Effects of an ergonomic program on the quality of life and work performance of university staff with physical disabilities: A clinical trial with three-month follow-up.

BACKGROUND: Problems related to physical disability may have an extremely negative impact in the work environment, reducing productivity and contributing to health problems and a worsening quality of life. OBJECTIVE: To assess the effects of an ergonomic intervention program on the quality of life and the work performance of people with physical disabilities working in a university environment. METHODS: A pilot clinical trial with three-month follow-up was conducted at the Physiotherapy Clinic of the Federal University of Paraíba (Brazil). Eight workers at the university took part in an ergonomic adjustment (using ErgoDis/IBV software) and physiotherapy program at their workplace for twelve weeks, in two 60-min sessions per week. The measuring instruments used were the WHOQoL-BREF questionnaire for quality of life and the Work Ability Index for work ability. A repeated-measures ANOVA analysis and Wilcoxon signed-rank test were also performed. RESULTS: Significant intra-group changes were observed in the QoL subscales for the physical dimension (F = 5.487, p = 0.017) and the environment dimension (F = 7.510, p = 0.006). The post-treatment analysis revealed significant changes for both the physical dimension (Z = -2.552, p = 0.011) and the environment dimension (Z = -2.201, p = 0.028). After the three-month follow-up period, only the environment dimension recorded a significant change (Z = -1.965, p = 0.049). The effect sizes were large. Regarding work ability, the repeated-measures ANOVA analysis showed a significant time effect (F = 5.067, p = 0.022), with large pre-post treatment improvement (Z = -2.555, p = 0.011, d = 0.914). CONCLUSIONS: The program based on ergonomic and physiotherapy program greatly enhanced the subjects' quality of life and work ability.

Effectiveness of two home ergonomic programs in reducing pain and enhancing quality of life in informal caregivers of post-stroke patients: A pilot randomized controlled clinical trial.

BACKGROUND: Informal caregivers of post-stroke patients usually undergo high levels of pain and stress and have a reduced quality of life. OBJECTIVE: To evaluate the effectiveness of two home ergonomic interventions aimed at reducing pain intensity and perceived stress and enhancing the quality of life in informal caregivers of chronic post-stroke patients. METHODS: A randomized single-blind controlled clinical trial was conducted, with a sample of 33 informal caregivers of patients with stroke. Three groups were included: one received postural hygiene training and kinesiotherapy, for 12 weeks, two days a week, one hour per session; another received adaptation of the home environment, and the third was a control group. Pain intensity, stress level and general quality of life were evaluated at three-time points: pre-intervention, post-intervention, and after a follow-up period of three months. RESULTS: Neck pain decreased in the two experimental groups, and increased in the control group. Pain in the shoulders and knees was alleviated in the group that received postural hygiene and kinesiotherapy. In addition, regarding quality of life, this group obtained an improvement in the physical health dimension, while the home adaptation group reported improved social relationships. CONCLUSIONS: These results suggest that 12 weeks of training in postural hygiene, combined with kinesiotherapy, and home adaptations can reduce pain and improve several aspects of the quality of life of this population. CLINICALTRIALS. GOV ID: NCT03284580.

[The impact of therapy with TNF-blockers on health-related quality of life in rheumatoid arthritis patients. A pilot study]. / Calidad de vida relacionada con la salud tras terapia anti-factor de necrosis tumoral alfa en pacientes con artritis reumatoide. Un estudio piloto.

INTRODUCTION: The aim of this pilot study was to evaluate the initial response to 16 weeks of treatment with infliximab and etanercept of disease activity and quality of life in a cohort of 37 patients with established rheumatoid arthritis. PATIENTS AND METHOD: Patients were selected from the Unit of Rheumatology in Hospital Clínico San Cecilio from Granada, refractory to conventional treatment with disease modifying antirheumatic drugs. To assess the disease activity, Disease activity score (DAS28) was used and the measurement of quality of life was evaluated with the Spanish version of the SF-36 Health Survey (SF-36) and the RA-specific questionnaire QoL Scale (Quality of Life in Rheumatoid Arthritis). RESULTS: Preliminary results show a significant decrease in inflammatory activity of the disease and consequently in HRQL scores. The comparison with the general reference population shows a deviation well below average, especially in the "physical function" dimension with a rising response pattern in all dimensions. The correlation between specific scores (QoL-RA scale) and generic ones (SF-36) for HQ-treatment also showed significance, especially with the physical aggregate. DISCUSSION: An important limitation of the present study is the number of patients and the duration of the treatment; despite this, improvements in functional parameters and quality of life are evident and remain roughly stable since the first weeks of treatment. This allow us to continue the study and increase the number of patients. CONCLUSIONS: The preliminary results obtained with TNF-blockers after 16 weeks of treatment in RA objectively show the effectiveness of these drugs and also the perception by the patients of the effect on their quality of life.

Calidad de vida relacionada con la salud tras terapia anti-factor de necrosis tumoral alfa en pacientes con artritis reumatoide. Un estudio piloto / The impact of therapy with TNF-blockers on health-related quality of life in rheumatoid arthritis patients. A pilot study

Introducción. El objetivo de este estudio piloto ha sido valorar la respuesta inicial tras 16 semanas de tratamiento con infliximab y etanercept sobre la actividad de la enfermedad y la calidad de vida (CV), en una cohorte de 37 pacientes con artritis reumatoide establecida. Pacientes y método. Los pacientes fueron seleccionados en el Servicio de Reumatología del Hospital Clínico San Cecilio de Granada, por ser refractarios al tratamiento convencional con fármacos antirreumáticos modificadores de la enfermedad. Para evaluar la actividad de la enfermedad se utilizó el índice DAS28 (Disease Activity Score) y para CV, la versión española del Cuestionario de Salud SF-36 (Health Survey SF-36) y el cuestionario específico QoL-RA Scale (Quality of Life in Rheumatoid Arthritis). Resultados. Los resultados preliminares muestran una disminución significativa en la actividad inflamatoria y consecuentemente en las puntuaciones de la CV. La comparación con la población general de referencia muestra una desviación muy por debajo de la media, especialmente en la dimensión “función física” con un patrón de respuesta ascendente en todas las dimensiones. La correlación entre puntuaciones específicas (QoL-RA Scale) y genéricas (SF-36) de CV postratamiento, también mostraron significación, especialmente con el agregado físico. Discusión. Consideramos una limitación importante del estudio el número de pacientes y el tiempo de evolución postratamiento. No obstante, las mejorías en los diferentes parámetros funcionales y de CV son objetivables y permanecen prácticamente estables desde las primeras semanas de tratamiento, lo que nos permitirá continuar el estudio y ampliar el número de pacientes. Conclusiones. Los resultados preliminares obtenidos con anti-TNF alfa tras 16 semanas de tratamiento en artritis reumatoide, muestran la efectividad de los fármacos objetivamente y subjetivamente según la percepción del paciente sobre su CV (AU)

Introduction. The aim of this pilot study was to evaluate the initial response to 16 weeks of treatment with infliximab and etanercept of disease activity and quality of life in a cohort of 37 patients with established rheumatoid arthritis. Patients and method. Patients were selected from the Unit of Rheumatology in Hospital Clínico San Cecilio from Granada, refractory to conventional treatment with disease modifying antirheumatic drugs. To assess the disease activity, Disease activity score (DAS28) was used and the measurement of quality of life was evaluated with the Spanish version of the SF-36 Health Survey (SF-36) and the RA-specific questionnaire QoL Scale (Quality of Life in Rheumatoid Arthritis). Results. Preliminary results show a significant decrease in inflammatory activity of the disease and consequently in HRQL scores. The comparison with the general reference population shows a deviation well below average, especially in the “physical function” dimension with a rising response pattern in all dimensions. The correlation between specific scores (QoL-RA scale) and generic ones (SF-36) for HQ-treatment also showed significance, especially with the physical aggregate. Discussion. An important limitation of the present study is the number of patients and the duration of the treatment; despite this, improvements in functional parameters and quality of life are evident and remain roughly stable since the first weeks of treatment. This allow us to continue the study and increase the number of patients. Conclusions. The preliminary results obtained with TNF-blockers after 16 weeks of treatment in RA objectively show the effectiveness of these drugs and also the perception by the patients of the effect on their quality of life (AU)

Nivel funcional y calidad de vida en espondilitis anquilosante. Estudio piloto tras 16 semanas de tratamiento anti-TNF / Functional level and quality of life in ankylosing spondylitis, pilot study after 16 weeks TNF blocker treatment

Objetivo. El objetivo del presente estudio ha sido valorar el efecto de infliximab y etanercept, sobre la capacidad funcional y la calidad de vida relacionada con la salud (CVRS) de 13 pacientes, mayores de 65 años, con espondilitis anquilosante (EA). Pacientes y métodos. Se incluyeron de forma consecutiva aquellos pacientes mayores de 65 años, refractarios al tratamiento convencional con fármacos antireumáticos modificadores de la enfermedad (FAME) diagnosticados en el Servicio de Reumatología del Hospital Clínico San Cecilio de Granada. Para evaluar actividad de la enfermedad utilizamos el índice BASDAI (bath ankylosing spondylitis disease activity index); para capacidad funcional y CVRS, el índice BASFI (bath ankylosing spondylitis functional index) y ASQoL (ankylosing spondylitis quality of life) respectivamente. Resultados. Se trata de un estudio piloto para valorar la respuesta a fármacos anti-TNFalfa (bloqueantes del factor de necrosis tumoral alfa) de 13 pacientes con EA mayores de 65 años, en los que se constata la disminución de actividad de la enfermedad. Los valores medios de las puntuaciones del dolor y de la enfermedad (BASDAI), muestran un descenso de 6,72 a 3,67 y de 6,15 a 2,79 respectivamente (p<0,0001), por debajo de 4, considerado como respuesta aceptable. También hubo mejorías significativas en la capacidad funcional (BASFI) pasando de 6,15 a 2,79 (p<0,001) y de la calidad de vida (ASQoL) de 13,85 a 4,22 (p<0,0001). Conclusiones. Nuestros resultados están en la línea de lo informado por otros autores sobre la eficacia de los fármacos anti-TNF, reduciendo significativamente la sintomatología clínica inflamatoria de la enfermedad a las 16 semanas y mejorando la funcionalidad y CV en pacientes con EA, mayores de 65 años(AU)

Background and objectives. The aim of the present study is to assess the impact of infliximab and etanercept, TNF-alpha (tumour necrosis factor-alpha blockers) on functional disability and quality of life in thirteen patients over 65 years-old with ankylosing spondylitis (AS). Patients and methods. We consecutively included patients over 65 years-old, attending our clinic from Rheumatology Service in Hospital Clínico de Granada. These patients were all refractory to conventional therapy with disease-modifying anti-rheumatic drugs (DMARD). Disease activity was assessed using BASDAI index (bath ankylosing spondylitis disease activity index). Functional disability was assessed using BASFI (bath ankylosing spondylitis functional index) and ASQol index (ankylosing spondylitis quality of life index). Results. We present a pilot study with 13 patients over 65 years-old treated with TNF blockers for 16 weeks. A significant decrease in disease activity was observed. Mean values of VAS (visual analogue scale) pain scores and disease decreases significantly after treatment (from 6.72 to 3.67 and 6.15 to 2.79 respectively), less than 4, which is considered an acceptable BASDAI response. Functional ability (BASFI) and health related quality of life (HRQOL) improved significantly from 6.15 to 2.79 and 13.85 to 4.22. Conclusions. Our results are consistent with the data available in the literature about TNF blockers decreasing clinical signs of the disease. Disease activity had significantly decreased 16 weeks after the onset of TNF blocker therapy. Functionality and quality of life have been also improved in elderly people with AS(AU)

[Functional level and quality of life in ankylosing spondylitis, pilot study after 16 weeks TNF blocker treatment]. / Nivel funcional y calidad de vida en espondilitis anquilosante. Estudio piloto tras 16 semanas de tratamiento anti-TNF.

BACKGROUND AND OBJECTIVES: The aim of the present study is to assess the impact of infliximab and etanercept, TNF-alpha (tumour necrosis factor-alpha blockers) on functional disability and quality of life in thirteen patients over 65 years-old with ankylosing spondylitis (AS). PATIENTS AND METHODS: We consecutively included patients over 65 years-old, attending our clinic from Rheumatology Service in Hospital Clínico de Granada. These patients were all refractory to conventional therapy with disease-modifying anti-rheumatic drugs (DMARD). Disease activity was assessed using BASDAI index (bath ankylosing spondylitis disease activity index). Functional disability was assessed using BASFI (bath ankylosing spondylitis functional index) and ASQol index (ankylosing spondylitis quality of life index). RESULTS: We present a pilot study with 13 patients over 65 years-old treated with TNF blockers for 16 weeks. A significant decrease in disease activity was observed. Mean values of VAS (visual analogue scale) pain scores and disease decreases significantly after treatment (from 6.72 to 3.67 and 6.15 to 2.79 respectively), less than 4, which is considered an acceptable BASDAI response. Functional ability (BASFI) and health related quality of life (HRQOL) improved significantly from 6.15 to 2.79 and 13.85 to 4.22. CONCLUSIONS: Our results are consistent with the data available in the literature about TNF blockers decreasing clinical signs of the disease. Disease activity had significantly decreased 16 weeks after the onset of TNF blocker therapy. Functionality and quality of life have been also improved in elderly people with AS.

Síndrome de Sjögren primario y edema en las manos / Primary Sjogren syndrome and hands edema

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No disponible

Fractura-luxación atlantoaxoidea tras traumatismo craneoencefálico leve en paciente con artritis reumatoide / No disponible

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Successful use of infliximab in a patient with neuro-Behçet's disease.

Behçet's disease (BD) is a systemic vasculitic disorder of unknown aetiology characterised by recurrent oral and often genital ulcers, which may be associated with ocular, cutaneous, articular, neurological or vascular involvement. We report a 52-year-old woman diagnosed of neuro-BD who was treated with infliximab with a dramatic response to this treatment.