Monocentric Cross-sectional Study Research Articles

The Onset of Intussusceptive Angiogenesis in COVID-19 Patients Might Come from the Mobilization of Stem Cell Sub-Populations Expressing the Hemangioblast Marker CD143.

COVID-19 and infectious diseases have been included in strategic development goals (SDG) of United Nations (UN). The SARS-CoV-2 pandemic has unveiled complex pathophysiological mechanisms underpinning COVID-19, notably inducing a systemic acquired vascular hemopathy characterized by endothelial dysfunction and intussusceptive angiogenesis, a rapid vascular remodeling process identified as a hallmark in severe COVID-19 cases affecting pulmonary and cardiac tissues. Stem cell migration have been proposed as significant regulators of this neoangiogenic process. In a monocentric cross-sectional study, through spectral flow cytometry analysis of peripheral blood mononuclear cells, we identified a distinct stem cell subpopulation mobilized in critical COVID-19. Indeed, by an unsupervised analysis generating a UMAP representation we highlighted eleven different clusters in critical and non-critical COVID-19 patients. Only one cluster was significantly associated to critical COVID-19 compared to non-critical patients. This cluster expressed the markers: CD45dim, CD34+, CD117+, CD147+, and CD143+, and were negative for CD133. Higher level of expression of hemangioblast markers CD143 were found in critical COVID-19 patients. This population, indicative of hemangioblast-like cells, suggests a key role in COVID-19-related neoangiogenesis, potentially driving the severe vascular complications observed. Our findings underscore the need for further investigation into the contributions of adult stem cells in COVID-19 pathology, offering new insights into therapeutic targets and interventions.

Relationship between interprofessional collaboration and psychological distress experienced by healthcare professionals during COVID-19: a monocentric cross-sectional study.

Since the onset of the COVID-19 pandemic, global healthcare systems have faced unprecedented challenges, leading to significant psychological distress among healthcare professionals. Recognizing the importance of enhanced interprofessional collaboration in alleviating this burden, as emphasized by the World Health Organization in 2020, we investigated whether such collaboration could mitigate staff psychological distress during crises. To our knowledge, no study has yet explored the role of interprofessional collaboration as a resilience factor in crises. For this monocentric cross-sectional study at a German university hospital, we examined the relationship between the quality of interprofessional collaboration and the psychological distress of healthcare professionals during the initial pandemic wave. We employed validated mental health instruments, such as the GAD-7 and PHQ-2, to assess anxiety and depressive symptoms. Additionally, custom-designed questionnaires evaluated "Pandemic-Associated Burden and Anxiety (PAB; PAA)" and interprofessional crisis management experiences. A novel "Interprofessional collaboration and communication (IPC)" assessment tool was developed based on international competency frameworks, demonstrating strong reliability. The study involved 299 healthcare professionals (78.6% in direct contact with COVID-19 patients). Moderate levels of PAB/PAA were reported. However, a significant proportion experienced clinically relevant anxiety, as indicated by GAD-7. Negative IPC perceptions correlated with higher levels of psychological distress. Linear regression analysis showed associations between interprofessional collaboration and anxious and depressive symptoms, and pandemic-related burden. Our findings highlight the vital role of enhanced interprofessional collaboration in strengthening the psychological well-being of healthcare professionals during crises. The study underscores the need to foster a collaborative environment and integrate interprofessional education for resilience.

Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis

Objective. A monocentric cross-sectional study recruiting rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients residing in the Lazio region, Italy, to assess factors related to diagnostic delay and treatment accessibility. Methods. Clinical/serological data, including the time between symptom onset, diagnosis, and the beginning of treatment, were collected. Residence, referral to a rheumatologic center, physician who made the diagnosis, and previous misdiagnosis were also evaluated. Results. A higher diagnostic delay (p=0.003), and time between symptom onset and the start of I-line therapy (p=0.006) were observed in PsA compared to RA. A delayed start of II-line therapy was observed in RA compared to PsA (p=0.0007). Higher diagnostic delay (p=0.02), and time between symptom onset and the start of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (p=0.02) were observed among residents of small-medium cities for both groups. Patients who have been diagnosed by another physician rather than a rheumatologist had a longer diagnostic delay (p=0.034) and a delayed start of I-line therapy (p=0.019). Patients who received a different previous diagnosis experienced greater diagnostic delay (p=0.03 and p=0.003) and time of start of csDMARDs (p=0.05 and p=0.01) compared with those receiving RA or PsA as the first diagnosis. PsA had a delay in starting targeted synthetic disease-modifying anti-rheumatic drugs (p=0.0004) compared to RA. Seronegative RA had delayed diagnosis (p=0.02) and beginning of therapies (p=0.03; p=0.04) compared to seropositive ones. Conclusions. According to our results, greater diagnostic delay was found in PsA compared to RA, in patients living in small-medium cities, in those who did not receive the diagnosis from a rheumatologist, in those who were previously misdiagnosed, and in seronegative RA.

Ectasia Detection by Anterior Segment Optical Coherence Tomography in Scheimpflug Tomographically Normal Keratoconus Fellow Eyes.

The purpose of this study was to determine whether the Scheimpflug tomographically normal fellow eyes of keratoconus patients are also classified as normal using an ectasia screening algorithm based on anterior segment optical coherence tomography (AS-OCT). This monocentric cross-sectional study included 22 very asymmetric ectasia patients with tomographically significant keratoconus in 1 eye and normal Scheimpflug tomography in the fellow eye. Twenty-two eyes of 22 healthy subjects served as a control group. We performed corneal tomography using Pentacam AXL (Oculus, Wetzlar, Germany) and used Belin/Ambrósio Enhanced Ectasia total deviation index as well as Belin ABCD keratoconus classification to identify Scheimpflug tomographically normal eyes. We also performed AS-OCT using Anterion (Heidelberg Engineering, Heidelberg, Germany) and analyzed for the presence of ectasia using the Screening Corneal Objective Risk of Ectasia (SCORE) algorithm, with positive values indicating ectasia suspect tomography. The SCORE value was positive in 9.1% (n = 2) of the healthy eyes, in 45.5% (n = 10) of the Scheimpflug tomographically normal eyes of keratoconus patients and in all eyes (n = 22) with tomographically significant keratoconus. The Scheimpflug tomographically normal eyes of keratoconus patients had higher SCORE values compared with healthy controls (P < 0.001). The median (interquartile range) SCORE value was -1.7 (1.3) in healthy controls, -0.5 (2.2) in Scheimpflug tomographically normal eyes of keratoconus patients, and 11.1 (11.0) in tomographically significant keratoconus eyes. The Scheimpflug tomographically normal fellow eyes of keratoconus patients had higher AS-OCT-based SCORE values than healthy controls, with positive SCORE values found in 46% of the eyes, indicating early tomographic ectatic changes.

Illustration of self-perceived knowledge, skills, and interests in undergraduate dental students using a visual metaphor– results of a monocentric cross-sectional study

BackgroundSelf-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM).MethodsSeventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman’s Rho was used to reveal correlations between knowledge, skills, and interests in the cohort.ResultsPerceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p < 0.05). However, students’ interests did not significantly vary between groups (p > 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p < 0.01), and weak to moderate positive correlations were found between interests and knowledge (p < 0.05). Regarding the relationship between perceived interests and skills, only restorative dentistry, endodontology and periodontology were significant and only moderate to weak correlations were found (p < 0.05).ConclusionPRISM revealed differences in perceived knowledge and skills between third-, fourth-, and fifth-year dental students. Correlations were found between perceived knowledge and skills, as well as between interests and knowledge. PRISM may be a promising tool to support students and teachers in dental education.

(263) Sexuality and Fertility among Young Women Treated for Cervical Cancer

Abstract Introduction Cervical cancer is the fourth cancer in women. Its incidence is particularly high in developing countries. The increase in cases among young women in low- and middle-income countries may be due to changes in sexual behaviors and an increased risk of HPV infection and the absence of vaccination programs. The mortality and morbidity rates of cervical cancer are very high if diagnosed at an advanced stage. It is a preventable Human Papilloma Virus (HPV) related cancer. Cervical cancer patients are often stigmatized because of the idea that this cancer is associated with early-onset sexuality. Furthermore, the treatments for such cancer are mutilating for women often causing definitive infertility and sexual and/or couple dysfunctions. Objective This study aims to describe the changes in sexuality and fertility among young women diagnosed and treated for cervical cancer Methods It is a monocentric cross-sectional study based on a phone survey. We included and contacted all young women (under 40) when they were diagnosed with and/or treated for cervical cancer in our institution for 11 years from January 2010 to December 2020. We excluded all patients with a history of chronic disease other than cervical cancer. The study took place from January To May 2022. We developed an 8-item questionnaire in the local dialect and used the validated translation of the Female Sexual Function Index (FSFI) to evaluate the participants' sexual function. Results We included 23 cases of cervical cancer in young women, i.e. a response rate of 4.6%. The average age of our sample was 34.7 years (±4.7). The median age of first sexual intercourse was 21.5 years [20–25.25]. The abortion rate was 2 [0.25–2.75] per participant. The median age of the first pregnancy was 21 years [21–27]. The most common symptom leading to the cancer diagnosis was post-coital metrorrhagia in 12 (52.2%) of cases. The first Pap smear led to a cervical cancer diagnosis in 13 cases (56.5%). Five patients had a tumor size ≤ 40 mm and 4 patients were metastatic at the time of the diagnosis. Eighteen patients underwent surgical treatment of whom 5 had a fertility-sparing technique. All patients got radiation. The average duration of follow-up was 5.72 years ±0.3.247. The average survival is 9.7 years (±0.9 years; 95% CI 7.9 – 11.5 years). The 3-year survival rate is 82.6%, and the 5-year survival rate is 82.6%. Five patients expressed a desire for pregnancy after the treatment, one got pregnant after 5 years. Five patients expressed that there was an impact on their sexuality after the treatment with sexual disorders with pain, in particular dyspareunia and vulvodynia, and a decrease in female desire associated with a guilty feeling. All patients had pathological FSFI scores regarding all the domains of female sexual function Conclusions Sexuality and fertility are taboo among young cervical cancer survivors. The sexual stigma of cervical cancer as a sexually transmitted disease is present in our population. Fertility-sparing surgical techniques and less sexually harmful radiation techniques are still to be perfected. Disclosure No.

Bronchiectasis in renal transplant patients: a cross-sectional study

BackgroundBronchiectasis is a chronic airway disease characterized by permanent and irreversible abnormal dilatation of bronchi. Several studies have reported the development of bronchiectasis after renal transplantation (RT), but no prospective study specifically assessed bronchiectasis in this population. This study aimed to compare features of patients with bronchiectasis associated with RT to those with idiopathic bronchiectasis.MethodsNineteen patients with bronchiectasis associated with RT (RT-B group) and 23 patients with idiopathic bronchiectasis (IB group) were prospectively included in this monocentric cross-sectional study. All patients underwent clinical, functional, laboratory, and CT scan assessments. Sputum was collected from 25 patients (n = 11 with RT-B and n = 14 with IB) and airway microbiota was analyzed using an extended microbiological culture.ResultsDyspnea (≥ 2 on mMRC scale), number of exacerbations, pulmonary function tests, total bronchiectasis score, severity and prognosis scores (FACED and E-FACED), and quality of life scores (SGRQ and MOS SF-36) were similar in the RT-B and IB groups. By contrast, chronic cough was less frequent in the RT-B group than in the IB group (68% vs. 96%, p = 0.03). The prevalence and diversity of the airway microbiota in sputum were similar in the two groups.ConclusionClinical, functional, thoracic CT scan, and microbiological characteristics of bronchiectasis are overall similar in patients with IB and RT-B. These results highlight that in RT patients, chronic respiratory symptoms and/or airway infections should lead to consider the diagnosis of bronchiectasis. Further studies are required to better characterize the pathophysiology of RT-B including airway microbiota, its incidence, and impact on therapeutic management.

P474 IBD-Disk : Towards validating the classical Arabic version of the questionnaire ?

Abstract Background The IBD-Disk is a validated 10-question, self-administered visual questionnaire used to assess the inflammatory bowel disease (IBD) related disability. It has been translated into several languages and validated in different populations since its emergence. The aim of our study is to explore the internal consistency and item reliability of the IBD-Disk in its classical Arabic version, and to analyze the strength of correlation between each item and the sum of the scale. Methods We conducted a monocentric cross-sectional study including IBD patients. All individuals completed the IBD-Disk questionnaire in classical Arabic. The internal consistency of the IBD-Disk was assessed using Cronbach's alpha between item combinations. A value &amp;gt; 0.70 was considered acceptable, &amp;gt; 0.80 good, and &amp;gt; 0.90 excellent. Cronbach's corrected correlation was assessed using Pearson's correlation coefficient. Results We included 166 patients, 53.6% were men and 69.3% had Crohn's disease. Median age was 38 years [30 - 48]. The mean total score was 36.4 ± 21.0. The "Energy", "Emotions" and "Education &amp; work" items had the highest scores (4.9 ± 2.9, 4.7 ± 3.1, and 4.4 ± 3.2 respectively). Including the 10 items of the IBD-Disk scale, a value of 0.913 95% CI [0.893-0.932] was observed for Cronbach's alpha, demonstrating good reliability between the different sub-scores. By performing the removal procedure one by one, Cronbach's alpha varied between 0.902 and 0.915, confirming that all items contribute to the construct. In addition, all items showed a Cronbach corrected correlation between each item and the rest of the scale r &amp;gt; 0.4, p&amp;lt;0.001. Energy showed the highest correlation (r=0.751), and joint pain the lowest (r=0.506) (Table 1). Also, Cronbach's alpha was positive for every pair of IBD-Disk items at the start of the study. The item pairs that showed the best correlation were [Abdominal pain - Regulating defecation], [Energy - Regulating defecation] and [Energy - Sleep]. In contrast, the item pairs that were least interconnected were [Abdominal pain - Joint pain], [Interpersonal interaction - Joint pain] and [Body image - Joint pain] (Table 2). Conclusion Our work has demonstrated excellent item homogeneity in the classical Arabic version of the IBD-Disk, and a good correlation between each item and the remaining total score. However, a prospective measurement of the intra-class correlation coefficient of the classical Arabic version will be necessary to assess its reproducibility over time.

Access to dental care is still complex in 2022 for patients living with HIV despite the need for careful monitoring of pathologies of the oral mucosa. Results of a monocentric cross-sectional study in the Infectious Diseases Department of Clermont-Ferrand University Hospital.

Describe the dental care pathway of people living with HIV (PLHIV) and their oral pathologies. A monocentric cross-sectional study involving adult PLHIVs followed (October 2021/April 2022) in our department. Socio-demographic and medical data, course of dental care, and presence of pathologies of the oral mucosa were recorded. 112 PLHIV (71% men, 54 ± 14years) were included. Of the 112, 96% had already consulted a dentist, and 78% had a referring dentist; 73% had disclosed their seropositivity; for 84%, the visit proceeded normally, 7% refused treatment; for 8%, the dentist was not comfortable, and for 4% the dentist's attitude became negative; 21% of the PLHIV had already encountered difficulties in finding a dentist including 37% because of their viral status. Among the oral pathologies listed, 23 lesions were identified: 15 (65%) were unrelated to HIV, 4 (17%) were classified stages B/C (1 Kaposi's sarcoma, 1 oral villous leukoplakia, 2 chronic candidiasis), and 4 (17%) were lesions with evolution specifically due to HIV (2 inhomogeneous leukoplakias, 1 cancer, 1 verrucous papilloma). Although 78% of the PLHIV included had a referring dentist, discrimination by dentists toward PLHIV still persists (16% of the PLHIV concerned). 27% of participants did not feel ready to disclose their infection. The resulting lack of follow-up is also a loss of opportunity because while most of the small number of oral lesions diagnosed in this population are related to age or comorbidities, some are serious and need to be identified.

Motives for desiring children among individuals of different sexual-romantic orientations: a cross-sectional study.

Little is known about the reasoning behind the desire to have children in non-heterosexual individuals. This study compares the motives of different sexual-romantic orientations and their preferred ways of fulfilling this desire. This was a monocentric cross-sectional study. Subjects were recruited via social media, personal contacts and queer organisations in Switzerland. An anonymous questionnaire comprised general questions about the participant's background, a validated survey about the desire to have children and additional non-validated questions addressing the impact of sexual-romantic orientation on the desire to have children. The inclusion criteria were adults without children and a completed questionnaire. Of 837 participants, 642 were included in the study. Four groups of sexual-romantic orientations consisted of more than 35 participants: bisexual-biromantic (n = 38), heterosexual-heteroromantic (n = 230), homosexual-homoromantic (n = 159) and pansexual-panromantic (n = 55). Subgroups with a positive wish for a child rated all motives in the same order and with minimal numeric difference. The most important aspect seemed to be emotional involvement. Non-heterosexual-heteroromantic showed concerns about adverse reactions regarding their wish for a child. All orientations hoped for a biological child. Our findings about bi-, hetero-, homo- and pansexual people and their motives for a desire to have children agree with the existing literature about hetero, homo and bisexual. The impact of the fear of adverse reaction and discrimination has been discussed before and is supported by our data. We suggest better support before and during the realization of the wish for a child as well as support for non-traditional aspiring parents.

Microbiological characterization of a population affected by periodontitis with different levels of bone health

ntroduction: Both osteoporosis and periodontitis are diseases characterized by deficits at the level of bone tissue, where bone resorption exceeds neo-formation, resulting in bone loss. Materials and methods: In the context of a monocentric cross-sectional observational study carried out through the collaboration between the University of Florence and the private dentistry institute Excellence Dental Network, 110 subjects affected by periodontitis were recruited. Of these, 71 were also affected by osteoporosis or osteopenia and 39 were not osteoporotic or osteopenic. Data were collected on oral microbiota, oral health and bone health. Results: The collected data reveal a population of frail subjects in terms of fracture risk. The most common forms of periodontitis were essentially chronic in nature, and mainly of a moderate or even severe type, with high gingival recession and periodontal pocket depth values. The microbial species associated with Socransky's red and orange complexes showed concentration values nearly always above 10³ copies/mL. Conclusions: The relationship between osteoporosis and periodontitis still needs to be explored in depth. Data from our analyses are certainly interesting and provide a basis for designing further studies in larger populations. KEY WORDS: Periodontal disease, bone disease, oral microbiota.

Describing the readiness for interprofessional education among university students attending healthcare programs: insights from a monocentric cross-sectional study.

Readiness for interprofessional education (IPE) was recognized by international authorities as a key approach for educating students attending healthcare programs. Thus far, there are no descriptions of readiness for IPE in the Albanian context. For this reason, this study aimed to describe readiness for IPE, assessed by measuring "teamwork and collaboration" and "positive professional identity, roles, and responsibilities" among students attending healthcare programs in an Italian-speaking university based in Albania, and describe the correlations between readiness for IPE and the characteristics of the respondents. This study had a descriptive observational design, a cross-sectional data collection, and a convenience sampling procedure performed in a single centre. The study was accomplished between April 2020 and June 2021, involving 688 students, 38.2% of the entire population of students attending healthcare programs in the context of the investigation. The teamwork and collaboration mean score was 4.40 (standard deviation = 0.56), and no differences were found between programs (p-value=0.159). The positive professional identity, roles, and responsibilities mean score was 4.33 (standard deviation = 0.64) with no differences between programs (p-value=0.340). Females attending nursing or midwifery reported higher positive professional identity, roles, and responsibilities scores (p-value=0.020), and females in dentistry reported higher teamwork and collaboration scores than males (p-value=0.045). Future research should evaluate readiness for IPE longitudinally to ascertain its trajectories over time and analyze any potential individual- or organizational-level variables that may impact IPE and sex-related differences regarding factors influencing IPE.

Defining the physician global assessment threshold equivalent to remission in patients with systemic lupus erythematosus.

The optimal threshold of the physician global assessment (PGA) for remission in SLE has never been evaluated systematically. The aim of this study was to assess the ideal PGA threshold associated with physician remission and to investigate its impact on remission rates in our Lupus cohort. In this monocentric cross-sectional study, patients with SLE were evaluated for physician remission by asking the treating physicians if they considered their patient in remission regardless of objective remission criteria. Further, two objective remission definitions were applied: 1) DORIS remission using a PGA of < 2 (0-10) (corresponding to < 0.5 on a VAS 0-3 used in DORIS); 2) DORIS remission with omission of PGA (modDORIS). A receiver operating characteristic analysis and regression analyses were performed to assess the ideal PGA threshold and factors influencing PGA. Of the 233 patients included, 126 patients (54.0%) were in physician remission, 42.5% in DORIS remission and 67.0% in modDORIS remission. A PGA of < 2 NRS 0-10) had the highest sensitivity (79%) and specificity (81%) for physician remission and modDORIS (AUC 0.85 and 0.69). PGA of patients fulfilling any of the remission definitions was associated with pain and hypocomplementemia. Damage was numerically higher in patients in modDORIS only; no association between PGA and damage was found in regression analysis. Using a PGA threshold of < 2 (0-10), corresponding to < 0.6 (0-3) resulted in best prediction of physician remission. PGA levels seem to be influenced by pain and complement levels but not disease damage.

A cross-sectional study to evaluate hypovitaminosis C prevalence and risk factors in an acute geriatric unit in Lyon, France: the HYPO-VIT-C protocol

IntroductionVitamin C is an essential micronutrient playing crucial roles in human biology. Hypovitaminosis C is defined by a plasmatic ascorbemia below 23 µmol/L and is associated with numerous outcomes such...

Identifying physical and psychological risk factors for musculoskeletal pain in student musicians to tailor the curriculum: a cross-sectional study protocol

IntroductionInsufficient identification and understanding of risk factors make musicians engaging in professional practice particularly vulnerable to musculoskeletal pain. To support positive music learning and good mental, physical, and social health,...

E06 Does GGT level correlate with activity parameters in enthesitis-related arthritis?

Abstract Introduction Enthesitis-related arthritis (ERA) is one of the main subgroups of juvenile idiopathic arthritis. As in the adult population, monitoring of patients with ERA is based on clinical and laboratory evaluation. Some studies showed a correlation between Gamma-glutamyl transferase (GGT) levels and rheumatoid arthritis disease activity markers. Thus, we aimed to evaluate the correlation between GGT levels and ERA activity parameters. Methods This is a cross-sectional monocentric study including patients meeting the International League of Associations for Rheumatology (ILAR) 2001 criteria for ERA. We collected the demographic and clinical data. We assessed the ERA activity using clinical parameters including Patient Global Assessment (PGA), Visual Analogue Scale (VAS), Morning stiffness (MS), tender joint count (TJC), swollen joint count (SJC), active enthesitis count (AEC), clinical sacroiliitis, back mobility, and ocular involvement. We collected biological parameters such as the C-reactive protein (CRP) and the Erythrocyte sedimentation rate (ESR). We calculated the Juvenile spondyloarthritis disease activity (JSpADA). GGT level was measured on the same day. The correlation was evaluated using Spearman’s rho coefficient (r). r-value &amp;lt;0.3 was considered poor; between 0.3 and 0.39, moderate; between 0.4 and 0.69, strong; and &amp;gt;0.7 very strong. Results Thirty patients with a mean age of 15.1 ± 4.1 years, and a ratio-sex of 2.75 were included. The mean disease duration was 4.3 ± 3.2 years. The mean PGA and the mean VAS were 6.2 ± 7.1 and 8.9 ± 2.9 respectively. Mean TJC, mean SJC, and mean AEC were 1.53 ± 2.8, 0.18 ± 0.47, and 1.2 ± 1.6 respectively. Clinical sacroiliitis was found in eight patients, limited back mobility in six, and uveitis in three patients. The mean CRP and ESR were 15.1 ± 22.7 mg/l and 23.8 ± 21.2 mm, respectively. The mean JSpADA was 2.6 ± 1.7. Mean GGT was 14.3 ± 6.6 mg/l. A strong correlation was noted between the GGT level and both CRP (r = 0.504, P = 0.05) and ESR (r = 0.601, P = 0.01). However, no correlation was noted between GGT level and PGA (r = 0.107, P = 0.6), VAS (r = 0.03, P = 0.9), SJC (r = -0.17, P = 0.368), nor JSpADA (r = 0.323, P = 0.87). Conclusion Our results suggest a strong correlation between GGT level and biological ERA activity parameters, unlike clinical parameters and disease activity scores. More studies are needed to confirm these findings. Ethics The authors have no conflicts of interest to declare.

E21 Pain catastrophism in Juvenile Idiopathic Arthritis

Abstract Introduction Catastrophism, or dramatization, is a cognitive and affective response that is based on an inadequate perception of pain. It is characterized by a negative mindset and magnification of pain through the interaction of physiological and psychological processes. Thanks to the development of a pediatric version of the Pain Catastrophizing Scale (PCS), the interest in pain catastrophizing in the pediatric area is progressively increasing. Persistent pain is the most common and bothersome symptom of Juvenile Idiopathic Arthritis (JIA). Our goal was to evaluate pain catastrophism in JIA patients as well as the factors that are associated. Patients and Methods We conducted a cross-sectional monocentric study on 12–18-year-old patients with JIA. Only those who agreed to participate were included. We collected socio-demographic and clinical data including Juvenile Arthritis Disease Activity Score (JADAS) and Patient Global Assessment (PGA). Catastrophism was evaluated by the French version of the Pain Catastrophizing Scale (PCS) adapted for adolescents (PCS-Ado). A PCS score of 30 or more represents a high level of catastrophism. Regarding quantitative variables, the normality of the variables was assessed by the Kolmogorov-Smirnov test. We calculated the median and variance of data with no Gaussian distribution and the mean with Standard deviation in quantitative variables with the normal curve. For the comparison of 2 independent series, we used the Mann–Whitney test for independent series. The Spearman test was used to calculate the correlation coefficient (r) between two quantitative variables. The significance level in all statistical tests was set at 0.05. Results Our study included a total of 20 JIA patients with a male predominance of 65%. The mean age was 14.30 ± 1.87 years and the mean disease duration was 3.39 ± 2.49 years. The Enthesitis Related Arthritis (ERA) form was noted in 50% of JIA patients. The average PGA was 3.86 ± 2.88. Mean JADAS was 6.45 ± 6.05. The PCS-Ado score was 32/52 on average. In 60% of cases, there was a high level of catastrophism (PCS-Ado ≥30). No statistically significant differences were seen in PCS-Ado based on gender, age, disease duration, or JADAS. However, statistical analysis showed that the ERA form had significantly higher PCS-Ado than the non-ERA form (mean PCS-Ado: 36.87 vs 26.75; P = 0.026). We also found a positive correlation between PCS-Ado and PGA (P = 0.026; r = 0.591). Conclusion In our study, more than half of patients with JIA had high PCS scores with a significant relationship to ERA form and PGA. This leads us to systematically detect catastrophist thinking in this population to avoid amplifying pain and installing emotional distress and pain-related disability.

Health-Related Quality of Life and Associated Factors Among Patients With Knee Osteoarthritis.

Knee osteoarthritis, a chronic degenerative disease, is becoming a public health problem around the world due to increasing life expectancy. We aimed to assess the impact of knee osteoarthritis on the quality of life (QoL) of the patients and to identify factors associated with impaired QoL. We conducted a cross-sectional monocentric study including patients with knee osteoarthritis. The pain was evaluated by the Visual Analog Scale (VAS). The short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-PS) was used to assess functional impact. QoL was assessed using the OsteoArthritis of Knee Hip Quality Of Life (OAKHQOL) questionnaire. Fifty patients were included. The mean age of patients was 59 ± 9 years. The sex ratio was 0.25. At least one comorbidity was noted in 77% of patients. The mean disease duration was 8.82 years. Mean VAS pain and KOOS-PS were 6.8 ± 1.1 and 54.7 ± 9.6/100; respectively. Assessment of the QoL by OAKHQOL showed impaired QoL in all domains; the worst scores concerned the areas of social functioning and pain. Factors associated with an altered QoL were age > 65 years, longer disease duration, higher pain intensity, comorbidities, and functional impairment. Our patients showed an impaired QoL in all domains, particularly in terms of physical activity and social functioning. Lower QoL scores were associated with age, comorbidities, pain, function, and disease duration. Factors associated with QoL should be considered in the management program of these patients. Screening and the treatment of comorbidities are also useful for the management of knee OA.

High prevalence of malnutrition in systemic sclerosis: Results from a French monocentric cross-sectional study

ObjectivesSystemic sclerosis (SSc) can cause malnutrition due to frequent gastrointestinal involvement. However, prevalence of malnutrition in SSc is poorly known. The aim of this study was to evaluate the prevalence of malnutrition in SSc and its potential associations with disease features in patients from a tertiary referral center. MethodsAll patients meeting American College of Rheumatology/European Alliance of Associations for Rheumatology criteria for SSc followed between January 1, 1985, and January 1, 2019, at the Department of Internal Medicine, Saint Eloi University Hospital, were included. Malnutrition was assessed using the 2020 French recommendations for SSc and the malnutrition universal screening tool score. Severe malnutrition was defined via the French Haute Autorité de Santé (National Health Authority) 2007 criteria. ResultsA total of 120 patients were included, with mean age 64 (± 15) y and a female-to-male sex ratio of 5:1. According to 2020 French recommendations, 71 patients (59.2%) were malnourished and 30 (25%) had at least one criterion of severe malnutrition. With the malnutrition universal screening tool score, 41.7%, 20%, and 38.3%, respectively, had low, medium, and high risk of malnutrition. Multivariate analysis revealed the following results: 1) malnutrition was associated with cardiac involvement (P < 0.01); 2) a high malnutrition universal screening tool score was also associated with specific cardiac involvement (P < 0.01); and 3) severe malnutrition was strongly correlated with interincisal distance <35 mm (P = 0.02). ConclusionsMalnutrition affects more than half of SSc patients and is associated with specific cardiac involvement. Interincisal distance <35 mm could be a red flag for severe malnutrition in SSc.

Characteristics and Risk Factors of Upper Gastrointestinal Bleeding in Patients on Antithrombotic Therapy: A Prospective Study

Study aims: Evaluate the effect of antithrombotic therapy use on endoscopic outcomes in patients admitted for upper gastrointestinal bleeding. Patients and Methods: This is a prospective monocentric cross-sectional study of 332 patients conducted between June2020 and August 2021.We considered as users of AT drugs all patients on antiplatelet agents (low-dose aspirin, thienopyrimidines) and/or anticoagulants (vitamin K antagonists, direct-acting anticoagulants, heparin). Results: The average age was 59+/−16.7 years. Our series was characterised by a clear male predominance of 77.1%.63 patients (19%) were taking AT drugs (41 antiplatelet, 39 anticoagulant). The two groups differed in age (68 vs 57; p&lt;0.001), comorbidities (75.8% vs 16.7%; p&lt;0.001), however there was no statistically significant difference in active bleeding at endoscopy (12.7%vs 16.8%; p=0.425), and the need for endoscopic haemostasis (7.9%vs 16%; p=0.1).In multivariate analysis and adjusting for age, sex, comorbidities, presence of active bleeding and use of antithrombotics, only the presence of active bleeding could predict the need for endoscopic haemostasis. Indeed, the presence of active bleeding at the time of endoscopy multiplies by 26 the risk of recourse to endoscopic haemostasis (OR: 26, CI: 12.9–62.15, p&lt;0.001), whereas the use of AT drugs does not influence the need for endoscopic haemostasis (OR: 0.386, CI: 0.105- 1.42, p=0.154). Conclusions: Older patients using AT admitted for UGIB do not appear to have an increased risk of active bleeding at endoscopy or needing endoscopic haemostasis.