijde D, Dougados M. Identification of clinical phenotypes of peripheral involvement in patients with spondyloarthritis, including psoriatic arthritis: a cluster analysis in the worldwide ASAS-PerSpA study. RMD Open 2021; 7:rmdopen-2021-001728. [PMID: 34750246 PMCID: PMC8576480 DOI: 10.1136/rmdopen-2021-001728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/05/2021] [Indexed: 11/06/2022] Open
Abstract
Objective To identify clusters of peripheral involvement according to the specific location of peripheral manifestations (ie, arthritis, enthesitis and dactylitis) in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), and to evaluate whether these clusters correspond with the clinical diagnosis of a rheumatologist. Methods Cross-sectional study with 24 participating countries. Consecutive patients diagnosed by their rheumatologist as PsA, axial SpA or peripheral SpA were enrolled. Four different cluster analyses were conducted: one using information on the specific location from all the peripheral manifestations, and a cluster analysis for each peripheral manifestation, separately. Multiple correspondence analyses and k-means clustering methods were used. Distribution of peripheral manifestations and clinical characteristics were compared across the different clusters. Results The different cluster analyses performed in the 4465 patients clearly distinguished a predominantly axial phenotype (cluster 1) and a predominantly peripheral phenotype (cluster 2). In the predominantly axial phenotype, hip involvement and lower limb large joint arthritis, heel enthesitis and lack of dactylitis were more prevalent. In the predominantly peripheral phenotype, different subgroups were distinguished based on the type and location of peripheral involvement: a predominantly involvement of upper versus lower limbs joints, a predominantly axial enthesitis versus peripheral enthesitis, and predominantly finger versus toe involvement in dactylitis. A poor agreement between the clusters and the rheumatologist‘s diagnosis as well as with the classification criteria was found. Conclusion These results suggest the presence of two main phenotypes (predominantly axial and predominantly peripheral) based on the presence and location of the peripheral manifestations.
Collapse
Affiliation(s)
- Clementina López-Medina
- Rheumatology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France .,Rheumatology, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Sylvie Chevret
- CRESS, Université de Paris, INSERM U-1153, Paris, France
| | - Anna Molto
- Rheumatology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,CRESS, Université de Paris, INSERM U-1153, Paris, France
| | - Joachim Sieper
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité Universitatsmedizin Berlin, Berlin, Germany
| | - Tuncay Duruöz
- PMR Department, Rheumatology Division, Marmara University School of Medicine, Istanbul, Turkey
| | - Uta Kiltz
- Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany.,Rheumatology, Ruhr University Bochum, Bochum, Germany
| | | | | | - Ruben Burgos-Vargas
- Rheumatology, Hospital General de México Eduardo Liceaga, Mexico City, Mexico
| | - José Maldonado-Cocco
- Rheumatology, Buenos Aires University School of Medicine, Buenos Aires, Argentina
| | - Nelly Ziade
- Rheumatology, Saint Joseph University, Beirut, Lebanon.,Rheumatology, Mount Lebanon Hospital, Beirut, Lebanon
| | - Meghna Gavali
- Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Shue-Fen Luo
- Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Alessandro Biglia
- Rheumatology, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Kim Tae-Jong
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | | | | | - Jieruo Gu
- Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Laura Muntean
- Rheumatology, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.,Rheumatology, County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Floris A van Gaalen
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Pál Geher
- Rheumatology, Semmelweis University, Budapest, Hungary
| | - Marina Magrey
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Wilson Bautista-Molano
- Rheumatology, University Hospital Fundación Santa Fé de Bogotá and Universidad El Bosque, Bogotá, Colombia
| | | | - Pedro M Machado
- Centre for Rheumatology and Department of Neuromuscular Diseases, University College London, London, UK.,Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK.,Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Robert Landewé
- Clinical Immunology & Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
| | | | - Maxime Dougados
- Rheumatology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,CRESS, Université de Paris, INSERM U-1153, Paris, France
| |
Collapse
|
5
|
Limami Y, Senhaji N, Zaid N, Khalki L, Naya A, Hajjaj-Hassouni N, Jalali F, Oudghiri M, Zaid Y. PKC-Delta-Dependent Pathways Contribute to the Exacerbation of the Platelet Activity in Crohn's Disease. Semin Thromb Hemost 2021; 48:246-250. [PMID: 34749401 DOI: 10.1055/s-0041-1736571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Youness Limami
- Department of Biology, Faculty of Sciences Ain Chock, Immunology and Biodiversity Laboratory, Hassan II University, Casablanca.,Department of Medicine, Research Center of Abulcasis University of Health Sciences, Rabat, Morocco
| | - Nezha Senhaji
- Faculty of Medicine, Laboratory of Genetic and Molecular Pathology, Hassan II University, Casablanca, Morocco
| | - Nabil Zaid
- Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
| | - Loubna Khalki
- Faculty of Medicine, Research Center, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Abdallah Naya
- Department of Biology, Faculty of Sciences Ain Chock, Immunology and Biodiversity Laboratory, Hassan II University, Casablanca
| | | | - Farid Jalali
- Department of Gastroenterology, Saddleback Medical Group, Laguna Hills, California
| | - Mounia Oudghiri
- Department of Biology, Faculty of Sciences Ain Chock, Immunology and Biodiversity Laboratory, Hassan II University, Casablanca
| | - Younes Zaid
- Department of Biology, Faculty of Sciences Ain Chock, Immunology and Biodiversity Laboratory, Hassan II University, Casablanca.,Department of Medicine, Research Center of Abulcasis University of Health Sciences, Rabat, Morocco.,Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
6
|
López-Medina C, Molto A, Sieper J, Duruöz T, Kiltz U, Elzorkany B, Hajjaj-Hassouni N, Burgos-Vargas R, Maldonado-Cocco J, Ziade N, Gavali M, Navarro-Compan V, Luo SF, Monti S, Tae-Jong K, Kishimoto M, Pimentel-Santos FM, Gu J, Schiotis R, van Gaalen FA, Geher P, Magrey M, Ibáñez Vodnizza SE, Bautista-Molano W, Maksymowych W, Machado PM, Landewé R, van der Heijde D, Dougados M. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study. RMD Open 2021; 7:rmdopen-2020-001450. [PMID: 33462157 PMCID: PMC7816910 DOI: 10.1136/rmdopen-2020-001450] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/09/2020] [Accepted: 12/12/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world. METHODS Cross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated. RESULTS A total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%). CONCLUSION These results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.
Collapse
Affiliation(s)
- Clementina López-Medina
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France .,ECAMO, INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris, Paris, France.,Rheumatology Department, Reina Sofia University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain
| | - Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,ECAMO, INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris, Paris, France
| | - Joachim Sieper
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité University, Berlin, Germany
| | - Tuncay Duruöz
- PMR Department, Rheumatology Division, Marmara University School of Medicine, Istanbul, Turkey
| | - Uta Kiltz
- Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany
| | | | - Najia Hajjaj-Hassouni
- Rheumatology, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
| | - Ruben Burgos-Vargas
- Rheumatology Department, Hospital General de México Eduardo Liceaga, Mexico City, Mexico
| | - José Maldonado-Cocco
- Rheumatology, Buenos Aires University School of Medicine, Buenos Aires, Argentina
| | - Nelly Ziade
- Rheumatology Department, Saint-Joseph University and Mount Lebanon Hospital, Beirut, Lebanon
| | - Meghna Gavali
- Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Shue-Fen Luo
- Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Sara Monti
- Rheumatology Department, Fondazione IRCCS Policlinico S Matteo, University of Pavia, Pavia, Italy
| | - Kim Tae-Jong
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - F M Pimentel-Santos
- Rheumatology, NOVA Medical School, Nova University of Lisbon, Lisboa, Portugal
| | - Jieruo Gu
- Rheumatology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ruxandra Schiotis
- Pharmacology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Rheumatology Department, SCBI, Cluj-Napoca, Romania
| | - Floris A van Gaalen
- Rheumatology Department, Leiden University Medical Center, Leiden, The Netherlands
| | - Pál Geher
- Rheumatology Department, Semmelweis Egyetem, Budapest, Hungary
| | - Marina Magrey
- Rheumatology Department, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Wilson Bautista-Molano
- Rheumatology Department, University Hospital Fundación Santa Fé de Bogotá and Universidad El Bosque, Bogotá, Colombia
| | | | - Pedro M Machado
- Centre for Rheumatology and Department of Neuromuscular Diseases, University College of London, London, UK.,Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Robert Landewé
- Rheumatology, Amsterdam Rheumatology Center, AMC, Amsterdam, Netherlands.,Rheumatology Department, Zuyderland MC, Heerlen, The Netherlands
| | | | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,ECAMO, INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris, Paris, France.,Rheumatology, Université de Paris Descartes, Paris, France
| |
Collapse
|
7
|
El Joumani T, Rkain H, Fatima Zahrae T, Kenza H, Radouan A, Laila N, Bahloul S, Nada EA, Latifa T, Hajjaj-Hassouni N, Allali F. AB0901-HPR SOCIAL AND PSYCHOLOGICAL IMPACT OF THE CONTAINEMENT DURING COVID-19 PANDEMIC ON PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATIC DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Covid-19 pandemic had a worldwide impact on the population, global economy and health care systems.Objectives:To evaluate the psychological state and social impact of patients with Chronic Inflammatory Rheumatic Diseases (CIRD) during this pandemic in order to understand how to optimize their quality of life.Methods:It’s a cross-sectional survey, where the data were collected through the online survey tool “google forms”. A pilot test were conducted with the study committee members who analyzed the apparent validity of the questionnaire and identified issues that could lead to misunderstandings, and their suggestions were refined by a retest reliability until general agreement.The social and psychological impacts were evaluated by 14 questions exploring the different effects of the containment on negative feelings, interest in the family, changes in daily activities and plans, quality of sleep, practice of physical activity before and during containment, as well as the impact of the Coronavirus on psychological health.Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the survey data.Results:350 patients had participated in this online survey (mean age of 46,1 ± 14,4, 68% were women, 15.7% were illiterate, 45.7% were unemployed, rural residence in 11.7% of cases).Patients reported that their mental health has been negatively affected by Coronavirus in 59.1% of cases. Table 1 summarizes the psychological events during the containment.Table 1.Negative feelings during the containmentNegative feelings (%)N = 350Hopelessness23.7Anxiety55.4Fear29.7Frustration22.9Loneliness17.4Anger22.6Powerlessness24.3Patients reported that they paid more attention to their family in 87.1% during containment. Their daily lives and their life plans had changed because of Coronavirus(in 89.7% and 81.4%). Sleep during the pandemic has been negatively affected in 72.6% of patients. Physical activity practice had significantly decreased during containment (26.6% vs 51.7%)Conclusion:This study illustrates the social and psychological impact of COVID-19 pandemic on patients with CIRD. In the light of those results, we have lunched an awareness campaign to reinforce psychologic and social support of patients with CIRD during this global health crisis.Disclosure of Interests:None declared
Collapse
|
8
|
El Joumani T, Rkain H, Fatima Zahrae T, Kenza H, Abouqal R, Laila N, Bahloul S, Nada EA, Latifa T, Hajjaj-Hassouni N, Allali F. AB0898-HPR WICH FACTORS ARE RELATED TO PAINFUL EXPERIENCE IN PATIENTS AFFECTED BY CHRONIC INFLAMMATORY RHEUMATIC DISEASE DURING THE COVID-19 PANDEMIC? Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:To evaluate the effect of containment, during the Covid-19 pandemic, on the pain of patients with CIRD, and to analyze the factors associated with the experience of pain.Methods:A cross-sectional study was conducted among patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics. Impact of COVID-19 on This is a cross-sectional study that consecutively includedPatients were asked to assess the global pain which they had experienced before and during the containment period, using a single Visual Analogue Scale (VAS) ranging from 0 (no pain) to 10 (greatest pain).Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the study data.We performed univariate then multivariate analysis to search any related factors to pain perception during to quarantines. Qualitative values were analyzed by the chi2 test. Quantitative values were analyzed by the Student test when the measures were normally distributed or by nonparametric test (Mann–Whitney U) when the measures were not normally distributed (Kolmogorov–Smirnov test was used to test normality).Results:Among the 350 patients who answered to the questionnaire online, rheumatoid arthritis represented 62.3%, spondyloarthropathy 34.3% and undifferentiated CIRD 3.4%.Pain experience caused by the CIRD during the containment was reported by 79.1% of patients.The level of pain, using the VAS of Pain increased significantly during the COVID-19 pandemic (4,6 ± 2,8 and 5,4 ± 3 before and during the containment; p<0.001).In multivariate analysis, the factors implicated in pain were the negative impact of Coronavirus on access to rheumatologic care, discontinuation of therapeutic adherence, the disturbed quality of sleep and the negative psychological impact (table 1).Table 1: Summarize multivariable analysis of factors associated with painful experience related to CIRD during containement.Table 1.Multivariable analysis of factors associated with painful experience related to CIRD during containementPImpact on monitoring0.05Impact on therapeutic adherence<0.001Quality of sleep disturbed0.001Negative psychological impact0.02Conclusion:This survey showed the that the COVID-19 pandemic have incresed painful experience in CIRD patients. Factors influencing painful experience should be taken into account to help patients to cope with their chronic rheumatism and this global health crisis.Disclosure of Interests:None declared
Collapse
|
9
|
El Joumani T, Rkain H, Fatima Zahrae T, Kenza H, Radouan A, Laila N, Bahloul S, Nada EA, Latifa T, Hajjaj-Hassouni N, Allali F. AB0902-HPR COVID-19 PANDEMIC: KNOWLEDGE, BELIEVES AND FEARS IN PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATIC DISEASES IN A DEVELOPING COUNTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:To investigate the knowledge, believes, and fears of patients with Chronic Inflammatory Rheumatic Diseases (CIRD) in Morocco regarding the Covid-19 pandemic.Methods:COVID-19 related knowledge was evaluated through following items: clinical presentations, age of infection, transmission routes, self-reported preventive behaviors, patient’s approach in case of suspicion of being infected by COVID-19 and vaccination. We also investigated the source of the patients’ information.Believes and fears of patients regarding COVID-19 was assessed using 2 items that explored participant’s perception of the degree of threat to public health and their individual infection susceptibility compared to the general population.Results:A cross-sectional study was conducted among patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics.350 patients had participated in this online survey (mean age of 46,1 ± 14,4, 68% were women, 15.7% were illiterate, 45.7% were unemployed, rural residence in 11.7% of cases).The correct answer rates of the 6 questions of the knowledge section of the questionnaire were 53.4-100% with an average mean of 90.7%. The mean COVID-19 knowledge score was 5,43/6 (SD:0,48). Most participants (96.6%) correctly identified the age group concerned about Covid-19 infection. Remarkably 92.3% of the participants recognized 3 clinical features when 97.7% and 72.3% of the sample recognized perfectly modes of transmission and disease prevention measures. 87.4% of patients knew the recommended course of action to do if they have fever or cough and have recently been in contact with an infected patient. 64% of the study population thought that there was no vaccine available yet.The sources of information on COVID-19 were in descending order: rheumatologist (56.6 %), personal research (on the internet or other) (43.4%), video broadcasts on national television channels (28%), other Awareness Video (24.2%).Regarding the patients believes and fears toward COVID-19, 81.7% of patients believed that the pandemic is a serious threat for the public health and 80.6% thought that their CIRD makes them more exposed to the risk of contamination than general population.Conclusion:The results of this survey show a high prevalence of patient concern about COVID-19. However, the majority of patients responded correctly on the mode of transmission and the means of protection for the COVID-19 infection. Those results could be explained by enormous awareness-raising efforts carried out by our differents departments of our government.Disclosure of Interests:None declared
Collapse
|
10
|
López-Medina C, Chevret S, Moltó A, Sieper J, Duruöz MT, Kiltz U, Zorkany B, Hajjaj-Hassouni N, Burgos-Vargas R, Maldonado-Cocco J, Ziade N, Gavali M, Navarro-Compán V, Luo SF, Biglia A, Kim TJ, Kishimoto M, Pimentel Dos Santos F, Gu J, Muntean L, Van Gaalen FA, Géher P, Magrey M, Ibáñez S, Bautista-Molano W, Maksymowych WP, Machado PM, Landewé RBM, Van der Heijde D, Dougados M. OP0047 IDENTIFICATION OF CLINICAL PHENOTYPES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS, PERIPHERAL SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS ACCORDING TO PERIPHERAL MUSCULOSKELETAL MANIFESTATIONS: A CLUSTER ANALYSIS IN THE INTERNATIONAL ASAS-PERSPA STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Patients with a diagnosis of Spondyloarthritis (SpA) and Psoriatic Arthritis (PsA) may have predominant axial or peripheral symptoms, and the frequency and distribution of these symptoms may determine the clinical diagnosis by the rheumatologist (“clinical clusters”). Clustering analysis represents an unsupervised exploratory analysis which tries to identify homogeneous groups of cases (“statistical clusters”) without prior information about the membership for any of the cases.Objectives:To identify “statistical clusters” of peripheral involvement according to the specific location of these symptoms in the whole spectrum of SpA and PsA (without prior information about the diagnosis of the patients), and to evaluate whether these “statistical clusters” are in agreement with the “clinical clusters”.Methods:Cross-sectional and multicentre study with 24 participating countries. Consecutive patients considered by their treating rheumatologist as suffering from either PsA, axial SpA (axSpA) or peripheral SpA (pSpA) were enrolled. Four different cluster analyses were conducted: the first one using information about the specific location from all the peripheral musculoskeletal manifestations (i.e., peripheral arthritis, enthesitis and dactylitis), and thereafter a cluster analysis for each peripheral manifestation individually. Multiple correspondence analyses and k-means clustering methods were used. Distribution of peripheral manifestations and clinical characteristics were compared across the different clusters.Results:4465 patients were included in the analysis. Two clusters were found with regard to the location of all the peripheral manifestations (Fig. 1). Cluster 1 showed a low prevalence of peripheral manifestations in comparison with cluster 2; however, when peripheral involvement appeared in cluster 1, this was mostly represented by arthritis of hip, knee and ankle, as well as enthesitis of the heel. Patients from cluster 1 showed a higher prevalence of males (63% vs 44%), HLA-B27 positivity (69% vs 38%) and axial involvement (80% vs 52%), as well as more frequent diagnosis of axSpA (66% vs 21%) and more frequently fulfilling the ASAS axSpA criteria (69% vs. 41%). Patients from cluster 2 showed a higher prevalence of psoriasis (63% vs 25%), a more frequent diagnosis of PsA (61% vs 19%), and they fulfilled more frequently the peripheral ASAS (26% vs 11%) and the CASPAR criteria (57% vs 19%).Figure 1.Distribution of the peripheral involvement across clustersThree clusters were found with regard to the location of the peripheral arthritis. Clusters 2 and 3 showed a high prevalence of peripheral joint disease, although this was located more predominantly in the lower limbs in cluster 2, and in the upper limbs in cluster 3. Cluster 1 showed a higher prevalence of males, HLA-B27 positivity, axial involvement, a lower presence of psoriasis, a more frequent diagnosis of axSpA and fulfilling the ASAS axSpA criteria in comparison with clusters 2 and 3, respectively. Clusters 2 and 3 showed a higher prevalence of enthesitis and dactylitis in comparison with cluster 1, a more frequent diagnosis of PsA and fulfillment of the CASPAR criteria.Information about the location of enthesitis exhibited three groups: cluster 1 showed a very low prevalence of enthesitis, while cluster 2 and 3 showed a high prevalence of enthesitis, with a predominant involvement of axial enthesis in cluster 2 and peripheral enthesitis in cluster 3.Finally, the analysis of dactylitis also exhibited three clusters that showed a very low prevalence of dactylitis, predominantly toes and predominantly fingers involvement, respectively.Conclusion:These results suggest the presence of heterogeneous patterns of peripheral involvement in SpA and PsA patients without clearly defined groups, confirming the clear overlap of these peripheral manifestations across the different underlying diagnoses.Acknowledgements:This study was conducted under the umbrella of ASAS with unrestricted grant of Abbvie, Pfizer, Lilly, Novartis, UCB, Janssen and Merck.Disclosure of Interests:None declared
Collapse
|
11
|
Aachari I, Rkain H, Safaa F, Benzakour L, Latifa T, Alami N, Guieu R, Jammes Y, Hajjaj-Hassouni N, Allali F. FRI0612-HPR EFFECT OF THERMOFORMABLE ORTHOSES ON FOOT FUNCTION IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Orthoses and footwear can play an important role in managing foot pathology in patients whose systemic disease is controlled. Foot orthoses are frequently prescribed in clinical practice as an intervention for people with rheumatoid arthritis (RA).Objectives:The aim of our study is to evaluate the impact of thermoformable orthoses on the functional index of the foot (FFI) in patients with rheumatoid arthritis.Methods:We conducted an open clinical trial, having consecutively included 14 patients (85.7% female, average age 54.8 ± 10 years) suffering from rheumatoid arthritis (median progression time of 9 years [5 - 12]). The average DAS28 was 2.7 ± 1.2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The median deadline from the start of RA and the onset of the foot problem was 3 years [0 – 7,75]. The foot problem was bilateral in 100% of the cases and inaugural in 85.7% of the cases.We evaluated the functional impact of foot injury for all our patients at baseline and 8 weeks after the use of thermoformable orthoses, based on the FFI (Foot function Index) measuring the impact of foot pathology on function in terms of pain, disability and activity limitation.The comparison of the FFI domains before and after the use of orthoses was carried out using parametric or nonparametric paired tests using The SPSS statistical software.Results:With the use of foot orthoses, FFI values decreased in all subscales (p=0,024) (pain, disability and activity limitation). This reduction was significant for disability (0,011) but not for pain and activity limitation.There were no significant correlations between the global FFI and the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Table 1. The comparison of the FFI domains before and after the use of orthoses.psignificatif if< 0,05; Test used: Non-parametric test for two linked samples.Conclusion:Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced disability as measured by the FFI. The absence of factors associated with pain and limitation of activity could possibly be related to the small sample size.Disclosure of Interests:None declared
Collapse
|
12
|
Afilal S, Rkain H, Berchane B, Moulay Berkchi J, Fellous S, Fatima Zahrae T, Ilham A, Alami N, Latifa T, Hajjaj-Hassouni N, Allali F. THU0642-HPR EVOLUTION OF THE PERCEPTIONS OF RA PATIENTS AFTER EDUCATION PATIENT SESSION TEACHING METHOTREXATE SELF-INJECTION A PROSPECTIVE PILOT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Methotrexate is a gold standard for treatment of RA. In our context, RA patients prefer to be injected by paramedics rather than self-injecting. This can be explained by patients’ bad perceptions of self-injection or lack of information. Appropriate self-injection education can therefore be an important element in overcoming these obstacles and improving disease self-management.Objectives:Compare the RA patients’ perceptions on methotrexate self-injection before and after a patient education session.Methods:Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist with a control a week later. Perceptions of the reluctance to self-inject and the difficulties encountered by patients were assessed before the patient education session, after the 1st and 2nd self-injection of methotrexate using a 10 mm visual analog scale. Patients also reported their level of satisfaction (10 mm VAS) after the 1st and 2nd self-injection.Results:The mean duration of patient education session is 13 min.Table I compares the evolution of the degrees of reluctance to self-injection, the difficulties encountered, and the satisfaction experienced by the patients.Table 1.Evolution of RA patients’ perceptions on the methotrexate self-injection. (N = 27)BeforeAfter the 1stself-injectionAfter the 2end self-injectionpVAS reluctance (0-10mm)6,5 ± 3,62,2 ± 2,91,0 ± 2,3<0,0001VAS difficulty (0-10mm)7,5 ± 2,62,5 ± 2,71,0 ± 1,9<0,0001VAS satisfaction (0-10mm)-8,9 ± 1,89,5 ± 1,50,002Conclusion:This study suggests the effectiveness of a methotrexate self-injection patient education session in RA patients. It also highlights the value of patient education in rheumatologic care. A large-scale study is necessary to better interpret and complete these preliminary results from this pilot study.Disclosure of Interests:None declared
Collapse
|
13
|
Fellous S, Rkain H, Ilham A, Benzakour L, Latifa T, Alami N, Guieu R, Jammes Y, Hajjaj-Hassouni N, Allali F. FRI0620-HPR THE EFFECT OF THERMOFORMABLE FOOT ORTHOSES ON WALKING IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Foot pain is common in rheumatoid arthritis and appears to persist despite modern day medical management.Objectives:To evaluate the impact of thermoformable foot orthoses on walking in rheumatoid arthritis (RA) patients.Methods:This is a open clinical trial, that included 14 consecutive patients (85,7% female, mean age 54,8 ± 10 years) with RA (median duration of progression of 9 [5-12] years), the average DAS28 was 2,7+/-1,2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The foot problem was bilateral in 100% and inaugural in 85.7% of the cases.The 14 rheumatoid subjects were examined and appropriate foot orthoses were prescribed according to each patient’s needs. All the patients were evaluated at baseline and 8 weeks after use of orthoses. Gait pain, difficulty walking and the 10 Meter Walk test were noted at each appointment.We used dynamic baropodometric analysis to assess postural evaluation. We calculated the lateral-medial index of each foot before and after the use of orthoses.Table 1.Assessment of walking before and after the use of orthosesBefore orthosesAfter orthosespPain when walking*(EVA 0-10)5 [3-5,2]0 [0-2]0,002Difficulty walking* (0-10)- In house4 [3-5,2]2 [0-2]0,002- Outside6 [4,7-7]2 [1,5-2,5]0,0210 Meter Walk test**(Normal comfortable speed)- Nomber of steps18,64 ± 3,716,9 ± 50,2- Duration (sec)11,9 ± 4,611,8 ± 5,20,9- Walking speed (m/min)56,4 ±17,758,6 ± 20,30,6latero-medial (L/M) index**- L/M index of the right foot1,18 ± 0,171,23 ± 0,230,1- L/M index of the left foot1,25 ± 0,171,26 ± 0,190,9*median and quartile**average and standard deviationp significant if< 0,05Results:A significant decrease in walking pain (p = 0.002) and difficulty walking (p = 0.02) was found with the use of orthoses. The variations in 10 meter walk test and dynamic baropodometric parameters were not significant (p>0,05).There were no significant correlations between pain and difficulty walking, the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Conclusion:Thermoformable foot orthoses significantly reduced pain and difficulty walking. The absence of factors associated with pain and difficulty walking could possibly be related to the small sample size.Disclosure of Interests:None declared
Collapse
|
14
|
Afilal S, Rkain H, Berchane B, Moulay Berkchi J, Fellous S, Fatima Zahrae T, Ilham A, Alami N, Latifa T, Hajjaj-Hassouni N, Allali F. THU0641-HPR ILLITERACY IS NOT AN OBSTACLE FOR ASSIMILATION OF A PATIENT EDUCATION SESSION ON METHOTREXATE SELF-INJECTION IN RA PATIENTS A PROSPECTIVE PILOT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patient education for RA patients has been shown to improve adherence and self-management of this chronic disease.Objectives:To assess the impact of illiteracy on assimilation of a patient education session on methotrexate self-injection in RA patients.Methods:Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist. A 10-question dichotomous questionnaire was then administered to patients to assess the level of uptake of messages passed during the patient education session. The prevalence of correct answers was compared between illiterate and non-illiterate patients.Results:The mean duration of patient education session is 13 min.Table I illustrates the results of the correct responses prevalence and the comparison of correct response rates between illiterate and non-illiterate patients.Table 1.Prevalence of correct responses and comparison of correct response rates between illiterate and non-illiterate patients.QuestionsN=27IlliteratePYes (N=11)No (N=16)1.Do I always have to self-inject on the same day of the week? (%)96,390,9100NS2.Should Methotrexate be protected from light and away from children? (%)96,310093,7NS3.Can I self-inject anywhere on my thigh and belly 5 cm from the navel? (%)85,210075NS4.Is it important to change the injection sites? (%)70,472,768,75NS5.Do I need to pinch the skin before self-injection? (%)92,610087,5NS6.Can I always use the same needle for each injection? (%)81,590,975NS7.Do I have to wear gloves to inject Methotrexate? (%)81,590,975NS8.Do I have to apply an antiseptic product (alcohol, Betadine) to the injection site before self-injecting? (%)88,990,987,5NS9.Can I use the rest of the MTX ampoule for the next injection? (%)74,181,868,7NS10.Do I tell my doctor if I have side effects? (%)100100100NSConclusion:This study suggests that illiteracy does not affect the assimilation of information given during a patient education session. These preliminary results should encourage the development of patient education programs in our context where illiteracy rate is high.Disclosure of Interests:None declared
Collapse
|
15
|
Moulay Berkchi J, Rkain H, Benbrahim L, Aktaou S, Lazrak N, Faiz S, Ahid S, Abouqal R, Labzizi S, Ouzeddoun N, Oukerraj L, Hmamouchi I, Hajjaj-Hassouni N, Allali F. Management of gout by Moroccan rheumatologists: a Moroccan Society for Rheumatology National Survey. Rheumatol Int 2020; 40:1399-1408. [PMID: 32447422 DOI: 10.1007/s00296-020-04599-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/04/2020] [Indexed: 12/27/2022]
Abstract
To assess the modalities and current practices in gout management reported by Moroccan rheumatologists. We performed a cross-sectional online survey using a questionnaire e-mailed to 360 rheumatologists included 30 multiple-choice questions. 105 rheumatologists responded to the survey with 29% of response rate. The number of gout patients seen per month was five (3-9); they were referred in 58.7% by a general practitioner. The clinical presentation of gout patients was dominated by gout crisis in 71%, and the association gout crisis and gouty arthropathy accounted for 19% of severe forms. 40% of rheumatologists apply the 2015ACR/EULAR classification criteria. Obesity accounted for 85.7% of the associated comorbidities. The most commonly prescribed Urate-lowering therapy (ULT) was allopurinol in 81.3% (± 12). 48% of rheumatologists reported starting allopurinol at 200 mg daily and associated it with colchicine during the first 6 months by 33.3%. The determination of uric acid levels was monitoring in 76.2% every 3 months. Administration of ULT to asymptomatic hyperuricemia was found in 69.5% when patients had renal complications, while only 14.3% recommended dietary and lifestyle measures. The median duration for therapeutic education was 15 min (10, 20). In 96.2%, the education of the patient was done orally. 93.3% of rheumatologists inform their patients on how to manage a gout attack, and 96.2% on the measures of hygiene and diet has adopted. Our survey gives an insight into the elements that should be improved in the management of gout by the Moroccan rheumatologists. It highlights the need to standardize the management of gout, hence the importance of developing Moroccan recommendations on gout.
Collapse
Affiliation(s)
- Jihad Moulay Berkchi
- Department of Rheumatology B, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.
| | - Hanan Rkain
- Department of Rheumatology B, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.,Laboratory of Physiology, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Laila Benbrahim
- Day Clinic, Delegation of the Ministry of Health at the Rabat Prefecture, Rabat Regional Hospital, Rabat, Morocco
| | | | | | - Souad Faiz
- Delegation of the Ministry of Health at the Prefecture of Casablanca, Casablanca, Morocco
| | - Samir Ahid
- Pharmacology and Toxicology Laboratory, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.,Faculty of Pharmacy, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Saloua Labzizi
- National Nutrition Program, Direction of Population, Ministry of Public Health, Rabat, Morocco
| | - Naima Ouzeddoun
- Department of Nephrology-Hemodialysis, CHU Ibn Sina, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Latifa Oukerraj
- Department of Cardiology B, Souissi Maternity, CHU Ibn Sina, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Ihsane Hmamouchi
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | | | - Fadoua Allali
- Department of Rheumatology B, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| |
Collapse
|
16
|
Haldeman S, Nordin M, Chou R, Côté P, Hurwitz EL, Johnson CD, Randhawa K, Green BN, Kopansky-Giles D, Acaroğlu E, Ameis A, Cedraschi C, Aartun E, Adjei-Kwayisi A, Ayhan S, Aziz A, Bas T, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dudler J, Dunn R, Eberspaecher S, Emmerich J, Farcy JP, Fisher-Jeffes N, Goertz C, Grevitt M, Griffith EA, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Kane EJ, Laplante J, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Rajasekaran S, Shearer H, Smuck M, Sönmez E, Tavares P, Taylor-Vaisey A, Torres C, Torres P, van der Horst A, Verville L, Vialle E, Kumar GV, Vlok A, Watters W, Wong CC, Wong JJ, Yu H, Yüksel S. The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities. Eur Spine J 2018; 27:776-785. [PMID: 30151809 DOI: 10.1007/s00586-018-5722-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. METHODS Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. RESULTS Literature reviews on the burden of spinal disorders and six categories of evidence-based interventions for spinal disorders (assessment, public health, psychosocial, noninvasive, invasive, and the management of osteoporosis) were completed. In addition, participants developed a stratification system for surgical intervention, a classification system for spinal disorders, an evidence-based care pathway, and lists of resources and recommendations to implement the GSCI model of care. CONCLUSION The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders. The model requires testing to determine feasibility. If it proves to be implementable, this model holds great promise to reduce the tremendous global burden of spinal disorders. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.,Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Arthur Ameis
- Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of Medicine, University of Montreal, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Afua Adjei-Kwayisi
- Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Amer Aziz
- Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital Lahore Pakistan, Lahore, Punjab, Pakistan
| | - Teresa Bas
- Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health, Madrid, Spain.,Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Jean Dudler
- Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, Western Cape, South Africa.,Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | | | - Juan Emmerich
- University of La Plata, La Plata, Buenos Aires, Argentina
| | - Jean Pierre Farcy
- Department of Orthopedic Surgery (retired), New York University, Piermont, NY, USA
| | - Norman Fisher-Jeffes
- Groote Schuur Hospital, Cape Town, Western Cape, South Africa.,Panorama Medi Clinic, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA.,The Spine Institute for Quality, Davenport, IA, USA
| | | | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | - Julie Laplante
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | | | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | | | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Alexander van der Horst
- Department of Surgery, University of Namibia, Windhoek, Namibia.,Central Hospital, Windhoek, Namibia
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | | | | | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| |
Collapse
|
17
|
Kopansky-Giles D, Johnson CD, Haldeman S, Chou R, Côté P, Green BN, Nordin M, Acaroğlu E, Ameis A, Cedraschi C, Hurwitz EL, Ayhan S, Borenstein D, Brady O, Brooks P, Davatchi F, Dunn R, Goertz C, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Lemeunier N, Mayer J, Mior S, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Torres C, Torres P, Vlok A, Wong CC. The Global Spine Care Initiative: resources to implement a spine care program. Eur Spine J 2018; 27:915-924. [PMID: 30151804 DOI: 10.1007/s00586-018-5725-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries. METHODS Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.g., back and neck pain, deformity, spine injury, neurological conditions, pathology and spinal diseases). An iterative expert consensus process was used using electronic surveys. RESULTS Thirty-five experts completed the process. An iterative consensus process was used through an electronic survey. A consensus was reached after two rounds. The checklist of resources included the following categories: healthcare provider knowledge and skills, materials and equipment, human resources, facilities and infrastructure. The list identifies resources needed to implement a spine care program in any community, which are based upon spine care needs. CONCLUSION To our knowledge, this is the first international and interprofessional attempt to develop a list of resources needed to deliver care in an evidence-based care pathway for the management of people presenting with spine-related concerns. This resource list needs to be field tested in a variety of communities with different resource capacities to verify its utility. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA.
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
- World Spine Care, Santa Ana, CA, USA
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | | | - Arthur Ameis
- Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal Faculty of Medicine, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'I, Mānoa, Honolulu, HI, USA
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, Western Cape, South Africa
- Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA
- The Spine Institute for Quality, Davenport, IA, USA
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Carlos Torres
- University of Ottawa, Ottawa, ON, Canada
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | | |
Collapse
|
18
|
Haldeman S, Johnson CD, Chou R, Nordin M, Côté P, Hurwitz EL, Green BN, Kopansky-Giles D, Cedraschi C, Aartun E, Acaroğlu E, Ameis A, Ayhan S, Blyth F, Borenstein D, Brady O, Davatchi F, Goertz C, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Mullerpatan R, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Sönmez E, Torres C, Torres P, Watters W, Yu H. The Global Spine Care Initiative: classification system for spine-related concerns. Eur Spine J 2018; 27:889-900. [PMID: 30151807 DOI: 10.1007/s00586-018-5724-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway. METHODS Existing classification systems for spinal disorders were assembled. A seed document was developed through round-table discussions followed by a modified Delphi process. International and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. RESULTS Thirty-six experts from 15 countries participated. After the second round, there was 95% agreement of the proposed classification system. The six major classifications included: no or minimal symptoms (class 0); mild symptoms (i.e., neck or back pain) but no interference with activities (class I); moderate or severe symptoms with interference of activities (class II); spine-related neurological signs or symptoms (class III); severe bony spine deformity, trauma or pathology (class IV); and spine-related symptoms or destructive lesions associated with systemic pathology (class V). Subclasses for each major class included chronicity and severity when different interventions were anticipated or recommended. CONCLUSIONS An international and interprofessional group developed a comprehensive classification system for all potential presentations of people who may seek care or advice at a spine care program. This classification can be used in the development of a spine care pathway, in clinical practice, and for research purposes. This classification needs to be tested for validity, reliability, and consistency among clinicians from different specialties and in different communities and cultures. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.,Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | | | - Arthur Ameis
- Faculty of Medicine, Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA.,The Spine Institute for Quality, Davenport, IA, USA
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Rajani Mullerpatan
- Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Erkin Sönmez
- Department of Neurological Surgery, School of Medicine, Başkent University, Ankara, Turkey
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| |
Collapse
|
19
|
Johnson CD, Haldeman S, Nordin M, Chou R, Côté P, Hurwitz EL, Green BN, Kopansky-Giles D, Randhawa K, Cedraschi C, Ameis A, Acaroğlu E, Aartun E, Adjei-Kwayisi A, Ayhan S, Aziz A, Bas T, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dudler J, Dunn R, Eberspaecher S, Emmerich J, Farcy JP, Fisher-Jeffes N, Goertz C, Grevitt M, Griffith EA, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Kane EJ, Laplante J, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Rajasekaran S, Shearer H, Smuck M, Sönmez E, Tavares P, Taylor-Vaisey A, Torres C, Torres P, van der Horst A, Verville L, Vialle E, Kumar GV, Vlok A, Watters W, Wong CC, Wong JJ, Yu H, Yüksel S. The Global Spine Care Initiative: methodology, contributors, and disclosures. Eur Spine J 2018; 27:786-795. [PMID: 30151808 DOI: 10.1007/s00586-018-5723-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. METHODS World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiative aims to improve the management, prevention, and public health for spine-related disorders worldwide; thus, global representation was essential. A series of meetings established the initiative's mission and goals. Electronic surveys collected contributorship and demographic information, and experiences with spinal conditions to better understand perceptions and potential biases that were contributing to the model of care. RESULTS Sixty-eight clinicians and scientists participated in the deliberations and are authors of one or more of the GSCI articles. Of these experts, 57 reported providing spine care in 34 countries, (i.e., low-, middle-, and high-income countries, as well as underserved communities in high-income countries.) The majority reported personally experiencing or having a close family member with one or more spinal concerns including: spine-related trauma or injury, spinal problems that required emergency or surgical intervention, spinal pain referred from non-spine sources, spinal deformity, spinal pathology or disease, neurological problems, and/or mild, moderate, or severe back or neck pain. There were no substantial reported conflicts of interest. CONCLUSION The GSCI participants have broad professional experience and wide international distribution with no discipline dominating the deliberations. The GSCI believes this set of papers has the potential to inform and improve spine care globally. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.,Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawaii, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, North York, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Arthur Ameis
- University of Montreal Faculty of Medicine Certification Program in Insurance Medicine and MedicoLegal Expertise, Toronto, ON, Canada
| | | | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Afua Adjei-Kwayisi
- Ghana World Spine Care, Ridge Regional Hospital, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Amer Aziz
- Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital Lahore Pakistan, Lahore, Punjab, Pakistan
| | - Teresa Bas
- Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Jean Dudler
- Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | | | - Juan Emmerich
- University of La Plata, La Plata, Buenos Aires, Argentina
| | | | - Norman Fisher-Jeffes
- Panorama Medi Clinic, Cape Town, Western Cape, South Africa.,Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic and The Spine Institute for Quality, Davenport, IA, USA
| | | | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | - Julie Laplante
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | | | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | | | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Carlos Torres
- Department of Medical Imaging, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Alexander van der Horst
- Department of Surgery, University of Namibia, Windhoek, Namibia.,Central Hospital, Windhoek, Namibia
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | | | - Gomatam Vijay Kumar
- Head of Neurosurgery, AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| |
Collapse
|
20
|
Erraoui M, Amine B, Tahiri L, El Binoune I, Bahha J, Hajjaj-Hassouni N. Noncontiguous multi-tiered spinal tuberculosis associated with sternal localization: a case report. J Med Case Rep 2017; 11:181. [PMID: 28676098 PMCID: PMC5497373 DOI: 10.1186/s13256-017-1323-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tuberculous spondylodiscitis is a frequent localization of tuberculosis. Multi-tiered involvement and an association with sternal localization are rare. CASE PRESENTATION We report a case of multi-tiered tuberculous spondylodiscitis with sternal localization in an immunocompetent 41-year-old Arab woman who had inflammatory bilateral sciatica L5 and S1 and a history of low back pain caused by a trauma. Radiography, computed tomography, and a vertebral biopsy were useful for diagnosis. She reacted well to anti-bacillary treatment despite the occurrence of multiple paravertebral and subcutaneous abscesses. The medullar magnetic resonance imaging control performed at 4 months, 12 months, and 1 year after the end of treatment showed a favorable evolution. CONCLUSIONS To avoid the delay of diagnosis, especially in our endemic context, tuberculosis must be evoked usually. This will improve the prognosis of our patients.
Collapse
Affiliation(s)
- Mariam Erraoui
- Faculty of Medicine and Pharmacy, LIRPOS, URAC 30, Rheumatology, Mohammed V University, Rabat, Sale Morocco
| | - Bouchra Amine
- Faculty of Medicine and Pharmacy, LIRPOS, URAC 30, Rheumatology, Mohammed V University, Rabat, Sale Morocco
| | - Latifa Tahiri
- Faculty of Medicine and Pharmacy, LIRPOS, URAC 30, Rheumatology, Mohammed V University, Rabat, Sale Morocco
| | - Imane El Binoune
- Faculty of Medicine and Pharmacy, LIRPOS, URAC 30, Rheumatology, Mohammed V University, Rabat, Sale Morocco
| | - Jihane Bahha
- Faculty of Medicine and Pharmacy, LIRPOS, URAC 30, Rheumatology, Mohammed V University, Rabat, Sale Morocco
| | - Najia Hajjaj-Hassouni
- Faculty of Medicine and Pharmacy, LIRPOS, URAC 30, Rheumatology, Mohammed V University, Rabat, Sale Morocco
| |
Collapse
|
21
|
Ngeuleu A, Allali F, Medrare L, Madhi A, Rkain H, Hajjaj-Hassouni N. Sarcopenia in rheumatoid arthritis: prevalence, influence of disease activity and associated factors. Rheumatol Int 2017; 37:1015-1020. [PMID: 28258473 DOI: 10.1007/s00296-017-3665-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 01/20/2017] [Indexed: 12/12/2022]
Abstract
Evaluate the prevalence of sarcopenia on patients with rheumatoid arthritis (RA), the influence of sarcopenia on disease activity and factors associated with sarcopenia. One hundred and twenty-three patients aged over 18 years with RA based on the 1987 ACR/EULAR classification criteria were enrolled. We performed a whole body DXA scan using a dual-energy X-ray absorptiometry (DXA) scanner lunar prodigy to measure fat mass, lean mass, and bone mass in the whole body and body parts. According to the anthropometric equation by Baumgartner et al., sarcopenia was defined as Relative skeletal mass index (RSMI) <5.5 kg/m2 on women and <7.26 kg/m2 on men. Body mass index (BMI) and waist circumference were measured and patients were classified according to World Health Organization. Disease activity was evaluated by: disease activity score 28 ESR (DAS28 ESR), disease activity score 28 CRP (DAS28 CRP), clinical disease activity index (CDAI), simplify disease activity index (SDAI). We measured functional disability by Health assessment questionnaire (HAQ). History and previous medication use including steroids were also checked, and comorbidities were recorded. We analyzed the relation between disease parameters and sarcopenia with the r of Pearson and Spearman. Factors associated and related to sarcopenia were assessed using multiple regression analysis and t independent test. We included 123 patients (107 women). 49 subjects (39.8%) where suffering from sarcopenia, of which 40 women. Most of the sarcopenic patients were between 41 and 50 years old. Sarcopenia on female subjects was not related to parameters of disease activity evaluated by DAS 28, CDAI and SDAI. Most of the sarcopenic patients had normal BMI and abnormal waist circumference. In simple regression analysis sarcopenia was related to BMI, DAS 28 ESR, bone erosion, waist circumference and HAQ. In multiple regression analysis, sarcopenia was positively related to an increase cardiometabolic risk [p = 0.025, OR 0.176, CI (0.038-0.980)], normal BMI [p = 0.004, OR 12.3, CI (2.27-67.6)], over fat BMI [p = 0.004, OR 12.3, CI (2.27-67.6)] and bone erosion [p = 0.012, OR 0.057 CI (0.006-0.532)]. No statistical difference was found according to disease duration and steroids use between sarcopenic and non sarcopenic patients. Sarcopenia is prevalent and related to age, bone erosion, normal/over fat BMI and high cardiometabolic risk according to waist circumference but not with disease activity.
Collapse
Affiliation(s)
- Ange Ngeuleu
- Department of Rheumatology, El Ayachi University-Hospital, Rabat-Salé Ibn Sina Teaching Hospitals, Faculty of Medicine and Pharmacy, Mohamed Vth University, Salé, Morocco.
| | - F Allali
- Department of Rheumatology, El Ayachi University-Hospital, Rabat-Salé Ibn Sina Teaching Hospitals, Faculty of Medicine and Pharmacy, Mohamed Vth University, Salé, Morocco.,Laboratory of Information and Research on Bone Diseases (LIRPOS-URAC 30), Faculty of Medicine and Pharmacy, University Mohammed Vth, Rabat, Morocco.,Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, University Mohammed Vth, Rabat, Morocco
| | - L Medrare
- Department of Rheumatology, El Ayachi University-Hospital, Rabat-Salé Ibn Sina Teaching Hospitals, Faculty of Medicine and Pharmacy, Mohamed Vth University, Salé, Morocco
| | - A Madhi
- Department of Rheumatology, El Ayachi University-Hospital, Rabat-Salé Ibn Sina Teaching Hospitals, Faculty of Medicine and Pharmacy, Mohamed Vth University, Salé, Morocco
| | - H Rkain
- Department of Rheumatology, El Ayachi University-Hospital, Rabat-Salé Ibn Sina Teaching Hospitals, Faculty of Medicine and Pharmacy, Mohamed Vth University, Salé, Morocco.,Laboratory of Information and Research on Bone Diseases (LIRPOS-URAC 30), Faculty of Medicine and Pharmacy, University Mohammed Vth, Rabat, Morocco.,Laboratory of Physiology, Faculty of Medicine and Pharmacy, University Mohammed Vth, Rabat, Morocco
| | - N Hajjaj-Hassouni
- Department of Rheumatology, El Ayachi University-Hospital, Rabat-Salé Ibn Sina Teaching Hospitals, Faculty of Medicine and Pharmacy, Mohamed Vth University, Salé, Morocco.,Laboratory of Information and Research on Bone Diseases (LIRPOS-URAC 30), Faculty of Medicine and Pharmacy, University Mohammed Vth, Rabat, Morocco
| |
Collapse
|
22
|
Kleinmann J, Tubach F, Le Guern V, Mathian A, Richez C, Saadoun D, Sacré K, Sellam J, Seror R, Amoura Z, Andres E, Audia S, Bader-Meunier B, Blaison G, Bonnotte B, Cacoub P, Caillard S, Chiche L, Chosidow O, Costedoat-Chalumeau N, Daien C, Daugas E, Derdèche N, Doria A, Fain O, Fakhouri F, Farge D, Gabay C, Guillo S, Hachulla E, Hajjaj-Hassouni N, Hamidou M, Houssiau F, Jourde-Chiche N, Kone-Paut I, Ladjouz-Rezig A, Lambotte O, Lipsker D, Mariette X, Martin Silva N, Martin T, Maurier F, Meckenstock R, Mekinian A, Meyer O, Mohamed S, Morel J, Moulin B, Mulleman D, Papo T, Poindron V, Puéchal X, Punzi L, Quartier P, Sailler L, Smail A, Soubrier M, Sparsa A, Tazi Mezalek Z, Zakraoui L, Zuily S, Sibilia J, Gottenberg J. Recommandations francophones, internationales et multidisciplinaires d’experts pour l’utilisation de biomédicaments dans le lupus érythémateux systémique : le groupe de travail du CRI-IMIDIATE. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Elbinoune I, Amine B, Wabi M, Rkain H, Aktaou S, Hajjaj-Hassouni N. Rheumatoid shoulder assessed by ultrasonography: prevalence of abnormalities and associated factors. Pan Afr Med J 2016; 24:235. [PMID: 27800090 PMCID: PMC5075465 DOI: 10.11604/pamj.2016.24.235.9068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/06/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The shoulder involvement in rheumatoid arthritis (RA) is common. It can be subclinical and compromise the function of the upper limb. Musculoskeletal ultrasonography can detect subclinical abnormalities in rheumatoid shoulder. Our aim was to assess the prevalence of ultrasound abnormalities in rheumatoid shoulder, and investigate their association with different parameters. METHODS Cross-sectional study including 37 patients with RA, meeting the ACR/EULAR 2010 classification criteria, who were enrolled during a month. A questionnaire with sociodemographic, clinical and laboratory data was filled in for all patients. Ultrasound evaluation was performed by a single experienced operator. For each patient, both of shoulders were evaluated. RESULTS Mean age was 50 years with female predominance. Median disease duration of RA was 7.5 years. All patients had a seropositive form of RA. Mean clinical DAS28 was 5.1. Mean HAQ was 1.2. Thirty-one (83.8%) patients had involvement of the shoulder: unilateral in 9(24.3%) cases and bilateral in 22(59.5%) cases. Synovitis was found in 16(43.2%) patients with Doppler in 4 (10.8%) cases. Sub-acromial bursitis was noted in 14 (37.8%) cases and the effusion in 20 (54.1%). Synovitis was noted especially in elderly individuals (p: 0.01). The Doppler was visualized in elderly patients (p: 0.01), with a shorter disease duration (p: 0.02) and with a high SDAI (p: 0.006). US inflammatory findings in anterior recess of glenohumeral joint were linked to a higher synovial index (p: 0.03) and a higher level of rheumatoid factor (p: 0.01). CONCLUSION 59.5% of our RA patients had bilateral involvement of the shoulder which was related to the disease activity. Ultrasound should be a systematic tool to look for the involvement of this joint in RA patients.
Collapse
Affiliation(s)
- Imane Elbinoune
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Bouchra Amine
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| | - Moudjibou Wabi
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Hanan Rkain
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| | - Souad Aktaou
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Najia Hajjaj-Hassouni
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| |
Collapse
|
24
|
Kviatkovsky MJ, Ramiro S, Landewé R, Dougados M, Tubach F, Bellamy N, Hochberg M, Ravaud P, Martin-Mola E, Awada H, Bombardier C, Felson D, Hajjaj-Hassouni N, Logeart I, Matucci-Cerinic M, van de Laar M, van der Heijde D. The Minimum Clinically Important Improvement and Patient-acceptable Symptom State in the BASDAI and BASFI for Patients with Ankylosing Spondylitis. J Rheumatol 2016; 43:1680-6. [DOI: 10.3899/jrheum.151244] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 01/22/2023]
Abstract
Objective.To establish cutoffs for the minimum clinically important improvement (MCII) and the patient-acceptable symptom state (PASS) for the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with ankylosing spondylitis (AS).Methods.Patients with AS who started nonsteroidal antiinflammatory drugs were included. After 4 weeks, the PASS and the MCII were defined using external anchor questions (for the PASS, patients considering their condition of AS over the prior 48 h as “acceptable” forever; and for the MCII, those reporting moderate or slightly important improvement). Consistency of the MCII and PASS were tested according to HLA-B27 status, presence/absence of SpA extraarticular manifestations, age, sex, disease duration, and baseline BASDAI/BASFI score. The 75th percentile of the cumulative distribution was used to determine the MCII and PASS.Results.In total, 283 patients from a multinational cohort were included. Overall cutoffs for the PASS were 4.1 in the BASDAI and 3.8 in the BASFI. Cutoffs for the MCII were 0.7 and 0.4 for the BASDAI and BASFI, respectively. Subgroup analyses revealed that disease duration and baseline BASDAI/BASFI were significantly associated with the PASS and MCII. In a subanalysis limited to patients with active disease (baseline BASDAI ≥ 4), the MCII was 1.1 for the BASDAI and 0.6 for the BASFI.Conclusion.The conceptual viability of the PASS for the BASDAI is questionable because levels approach those required for the start of biological therapy. Because the MCII is less variable than the PASS, we propose its exclusive use, with cutoffs of 1.1/0.6 for the BASDAI/BASFI in patients with active disease. Because these values are based on a subset of the study population, we recommend confirmation in larger studies focused on patients with baseline BASDAI ≥ 4.
Collapse
|
25
|
Elbinoune I, Amine B, Shyen S, Gueddari S, Abouqal R, Hajjaj-Hassouni N. Chronic neck pain and anxiety-depression: prevalence and associated risk factors. Pan Afr Med J 2016; 24:89. [PMID: 27642428 PMCID: PMC5012832 DOI: 10.11604/pamj.2016.24.89.8831] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 03/14/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction Chronic pain in rheumatology often has a psychic impact, which may aggravate the daily life of patients. Chronic neck pain, as an example, is a frequent reason for consultation. The aim of this study is to assess the prevalence of anxiety and depression in patients with neck pain, and identify risk factors associated with their occurrence. Methods It was a cross-sectional study that concerned 80 patients with neck pain lasting for more than 3 months, seen in rheumatology consultations. All patients with symptomatic neck pain or psychological history or receiving psychotropic medication were excluded from the study. For each patient, we determined the sociodemographic characteristics and clinical ones. The anxious and depressed mood was assessed by the Hospital Anxiety and Depression Scale (HAD). Results Of the 80 patients, 67 (83.8%) were women. Average age of our population was 51.8± 11.8 years. Median duration of symptoms was 24 months [12, 48]. Mean VAS pain was 63.9% ± 12.5, mean VAS functional discomfort was 60.9% ± 14.2 and mean VAS disability was 59.8% ± 14.7. 32 patients (40%) were illiterate and 18 (22.5%) had university level. Anxiety was found in 54 (68.4%) and 44 (55.7%) patients were depressed. In univariate analysis, VAS disability was statistically linked to anxiety (OR:1.05; 95%CI: 1.01-1.08; p = 0.02). The cervicobrachial neuralgia (CBN) was significantly associated with depression (OR: 3.33; 95%CI: 1.20-9.23; p = 0.02). Primary education level had a statistically significant relationship with anxiety (OR: 6.00; 95%CI: 1.03-34.84; p = 0.04) and depression (OR: 5.00; 95%CI: 1.09-22.82; p = 0.03). In multivariate analysis, VAS disability and CBN were independently associated with anxiety and depression respectively. Conclusion This study underlines the fact that anxiety and depression are prevalent in chronic neck pain (CNP) patients. Furthermore, disability and CBN which are linked to CNP can predict which patient is at higher risk of psychological distress.
Collapse
Affiliation(s)
- Imane Elbinoune
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Bouchra Amine
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| | - Siham Shyen
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Sanae Gueddari
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco
| | - Najia Hajjaj-Hassouni
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| |
Collapse
|
26
|
Khnaba D, Rostom S, Lahlou R, Bahiri R, Abouqal R, Hajjaj-Hassouni N. Sexual dysfunction and its determinants in Moroccan women with rheumatoid arthritis. Pan Afr Med J 2016; 24:16. [PMID: 27583080 PMCID: PMC4992373 DOI: 10.11604/pamj.2016.24.16.9081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/29/2016] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION To assess the prevalence of sexual dysfunction in married women with rheumatoid arthritis (RA) and compare it with a control group and to determine its association with clinical and disease activity factors. METHODS We conducted a cross-sectional study including sixty married women with a confirmed diagnosis of Rheumatoid Arthritis according to the American College of Rheumatology (ACR)/ European League against Rheumatism (EULAR) 2010 Criteria, aged 18 or over and having sexual activity. Our controls were healthy volunteers women matched for age. Clinical and sociodemographic characteristics were collected. Sexual function was assessed by a self-reported questionnaire the index of female sexual function (FSFI). Sociodemographic and disease activity profiles were compared between those who had and did not have sexual dysfunction. RESULTS The prevalence of female sexual dysfunction in women with rheumatoid arthritis attending El Ayachi hospital was 71.9%, it was 54% in controls. There was a significant difference in the total FSFI score between patients 18.29±9.09 and controls 23.05±7.91 (p=0.016). We found a statistically significant difference between the two groups in almost all dimensions of sexual function (desire, arousal, orgasm, satisfaction), except for pain and lubrication. In multivariate analysis, pain assessed by visual analogue scale (VAS) and depression assessed by hospital anxiety and depression score (HAD) were the independent determinants of sexual dysfunction. CONCLUSION Our study suggests that sexual dysfunction is more common among patients with RA compared to controls. These dysfunctions were related to desire, arousal, orgasm and satisfaction. Pain and depression appear to be the most important predictors of sexual dysfunction.
Collapse
Affiliation(s)
- Dina Khnaba
- Mohammed V University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc
| | - Samira Rostom
- Mohammed V University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc
| | - Racha Lahlou
- Mohammed V University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc
| | - Rachid Bahiri
- Mohammed V University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc
| | - Redouane Abouqal
- Laboratory of Biostatistical, Clinical and Epidemiological Research, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Maroc
| | - Najia Hajjaj-Hassouni
- Mohammed V University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc
| |
Collapse
|
27
|
Moltó A, Etcheto A, van der Heijde D, Landewé R, van den Bosch F, Bautista Molano W, Burgos-Vargas R, Cheung PP, Collantes-Estevez E, Deodhar A, El-Zorkany B, Erdes S, Gu J, Hajjaj-Hassouni N, Kiltz U, Kim TH, Kishimoto M, Luo SF, Machado PM, Maksymowych WP, Maldonado-Cocco J, Marzo-Ortega H, Montecucco CM, Ozgoçmen S, van Gaalen F, Dougados M. Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA study. Ann Rheum Dis 2015; 75:1016-23. [PMID: 26489703 DOI: 10.1136/annrheumdis-2015-208174] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 09/26/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Increased risk of some comorbidities has been reported in spondyloarthritis (SpA). Recommendations for detection/management of some of these comorbidities have been proposed, and it is known that a gap exists between these and their implementation in practice. OBJECTIVE To evaluate (1) the prevalence of comorbidities and risk factors in different countries worldwide, (2) the gap between available recommendations and daily practice for management of these comorbidities and (3) the prevalence of previously unknown risk factors detected as a result of the present initiative. METHODS Cross-sectional international study with 22 participating countries (from four continents), including 3984 patients with SpA according to the rheumatologist. STATISTICAL ANALYSIS The prevalence of comorbidities (cardiovascular, infection, cancer, osteoporosis and gastrointestinal) and risk factors; percentage of patients optimally monitored for comorbidities according to available recommendations and percentage of patients for whom a risk factor was detected due to this study. RESULTS The most frequent comorbidities were osteoporosis (13%) and gastroduodenal ulcer (11%). The most frequent risk factors were hypertension (34%), smoking (29%) and hypercholesterolaemia (27%). Substantial intercountry variability was observed for screening of comorbidities (eg, for LDL cholesterol measurement: from 8% (Taiwan) to 98% (Germany)). Systematic evaluation (eg, blood pressure (BP), cholesterol) during this study unveiled previously unknown risk factors (eg, elevated BP (14%)), emphasising the suboptimal monitoring of comorbidities. CONCLUSIONS A high prevalence of comorbidities in SpA has been shown. Rigorous application of systematic evaluation of comorbidities may permit earlier detection, which may ultimately result in an improved outcome of patients with SpA.
Collapse
Affiliation(s)
- Anna Moltó
- Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
| | - Adrien Etcheto
- Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
| | | | - Robert Landewé
- ARC, Amsterdam & Atrium MC Heerlen, Amsterdam, The Netherlands
| | | | | | - Ruben Burgos-Vargas
- Servicio de Reumatologia, Hospital General de México and Universidad Nacional Autonoma de México, México City, Mexico
| | - Peter P Cheung
- Division of Rheumatology, National University Hospital, Singapore, Singapore
| | - Eduardo Collantes-Estevez
- Rheumatology Department, Reina Sofia Hospital; Maimonides Institute for Biomedical Research of Cordoba/University of Cordoba, Cordoba, Spain
| | - Atul Deodhar
- Div Arthritis/Rheumatic Diseases (OPO9), Oregon Health and Science University, Portland, USA
| | | | | | - Jieruo Gu
- Division of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guanzhou, China
| | - Najia Hajjaj-Hassouni
- Department of Rheumatology, Mohamed Vth University, URAC 30, El Ayachi Hospital, Salé, Morocco Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Tae-Hwan Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - Mitsumasa Kishimoto
- Immuno-Rheumatology Center, St Luke's International Hospital, St Luke's International University, Tokyo, Japan
| | - Shue-Fen Luo
- Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan
| | - Pedro M Machado
- Department of Rheumatology, University of Coimbra, Coimbra, Portugal University College London, London, UK
| | | | - José Maldonado-Cocco
- Rheumatology Section, Instituto de Rehabilitacion Psicofisica and Argentine Rheumatologic Foundation "Dr Osvaldo Carcia Morteo", Buenos Aires, Argentina
| | - Helena Marzo-Ortega
- NIHR-Leeds Musculoskeletal Biomedical research Unit, Leeds Institute of Molecular Medicina, University of Leeds, Leeds, UK
| | | | - Salih Ozgoçmen
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University, Gevher Nesibe Hospital, Kayseri, Turkey
| | - Floris van Gaalen
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maxime Dougados
- Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
| |
Collapse
|
28
|
Slama IB, Allali F, Lakhdar T, El Kabbaj S, Medrare L, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. Reliability and validity of CDAI and SDAI indices in comparison to DAS-28 index in Moroccan patients with rheumatoid arthritis. BMC Musculoskelet Disord 2015; 16:268. [PMID: 26420567 PMCID: PMC4588315 DOI: 10.1186/s12891-015-0718-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 09/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical disease activity index (CDAI) and simplified disease activity index (SDAI) are useful tools for the evaluation of disease activity in patients with rheumatoid arthritis (RA), but have not been comparatively validated in Moroccan population. Therefore, this study was designed to assess validity and reliability of CDAI and SDAI in comparison to disease activity score-28 joints (DAS-28) in Moroccan patients with RA. METHODS Patients with RA were included in a cross-sectional study. Patient characteristics and RA were collected. The disease activity was assessed by DAS-28, CDAI and SDAI. Patients were splitted into groups of remission, low, moderate and high activity on the basis of predefined cut-offs for DAS-28, CDAI, and SDAI. A Spearman correlation between composite indexes and inter-group comparison of the indexes were performed. Using DAS-28 as a gold standard, the Receiver operator characteristic (ROC) curve was used to assess the performance of a screening test at different levels. RESULTS The study was conducted with 103 patients of female predominance (87.4%). Mean age was 49.7 ± 11.4 years. Median disease duration was in the order of 8 years [3-14]. There was an excellent correlation between DAS-28 and CDAI (r = 0.95, p <0.001), CDAI and SDAI (r = 0.90, p <0.001), and DAS-28 and SDAI (r = 0.92, p <0.001). There was a good inter-rater alignment between the DAS-28 and CDAI (Weighted kappa =0.743) and there was a moderate inter-rater alignment between the DAS-28 and SDAI (Weighted kappa =0.60), and also between the SDAI and CDAI (Weighted kappa = 0.589). There was no statistically significant difference between AUROC of CDAI and SDAI as both were performed equally well. DISCUSSION This study is the first Moroccan case study to compare the performance of both CDAI and SDAI in evaluation of disease activity in patients with RA. Our study showed that there was a direct and excellent correlation between DAS-28 and CDAI, and SDAI and DAS-28. CONCLUSION Our study shows a strong positive correlation between DAS-28, CDAI and SDAI. The cut-off values for CDAI and SDAI used in western literature can be used with minor modifications in Moroccan scenario.
Collapse
Affiliation(s)
- Imane Ben Slama
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco.
| | - Fadoua Allali
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco. .,Laboratory of Information and Research on Bone Diseases (LIRPOS-URAC 30), Mohamed V University, Souissi Rabat, Rabat, 10000, Morocco. .,Biostatistics Laboratory, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University, Souissi Rabat, Rabat, 10000, Morocco.
| | - Touria Lakhdar
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco.
| | - Sarra El Kabbaj
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco.
| | - Lamyae Medrare
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco.
| | - Ange Ngeuleu
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco.
| | - Hanan Rkain
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco. .,Laboratory of Physiology, Faculty of Medicine and Pharmacy, Mohamed V University, Souissi Rabat, Rabat, 10000, Morocco.
| | - Najia Hajjaj-Hassouni
- Department of Rheumatology, El Ayachi Sale University-Hospital, Sale, 11000, Morocco. .,Laboratory of Information and Research on Bone Diseases (LIRPOS-URAC 30), Mohamed V University, Souissi Rabat, Rabat, 10000, Morocco. .,Biostatistics Laboratory, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University, Souissi Rabat, Rabat, 10000, Morocco.
| |
Collapse
|
29
|
Bellamy N, Hochberg M, Tubach F, Martin-Mola E, Awada H, Bombardier C, Hajjaj-Hassouni N, Logeart I, Matucci-Cerinic M, van de Laar M, van der Heijde D, Dougados M. Development of multinational definitions of minimal clinically important improvement and patient acceptable symptomatic state in osteoarthritis. Arthritis Care Res (Hoboken) 2015; 67:972-80. [PMID: 25581339 DOI: 10.1002/acr.22538] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/03/2014] [Accepted: 12/16/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The ability to interpret scores from patient-reported outcome measures at the individual patient level depends on the availability of valid, clinically meaningful benchmarks of response and state attainment. The goal was to develop multinational estimates for minimal clinically important improvement (MCII) and patient acceptable symptomatic state (PASS). METHODS A multinational sample of patients with osteoarthritis (OA) was evaluated before and 4 weeks after treatment with nonsteroidal antiinflammatory drugs. Patients completed either the Western Ontario and McMaster Osteoarthritis Index (WOMAC) numerical rating scale 3.1 (hip and knee OA) or the Australian/Canadian Index (AUSCAN) numerical rating scale 3.1 (hand OA) before and after treatment. Patients rated the clinical importance of their response to treatment and their satisfaction with the health state achieved, from which multinational MCII and PASS estimates were calculated for both the WOMAC and AUSCAN indices. RESULTS A total of 609 patients from 7 countries participated in the study. MCII and PASS estimates varied slightly by instrument and subscale. Absolute (percentage) change for MCII ranged 6-9 (10% to 17%) for WOMAC and 4-9 (8% to 15%) for AUSCAN. PASS estimates ranged 39-48 for WOMAC and 38-45 for AUSCAN. Some between-country variation was observed in MCII and PASS. CONCLUSION Preliminary multinational estimates for MCII and PASS have been developed for several countries. Further research is required to evaluate the robustness, temporal consistency, and age- and sex-dependency of the preliminary estimates as well as their generalizability to other countries, languages, cultures, regions, and other condition-specific outcome measures.
Collapse
Affiliation(s)
- Nicholas Bellamy
- University of Queensland School of Medicine, Brisbane, Queensland, Australia, and Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Marc Hochberg
- University of Maryland School of Medicine, Baltimore
| | - Florence Tubach
- Université Paris Diderot, Sorbonne Paris Cité, INSERM, UMR-S 1123, INSERM, CIC 1425-EC, UMR-S 1123, and AP-HP Hôpital Bichat, Paris, France
| | - Emilio Martin-Mola
- Hospital Universitario La Paz and Universidad Autónoma Madrid, Madrid, Spain
| | - Hassane Awada
- Saint Joseph University Hôtel-Dieu de France, Beirut, Lebanon
| | - Claire Bombardier
- University of Toronto, Toronto General Research Institute, Institute for Work and Health, and Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Najia Hajjaj-Hassouni
- Mohammed Vth Souissi University, CNRST, and Laboratory of Information and Research on Bone Diseases (LIRPOS-URAC 30), Rabat, Morocco, and El Ayachi Hospital and University Hospital, Salé, Morocco
| | | | | | - Mart van de Laar
- Arthritis Center Twente, Medisch Spectrum Twente, and University Twente, Enschede, The Netherlands
| | | | - Maxime Dougados
- Paris Descartes University, Cochin Hospital, AP-HP, INSERM (U1153), PRES Sorbonne Paris-Cité, Paris, France
| |
Collapse
|
30
|
El Binoune I, Amine B, Moudjibou W, Moussa F, Rkain H, Aktaou S, Hajjaj-Hassouni N. SAT0614 Rheumatoid Shoulder Assessed by Ultrasonography: Prevalence of Abnormalities and Associated Factors. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
31
|
Medrare L, Ngeuleu A, Mahdi A, Benslama I, Lakhdar T, Rkain H, Allali F, Hajjaj-Hassouni N. AB0361 Rheumatoid Cachexia: Prevalence and Associated Factors. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Tazi Lachhab H, Rostom S, Amine B, Bensaoud N, Khnaba D, Bouhouche L, Bahiri R, Hajjaj-Hassouni N. FRI0517 Cross-Cultural Adaptation and Validation of the Screen for Child Anxiety Related Disorders Test (SCARED) in Juvenile Idiopathic Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Bensaoud N, Rostom S, Tazi Lachhab H, Khnaba D, Bouhouche L, Bahiri R, Hajjaj-Hassouni N. AB0105 The Relationship Between Body Composition and Structural Damage on MRI in Knee Osteoarthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
34
|
Medrare L, Ngeuleu A, Mahdi A, Benslama I, Lakhdar T, Rkain H, Allali F, Hajjaj-Hassouni N. AB0859 Is There a Relationship Between Sarcopenia, Obesity and Radiographic Severity of Knee Osteoarthritis? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
35
|
Bensaoud N, Rostom S, Tazi Lachhab H, Bouhouche L, Khnaba D, Bahiri R, Hajjaj-Hassouni N. AB0104 Correlation Between MRI and Conventional Radiography Findings in Knee Osteoarthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Hari A, Rostom S, Lahlou R, Bahiri R, Hajjaj-Hassouni N. Sexual function in Moroccan women with rheumatoid arthritis and its relationship with disease activity. Clin Rheumatol 2015; 34:1047-51. [DOI: 10.1007/s10067-015-2888-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 01/26/2015] [Accepted: 01/26/2015] [Indexed: 01/29/2023]
|
37
|
Hari A, Rostom S, Hassani A, El Badri D, Bouaadi I, Barakat A, Chkirat B, Elkari K, Amine B, Hajjaj-Hassouni N. Body composition in children with juvenile idiopathic arthritis: effect of dietary intake of macronutrient: results from a cross sectional study. Pan Afr Med J 2015; 20:244. [PMID: 26161167 PMCID: PMC4484190 DOI: 10.11604/pamj.2015.20.244.4488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 03/12/2015] [Indexed: 11/11/2022] Open
Abstract
Introduction The aim of this study was to evaluate the relationship between macronutrient intake, body composition (lean body mass and fat mass) and bone mineral content in Moroccan children with juvenile idiopathic arthritis (JIA). Methods A cross-sectional study, conducted between May 2010 and June 2011, covering out patient with JIA. The characteristics of patients were collected. The nutritional status was assessed by a food questionnaire including data of food intake during 7 consecutive days using 24-hour dietary recall. Food intake was quantified using the software Bilnut (Bilnut version 2.01, 1991). Dietary intake of macronutrients was expressed as percentage contribution to total energy. Body composition was evaluated with DXA total-body measurements (bone mineral content BMC expressed in g, lean body mass LBM and fat mass FM expressed in kg). Results 33 patients were included. The mean age was 10.4 ± 4.3 years. The median disease duration was 2 (1-4.5) years. The median of LBM, FM and BMC were 19 kg (13.82-33.14), 5 kg (3.38-9.14) and 1044.90 g (630.40-1808.90) respectively. We found a positive correlation between LBM and dietary intake of carbohydrate (r= 0.4; p = 0.03). There were no significant association between LBM and intake of lipids, or protein. Moreover, no association was found between FM, BMC and intake of carbohydrates, lipids and proteins. Conclusion This study suggests that there is a positive correlation between carbohydrates intake and LBM; however, dietary intake does not influence FM and BMC. Prospective studies with larger numbers of patients appear to be needed to confirm our findings.
Collapse
Affiliation(s)
- Asmae Hari
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| | - Samira Rostom
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| | - Asmae Hassani
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| | - Dalal El Badri
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| | - Ilham Bouaadi
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| | - Amina Barakat
- Department of Pediatrics, Hospital of Children, University Hospital of Rabat-Sale, Rabat, Morocco
| | - Bouchra Chkirat
- Department of Pediatrics, Hospital of Children, University Hospital of Rabat-Sale, Rabat, Morocco
| | - Khalid Elkari
- Department of Nutrition, University Ibn Tofaïl, Faculty of Science of Kenitra, Kenitra, Morocco
| | - Bouchra Amine
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| | - Najia Hajjaj-Hassouni
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco
| |
Collapse
|
38
|
Ben Slama I, Allali F, El Kabbaj S, Lakhdar T, Medrare L, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. AB0325 Comparison of Activity Score DAS28-ESR and DAS28 -CRP in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
39
|
Lahlou R, Rostom S, Hari A, Bensaoud N, Bahiri R, Hajjaj-Hassouni N. AB0912 Effect of Corticosteroids on Bone Mineral Density and Body Composition in Patients with Juvenile Idiopathic Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
40
|
Lakhdar T, Allali F, Medrare L, El Kabbaj S, Ben Slama I, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. AB0365 Sleep Disorders in Moroccan Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
41
|
Lakhdar T, Allali F, Ben Slama I, El Kabbaj S, Medrare L, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. AB0364 Relationship between Self Esteem and Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
42
|
Shyen S, Amine B, Binoune I, Gueddari S, Hajjaj-Hassouni N. THU0356 Presenteeism, Work Disability in the Patients with Chronic Neck Pain. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
43
|
Hari A, Rostom S, Lahlou R, Khnaba D, Bahiri R, Hajjaj-Hassouni N. AB0222 Comparison of Rheumatoid Arthritis Impact Disease (RAID) and Composite Indexes for the Evaluation of the Activity in the Daily Care in Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
44
|
Hari A, Rostom S, Lahlou R, Khnaba D, Bahiri R, Hajjaj-Hassouni N. AB0884 The Factors Affecting Bone Mineral Content in Patients with Juvenile Idiopathic Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
45
|
Bensaoud N, Rostom S, Bahiri R, Amine B, Allali F, Hajjaj-Hassouni N. FRI0028 Efficacy of TOCILIZUMAB on MRI- Determined Bone Oedema in Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
46
|
Ben Slama I, Allali F, El Kabbaj S, Lakhdar T, Medrare L, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. AB0323 Household Work Disability of Moroccan Housewives with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
47
|
Ben Slama I, Allali F, El Kabbaj S, Lakhdar T, Medrare L, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. SAT0153 Anxiety and Depression in Rheumatoid Arthritis: Which is More Frequent? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
48
|
El Binoune I, Amine B, Shiyen S, Guedarri S, Hajjaj-Hassouni N. AB0872 Chronic Neck Pain and Anxiety-Depression: Prevalence and Associated Risk Factors. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
49
|
Hari A, Rostom S, Lahlou R, Khnaba D, Bahiri R, Hajjaj-Hassouni N. AB0882 To Determine the Factors Influencing the Lean Body Mass in Patients with Juvenile Idiopathic Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
50
|
El Kabbaj S, Allali F, Ben Slama I, Lakhdar T, Medrare L, Ngeuleu A, Rkain H, Hajjaj-Hassouni N. AB0324 Physical Activity in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|