Nature Awards NA01–NA02

i33 In order to achieve the better outcome, the timing of referral and diagnosis of early arthritis should be optimized. We examine the time to referral of patients with joint symptoms, and diagnosis delay of RA and SpA in a rural community medical center in Japan. Methods: A total of 556 who visited Kameda Medical Center from January 2009 to December 2010 with joint symptoms (arthralgia, joint swelling and/or morning stiffness) without any previous treatment except for NSAIDs were included. In the patients diagnosed as RA and SpA, the time intervals from the onset of symptom to primary care physician (PCP) (patient delay), from PCP referral to a rheumatologist (PCP delay), from the onset of symptoms to rheumatology visit (total delay) were determined. Results: Ninety-one patients were diagnosed as RA, 32 patients were diagnosed as SpA (17 Psoriatic arthritis, 8 SAPHO syndrome, and 7 Reactive Arthritis). The median patient, PCP, total delays [interquartile range [IQR]] were 8.9 weeks [2.6-27.9], 5 weeks [2-19.2], 27 weeks [11.4-60.1] for RA patients and 18.7 weeks [3-61.3], 4 weeks [1.4-9], 27.4 weeks [6.6-87.2] for SpA patients, respectively. The total delay was similar in both groups and the patient delay was longer than PCP delay, which was significant only for SpA patients (p ¼ 0.04), but not for RA patients (p ¼ 0.1682). When analyzed in subgroups, the median total delay for reactive arthritis patients (n ¼ 7) was 4.3 weeks [3.7-7.7], which was shorter than for RA patients. Conclusion: In a rural community medical center in Japan, the patient delay is longer than the PCP delay. Although the total delay was similar, the patient delay for SpA was longer than RA. This study indicates the key delay in early arthritis diagnosis in Japan. Disclosure statement: The presenting author and all the other authors declared no conflicts of interest. PP64. Abstract withdrawn. PP65. Abstract withdrawn. PP67. NOVEL THERAPIES DERIVED FROM ORIENTAL MEDICINE FOR ANKYLOSING SPONDYLITIS Jiyeon Yoon1, Nara Yoon2, Shinkyu Lee1 and Youngjin Kim1 Nemizi Oriental Hospital, Seoul, Korea, 2Institute for Regenerative Medicine, Texas A&M Health Science Center, College of Medicine at Scott & White, Temple, TX, USA 1 Background: Ankylosing spondylitis (AS) is an autoimmune disease with chronic inflammation in joints that affects mainly axial skeleton with eventual fusion of the spine. There are no cures available but only treatments to relieve pain and symptoms, mainly through medications such as anti-inflammatory drugs, steroids or TNF-a blockers. Unfortunately, there are some patients whose symptoms did not alleviate with current treatments. Our study was to investigate novel therapies to treat the symptoms of AS and reduce the inflammation. Methods: The novel therapies were developed by combinatorial treatment derived from oriental medicine, including herbal tea and acupuncture to reduce pain and inflammation. The intensity of pain and stiffness were recorded based on patients’ score. The level of inflammation was determined by measuring C-reactive protein level in blood samples of patients. The treatments were performed on 3 AS patients for approximately 12 months. Results: All three patients with AS were presented severe pain and stiffness around their axial joints, including spine and pelvis before treatments. Their initial CRP levels were ranged from 5 to 300 mg/L. After the combination of treatments, the CRP levels were reduced dramatically to normal level at 0  1 mg/L. The patients also experienced reduced pains where pain scores reduced from 10 to 0 or 1. The pain and stiffness of their joints of spines, knees and ankles disappeared after the treatments. Conclusions: The study demonstrated a novel therapy derived from oriental medicine that can treat the symptoms of AS, suggesting alternative treatments for AS patients who did not experience any effect from conventional therapies. Disclosure statement: The presenting authors have declared no conflicts of interest. PP66. SEXUAL FUNCTIONS IN MALE WITH ANKYLOSING SPONDYLITIS Aylin Rezvani1, OK S° eniz2 and Saliha Eroğlu Demir1 Bezmialem Vakif University, Physical Medicine and Rehabilitation Department, Istanbul, Turkey, 2Ministry of Health, Gebze Fatih State Hospital, Physical Medicine and Rehabilitation Clinic, Izmit, Turkey NATURE AWARDS NA01–NA02 1 Background: There are numerous studies investigating the impact of Ankylosing Spondylitis (AS) on sexual functions in male patients with the disease. However, results are contradictory. New studies on this area are stil necessary. Using International Index of Erectile Function (IIEF), the aim of this study was to determine the impact of AS on sexual functions in male patients, to compare with healthy controls and to identify the associations with demographic, disease-related variables and the level of depression in these patients Methods: A total of 40 male patients with AS and 27 healthy were included in the study. Bath Metrology Index, Bath AS Functional Index, Bath AS Disease Activity Index, Short Form-36 (SF-36), AS Quality of Life (ASQoL), IIEF and Beck Depression Inventory (BDI) were applied to the study population. Results: Prevalence of ED in patients and healthy controls were 43.6% and 51.9%, respectively (p: 0.512). No statistically significant differences were found between male patients and controls in the demographic characteristics, IIEF and BDI scores (p > 0.05). When we compared patients according to tumor necrosis factor (TNF) usage, no statistically significant difference was found between TNF naive patients and patients receiving TNF according to demographic characteristics, IIEF and BDI. TOTAL IIEF was correlated with Creactive protein levels, chest expansion and BDI. Overall Satisfaction subscale of IIEF was correlated with ASQoL, Intercourse Satisfaction with Pain subscale of SF-36, Orgasmic Function with Social Function subscale of SF-36. Conclusions: Sexual function are common, but not different in male AS patients when compared with healthy controls. Sexual problems in male patients with AS seem to be associated with higher depression level, decreased quality of life, decreased chest expansion and Creactive protein levels. However, to achieve a better results of sexual functioning in AS patients, it might be better to evaluate the issue in the longitudinal follow-up. Disclosure statement: The authors have declared no conflicts of interest. NA01. RHEUMATOLOGIC BACKGROUND IN CANDIDATES OF VALVULAR HEART SURGERY: A SINGLE CENTER SURVEY M B Owlia1, H. Soleimani2, SM Y Mostavavi3, Naderi3 and Jalil Mirhosseini4 1 Associate professor of rheumatology, Shahid Sadoughi University of Medical Sciences, 2Yazd, Iran, 3Assistant professor of rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, 4Medical students, Azad University, Yazd, Iran Background: Valvular heart diseases are among the frequent causes of cardiac surgery. Some of the patients hav (...truncated)