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Ibn Yacoub Y.,University Hospital of Rabat Sale | Amine B.,University Hospital of Rabat Sale | Laatiris A.,University Hospital of Rabat Sale | Abouqal R.,Clinical Research and Epidemiology | Hajjaj-Hassouni N.,University Hospital of Rabat Sale
Clinical Rheumatology | Year: 2010

This study aims to assess fatigue aspects in Moroccan patients with ankylosing spondylitis (AS), and its relationships with disease-specific variables of activity and severity. A cross-sectional study included patients with ankylosing spondylitis according to New York Classification criteria for the diagnosis of AS. To assess fatigue, the first item of Bath Ankylosing Spondylitis Disease Activity index (BASDAI) and the Multidimensional assessment of fatigue were used (MAF). The evaluation included the activity of the disease (BASDAI), global well-being (Bath Ankylosing Spondylitis Global Index), functional status (Bath Ankylosing Spondylitis Functional Index), enthesitis and health-related quality of life (SF-36 generic instrument). One hundred patients were included (67 men and 33 women), of average age 38.0 years±12.9 [18-72]. Our patients had a moderately active and a severe disease. In our data, 60% experienced severe fatigue (BASDAI fatigue≥50 mm) and mean total score of MAF = 32.0± 20. Gender, NSAID therapy and the presence of biological inflammatory syndrome did not influence the MAF scores. Higher scores of fatigue were correlated with functional disability, general well-being, disease activity, enthesitis, and the deterioration of five domains of SF-36. Multivariate regression showed strong relationship between fatigue severity and general well-being and enthesitis. Severe fatigue (MAF) was most related with the domain of physical function. This study state the importance of fatigue in AS patients. The severity of fatigue is associated with disease activity, functional disability, general well-being, and enthesitis. Fatigue influences negatively different aspects of quality of life. Fatigue is an important outcome measure that must be part of routine clinical evaluation of our AS patients. © 2010 Clinical Rheumatology. Source


Wafki F.,El Ayachi Hospital | Amine B.,El Ayachi Hospital | Ibn Yacoub Y.,El Ayachi Hospital | Laatiriss A.,El Ayachi Hospital | And 3 more authors.
Clinical Rheumatology | Year: 2012

To determine the prevalence and predictors factors of depression in Moroccan patients with systemic sclerosis (SSc), we conducted a cross-sectional study of 59 Moroccan patients with systemic sclerosis. Patients were assessed by using the Patient Health Questionnaire depression scale "PHQ-9" and through extensive clinical histories and medical examinations. The Arabic version of HAQ and SF-36 was used to assess functional disability and health status, respectively. Forty-six patients (77.4%) presented symptoms of depression. Thirty six (61%) have a major depressive syndrome and 10 (16.4%) have a minor depressive syndrome. The PHQ-9 score was significantly higher in the patient with prolonged disease duration, severe joint pain, higher disease severity, and important acute-phase reactants. Also, depression had a negative impact on physical and mental scores. Systemic scleroderma is associated with a high prevalence of depression. Screening for depression among patients with SSc is recommended and it should be assessed for routinely. © 2011 Clinical Rheumatology. Source


Ibn Yacoub Y.,University Hospital of Rabat | Amine B.,University Hospital of Rabat | Laatiris A.,University Hospital of Rabat | Abouqal R.,Clinical Research and Epidemiology | Hajjaj-Hassouni N.,University Hospital of Rabat
Clinical Rheumatology | Year: 2011

The main objective of this study was to assess the aspects of health-related quality of life (QOL) in patients with ankylosing spondylitis (AS) and to explore the disease-related parameters influencing it. One hundred patients with AS according to New York Classification criteria were recruited in this cross-sectional study. The Medical Outcomes Study Short Form 36 Health Survey (SF-36) was used to assess health-related QOL. Assessment criteria included the evaluation of disease activity (Bath Ankylosing Spondylitis Disease Activity index [BASDAI]), global well-being (Bath Ankylosing Spondylitis Global Index [BASGI]), enthesitis (Mander enthesis index [MEI]), functional status (Bath Ankylosing Spondylitis Functional Index [BASFI]); metrology (Bath Ankylosing Spondylitis Metrology Index [BASMI]) and radiographic damage (Bath Ankylosing Spondylitis Radiologic Index [BASRI]). In this study, males comprised 67% of the subjects; mean age was 38±13 years and mean disease duration was 9.5±6.8 years. Among these patients, 52% had hip involvement. Our patients had a moderately active disease and severe functional disability. All domains of SF-36 were deteriorated with low scores. The SF-36 subgroups most affected were role limitation (18.8±28.1), role emotional (19.4±35), general health (44.9±20.3) and vitality (38.0±18.2). Lower scores of SF-36 had good statistically significant correlations with altered functional status (BASFI), worse general well-being (BASGI), altered metrology (BASMI); and moderate correlations with high disease activity (BASDAI), important radiological damage (BASRI); restricted chest expansion and prolonged morning stiffness (p<0.001). This study states that health-related QOL in Moroccan patients with AS is damaged in a significant way. Mental as well as physical aspects were affected. Functional disability, patient's well-being, metrology and disease activity are the main factors associated with deteriorating domains of QOL in AS. Recognizing complicated relationships between clinical measures and QOL in patients with AS can help us to develop further management strategies to improve their QOL. © Clinical Rheumatology 2010. Source


Yacoub Y.I.,University Hospital of Rabat Sale | Amine B.,University Hospital of Rabat Sale | Laatiris A.,University Hospital of Rabat Sale | Abouqal R.,Clinical Research and Epidemiology | Hajjaj-Hassouni N.,University Hospital of Rabat Sale
Clinical Rheumatology | Year: 2011

The main objective of this cross-sectional study was to assess spinal mobility and its relationship with disease-related parameters of activity, severity, and quality of life in Moroccan patients with ankylosing spondylitis (AS). One hundred patients with AS according to New York Classification criteria were recruited. Chest expansion, Schober index, occiput-to-wall distance, and the combined index of Bath Ankylosing Spondylitis Metrology Index (BASMI) were used to assess spinal mobility. Assessment criteria included the evaluation of disease activity (Bath Ankylosing Spondylitis Disease Activity index), functional status (Bath Ankylosing Spondylitis Functional Index), and radiographic damage (Bath Ankylosing Spondylitis Radiologic Index).The short form-36 (SF-36) generic instrument was used to assess health-related quality of life. The mean age of patients was 38±13 years. There were 67% of males in our data. Our patients had moderate disease activity, severe functional disability, and important radiological damage. The mean value of occiput-to-wall distance was 4±6.2 cm, chest expansion was 3.4±1.2 cm, Schober index was 2.7±1.2 cm, and BASMI was 4±3. Impaired spinal mobility, corresponding to higher scores of BASMI, had good statistically significant correlations with prolonged disease duration, severe functional disability (BASFI), important radiological damage (BASRI) and with the deterioration of most domains of SF-36 (p<0.001). In our study, we state that functional status and radiographic damage are the main factors associated with limited spinal mobility. Also, altered spinal measurements had a negative impact on physical function domain of quality of life. Recognizing relationships between spinal mobility measures and clinical and radiological measures in AS can help us to develop early therapeutic strategies to reduce loss of spinal mobility in Moroccan patients. © Clinical Rheumatology 2010. Source


Ali Ou Alla S.,University Hospital of Rabat Sale | Bahiri R.,University Hospital of Rabat Sale | Amine H.,University Hospital of Rabat Sale | El Alaoui H.,University Hospital of Rabat Sale | And 5 more authors.
BMC Musculoskeletal Disorders | Year: 2013

Background: During Ankylosing spondylitis (AS) courses, shoulder involvement is common. However, etiologies of shoulder pain in patients with AS remain to be defined. The aim of this study was to investigate the prevalence of ultrasound (US) abnormalities in shoulders of patients with ankylosing spondylitis (AS), and to determine predictive factors of ultrasound shoulder enthesitis. Methods. 38 patients with AS were included with 38 age and sex-matched healthy controls. All patients fulfilled the modified New York criteria for ankylosing spondylitis. Clinical and demographical data were recorded. US examination of bilateral shoulders was performed by a musculoskeletal sonographer according to a defined protocol that included imaging of the insertions of supraspinatus, subscapularis and infraspinatus tendons, rotator cuff tendons, subacromial-subdeltoid bursa, acromioclavicular joint, and glenohumeral joint. Results: The mean age of patients and controls was 36 years, each group of patients and controls comprised 22 men (57.9%) and 16 women (42.1%). Disease duration was 9.6 ± 7.2 years. Among 38 patients with AS, 21 had coxitis (55%) and 19 had previous or current shoulder pain (50%). AS shoulders presented significantly more ultrasound enthesitis than controls shoulders (43 shoulders (56.6%) versus 8 shoulders (10.5%) respectively). Involvement of rotator cuff tendons was significantly higher in patients with AS compared with control subjects (16/38 (42.1%) versus 6 (15.2%) respectively). However, involvement of gleno-humeral and acromio-clavicular joints was infrequent in both groups. In patients with AS, we found that the presence of coxitis was the only significant predictive factors of shoulder enthesitis (Odds Ratio (OR) = 9.4; Confidence interval (CI) 95% (1.10; 81.9), p = 0.04). Conclusions: Ultrasound abnormalities of shoulders are common in patients with AS, and the most frequent abnormalitie was enthesitis, which was associated with the presence of coxitis. © 2013 Ali Ou Alla et al.; licensee BioMed Central Ltd. Source

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