Rheumatoid arthritis: travelling biological era a Romanian X-ray population.

BACKGROUND: Rheumatoid arthritis (RA) is associated with loss of overall functionality of the locomotion system and it is connected with substantial economic losses. OBJECTIVE: To describe the clinical characteristics and healthcare resource utilization characteristics and to analyze the correlations in a cross-sectional sample of 206 patients in Romania. METHOD: RA cases have been enrolled from southern and western part of the country, covering a surface of 23 counties. RESULTS: Particularly in the literature data, Romanian RA patients become work disabled at 5.65 +/- 5.99 years old after the diagnosis. At cohort level, retirement in the first year after RA diagnosis is of 22.9%. From those, 13% were treated with biologic DMARDs; those on non-biologic DMARDs were 28.6%. In oral therapy group the most prescribed drug is lefunomide (61.2%). RA has an important impact on pain, function and utility, influenced by social factors. Patients' follow up is often based on hospitalization. CONCLUSION: Currently, when the clinician may choose for one certain therapy or another, the social influence is still overwhelming at all the evaluation levels in RA patients, as well as at economic impact.

Evaluation of a Romanian version of the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with spondylarthropathies.

OBJECTIVE: To develop a Romanian version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and to determine its metric properties in patients with spondylarthropathies (SpA). METHODS: A Romanian version of BASFI was obtained after translation, back-translation and pretesting. Altogether 41 SpA patients fulfilling the ESSG criteria were included, 34 of them satisfying the modified New York criteria for ankylosing spondylitis. BASFI was completed by the patients along with assessment of clinical and disease activity variables by both the patient and physician. Scalability, internal consistency, reliability and construct validity of the Romanian BASFI were assessed. RESULTS: Mean time to complete the questionnaire was 2 minutes. Scalability (0.2-9.7, 95% of the scale), internal consistency (Cronbach's alpha = 0.93), reliability (intraclass correlation coefficient = 0.82) and construct validity (correlations (absolute value(r) = 0.37-0.59) with spinal pain, nocturnal pain, patient's and physician's global assessment, fingers-to-floor distance, occiput-to-wall distance, modified Schober test, intermalleolar distance, and Dougados articular index) were all very satisfactory. CONCLUSIONS: Translation and cultural differences did not alter the well-known value of BASFI. Therefore, the Romanian version of BASFI is reproducible and valid for the assessment of patients with spondylarthropathies.

A Romanian instrument to facilitate bone density measurement indication in postmenopausal women.

UNLABELLED: The aim of the study is to find and valid a clinical instrument which identifies the women that need a bone density measurement because of their high risk for osteoporosis. MATERIAL AND METHOD: A number of 356 women were enrolled in this study. They filled in a study formular and their bone density was measured by DEXA exam (dual energy X-ray absorbtiometry) in the lumbar spine and proximal femur. Statistical correlations between the dependent variable minimal T-score and the other variables (clinical risk factors) were established. The most significant osteoporosis risk factor were included in a classification tree for the dependent variable minimal T-score with 5 splits, 5 independent splitting variables and 6 terminal knots. RESULTS: The most significant osteoporosis predictors included in our classification tree are: current weight, decreasing of height, sedentary life, alcohol consumption, number of deliveries. In predicting osteoporosis, the classification tree has high values both for sensitivity and for specificity (88.2%, respectively 74.11%).The osteoporosis prevalence is very high (74.34%) within the group predicted as having osteoporosis (53.7% of all women). The osteoporosis prevalence was 11% within the group predicted as having osteopenia. CONCLUSIONS: The classification tree facilitates a bone density measurement strategy and establishes the criteria for initiation of the treatment in high risk osteoporosis cases. It allows postponing the DEXA-exam for low risk women and selective measurement of the bone density for intermediar osteoporosis risk women.