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P0161 AUTOANTIBODIES IN THREE FAMILY SYSTEMIC LUPUS ERYTHEMATOSUS
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
S59
P0160 SEVERITY INDEXES IN AN INTERMEDIATE CARE UNIT
Patricia Freitas 1 , Joana Silvestre 1 , Sofia Duque 1 , Diana Fernandes 1 , Alice Sousa 1 , João Pereira 2 , Vitor Batalha 1 , Luis Campos 1 . 1 Unidade De Cuidados Intermédios Médicos, Serviço De Medicina Iv, Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal; 2 Unidade De Cuidados Intensivos Médicos; Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal
nodules, usually located on the periorbital area. The lesions frequently show tendency to atrophy and ulceration. Most cases are asymptomatic, and oral mucosal erosions are sometimes present. Ophthalmologic complications are observed in many patients, and NXG may involve other extracutaneous sites. NXG may involve other extracutaneous sites, including the heart, lungs, kidneys, liver, spleen, intestines, skeletal muscle, and central nervous system. Paraproteinemia is closely associated with NXG, with approximately 80 percent of patients demonstrating a monoclonal gammopathy on serum protein electrophoresis; furthermore, 10 percent of these patients develop multiple myeloma.Other lymphoproliferative disorders such as Hodgkin’s lymphoma have been associated with NXG. Hepatosplenomegaly, an increased erythrocyte sedimentation rate, leukopenia, hypocomplementemia, and cryoglobulinemia are other common findings. Large areas of degenerated collagen alternating with granulomatous inflammation, multinucleate giant cells, cholesterol clefts, and lymphoid follicles are the most outstanding histopathologic characteristics of NXG. The prognosis for NXG is good, but no curative treatment is available. Chemotherapy with alkylating agents is the most frequently administered treatment, but oral and intralesional corticosteroids, interferon alpha, plasmapheresis, surgical excision, and radiation therapy also have been used for this disorder with variables result.
P0159 CONSULTING OF INTERNAL MEDICINE, A RETROSPECTIVE STUDY OF 36 MONTHS
Leonor Viegas, António Sousa, Francisco Azevedo. Hospital Espírito Santo E.p.e Internal Medicine is a specialty which integrates knowledge and experiences, while evaluating the patient as a whole. The Internist, with his thorough knowledge of the patient as a whole, is the specialist with natural talent for the consult of other medical specialties. The authors present a retrospective study, done in an average sized hospital, during 36 months, where the Internal Medicine Consulting to patients of three specialties, medical and surgical, was evaluated. A total of 369 patients were observed in 556 consults, 229 of which were female and 140 male. The authors present the data concerning the age average and its distribution, characterization of the reasons for consult and its nosological framing as well as their final outcome. Even though there are no indicators that evaluate the impact of Internal Medicine Consulting, its utility cannot be denied in the reduction of patients’ complications, length of stay and mortality. Being an almost unknown activity, with scarce recognition and in need of proper placement, the growth in Medical subspecialties will lead, nonetheless, to an important growth of consulting in Internal Medicine. Keywords: consulting, internist, internal medicine.
Background: There are no severity indexes validated to evaluate the prognosis of patients in Intermediate Care Units (ICU). The severity indexes Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA) are used to identify patients with a higher risk of mortality in Intensive Care. Aims: Evaluate the mortality in ICU and in hospital, of patients with UCI admission and assess mortality predictors in the first 24 hours, through the indexes APACHE II, SAPS II e SOFA. Methods: Prospective, observational study in an UCI of a University Hospital for an 8 months period (April to November 2008). Results: 92 patients where included, with an average age of 64, 59 being females (64,1%). The mortality rate in UCI was 5,9% and in hospital 10,8%. The areas under the receiver operating characteristic (AUROC) to evaluate the mortality in UCI from APACHE II, SAPS II e SOFA, where respectively 0,85 (95% confidence interval (CI): 0,76-0,96); 0,78 (95% CI: 0,59-0,97); 0,77 (95% CI: 0,61-0,92). In what concerns to mortality in hospital, and for the same indexes, the next results where found for the AUROC: 0,76 (95% CI: 0,61-0,90); 0,80 (95% CI: 0,66-0,93); 0,77 (95% CI: 0,64-0,90). Conclusions: In patients admitted in UCI the APACHE II was the best prognosis index for mortality. In the assessment of hospital mortality no significant differences where found between the studied indexes.
P0161 AUTOANTIBODIES IN THREE FAMILY SYSTEMIC LUPUS ERYTHEMATOSUS
Hamzaoui Amira 1 , Boumiza Radhia 2 , Harzallah Olfa 1 , Sakly Nabil 2 , Mahjoub Silvia 1 . 1 Departement of Internal Medicine; 2 Departement of Immunology Introduction: Systemic lupus erythematosus (SLE) is an auto-immune disease of unknown pathogenesis. Familial studies and concordance rate among affected and relatives suggest that human SLE has a strong genetic and auto-immune basis. Objective: To describe the immunological features in 3 Tunisian families of 4 SLE affected patients. The diagnosis was made according to the revised American College of Rheumatology criteria. Auto-antibodies were search by ELISA: Antinuclear antibodies (ANA), anti-DNA, anti Ro, anti La, anti-Sm, anti-Sm- RNP, anti-SCL 70 and anti-JO1. Results: We identified 3 families with 4 SLE patients and 16 first degree relatives. The 4 affected patients shared: ANA (4 cases), anti-DNA (3 cases), anti-Ro (3 cases), anti –La (1 case) and anti- Sm/RNP (2 cases). Among the 16 relatives, 6 (37, 5%) had positive ANA (1/100). One of them had a diagnosis of primary Sjögren syndrome. No correlation with clinical manifestations was found. Conclusion: The higher rate of auto-immunity among blood relatives found in our study suggests a complex interaction of genetic, auto-immune and environmental factors contributing to disease.
P0162 NURSES’ KNOWLEDGE ABOUT FOOD-DRUG INTERACTION
Güler Balcı Alparslan. Dumlupınar University School of Health Nursing Department Background: Giving information which focus on interaction food-drug to patients by nurse could increase effects of treatment. However it is observed that the patients weren’t given information about food-drug interaction. It is hypothesized that the nurses haven’t enough knowledge about this as reason. Nurses could revise their knowledge by conducting this study which hadn’t been conducted in our country. In addition, its results could encourage the nurses to give information to patients about food-drug interaction. Aim: Aim of this study is to determine nurses’ knowledge about food-drug interaction and whether knowledge food-drug interaction is associated with nurse characteristics.
S59
P0160 SEVERITY INDEXES IN AN INTERMEDIATE CARE UNIT
Patricia Freitas 1 , Joana Silvestre 1 , Sofia Duque 1 , Diana Fernandes 1 , Alice Sousa 1 , João Pereira 2 , Vitor Batalha 1 , Luis Campos 1 . 1 Unidade De Cuidados Intermédios Médicos, Serviço De Medicina Iv, Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal; 2 Unidade De Cuidados Intensivos Médicos; Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal
nodules, usually located on the periorbital area. The lesions frequently show tendency to atrophy and ulceration. Most cases are asymptomatic, and oral mucosal erosions are sometimes present. Ophthalmologic complications are observed in many patients, and NXG may involve other extracutaneous sites. NXG may involve other extracutaneous sites, including the heart, lungs, kidneys, liver, spleen, intestines, skeletal muscle, and central nervous system. Paraproteinemia is closely associated with NXG, with approximately 80 percent of patients demonstrating a monoclonal gammopathy on serum protein electrophoresis; furthermore, 10 percent of these patients develop multiple myeloma.Other lymphoproliferative disorders such as Hodgkin’s lymphoma have been associated with NXG. Hepatosplenomegaly, an increased erythrocyte sedimentation rate, leukopenia, hypocomplementemia, and cryoglobulinemia are other common findings. Large areas of degenerated collagen alternating with granulomatous inflammation, multinucleate giant cells, cholesterol clefts, and lymphoid follicles are the most outstanding histopathologic characteristics of NXG. The prognosis for NXG is good, but no curative treatment is available. Chemotherapy with alkylating agents is the most frequently administered treatment, but oral and intralesional corticosteroids, interferon alpha, plasmapheresis, surgical excision, and radiation therapy also have been used for this disorder with variables result.
P0159 CONSULTING OF INTERNAL MEDICINE, A RETROSPECTIVE STUDY OF 36 MONTHS
Leonor Viegas, António Sousa, Francisco Azevedo. Hospital Espírito Santo E.p.e Internal Medicine is a specialty which integrates knowledge and experiences, while evaluating the patient as a whole. The Internist, with his thorough knowledge of the patient as a whole, is the specialist with natural talent for the consult of other medical specialties. The authors present a retrospective study, done in an average sized hospital, during 36 months, where the Internal Medicine Consulting to patients of three specialties, medical and surgical, was evaluated. A total of 369 patients were observed in 556 consults, 229 of which were female and 140 male. The authors present the data concerning the age average and its distribution, characterization of the reasons for consult and its nosological framing as well as their final outcome. Even though there are no indicators that evaluate the impact of Internal Medicine Consulting, its utility cannot be denied in the reduction of patients’ complications, length of stay and mortality. Being an almost unknown activity, with scarce recognition and in need of proper placement, the growth in Medical subspecialties will lead, nonetheless, to an important growth of consulting in Internal Medicine. Keywords: consulting, internist, internal medicine.
Background: There are no severity indexes validated to evaluate the prognosis of patients in Intermediate Care Units (ICU). The severity indexes Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA) are used to identify patients with a higher risk of mortality in Intensive Care. Aims: Evaluate the mortality in ICU and in hospital, of patients with UCI admission and assess mortality predictors in the first 24 hours, through the indexes APACHE II, SAPS II e SOFA. Methods: Prospective, observational study in an UCI of a University Hospital for an 8 months period (April to November 2008). Results: 92 patients where included, with an average age of 64, 59 being females (64,1%). The mortality rate in UCI was 5,9% and in hospital 10,8%. The areas under the receiver operating characteristic (AUROC) to evaluate the mortality in UCI from APACHE II, SAPS II e SOFA, where respectively 0,85 (95% confidence interval (CI): 0,76-0,96); 0,78 (95% CI: 0,59-0,97); 0,77 (95% CI: 0,61-0,92). In what concerns to mortality in hospital, and for the same indexes, the next results where found for the AUROC: 0,76 (95% CI: 0,61-0,90); 0,80 (95% CI: 0,66-0,93); 0,77 (95% CI: 0,64-0,90). Conclusions: In patients admitted in UCI the APACHE II was the best prognosis index for mortality. In the assessment of hospital mortality no significant differences where found between the studied indexes.
P0161 AUTOANTIBODIES IN THREE FAMILY SYSTEMIC LUPUS ERYTHEMATOSUS
Hamzaoui Amira 1 , Boumiza Radhia 2 , Harzallah Olfa 1 , Sakly Nabil 2 , Mahjoub Silvia 1 . 1 Departement of Internal Medicine; 2 Departement of Immunology Introduction: Systemic lupus erythematosus (SLE) is an auto-immune disease of unknown pathogenesis. Familial studies and concordance rate among affected and relatives suggest that human SLE has a strong genetic and auto-immune basis. Objective: To describe the immunological features in 3 Tunisian families of 4 SLE affected patients. The diagnosis was made according to the revised American College of Rheumatology criteria. Auto-antibodies were search by ELISA: Antinuclear antibodies (ANA), anti-DNA, anti Ro, anti La, anti-Sm, anti-Sm- RNP, anti-SCL 70 and anti-JO1. Results: We identified 3 families with 4 SLE patients and 16 first degree relatives. The 4 affected patients shared: ANA (4 cases), anti-DNA (3 cases), anti-Ro (3 cases), anti –La (1 case) and anti- Sm/RNP (2 cases). Among the 16 relatives, 6 (37, 5%) had positive ANA (1/100). One of them had a diagnosis of primary Sjögren syndrome. No correlation with clinical manifestations was found. Conclusion: The higher rate of auto-immunity among blood relatives found in our study suggests a complex interaction of genetic, auto-immune and environmental factors contributing to disease.
P0162 NURSES’ KNOWLEDGE ABOUT FOOD-DRUG INTERACTION
Güler Balcı Alparslan. Dumlupınar University School of Health Nursing Department Background: Giving information which focus on interaction food-drug to patients by nurse could increase effects of treatment. However it is observed that the patients weren’t given information about food-drug interaction. It is hypothesized that the nurses haven’t enough knowledge about this as reason. Nurses could revise their knowledge by conducting this study which hadn’t been conducted in our country. In addition, its results could encourage the nurses to give information to patients about food-drug interaction. Aim: Aim of this study is to determine nurses’ knowledge about food-drug interaction and whether knowledge food-drug interaction is associated with nurse characteristics.