Validation of the Spanish, Portuguese and French versions of the Lupus Damage Index questionnaire: data from North and South America, Spain and Portugal.

We have previously developed and validated a self-administered questionnaire, modelled after the Systemic Lupus International Collaborating Clinics Damage Index (SDI), the Lupus Damage Index Questionnaire (LDIQ), which may allow the ascertainment of this construct in systemic lupus erythematosus (SLE) patients followed in the community and thus expand observations made about damage. We have now translated, back-translated and adapted the LDIQ to Spanish, Portuguese and French and applied it to patients followed at academic and non-academic centres in North and South America, Portugal and Spain while their physicians scored the SDI. A total of 887 patients (659 Spanish-speaking, 140 Portuguese-speaking and 80 French-speaking patients) and 40 physicians participated. Overall, patients scored all LDIQ versions higher than their physicians (total score and all domains). Infrequent manifestations had less optimal clinimetric properties but overall agreement was more than 95% for the majority of items. Higher correlations were observed among the Spanish-speaking patients than the Portuguese-speaking and French-speaking patients; further adjustments may be needed before the Portuguese and French versions of the LDIQ are applied in community-based studies. The relationship between the LDIQ and other outcome parameters is currently being investigated in a different patient sample.

Amerindian ancestry in Argentina is associated with increased risk for systemic lupus erythematosus.

Previous studies have demonstrated that in admixed populations, West African ancestry is associated with an increased prevalence of systemic lupus erythematosus (SLE). In the current study, the effect of Amerindian ancestry in SLE was examined in an admixed population in Argentina. The Argentine population is predominantly European with approximately 20% Amerindian admixture, and a very small (<2%) contribution from West Africa. The results indicate that Amerindian admixture in this population is associated with a substantial increase in SLE susceptibility risk (Odds Ratio=7.94, P=0.00006). This difference was not due to known demographic factors, including site of collection, age and gender. In addition, there were trends towards significance for Amerindian ancestry influencing renal disease, age of onset and anti-SSA antibodies. These studies suggest that populations with Amerindian admixture, like those with West African admixture, should be considered in future studies to identify additional allelic variants that predispose to SLE.

No evidence of association between genetic variants of the PDCD1 ligands and SLE.

PDCD1, an immunoreceptor involved in peripheral tolerance has previously been shown to be genetically associated with systemic lupus erythematosus (SLE). PDCD1 has two ligands whose genes are located in close proximity on chromosome 9p24. Our attention was drawn to these ligands after finding suggestive linkage to a marker (gata62f03, Z=2.27) located close to their genes in a genome scan of Icelandic families multiplex for SLE. Here, we analyse Swedish trios (N=149) for 23 single nucleotide polymorphisms (SNPs) within the genes of the PDCD1 ligands. Initially, indication of association to eight SNPs was observed, and these SNPs were therefore also analysed in Mexican trios (N=90), as well as independent sets of patients and controls from Sweden (152 patients, 448 controls) and Argentina (288 patients, 288 controls). We do not find support for genetic association to SLE. This is the first genetic study of SLE and the PDCD1 ligands and the lack of association in several cohorts implies that these genes are not major risk factors for SLE.

Efecto antipirético de la indometacina versus aspirina en la fiebre de origen tumoral / Antipyretic effect of indomethacin vs aspirin in fever of tumor origin

La fiebre se presenta frecuentemente como síntoma en pacientes con cáncer y en la mayoría de los casos está relacionada con complicaciones infecciosas o intervenciones terapéuticas. Algunos cánceres son capaces de producir fiebre por sí mismos. Se tomaron 28 epidódios febriles en 8 pacientes con cáncer internados en nuestro Servicio. Se concluyeron pacientes febriles con diagnóstico de cáncer de cualquier edad y sexo, en los cuales se descartó la etiología infecciosa y a la fiebre por drogas. Se administraron al azar 500 mg de aspirina o 50 mg de indometacina por vía intramuscular, y la respuesta fue evaluada en forma horaria durante las primeras 6 hs. En los pacientes tratados con indometacina se produjo una respuesta inicial completa y permanecieron afebriles hasta 48 hs después. En los pacients tratados con aspirina no se logró el control de la fiebre. Los resultados obtenidos demuestran que al indometacina a las dosis y vía propuestas, fue significativamente superior a la aspirina en el control de los episodios febriles (p < 0,01), y de acuerdo con estos resultados, la indometacina podría ser de utilidad en el tratamiento sintomático de la fiebre de origen tumoral

[Antipyretic effect of indomethacin vs aspirin in fever of tumor origin]. / Efecto antipirético de la indometacina versus aspirina en la fiebre de origen tumoral.

Fever is frequently a symptom in patients suffering from cancer and in most cases it is related to infections or complications of the treatment. Some cancers can also be the direct cause of fever. A total of 28 episodes of fever in 8 patients with cancer were studied. The diagnoses were: 3 patients with lung cancer, 1 patient with chronic myelogenous leukemia, 1 patient with kidney cancer, 2 patients with non-Hodgkin lymphoma, and 1 patient with Hodgkin's disease. Were included cancer diagnosed patients of any age and sex, with three or more episodes of fever of more than 37.5 C (with a case of 38.5 C or more) after having eliminated any infectious etiology or fever caused by drugs. Were not excluded any patients who had received whole blood or blood derivative transfusions, chemotherapy or antibiotic treatment up to 48 hs before the fever peak. The patients were given intramuscularly 500 mg of aspirin or 50 mg of indomethacin. The first response in the temperature curve was evaluated while checking the axillary temperature six hours after drug administration and 48 hs later if the fever persisted. The patients who were given aspirin at first, were then given indomethacin and vice versa, using the same criteria to evaluate the response. In patients treated with indomethacin the temperature diminished quickly and completely (Fig. 1), unlike the effect achieved with the use of aspirin (Fig. 2). All patients treated with indomethacin also showed a remarkable clinical improvement which was not observed when aspirin was used.(ABSTRACT TRUNCATED AT 250 WORDS)