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Background. Systemic sclerosis (SSc) is a complex autoimmune disease that involves various organs and systems and is associated with high mortality and morbidity rates. Objectives. To identify even from the first visit to the physician clinical and non-clinical parameters with predictive value for death, in patients with SSc. Methods. Demographic, clinical and non-clinical data were assessed (at each visit, according to EUSTAR recommendations) for all patients with SSc that visited our clinic between 2004-2012. Statistical analysis was done through SPSS 20.0, using chi-square and uni- and multivariate logistic regression. Results. 96 patients with SSc were included in the study, with a mean follow-up of 4.2±1.6 years. Throughout the follow-up period, there were 13 (13.5%) deaths, of whom 6 (6.2%) were of SSc cause and 7 (7.2%) of non-SSc cause. Sex- and age-adjusted univariate analysis identified the diffuse subset, a modified Rodnan score (mRSS) >14, digital ulcers, restrictive ventilatory syndrome, proteinuria, heart rhythm and conduction anomalies and hypo/ hyperpygmentation of the skin to be associated with increased mortality in all patients. Sex- and age-adjusted multivariate model identified a mRSS >14 and proteinuria as predictors of death. With regard to deaths that can be attributed to SSc, univariate analysis identified a mRSS >14, digital ulcers and proteinuria as predictive factors. Conclusions. The survival rate of patients included in the study was over 86% during a mean follow-up period of 5 years. Several clinical and non-clinical parameters which can be deemed predictive factors for death in patients with SSc were identified. Moreover, these can be detected early, from the patient's first visit to the physician, and can have an important role in developing a management strategy for the patient with SSc. [ABSTRACT FROM AUTHOR]

Women with rheumatoid arthritis (RA) may carry an increased risk of adverse pregnancy outcomes (APO). The aims of this study were to compare pregnancy outcomes in RA patients as compared to the general obstetric population (GOP) and to identify a risk profile in RA. A case-control study was conducted on 82 prospectively followed pregnancies in RA and 299 pregnancies from the GOP. The mean age at conception was 31.50 ± 4.5 years, with a mean disease duration of 8.96 ± 6.3 years. The frequency of APO in RA patients was 41.5%, 18.3% experienced spontaneous abortions, 11.0% underwent preterm deliveries, 7.3% had small for gestational age infants, 4.9% experienced intrauterine growth restriction, 1.2% experienced stillbirth, and 1.2% suffered from eclampsia. The risk of APO was correlated with a maternal age higher than 35 years ( p = 0.028, OR = 5.59). The rate of planned pregnancies was 76.8%, and the subfertility rate was 4.9%. Disease activity improved every trimester, and approximately 20% experienced an improvement in the second trimester. Planned pregnancies and corticosteroids use (≤10 mg daily) were protective factors for APO in RA pregnancies ( p < 0.001, OR = 0.12, p = 0.016, OR = 0.19, respectively). There was no significant association between APO and disease activity or DMARDs used before and during pregnancy. Regarding the comparison between the RA group and the controls, RA mothers were significantly older ( p = 0.001), had shorter pregnancies ( p < 0.001), and had neonates with a lower birth weight ( p < 0.001).

Thrombocytopenia is defined as a platelet count below 150,000/mm 3 for adults. There is still controversy about whether individuals with platelet counts of 100,000/mm 3 to 150,000/mm 3 should be classified as having genuine thrombocytopenia or borderline thrombocytopenia. Thrombocytopenia is considered mild when the platelet count is between 70,000 and 150,000/mm 3 and severe if the count is less than 20,000/mm 3 . Thrombocytopenia in rheumatoid arthritis is a rare complication, with an incidence estimated between 3 and 10%. The main etiological aspects include drug-induced thrombocytopenia and immune thrombocytopenic purpura. The most common hematological abnormalities in SARS-CoV-2 infection are lymphopenia and thrombocytopenia. It has been observed that the severity of thrombocytopenia correlates with the severity of the infection, being a poor prognosis indicator and a risk factor for mortality. COVID-19 can stimulate the immune system to destroy platelets by increasing the production of autoantibodies and immune complexes. Autoimmunity induced by viral infections can be related to molecular mimicry, cryptic antigen expression and also spreading of the epitope. During the COVID-19 pandemic, it is of great importance to include the SARS-CoV-2 infection in differential diagnoses, due to the increased variability in forms of presentation of this pathology. In this review, our aim is to present one of the most recently discovered causes of thrombocytopenia, which is the SARS-CoV-2 infection and the therapeutic challenges it poses in association with an autoimmune disease such as rheumatoid arthritis.

Background: Psoriasis is a chronic inflammatory disease characterized by an excessive hyperproliferation of keratinocytes and a combination of genetic, epigenetic, and environmental influences. The pathogenesis of psoriasis is complex and the exact mechanism remains elusive. Objectives: The study of the prevalence of psoriasis will allow the estimation of the number of people suffering from this condition at the national level, as well as the development and validation of a questionnaire to estimate the prevalence and the risk factors associated with the disease. Methods: A quantitative research was conducted at a national level among the target population in order to validate the questionnaire and estimate the national prevalence. Results: Declaratively, the prevalence of psoriasis in the studied group (N = 1500) is 4%, the first symptoms appearing around the age of 50, with a certified diagnosis being made on average at 55 years. The prevalence of psoriasis vulgaris was 4.99%. Conclusions: The results obtained will be useful in guiding future initiatives and communication campaigns related to this condition, and the methodological approach used will provide the opportunity to make recommendations for improving similar initiatives in the future.