RESUMO
OBJECTIVES: To validate the systemic lupus activity questionnaire (SLAQ) in Spanish language. METHODS: The SLAQ questionnaire was translated and adapted in Spanish. Consecutive SLE patients from 8 centers in Argentina were included. A rheumatologist completed a Systemic Lupus Activity Measure (SLAM), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K, and a physician's assessment. Reliability was assessed by internal consistency (Cronbach's alpha), stability by test-retest reliability (intraclass correlation coefficient), and construct validity by evaluating the correlation with clinically relevant scores. Sensitivity and specificity for clinically significant disease activity (SLEDAI ≥6) of different S-SLAQ cut-off points were evaluated. RESULTS: We included 97 patients ((93% female, mean age: 40 years (SD14.7)). Internal consistency was excellent (Cronbach's alpha = 0.84, p < 0.001), and the intraclass correlation coefficient was 0.95 (p < 0.001). Mean score of S-SLAQ was 8.2 (SD 7.31). Correlation of S-SLAQ was moderate with Patient NRS (r= 0.63 p< 0.001), weak with SLAM-no lab (r = 0.42, p <0.001) and SLAM (r = 0.38, p < 0.0001), and very weak with SLEDAI-2K (r = 0.15, p =0.1394). Using the S-SLAQ cutoff of five points, the sensitivity was 72.2% and specificity was 37.9%, for clinically significant disease activity. CONCLUSIONS: The S-SLAQ showed good validity and reliability. A good correlation, similar to the original instrument, was observed with patient´s global disease activity. No correlation was found between S-SLAQ and gold standard disease activity measures like SLEDAI-2K and SLAM. The S-SLAQ cutoff point of 5 showed a good sensitivity to identify the active SLE population and therefore could be an appropriate screening instrument for disease activity in clinical and epidemiological studies.
Assuntos
Lúpus Eritematoso Discoide , Lúpus Eritematoso Sistêmico , Adulto , Feminino , Humanos , Idioma , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
El estrés es un factor de riesgo en la patogénesis de las enfermedades reumáticas autoinmunes. Objetivo: Evaluar la asociación entre la actividad de la enfermedad en pacientes con artritis reumatoidea y estrés. Secundarios: Evaluar la asociación de los niveles de estrés percibido con otros índices de actividad, así como también con discapacidad, ansiedad y depresión y calidad de vida. Material y métodos: Se incluyeron pacientes consecutivos, mayores de 18 años, con diagnóstico de AR (ACR 1987 y/o ACR/EULAR 2010). Se consignaron datos sociodemográficos, características de la enfermedad, parámetros de laboratorio y tratamiento actual. Resultados: Se incluyeron 45 pacientes, edad 48 (DE 11) años. Factor reumatoide + 96%, ACPA + 90%. El 26% de los pacientes presentó Remisión/Baja actividad (R/BA) por RAPID3 (2.6±2) VS 74% con moderada/alta actividad (MA/AA) (15±4). Análisis comparativo entre ambos grupos según nivel de estrés percibido: EEP-10 13±6 (RAPID3 R/BA) VS EEP-10 18±6 (RAPID3 MA/AA) (p=0.02). La EEP-10 presentó correlación con ansiedad (HAD-A) (r=0.7, p<0.001), depresión (HAD-D) (r=0.7, p<0.001), con calidad de vida (EQ5D) (r=-0.36, p=0.02) y con discapacidad funcional (HAQ-A) (r=0.55, p=0.001). Conclusión: Los pacientes con AR con elevada actividad de la enfermedad evaluados por RAPID3, DAS28 e IAS presentaron mayores niveles de estrés percibido con respecto a los pacientes con remisión o baja actividad.
Stress is a risk factor in the pathogenesis of autoimmune rheumatic diseases. Objective: To evaluate the association between disease activity in patients with RA. Secondary: To evaluate the association of perceived stress levels with other activity indexes (SDAI, CDAI, DAS28 and IAS) as well as with disability, anxiety and depression and quality of life. Material and methods: Patients consecutive, older than 18 years, with diagnosis of RA (ACR 1987 and / or ACR / EULAR 2010) were included. Sociodemographic data, characteristics of the disease, laboratory parameters and current treatment were recorded. The patients completed: SSP-10, HAQ-A, HAD, EQ-5D, RAPID3, VAS Pain and PGA, the physicians calculated DAS28, IAS, CDAI, SDAI and completed PGA. Results: Forty-five patients with an average age of 48 (SD 11) years were included. Rheumatoid factor + 96%, ACPA + 90%. Twenty six percent of the patients had Remission/Low activity (R/LA) by RAPID3 (2.6 ± 2) VS 74% with Moderate / High Activity (MA/HA) (15 ± 4).Comparative analysis between both groups according to perceived stress scale: PSS-10 13±6 (RAPID3 R/LA) Vs PSS-1018±6 (RAPID3 MA/HA) (p=0.02). The same happened when comparing DAS28 and IAS, where there was a significant difference according to PSS-10. The PSS-10 presented correlation with anxiety (HAD-A) (r=0.7, p<0.001), depression (HAD-D) (r=0.7, p<0.001), with quality of life (EQ5D) (r=- 0.36, p=0.02) and with functional disability (HAQ-A) (r=0.55, p=0.001). Conclusion: Patients with RA with high disease activity evaluated by RAPID3, DAS28 and IAS presented higher levels of perceived stress with respect to patients with remission or low activity
Assuntos
Humanos , Artrite Reumatoide , Ansiedade , Terapêutica , Fatores de Risco , DepressãoRESUMO
Primary Sjögren's syndrome (pSS) is a condition that predominantly affects women. Reports of pregnancy outcome in these patients are limited and contradictory. OBJECTIVE: To describe pregnancy characteristics and outcomes and newborn morbidity in women with pSS. MATERIAL AND METHODS: We included women with pSS who became pregnant after the onset of the symptoms of the disease. Clinical and serological characteristics, risk factors and previous maternal comorbidities are described. For each pregnancy in a woman with pSS, we recorded pregnancy course and outcome and newborn condition. RESULTS: We assessed 11 patients with 18 pregnancies after the onset of pSS symptoms. All of them presented FAN +; 10 anti-Ro / SSA + and 7 anti-La / SSB +. The mean age in years at the onset of symptoms was 24.9 (SD 6.9) and at the time of pregnancy was 30.3 (SD 5.4). Thirteen pregnancies happened before the diagnosis, reporting only one miscarriage. Two preterm births, 1 case of oligohydramnios, 2 of premature membrane rupture and 2 low birthweight babies were reported after the onset of pSS symptoms. There was 1 newborn with congenital atrioventricular block and another with neonatal cutaneous lupus. All the women with pregnancy complications (n=6) had anti-Ro/SSA antibodies. CONCLUSIONS: Almost half of the pregnancies assessed in women with pSS were associated with complications not attributable to factors other than the disease.