BackgroundValidated disease activity scores and damage measurements were developed over time in order to allow a better way to evaluate patients and decide treatment plans.There are scores designed for a great variety of vasculitis like Birmingham Activity Score and others that are more specific like Behcet's Disease Current Activity Form2006.ObjectivesTo evaluate the ability of the activity scores (BVASv3and BDCAF)to predict damage,and the influence of immunosuppressive therapy on damage progression,as measured byVDI, in a group of patients with Behcet's Disease.MethodsA study was performed on a cohort of patients diagnosed with Behcet's Disease under surveillance in one tertiary Rheumatology Centre, from a non-endemic area.All documented cases of Behcet's Disease have been diagnosed according to The International Criteria for Behçet's Disease.The Birmingham Activity Score (BVAS)v3, Behcet's Disease Current Activity Form2006 (BDCAF)and Vasculitis Damage index (VDI) were calculated for all patients. Spearman's correlation coefficients were calculated between BVASv3 Score, BDCAF, VDI and immunosuppressive treatment.WindowsExcel/SPSS20.0 has been used to analyse the data.Results20 patients were included in the study, with ages at the time of the diagnosis between 13and 60years, 14 (70%) under the age of 40,with a male predominance 60% (12 patients). All patients presented active disease at the time of the diagnosis. In the clinical case series, Spearman's rank correlation coefficient between BVASv3 and BDCAFwas strong r=0,862with p<0,001.The outcome analysis after remission was calculated and rank correlation coefficient betweenVDI, and both BVASv3 and BDCAF was moderate (VDI-BVASv3 r=0,747, p<0,001, VDI- BDCAF r=0,795, p<0,001).As for immunosuppression induction decision and activity scores,the correlation coefficient was moderate (r=0,734 for BVASv3,r=0,647 for BDCAF)with p<0,001. There was a moderate correlation between immunosuppressive treatment and VDI (r=0,700, p<0,001). Since the cause of damage (vasculitis vs. treatment)is not taken into consideration when we calculate VDI, we tried to observe if there are any connections between this and immunosuppression duration. There was a mild correlation and no statistical impact between cyclophosphamide treatment duration and damage calculated as VDI (r=0,474, p=0,36).In contrast, when rank correlation coefficient between cortisone therapy and VDI was calculated, a moderate statistical impact was observed (r=0,609, p<0,001).ConclusionsBirmingham Vasculitis Activity score (BVAS) v3 and Behcet's Disease Current Activity Form2006 (BDCAF) are reliable tools for evaluating disease activity in patients with Behcet's Disease. They are able to anticipate the need for immunosuppressive therapy and the damage progression, as calculated with Vasculitis Damage Index (VDI).References Mukhtyar C, Lee R, et al. Modification and validation of the Birmingham vasculitis activity score, Ann Rheum Dis, 2009.Flossmann O, et al. Development of comprehensive disease assessment in systemic...

Background:Since the beginning of 2020, the medical staff caring for patients with rheumatic disorders has been exposed to considerable emotional and physical stress due to the COVID19 pandemic outbreak. Newly-designed circuits were imposed to better manage chronic patient admissions.Objectives:To assess the level of motivation in healthcare personnel caring for patients with rheumatic disorders and identify determinants that lead to dissatisfaction during the COVID19 spread.Methods:A 15-item questionnaire was distributed among medical and paramedical staff looking after chronic rheumatic patients. Motivation factors were included in questions having five preset answers, ranging from “not al all”, “to a small extent”, “moderately”, “to a large extent” and “to a very large extent”. The final item was an open-type question, favoring personal suggestions and potential changes in local management.Results:Out of a total of a 124 responders, 82 were doctors with various degrees in training (fellow trainees, specialists in Rheumatology, Head of Department), 37 medical assistants, 3 nurses, a physical therapist, one clinical psychologist. Mean age in the group was 38.3 years old with a strikingly female dominance (87.6%). Within the responders, the financial factor represented by monthly salary or bonuses had no or little impact on work motivation during the pandemic since more than 70% answered with “not al all / to a small extent / moderately”. Regarding motivation through working hours, 26.7% responded either “not at all” or “to a small extent”, 32.4% were moderately motivated while only 12.4% were more enthusiastic. More than half (53.4%) of the staff stated that motivation was not entirely affected by working conditions in the hospital. Answers were relatively equally divided referring to motivation by safety at their workplace (almost 20% for each statement), and 40.9% suffered some extent of demotivation due to risk of contamination while caring for COVID19 positive patients. 42% of the staff was only moderately motivated by hospital’s measure to limit the spread of COVID throughout the personnel. Almost 75% of the healthcare workers were not motivated by news media. Around 54% said that personal motivation was not influenced by a larger work volume and 43% were very much motivated by work relationships with colleagues. 41% of the staff is only moderately satisfied with their work during the COVID outbreak while 18% are not at all satisfied. Finally, the last open-question confirmed that for some the pandemic period was a time to bring healthcare professionals together to a stronger bond. Other responders felt that chronic rheumatic patients were left aside, while caring mostly for COVID19 patients and only limited admissions for life-threatening conditions. Moreover, medical staff suggested that the lack of a more frequent testing throughout the personnel to avoid contamination was demotivating, while still living with families or relatives.Conclusion:Motivation of the personnel is a process with great economic and social impact. This study challenged the level of healthcare staff in difficult times caused by medical crisis. Results of the enquiry showed that financial benefits had no impact on motivation. Harsher working conditions or larger volume did not negatively impact motivation of staff, but the fear of contamination was considerable. Apparently the media influence was not a motivator for medical staff during the outbreak. Medical teams should find their stamina until the end of pandemia.References:[1]Barati, M, Bashirian, S et al, Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: an application of the Protection Motivation Theory, Journal of Hospital Infection 2020.[2]Barati, M, Bashirian, S et al, Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: an application of the Protection Motivation Theory, Journal of Hospital Infection 2020.Disclosure of Interests:None declared

characteristics of autoimmune diseases associated with sarcoidosis (sarcoidosisoverlap group) patients and isolated sarcoidosis (isolated sarcoidosis group) were analyzed and compared. Results: Autoimmune disease was detected in 15 (11.5%) of 131 patients with sarcoidosis (1Sjögren syndrome, 3rheumatoid arthritis, 1Still disease, 1scleroderma, 4ankylosing spondylitis, 1familial Mediterranean fever, 1gut arthritis, 1immune trombocytopenic purpura, 1Hashimoto thyroiditis and 1Graves disease). Most of these diseases occurred before (such as RA, AS, Still, FMF) and others after sarcoidosis diagnosis. Among 15 sarcoidosis patients with autoimmune disease 10 were female and 5 were male, the mean age was 50.8 years and mean disease duration was 3 months (1-30 months). When compared with isolated sarcoidosis patients, more hand finger joint involvement, RF positivity, higher ESR and less NSAIDs usage were found in patients with sarcoidosis-overlap group (p=0.035, p=0.049, p=0.015, p=0.018 respectively). There was no statistically significant differences between the two groups when evaluated for demographic, clinical parameters and other treatment modalities. Conclusions: Concomitant autoimmune diseases in patients with sarcoidosis may be often seen. This patients are characterized with more hand finger joint involvement, RF positivity, higher ESR and less NSAIDs usage. Therefore, in patients with a diagnosis of sarcoidosis, it is necessary for the physician to be careful and to make a wider differential diagnosis in terms of the presence of another underlying autoimmune disease. Multicenter, prospective studies involving large numbers of patients are needed to understand whether the association of sarcoidosis-autoimmune diseases is based only on coincidence or on a common etiopathogenesis.