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BackgroundOver the years, the number of patients with an affected hip joint has been increasing. The pathology of the illness is moving towards a younger age and often handicaps the patients. As their age increases, the symptoms become more acute and endoprosthesis is required. With the complex rheumatologic and physiotherapy treatment, a surgery intervention can be postponed in time, and the symptoms significantly reducedObjectivesTo measure the effect of conducting a one-year complex drug treatment combined with a physiorehabilitation program in patients with hip joint osteoarthritis.MethodsBetween 2010 and 2014, 147 patients with coxarthrosis were hospitalized and treated at the Rheumathology Ward at UMHAT “Georgi Stranski” – Pleven. 58 of them were male and 89 female, aged between 42 and 81, with active arthrosis (ESR<25 mm, fibrinogen and CRP at relevant values, AST and RF (-).In addition to the drug therapy with NSAIDs and chondoprotectors, the patients also undergo a complex physical and rehabilitation program consisting of: electrostimulation, therapeutic massages, kinesitherapy and ergotherapy.Functional tests and measurements were made for the purpose of the study: the movement volume in the affected joints, VAS for the pain, locomotion tests, necessity for any walking aids.ResultsAn individual patient file is created for every patient where his results from the tests and measurements are stored in order to track the patient's condition over the course of one year (which consists of treatment in the Rheumathology ward, treatment in the Medical Rehabiltation ward and ambulatory physiorehabilitation courses).The Wilcoxon rank test (a statistical method for analysis and spreading of non-parametric data) was used to measure the daily activities test results. The Wilcoxon curve shifts to the right, which indicates an improvement of the patients' self-sufficiency and of their quality of life. When applying the VAS test for pain and goniometry, the average values at the beginning and at the end of the observed period are measured and compared. The results show a pain decrease by around 30%, and an increase in the joint movement volume. The ANOVA statistical analysis method was applied to the results of the locomotion test.ConclusionsThe collaboration between rheumatologists and physiotherapists for treatment of patients with coxarthrosis widens the range of daily activities that the patients can perform without experiencing pain, slows down the progression of the deterioration process and makes the daily life of patients more complete and self-sufficient.For patients who are still at working age, the duration of their temporary inability to work is decreased, and they can resume working activities sooner, or they can acquire new professional skills with a lower degree of physical stress which suits their condition and physical abilities. The advent of permanent disability for patients and early endoprosthesis are delayed.The complex physiorehabilitational and rheumathological treatment for patients with hip joi...

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Background Gout is one of the most common rheumatic diseases in general medical practice. Management of patients with gout includes prevention and treatment of the disease during acute attacks, as well as in the symptom-free period. Treatment outcomes strongly depend on the relationship doctor-patient. Objectives The objective of the current study was to assess the level of competency of general practitioners (GPs) in the management and education of patients with gout to optimize disease control. Methods An anonymous survey among 31 GPs was conducted. The survey included six questions with a yes/no answer. Data was analyzed using alternative analysis. Results A positive answer was given to the following questions: 1) Is minimizing risk factors such as elevated BMI and chronic alcohol consumption a first-line treatment option? - 27/31 (87.06%); 2) Is diet an obligatory component in the prevention and treatment of gout attacks? - 24/31 (77.42%); 3) Does the patient with gout need information about the clinical manifestation of acute gout arthritis? - 15/31 (48.39%); 4) Does acute gout arthritis need urgent treatment? - 22/31 (70.97%); 5) Is it the doctor's obligation to inform patients with gout about the side effects of the drug therapy? - 17/31 (54.84%); 6) Should patients be informed about the association between gout and the following factors: dyslipidemia, diabetes mellitus and arterial hypertension? - 14/31 (45.16%). Conclusions Data from the conducted study revealed that the predominant portion of the respondents recognized prevention and treatment of gout a main competency of the physician. Insufficient information and patient education are the basis of partially satisfactory results. References Rudichenko VM. Importance of the hyperuricaemia, gout and gender nosological features in the activity of general practitioner - family doctor. Lik Sprava. 2012 Jul-Sep;(5):44-57. Hamburger M, Baraf HS, Adamson TC 3rd, Basile J, Bass L, Cole B, Doghramji PP, Guadagnoli GA, Hamburger F, Harford R, Lieberman JA 3rd, Mandel DR, Mandelbrot DA, McClain BP, Mizuno E, Morton AH, Mount DB, Pope RS, Rosenthal KG, Setoodeh K, Skosey JL, Edwards NL; European League Against Rheumatism 2011 Recommendations for the diagnosis and management of gout and hyperuricemia. Postgrad Med. 2011 Nov;123(6 Suppl 1):3-36. doi: 10.3810/pgm.2011.11.2511. Chandratre P, Roddy E, Clarson L, Richardson J, Hider SL, Mallen CD.Health-related quality of life in gout: a systematic review. Rheumatology (Oxford). 2013 Nov;52(11):2031-40. doi: 10.1093/rheumatology/ket265. Epub 2013 Aug 11. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4114