Introduction: Clinical outcomes in rheumatoid arthritis have greatly improved with therapeutic advances. Despite the availability of substantial clinical trial evidence, there is a lack of real-life data. The aim of this study was to assess disease status and quality of life in an outpatient population treated with biological disease-modifying anti-rheumatic drugs.Material and Methods: Cross-sectional study recalling all patients ever treated in our unit with biological disease-modifying antirheumatic drugs. Clinical and demographic data, compliance, disease activity, functional status, joint deformities, and comorbidities were documented, and patients queried on occupational status, education, marital status and generic health related quality of life questionnaires.Results: Recall was attended by 77 of the original 94 patients. At recall, median age was 63 years old, 82% of the patients were female and the median disease duration was 12 years. Biological therapy was started at a median of four years following disease onset. According to the disease activity score (DAS28), the percentage of patients with high, moderate, low disease activity or remission changed from 50, 45, 0 and 5 (pre-therapy) to 11, 37, 25 and 26 at recall, respectively; functional status was significantly improved. Seventy-five per cent of the patients retained the original treatment with good compliance. Lower Short Form-36 domain scores accompanied a low EQ-5D-3L score. Deceased patients (n = 6) had a lower estimated 10-year survival rate. In this group, biological therapy was discontinued at a higher frequency during follow-up.Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset.Conclusion: Despite therapy switches and regular follow-up, a significant percentage of patients still presented with moderate disease activity, functional impairment and a poor health-related quality of life.
Analisar linhas delimitadoras de um certo desenvolvimento tecnológico é uma tarefa já empreendida por diversos autores. Este é um tipo de abordagem que se inspira em parte em ação semelhante empreendida em relação à ciência. Neste artigo pretendemos apresentar algumas linhas, a que chamamos tendências, que marcam as tecnologias móveis, como celulares, smartphones ou tablets. Estudamos alguns artefactos e funcionalidades que, não sendo exclusivos deste tipo de dispositivo, marcam direções e hegemonias. Para o efeito, desenvolvemos uma análise sociotécnica que se centra em uma observação e utilização desse tipo de tecnologia. O resultado é uma tipologia que mostra cinco tendências: realismo; continuidade técnico-corporal; prioridade ao contexto; velocidade; e compatibilidade/multifuncionalidade. Essas diferentes formulações sociotécnicas permitem compreender como essas materialidades inscrevem-se no espaço social, ao mesmo tempo que exibem projetos que emergem de intenções sociais. O proliferar das tecnologias móveis faz com que a compreensão dessas dinâmicas seja de enorme relevância para questionarmos o futuro tecnológico que se instala. Palavras-chave • Tendências sociotécnicas. Tecnologias móveis. Materialidade. Sociedade. Etnografia material. Estudos sociais de ciência e tecnologia.
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