Association between disease activity and quality of life among patients with rheumatoid arthritis

Abstract The aim of this study is the association between the scores of disease activity, functional capacity and quality of life among patients diagnosed with rheumatoid arthritis, under clinical treatment at the Regional University Hospital of Campos Gerais - Wallace Thadeu de Mello and Silva. The sample was composed by volunteer patients, who freely underwent 3 research questionnaires. With the results of the survey, the disease activity score was correlated to the functional capacity and the quality-of-life scores. A mean of 3.87 and 1.2 was observed for the disease activity and the functional capacity scores, respectively, yet not achieving a correlation between those two variables. A strong correlation between the disease activity and the "functional capacity", "general health status" and "mental health" domains was found. The lowest average observed corresponded to "physical limitation", from the quality-of-life questionnaire. There was no statistically significant correlation between disease activity and functional capacity, although disease activity seems to affect the mental health, general health status and functional capacity of patients.

Relationship between corticotherapy and increased cardiac risk in patients with rheumatoid arthritis

Rheumatoid arthritis is an autoimmune inflammatory joint disease with global prevalence of 0.4% to 1.0%. Extra-articular manifestations increase its morbidity and severity, and cardiovascular diseases present the greatest risk. Therapeutic approaches have been used to treat rheumatoid arthritis, often involving the use of multiple classes of drugs with different mechanisms and forms of action. Corticosteroid therapy is widely used in this therapeutic combination; however, its use has been widely questioned because of its high toxicity and some negative effects, including the possibility of increased cardiovascular risk, depending on the dosage. Some studies have provided important insights into how glucocorticoids have an impact on cardiac complications in patients with rheumatoid arthritis. Most of these studies have concluded that exposure to these drugs at high or cumulative doses is associated with increased risk of death, as well as possibly being associated with the presence of a positive rheumatoid factor.

Relações Entre Ações de uma Invervenção Educativa na Adesão ao Tratamento e no RNI de Pacientes em Uso de Antagonistas de Vitamina K / Relationship Between Educative Intervention on Treatment Adherence and INR of Patients on Vitamin K Antagonists

Avaliar se uma intervenção educacional interfere na adesão ao tratamento, meta terapêutica e frequência de eventos hemorrágicos de pacientes em uso de antagonistas de vitamina K e se características socioeconômicas/clínicas possuem efeito sobre os resultados encontrados. Método: Estudo analítico intervencionista não controlado qualitativo. Foram incluídos 49 pacientes e aplicados os questionários de medida de adesão ao tratamento (MAT) e socioeconômico. Posteriormente foram realizadas ligações mensais educativas sobre anticoagulação e foram coletadas informações sobre eventos hemorrágicos e valores de RNI. Ao termino da intervenção foi aplicado mais um questionário MAT. Foram comparados os dados antes e após a intervenção. Resultados: Os pacientes foram considerados mais aderentes após a intervenção (p=0,04) e houve diminuição na frequência de eventos hemorrágicos (p=0,01), existindo nenhuma relação com as variáveis socioeconômicas ou clínicas. Não houve melhora significativa em relação à meta de RNI (p=0,06), porém o estado civil desses pacientes teve associação com a estabilidade terapêutica (p=0,04). Conclusões: A intervenção melhorou a aderência e diminuiu os eventos hemorrágicos dos pacientes, não tendo influência sobre a meta terapêutica. Pacientes com cônjuge apresentaram melhores metas terapêuticas se comparados aos solteiros. Não houve interferência de outras variáveis socioeconômicas ou clínicas sobre os desfechos encontrados

Objectives: To evaluate if an educational intervention interfere in treatment adherence, therapeutic ranges and hemorrhagic.events of patients on vitamin K antagonists; and if social, economic and clinical.characteristics are associated with the ending points. Methods: It's an interventionist analytic study. 49 patients were included.and an adherence.and social/economic questionnaires were applied. Then, monthly educative phone calls.were performed about anticoagulation and information about hemorrhagic,events and INR were collected. When intervention,were done, another adherence questionnaire was applied. Data before and after intervention were compared. Results: Patients had their adherence improved (p=0,04) and there was a fall on the prevalence,of hemorrhagic events (p=0,01) with,no,social/clinical variables association. There were no significant,changes,on the therapeutic ranges (p=0,06), although there was a relationship,between marital state and INR,stability (p=0,04). Conclusions: Educational intervention increased adherence,and decreased hemorrhagic events. Marital state has been associated with better therapeutic,ranges. No other social, economic.or clinical.variable has been associated with the ending points