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Rodriguez-Muguruza S, Castro S, Poveda MJ, Paredes S, Taverner D, Fontova R. AB0251 * FATIGUE IN RHEUMATOID ARTHRITIS: DOES PATIENT AGE INFLUENCE? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFatigue in RA has a multi-causal pathway. It is recommended that it should be measured in all RA studies using a validated instrument. Fatigue in elderly patients could have a different perception than in younger patients, identifying the associated factors could be a key to the management of this complex symptom.ObjectivesTo compare fatigue and its associated factors in young and elderly patients with RA from two university hospitals.MethodsA cross-sectional analysis was performed in 167 RA patients diagnosed according to the 2010 ACR-EULAR criteria. Patients were divided into two groups based on age (≥60 and <60) for comparative purposes. Fatigue was assessed using 4 instruments: the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), the fatigue subscale of the Short-form 36 survey (fatigue-SF36), the Visual Analogic scale of fatigue (VASf) and the Functional Assessment of chronic illness Therapy Fatigue Scale (FACIT-F). To compare the mean of fatigue between groups we used a T-Test.To determine in each group of patients (young and elderly patients) the relationship between the 4 subscales of fatigue (assessed by BRAF-MDQ) and the other variables (DAS28, CPR, ESR, hemoglobin, vitamin D, HAQ, RAID [Rheumatoid Arthritis Impact of Disease], SF36, Hospital Anxiety and depression Scale [HAD] and Brief Pain Inventory) a Spearman correlation was performed. A value of p < 0.05 was accepted as statistically significant.ResultsA total of 167 patients were included, 81 (48.5%) young and 86 (51.5%) elderly patients. We found fatigue (using 4 instruments) has not significant differences in young and elderly patients (Table 1). In young and elderly patients, physical, living, cognitive and emotional fatigue were correlated to RAID, SF36, HAD and pain but they were not associated to CRP, ESR, hemoglobin and vitamin D. In young patients, all dimensions of fatigue were associated with DAS28. Furthermore, in elderly patients we found a relationship between physical (p-value 0.044) and living fatigue (p-value 0.012) with DAS28, nevertheless cognitive and emotional fatigue (p-value 0.078 and 0.079 respectively) were not related.Table 1.Scores of the Fatigue Questionnaires used to assess fatigue in young and elderly patients with RA.Young Mean (SD)Elderly Mean (SD)p-valueFACIT-F36.5 (12.5)35.9 (11.7)0.2963VAS-F4.3 (2.8)3.8 (2.8)0.119SF36-Fatigue50.9 (23.9)51.0 (21.9)0.628BRAF-MDQ Physical9.2 (6.2)8.5 (6.3)0.4670 Living5.3 (5.6)4.2 (4.6)0.1446 Cognitive3.3 (3.8)4.2 (4.6)0.2932 Emotional3.5 (3.5)2.6 (2.7)0.0932ConclusionIn young and elderly patients, all dimensions of fatigue appear to be related with subjective but not with objective variables. In young patients, all dimensions of fatigue were associated with DAS28 but in elderly patients only physical and living fatigue were correlate to disease activity. These results could indicate that it is important to evaluate fatigue in a multidimensional perspective in elderly patients.References[1]Belza BL, Henke CJ, Yelin EH, Epstein WV, Gilliss CL. Correlates of fatigue in older adults with rheumatoid arthritis. Nurs Res. 1993 Mar-Apr;42(2):93-9.[2]Hewlett S, Dures E, Almeida C. Measures of fatigue: Bristol Rheumatoid Arthritis Fatigue MultiDimensional Questionnaire (BRAF MDQ), Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scales (BRAF NRS) for severity, effect, and coping, Chalder Fatigue Questionnaire (CFQ), Checklist Individual Strength (CIS20R and CIS8R), Fatigue Severity Scale (FSS), Functional Assessment Chronic Illness Therapy (Fatigue) (FACIT-F), Multi-Dimensional Assessment of Fatigue (MAF), Multi-Dimensional Fatigue Inventory (MFI), Pediatric Quality Of Life (PedsQL) Multi-Dimensional Fatigue Scale, Profile of Fatigue (ProF), Short Form 36 Vitality Subscale (SF36 VT), and Visual Analog Scales (VAS). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S263-86.Disclosure of InterestsNone declared
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Pàmies A, Samitier A, Rodríguez-Fernández J, Fontova R. Ossifying myositis of the neck muscles. Reumatol Clin 2015; 11:182-183. [PMID: 25488113 DOI: 10.1016/j.reuma.2014.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/17/2014] [Accepted: 08/03/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Anna Pàmies
- Servicio de Reumatología, Hospital Universitari Joan XXIII de Tarragona, Tarragona, España; Servicio de Reumatología, Hospital de Tortosa Verge de la Cinta, Tostosa, España.
| | - Alex Samitier
- Servicio de Radiología, Hospital Universitari Joan XXIII de Tarragona, Tarragona, España
| | | | - Ramon Fontova
- Servicio de Reumatología, Hospital Universitari Joan XXIII de Tarragona, Tarragona, España; Servicio de Reumatología, Universitat Rovira i Virgili, Reus, Tarragona, España
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Qanneta R, Fontova R, Castel A. Response to: fibromyalgia and chronic fatigue syndrome caused by non-celiac gluten sensitivity. Reumatol Clin 2015; 11:185. [PMID: 25453597 DOI: 10.1016/j.reuma.2014.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/27/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Rami Qanneta
- Unidad de Fibromialgia y Síndrome de Fatiga Crónica, Departamento de Reumatología, Hospital Universitari de Tarragona Joan XXIII, Tarragona, España.
| | - Ramon Fontova
- Departamento de Reumatología, Hospital Universitari de Tarragona Joan XXIII, Tarragona, España
| | - Antoni Castel
- Clínica del dolor, Hospital Universitari de Tarragona Joan XXIII, Tarragona, España; Departamento de Psicología, Universitat Rovira i Virgili, Tarragona, España
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Castel A, Castro S, Fontova R, Poveda MJ, Cascón-Pereira R, Montull S, Padrol A, Qanneta R, Rull M. Body mass index and response to a multidisciplinary treatment of fibromyalgia. Rheumatol Int 2014; 35:303-14. [PMID: 25080875 DOI: 10.1007/s00296-014-3096-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/11/2014] [Indexed: 11/25/2022]
Abstract
The purpose of this study is to determine whether there are some differences in the treatment responses to a multidisciplinary fibromyalgia (FM) treatment related with the baseline body mass index (BMI) of the participants. Inclusion criteria consisted of female sex, a diagnosis of FM (American College of Rheumatology criteria), age between 18 and 60 years, and between 3 and 8 years of schooling. Baseline BMI was determined, and patients were randomly assigned to one of the two treatment conditions: conventional pharmacologic treatment or multidisciplinary treatment. Outcome measures were pain intensity, functionality, catastrophizing, psychological distress, health-related quality of life, and sleep disturbances. One hundred thirty patients participated in the study. No statistical significant differences regarding pre-treatment outcomes were found among the different BMI subgroups, and between the two experimental conditions for each BMI category. General linear model analysis showed a significant interaction group treatment × time in pain intensity (p < .01), functionality (p < .0001), catastrophizing (p < .01), psychological distress (p < .0001), sleep index problems (p < .0001), and health-related quality of life (p < .05). No significant interactions were found in BMI × time, and in BMI × group treatment × time. There are not differences among normal weight, overweight and obese patients with FM regarding their response to a multidisciplinary treatment programme for FM which combines pharmacological treatment, education, physical therapy and cognitive behavioural therapy.
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Affiliation(s)
- Antoni Castel
- Pain Clinic, Hospital Universitari de Tarragona Joan XXIII, C/Doctor Mallafré Guasch, 4, 43007, Tarragona, Spain,
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Qanneta R, Fontova R, Pàmies A. Etiology of sicca syndrome in a consecutive series of 199 patients with chronic fatigue syndrome. Reumatol Clin 2014; 10:269-270. [PMID: 24355593 DOI: 10.1016/j.reuma.2013.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 11/05/2013] [Accepted: 11/11/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Rami Qanneta
- Chronic Fatigue Unit, Department of Rheumatology, Hospital Universitari Joan XXIII, Tarragona, Spain.
| | - Ramon Fontova
- Department of Rheumatology, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Anna Pàmies
- Department of Rheumatology, Hospital Universitari Joan XXIII, Tarragona, Spain
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Qanneta R, Fontova R, Poveda MJ, Castro S. Clinical typology of chronic fatigue syndrome: classificatory hypothesis. Reumatol Clin 2014; 10:132-133. [PMID: 23849741 DOI: 10.1016/j.reuma.2013.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 04/15/2013] [Accepted: 04/24/2013] [Indexed: 06/02/2023]
Affiliation(s)
- Rami Qanneta
- Unidad de Fatiga Crónica, Departamento de Reumatología, Hospital Universitari Joan XXIII, Tarragona, España.
| | - Ramon Fontova
- Departamento de Reumatología, Hospital Universitari Joan XXIII, Tarragona, España
| | - María José Poveda
- Departamento de Reumatología, Hospital Universitari Joan XXIII, Tarragona, España
| | - Sonia Castro
- Departamento de Reumatología, Hospital Universitari Joan XXIII, Tarragona, España
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Castro S, Fontova R, Poveda M, Castel A, Qanneta R, Montull S, Periñan R, Miralles I, Aragonés N, Salvat I, Cascόn R, Monterde S, Padrol A, Añez C, Rull M. THU0356 Benefits of a multidisciplinary treatment in women with fibromyalgia and obesity. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Castro S, Poveda M, Fontova R, Castel A, Qanneta R, Montull S, Periñán R, Miralles I, Aragonés N, Salvat I, Cascόn R, Monterde S, Padrol A, Añez C, Rull M. AB1099 Obesity and fibromyalgia: Relationship between body mass index and severity of the symptoms. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Castel A, Fontova R, Montull S, Periñán R, Poveda MJ, Miralles I, Cascón-Pereira R, Hernández P, Aragonés N, Salvat I, Castro S, Monterde S, Padrol A, Sala J, Añez C, Rull M. Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: A randomized controlled trial. Arthritis Care Res (Hoboken) 2013; 65:421-31. [DOI: 10.1002/acr.21818] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 07/27/2012] [Indexed: 11/11/2022]
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Simón I, Vendrell J, Gutiérrez C, Fernández-Real JM, Vendrell I, Gallart L, Fontova R, Richart C. Pro12Ala substitution in the peroxisome proliferator-activated receptor-gamma is associated with increased leptin levels in women with type-2 diabetes mellitus. Horm Res Paediatr 2003; 58:143-9. [PMID: 12218380 DOI: 10.1159/000064490] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To analyze the relationship between the peroxisome proliferator-activated receptor-gamma (PPARgamma2) Pro12Ala variant and type-2 diabetes mellitus and its correlation with some cytokine determinants of insulin resistance such as tumor necrosis factor (TNF)-alpha and leptin. METHODS The PPARgamma2 Pro12Ala genetic polymorphism was studied in 167 type-2 diabetic patients and 63 healthy controls. Serum leptin and plasma-soluble TNF-R2 were measured. RESULTS Women carriers of the Pro12Ala mutation exhibited higher leptin levels than women non-carriers (median 31.4 vs. 17.5 ng/ml; p < 0.005). sTNF-R2 levels did not show differences between the two genotypes. Analysis by the multiple linear regression model of leptin-body mass index controlled by the PPARgamma2 genotype showed that leptin levels were determined by the Pro12Ala mutation in type-2 diabetic women but not in men. CONCLUSIONS PPARgamma2 seems to be implicated in leptin homeostasis in type-2 diabetic women.
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Affiliation(s)
- I Simón
- Medicine and Surgery Department, University Hospital Joan XXIII, Tarragona, Institut d'Estudis Avançats, Universitat Rovira i Virgilli, Tarragona, Spain.
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Fontova R, Gutiérrez C, Vendrell J, Broch M, Vendrell I, Simón I, Fernández-Real JM, Richart C. Bone mineral mass is associated with interleukin 1 receptor autoantigen and TNF-alpha gene polymorphisms in post-menopausal Mediterranean women. J Endocrinol Invest 2002; 25:684-90. [PMID: 12240899 DOI: 10.1007/bf03345101] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Bone mass is known to be under genetic control. Interleukin-1 (IL-1), interleukin-6 (IL-6) and TNF-alpha are strong inductors of bone resorption. The estrogenic deficiency that occurs during menopause leads to an increase in the production of these cytokines. We analyzed the genetic susceptibility of several polymorphisms of the interleukin-1 receptor antagonist (IL-1ra), IL-6 and TNF-alpha genes in lumbar spine and hip bone mass in a sample of post-menopausal Caucasian Mediterranean women with osteoporosis. 104 post-menopausal osteoporotic women (58.6+/-4.8 yr) and 51 post-menopausal women without osteoporosis as the control group (57.2+/-4.5 yr) were studied. The osteoporotic group was in turn sub-classified into severe and non-severe osteoporosis. The variable number of tandem repeats IL1-ra, IL-6 SfaNI and TNF-alpha NcoI genetic polymorphisms were studied. Biochemical markers of bone turnover were measured in blood and urine. Women carrying the A2 allele (A2+) of the IL-1ra gene showed greater BMD in the lumbar spine (p=0.02) and hip (p=0.006), compared to those not carrying the allele (A2-). The IL-6 polymorphism studied in its 5' flanking region did not show any association with BMD values. The TNF-alpha gene G allele was associated with a greater bone mass in the non-severe osteoporotic subgroup, both in the lumbar spine (p=0.0007) and in the hip (p=0.02). Likewise, genotype combination A2+GG was associated to a greater hip BMD at the femoral neck and Ward triangle levels (p=0.02). We conclude that both IL-1ra and TNF-alpha can be candidate loci to be studied in the susceptibility to develop post-menopausal osteoporosis.
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Affiliation(s)
- R Fontova
- University Hospital of Tarragona Joan XXIII, Medicine and Surgery Department, Spain.
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Kilani S, Verdú M, Ruíz T, Fontova R, Parra L, Monsalve M, Cisneros S, Alonso JG. [Systemic lupus erythematosus (S.L.E.) and (lupoid) interstitial cystitis]. Actas Urol Esp 1993; 17:457-60. [PMID: 8368121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- S Kilani
- Servicio de Urología, Hospital Camino de Santiago, Ponferrada
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Gallegos A, Pascual E, García-Arroba J, Rodríguez Heredia JM, Alvarez JL, Fontova R. [Vasculitis associated with proliferation of large granular lymphocytes]. Med Clin (Barc) 1990; 95:103-5. [PMID: 2250516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We report a patient with the syndrome of large granular lymphocytes in whom the initial clinical features were polyarthritis, hepatosplenomegaly and neutropenia. Relative lymphocytosis was also demonstrated at the expense of a subpopulation with morphology and surface markers characteristic of large granular lymphocytes (CD2+, CD8+, CD16+ and HNK-1+). After 6 months of asymptomatic course, without changes in clinical or laboratory data, the patient died from an acute abdomen with mesenteric ischemia of different likely causes as suggested by necropsy data (multivisceral diffuse infiltrate by large granular lymphocytes, systemic vasculitis and Clostridium sepsis). The association between this syndrome and systemic vasculitis is discussed.
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Affiliation(s)
- A Gallegos
- Servicio de Reumatología, Hospital Central de la Cruz Roja, Madrid
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