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OBJECTIVE: Response to the coronavirus disease 2019 (COVID-19) pandemic has resulted in shelter-in-place orders and major changes to individuals' daily lives. The impact of such stressors on disease activity in individuals with axial spondyloarthritis (axSpA) is unclear. The aim of this study is to examine whether stress, anxiety, and depression are associated with patient-reported disease activity, after accounting for important factors. METHODS: We administered a survey to an axSpA cohort from a single center with well-defined demographic and disease characteristics. We included questions about job status changes, exercise, medication use, disease activity (by the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and psychological factors (stress, depressive symptoms, and anxiety). Separate multivariable linear models examined the associations between perceived stress, anxiety, and depression with the BASDAI. RESULTS: After adjustment for potential confounders, those with higher levels of stress had a statistically significant 0.54-point higher BASDAI, on average, compared with those with lower levels of stress (95% confidence interval [CI]: 0.11, 0.97). Those with higher levels of anxiety also had a statistically significant higher BASDAI, on average, compared with those with lower levels of anxiety (ß: 0.95, 95% CI: 0.18, 0.99). The association between depression and BASDAI was not statistically significant. We did not find differences in these associations among subgroups of age, job status, or county of residence. CONCLUSION: Individuals with axSpA with higher levels of stress and anxiety had significantly higher disease activity levels, although with a difference below clinical importance. Further planned studies will evaluate the trajectory of disease activity.
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INTRODUCTION: Elevated acoustic noise during Magnetic Resonance Imaging (MRI) has been associated with patient anxiety and altered cochlear function. Acoustic Reduction Technique (ART) T2 weighted (T2w) periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) has been studied in brain MR but not abdominopelvic imaging. The purpose of our study was to evaluate the image quality and acoustic noise level of ART T2w PROPELLER sequence in comparison with the conventional T2w PROPELLER sequence in pediatric abdomino-pelvic imaging. METHODS: Eleven consecutive pediatric patients undergoing abdomino-pelvic MRI were scanned on a 3 Tesla magnet using standard and ART T2w PROPELLER sequences. After scanning completion, objective sound level measurements were performed with a sound level meter and microphone. Mann-Whitney U test was used for a non-parametric two-tailed statistical analysis of acoustics, image rating and scan time with significance level set to 0.05. Overall inter-rater agreement was calculated using Cohen's kappa coefficient. RESULTS: Eleven pediatric patients (4 females and 7 males) between 26â¯days and 18â¯years of age (meanâ¯=â¯10.0, SDâ¯=â¯5.8) were included. ART T2w produced lower levels of acoustic noise than standard technique in a comparison of mean decibel readings from eleven trials of standard and ART T2w (p valueâ¯=â¯0.00008). Streak artifacts were rated greater in ART T2w by both raters (p-valueâ¯=â¯0.00278 and 0.00252). There was no significant difference in bile duct blurring, respiratory ghosting, pulsation, fat suppression or hepatic parenchymal depiction. CONCLUSION: Presence of additional streaking artifacts should be considered along with the benefit of reduced acoustic noise from ART T2w.