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The article presents the results of a clinical observation of a case of the onset of axial spondyloarthritis in an elderly woman which developed against the background of the new coronavirus infection. The difficulties of the diagnostic search and, as a consequence, the selection of adequate therapy in combination with the patient’s post-COVID period and the onset of immuno-inflammatory disease are described. The characteristics of the clinical course and functional features of the patient are given. The issues of differential diagnosis between immuno-inflammatory disease, infectious and paraneoplastic processes are considered. Colonoscopy gave new data on the presence of Crohn’s disease in the patient and allowed excluding the oncological process, serving as a reason for further diagnostic search for spondyloarthritis. The revealed laboratory and instrumental changes made it possible to diagnose axial spondyloarthritis in this patient.

The article analyzes the current status of the issue of senile asthenia as a key geriatric syndrome. The definition, epidemiology, risk factors, diagnosis and prevention of senile asthenia are considered. The pathogenetic mechanisms of senile asthenia are described, on which the treatment, rehabilitation and prevention of this syndrome are based. The detailed characteristic of risk factors is given, which are divided into categories: physiological, medical diseases / comorbidities, socio-demographic, psychological states, and disability. The main components of a comprehensive geriatric assessment are reflected, including the study of the functional, physical, social and psychological status of the patient. The emphasis is made on using the most convenient and available tools for assessing the health of the elder, describing their advantages and principles of application. The most useful strategies to prevent senile asthenia are considered, which are aimed at improving the quality of life of the aged patients and reducing the frequency of adverse outcomes.

Узловатая эритема (УЭ) является наиболее часто встре-чающимся клинико-патологическим вариантом паннику-лита [1]. УЭ рассматривается как неспецифический имму-новоспалительный синдром, который может быть вызван широким спектром этиологических факторов [2].Хотя УЭ встречается нередко и характеризуется яркой клинической симптоматикой, до настоящего времени не су-ществует цельной и единой концепции ее этиологии и пато-генеза, клинико-морфологического субстрата и терапии [3].Нередко УЭ выступает как один из симптомов систем-ной патологии. К числу наиболее частых причин возник-новения УЭ относят саркоидоз, туберкулез, болезнь Кро-на, неспецифический язвенный колит, ревматические за-болевания, паранеопластический процесс, что может при-вести к поздней диагностике. Почти в 30% случаев причи-на УЭ остается неуточненной, и она расценивается как идиопатическая [4].Приводим наблюдение УЭ как одного из ассоцииро-ванных симптомов при первичном миелофиброзе (ПМФ

Background Effective and long-term therapy of ankylosing spondylitis (AS) is not possible without the active participation of the patient in this process, which requires educational programs. Objectives To evaluate the effectiveness of educational activities for patients with early AS. Methods Main group: 25 patients with a documented AS, disease duration less than 5 years and ra diological stage no more than 2, were trained in schools for patients 4 times (2 in the first month and 2 every 2 months). The issues of the importance of regular exercises, physical therapy, continuous administration of non-steroidal anti-inflammatory drugs (NSAIDs), the need for monitoring at the rheumatologist were discussed. Control group: 25 patients received information about their disease only during rheumatologist consultation. The groups were matched for sex, age, duration of symptoms, disease activity, appointed drug therapy. At baseline and after 6 months BASDAI, ASDAS, BASFI, WPAI, regularity of exercises and commitment to treatment were determined. Results After 6 months of the training BASDAI decreased by 2,9±0,2 points in the main group and 1,6±0,3 points in the control group (p<0,05), BASFI at 1,9±0,3 score - main group, 1,01±0,3 control group (p<0,05), ASDAS decreased by 1,91±0,35 in the group trained and 123±0,26 in the control group (p<0,05). After 6 months, 80% patients achieved improvement criteria ASAS40, 44% patients - partial remission (main group) against 48.0% and 14% respectively in the control, p<0.05. After 6 months, the proportion of patients, who regularly perform physical exercises in the study group increased by 4 times and amounted to 84% of patients, in the control group - 2 times and amounted to 44%. In the study group 76% of the patients constantly used NSAIDs, regardless of pain, in the control group 36% of patients received NSAIDs on request only. WPAI was 32.4% at baseline in training patients, after 6 months - 20.6%, in the control group - 30.4% at baseline and 25.8% at 6 months, respectively. Dynamics in patients who have received training was more important, which determined to significant differences between groups for most indicators (p<0.05). Conclusions Educational program for patients with early AS, increases compliance to treatment and contributes to a better implementation of the recommendations of the doctor, which helps to control disease activity, to achieve remission, improves functional status and performance of patients with AS. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5558