scholarly journals POS1476-HPR THE NEED FOR INFORMATION AMONG PATIENTS WITH ANCA ASSOCIATED VASCULITIS DIFFERS BETWEEN GROUPS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1023.1-1023
Author(s):  
S. Brolin ◽  
B. Lövström ◽  
E. Welin ◽  
I. Gunnarsson ◽  
S. Pettersson
Keyword(s):  
Information Needs ◽  
Disease Duration ◽  
Support Systems ◽  
Disease Process ◽  
Information Need ◽  
Maximum Score ◽  
Self Help ◽  
Anca Associated Vasculitis ◽  
The Mean ◽  
Need For Information

Background:Being diagnosed with ANCA associated vasculitis (AAV) can be a frightening experience and means facing changes that involves adapting to new situations1. Patients that are provided adequate information are better equipped to make well informed decisions regarding their care and stay compliant to the treatment plan. In order to provide adequate patient-centered information at the appropriate time and to identify those who may need extra support, the information needs must be explored2. There have been several studies on the information needs of rheumatological patients, although very few studies for patients with AAV.Objectives:The aim of this study was to explore what information patients with AAV need from their rheumatological team and how it differs between groups (gender, disease duration).Methods:Men and women over 18 years were included through a consecutive sample from a Rheumatology or Nephrology Clinic at Karolinska University Hospital in Sweden during 2008-2019. Patients with all forms of AAV (GPA, MPA and EGPA), that had the Rheumatology clinic as primary contact, were included.The participants were given Educational Needs Assessment Tool (ENAT) that measures the patient’s information needs3. The initial question, ‘Do you need information right now about something that can help you with your rheumatic disease?’ is answered yes/no. ENAT then includes 7 domains (Managing pain, Movement, Feelings, Disease process, Treatments, Self-help measures and Support systems) each containing 4-7 items (4-point Likert scale, ’not at all important = 0’ to ‘extremely important = 3’). The total sum is divided by the maximum score and gives the percentage response of maximum score (0-100%), 0% meaning no information need and 100% highest information need. The responses are presented as “mean % of the domain score”. Independent-sample t-test was used to compare the mean between groups. One way ANOVA was used to compare the mean domain score between the different diagnoses and age groups.Results:178 individuals completed the questionnaire, equally divided by gender. Age ranged from 18-85, median 61. 33,7% had been diagnosed within 2 years.The mean total score was 56,8 % of the highest possible score (0-100%). The highest information need was found in the domains ‘Disease process’ (78,1%), ‘Self-help measures’ (68,5%) and ‘Treatments’ (63,6%) whereas lesser need for information was found in the domains ‘Managing pain’ (47,5%), ‘Support systems’ (46,5%) and ‘Movement’ (41,1%). The domain ‘Feelings’ was scored as moderate (55,5%).Those who acknowledge a present information need also scored significantly higher overall in all the domains. Disease duration and gender showed significantly affect the information need. Highest scores were found among women with a disease duration < 2 years with significant difference in 3/7 domains. Age, disease activity, diagnosis and social status did not affect the ENAT scores.Conclusion:Even though only 38% of participants stated a current need for information, the results indicate that there are certain areas that patients with AAV consider important to receive more information about. Special consideration needs to be taken to women with short disease duration since they were shown to have a significantly higher need for information.References:[1]Mooney, J., et al. (2013). ‘In one ear and out the other - it’s a lot to take in’: a qualitative study exploring the informational needs of patients with ANCA-associated vasculitis. Musculoskeletal Care, 11(1)[2]Ntatsaki, E., et al. (2014). BSR and BHPR guideline for the management of adults with ANCA-associated vasculitis. Rheumatology (Oxford), 53(12)[3]Hardware, B., et al. (2004). Towards the development of a tool to assess educational needs in patients with arthritis. Clinical Effectiveness in Nursing, 8(2)Disclosure of Interests:None declared

scholarly journals Information Needs of Cancer Patients are Influenced by Time Since Diagnosis, Stage of Cancer, Patients’ Age, and Preferred Role in Treatment-related Decisions

2006 ◽  
Vol 1 (3) ◽  
pp. 80 ◽  
Author(s):  
John Loy
Keyword(s):  
Cancer Patients ◽  
Information Seeking ◽  
Information Needs ◽  
English Language ◽  
Meta Analysis ◽  
Active Role ◽  
Post Treatment ◽  
Inclusion Criteria ◽  
Information Need ◽  
Need For Information

A review of: Kalyani, Ankem. “Factors Influencing Information Needs Among Cancer Patients: A Meta-Analysis.” Library & Information Science Research; 28.1 (2006) 7-23. Objective – The author aims to study the aggregate influence of demographic and situational variables on the information needs of cancer patients, in order to inform the provision of information to those patients. Design – Meta-analysis. Setting – Research articles published in the MEDLINE and CINAHL databases. Subjects – English language studies published between 1993 and 2003. An initial search set of 196 studies from MEDLINE and 283 studies from CINAHL were identified. Following rigorous assessment, 12 studies met the inclusion criteria. Methods – A comprehensive search of the databases was conducted, initially combining “neoplasm” with “cancer patients” using the Boolean “or”. These results were then combined with five separate searches using the following terms; information need(s), information seeking, information seeking behaviour, information source(s) and information resource(s). This identified in total 479 English language articles. Based on a review of titles and abstracts, 110 articles were found covering information resources or the information needs of cancer patients. These articles were then subjected to the further inclusion criteria and limited to studies which included: analysis of information needs and/or information sources of cancer patients; adults as subjects of the research; and application of quantitative research methods and relevant statistics. This eliminated a further 35 papers. Twelve of the remaining 75 studies were selected for meta-analysis based on their use of the same variables measured consistently in comparable units. The final 12 studies included various forms of cancer, and no distinction was made among them. All 12 studies appeared in peer-reviewed journals. Main results – The meta-analysis found there was consistently no difference between the information needs of men and women. Five subsets were identified within the meta-analysis, and findings for each can be stated as follows: The younger the age of the patient, the greater their overall need for information was likely to be. During treatment, the time elapsed from the diagnosis to the information need was not significant. Once identified, the information need remained constant. During treatment and post-treatment phases, the time elapsed from the diagnosis to the information need made no significant difference, with the information need remaining constant and continuing into the post-treatment phase. The stage of cancer made no difference to the need for information. Those patients in the advanced stages of cancer required an equal amount of information to those in the early stages of cancer. The individual patient’s preferred role in treatment-related decisions made a difference to the information need. Patients who took an active role in treatment-related decisions had a greater need for information than those who did not take an active role. Conclusion – Findings from this meta-analysis can be used to guide information provision to cancer patients, specifically taking patient age and preferred role in treatment decision-making into consideration. Further research into the reasons behind the lower information needs among older patients is called for by the author.

Measuring educational needs among patients with systemic lupus erythematosus (SLE) using the Dutch version of the Educational Needs Assessment Tool (D-ENAT)

Lupus ◽  
2014 ◽  
Vol 23 (13) ◽  
pp. 1370-1376 ◽  
Author(s):  
E J M Zirkzee ◽  
M E Ndosi ◽  
T P M Vliet Vlieland ◽  
J J L Meesters
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Assessment Tool ◽  
Disease Process ◽  
Educational Needs ◽  
Information Need ◽  
Systemic Lupus ◽  
Dutch Version ◽  
Educational Needs Assessment ◽  
Self Help

Objective The Educational Needs Assessment Tool (ENAT) was developed in the United Kingdom (UK) to systematically assess the educational needs of patients with rheumatic diseases. The aim of the present study was to describe the educational needs of Dutch patients with systemic lupus erythematosus (SLE) by means of a Dutch version of the ENAT (D-ENAT). Methods The D-ENAT was sent to a random sample of 244 SLE patients registered at the outpatient clinic of a university hospital. D-ENAT consists of 39 items in seven domains. The D-ENAT domain scores range from 0–16 to 0–28 (higher scoring equals higher educational needs) depending of the number of items in the domain. A total D-ENAT score (0–156) is calculated by summing all 39 items. In addition, age, disease duration, gender, educational level, present information need (yes/no) and the extent of information need (1–4: nothing–everything) were recorded. Univariate regression analysis was used to examine the D-ENAT’s potential determinants. Results The response rate was 122 out of 244 (50%). The mean (% of maximum score) educational needs scores were 56% for ‘D-ENAT total score’, 62% for ‘Self-help measures’, 60% for ‘Disease process’, 58% for ‘Feelings’, 56% for ‘Treatments’, 50% for ‘Movement’, 49% for ‘Support systems’ and 46% for ‘Managing pain’. Being female was significantly associated with higher scoring on the D-ENAT total score (β 23.0; 95% CI 5.9, 40.3). Conclusion SLE patients demonstrated substantial educational needs, especially in the domains: ‘Self-help measures’, ‘Disease process’ and ‘Feelings’. The validity and practical applicability of the D-ENAT to make an inventory of SLE patients’ educational needs requires further investigation.

scholarly journals POS0119 RENAL INVOLVEMENT AND NEED OF RENAL REPLACEMENT THERAPY IN ANCA ASSOCIATED VASCULITIS IN A SPANISH SINGLE-CENTER STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 270.2-271
Author(s):  
J. Álvarez Troncoso ◽  
J. C. Santacruz Mancheno ◽  
A. Díez Vidal ◽  
S. Afonso Ramos ◽  
A. Noblejas Mozo ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Granulomatosis With Polyangiitis ◽  
Renal Involvement ◽  
Age At Diagnosis ◽  
Systemic Involvement ◽  
Risk Of Death ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EPGA). Renal involvement is frequent in AAV and is an important factor for morbidity and mortality.Objectives:The main objective of this study was to analyze the demographic, clinical, histological and therapeutic characteristics of renal involvement in patients with AAV and the risk of renal replacement therapy (RRT) or death.Methods:Retrospective observational study of 56 patients with AAV fulfilling classificatory criteria and renal involvement diagnosed between 1995 and 2020 from a Spanish tertiary centre. We studied the histological involvement (according to the 2010 classification in focal, crescentic, mixed or sclerotic), immunofluorescence (IF) and the treatment received with the risk of RRT or death.Results:We included 56 patients diagnosed with AAV and renal involvement. The mean age was 61.08±4.05 years; 58.9% were women. The mean follow-up time of these patients was 16.14± 8.80 years. Only 57.1% of patients presented systemic involvement.Most frequent non-renal AAV manifestations were lung involvement (39.3%), central nervous system (30.4%), otorhinolaryngology (ORL) (14.3%), skin (8.9%) and cardiac involvement (8.9%). Main immunological findings were ANCA-MPO+ (69.6%), ANCA-PR3+ (23.2%), ANCA-negative (5.4%). Low C3 was found in 19.6% patients. Histologic classification (HC) and need of RRT is described in table 1. Main HC in renal AAV was crescentic, mixed, focal and sclerotic respectively. Eight patients had not biopsy performed. IF was positive for C3 deposits in 20 patients (35.7%). Half of the patients presented <50% normal glomeruli.The treatment of renal involvement in AAV in our cohort was as follows: 83.9% (47) corticosteroids (CS) and cyclophosphamide (of which 40 received intravenous and 7 oral cyclophosphamide; and 12 patients associated plasma exchange (PE) with this treatment), 5.36% CS alone, 2 patients received CS and mycophenolate; 1 CS and rituximab, 1 CS and PE, and 2 patients received no treatment. A total of 13 patients received PE and 18 RRT. The mean time to RRT was 65.44±32.72 months. Relapses were not uncommon, 33.93% of the patients presented ≥1 relapse and 10.71% presented ≥2.Infections were very frequent since they were present in 91.07% of the patients. Other frequent non-immunological complications observed in the follow-up of these patients were thrombosis in 31.14%, cardiovascular events in 28.57% and cancer in 19.64%.Patients with ANCA-PR3+ were younger at diagnosis (p<0.001), were more likely to present cardiac (p=0.045) and ORL involvement (p<0.001). However, neither ANCA-PR3+ nor ANCA-MPO+ were specifically associated with the need of RRT or higher risk of death in our cohort. Use of CS alone for the treatment of renal AAV was associated with higher mortality (p=0.006) but CS and cyclophosphamide with lower mortality (p=0.044). ANCA-negative patients were more likely to receive no treatment. Having <50% normal glomeruli and C3 deposits on IF were associated with an increased need for RRT. Presenting focal disease on HC was protective for the need of RRT. Older age at diagnosis, systemic involvement of AAV and need of RRT was associated with higher mortality.Conclusion:AAVs are complex vasculitides with frequent renal involvement. Increased C3 deposition, non-focal histological forms, and <50% normal glomeruli were related to the need for RRT. In turn, the need for RRT, a later age at diagnosis, and systemic involvement were associated with higher mortality. Holistic and multidisciplinary early management of AAVs in experience centers can help improve renal prognosis and decrease mortality.References:[1]Binda et al. ANCA-associated vasculitis with renal involvement. J Nephrol. 2018 Apr;31(2):197-208.[2]Kronbichler et al. Clinical associations of renal involvement in ANCA-associated vasculitis. Autoimmun Rev. 2020 Apr;19(4):102495.Disclosure of Interests:None declared

scholarly journals AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1563.3-1563
Author(s):  
H. Tamaki ◽  
S. Fukui ◽  
T. Nakai ◽  
G. Kidoguchi ◽  
S. Kawaai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Autoimmune Disease ◽  
General Population ◽  
Granulomatosis With Polyangiitis ◽  
Dietary Habits ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared

scholarly journals AB0797 ULTRASONOGRAPHIC ASSESSMENT OF ENTHESEAL INVOLVEMENT IN PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1698.2-1699
Author(s):  
I. Mahmoud ◽  
S. Rahmouni ◽  
A. Ben Tekaya ◽  
S. Bouden ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Achilles Tendon ◽  
Patellar Tendon ◽  
Clinical Examination ◽  
Disease Duration ◽  
Plantar Fascia ◽  
Quadriceps Tendon ◽  
The Mean ◽  
Triceps Tendon ◽  
Nail Involvement

Background:Entheseal involvement is a frequent and distinctive feature of psoriatic arthritis (PsA), often under diagnosed. It is especially associated with nail involvement. Because clinical examination is not sensitive enough for the detection of early signs of this involvement, US may be considered as an alternative imaging technique in the diagnosis of enthesopathy.Objectives:The aim of the present study is to evaluate US entheses abnormalities in PsA and their correlation with clinical characteristicsMethods:The study included patients diagnosed with PsA according to the CASPAR criteria. They underwent a thorough clinical examination with special regard to the presence of enthesitis using the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index.The US study bilaterally explored entheses at six sites: proximal plantar fascia, distal Achilles tendon, distal and proximal patellar tendon insertion, distal quadriceps tendon and distal brachial triceps tendon. We evaluated the following elemental lesions of enthesis at each site: thickness and structure of the tendon, calcifications, bursae, erosions, power Doppler signal in bursa or enthesis full tendon.Results:Of the 33 patients, 39.4 % were male. The mean age was 51.2±12.5 years. The mean disease duration was 13.5±10.2 years.The mean DAPSA was 22.8± 19.7 [0.1-84.5]: remission(n=9), low activity (n=5),moderate activity (n=11),high activity(n=8).At inclusion, 11 patients (33.4%) patients presented with psoriatic onychopathy (45 fingernails) with a mean mNAPSI of 14.1±16. Out of the 528 entheseal sites, 92 were tender at the palpation (17,4%) with a mean SPARCC at 2.87.A total of 396 entheseal sites were examined by US. In 140 of them (35.35%), US found at least 1 sign indicative of enthesopathy. The most affected tendon was the distal Achilles tendon (42/396), followed by proximal plantar fascia (32/396), distal patellar tendon (20/396), quadriceps tendon (20/396), distal brachial triceps tendon(14/396) and finally proximal patellar tendon (12/396).The most common elemental lesions were enthsophytes (176), erosions (114) and calcifications (50).We found a positive correlation between age and both calcification (r=0,4, p=0.021) and enthesophytes (r=0.479, p=0.005).We found a positive correlation between enthesophyte and the tender and swollen joints count (r= 0.352, p=0.045, r=0.378, p=0.03) and the SPARCC score (r=0.397, p=0.022).Patients with higher BASDAI had thicker tendons (r=0.355, p=0.05).Patients with nail dystrophy had more bursitis and erosions.US scores did not correlate with sexe, disease duration and disease activity measures (ASDAS, DAPSA, DAS28 and PASI). Patients with subclinical entheseal involvement didn’t have higher inflammatory biomarkers (ESR, CRP).Conclusion:US subclinical enthesopthy are not rare in psoriatic arthritis, in particular in patients with active disease.Clinical nail involvement was associated with bursitis and erosions. New studies including larger study groups are required to verify the findings of the present studyDisclosure of Interests:None declared

An Analysis of Leptospirosis Control in a Flood-Affected Region of Kerala and the Role of Accredited Social Health Activists – A Questionnaire Study

2021 ◽  
pp. 1-5
Author(s):  
M.K. Sreelakshmi ◽  
Suneesh Kuruvilla ◽  
Ramanarayanan Subramaniam ◽  
Pooja Latti ◽  
Ramanarayanan Venkitachalam
Keyword(s):  
General Population ◽  
Knowledge Score ◽  
Social Health ◽  
Attitude Score ◽  
Cross Sectional ◽  
Maximum Score ◽  
South Indian ◽  
The Mean ◽  
Knowledge And Attitude ◽  
Kerala State

Abstract Background: Chengannur, a town in the south Indian state of Kerala, was 1 of the worst affected towns during the floods of 2018. Post-flood, Kerala state was under the threat of many infectious diseases including leptospirosis, but did not report any leptospirosis infections. Objectives: This study was conducted with the following objectives: (1) Assess the knowledge, attitude and practices regarding the prevention of leptospirosis among the flood affected population and Accredited Social Health Activists (ASHAs) of Chengannur; and (2) Analyze the factors responsible for and contributing to leptospirosis control in the area post flood. Methodology: A cross-sectional questionnaire based observational study was conducted among 2 groups: the flood affected population, and ASHA. The questionnaire was divided into 3 parts. Part A contained the socio-demographic information. Part B contained questions on assessment of knowledge, attitude, and practices regarding the prevention, and control of leptospirosis. Part C was only for the ASHA involved. Results: The final sample size was 331 (244 from the general population and 87 ASHAs). With respect to knowledge, attitude, and practice, the responses were dichotomized into correct and wrong responses. The mean knowledge score was 9.01 ± 1.08 (maximum score of 10), mean attitude score was of 3.61 ± 0.55 (maximum score of 4) and the mean practice score was 4.12 ± 1.05 (maximum score of 5). Conclusion: Knowledge and attitude scores did not significantly differ between the general population and ASHA, but the practice score showed a higher score among the ASHA, all of which could have probably contributed to the prevention of a leptospirosis outbreak in the region.

scholarly journals POS0830 FACTORS INFLUENCING PATIENT-REPORTED OUTCOMES IN ANCA-ASSOCIATED VASCULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 668.2-669
Author(s):  
S. Monti ◽  
P. Delvino ◽  
C. Klersy ◽  
G. Coppa ◽  
A. Milanesi ◽  
...  
Keyword(s):  
Disease Activity ◽  
Global Assessment ◽  
Patient Reported Outcomes ◽  
Granulomatosis With Polyangiitis ◽  
Disease Duration ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Anca Associated Vasculitis ◽  
Organ Systems ◽  
Damage Accrual ◽  
Patient Reported

Background:Patient-reported outcomes (PROs) are currently poorly integrated in the clinical evaluation of disease activity in patients with ANCA-associated vasculitis (AAV).Objectives:To assess the distribution of the Patient Global Assessment (PtGA) in patients with AAV in stable remission, and to identify correlates of PtGA; to assess the discordance between PtGA score and PhGA.Methods:Patients with a diagnosis of AAV [eosinophilic granulomatosis with polyangiitis, granulomatosis with polyangiitis, microscopic polyangiitis] in stable, complete remission (defined by a BVAS=0) and with a Physician Global Assessment (PhGA)=0 were included. A questionnaire including several aspects of disease captured by PROs was collected. PtGA on a 0-100 mm visual analogue scale (VAS) was assessed, with higher scores representing higher/worse levels of disease activity. Similarly, VAS for pain, chronic damage according to the patient’s opinion, general health (GH), fatigue, and sleep quality were collected. The worst symptom in the patient’s opinion affecting the overall assessment of disease activity was recorded. The Cragg Hurdle model was used to assess the predictors of PtGA.Results:65 patients were included, female 57%, mean age 61±12 years. Mean disease duration at enrollment was 8±6 years. Mean vasculitis damage index (VDI) was 4.4 ±2.3, with 45% of patients having a VDI ≥ 5. Despite having been classified as being in remission, PtGA was elevated in 37% of patients. We explored several correlates of PtGA. Higher degree of damage accrual (VDI) did not influence the patient’s evaluation of current disease activity. Similarly, we did not identify a correlation between older age, educational level, number of organ-systems involved, number of comorbidities, the number of previous major or minor relapses, higher disease duration, nor the type of AAV diagnosis (figure 1, panel A). Only sex significantly correlated with PtGA scores: 19 (51%) of female patients reported an elevated PtGA compared to only 5 (18%) of male (p=0.009). PtGA resulted to be significantly correlated with other (mostly modifiable) PROs including VAS pain, perception of the level of chronic damage accrual, GH, and fatigue (figure 1, panel B). The agreement between patients’ and physicians’ assessments of disease activity was 63%. Patients reported pain, followed by chronic respiratory symptoms to be the worst-experienced ongoing manifestations affecting their evaluation of disease activity.Conclusion:A significant proportion of patients with AAV considered to be in remission by the physician still declares to have persistent aspects of uncontrolled disease. PtGA is significantly influenced by persistent pain and fatigue, which warrant better assessment in the future.Disclosure of Interests:None declared

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

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.1-1079
Author(s):  
I. Yoshii
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Remission Rate ◽  
Mean Value ◽  
Time Span ◽  
Mean Values ◽  
The Mean ◽  
The Relationship

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

scholarly journals AB0747 SPECIFIC ULTRASOUND LESIONS IN PSORIATIC ARTHRITIS: PREVALENCE AND CORRELATION WITH DISEASE ACTIVITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1670.2-1670
Author(s):  
K. Ben Abdelghani ◽  
H. Boussaa ◽  
S. Miladi ◽  
A. Fazaa ◽  
K. Ouenniche ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Soft Tissue ◽  
Disease Activity ◽  
Disease Duration ◽  
Extensor Tendon ◽  
Biological Data ◽  
Dorsal Aspect ◽  
Tissue Edema ◽  
Linear Probe ◽  
The Mean

Background:Psoriatic arthritis (PsA) is a systemic inflammatory disease with articular and extra-articular features. In recent years, Ultrasonography (US) is playing an important role in the diagnosis and monitoring of this disease. Specific US features of PsA have been reported such as enthesitis, peritenon extensor tendon inflammation (PTI) and soft tissue edema.Objectives:The aims of this study were to evaluate the prevalence of these US signs in PsA patients and to determine their association with disease duration and activity.Methods:Patients with peripheral PsA responding to the Classification Criteria for Psoriatic Arthritis (CASPAR) were enrolled. Clinical and biological data were extracted, and then US examination was performed by an experimented rheumatologist blinded to clinical data using a machine type Esaote MyLAb 60 with a linear probe of 6-18 MHz. The following US features were evaluated: PTI at the dorsal aspect of metacarpo-phalangeal (MCP) joints, soft edema at the volar aspect of MCP joints and enthesitis of the digitorum extensor at the dorsal aspect of distal inter-phalangeal (DIP) joints.A p<0.05 was considered statistically significant.Results:We included twenty PsA patients, 8 men and 12 women, with a mean age of 55 ± 11 [33-77] years old. The mean disease duration was of 10±8 [1-34] years. A family history of PsA or psoriasis was reported in 53% of cases.Oral corticosteroids were used in 21% of patients, at a mean daily posology of 7 mg [5-10] of Prednisone equivalent, Methotrexate in 84% of cases at a mean posology of 15 mg [10-20] per week, Sulfasalazine in 10% of cases and a biological DMARD in 32% of cases (Etanercept=4, Infliximab=1, Adalimumab=1).The mean number of tender and swollen joints were respectively of 8 [0-16] and 2 [0-8]. The mean rate of patient global evaluation and visual analogue scale was of 5 [0-9].The mean DAPSA (Disease Activity in PSoriatic Arthritis) score was of 32±27 [4-112].US examination demonstrated that all patients had at least one of the three specific signs that we were looking for. At MCP level, PTI was noted in 11% of joints with Power Doppler (PD) signal in one case and soft tissue edema was noted in 3% of joints.At DIP level, enthesitis of digitorum extensor tendon was noted in 39% of joints. The elementary lesions reported were: enthesophyte in 25%, erosion in 8%, calcification in 5% and thickened or hypoecoic tendon in 4% of joints. However, no PD signal was detected at the enthesis.A positive association was found between DAPSA score and soft tissue edema (p=0.000), but not with PTI (0.668) and enthesitis (0.137). No relation was found between these three lesions and the disease duration.Conclusion:The presence of soft tissue edema, enthesitis and/or PTI on US can be an argument for the diagnosis of PsA. Soft tissue edema is shown to be associated with disease activity.Disclosure of Interests:None declared

An interactive query-based approach for summarizing scientific documents

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Farnoush Bayatmakou ◽  
Azadeh Mohebi ◽  
Abbas Ahmadi
Keyword(s):  
User Satisfaction ◽  
Information Needs ◽  
Specific Information ◽  
Information Need ◽  
Science Data ◽  
Data Set ◽  
Content Type ◽  
Interactive Query ◽  
Summarization System ◽  
Clear Idea

Purpose Query-based summarization approaches might not be able to provide summaries compatible with the user’s information need, as they mostly rely on a limited source of information, usually represented as a single query by the user. This issue becomes even more challenging when dealing with scientific documents, as they contain more specific subject-related terms, while the user may not be able to express his/her specific information need in a query with limited terms. This study aims to propose an interactive multi-document text summarization approach that generates an eligible summary that is more compatible with the user’s information need. This approach allows the user to interactively specify the composition of a multi-document summary. Design/methodology/approach This approach exploits the user’s opinion in two stages. The initial query is refined by user-selected keywords/keyphrases and complete sentences extracted from the set of retrieved documents. It is followed by a novel method for sentence expansion using the genetic algorithm, and ranking the final set of sentences using the maximal marginal relevance method. Basically, for implementation, the Web of Science data set in the artificial intelligence (AI) category is considered. Findings The proposed approach receives feedback from the user in terms of favorable keywords and sentences. The feedback eventually improves the summary as the end. To assess the performance of the proposed system, this paper has asked 45 users who were graduate students in the field of AI to fill out a questionnaire. The quality of the final summary has been also evaluated from the user’s perspective and information redundancy. It has been investigated that the proposed approach leads to higher degrees of user satisfaction compared to the ones with no or only one step of the interaction. Originality/value The interactive summarization approach goes beyond the initial user’s query, while it includes the user’s preferred keywords/keyphrases and sentences through a systematic interaction. With respect to these interactions, the system gives the user a more clear idea of the information he/she is looking for and consequently adjusting the final result to the ultimate information need. Such interaction allows the summarization system to achieve a comprehensive understanding of the user’s information needs while expanding context-based knowledge and guiding the user toward his/her information journey.

Sign in / Sign up

Export Citation Format

Share Document