ABSTRACT
Se presenta un caso de embolismo pulmonar luego de vertebroplastia, realizada por fractura vertebral por osteoporosis. El embolismo se confirmó por métodos complementarios. Se sugiere atención a los síntomas respiratorios y radiografía de tórax posterior a la vertobroplastia a los efectos de mejorar la seguridad del paciente luego del procedimiento
A case of pulmonary embolism is presented after vertebroplasty, performed for a vertebral fracture due to osteoporosis. Embolism was confirmed by complementary methods. Attention to respiratory symptoms and a chest x-ray after vertobroplasty are suggested in order to improve patient safety after the procedure.
Subject(s)
FemaleABSTRACT
Resumen Se presenta un caso de embolismo pulmonar luego de vertebroplastia, realizada por fractura vertebral por osteoporosis. El embolismo se confirmó por métodos complementarios. Se sugiere atención a los síntomas respiratorios y radiografía de tórax posterior a la vertobroplastia a los efectos de mejorar la seguridad del paciente luego del procedimiento.
Abstract A case of pulmonary embolism is presented after vertebroplasty, performed for a vertebral fracture due to osteoporosis. Embolism was confirmed by complementary methods. Attention to respiratory symptoms and a chest x-ray after vertobroplasty are suggested in order to improve patient safety after the procedure.
ABSTRACT
OBJECTIVE: To describe characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Argentina, Mexico and Brazil, and to assess factors associated with mortality in this population. METHODS: Data from 3 national registries, SAR-COVID (Argentina), CMR-COVID (Mexico), and ReumaCoV-Brasil (Brazil), were combined. Adult patients with IMIDs and SARS-CoV-2 infection were recruited. Sociodemographic data, comorbidities, IMID clinical characteristics and treatment, and SARS-CoV-2 infection presentation and outcomes were recorded. RESULTS: A total of 4827 individuals were included: 2542 (52.7%) from SAR-COVID, 1167 (24.2%) from CMR-COVID, and 1118 (23.1%) from ReumaCoV-Brasil. Overall, 82.1% were female with a mean age of 49.7 (SD, 14.3) years; 22.7% of the patients were hospitalized, and 5.3% died because of COVID-19 (coronavirus disease 2019). Argentina and Brazil had both 4% of mortality and Mexico 9.4%. In the multivariable analysis, older age (≥60 years; odds ratio [OR], 7.4; 95% confidence interval [CI], 4.6-12.4), male sex (OR, 1.5; 95% CI, 1.1-2.1), living in Mexico (OR, 3.0; 95% CI, 2.0-4.4), comorbidity count (1 comorbidity: OR, 1.5; 95% CI, 1.0-2.1), diagnosis of connective tissue disease or vasculitis (OR, 1.8; 95% CI, 1.3-2.4), and other diseases (OR, 2.6; 95% CI, 1.6-4.1) compared with inflammatory joint disease, high disease activity (OR, 4.2; 95% CI, 2.5-7.0), and treatment with glucocorticoids (OR, 1.9; 95% CI, 1.4-2.5) or rituximab (OR, 4.2; 95% CI, 2.7-6.6) were associated with mortality. CONCLUSIONS: Mortality in patients with IMIDs was particularly high in Mexicans. Ethnic, environmental, societal factors, and different COVID-19 mitigation measures adopted have probably influenced these results.
Subject(s)
COVID-19 , Rheumatic Diseases , Adult , Humans , Male , Female , Middle Aged , SARS-CoV-2 , Mexico/epidemiology , Latin America , Argentina/epidemiology , Brazil/epidemiology , Rheumatic Diseases/epidemiology , Immunomodulating AgentsABSTRACT
Background: Quality of life (QoL), according to the WHO, includes the perception that a person has about their physical health, level of independence, social relationships, system of values ââand goals, expectations, standards and concerns. The medical student faces a high level of competitiveness in the course of his academic training with an increase in the workload as he progresses; this causes symptoms such as anxiety, stress, sadness, among others. If these aspects are not treated or are masked, they can turn into depression, generalized anxiety, burnout and even suicide (2). Aim: To describe the QoL of the students of medicina at the National University of Córdoba, considering the complete training cycle divided into two groups from 1 to 3° and from 4 to 5°. Methods: Cross-sectional study, through the Guarani System of the UNC. The WHOQoL-BREF online questionnaire, which uses the Likert scale, was applied to all students. This assesses the global QoL and satisfaction regarding the state of physical and psychological health, interpersonal relationships and environment. p was considered significant <0.05. This work was approved by the Adult CIEIS. Results: 854 responses were obtained, 72% were female, 43% were from another province/country and 63% corresponded to the 1-3° group. Of these, 37% rated their QoL as "fairly good", while 36% of the 4-5th grade group perceived their QoL as "normal" (p:0.0469). The most influential variables correspond to the supply of money for their needs (p:0.0005), sexual satisfaction (p:0.0056) and access to health services (p:0.0042) . Cronbach's alpha was 0.8899. Conclusion: QoL is better perceived in the 1-3 year group and economic supply, sexual satisfaction and access to health services were the main points to take care of in this medicine students.
Introducción: La calidad de vida (CV), según la OMS, comprende la percepción que tiene una persona sobre su salud física, nivel de independencia, relaciones sociales, sistema de valores y metas, expectativas, estándares y preocupaciones (1). El estudiante de medicina se enfrenta con un alto nivel de competitividad en el transcurso de su formación académica con aumento de la carga horaria a medida que avanza; esto origina síntomas como ansiedad, estrés, tristeza, entre otros. Si tales aspectos no son tratados o son enmascarados pueden transformarse en depresión, ansiedad generalizada, burnout y hasta suicidio (2). Objetivo: Describir la CV de los estudiantes de medicina de la Universidad Nacional de Córdoba, considerando el ciclo completo de formación divididos en dos grupos de 1-3° y 4-5°. Métodos: Estudio transversal, mediante el Sistema Guaraní de la UNC se aplicó el cuestionario online WHOQOL-BREF, que utiliza escala de Likert a todos los alumnos. Este valora la CV global y satisfacción respecto al estado de salud física, psicológica, relaciones interpersonales y entorno. Se consideró significativo una p<0.05. Este trabajo fue aprobado por el CIEIS del Adulto. Resultados: Se obtuvieron 854 respuestas, el 72% fue de género femenino, el 43% es originario de otra provincia/país y el 63% correspondió al grupo de 1-3°. De estos, el 37% calificó su CV como "bastante buena", mientras que el 36% del grupo de 4-5° percibió su CV como "normal" (p:0,0469). Las variables más influyentes corresponden al abastecimiento de dinero para sus necesidades (p:0,0005), satisfacción sexual (p:0,0056) y el acceso a los servicios sanitarios (p:0,0042). El alfa de Cronbach fue 0.8899. Conclusión: La CV es mejor percibida en el grupo de 1-3° año y se destacan el suministro económico, la satisfacción sexual y el acceso a los servicios sanitarios.
Subject(s)
Quality of Life , Students, Medical , Adult , Male , Humans , Female , Cross-Sectional Studies , Argentina , Surveys and Questionnaires , Retrospective StudiesABSTRACT
BACKGROUND: Primary Sjögren syndrome (pSS) is a chronic autoimmune disease with its main target being exocrine glands, and is the connective tissue disease more frequently associated with other autoimmune diseases. The aim of this study was to assess the frequency of another autoimmune rheumatic disease (ARD) developed in primary Sjögren syndrome (pSS) patients and to describe it's clinical, serological and histologic characteristics. MATERIALS AND METHODS: This is a retrospective cohort study. Data of patients with pSS diagnosis (American-European criteria 2002), included in the GESSAR database (Grupo de Estudio Síndrome de Sjögren, Sociedad Argentina de Reumatología) were analyzed. The development of a second ARD was registered during the follow up. RESULTS: 681 patients were included, 94.8% female. The mean age was 54 (SD 14) years and mean age at diagnosis of 50 (SD 13) years. The mean follow-up was 4.7 (SD 4.9) years; 30 patients (4.41%, CI 95%: 3.1-5.7) developed a second ARD during the follow up, incidence rate was 9.1/1000 patients-year (IR 95%: 5.8-12.4/1000 patients-year), the most frequent being rheumatoid arthritis (RA). 96% out of these 30 patients had xerophthalmia, 86.2% xerostomia, 92% positive Schirmer test, 88.24% positive Rosa Bengala test, lisamine green or Ocular Staining Score, 81.2% positive unstimulated salivary flow, 82.1% Ro(+) and 33.33% La(+). Minor salivary gland biopsy had been performed in 14 of the 30 patients, 12 with positive results. There were no statistically significant differences respect baseline characteristics when comparing the patients who developed another ARD to the ones that did not. CONCLUSIONS: Of all the patients analyzed, 4.4% presented another ARD during their follow-up. It is important to be aware of this, to make an early and proper diagnosis and treatment of our patients.
Subject(s)
Autoimmune Diseases , Sjogren's Syndrome , Xerostomia , Autoimmune Diseases/complications , Autoimmune Diseases/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Sjogren's Syndrome/complications , Sjogren's Syndrome/diagnosis , Sjogren's Syndrome/epidemiologyABSTRACT
BACKGROUND: Pregnancy in women with systemic lupus erythematosus (SLE) and nephritis (LN) is at risk of foetal and maternal complications. OBJECTIVE: To evaluate the effect of LN on pregnancy with respect to foetal and maternal outcome. METHODS: We retrospectively studied all pregnant SLE patients with and without diagnosis of LN, who attended the Materno Neonatal Hospital in Cordoba city, Argentina, from January 2015 to April 2017. Demographic, clinical, and laboratory data were collected. The presence of antiphospholipid syndrome (APS) and antiphospholipid antibodies (AAF), and maternal and foetal outcome were evaluated. RESULTS: 121 pregnancies in 79 patients were included. Pregnancies were divided into those with LN (69) and those without LN (52). The presence of APS and AAF was more frequent in the LN group as well as higher basal SLEDAI. The LN group received more immunosuppressive therapy and increased steroid dose treatment. Of the patients, 47.5% had Class IV LN. Lupus flares occurred more frequently in the LN group 25.8% vs 10.9% in the group without LN (P = .041), mainly renal flares in the LN group. No patients developed end-stage renal failure. Preeclampsia was more frequent in the LN group, 18.8% vs 6.3% in the group without LN (P = .047). There was only one maternal death. A caesarean section was required in 68.5% of the LN group vs 31.5 in the group without LN, and urgent caesarean section was also performed in the LN group. There were no differences in foetal outcomes in either group: live birth, gestational age, weight birth, perinatal death, foetal distress. CONCLUSIONS: Patients with LN experienced more maternal complications such as lupus flares and preeclampsia. However, LN does not lead to a worse pregnancy and foetal outcome. Patients should be strictly monitored before and after conception.
Subject(s)
Lupus Erythematosus, Systemic , Lupus Nephritis , Pre-Eclampsia , Pregnancy Complications , Cesarean Section/adverse effects , Female , Humans , Lupus Erythematosus, Systemic/complications , Lupus Nephritis/complications , Lupus Nephritis/diagnosis , Pre-Eclampsia/epidemiology , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Outcome , Retrospective StudiesABSTRACT
Abstract Background: Primary Sjögren syndrome (pSS) is a chronic autoimmune disease with its main target being exocrine glands, and is the connective tissue disease more frequently associated with other autoimmune diseases. The aim of this study was to assess the frequency of another autoimmune rheumatic disease (ARD) developed in primary Sjögren syndrome (pSS) patients and to describe it's clinical, serological and histologic characteristics. Materials and methods: This is a retrospective cohort study. Data of patients with pSS diagnosis (American-European criteria 2002), included in the GESSAR database (Grupo de Estudio Síndrome de Sjögren, Sociedad Argentina de Reumatología) were analyzed. The development of a second ARD was registered during the follow up. Results: 681 patients were included, 94.8% female. The mean age was 54 (SD 14) years and mean age at diagnosis of 50 (SD 13) years. The mean follow-up was 4.7 (SD 4.9) years; 30 patients (4.41%, CI 95%: 3.1-5.7) developed a second ARD during the follow up, incidence rate was 9.1/1000 patients-year (IR 95%: 5.8-12.4/1000 patients-year), the most frequent being rheumatoid arthritis (RA). 96% out of these 30 patients had xerophthalmia, 86.2% xerostomia, 92% positive Schirmer test, 88.24% positive Rosa Bengala test, lisamine green or Ocular Staining Score, 81.2% positive unstimulated salivary flow, 82.1% Ro(+) and 33.33% La(+). Minor salivary gland biopsy had been performed in 14 of the 30 patients, 12 with positive results. There were no statistically significant differences respect baseline characteristics when comparing the patients who developed another ARD to the ones that did not. Conclusions: Of all the patients analyzed, 4.4% presented another ARD during their follow-up. It is important to be aware of this, to make an early and proper diagnosis and treatment of our patients. Key points Patients with primary Sjögren's Syndrome may develop another connective tissue disease during follow-up. The most frequently connective tissue disease developed during follow-up in the population of patients with primary Sjogren's Syndrome studied was rheumatoid arthritis. It is important to be aware of this to make an early and proper diagnosis.
ABSTRACT
Background: Burnout syndrome is a chronic, adaptive disorder, being considered the most important cause of work injury of psychosocial cause. The objective was to know the risk of burnout in Córdoba city's physician and its relationship with sociodemographic factors and clinical and surgical specialties. Methods: An observational cross-sectional study was performed in 10 care centers in Córdoba City. Physicians were interviewed, we ask about sociodemographic variables and the Maslach Burnout Inventory questionnaire was done to objectify the risk of Burnout. The age was stratified by decades from 20 to 60 years. p < a 0,05 was considered significant. Results: 483 physicians were interviewed, 62,1% were women, 70% were between 20 and 40 years of age; 54.2% single, 42.9% had a time of exercised in the profession below 5 years. 66 of the total (16,5%) had a high risk of burnout, it was associated with the fact to work in a public establishment (p < 0.00001), to be single (p < 0.009), to work more than 60 h (p<0.001), sleeping less than 42 h per week (p < 0.005), less than five years of profession (p < 0.0002); to be from 20 to 29 years old ( p <0.0005) , the protective factor was to have children (p <0.006).There were no differences between clinical and surgical specialties. Young professionals, with lower family restraint and greater labor demand, are those that present a greater risk of burnout. Institutions should identify their risk professionals and develop mechanisms for the protection and treatment of those affected.
Introducción: El Síndrome de Burnout es un trastorno adaptativo, crónico, asociado con inadecuado afrontamiento de las demandas psicológicas del trabajo, es el origen de daño laboral de causa psicosocial más importante. Objetivo: Conocer el riesgo de Burnout en médicos de la ciudad de Córdoba, su relación con factores sociodemográficos y con especialidades clínicas o quirúrgicas. Métodos: Se realizó un estudio observacional de corte transversal en 10 centros asistenciales públicos y privados de la Ciudad de Córdoba. Se entrevistaron 483 médicos, recogiendo variables sociodemográficas y cuestionario Maslach Burnout Inventory evaluando el riesgo de Burnout. La edad fue estratificada desde los 20 años, de 10 en 10 hasta 60. p < 0,05 fue significativa. Resultados: Se entrevistaron 483 médicos, 62,1% mujeres, el 70% entre los 20 y los 40 años; 54,2% solteros, 42.9% ejerció < de 5 años la profesión; el 66 del total (16,5%) tuvo alto riesgo de Burnout, las variables asociadas fueron: trabajar en un establecimiento público (p < 0,00001), ser soltero (p < 0,009), trabajar más de 60 hs (p < 0,001), dormir menos de 42 hs semanales (p< 0,005), tener entre 20 y 29 años (p <0.0005) y tener menos de cinco años de profesión p < 0,0002; se identificó como factor protector tener hijos (p < 0,006). No hubo diferencias entre especialidades clínicas y quirúrgicas. Conclusiones: Los profesionales jóvenes, con menor contención familiar y mayor demanda laboral son los que presentan mayor riesgo de Burnout. Se deberían identificar y desarrollar mecanismos para proteger y tratar los afectados.
Subject(s)
Burnout, Professional , Sociodemographic Factors , Adult , Argentina/epidemiology , Burnout, Professional/epidemiology , Child , Cross-Sectional Studies , Female , Humans , Middle Aged , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: Pregnancy in women with systemic lupus erythematosus (SLE) and nephritis (LN) is at risk of foetal and maternal complications. OBJECTIVE: To evaluate the effect of LN on pregnancy with respect to foetal and maternal outcome. METHODS: We retrospectively studied all pregnant SLE patients with and without diagnosis of LN, who attended the Materno Neonatal Hospital in Cordoba city, Argentina, from January 2015 to April 2017. Demographic, clinical, and laboratory data were collected. The presence of antiphospholipid syndrome (APS) and antiphospholipid antibodies (AAF), and maternal and foetal outcome were evaluated. RESULTS: 121 pregnancies in 79 patients were included. Pregnancies were divided into those with LN (69) and those without LN (52). The presence of APS and AAF was more frequent in the LN group as well as higher basal SLEDAI. The LN group received more immunosuppressive therapy and increased steroid dose treatment. Of the patients, 47.5% had ClassIV LN. Lupus flares occurred more frequently in the LN group 25.8% vs 10.9% in the group without LN (P=.041), mainly renal flares in the LN group. No patients developed end-stage renal failure. Preeclampsia was more frequent in the LN group, 18.8% vs 6.3% in the group without LN (P=.047). There was only one maternal death. A caesarean section was required in 68.5% of the LN group vs 31.5 in the group without LN, and urgent caesarean section was also performed in the LN group. There were no differences in foetal outcomes in either group: live birth, gestational age, weight birth, perinatal death, foetal distress. CONCLUSIONS: Patients with LN experienced more maternal complications such as lupus flares and preeclampsia. However, LN does not lead to a worse pregnancy and foetal outcome. Patients should be strictly monitored before and after conception.
ABSTRACT
Background: Mortality from cardiovascular disease (CVD) is increased in rheumatoid arthritis, not explained by traditional cardiovascular risk factors (CVRF), suggesting a role of inflammation. This process would occur early. The common sonographic markers of subclinical atherosclerosis (SA), are increased carotid intima-media thickness (cIMT) or the presence of carotid atherosclerotic plaque and they are closely related to CVD. Aims: To evaluate sonographic markers and cardiovascular risk factors in early Arthritis (EA). Methods: A case control study of patients with EA, defined by 3 joints swollen with <1 year of evolution, served consecutively from January 2011 to may 2013, matched with healthy controls, by sex, age and cardiovascular risk factors (hypertension, diabetes mellitus, cardiovascular disease -IAM and ACV, dyslipidemia, family history of CVD) was conducted. We studied demographics data, cardiovascular risk factors, carotid ultrasound measuring increased cIMT or the presence of carotid atherosclerotic plaque in Common Carotid Artery (CCA) and Carotid Bulb (BC), laboratory test that included cholesterol, LDL, HDL, triglycerides in mg%, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR ), anti citrullinated peptide (ACCP), rheumatoid factor (RF), antinuclear antibodies (ANA). EA activity was measured by DAS 28, considering high disease activity (HDA) 5.1; moderate (MDA) from 5.1 to 3.2; and low (LDA) <3.2. Statistics: test Mann-Whitney and chi-square were used, p <0.05 was significant. Results: 25 women, 5 men, average age 43 years (DS 14.7) and 30 controls were included. The average DAS 28 was 4, 8 ± 1. 8; 47% had HDA, 33%MDA and 20%BDA. Both groups had similar values cIMT CCA (0, 57 ± 0.10 mm vs. 0.58 ± 0.15 mm, respectively, P = 0.82) and cIMT BC (0.18mm ± 0.67 vs 0.62 ± 0.15 mm respectively, P = 0.47). There were no carotid plaques. The median total cholesterol was 181,5 vs 183,5 (p = 0.35); triglycerides 99 vs 92,5 (p = 0.68); HDL 54,5 vs 52,5 (p = 0.921 and LDL 105 vs 110 (p = 0.27) in EA and controls respectively. The cIMT CCA and CB were not related to RF, ACCP, CRP, DAS 28 and smoking (NS). There was no difference in other cardiovascular risk factors Conclusions: Ultrasound evidence of atherosclerosis subclinical markers was not found in this study, suggesting that this process may occur after a year of diagnosis.
Introducción: La mortalidad por Enfermedad cardiovascular (ECV) temprana está incrementada en enfermedades inflamatorias. Los marcadores ecográficos de aterosclerosis subclínica (AS) están estrechamente relacionados con ECV. Objetivo: Evaluar marcadores de AS ecográficos y Factores de Riesgo Cardiovascular (FRCV) en Artritis temprana (AT) y correlacionarlo con la actividad de la enfermedad. Material y Métodos: Estudio transversal de casos y controles en pacientes con AT, definida por 3 articulaciones inflamadas con menos de 1 año de evolución, realizado desde 2011 a 2013, apareados con controles sanos, por sexo, edad y FRCV. Se registraron datos demográficos, FRCV, rigidez de pared (cIMT) en Arteria Carótida Común (ACC) y en Bulbo Carotídeo (BC) y presencia de placas ateroscleróticas por ecografía, perfil lipídico, Proteína C Reactiva, eritrosedimentación, anticuerpos anti péptido citrulinado, Factor reumatoide, anticuerpos antinucleares. La actividad de AT se midió por Disease Activity Score (DAS) 28. Estadística: Se usaron test U de Mann-Whitney, Kruskal Wallis y chi-cuadrado, p <0,05 fue significativo. Resultados: Se incluyeron 25 mujeres, 5 hombres con edad promedio 40 años (18-61) y 30 controles. El DAS 28 promedio fue 4,8 ±1.8. Pacientes y controles tuvieron similares valores cIMT ACC (0, 57 ±0.10 mm vs 0,58 ± 0,15 mm, respectivamente) y cIMT CB (0,67 ±0,18mm vs 0,62 ±0,15 mm), no hubo placas carotídeas y el perfil lipídico fue similar en ambos grupos, PNS. El cIMT CCA y CB no tuvieron relación con DAS 28, serología, ni FRCV, P: NS. Conclusiones: La aterosclerosis subclínica se produciría después del primer año de enfermedad en artritis temprana.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Atherosclerosis/diagnostic imaging , Biomarkers/blood , Adult , Arthritis, Rheumatoid/blood , Arthritis, Rheumatoid/complications , Atherosclerosis/blood , Atherosclerosis/complications , Cardiovascular Diseases/blood , Cardiovascular Diseases/diagnostic imaging , Cardiovascular Diseases/etiology , Carotid Artery, Common/diagnostic imaging , Carotid Artery, Common/pathology , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Risk Factors , UltrasonographyABSTRACT
Cardiovascular risk is increased in Rheumatoid Arthritis and it is associated with higher morbility and mortality. Few studies have evaluated the lipid profile in early arthritis (EA). Aims: To study the lipid profile in patients with EA and its association with disease activity (DA). Methods: We studied 31 patients with diagnosis of EA and a control group, with age, gender and cardiovascular risk factors matched, who were attended to Rheumatology Unit at Córdoba Hospital from January 2011 to May 2013. We evaluated demographic data, lipid profile and DA by DAS28. Results: 31 patients were included with mean age of 42.3 years old, 87% female , the cholesterol level was 191.9 mg/dl, HDL 54, LDL 115.8, Triglycerides 117,6; and 31 patients were included in the control group with average age of 42.7 years old, and cholesterol level of 198.7 mg / dl, HDL 56.9 LDL 122.6, Triglycerides 99.6 (p NS). Regards disease activity, in the low DA group the Cholesterol level was 196.3 , LDL 115.8, HDL 62 y triglycerides 95.17, and in the Moderate and High DA the Cholesterol level was 190 mg/ dl, LDL 115, HDL 52 y triglycerides 122,9 (p NS) Conclusions: The lipid profile was normal and it was not associated with DA in EA patients.
El riesgo cardiovascular está aumentado en pacientes con Artritis Reumatoidea establecida, con aumento de la morbimortalidad cardiovascular, inclusive tempranamente y puede ser expresión subclínica de la enfermedad. Pocos estudios han evaluado el perfil lipídico en artritis temprana (AT). Objetivos: Determinar la prevalencia y el tipo de alteración del perfil lipídico en pacientes con AT y su asociación con la actividad de la enfermedad (AE). Material y métodos: Se estudiaron pacientes con diagnóstico de AT comparados con un grupo control, apareados por sexo, edad y factores de riesgo cardiovascular, asistidos de forma consecutiva desde enero de 2011 a mayo de 2013 en el Hospital Córdoba. Se recolectaron datos demográficos, perfil lipídico y actividad de la enfermedad (AE) por Disease Activity Score (DAS 28). Se comparó el nivel de lípidos en ambos grupos y entre pacientes con artritis según el nivel de AE, clasificándolos en Baja AE y Mediana / Alta AE. P menor a 0.05 fue considerada significativa. Resultados: El número de pacientes con Artritis temprana fue de 31, con una media de edad de 42.3 años, 87% sexo femenino y el nivel de Colesterol Total promedio fue de 191.9 mg/dl, HDL 54, LDL 115.8, Triglicéridos 117,6, mientras que el grupo control fue de 31 pacientes con una media de edad de 42.7 años, con nivel promedio de Colesterol 198.7 mg/dl, HDL 56.9, LDL 122.6, Triglicéridos 99.6 (p=NS, para todas las determinaciones). En cuanto a la actividad de la enfermedad, en el grupo de Baja AE los niveles de Colesterol fueron 196.3, LDL 115.8, HDL 62 y triglicéridos 95.17 y en el grupo moderada y alta AE, Colesterol 190,1 LDL 115, 8, HDL 52 y triglicéridos 122,9 (p NS para todas las comparaciones) Conclusion: El perfil lipídico fue normal y no se encontró asociado a la AE en pacientes con AT.
Subject(s)
Arthritis, Rheumatoid/blood , Dyslipidemias/etiology , Inflammation/blood , Lipids/analysis , Adolescent , Adult , Arthritis, Rheumatoid/complications , Case-Control Studies , Dyslipidemias/blood , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , Young AdultABSTRACT
Se realizó un estudio de corte transversal, descriptivo simple, observacional, correlacional, estudiando osteoporosis y factores de riesgo asociados en 31 personas, 16 varones y 15 mujeres mayores de 50 años que viven en una población rural de montaña, en la pampa de Achala, Povincia de Córdoba, República Argentina. Se realizó cuestionario para detectar factores de riesgo para osteoporosis, examen físico, laboratorio de metabolismo fosfocálcico, radiografías de columna dorsal y lumbar y densitometría ósea de columna lumbar y caderas. Considerando las dos regiones estudiadas 66% de la muestra tuvo baja densidad mineral ósea. 19% tuvo osteoporosis en columna lumbar y 19% en caderas, 29% osteopenia en columna lumbar y 25% en caderas. Si consideramos población femenina, el 33% tuvo osteoporosis y el 33% osteopenia en columna lumbar, mientras que el 26% tuvo osteoporosis y el 20% osteopenia en cadera. En cuanto a la población masculina, el 6% tuvo osteoporosis y el 25% osteopenia en columna lumbar, y el 12,5% 12,5% osteoporosis y 31% osteopenia en caderas. 10 personas, que equivale al 32% de la muestra, tuvieron fracturas vertebrales radiológicas, de las cuales el 40% fueron asintomáticas. Los factores de riesgo que demostraron asociación significativa fueron por test de chi cuadrado fueron antecedentes familiares (p<0.05), la hipocalcemia (p<0.05) y hubo una tendencia que no alcanzó significación estadística con la vitamina D (p<0.07), por coeficiente de Spearman fueron el índice de masa corporal en mujeres, el antecedente personal de fractura, en ambas regiones, ambos sexos, el consumo de calcio por día en columna en varones, las horas de caminata en ambos sexos y la vitamina D con mejores resultados en trocanter en mujeres.