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SPECIFIC ASPECTS OF THE EVOLUTION AND PROGNOSIS OF RHEUMATOID ARTRITIS
COORDINATOR: Prof. Dr. GEORGESCU LIA, Dr. SZASZ SIMONA
FIRST AUTHOR: OPRIȘ IULIA-CRISTINAAUTHOR: ANGHEL (BUJOR) VALENTINA
INTRODUCTION
-systemic autoimmune disease→ chronic evolution
-unknown etiology
-produce an inflammatory response
-afffect –joints cartilage
-epiphyses
-ligaments
-tendons
-causes - pain,
- swelling,
- stiffness
-loss of function
OBJECTIVE AND METHODS
Follow: - the evolution -the prognosis
A -retrospective -observational -analytical study
In the Rheumatology Clinic of Targu Mures
On a number of 100 patients - 85 woman - 15 men
The evolution and the prognosis according to :1 sex
15%
85%
sex masculinsex feminin
-common in woman with a privalence of 4-5:1
2 age
21-29 ani 30-39 ani 40-49 ani 50-59 ani >60 ani0%5%
10%15%20%25%30%35%40%45%50%
1%4%
8%
38%
49%
increased disease prevalence in patients aged over 60 years is explained by the fact that this disease started with 10 to 15 years before carrying out this study
3 According to the environment
43%57% Rural areasUrban areas
-the patients form the rural areas - lower access to health services -distrust of pharmacotherapy provided by hospitals -lower awareness of the disease
Analyzing the age when the first symptoms appeared and when they were diagnosed
0-9 10 - 19
20-29 30-39 40-49 50-59 60-69 70-790
10
20
30
40
50
60
70
0 1
913
33
1912
20 2
710
26
30
12
2
Num
ăr d
e pa
cienț
i
0-9 10 - 19
20-29
30-39
40-49
50-59
60-69
70-79
0
1
2
3
4
5
6
7
8
0 0
1
0
4
2 2
00 0
1
1
3
2 2
0
The age of diagnosis
The age when the first symp-toms apeared
Num
ăr d
e pa
cienț
i
- woman - men ↓ ↓ 2,2 years 0,8 years
Analyzing the differences between the first symptoms and the age of diagnosis
93,33%
6,67%
Men
52.94%47.06%
Woman
< 1 an
> 1 an
-from15 patients : -14 (93,33%) early diagnosis (0-1 year) -1 patient (6,67%) over this period
-from 85 patients : -45 (52,94%) early diagnosis - 40 (47,06%) over 1 year
p=0,0024
3 The association between a delayed diagnosis and the social environment of female patients
30.76%
69,24%
Rural area
76.08%
23.92%
Urban area
≤ 1year
> 1year
-from 39 pratients from the rural areas -12 patients(30,76%)-early diagnisis (< 1 year)-27 patients 69,24%) over this period.
-from 46 patients from the urban area -35 (76,08%)- early diagnosis (<1year) -11 (23,92%) over this period
4.The association between a delayed diagnosis and the social enronment of male patients
25.00%
75.00%
Rural area
90.90%
9.10%
Urban area
≤ 1year
> 1year
This difference was not noticed to the male patients
5.The association between a delayed diagnosis and the evolution of the disease
Studying the relationship between delay in diagnosis and the anatomical stage, statistics obtained a p value=0,0035
3
5
The anatomical stage III-IV
≤2years>2years
25
2
The anatomical stage I-II
The distribution of the pacients depending the rheumatoid factor presence or absence
89.41%
10.59%
woman
73.33%
26.67%
pacienți de sex masculin
The presence of the rheumatoid factor
The absence of the rheumatoid factor
-The rheumatoid factor was positive at - 76 (89,41%) woman - 11 (73,33%) men
Staging of patients in the study
30.58%
69.42%
Woman
26.66%
73.34%
Men
Anatomical stage I-II
Anatomical stage III-IV
-anatomical stage I și II -26 ( 30,58%) woman -4 ( 26,66%) mal-anatomical stage III-IV - 59 (69,41%) woman -11 (73,34%) men
CONCLUSIONS• The prevalence of the disease is higher in
females than males • The incidence of rheumatoid arthritis in
rural versus urban areas is similar• The time interval between symptom onset
and diagnosis is higher in women (2.2 years)
• Early diagnosis of rheumatoid arthritis is associated with a less aggressive evolution both anatomically and clinically.
Thank you!