Background:Knee osteoarthritis (OA) is an increasingly common and disabling problem in worldwide. Exercises are considered the cornerstone of non-surgical management of knee OA and is recommended in all current clinical guidelines. The diversity of exercise programs determines the need to compare their efficiency, in order to recommend the best option for the patient.Objectives:The aim of the present study was to compare the effect on knee functionality of conventional exercises program and combinate with manual therapy in patients with knee osteoarthritis.Methods:164 patients that fulfilled the ACR classification criteria for knee osteoarthritis (127 females and 37 males) ranging in age from 42 to 84 years (mean 62,2 SD 8,76), participated in a 10 days two-arm randomized trial. One group (Gr.1) received an exercises program, the other group additionally manual therapy methods (Gr.2). Pain and function were measured with a Visual Analogue Scale (VAS, mm) and Knee Injury and Osteoarthritis Outcomes Score (KOOS) with 5 domains (Pain, Symptoms, Activity in Daily Living (ADL), Sport and recreation (Sport/rec.) and Quality of life (QoL)).Results:In the Gr.1 were 82 patients mean age 61,8±9,2 years and in Gr.2 – 82 patients 62,7±8,3 years (p>0.05). The initial level of pain (63,4±14,2 vs 60,2±18,8mm) and knee functionality according to KOOS (Tab1.) were similar in both groups, p>0.05. After 10 days rehabilitation program, VAS in Gr.1 was 39,6±14,8 mm, in Gr.2- 28,5±11,6 mm, (p<0.01). The KOOS results at the end of the rehabilitation program were with improvement, statistically significative in the Gr.2 (p<0,05).Table 1.The KOOS results at baseline and after 10 days of rehabilitation program.KOOS scales(M±SD), %Group 1Group 2BaselineAfter 10 daysBaselineAfter 10 daysPain55,5 ±13,863,4±13,653,0±22,364,3±19,1Symptoms59,0±18,765,6±18,156,6±19,069,0±15,9ADL46,3±15,554,5±16,043,0±19,955,1±18,2Sport/rec15,6±17,323,1±19,616,0±24,330,5±23,6QoL29,3±22,236,5± 22,934,8±23,950,6±18,9Conclusion:The reduction of pain and recovery of function were found in both groups, with better results in patients who received manual therapy and exercises program. This study supports the routine manual therapy in rehabilitation program in patients with knee osteoarthritis.Disclosure of Interests:None declared.

As compared to the incidence in general French population, invasive PI was 26 times more frequent in SLE patients. PI occurred at a younger age (43.5+14.9 versus 65.3+18.7 years, p=0.009) and was more severe, with a higher frequency of invasive infection (p<0.001) and higher need for ICU admission (p=0.015) in SLE as compared to non SLE patients. Of note, unusual PI sites, including pneumococcal endocarditis (n=1), arthritis (n=1) and peritonitis (n=1) were observed in SLE patients only. Risk factors associated with PI in SLE patients were a serum gammaglobulin level <5g/L (p=0.003) and a past history of lupus nephritis (p=0.047), only. Steroids (p<0.001) and immunosuppressive drugs (p=0.027) were associated with infection severity. Conclusions: Pneumococcal infections occur at a younger age, are more frequent and severe in SLE patients. Hypogammaglobulinemia and lupus nephritis increased the risk for PI, whereas steroids and immunosuppressive drugs were associated with infection severity only. Our study shows that SLE patients have an increased risk for invasive PI and points to the need for vaccination against streptococcus pneumoniae in SLE.

BackgroundIdiopathic Inflammatory Myopathies (IIM) are the group of rare diseases that carry a significant impact on patient's quality of life, influenced by the level of patient's satisfaction regarding medical services.ObjectivesTo assess the patient's satisfaction and quality of life.MethodsA cross-sectional study was performed from December 2015 to December 2016. There were included consecutive patients that fulfilled the Bohan and Peter1 criteria for IIM. The collected information was about demographic data, clinical and laboratory findings. The patient's satisfaction was assessed by self-administered Patient Satisfaction Questionnaire (PSQ III)2, which is a 50-item tool, covering 7 domains: general satisfaction, technical quality, interpersonal aspects, communication, financial aspects, time spent with doctor, access/availability/convenience. To estimate the quality of life we applied Short Form-8 questionnaire with 8 items for 8 domains and two components: mental and physical.ResultsThere were 32 patients enrolled in the study, including 23 females and 9 males, mean age 52.5±14.26 (range 25–78), the disease duration was 8.3±5.3 (range 0.5–12) years. The physical component was lower 37.49±8.49, than the mental component 44.96±6.24 points, we determined that the quality of patient's life was reduced. The PSQ III results were: general satisfaction 20±2.93, technical quality 36.8±5.93, interpersonal aspects 26.50±4.92, communication 19.7±3.25 and access/availability/convenience indicated 44.75±6.29 score. The time spent with doctor was 7±1.15, a border score. The average result in the financial aspects domain was 21.6±6.6, lower than the midpoint scoring (24). We identified correlation between the quality of life and the access/availability/convenience PSQ III domain. For the mental compound the correlation was moderate (r=0.5 p<0.005) and for physical domain it was weak (r=0.27 p<0.005), these results can be explained by the fact that patients got accustomed with the disease, but they are more interested in access to care and require increasement of the duration of medical consultation.ConclusionsPatients with idiopathic inflammatory myopathies have reduced quality of life; however they are satisfied of the medical attendance. The dissatisfaction was with the financial aspect, due to the long-term disease course and high indirect costs.References Bohan A, Peter JB. N Engl J Med 1975 Feb 13;292(7):344–7.Ware J.Jr. et al. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983; 6(3–4): 247–63. Disclosure of InterestNone declared

BackgroundPatients with systemic lupus erythematosus have a very high burden of comorbidities. Identification and management of these comorbidities are critical for optimal medical care to this population.ObjectivesTo assess the prevalence of comorbidities in SLE patients with pulmonary involvement.MethodsIn a cross-sectional study, patients who fulfiled the SLICC (2012) classification criteria for SLE, were recruited from Rheumatology Departement. Data collection included demographics, disease duration, physician-rated indices of disease activity (by SLAM), damage (by SLICC/ACR DI) and Charlson comorbidity Index. The pulmonary involvement was assessed by chest X-ray, EcoCG Doppler and pulmonary functional tests.ResultsThe study included 106 patients (97 women, 9 males) with a mean age (±SD) of 41,1±12,6 yrs, mean disease duration of 90,3±87,3 months. The disease activity by SLAM was 11±5,17 points and mean SLICC/ACR DI 1,9±2,4 points (66% of patients had at least 1 point). Pulmonary assessment revealed that 45 (42,5%) patients had different types of pulmonary involvement due to lupus: pleuritis - 24 patients, pneumonitis – 1 patient, pulmonary embolism – 4 patients, interstitial lung disease – 15, shrinking lung syndrome – 1 and pulmonary arterial hypertension – 9 patients. The most frequent comorbidities in study group were: arterial hypertension - in 57 (53,7%) cases, from which 33 (57,9%) patients had pulmonary involvement and 24 (42,1%) without, obesity (BMI>30 kg/m2) had 29 (27,4%) patients, from which 17 (58,6%) with lung involvement and 12 (41,4%) without, anemia (Hb<110g/l) had 24 (22,6%) patients, from them 14 (58,3%) with lung disease and 10 (41,7%) patients - without, heart failure (I-II NYHA) had 23 (21,7%) patients, from them 20 (86,9%) were with lung implication, thyroiditis had 22 (20,8%) and 15 (68,2%) of them were with pulmonary involvement, diabetes mellitus type II had only 6 (5,7%) patients and half of them had lung disease. Assessing the impact of associated diseases through Charlson comorbidity index, we found that the score for patients diagnosed with damage to the respiratory system was twice as big vs. patients without respiratory impairment from SLE (6,3±2,4 vs. 3,4±1,4 points). Also, Charlson comorbidity score ≥1 was identified as a risk factor for lung involvement (OR 5,5294, 95% CI 2,367 – 12,91, p<0,01). Evaluation of disease activity by SLAM showed that patients with lung involvement have a higher disease activity vs. patients without (13,9±6,0 vs. 8,9±4,0, p<0,05).ConclusionsOn the one hand, according to our results patients with SLE and pulmonary involvement have a higher prevalence of comorbidities comparative with patients without them. Hypertension was found to be the most common comorbidity and it was determined in 73,3% of patients with impaired respiratory system (p<0,01). On the other hand, association of comorbidities (Charlson comorbidity score ≥1) was identified as a risk factor for lung lesions.References Rees F., Doherty M., Grainge M. et al. The Burden of Comorbidity ...

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