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Publisher Copyright: © 2023, Sociedade Portuguesa de Reumatologia. All rights reserved. Objectives: Chronic low back pain (CLBP) is a common health problem and in most patients it is not possible to identify a specific cause (non-specific CLBP). Spondyloarthritis is a musculoskeletal disorder characterized by (often inflammatory) back pain and spinal stiffness. The impact of CLBP and spondyloarthritis on patients’ physical function may be different. This study aims to compare physical disability in patients with spondyloarthritis and CLBP, in a population-based setting. Furthermore, we aim to identify modifiable risk factors for physical disability among these two populations. Methods: Data from EpiReumaPt, a national health cohort with 10 661 individuals, conducted from September 2011 to December 2013, was used. Physical function was accessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and by the physical function dimension of the 36-Item Short Form Survey (SF-36). Univariable and multivariable linear regression analyses were used to assess the differences between groups. Factors associated with physical disability were explored for both diseases. Results: We evaluated 92 patients with spondyloarthritis, 1376 patients with CLBP and 679 subjects without rheumatic and musculoskeletal diseases (RMDs). Spondyloarthritis and CLBP patients reported significantly higher levels of disability in HAQ-DI (b=0.33; p

Objective: To investigate the relationship between body mass index (BMI) and disease activity in patients with Juvenile Idiopathic Arthritis (JIA). Methods: Patients with JIA, aged ≤18 years, registered at the Rheumatic Diseases Portuguese Register (Reuma.pt) in Portugal and Brazil were included. Ageand sex-specific BMI percentiles were calculated based on WHO growth standard charts and categorized into underweight (P97). Disease activity was assessed by Juvenile Arthritis Disease Activity Score (JADAS-27). Uni- and multivariable analyses were performed. Results: A total of 275 patients were included. The prevalence of underweight, normal weight, overweight and obesity was 6.9%, 67.3%, 15.3% and 10.5%, respectively. Underweight patients had significantly higher number of active joints (p

Background: Loss of a spouse is a frequent occurrence in later life, with about 10% of the individuals finding themselves unable to cope and progressing to prolonged grief, risking further mental and physical problems.Objective: The development and implementation of an online grief program, such as LEAVES (optimizing the menta L hEalth and resilience of older Adults that haVe lost th Eir spou Se via blended, online therapy), intends to improve prevention and treatment of prolonged grief, so that elderly mourners can continue to lead an active, meaningful and dignified life.Methods: The LEAVES program, a project under AAL (Active and Assisted Living) 2019 Call for Sustainable Smart Solutions for Ageing Well, is in development by an international consortium and integrates academical, clinical and technical experts. The project will take place between February 2020 and January 2023 and involve real-life evaluation of 315 end-users. The Psychiatric Department at the Health Unit of Baixo Alentejo (ULSBA) will offer the service to its primary users, blending online services with telephone, video calls and face-to-face sessions. Widowed older adults >65 that express the need for help in mourning their spouse will be recruited in the community as well as via the geriatric psychiatry team and primary care.Results: With LEAVES program we aim for older adults to process the loss of a spouse in a blended online/presential environment, detecting olders at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The evaluation will focus on wellbeing and involve several measures to assess grief symptoms, loneliness, hopelessness, satisfaction and quality of life. Conclusions: ULSBA will use LEAVES to improve clinical practice on preventing and managing prolonged grief as well as, after testing and validating it in this project, to save economical costs and improve effectiveness, both to hospital and patients.

Summary Vitamin D deficiency is prevalent worldwide, but its prevalence is unknown in adult Portuguese population. In Portugal, 66% of adults present Vitamin D insufficiency/deficiency. Winter, living in Azores, older age, and obesity were the most important risk factors. It highlights the need of strategies to prevent vitamin D deficiency in Portugal. Objective To estimate the prevalence and risk factors of vitamin D deficiency in the adult Portuguese population. Methods Adults (≥ 18 years old) from the EpiReumaPt Study (2011–2013) were included. Standardized questionnaires on sociodemographic and lifestyle features were obtained. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were evaluated using ADVIA Centaur VitD competitive immunoassay (Siemens Healthineers) in 2015–2017 as 25 (OH)D Level 0: ≤ 10 ng/mL; Level 1: 11–19 ng/mL; Level 2: 20–29 ng/mL, and Level 3: ≥ 30 ng/mL. Weighted multinomial regression analysis was conducted to evaluate the association between socio-demographic and lifestyle variables and vitamin D status. Results Based on weighted analysis, the estimated prevalence of levels of 25(OH)D ≤ 10, < 20, and < 30 ng/mL was 21.2, 66.6, and 96.4%, respectively. The strongest independent predictors of serum 25 (OH)D ≤ 10 ng/mL were living in the Azores archipelagos (OR 9.39; 95%CI 1.27–69.6) and having the blood sample collection in winter (OR 18.53; 95%CI 7.83–43.87) or spring (11.55; 95%CI 5.18–25.74). Other significant predictors included older age (OR 5.65, 95%CI 2.08–15.35), obesity (OR 2.61; 95%CI 1.35–5.08), current smoking (OR 2.33; 95%CI 1.23–4.43), and female gender (OR 1.9, 95%CI 1.1–3.28). Conversely, physical exercise (OR 0.48, 95%CI 0.28–0.81) and occasional alcohol intake (OR 0.48, 95%CI 0.29–0.81) were associated with a lower risk of 25(OH)D ≤ 10 ng/mL. Conclusion Vitamin D deficiency/insufficiency [25(OH)D < 20 ng/ml] is highly prevalent in Portugal, affecting > 60% of all Portuguese adults, with strong geographical and seasonal variation. This study highlights the need to critically assess the relevance of vitamin D deficiency as a public health problem and the urgent need for a wide and scientifically robust debate about the most appropriate interventions at the individual and societal levels. info:eu-repo/semantics/publishedVersion

Erythema elevatum diutinum is a rare neutrophilic dermatosis with vasculitis, which presents as persistent, symmetrical, purple or brownish papules and nodules, mainly in the extensor surface of the limbs. We describe a case of erythema elevatum diutinum and polyarthritis as initial manifestations of Crohn's disea se associated spondyloarthritis. A 51-year-old man, from São Tomé e Príncipe, with previous history of treated tuberculosis and chronic hepatitis B infection, was admitted due to 4 months history of polyarthritis, hyperpigmented papules on the extensor surfaces, occasional episodes of bloody mucous diarrhea and significant weight loss. Histology of the skin showed myeloperoxidase positive neutrophilic granulocytes with moderate karyorrhexis, consistent with erythema elevatum diutinum. Colonoscopy showed erosions in sigmoid and rectum. Diagnosis of erythema elevatum diutinum secondary to Crohn's disease with associated peripheral spondyloarthritis was assumed. The patient was treated with prednisolone, sulphasalazine, metronidazole, azathioprine and tenofovir with good clinical response. As erythema elevatum diutinum can be secondary to multiple systemic diseases, including rheumatic diseases and inflammatory bowel disease, being aware and re - cognizing this entity can be of great importance for rheumatologists. publishersversion published

Objectives: Falls are a major public health issue, given its prevalence and social impact. This study aimed to (1) characterize fallers in the adult Portuguese population as well as (2) identify if some chronic conditions are fall determinants. Material and methods: Our data of 7403 adults (≥18 years) was retrieved from phase 1 survey of EpiReumaPt, a representative sample of adult Portuguese population. We analyzed sociodemographic variables and the presence of chronic diseases, which was evaluated by self-report. Anxiety/depression symptoms were assessed using The Hospital Anxiety and Depression Scale (HADS). Fall was defined by the presence of a self-report fall in the previous 12 months to the interview. Univariate and Multivariable logistic regression were used to assess fall determinants. Analyses were conducted in Stata v13. Results: The estimated prevalence of falls in the Portuguese population is 24,1%. Women are at 2.12 times higher risk of fall than man (95% CI 1.79 – 2.51) and there’s also a progressive increasing association between age and falls, with people with 75+ years having greater odds of falling (OR = 1.86 95% CI 1.49 – 2.31). Different chronic health conditions were identified as major determinants of falls in the Portuguese population. Neurologic (OR = 1.64 95% CI 1.17 – 2.32) and rheumatic (OR = 1.44 95% CI 1.18 – 1.74) disease were significantly and independently associated with falls. Similar results were found for presence of anxiety (OR = 1.33 95% CI 1.04 – 1.71) or depression (OR = 1.61 95% CI 1.20 – 2.15) symptoms. Conclusions: Our results show a perspective of the determinants of falls in the Portuguese population, allowing us to know that women and elders are at greater risk. We have showed that some chronic diseases are associated with falls, in particular musculoskeletal diseases and mental diseases. Implementing specific and adapted prevention strategies might reduce the number and complications of falls ultimately improving Portuguese overall health.

Trabalho apresentado em 10th Interdisciplinary World Congress on Low Back & Pelvic Girdle Pain, 28-31 de outubro 2019, Antuérpia, Bélgica N/A

Trabalho apresentado em 10th Interdisciplinary World Congress on Low Back & Pelvic Girdle Pain, 28-31 de outubro 2019, Antuérpia, Bélgica N/A