Outpatient Care Aspects of Rheumatic Patients in Latvia : Real Life Data in the Context of the First Month of the COVID-19 Pandemic

Publisher Copyright: © 2023 Julija Zepa et al., published by Sciendo.The aim of this study was to analyse the rheumatic disease profile and treatment aspects of the patients consulted in the outpatient department of Pauls Stradiņš Clinical University Hospital during the first month of the COVID-19 pandemic from 2020 March 13 till April 14. A total of 457 (76.04%) remote and 144 (23.96%) face-to-face consultations were analysed, totalling 601 patients: 434 (72.21%) females and 167 (27.79%) males with mean age 51.40 ± 14.73 years. Rheumatoid arthritis (223 (37.10%)), psoriatic arthritis (93 (15.47%)) and ankylosing spondylitis (80 (13.31%)) were the most frequently consulted conditions. Disease modifying antirheumatic drugs (DMARDs) or immunosuppressants (IS) were taken by 515 (85.69%) patients. These included synthetic DMARD (242 (46.99%)), mainly methotrexate; and biologic DMARD (156 (30.29%)), mainly tumour necrosis factor inhibitor. More than one-half of the cohort (427 (71.05%)) was not taking a glucocorticoid (GC). NSAIDs were used in 391 (65.08%) patients, mainly on demand (354 (90.54%)). Most patients (401 (66.72%)) had no comorbidities (hypertension, diabetes, malignancy and/or chronic respiratory disease). The profile of patients consulted in the outpatient department consisted mainly of middle-age females with autoimmune inflammatory arthritis treated by DMARD. Most of the patients did not use GCs, they did not regularly use NSAIDs and did not have comorbidities. Telemedicine is an acceptable way of care delivery for chronic rheumatic patients with previously known disease and treatment, especially during a pandemic.publishersversionPeer reviewe

The impact of body mass index on disease progression in ankylosing spondylitis

Publisher Copyright: © 2018 De Gruyter Open Ltd. All rights reserved.Obesity can be a factor that affects the course of chronic systemic inflammatory arthritis. The objective of this study was to characterise patients with ankylosing spondylitis (AS) according to an evaluation of their body mass index (BMI) and by exploring the link between the overweightness and obesity with routinely measured disease-specific variables, including disease activity (Bath Ankylosing Spondylitis Disease Activity Index BASDAI; Ankylosing Spondylitis Disease Activity Score, using CRP, ASDAScrp), spinal mobility (Bath Ankylosing Spondylitis Metrology Index, BASMI), functional capacity (BASFI), extraspinal manifestations like fatigue, uveitis, and peripheral arthritis present during the course of the disease. A total of 107 patients were included in the cross-sectional study fulfilling the modified New York criteria for AS. Patients were divided into three groups: with the evaluation of BMI 30.0 (obesity). The mean BMI was 25.13 (SD 4.07). 33% of patients were overweight and 15% were obese. The mean values of age, duration of AS, ASDAScrp, BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), BASMI, pain in spine, and fatigue in the group with BMI < 24.9 were lower than in the other groups (p < 0.05). There was no difference between groups in age of AS onset, uveitis and peripheral arthritis. AS patients who were overweight or obese had a higher level of the disease activity, pain, fatigue, functional disability and spinal mobility impairment with worse values in the case of obesity.publishersversionPeer reviewe

Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA Study

Introduction Gender as a predictor of outcomes of rheumatoid arthritis (RA) has evoked considerable interest over the decades. Historically, there is no consensus whether RA is worse in females or males. Recent reports suggest that females are less likely than males to achieve remission. Therefore, we aimed to study possible associations of gender and disease activity, disease characteristics, and treatments of RA in a large multinational cross-sectional cohort of patients with RA called Quantitative Standard Monitoring of Patients with RA (QUEST-RA). Methods The cohort includes clinical and questionnaire data from patients who were seen in usual care, including 6,004 patients at 70 sites in 25 countries as of April 2008. Gender differences were analyzed for American College of Rheumatology Core Data Set measures of disease activity, DAS28 (disease activity score using 28 joint counts), fatigue, the presence of rheumatoid factor, nodules and erosions, and the current use of prednisone, methotrexate, and biologic agents. Results Women had poorer scores than men in all Core Data Set measures. The mean values for females and males were swollen joint count-28 (SJC28) of 4.5 versus 3.8, tender joint count-28 of 6.9 versus 5.4, erythrocyte sedimentation rate of 30 versus 26, Health Assessment Questionnaire of 1.1 versus 0.8, visual analog scales for physician global estimate of 3.0 versus 2.5, pain of 4.3 versus 3.6, patient global status of 4.2 versus 3.7, DAS28 of 4.3 versus 3.8, and fatigue of 4.6 versus 3.7 (P LT 0.001). However, effect sizes were small-medium and smallest (0.13) for SJC28. Among patients who had no or minimal disease activity (0 to 1) on SJC28, women had statistically significantly higher mean values compared with men in all other disease activity measures (P LT 0.001) and met DAS28 remission less often than men. Rheumatoid factor was equally prevalent among genders. Men had nodules more often than women. Women had erosions more often than men, but the statistical significance was marginal. Similar proportions of females and males were taking different therapies. Conclusions In this large multinational cohort, RA disease activity measures appear to be worse in women than in men. However, most of the gender differences in RA disease activity may originate from the measures of disease activity rather than from RA disease activity itself

Surface Characterization of Antireflective Thin Films

In the visible part of the electromagnetic spectrum, a flat glass substrate reflects 8-9 % of the incoming light. In some cases this reflectance is undesired in optical layer systems consisting of many individual elements. Several techniques such as magnetron sputtering, spray pyrolysis, sol-gel, and chemical vapor deposition can be used to prepare anti-reflection thin films. Main drawbacks of magnetron sputtering preparation of anti-reflection film systems on glass substrates are connected with low deposition rates and long – term stability of films. Oxides are an important class of coating materials, because they generally form chemically and environmentally stable films with a good variety of refractive indices and spectral ranges of high transmission. This article gives an overview of anti-reflection characterization of SiO2 and TiO2 multilayer thin films (deposited onto one or both sides) on flat glass substrate obtained by magnetron sputtering. Optical properties (refractive index, reflectance, transmission) were determined, and discussed in connection with surface morphology of films studied by means of atomic force microscopy (AFM). The surface roughness and anti-reflection index depends on film preparation conditions. The highest transmission (up to 96,1%) in the range of 200 to 1100 nm was obtained for both side four layers deposited glass samples. In order to clarify the influence of environmental conditions onto properties of coatings, samples were tested in cyclic corrosion chamber (CCC). Results of present study show that environmental factors do not change quality of film surface and light reflection

Surface Characterization of Antireflective Thin Films

Optical properties (refractive index, reflectance, transmission) were determined, and discussed in connection with surface morphology of films studied by means of atomic force microscopy (AFM). The surface roughness and anti-reflection index depends on film preparation conditions. The highest transmission (up to 96,1%) in the range of 200 to 1100 nm was obtained for both side four layers deposited glass samples. In order to clarify the influence of environmental conditions onto properties of coatings, samples were tested in cyclic corrosion chamber (CCC). Results of present study show that environmental factors do not change quality of film surface and light reflection

Photocatalytic Activity of TiO2 Coatings Deposited onto Porous Silica Glass Fibres

Most sudied systems for photocatalytical applications are TiO2 thin film structures which photocatalytic activity strongly depends on the preparating method and post-deposition treatment

Determinants of discordance in patients' and physicians' rating of rheumatoid arthritis disease activity

Objective To assess the determinants of patients' (PTGL) and physicians' (MDGL) global assessment of rheumatoid arthritis (RA) activity and factors associated with discordance among them. Methods A total of 7,028 patients in the Quantitative Standard Monitoring of Patients with RA study had PTGL and MDGL assessed at the same clinic visit on a 0–10-cm visual analog scale (VAS). Three patient groups were defined: concordant rating group (PTGL and MDGL within ±2 cm), higher patient rating group (PTGL exceeding MDGL by >2 cm), and lower patient rating group (PTGL less than MDGL by >2 cm). Multivariable regression analysis was used to identify determinants of PTGL and MDGL and their discordance. Results The mean ± SD VAS scores for PTGL and MDGL were 4.01 ± 2.70 and 2.91 ± 2.37, respectively. Pain was overwhelmingly the single most important determinant of PTGL, followed by fatigue. In contrast, MDGL was most influenced by swollen joint count (SJC), followed by erythrocyte sedimentation rate (ESR) and tender joint count (TJC). A total of 4,454 (63.4%), 2,106 (30%), and 468 (6.6%) patients were in the concordant, higher, and lower patient rating groups, respectively. Odds of higher patient rating increased with higher pain, fatigue, psychological distress, age, and morning stiffness, and decreased with higher SJC, TJC, and ESR. Lower patient rating odds increased with higher SJC, TJC, and ESR, and decreased with lower fatigue levels. Conclusion Nearly 36% of patients had discordance in RA activity assessment from their physicians. Sensitivity to the “disease experience” of patients, particularly pain and fatigue, is warranted for effective care of RA