Background: The Roma population is one of the largest marginalized population groups in Europe. The aim of our work was to summarize the morbidity of lifestyle-related diseases and infectious diseases in the Roma population living in segregated settlements. Methods: We used data from the cross-sectional study HepaMeta, in which we examined 452 Roma subjects with an average age of 34.7 ± 9.1 years, 35.2% of which were men, and 403 non-Roma subjects with an average age of 33.5 ± 7.4 years, 45.9% of which were men. We collected data by means of a questionnaire, anthropometric measures, and we analyzed blood and urine samples. Results: Roma subjects had a higher incidence of metabolic syndrome (RR: 1.478 (1.159-1.885), p < 0.0001), obesity or waist circumference >94 cm in men/80 cm in women (RR: 1.287 (1.127-1.470), p < 0.0001), and HDL-C < 1.03 mmol/L in men or <1.29 in women (RR: 2.004 (1.730-2.321), p < 0.0001) than their non-Roma counterparts. Subjects of the Roma population were more frequently diagnosed with kidney disease (RR: 1.216 (1.096-1.349), p < 0.0001), HBsAg positivity (RR: 4.468 (2.373-8.415), p < 0.0001), anti HBc IgG positivity (RR: 3.13 (2.598-4.224), p < 0.0001), and anti HEV positivity (RR: 2.972 (1.226-7.287), p < 0.0001). Serological markers of Toxoplasma gondii infection and Toxocara spp. were observed much more frequently among Roma than non-Roma subjects (RR: 1.868 (1.520-2.296), p < 0.0001, for Toxoplasma gondii; and RR: 21.812 (8.097-58.761), p < 0.0001, for Toxocara spp.). Conclusions: Poor socio-economic conditions, an unhealthy lifestyle, and barriers precluding access to healthcare are factors that affect the Roma population in settlements and lead to an increased prevalence of metabolic syndrome and its components, kidney disease, viral hepatitis B and E, and some parasitic diseases.
ABSTRACT Background We aimed to assess the role of the COVID‐19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients. Methods We included 103 RA patients (81.6% females; mean age 56.1 ± 13.8 years). Patients filled out the VAS‐pain, GAD‐7, PHQ‐9, MFI‐20, and B‐IPQ. Paired sample t ‐tests, correlations, and multiple regression analyses were used to analyse the data. Results Our results showed significantly worsened pain in the data collected post‐pandemic ( p ≤ 0.05). Pre‐pandemic, the final regression models showed an association between functional disability ( β = 0.24; p ≤ 0.05), illness perception ( β = 0.34; p ≤ 0.05) and pain. In post‐pandemic models, significant associations were found between fatigue ( β = 0.33; p ≤ 0.01) and illness perception ( β = 0.36; p ≤ 0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic. Conclusion Findings indicate that patients with RA may have been negatively affected by the COVID‐19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post‐pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non‐pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA‐related pain, especially when dealing with a crisis.
The aim of the study was to examine whether rheumatoid arthritis (RA) patients with different levels of restriction in social participation differ in disease related as well as psychosocial variables and whether a similar pattern can be found among early and established RA patients.Two samples of RA patients with early (n = 97; age = 53 ± 12.3 years; disease duration = 2.8 ± 1.2 years; 76% women) and established (n = 143; age = 58 ± 10.3 years; disease duration = 16.1 ± 3.6 years; 86% women) were collected. The pattern of differences for the patients with different level of participation restriction (no restriction, mild, moderate or high restriction) was explored by the Jonckheere-Terpstra test.Significant differences were found between patients with different levels of social participation restrictions in both samples in pain, fatigue, functional disability, anxiety, depression and mastery. Generally, it was found that patients with higher restrictions experienced more pain and fatigue, more anxiety and depression and reported lower mastery. Similar pattern of differences concerning disease activity and self-esteem was found mainly in the established group.The study shows that the level of perceived restrictions in social participation are highly relevant regarding the disease related variables such as pain, fatigue and functional disability as well as psychological status and personal resources in both early and established RA.Supporting involvement and participation of individuals with rheumatoid arthritis is important for decreasing the impact of RA symptoms on everyday life. Recognition and empowerment of individual resources such a mastery and self-esteem of RA patients could be beneficial for overcoming restrictions in participation.
The ethiopathogenesis of auto-immune diseases has not yet been fully explored. Auto-immune diseases develop in individuals with a genetic pre-disposition. Among the endogenous factors, also sexual hormones play a role, especially prolactin. The objective of the study was to use basal exam and TRH test to determine stimulated prolactin values in patients with a systemic connective tissue disease: systemic lupus erythematosus (SLE), systemic sclerosis, Sjögren's syndrome, dermatomyositis.The authors examined 43 patients with systemic connective tissue diseases: 20 patients with SLE, 7 patients with Sjögren's syndrome, 7 patients with systemic sclerosis and 9 patients with dermatomyositis. The mean age of the patients was 39.87 years. The control group consisted of 30 volunteers with a mean age of 35.17 years.Prolactin level in the patients with systemic connective tissue diseases was 14.629 ng/ml, which is more than in the control group. A statistically significant increase in prolactin level was recorded 20 minutes after i.v. stimulation as compared with the control group (30.982 ng/ml). This statistically significant difference was still present 60 minutes after the TRH administration, with 16.43 ng/ml in the control group, and 36.890 ng/ml in the systemic connective tissue disorder patient group. The differences between prolactin levels for the different systemic connective tissue diseases were not statistically significant. A positive correlation in the patient group was found between the stimulated prolactin values and the FW value. On the whole, however, there was no clear correlation found between laboratory activity and prolactin levels.The authors found out that post-stimulation prolactin levels were statistically significantly higher in patients with systemic connective tissue disease as compared with the control group. Correlation analyses did not show a clear link between inflammatory activity and prolactin levels, and therefore the authors assume that medium increased values of prolactin are rather a risk factor for the disease than an inflammation marker in patients with a systemic connective tissue disease.
To analyze the Slovakian experiences in a national multicenter open label non-interventional phase IV study which evaluated tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) and an inadequate response to conventional disease-modifying antirheumatic drugs (DMARDs) or tumor necrosis factor inhibitors (TNFs).
Methods
A prospective open label, single arm study with descriptive statistics used to analyze primary endpoint DAS28 and secondary endpoints: physical disability (HAQ) and safety. Adult patients with moderate to severe active RA who are on infusions therapy of TCZ (8mg/kg) every 4 weeks, after inadequate clinical response to a stable dose of DMARDs. Study has been approved by local ethical committees and all patients provided informed consent before enrollment. TCZ can be given with methotrexate (MTX), or as monotherapy in case of intolerance to MTX or when treatment with MTX was inappropriate.
Results
In 62 RA patients reached one year retention rate 89%. 7 patients were prematurely withdrawn: one of them because of ineffectiveness, 4 adverse events and 2 other reason (withdrawal of inform consent or loss of control). After one year 63% of enrolled patients were in remission (DAS28<2,6) and other 19% reached low activity of disease (DAS28≤3,2). DAS28 index value decreased from baseline rate 6.54±0.78 to 2.99±1.26 (12 week), 2.82±1.21 (24 week), 2.29±1.04 (36 week) and 2.26±1.12 (48 week). After 12 months of TCZ treatment HAQ disability index decreased from average value 1,63±0,61 to 1,21±0,71, while improvment of the minimal clinically important difference (≥0,22) was recorded in 63% of patients. There were no new safety signals compared with other clinical studies. Adverse events have been confirmed in 28 patients, in 25 with low and moderate intensity. Serious adverse events occurred in 3 patients (1 arterial thrombosis, 1 acute sciatica with lumbar stenosis, 1 labile blood pressure). No case of death has been reported.
Conclusions
TCZ in Slovakian RA patients in open label study demonstrated high degree of one year retention rate (89%) with remission in 63% and low activity of disease in other 19% patient, without new safety signals.
Aim: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that can affect almost all organs of the body. Lupus is a non-curable disease and the treatment is based on symptom control by immunosuppressive and anti-inflammatory treatment. The disease itself as well as treatment-related adverse events have a significant negative impact on life expectancy and quality of life of patients. The aim of this study was to identify the impact of the disease on life of SLE patients. Methods: Data were collected anonymously using a special questionnaire. The survey involved 76 patients with SLE, results were processed by conventional methods and descriptive statistic methods. Results: The survey has confirmed the impact of SLE on professional activities i.e. up to 63% of patients are registered disabled, of which 46% are granted full disability pension. SLE negatively affects patients' career - up to 39% of SLE patients stated that they had to change a job due to their disease. SLE has a strong impact on everyday life of patients. SLE symptoms are significant even during the period of quiescence - predominantly fatigue, reduced physical activity, pain. The most influenced activities of daily living included sunbathing and more strenuous activities or sport. The fact that limitations in all monitored activities are present in more than 50% of patients is a serious finding. Treatment-related adverse events have negative impact on the quality of life in almost 70% of patients. The most frequent events include gastrointestinal symptoms, visual disturbance and osteoporosis. Conclusion: SLE has a significant impact on the quality of life of patients and hinders them from leading everyday life at the level comparable to healthy population.
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