Epidemiological and clinical Characteristics of patients With rheumatoid arthritis or Spondyloarthritis

UVOD: Reumatoidni artritis (RA) i spondiloartropatije (SpA) u koje se ubrajaju ankilozirajući spondilitis (AS), psorijazni artritis (PsA), reaktivni artritis (ReA), enteropatski artritis (EA), i nediferentovane spondiloartropatije (NeSpA) spadaju u najčešće zapaljenske reumatske bolesti. Do sada objavljeni rezultati prevalencije ovih bolesti pokazuju veoma velike varijacije za koje je moguće da su, pored razlika u genetskim, rasnim i kulturološkim obeležjima, klimatskim faktorima i slično, uzrokovane i različitim metodama istraživanja. CILJEVI RADA: odrediti ukupnu prevalenciju RA i SpA (kao i pojedinih vrsta SpA) u populaciji centralne Srbije, kao i u odnosu na demografske karakteristike ispitanika; ispitati razlike izmedju obolelih od RA ili SpA u odnosu na njihove demografske i kliničke karakteristike (lična i porodična anamneza); analizirati sposobnost primarne zdravstvene zaštite da odgovori na zahteve obolelih od RA ili SpA; proceniti validnost skraćene verzije upitnika kao skrining testa za rano otkrivanje osoba sa RA ili SpA u primarnoj zdravstvenoj zaštiti. ISPITANICI I METODE: Istraživanje je sprovedeno u okviru identične metodološke studije određivanja prevalencije RA i SpA u zemljama Evrope pod pokroviteljstvom Evropske Lige za zaštitu od Reumatskih bolesti (European League Against Rheumatism-EULAR), pod rukovodstvom Glavnog Komiteta za Epidemiologiju i Istraživanje Javnog Zdravlja (EULAR Standing Committee of Epidemiology and Health Service Research- SCEHSR). Jedinstven Upitnik je prethodno preveden uz proces transkulturne adaptacije i uspešno validiran. U srpsku verziju Upitnika dodata su ciljana pitanja koja se odnose na demografske karakteristike ispitanika. Urbano područje centralne Srbije predstavljaju 4 grada: Beograd (glavni grad) u severnom delu i tri grada u južnom delu: Čačak (Moravički okrug), Užice (Zlatiborski okrug) i Kruševac (Rasinski region). Izborom svakog 100-tog telefonskog pretplatnika u ovim gradovima dobijen je sistematski uzorak telefonskih brojeva koji su pozivani u prvoj, fazi detekcije. Na osnovu pozitivnih odgovora iz Upitnika, kao i dijagnoze dobijene od bolesnika, reumatolog je ponovo telefonom pozivao ispitanike za koje postoji sumnja da boluju od RA ili SpA u drugoj, fazi konfirmacije. Postavljana su ciljana pitanja o lekarima i ustanovi gde se leče, kao i o primenjenim lekovima, sa posebnim akcentom na dva pitanja: „Koliko je vremena prošlo od kada ste osetili prve simptome bolesti dok nije postavljena dijagnoza Vaše bolesti“ i „ Koju terapiju ste uzimali ili koristili u periodu od pojave prvih simptoma do vremena kada ste posetili reumatologa“...INTRODUCTION: Among the most common rheumatic diseases are Rheumatoid arthritis (RA) and Spondyloarthritis (SpA) (comprising of ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), enteropatic arthritis (EA) and undifferentiated spondyloarthritis (NeSpA)). Up to date prevalence results for those diseases are very discrepant, caused by genetic, racial or cultural differences, different climate factors etc, or maybe because of different study methods which have been used in the applied investigations. OBJECTIVES: to estimate total RA and SpA prevalence (and separate for diseases which belong to SpA group) in population of central Serbia, as well as according to demographic characteristics of patients (pts); to examine differences between RA and SpA pts according to their demographic and clinical characteristics (personal and family anamnesis); to analyze the capacity of the primary care units for RA and SpA early detection and care; to estamate validity of the short Questionnaire as a screening test for the early detection of RA and SpA pts in primary care units. PATIENTS AND METHODS: This investigation was conducted as part of the unique prevalence estimation study for RA and SpA in the European countries under the patronage of EULAR (European League Against Rheumatism), under the auspices of the SCEHSR (EULAR Standing Committee of Epidemiology and Health Service Research). The unique Questionnaire was previosly translated using transcultural adaptation process and successfully validated. The Serbian version of the Questionnaire was amended with demographic characteristics of the respondents. The urban population from central Serbia was represented by four towns: Belgrade (the capital) from the north and three towns from the south: Cacak (Moravicki okrug), Uzice (Zlatiborski okrug) and Krusevac (Rasinski region). The representative sample was formed by choosing every 100th telephone number from those towns. In a first, detection phase, the Questionnaire was conducted by trained interviewers in the selected towns. Relying on positive Questionnaire items and self reported diagnosis, persons suspected with RA or SpA were called again by a rheumatologist in a second, confirmation phase. They were asked about the institution they have been treated in, their doctor and the medicines they have been using, with two questions specially emphasized: „How long has it been since you felt the first symptoms of the disease until the confirmation of the diagnosis," and "What treatment have you been on and which medicines have you been using during the time period from the onset of symptoms to your rheumatologist visit."..

Characteristics of certain aspects of social participation of persons with rheumatoid arthritis

Patients with rheumatoid arthritis have noticed the change in their lives, in domains of physical health, in their independence degree, in their participation in everyday life and in their ability to work. These patients daily encounter the characteristic symptoms of damage caused by arthritis, as well as the impact of the disease on socioeconomic status, employment and life habits. The onset ofsymptoms in rheumatoid arthritis is characteristic for a life period when a person is expected to be very engaged in his/her workplace, family environment, leisure activities, as well as in developing social contacts and social participation. The aim of this research is to evaluate characteristics of certain aspects of social participation of persons with rheumatoid arthritis, by determining the importance of participation in diverse roles and the effects of restrictions in role participation, comparing the group of rheumatoid arthritis patients with the control group from general population. The sample consisted of 28 subjects with rheumatoid arthritis and 37 subjects from the control group. The study groups did not differ in gender, age, place of residence, educational, work, family and marital status and in the level of physical activity. In order to determine the importance of participation in diverse roles and the effects of restrictions in role participation the Importance of Participation in Diverse Roles and Restrictions in Role Participation Subscales within the Modified Social Role Participation Questionnaire, (Modif.SRPQ, Gignac et al., 2011)were used. The Importance of Participation in Diverse Roles Subscale in our research had a satisfactory [Cronbach’s alpha coefficient was 0.71), and the Restrictions in Role Participation Subscale had good internal consistency [Cronbach’s alpha coefficient was 0.86). The results obtained in this study show that there are no statistically significant differences in the perception of the importance of participation and the participation in diverse roles between persons with rheumatoid arthritis and the control group persons, except in the domain of offspring relationships, where the significance of these relationships is lower in persons with rheumatoid arthritis than in persons from the general population. However, the importance of restrictions in diverse role participation is statistically significantly more pronounced in the group ofrheumatoid arthritis subjects in the domains of hobbies, in community activities, social events, travel and vacations, daily contacts, but also in overall community activities. Thus, physical restrictions significantly limit the social participation of persons with rheumatoid arthritis. Regarding the association between demographic variables and the participation of persons with rheumatoid arthritis in diverse roles, the presence of restrictions associated with increased unemployment, i.e. decreased work engagement, was shown to be more frequent, while other variables were not related to the achievement of the subjects in the Importance of Participation in Diverse Roles and Restrictions in Role Participation Subscales. The findings of this research may be of use to practitioners working directly with people with RA in the rehabilitation process. On the other hand, these findings could serve as a starting point for future studies focusing on the issue of social participation for persons with RA

Quality of life and physical activity in people with rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common form of inflammatory rheumatism. The onset of synovitis in middle aged population, the irreversibility of damage and the progression of the disease reduce the possibilities and capacities of a person with RA to fulfill their needs and thus achieve the overall quality of life. Quality of life (Qol) is a multidimensional concept defined by the World Health Organization as a state of complete physical, mental, and social well-being. Early diagnosis, the therapeutic approach “treat to target” and the application of biological therapy are current recommendations that contribute to the Qol of people with RA. Regular physical activity (PA), or any physical movement that leads to energy expenditure, is a key component of a healthy life. Since existing research has shown a significant impact of PA on chronic diseases of the modern era, the question of the benefits of PA in RA arises. The objective of this paper is to review and analyze the available recent research in order to examine the effects and importance of the implementation of PA on the Qol of people with RA. This study is a review of the literature using PubMed/MEDLINE and Science Direct, not older than ten years. People with RA, in addition to designed programs of therapeutic exercises as part of physiotherapy, also practice different forms of PA in their free time or through organized activities. The results indicate that the implementation of regular PA, dosed according to time and intensity as well as according to the current picture of arthritis reduces the symptoms of arthritis, which improves the overall Qol of these people. Implementation of PA is beneficial for people with RA. In order to improve the Qol, it is necessary to design adapted programs of PA, respecting the specifics of each individual

Kvalitet života i značaj socijalne podrške kod osoba sa reumatoidnim artritisom

Uvod: Primenom dostupnih i savremenih pristupa u rehabilitaci- ji kod osoba sa reumatoidnim artritisom postižu se terapijski ciljevi i delimično poboljšanje kvaliteta života. Postavlja se pitanje na koji na- čin i kojim dodatnim postupcima sa psihosocijalnog aspekta se mogu umanjiti i kontrolisati negativni uticaji bolesti na kvalitet života ovih osoba. Socijalna podrška (social support, eng.) je u vezi sa pozitivnim zdravstvenim ishodima i ublažavanjem efekata artritisa – bola i umora, kao i održavanjem funkcionalnosti što je od primarnog značaja za oso- be sa reumatoidnim artritisom. Socijalni aspekt ovog vida podrške se odražava kroz učešće u porodičnom životu i socijalnom okruženju čime se utiče na kvalitet života pojedinca. Cilj: Cilj rada je da se analiziraju novija istraživanja kako bi se ispitao značaj i efekti socijalne podrške na kvalitet života osoba sa reumatoid- nim artritisom. Metod: Pregled naučnih radova dostupnih u bazama PubMed/ MEDLINE i Science Direct, objavljenih u poslednjih deset godina i do- stupnih u celosti. Rezultati: Socijalna podrška osnažuje i omogućava da se osobe sa reumatoidnim artritisom ostvare u ulogama koje su za njih veoma važ- ne – radno angažovanje, domaćinstvo, slobodno vreme, finansijski po- ložaj. Intervencije koje se oslanjaju na podršku porodice kao najbližeg okruženja, utiču na smanjenje bola i emocionalnog stresa, a sledstveno tome poboljšava se emocionalno i socijalno funkcionisanje. Jedna od preporuka je implementacija programa socijalne podrške za osobe kod kojih je artritis skorije dijagnostikovan, gde

Kvalitet života i značaj socijalne podrške kod osoba sa reumatoidnim artritisom

Uvod: Primenom dostupnih i savremenih pristupa u rehabilitaci- ji kod osoba sa reumatoidnim artritisom postižu se terapijski ciljevi i delimično poboljšanje kvaliteta života. Postavlja se pitanje na koji na- čin i kojim dodatnim postupcima sa psihosocijalnog aspekta se mogu umanjiti i kontrolisati negativni uticaji bolesti na kvalitet života ovih osoba. Socijalna podrška (social support, eng.) je u vezi sa pozitivnim zdravstvenim ishodima i ublažavanjem efekata artritisa – bola i umora, kao i održavanjem funkcionalnosti što je od primarnog značaja za oso- be sa reumatoidnim artritisom. Socijalni aspekt ovog vida podrške se odražava kroz učešće u porodičnom životu i socijalnom okruženju čime se utiče na kvalitet života pojedinca. Cilj: Cilj rada je da se analiziraju novija istraživanja kako bi se ispitao značaj i efekti socijalne podrške na kvalitet života osoba sa reumatoid- nim artritisom. Metod: Pregled naučnih radova dostupnih u bazama PubMed/ MEDLINE i Science Direct, objavljenih u poslednjih deset godina i do- stupnih u celosti. Rezultati: Socijalna podrška osnažuje i omogućava da se osobe sa reumatoidnim artritisom ostvare u ulogama koje su za njih veoma važ- ne – radno angažovanje, domaćinstvo, slobodno vreme, finansijski po- ložaj. Intervencije koje se oslanjaju na podršku porodice kao najbližeg okruženja, utiču na smanjenje bola i emocionalnog stresa, a sledstveno tome poboljšava se emocionalno i socijalno funkcionisanje. Jedna od preporuka je implementacija programa socijalne podrške za osobe kod kojih je artritis skorije dijagnostikovan, gde

Quality of life and physical activity in people with rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common form of inflammatory rheumatism. The onset of synovitis in middle aged population, the irreversibility of damage and the progression of the disease reduce the possibilities and capacities of a person with RA to fulfill their needs and thus achieve the overall quality of life. Quality of life (Qol) is a multidimensional concept defined by the World Health Organization as a state of complete physical, mental, and social well-being. Early diagnosis, the therapeutic approach “treat to target” and the application of biological therapy are current recommendations that contribute to the Qol of people with RA. Regular physical activity (PA), or any physical movement that leads to energy expenditure, is a key component of a healthy life. Since existing research has shown a significant impact of PA on chronic diseases of the modern era, the question of the benefits of PA in RA arises. The objective of this paper is to review and analyze the available recent research in order to examine the effects and importance of the implementation of PA on the Qol of people with RA. This study is a review of the literature using PubMed/MEDLINE and Science Direct, not older than ten years. People with RA, in addition to designed programs of therapeutic exercises as part of physiotherapy, also practice different forms of PA in their free time or through organized activities. The results indicate that the implementation of regular PA, dosed according to time and intensity as well as according to the current picture of arthritis reduces the symptoms of arthritis, which improves the overall Qol of these people. Implementation of PA is beneficial for people with RA. In order to improve the Qol, it is necessary to design adapted programs of PA, respecting the specifics of each individual

Quality of life and physical activity in people with rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common form of inflammatory rheumatism. The onset of synovitis in middle aged population, the irreversibility of damage and the progression of the disease reduce the possibilities and capacities of a person with RA to fulfill their needs and thus achieve the overall quality of life. Quality of life (Qol) is a multidimensional concept defined by the World Health Organization as a state of complete physical, mental, and social well-being. Early diagnosis, the therapeutic approach “treat to target” and the application of biological therapy are current recommendations that contribute to the Qol of people with RA. Regular physical activity (PA), or any physical movement that leads to energy expenditure, is a key component of a healthy life. Since existing research has shown a significant impact of PA on chronic diseases of the modern era, the question of the benefits of PA in RA arises. The objective of this paper is to review and analyze the available recent research in order to examine the effects and importance of the implementation of PA on the Qol of people with RA. This study is a review of the literature using PubMed/MEDLINE and Science Direct, not older than ten years. People with RA, in addition to designed programs of therapeutic exercises as part of physiotherapy, also practice different forms of PA in their free time or through organized activities. The results indicate that the implementation of regular PA, dosed according to time and intensity as well as according to the current picture of arthritis reduces the symptoms of arthritis, which improves the overall Qol of these people. Implementation of PA is beneficial for people with RA. In order to improve the Qol, it is necessary to design adapted programs of PA, respecting the specifics of each individual

Quality of life and physical activity in people with rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common form of inflammatory rheumatism. The onset of synovitis in middle aged population, the irreversibility of damage and the progression of the disease reduce the possibilities and capacities of a person with RA to fulfill their needs and thus achieve the overall quality of life. Quality of life (Qol) is a multidimensional concept defined by the World Health Organization as a state of complete physical, mental, and social well-being. Early diagnosis, the therapeutic approach “treat to target” and the application of biological therapy are current recommendations that contribute to the Qol of people with RA. Regular physical activity (PA), or any physical movement that leads to energy expenditure, is a key component of a healthy life. Since existing research has shown a significant impact of PA on chronic diseases of the modern era, the question of the benefits of PA in RA arises. The objective of this paper is to review and analyze the available recent research in order to examine the effects and importance of the implementation of PA on the Qol of people with RA. This study is a review of the literature using PubMed/MEDLINE and Science Direct, not older than ten years. People with RA, in addition to designed programs of therapeutic exercises as part of physiotherapy, also practice different forms of PA in their free time or through organized activities. The results indicate that the implementation of regular PA, dosed according to time and intensity as well as according to the current picture of arthritis reduces the symptoms of arthritis, which improves the overall Qol of these people. Implementation of PA is beneficial for people with RA. In order to improve the Qol, it is necessary to design adapted programs of PA, respecting the specifics of each individual

Cytogenetic alterations in rheumatoid arthritis patients treated with methotrexate and dry olive leaf extract

Oxidative stress and inflammation are DNA instability factors for rheumatoid arthritis (RA) patients. The aims of this study were to evaluate cytogenetic alterations in Peripheral Blood Lymphocytes (PBL) in two groups of RA patients: the early and the long-term RA group; and to examine potential of concomitant treatment with Methotrexate (MTX) and Dry olive leaf extract (DOLE) against cytogenetic damage in RA patients after a 3-weeks treatment. A total of 32 RA patients and 10 healthy individuals were included. RA patients were equally divided into four groups: two groups with early phase RA (one treated with MTX alone, the other in combination with DOLE); and two long-term phase RA groups (group with active disease and group with low disease activity)-both treated with MTX and DOLE combination. PBL cultures were screened for chromosome aberrations and micronuclei frequencies. Significantly increased frequencies of micronuclei were shown in active phase RA disease (both early and long-term) but not in the group with low disease activity, as compared to controls. Chromosome aberrations were detected for all 4 RA groups. The highest frequencies of micronuclei and chromosome aberrations were found in the long-term active RA group. After 3 weeks-treatment, there were no significant decrease of the micronuclei frequencies compared to baseline, although they were reduced in all RA groups, except for the group with the long-term active disease. High level of cytogenetic damage in RA patients was concordant with duration and activity of the RA disease. At 3 weeks of therapy, neither the combined treatment (MTX+DOLE), nor MTX alone did not affect the frequency of micronuclei formation

Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

BackgroundA EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed.MethodsSystematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage).ResultsIn total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression.ConclusionThe current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing