ABSTRACT
Introducción: los pacientes con artritis psoriásica (APs) presentan más comorbilidades. Las guías del Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) establecen lineamientos para los tratamientos de acuerdo a ellas. Objetivos: describir la prevalencia de comorbilidades en pacientes con APs según el Rheumatic Disease Comorbidity Index (RDCI), analizar el efecto sobre la enfermedad y estudiar la adherencia a las guías GRAPPA. Materiales y métodos: estudio observacional. Se incluyeron pacientes con APs de la cohorte RAPSODIA. Se reportaron características sociodemográficas y clínicas. Las comorbilidades se valoraron por RDCI. Se estudiaron variables asociadas a RDCI ≥1 mediante análisis multivariado. Se analizó el cumplimiento de las recomendaciones de tratamiento en relación a las comorbilidades según las guías GRAPPA. Resultados: se incluyeron 170 pacientes. El 67,6% presentó al menos una comorbilidad (RDCI ≥1); estos eran de mayor edad (X 57,3±12,7 años vs. 48,2±13,2 años; p<0,0001), presentaban más sobrepeso u obesidad (84,3% vs. 67,3%; p=0,011) y peor calidad de vida (PsAQoL X 7,6±6,6 vs. 5,2±6; p=0,025). El análisis multivariado evidenció asociación de la edad y el uso de antiinflamatorios no esteroideos (AINEs) con RDCI ≥1. Contrariamente a las recomendaciones de GRAPPA, el 70% de los pacientes con cardiopatía utilizaba AINEs, y la mitad de aquellos con enfermedades hepáticas o renales tomaba AINEs o metotrexato. Conclusiones: la prevalencia de comorbilidades en los pacientes con APs es alta. En algunos casos no se cumplían las recomendaciones de tratamiento en relación a las comorbilidades.
Introduction: comorbidities are common in patients with psoriatic arthritis (PsA). The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) guidelines strengthen the choice of treatments according to them. Objetives: to describe the prevalence of comorbidities in patients with psoriatic arthritis according to Rheumatic Disease Comorbidity Index (RDCI) and to analyze the influence of them on disease activity, functional capacity and quality life and to assess adherence to GRAPPA 2015 treatment recommendations according to the presence of comorbidities. Materials and methods: adult patients with PsA (CASPAR criteria) from the RAPSODIA cohort were included. Sociodemographic and clinical characteristics, disease activity and current treatment were recorded. Comorbidities were assessed by the RDCI. Variables associated with RDCI≥1 were studied by multivariate analysis. Adherence to treatment recommendations in relation to the reported comorbidities was analyzed according to the 2015 GRAPPA guidelines. Results: a total of 170 patients were included. Patients with RDCI ≥1 were reported by 67.6%. These patients were older (57±13 years vs 48±13 years, p<0.0001), had a higher frequency of overweight or obesity (84.3% vs 67.3%, p=0.011), and had a poorer quality of life (PsAQoL 7.6±6.6 vs 5.2±6, p=0.025). The multivariate analysis showed an association between age and the use of NSAIDs with RDCI≥1. Contrary to GRAPPA recommendations, 70% of patients with heart disease were using NSAIDs. Moreover, about half of those with hepatic or kidney disease took NSAIDs or methotrexate. Conclusions: most patients with PsA presented at least one comorbidity. GRAPPA recommendations were not followed in a considerable number of patients.
ABSTRACT
PURPOSE: DIR image is relatively free from susceptibility artifacts therefore, DIR image can make it possible to reliably measure cortical thickness/volume. One drawback of the DIR acquisition is the long scan time to acquire the fully sampled 3D data set. To solve this problem, we applied a parallel imaging method (GRAPPA) and verify the reliability of using the volumetric study. MATERIALS AND METHODS: Six healthy volunteers (3 males and 3 females; age 25.33+/-2.25 years) underwent MRI using the 3D DIR sequence at a 3.0T Siemens Tim Trio MRI scanner. GRAPPA simulation was performed from the fully sampled data set for reduction factor 2. Data reconstruction was performed using MATLAB R2009b. Freesurfer v.4.3.0 was used to evaluate the cortical thickness of the entire brain, and to extract white matter information from the DIR image, Analyze 9.0 was used. The global cortical thickness estimated from the reconstructed image was compared with reference image by using a T-test in SPSS. RESULTS: Although reduced SNR and blurring are observed from the reconstructed image, in terms of segmentation the effect was not so significant. The volumetric result was validated that there were no significant differences in many cortical regions. CONCLUSION: This study was performed with DIR image for a volumetric MRI study. To solve the long scan time of 3D DIR imaging, we applied GRAPPA algorithm. According to the results, fast imaging can be done with reduction factor 2 with little loss of image quality at 3.0T.
Subject(s)
Humans , Male , Artifacts , BrainABSTRACT
PURPOSE: DIR image is relatively free from susceptibility artifacts therefore, DIR image can make it possible to reliably measure cortical thickness/volume. One drawback of the DIR acquisition is the long scan time to acquire the fully sampled 3D data set. To solve this problem, we applied a parallel imaging method (GRAPPA) and verify the reliability of using the volumetric study. MATERIALS AND METHODS: Six healthy volunteers (3 males and 3 females; age 25.33+/-2.25 years) underwent MRI using the 3D DIR sequence at a 3.0T Siemens Tim Trio MRI scanner. GRAPPA simulation was performed from the fully sampled data set for reduction factor 2. Data reconstruction was performed using MATLAB R2009b. Freesurfer v.4.3.0 was used to evaluate the cortical thickness of the entire brain, and to extract white matter information from the DIR image, Analyze 9.0 was used. The global cortical thickness estimated from the reconstructed image was compared with reference image by using a T-test in SPSS. RESULTS: Although reduced SNR and blurring are observed from the reconstructed image, in terms of segmentation the effect was not so significant. The volumetric result was validated that there were no significant differences in many cortical regions. CONCLUSION: This study was performed with DIR image for a volumetric MRI study. To solve the long scan time of 3D DIR imaging, we applied GRAPPA algorithm. According to the results, fast imaging can be done with reduction factor 2 with little loss of image quality at 3.0T.