Rheumatoid Arthritis: Romicka AM

Romicka AM. · Klinika Reumatologii Wieku Rozwojowego Instytutu Reumatologicznego w Warszawie. · Pol Merkur Lekarski. · Pubmed #11995256 No free full text.

Abstract: In recent years a new nomenclature and classification childhood chronic arthritis has been introduced. The terms juvenile chronic arthritis and juvenile rheumatoid arthritis--have been replaced by juvenile idiopathic arthritis (JIA). The term JIA was adapted to indicate a childhood onset (before the 16th. birthday) characterized primarily by arthritis lasting for at least 6 weeks, and the cause haven't been found so far. In this paper the diagnosis and clinical course systemic arthritis, polyarthritis and oligoarthritis were characterized. The current therapeutic approach to JIA consists a complex management as the administration of antiinflammatory, immunosuppressive and immunomodulatory drugs--as well as rehabilitation.

Gutiérrez-Suárez R, Pistorio A, Cespedes Cruz A, Norambuena X, Flato B, Rumba I, Harjacek M, Nielsen S, Susic G, Mihaylova D, Huemer C, Melo-Gomes J, Andersson-Gare B, Balogh Z, De Cunto C, Vesely R, Pagava K, Romicka AM, Burgos-Vargas R, Martini A, Ruperto N, Anonymous00034. · IRCCS G. Gaslini, Università di Genova, Pediatria II - Reumatologia, Largo Gaslini, 5 16147 Genova, Italy. · Rheumatology (Oxford). · Pubmed #16877459 links to  free full text

Abstract: OBJECTIVES: To compare health-related quality of life (HRQL) and to identify clinical determinants for poor HRQL of patients with juvenile idiopathic arthritis (JIA) coming from three geographic areas. METHODS: The HRQL was assessed through the Child Health Questionnaire (CHQ). A total of 30 countries were included grouped in three geographic areas: 16 countries in Western Europe; 10 in Eastern Europe; and four in Latin America. Potential determinants of poor HRQL included demographic data, physician's and parent's global assessments, measures of joint inflammation, disability as measured by Childhood Health Assessment Questionnaire (CHAQ) and erythrocyte sedimentation rate. Poor HRQL was defined as a CHQ physical summary score (PhS) or psychosocial summary score (PsS) <2 S.D. from that of healthy children. RESULTS: A total of 3167 patients with JIA, younger than 18 yrs, were included in this study. The most affected health concepts (<2 S.D. from healthy children) that differentiate the three geographic areas include physical functioning, bodily pain/discomfort, global health, general health perception, change in health with respect to the previous year, self-esteem and family cohesion. Determinants for poor HRQL were similar across geographic areas with physical well-being mostly affected by the level of disability while the psychosocial well-being by the intensity of pain. CONCLUSION: We found that patients with JIA have a significant impairment of their HRQL compared with healthy peers, particularly in the physical domain. Disability and pain are the most important determinants of physical and psychosocial well-being irrespective of the geographic area of origin.

Romicka AM, Ruperto N, Gutowska-Grzegorczyk G, Musiej-Nowakowska E, Wyszynska E, Anonymous00078. · Institute of Rheumatology, Paediatric Clinic, Ul. Spartanska 1, 02 637 Warsaw, Poland. · Clin Exp Rheumatol. · Pubmed #11510314 No free full text.

Abstract: We report herein the results of the cross-cultural adaptation and validation into the Polish language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Polish CHAQ CHQ were fully validated with 1 forward and 1 backward translation. A total of 30 subjects were enrolled: 17 patients with JIA (35% systemic onset, 18% polyarticular onset, 29% extended oligoarticular subtype, and 18% persistent oligoarticular subtype) and 13 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Polish versions of the CHAQ-CHQ are reliable, and valid tools for the functional, physical and psychosocial assessment of children with JIA.