Rheumatoid Arthritis: Vujasinović-Stupar N

Obradović-Tomasević B, Vujasinović-Stupar N, Tomasević R. · Internisticka klinika, Klinicko-bolnicki centar Zemun, Zemun. · Med Pregl. · Pubmed #19368280 No free full text.

Abstract: INTRODUCTION: In the last three decades numerous epidemiologic studies have shown the correlation between risk factors and cardiovascular diseases. Clinical research has proven that rheumatoid arthritis patients (RA) have higher prevalence of classical risk factors in relation to general population, and over the last few years there has been an emphasis on some new risk factors which can contribute to cardiovascular diseases (CVD). MATERIAL AND METHODS: This study examined risk factor values for CVD in 88 patients with RA treated at Rheumatology Department, Clinical Hospital Centre, Zemun. All patients have been thoroughly examined (clinical findings, laboratory and echocardiographic examination). Apart from classical factors, "new" risk factors have been examined in all patients: C-reactive proteine (CRP), high-sensitive C-reactive proteine (hs-CRP) and homocystein. RESULTS: It has been determined that RA patients have more frequent higher new risk factors in comparison to classical ones. 84.1% of patients had higher CRP values, 97.1% had hsCRP and 39.5% had homocystein. The mean CRP values, especially hsCRP have been higher in patients with positive rheumatoid factor finding. DISCUSSION: Rheumatoid arthritis patients may have worse "background atherosclerosis" than even subjects matched for classical cardiovascular risk factors. Continuous exposure to high grade systemic inflammation may be linked to accelerated atherosclerosis. CONCLUSIONS: Timely identification of patients with risk factors, particularly with new risk factors, enables adequate approach in prevention of and treatment for CVD in rheumatoid arthritis patients.

Mustur D, Vesović-Potić V, Vujasinović-Stupar N, Ille T. · No affiliation provided · Srp Arh Celok Lek. · Pubmed #18959175 No free full text.

Abstract: INTRODUCTION: Rheumatoid arthritis (RA) is a chronic constantly deteriorating disease of unpredictable clinical course, with exacerbations, remissions and damaged joints. It leads to the loss of self-sufficiency, independence in performing many daily activities, decrease of working ability and invalidity. Beside physical factors, which are regarded as most responsible for the poorer quality of life of RA patients, psychological changes are also significant, such as the feeling of helplessness, hopelessness and depression. The goal of the treatment of patients with RA is to decrease illness symptoms, slow down the development of illness progression, improvement of physical functioning and provision of expert help to the RA patients to adapt to life. OBJECTIVE: The aim of the study was to assess the influence of spa therapy on the functional condition and life quality of RA patients. METHODS: The study involved 69 patients with RA (51 female and 18 male, on average aged 55.2 +/- 11.4 years, with illness duration 12.5 +/- 7.5 years), and were a part of a cohort from Norway, suffering of inflammatory rheumatism. All the patients came for four-week rehabilitation at the Institute for Physical Medicine, Rehabilitation and Rheumatology "Dr. Simo Milosević" in Igalo, Montenegro. The RA patients underwent treatment with mud compresses, mud, mineral and pearl baths, as well as with underwater shower massage (balneotherapy) kinesitherapy and certain forms of electrotherapy with analgesic effects. The evaluation was done on admission and after completed physical therapy when we assessed RA patients' functional condition and quality of life. The functional condition was determined using the Modified Health Assessment Questionnaire (MHAQ), and the quality of life using the Medical Outcomes Study Short Form 36-item Questionnaire (SF-36), which encompassed eight life domains. RESULTS: After completion of 28-dayspa therapy, RA patients showed a significant improvement in functional condition. Their quality of life was significantly improved in all dimensions of SF-36 Questionnaire (p < 0.01), and the functional status (MHAQ score) was also significantly better (p < 0.01). CONCLUSION: Balneotherapy, together with climatic factors in Igalo, leads to a significant improvement of functional status and quality of life in patients suffering from RA.

Mustur D, Vujasinović-Stupar N, Ille T. · No affiliation provided · Srp Arh Celok Lek. · Pubmed #18720741 No free full text.

Abstract: INTRODUCTION: This is an open uncontrolled study about effects of physical treatment on disease activity parameters of patients with rheumatoid arthritis and psoriatic arthritis. OBJECTIVE: The aim of the study was to establish if there was any improvement of disease activity parameters after four weeks of physical and spa treatment. METHOD: We compared morning stiffness, tender and swollen joint count, body pain level and Disease Activity Score 28 (DAS-28) in patients with rheumatoid and psoriatic arthritis, and assessed the effect of physical and spa treatment on those parameters. The research encompassed 109 patients: 69 with rheumatoid arthritis (RA group) and 40 with psoriatic arthritis (PA group). They were from Norway, staying for four weeks in June-September 2003. The groups served as their own controls--"one group pre-test post test" study. Disease activity measurement was made twice: at the beginning and at the end of treatment. The therapeutic set consisted of mud applications, kinesitherapy, mineral water pool and electrotherapy. RESULTS: At the beginning there was no significant difference in observed disease activity parameters between patients with rheumatoid and psoriatic arthritis (p > 0.05). After four weeks of physical and spa treatment disease activity was significantly reduced in all observed parameters in both groups: morning stiffness (p < 0.001 RA + PA), tender joint count (p < 0.01 RA + PA), swollen joint count (p < 0.01 RA; p < 0.05 PA), body pain (p < 0.01 RA + PA) and DAS-28 score (p < 0.01 RA+PA). CONCLUSION: Physical and spa treatment, together with climatic factors in Igalo, lead to a significant reduction of disease activity parameters of patients suffering from rheumatoid arthritis and psoriatic arthritis.

Mustur D, Vujasinović-Stupar N. · Institut za fizikalnu medicinu, rehabilitaciju i reumatologiju Dr Simo Milosević, Igalo. · Med Pregl. · Pubmed #17988056 No free full text.

Abstract: INTRODUCTION: This open, uncontrolled study examined the effects of physical therapy and rehabilitation on the quality of life in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). MATERIAL AND METHODS: The study included a total of 109 patients (69 with RA and 40 with PsA). Patients came from Norway for a four-week rehabilitation period at the Institute of Physical Medicine, Rehabilitation & Rheumatology--Igalo from June till October, 2003. This was a self-controlled, pretest/posttest study. All patients had six days of physical therapy per week, during a four-week stay, which made a total of 24 therapy days. Basic therapy included mud packs/baths, kinesitherapy, hydrokinesitherapy and electrotherapy with analgesic effects. Quality of Life measurements were conducted two times (on admission and discharge) using questionnaire EuroQoL (EQ-5D). The research also included evaluation of ACR improvement. RESULTS: Pain/disability scale and the well being scale showed that quality of life in patients with PsA was significantly lower in comparison with RA patients. However, after 4 weeks, quality of life was much better in most dimensions of the EuroQoL questionnaire. Patients showed no improvement in self-care activities (in both group.) and daily activities (in group with PsA). Significant improvement was measured also in ACR improvement criteria (around 30%). CONCLUSIONS: Physical therapy at the Igalo Institute and good climate conditions have significantly improved the Health-Related-Quality-of-Life in both groups of patients. ACR index showed great