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Background:The chronic nature of rheumatic diseases has a negative impact in quality of life. Pain and loss of function in the upper extremity cause a progressive difficulty to perform daily activities, often requiring integral physical rehabilitation programs. Anthropometric measurements habitually take prolonged periods of time, given the extensive nature of physical examination in rheumatic patients. It is unknown which factors are most efficient to better reflect the functional status of the rheumatic patient.Objectives:Determine the most efficient anthropometric measurements in the upper extremity to assess the functional status of rheumatic patients in rehabilitation programs.Methods:Thirty-six patients were recruited from Rheumatology consultation of University Hospital “Dr. José Eleuterio González” in Monterrey, Mexico. Patients had a complete physical examination by a board-certified rheumatologist, which referred patients to Physical Rehabilitation consultation if necessary. A cross-sectional study was carried out in these patients with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (1), measurement of ranges of motion (ROM) and hand strength with the Mathiowetz protocol (2). Analysis was performed through Principal Components Analysis including Total Variance Explained (TVE), Rotated Component Matrix (RCM) and dendrograms.Results:From the total of patients, 34 (94.4%) were women with a mean age of 34 years (SD 11.33). The most common diagnosis was rheumatoid arthritis (47.2%) followed by osteoarthritis (8.3%). The mean disability score in DASH was 29.3% (DE 23.36). The TVE analysis found that 3 elements explained 48.6% of the total variance, and 13 elements explained 89.4%. RCM correlations among hand strength parameters ranged from 0.51 to 0.93, whereas ROM correlation values were below 0.4. Graph 1 depicts data dispersion for ROM, grip strength and pinch gauge by dynamometer.Graph 1.Two main clusters are observed in the RCM plot of the data. In the center and superior to the x axis, a conglomeration corresponding to ROM is shown, consisting of radial and ulnar deviation; flexion, extension, abduction and adduction in carpal bones, metacarpophalangeal joints, and proximal and distal interphalangeal joints of the five fingers of both hands, accordingly. To the right and across the x axis, another cluster depicts the grip strength and tip, key, and lateral pinch gauge of the fingers according to the Mathiowetz protocol. Closeness of data points portray a higher similarity among variances in the second cluster.Conclusion:Hand strength is the most efficient parameter to assess the functional status of the upper extremity in rheumatic patients in rehabilitation programs.References:[1]Arreguín Reyes, R., López López, C. O., Alvarez Hernández, E., Medrano Ramírez, G., Montes Castillo, M., & Vázquez-Mellado, J. (2012). Evaluation of hand function in rheumatic disease. Validation and usefulness of the Spanish version AUSCAN, m-SACRAH and Cochin questionnaires. Reumatologia clinica, 8(5), 250–254. https://doi.org/10.1016/j.reuma.2012.03.005[2]Mathiowetz, V., Kashman, N., Volland, G., Weber, K., Dowe, M., & Rogers, S. (1985). Grip and pinch strength: normative data for adults. Archives of physical medicine and rehabilitation, 66(2), 69–74.Disclosure of Interests:None declared

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Background:Patients with rheumatic diseases (RD) are at increased risk of infections, attributed to the underlying RD, comorbidities and immunosuppressive therapy, including glucocorticoids, disease-modifying antirheumatic drugs, etc. (1). While many infectious diseases can generally be prevented by vaccines, immunization rates in this specific patient population remain suboptimal (2). Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs (3).Objectives:To describe the main causes of non-vaccination in patients with RD.Methods:A self-questionnaire was applied to a sample of patients with RD in the rheumatology clinic of the university hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico between September and December 2019. The questionnaire evaluated demographic characteristics (age, gender, diagnosis) and the vaccination status for Influenza (last year), pneumococcal (last 5 years), Herpes zoster (ever), Human papillomavirus (any dose) and Hepatitis B (any dose). It also includes a question asking: If you didn’t receive any of the previous vaccines, what was the reason? (multiple-choice are shown in Table 2). Results are shown in frequencies and percentages.Table 2.Vaccination barriersN=82If you didn’t receive any of the previous vaccines,what was the reason? n (%)1)Did not was recommended22 (26.8)2) Lack of availability21 (25.6)3) Vaccines don’t work13 (15.8)4) Fear of adverse events8 (9.7)5) Previous adverse event3 (3.6)6) Other reason- Own decision8 (9.7)- Disinformation7 (8.5)Results:102 patients were evaluated: Mean age was 51.27 (SD 14.68) years; 84 (82.4%) were females; 71 (69.6%) had rheumatoid arthritis, 13 (12.7%) had systemic lupus erythematosus, 6 (5.8%) had other autoimmune diseases and 12 (11.8%) had osteoarthritis. The rate of vaccination for Influenza was 49 (48%), for pneumococcal 25 (24.5%), for Herpes zoster 5 (4.9%), for Human papillomavirus 9 (8.8%), for Hepatitis B 14 (13.7%) (Table 1). 82 (80.3%) patients reported some barriers in vaccination, from these: 22 (26.8%) did not get the recommendation from the rheumatologist, 21 (25.6%) did not found available the vaccine, 13 (15.8%) believes that vaccines don’t work, 8 (9.7%) had fear of adverse events, 3 (3.6%) reported previous adverse events, and 15 (18.2%) reported other reasons, that we classified as own decision 8 (9.7%) and disinformation 7 (8.5%) (Table 2).Table 1.Demographic characteristicsN= 102Age, years, mean (SD)51.27 (14.68)Female, n (%)84 (82.4)Diagnosis, n (%)-RA71 (69.6)-SLE13 (12.7)-OA12 (11.8)-Other AID6 (5.8)Conclusion:The main barriers in vaccination of rheumatic patients reported were the lack of availability of the indicated vaccines and the medical and patient disinformation. This problem must be combated to ensure the complete vaccination of rheumatic patients.References:[1]Ann Rheum Dis. 2020;79:39-52.[2]J Rheumatol. 2019;46(7):751-754[3]Hum Vaccin Immunother. 2013;9(8):1763-73.Disclosure of Interests:None declared

Background:Vaccines are one of the safest and effective public health interventions (1). Patients with rheumatic diseases (RD) have a higher risk of morbidity and mortality from vaccine-preventable infections (2). Seasonal Influenza vaccination (SIV) had shown to reduce the incidence, complications, admissions, and mortality from Influenza in patients with RD (3). Vaccine hesitancy is one of the threats to global health established by the WHO.Objectives:To assess the knowledge and attitudes of rheumatic patients about SIV.Methods:A self-questionnaire was applied during a community speech for rheumatic patients in October 2019 and also was applied in the rheumatology clinic of the university hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico, between November and December 2019. The questionnaire asks age, rheumatic diagnosis, and ten questions. Results are shown in descriptive statistics, the Chi-square and Mann-Whitney U tests were performed to compare groups. A P-value ≤0.05 was considered statistically significant. Analyses were performed using SPSS version 22.0.Results:A total of 205 self-questionnaires were applied. 122 (59.5%) in the community speech and 83 (40.5%) in the clinic. The median age was 55 (45.75-62.25) years in the community population and 44 (28-59) years in the clinic, also the diagnosis distribution was different (Table 1). Most patients considered that rheumatic patients can be vaccinated. About 80% of patients have ever been vaccinated for seasonal influenza. 87.7% and 77.1% considered that SIV is safe and effective. About 85% of patients considered SIV the best way to avoid complications of Influenza. About 40% considered not safe to be vaccinated for influenza and other vaccine at the same time. 23.8% and 48.2% considered that SIV weakens the immune system and renders it susceptible to infections. Most of the patients know that SIV is free. 23.0% and 42.2% consider other measures better than SIV. 17.2% and 33.7% considered that SIV will get them worse instead of helping them, and 9.0% and 14.5% think that his RD will get worst with SIV.Table 1.Population CharacteristicsCommunityN= 95ClinicN= 83PAge, years, median (IQR)55 (45.75-62.25)44 (28-59)0.001*Diagnosis, n (%)-RA67 (70.5)46 (55.4)0.037*-OA14 (14.7)7 (8.4)0.194-SLE3 (3.2)11 (13.3)0.013*-Other AID8 (8.4)8 (9.6)0.780-Other NAID3 (3.1)11 (13.2)0.012*Conclusion:Misinformation about SIV is patent among rheumatic patients. It is a big challenge to clarify these myths to gain confidence about his safety and effectiveness and provide his benefits.References:[1]Hum Vaccin Immunother. 2013;9(8):1774-1778.[2]Hum Vaccin Immunother. 2018;14(6):1311-1322.[3]Ann Rheum Dis. 2020;79:39-52Table 2.QuestionnaireCommunityN= 122 (%)ClinicN= 83 (%)P1. Can rheumatology patients be vaccinated?Yes114 (93.4)75 (90.4)0.420No8 (6.6)8 (9.6)2. Have you ever been vaccinated for Influenza?Yes97 (79.5)68 (81.9)0.668No25 (20.5)15 (18.1)3. Influenza vaccine is safe and effective:Yes107 (87.7)64 (77.1)0.045*No15 (12.3)19 (22.9)4. The best way to avoid compilations of influenza is by using SIV:Yes104 (85.2)71 (85.5)0.953No18 (14.8)12 (14.5)5. It is safe to be vaccinated for Influenza and other vaccines at the same time:Yes73 (59.8)48 (57.8)0.774No49 (40.2)35 (42.2)6. SIV weakens the immune system and renders it susceptible to infectionsYes29 (23.8)40 (48.2)<0.001*No93 (76.2)43 (51.8)7. Do you know that SIV is freely provided?Yes115 (94.3)76 (91.6)0.453No7 (5.7)7 (8.4)8. Herbal medications, traditional medicine and some food (like orange) are better than SIV:Yes28 (23.0)35 (42.2)0.003*No94 (77.0)48 (57.8)9. SIV instead of helping me will get me worst:Yes21 (17.2)28 (33.7)0.006*No101 (82.8)55 (66.3)10. SIV will worst my rheumatic disease:Yes11 (9.0)12 (14.5)0.226No111 (91.0)71 (85.5)Disclosure of Interests:None declared