Linguistic and cultural adaptation of the EARP Questionnaire to European Portuguese
Rodrigues A, Jacinto S, Henriques A, Valada M, Tinazzi I, Sousa Rd, Canhão H
Objective: This study aims at the linguistic and cultural adaptation of the Early ARthritis for Psoriatic Patients (EARP) questionnaire into European Portuguese, for psoriatic patients attending dermatology medical examination.
Methods: Firstly, we performed a process of translation and back-translation of the English version of the EARP Questionnaire to European Portuguese, with interim and final harmonization. The resulting Portuguese version was approved by the EARP original author. Secondly, individual interviews were conducted to complete the linguistic and cultural adaptation of the initial translated Portuguese version, with the think-aloud and probe methods. At this stage, we conducted eight interviews, four with rheumatology and dermatology doctors (experts), and four with patients with psoriasis and psoriatic arthritis. Finally, the version resulting from the adaptation process was back-translated from Portuguese to English.
Results: Our results showed that EARP Questionnaire’s items are easy to understand and do not raise comprehension concerns in experts or patients. Our findings suggested that items demanding health literacy from patients and that do not include a precise cue to signal the inflammatory nature of the joint pain may lead to confusion while answering, potentially leading to the patient's need for assistance.
Conclusion: The Portuguese version of the EARP Questionnaire demonstrated adequate comprehension properties. Our findings support the use of this measure in clinical practice and future research, however, a validation study with Portuguese patients is needed.
Evaluation of the time of patients' admission to the tertiary pediatric rheumatology center for juvenile idiopathic arthritis
Kurt T, Tekin Z, Çelikel E, Aydın F, Tekgöz N, Sezer M, Karagöl C, Coşkun S, Kaplan M, Öner N, Polat M, Sezer S, Acar B
Background: To determine the interval between disease onset and admission to pediatric rheumatology clinic of patients with juvenile idiopathic arthritis (JIA) and, to identify the factors that affect the admission time (AT) to rheumatology center.
Methods: We designed a retrospective observational study in children with JIA. The study variables were age, gender, JIA subtype, acute phase reactants (APR), disease activity scales, presence of a pediatric rheumatologist, and distance to a pediatric rheumatology center. Outcome parameter was the duration between onset of symptoms and first visit of rheumatologist. The parameters were evaluated with variance analysis and regression models.
Results: 198 patients (female:120 (60.6%)) were included. There were 112 (56.5%) patients in oligo-articular JIA, 27 (13.6%) in rheumatoid factor negative poly-articular JIA, 22 (11.1%) in enthesitis related arthritis (ERA), 29 (14.6%) in systemic-JIA, 4 (2%) in rheumatoid factor positive poly-JIA, two patients each in undifferentiated and psoriatic arthritis. The median AT in the systemic-JIA and other groups was 16 (IQR 10.5-27.5) and 71 (IQR 33.5-211) days, respectively. There was a significantly longer AT in the ERA group than others (p=0.005). We found a correlation between longer AT and older age, low back pain, enthesitis, and low erythrocyte sedimentation rate (ESR). In the multivariate analysis, only low ESR and enthesitis contributed an increase in AT [OR 2.05 (1.07-3.93), 6.22 (1.29-29.99)].
The older age, low back pain, enthesitis and low ESR contribute to the late AT. JIA requires high suspicion in children with poorly defined findings and low APR.
Pregnancy in Takayasu arteritis: a cross-sectional study and review of literature
Pedreira AL, Chagas G, Santiago M
Objective: Takayasu arteritis (TA), a form of vasculitis affecting large-and medium-sized vessels; it mainly affects women of reproductive age. Although cardiovascular and hemodynamic changes during pregnancy represent a potential risk for TA, findings regarding risk in maternal and fetal outcomes are inconsistent. This study aimed to describe the prevalence and outcomes of pregnancies in patients with TA, along with a literature review of comparable studies on the subject matter.
Methods: This cross-sectional study was conducted between January and March 2020. We evaluated 20 women diagnosed with TA according to clinical and angiographic findings.
Results: The median age of the participants was 38 years. The median age at TA diagnosis was 26 years. Thirteen of the 20 participants reported at least one pregnancy. There were 38 pregnancies, including 26 deliveries (20 vaginal and six cesarean deliveries) and 12 abortions. The most common obstetric complication was spontaneous abortion (25%), followed by prematurity (7.89%), and eclampsia/preeclampsia (5.26%). Only one of our patients gave birth without any complications after being diagnosed with TA. In this case, the disease remained inactive throughout the pregnancy and postpartum periods.
Conclusions: The most common obstetric complication encountered was spontaneous abortion. The maternal and fetal outcome findings were similar to those of previously published studies. The literature shows that patients with stable pregestational TA generally have a good prognosis.