Introduction Neurogenic bowel dysfunction is commonly encountered after a spinal cord injury (SCI), leading to a tremendous impact on quality of life (QOL). The neurogenic bowel dysfunction score (NBDS) is commonly used to measure the severity of bowel dysfunction and predict QOL. However, there is no comprehensive instrument to assess bowel‐specific QOL for SCI patients. Instead, the Irritable Bowel Syndrome‐Quality of Life (IBS‐QOL) questionnaire evaluates the impact of bowel dysfunction on several aspects of QOL, although this questionnaire has not been validated for the SCI population. Motivated by the compelling need of instruments to accurately evaluate the QOL in patients who develope NBD after SCI, we aimed to assess the construct, content, and face validity of IBS‐QOL in this population. Methods Adult SCI patients with at least 3 months after their injury were recruited from the outpatient clinic of a national rehabilitation hospital. Patients completed the NBDS and IBS‐QOL via telephone interview or paper survey in the clinic. Content and face validity were assessed via interviews with professionals with expertise in providing chronic care for SCI, as well as a subgroup of patients. Construct validity was assessed using the hypotheses testing method. Internal consistency was assessed using Cronbach's ⍺. Factor analysis was performed to assess the dimensionality of the IBS‐QOL in the SCI population. Results A total of 106 patients with a median age of 45.5 years (interquartile range: 21–79) participated in the study. The majority of the sample were men (n = 82, 77%) and had endured thoracolumbar injuries (n = 74, 71.2%). Twelve patients (seven English‐ and five Spanish speakers) and six professionals took part in content/face validation interviews. The median IBS‐QOL total score was 15.91/100 (interquartile range: 4.55–33.14). IBS‐QOL differentiated the subgroups of patients with severe bowel symptoms in terms of uneasiness, sweating, or headaches during bowel emptying (p = 0.0003), time spent on bowel emptying (p = 0.0065), flatus incontinence (p = 0.0076), and overall satisfaction with bowel function (p < 0.001), demonstrating its adequate construct validity. Interviews with the patients and professionals supported the comprehensiveness, comprehensibility, and relevance of IBS‐QOL for assessment of bowel‐related QOL in the SCI population. Item‐level analysis of professional responses showed that 97% of questions were relevant to the construct and population of interest. Internal consistency analysis yielded a Cronbach's ⍺ of 0.9684. Exploratory factor analysis yielded six underlying factors which cumulatively accounted for 72.21% of the total variance, reflecting the dimensionality of bowel‐related QOL in SCI population. Discussion IBS‐QOL questionnaire is a comprehensive measure of bowel‐related QOL which encompasses the concerns of SCI patients. Our findings support the content, face and construct validity of IBS‐QOL as a measure of bowel‐related QOL in SCI. Further studies are warranted to ...

BackgroundWe performed a descriptive study of our patients with psoriatic arthritis (PsA) over 40 years old, attending to the presence of coronary disease and cardiovascular risk factors in each group of treatment (DMARDS vs biologic therapy).MethodsPatients older than 40 years, diagnosed with psoriatic arthritis attending clinics at the Department of Rheumatology were analysed to determine how many of them presented coronary disease. The following information was recorded: age, sex, disease duration and age at the coronary event, HLA-B27 positivity, hypertension, type II diabetes and hyperlipidemia, on medical records and discharge reports for each patient.ResultsAll 137 patients were identified from an electronic database. We found a male predominance: 57% versus 43% of women. Mean age 57.05±10.6 years. Of the 137 patients, 82% had only peripheral arthritis, while 18% also showed axial involvement. With regard to the latter subgroup, 16% patients had a positive HLA-B27 test, 56% were HLA-B27 negative and 28% showed lack of HLA-B27 test. Almost all patients (87%) were in DMARDs therapy, while 31% received biologic therapy: etanercept 42%, secukinumab 16%, adalimumab 12%, ustekinumab 12%, infliximab 9,5%, golimumab 4,7% and certolizumab 2%. About 7% of patients didn’t receive DMARDS neither biologic therapy, because of intolerance.Results regarding to cardiovascular risk factors, and coronary disease are as follows:DMARD therapyBiologic therapy (±DMARDS) Arterial Hypertension43%26%Diabetes19,5%7%Hyperlipidemia47,5%38%Coronary disease10,9%2,4%In DMARD subgroup, we found 6 myocardial infarction (all of them revascularized) and 3 angina, versus 1 myocardial infarction in biologic subgroup.ConclusionsThere is solid epidemiologic evidence linking PsA to cardiovascular risk factors and an increased risk of developing cardiovascular disease1. Furthermore, over the past two decades it has become increasingly clear that chronic inflammation is an independent risk factor for cardiovascular events. In our study the ratio of ischaemic heart disease for patients with PsA in DMARD therapy is four times higher than that of biologic treatment group. This may be due to the greater percentage of cardiovascular risk factors in the first group, although, the cardioprotective effect of biologic therapies, must be taken into account, as there are some studies that show association between antiTNF and significant reduction in carotid IMT2. Proper management of cardiovascular risk requires aggressive control of disease activity.References[1] Int. J. Mol. Sci2018;19(1):58. doi:10.3390/ijms19010058[2] Int J Rheumatol2012;2012:714321.Disclosure of InterestNone declared

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