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Background The role of the nursing consultation in rheumatology is becoming more prevalent, especially in patient monitoring, reducing the burden of care of rheumatologists in many cases where in-person consultation with the rheumatologist is not required. Objectives To analyze the usefulness of telephone consultation to nursing staff to resolve doubts and/or health incidents to rheumatic patients and to assess the involvement of physicians on it. Methods We collected clinical data for the period between June 2012 and January 2013 of all telephone consultation received in the nursing department: clinical and laboratory data, number of calls, characteristics of the proposed consultation and its resolution, and involvement of the rheumatologist in consultations. Results We registered 122 telephone consultations, in which 77% of cases the nursing staff resolved the consultation (72% of them require the nurse consultant support by the rheumatologist) and in 88.5% of all consultations have required an additional call from the nursing. From the 23% of the queries unresolved by nurses (n=28), 19 cases required telephone consultation with the patient’s rheumatologist, and 7 cases were derived to an in-person appointment with the doctor (5 cases the rheumatologist, 1 to Emergency door and 1 to Primary Care). Patients who performed telephone consultations are mostly diagnosed as rheumatoid arthritis (40.2%), ankylosing spondylitis (13.1%) and systemic lupus erythematous (9.8%). 49.2% of the patients were treated with methotrexate, and 35.3% received biologic therapy. Consultations by patients are for different reasons, but the 22.9% of consultations were supply problems in medication, 19.7% were disease outbreaks and 9.8% to check analytical results. Conclusions Telephone consultation to nurse staff contributes greatly to answer questions from patients about disease outbreaks, as well as problems in treatment and/or analytical results, without the presence of the rheumatologist. It also prevents unnecessary movement of patients, reducing the number of telephone consultations and medical attendance, and helping manage health hospital resources effectively. Disclosure of Interest None Declared

Water is one of the most important resources in the world, but its contamination has remained a serious environmental problem due to advances in industrialization, agriculture, urbanization and overpopulation. The present work is focused on recognizing environmental parameters in the sewage of a tannery industry located in Salcedo, Ecuador and hopefully avoid the effects that could be caused by it in the future. A total of 20 water samples were collected and transported according to Ecuadorian standards and regulations. Three different sampling points were chosen (located approximately 100 m apart) as well as three different days and two different times as factors for the experimental design. Water samples were transported to an independent laboratory for analysis. Parameters COD, BOD5, dissolved oxygen, and surfactants were analyzed by volumetry techniques and UV-VIS spectrophotometry. Parameters pH, flow and temperature were measured in situ. Analysis of variance was run on the resulting data (95% confidence). It was concluded that all parameters exceed official Ecuadorian thresholds, except for temperature and flow. This information is expected to be used as an alert for local regulators.

Background:Objectives:Analyse the effect of secukinumab in terms of the patient´s own variables, specifically: fatigue, sleep, pain and quality of life in patients with psoriatic arthritis or spondyloarthritis.Methods:A multicentric longtitudinal observational prospective study was carried out at 6 months in patients who begin treatment with secukinumab. At the start and after 6 months the following data was collected on the outcome: pain through an visual analogue scale (VAS), fatigue using the FACIT-fatigue scale, sleeping problems using the insomnia severity index (ISI) and quality of life with the EuroQol-3L-5D and the PsAQoL.The sample can be described in terms of the distribution of the variables through measures of central tendency.It was analysed if the change after 6 months was statistically relevant using Student´s t-test for paired data in the case of FACIT, VAS, PsAQoL and ISI and chi-squared for the dimensions of the EQ-5D. The size of the effect of each of the measurements taken was calculated using Cohen’s D. the results are given grouped by disease and globally. The analysis was carried out using Stata v12 (College Station Tx, USA)Results:In table 1, the changes in the scales of normal distribution can be seen. Apart from general VAS, all the scales experience significant relevant changes. The PROs preferred by the patient with the best therapeutic response is the quality of sleep. The adjustment of the regression models does not produce changes in the results, apart from small adjustments to the condidence intervals (final column table 1). The subdomain in which the most significant change in the EQ-5D is produced is in that of pain and discomfort.Conclusion:After 6 months patients who begin treatment with secukinumab, present with improvements in all sizes of the effects of the treatment in the various studied scales. The improvement achieves global and generalised statistical significance after 6 months of study. The greatest effect is on sleep, quality of life and fatigue.The measurements of the outcomes reported by the patients are a clinical value added to our objective evaluations of the health and activity of the disease, and allow us, in a more integrated and comprehensive manner, to undertake a more exact and close evaluation of their state of health and wellbeing.Disclosure of Interests:JUAN JOSE LERMA: None declared, Antonio Gracia: None declared, Antonio Perez: None declared, Amalia Rueda: None declared, Clara Molina: None declared, M. Dolores Pastor: None declared, Isabel Balaguer Trull: None declared, Inmaculada Valiente: None declared, Cristina Campos Fernández: None declared, Javier Calvo: None declared, Loreto Carmona Grant/research support from: Novartis Farmaceutica, SA, Pfizer, S.L.U., Merck Sharp & Dohme España, S.A., Roche Farma, S.A, Sanofi Aventis, AbbVie Spain, S.L.U., and Laboratorios Gebro Pharma, SA (All trhough institution)

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