Correlation of enthesitis indices with disease activity and function in axial and peripheral spondyloarthritis: a crosssectional study comparing MASES, SPARCC and LEI

Abstract Background: The presence of enthesitis is associated with higher disease activity, more disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA). There is currently no consensus on which clinical score should be used to assess enthesitis in SpA. The objective of the present work was to compare the correlation of three enthesitis indices (MASES, SPARCC and LEI) with measures of disease activity and function in a heterogeneous population of patients with axial and peripheral SpA. Methods: A cross-sectional study was conducted in three Brazilian public university hospitals; patients fulfilling ASAS classification criteria for peripheral or axial SpA were recruited and measures of disease activity and function were collected and correlated to three enthesitis indices: MASES, SPARCC and LEI using Spearman's Correlation index. ROC curves were used to determine if the the enthesitis indices were useful to discriminate patients with active disease from those with inactive disease. Results: Two hundred four patients were included, 71.1% (N = 145) fulfilled ASAS criteria for axial SpA and 28.9% (N = 59) for peripheral SpA. In axial SpA, MASES performed better than LEI (p = 0.018) and equal to SPARCC (p = 0.212) regarding correlation with disease activity (BASDAI) and function (BASFI). In peripheral SpA, only MASES had a weak but statistical significant correlation with DAS28-ESR (rs 0.310 p = 0.05) and MASES had better correlation with functional measures (HAQ) than SPARCC (p = 0.034). Conclusion: In this sample composed of SpA patients with high coexistence of axial and peripheral features, MASES showed statistical significant correlation with measures of disease activity and function in both axial and peripheral SpA.(AU)

Fatores de risco cardiovasculares e comorbidades em ambulatórios de cardiologia da região metropolitana de Porto Alegre, RS / Cardiovascular risk factors and comorbidities in cardiology outpatientin the metropolitan region of Porto Alegre, RS

As doenças cardiovasculares desempenham um importante papel na saúde pública atual, visto que representam a principal causa de morbimortalidade mundial e os mais altos custos em assistência médica. O objetivo do presente estudo foi descrever os fatores de riscos cardiovasculares e as comorbidades dos pacientes atendidos em ambulatórios de cardiologia na região metropolitana de Porto Alegre, RS. Métodos: Estudo transversal de pacientes adultos do ambulatório de cardiologia geral de atenção secundária à saúde, mantido pela Faculdade de Medicina da Universidade Luterana do Brasil (ULBRA). Entre setembro de 2009 e outubro de 2010, o estudo foi primeiramente realizado no posto de saúde da vila do IAPI, em Porto Alegre, e, posteriormente, no Hospital Universitário (HU), em Canoas. Foi utilizado um formulário padrão para a coleta de dados do prontuário médico. A análise estatística possibilitou descrever uma amostra única. Resultados: Foram analisados 204 pacientes no total. A maioria da população em estudo era composta de idosos (66%), mulheres (70,1%), brancos (83,3%), hipertensos (83,8%), sedentários (67%), com excesso de peso (85,6%) e obesidade visceral (92,1%). Quanto ao tabagismo, 12% eram ativos e 42% ex-tabagistas. A combinação de fatores de risco foi importante e identificada através da síndrome metabólica (85,0%). O cálculo do escore de risco de Framingham para um evento coronariano em 10 anos foi > 10% em 36,5% dos indivíduos. Conclusões: Foi identificada uma alta prevalência de fatores de risco cardiovasculares, suas combinações e comorbidades na população em estudo.

Cardiovascular diseases play an important role in public health today as the major cause of morbidity and mortality worldwide and the highest costs in medical care. The aim of this study was to describe the cardiovascular risk factors and comorbidities of patients seen in cardiology clinics in the metropolitan region of Porto Alegre RS. Methods: Cross-sectional study of adult patients from the general cardiology outpatient clinic of secondary care, run by the Medical School of Lutheran University of Brazil (ULBRA). Between Sep 2009 and Oct 2010, the study was first conducted at the Health Center of IAPI, a district in Porto Alegre, and afterwards at the School Hospital in Canoas. We used a standard form to collect data from medical records. The statistical analysis allowed to describe a unique sample. Results: We analyzed 204 patients in total. Most of the study population consisted of elderly (66%), females (70.1%), whites (83.3%), hypertensive (83.8%), sedentary (67%), overweight (85, 6%) and with visceral obesity (92.1%). As for smoking, 12% were active and 42% former smokers. The combination of risk factors was important and identified through the metabolic syndrome (85.0%). The calculation of Framingham risk score for a coronary event in 10 years was > 10% in 36.5% of individuals. Conclusions: We identified a high prevalence of cardiovascular risk factors, their combinations and comorbidities in the studied population.