Susana Oliveira

SAT0345 The impact of gastrointestinal involvement in health-related quality of life in patients with systemic sclerosis

Background Apart from skin involvement, the gastrointestinal (GI) system is the second most commonly involved organ in systemic sclerosis (SSc), affecting over 80% of the patients. Although rarely being a direct cause of death, it is associated to a high morbidity and to a significant impairment in health-related quality of life (HRQoL). Few data are published considering the influence of GI manifestations in the quality of life of SSc patients. Objectives The purpose of this study is to characterize the impact of GI involvement in HRQoL in SSc, and to compare it with that in patients with inflammatory bowel disease (IBD). Methods 29 consecutive SSc patients with GI involvement were selected from a cohort of 44 SSc patients, followed in a single referral centre and classified according to 2013 ACR/EULAR criteria. Comparative analysis was made with 24 consecutive patients with IBD without arthritis (14 Crohns disease; 10 - ulcerative colitis). Health Assessment Questionnaire (HAQ-DI) and Short Form 36 (SF36), physical component summary (PCS) and mental component summary (MCS) scales, were used to assess HRQoL in both groups. The UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 (UCLA SCTG GIT 2.0) was performed in SSc patients to assess the severity of GI involvement. Clinical data were obtained by medical records review. T-test and Fishers exact test were used to compare binary variables. Pearsons correlation was used for continuous variables. Results The most common GI segments involved in SSc patients were the esophagus in 90%, the stomach in 60% and the bowel in 48%, while the anorectum was involved in a smaller percentage (10.3%). The mean UCLA SCTG GIT 2.0 score was 0.64±0.51, compatible with a moderate severity, with higher scores obtained for reflux, distention and emotional wellbeing. The mean HAQ-DI score was 1.13±0.57 (0-best health), and the mean PCS and MCS scores were 35.2±9.4 and 35.3±11.4 (100-best health), respectively. These scores were significantly worse than in SSc patients without GI involvement (HAQ-DI - p=0.001; PCS - p=0.04 and MCS - p=0.005). There was a significant correlation between higher UCLA SCTG GIT 2.0 scores and worse quality of life evaluated by HAQ-DI (r=0.42, p=0.03), but the same correlation was not found for the SF36 components. Comparing with IBD patients, SSc patients with GI involvement had worse life quality, with statistical significantly higher HAQ-DI (p<0.001) and lower PCS (p<0.001) and MCS (p=0.01) scores. Conclusions GI involvement in SSc significantly impaired patients quality of life. The impact of GI involvement in HRQoL of SSc patients was more severe than in IBD patients. Although physical components were relevant, with esophagus being most frequently involved, mental components associated with GI involvement significantly compromised HRQoL in SSc. Therefore, the assessment of SSc patients using clinical severity measure tools, similar to UCLA SCTG GIT 2.0 score, is crucial for a better characterization of the disease and to an optimized clinical approach. Disclosure of Interest None declared

IgA-dominant postinfectious glomerulonephritis induced by methicillin-sensitive Staphylococcus aureus.

A 56-year-old man with alcohol-associated cirrhosis, arterial hypertension and diabetes, presented with a 1-month history of fever, lumbar back pain and lower limb weakness. MRI revealed a spinal epidural abscess extending from the cervical to the dorsolumbar spine. A methicillin-sensitive Staphylococcus aureus strain was isolated on blood cultures. Meropenem was initially started with no response, and then changed to vancomycin. During treatment, the patient’s condition progressed with anasarca and renal failure with nephrotic-range proteinuria. The renal biopsy showed a membranoproliferative glomerulonephritis with IgA deposition. After completing 2 months of antibiotic therapy the patient recovered from the neurological deficits, with a complete resolution of the abscess and partial recovery of renal function and proteinuria.

Xanthogranulomatous pyelonephritis presenting as palmoplantar keratoderma.

A 60-year-old woman with type 1 diabetes mellitus and a history of repeated urinary tract infections due to Proteus mirabillis presented with diffuse palmoplantar hyperkeratosis of 4 months duration (figure 1) and acute retrosternal pain. An ECG showed a diffuse concave ST segmental elevation and the echocardiogram showed a mild pericardial effusion, suggestive of pericarditis. Laboratory analysis showed negative troponin, leucocytosis, elevated erythrocyte sedimentation rate (110 mm/h) and C reactive protein (10 mg/dL). A CT scan revealed a hydronephrotic, non-functioning left kidney with an inflammatory infiltrate in …

EP-1493 ALTERNATIVE REGIMENS FOR PROSTATE CANCER TREATMENT USING RADIATION THERAPY

Purpose/Objective: The purpose of this work was to determine biologically equivalent alternative regimens for the treatment of prostate cancer using External Beam Radiotherapy (EBRT) and Low Dose-Rate Brachytherapy (LDRBT) with 125I implants and to evaluate the sensitivity of these regimens to different sets of radiobiological parameters of the LinearQuadratic (LQ) model. Materials and Methods: The biological effective dose (BED) was used to determinate equivalences of the two modalities assuming that BED values are additive for different treatment techniques. Two sets of parameters were employed considering whether accelerated repopulation of the clonogens during the treatment time occurs: LQ1) α/β=3.1 Gy, α=0.15 Gy-1,μ=2.6 h-1, Tpot=42 days, N=3x106 clonogens, or not, LQ2) α/β=1.5 Gy, α=0.03 Gy