Analysis of the image and corporate identity of the Colegio Mexicano de Reumatologia: Is it time to redefine it?

INTRODUCTION AND OBJECTIVES: The Colegio Mexicano de Reumatología (CMR) is a corporation whose brand has two elements-image and identity-that differentiate it from other corporations. We evaluated aspects of CMR's corporate image and identity. SUBJECTS AND METHODS: To assess corporate image, we designed a survey using proof-of-concept and discrete-choice-experiments approaches. It assessed which definition (orthopedist, rheumatologist, or rehabilitator) was most meaningful in four pain scenarios in healthy adults from the country's Western region. We used discourse analysis and five readability indices of the CMR website to assess corporate identity. RESULTS: In total, 700 respondents were included. For every rheumatologist chosen in the hand scenario, respondents chose 1.13 orthopedists and 0.70 rehabilitators. For every rheumatologist chosen in the knee scenario, respondents chose 2.36 orthopedists and 0.64 rehabilitators, whereas 0.85 orthopedists and 0.58 rehabilitators were chosen in the arthritis scenario. Only 38% of the respondents preferred the CMR's definition of a rheumatologist to describe a rheumatologist. The younger age group preferred orthopedists to rheumatologists (50% vs. 31%, p<0.001). In the arthritis scenario, the choice of rheumatologist increased from 27% in the elementary school group to 49% in the university group (p<0.001). Mother was the most influential in healthcare seeking. The discursive analysis revealed that the CMR is positioned as a "we" restricted to "colleagues;" the patient did not have agentive representation. The semiotic structure of the CMR's mission/vision was deemed imprecise and lacking in statements of value and purpose; the readability scores indicated that the text was challenging and dry. CONCLUSIONS: The CMR's corporate image does not differentiate it from other health providers. CMR's identity seems ambiguous with restricted directionality. It seems pertinent to redefine the CMR.

Delphi consensus on the use of telemedicine in rheumatology: RESULTAR study.

BACKGROUND AND OBJECTIVES: There is growing interest in the potential of telemedicine (TM) as an alternative to physical consultation. Although numerous studies prove the benefits of TM in rheumatology, there are no recommendations on its implementation in Spain. The aim of this study was to analyze the application of TM in rheumatology consultations in Spain. MATERIALS AND METHODS: Qualitative, cross-sectional, multicenter study with Delphi methodology in two rounds of queries. A structured ad hoc questionnaire was designed that included statements on teleconsultation, nursing teleconsultation, telecare, telerehabilitation, teleradiology, telehealth tele-education, main barriers, advantages and disadvantages of telehealth tele-education and TM in rheumatoid arthritis. The participants were rheumatology specialists practicing in Spain. RESULTS: The participating rheumatologists (N = 80) had a mean age of 42.4 (±9.0) years, with 12.6 (±8.4) years of experience. Some of the aspects of TM that obtained the greatest consensus were: TM is useful for follow-up of some patients, to help determine if a face-to-face consultation is necessary, or to assist patients with rheumatoid arthritis if they present low activity or in remission; certain patients, such as those in their first consultation or those who present digital barriers or cognitive deterioration, should be seen face-to-face; TM presents some technical and patient access barriers; TM can be useful in nursing and in continued medical education. CONCLUSIONS: TM can be beneficial for the treatment and follow-up of patients with rheumatic diseases, as well as for alleviating the face-to-face care burden in rheumatology.

An update on the study of synovial fluid in the geriatric patient / Panorama actual del estudio de líquido sinovial en el paciente geriátrico

Background: The characteristics of synovial fluid (SF) in geriatric patients differ from those in younger patients. In Mexico, epidemiologic data on the incidence of different rheumatic diseases in geriatric patients are scarce. Objective: To describe the physical characteristics of geriatric SF and the prevalence of crystals in knee and other joint aspirates from patients with previously diagnosed joint disease. Materials and methods: A retrospective study was performed with a baseline of 517 SF samples between 2011 and 2023. White blood cell count was performed by Neubauer chamber and crystals were identified by polarized light microscopy. Descriptive statistical analysis was performed and prevalence was reported as a percentage. Results: The mean age of the adults was 73.5±5.0 years, 54.4% were women and 45.6% were men. The mean SF volume was 6.3±9.5mL in older adults and 15.3±24.9mL in those younger than 65 years. The mean viscosity in older adults was 9.5±4.5mm and the mean leukocyte count was 7352±16,402leukocytes/mm3. Seventy percent of the older adults’ SFs were referred to the laboratory for osteoarthritis (OA), with lower proportions for rheumatoid arthritis (RA) (14.6%) and gout (5.1%). Of the crystals observed in the geriatric population, 14.6% corresponded to monosodium urate crystals (CUM) and 18.9% to calcium pyrophosphate crystals (CPP). Conclusions: The characteristics of LS in older adults were smaller volume, increased viscosity, and non-inflammatory. The main diagnoses were OA, RA, and gout. The crystal content of the SF of the geriatric population corresponded mainly to CPP.(AU)

Antecedentes: Las características del líquido sinovial (LS) en pacientes geriátricos varían en comparación con pacientes más jóvenes. En México, los datos epidemiológicos sobre la incidencia de diversas enfermedades reumáticas en el paciente geriátrico son escasos. Objetivo: Describir las características físicas del LS geriátrico y la prevalencia de cristales en aspirados de rodilla y otras articulaciones de pacientes con enfermedades articulares previamente diagnosticadas.Materiales y métodos: Se realizó un estudio retrospectivo con una base de 517 muestras de LS entre 2011 y 2023. El recuento de glóbulos blancos se realizó con cámara de Neubauer, y los cristales se identificaron por microscopia de luz polarizada. Se realizó un análisis estadístico descriptivo y la prevalencia se reportó como porcentaje. Resultados: La edad promedio en los adultos fue de 73,5±5,0 años; el 54,4% fueron mujeres y el 45,6%, hombres. El volumen promedio del LS en adultos mayores fue de 6,3±9,5ml, mientras que en menores de 65 años fue de 15,3±24,9ml. La viscosidad promedio fue de 9,5±4,5mm en los adultos mayores, y una cuenta de 7.352±16.402 leucocitos/mm3. El 70% de los LS de los adultos mayores fueron remitidos a laboratorio por osteoartritis (OA), u una proporción más baja, por artritis reumatoide (AR) (14,6%) y gota (5,1%). En cuanto a los cristales observados en los LS de la población geriátrica, el 14,6% correspondieron a cristales de urato monosódico (CUM) y el 18,9%, a cristales de pirofosfato de calcio (CPP). Conclusiones: Las características del LS en los adultos mayores fueron menor volumen, viscosidad incrementada y no inflamatorios. Los principales diagnósticos fueron OA, AR y gota. El contenido de los cristales en los LS de la población geriátrica correspondió principalmente a CPP.(AU)

An update on the study of synovial fluid in the geriatric patient.

BACKGROUND: The characteristics of synovial fluid (SF) in geriatric patients differ from those in younger patients. In Mexico, epidemiologic data on the incidence of different rheumatic diseases in geriatric patients are scarce. OBJECTIVE: To describe the physical characteristics of geriatric SF and the prevalence of crystals in knee and other joint aspirates from patients with previously diagnosed joint disease. MATERIALS AND METHODS: A retrospective study was performed with a baseline of 517 SF samples between 2011 and 2023. White blood cell count was performed by Neubauer chamber and crystals were identified by polarized light microscopy. Descriptive statistical analysis was performed and prevalence was reported as a percentage. RESULTS: The mean age of the adults was 73.5±5.0 years, 54.4% were women and 45.6% were men. The mean SF volume was 6.3±9.5mL in older adults and 15.3±24.9mL in those younger than 65 years. The mean viscosity in older adults was 9.5±4.5mm and the mean leukocyte count was 7352±16,402leukocytes/mm3. Seventy percent of the older adults' SFs were referred to the laboratory for osteoarthritis (OA), with lower proportions for rheumatoid arthritis (RA) (14.6%) and gout (5.1%). Of the crystals observed in the geriatric population, 14.6% corresponded to monosodium urate crystals (CUM) and 18.9% to calcium pyrophosphate crystals (CPP). CONCLUSIONS: The characteristics of LS in older adults were smaller volume, increased viscosity, and non-inflammatory. The main diagnoses were OA, RA, and gout. The crystal content of the SF of the geriatric population corresponded mainly to CPP.

Valores de referencia para el 1-minute sit-to-stand test en pacientes pediátricos con artritis idiopática juvenil / Reference values for the 1-minute sit-to-stand test in pediatric patients with juvenile idiopathic arthritis

Introducción: los niños con artritis idiopática juvenil (AIJ) experimentan períodos de dolor e inmovilidad que afectan sus capacidades condicionales. Objetivos: describir los valores de referencia para el 1-minute Sit-to-Stand Test(1-STS; test de 1 minuto de sentarse y pararse) en niños con AIJ como evaluación de la capacidad aeróbico-funcional y de la fuerza muscular de los miembros inferiores (MMII).Materiales y métodos: se realizó un estudio observacional que incluyó a 15 niños con AIJ de entre 5 y 16 años. Se evaluó su rendimiento en el 1-STS. Resultados: se encontró una correlación positiva significativa entre el 1-STS y el test de la marcha de 6 minutos (r=0,56; p=0,03), como con el índice de capacidad funcional (CAPFUN) (r=0,54; p=0,03). No se observaron correlaciones significati-vas entre el Childhood Health Assessment Questionnaire (CHAQ) y el 1-STS (r=-0,21; p=0,44), tampoco con el Juvenile Arthritis Disease Activity Score (JADAS-10) (p=0,83). Conclusiones: el 1-STS parece prometedor para medir la capacidad aeróbi-co-funcional y la fuerza muscular de los miembros inferiores en niños con AIJ oligoarticular.

Introduction: children with juvenile idiopathic arthritis (JIA) experience periods of pain and immobility that affect their physical capacities. Objectives: to describe reference values for the 1-minute sit to stand test (1-STS) in children with JIA as an assessment of aerobic-functional capacity and lower limb muscle strength.Materials and methods: an observational study was conducted, including 15 children with JIA aged between 5 and 16 years. Their performance in the 1-STS was assessed. Results: a significant positive correlation was found between the 1-STS and the 6-Minute Walk Test (r=0,56; p=0,03), as well as with the Functional Capacity Index (CAPFUN) (r=0,54; p=0,03). No significant correlations were observed between the Childhood Health Assessment Questionnaire (CHAQ) and the 1-STS (r=-0,21; p=0,44), nor with the Juvenile Arthritis Disease Activity Score (JADAS-10) (p=0,83). Conclusions: the 1-STS appears promising for assessing aerobic-functional capacity and lower limb muscle strength in children with oligoarticular JIA.

Características del empleo y la remuneración económica en el ejercicio de la Reumatología en diferentes distritos de Argentina / Characteristics of employment and economic remuneration in the practice of Rheumatology in different districts of Argentina

Introducción: la Reumatología es una especialidad clínica con elevada de-manda y gran desigualdad en su ejercicio en Latinoamérica y el país. Objetivos: describir el estado del ejercicio de la Reumatología en nuestro país. Materiales y métodos: estudio observacional de corte transversal que recabó información a través de una encuesta online difundida por e-mail y de un código QR en el 54º Congreso Argentino de Reumatología. Resultados: se recibieron 127 respuestas; 86 (67,7%) fueron del sexo femenino, con una mediana de edad de 45 años. Ciento trece (113; 89%) encuestados eran especialistas en Reumatología, con 20 años (RIC 14-28) de ejercicio de la medicina y 13 años (RIC 6,5-20) de la especialidad. El 55,5% ejercía tanto en el ámbito público como privado, el 38,6% solo en el privado y el 7,6% únicamente en el público. Del total, el 84,3% trabajaba en dos o más lugares y el 21,2% en cuatro o más. Sesenta de los encuestados (60; 59,8%) recibía una remuneración mensual de entre 100.000 a 249.000 pesos (U$S: 501,68-1249,18) y 27 (23,1%) de menos de 100.000 pesos (U$S 501,68). Conclusiones: nuestro estudio muestra un alto porcentaje de profesionales que se desempeña en múltiples lugares de trabajo. Una quinta parte de ellos tenía remuneración baja.

Introduction: Rheumatology is a clinical specialty with high demand and great inequality in its practice throughout Latin America and our country. Objectives: to describe the state of the practice of Rheumatology in our country. Materials and methods: cross-sectional observational study that collected information through an online survey distributed by email and through a QR code in the 54thArgentine Congress of Rheumatology. Results: 127 responses were received. Eighty-six (67.7%) were women, with a median age of 45 years. One hundred thirteen (89%) were specialists in Rheumatology, with 20 years (IQR 14-28) in the practice of medicine and 13 years (IQR 6.5-20) in the specialty.The 55.5% worked in both the public and private spheres, 38.6% only in the private sphere and 7.6% only in the public sphere. Of the total, 84.3% worked in 2 or more locations, with 21.2% working in 4 or more. In 60 (59.8%), the monthly remuneration was between 100,000 to 249,000 pesos (U$S: 501.68-1249.18) and in 27 (23.1%) it was less than 100,000 pesos (US$ 501.68). Conclusions: Our study shows that a high percentage of professionals who work in multiple places. One-fifth of respondents had low pay

Tasas de promoción, repitencia y abandono en la Carrera de Especialistas en Reumatología en la Ciudad de Buenos Aires / Specialty training in rheumatology: Promotion, repetition and dropout rates in the city of Buenos Aires

Objetivos: Evaluar la trayectoria de los alumnos de la Carrera de Especialistas en Reumatología y determinar factores asociados al resultado en el posgrado. Métodos: Análisis retrospectivo (2009-2016). Se determinaron las tasas de promoción, la repitencia y el abandono. Se realizaron análisis multivariados para determinar variables asociadas al éxito académico. Resultados: Sobre 119 alumnos, la promoción efectiva fue del 66,4%, la repitencia sin retraso fue del 14,3%, la repitencia con retraso fue del 11,8% y el abandono fue del 7,6%. La promoción efectiva de la residencia fue del 82,5% vs el 48,2% en el resto (p<0,001), la repitencia con retraso fue del 3,2% vs el 21,4% en el resto (p=0,005) y el abandono fue del 3,2% vs el 12,5% en el resto (p=0,06). El éxito en el posgrado fue mayor a mejor promedio en la carrera de Medicina (OR: 3,41; IC95%: 2,0-6,4; p<0,001). Conclusiones: La residencia se asoció a mayor éxito académico en el posgrado. El puntaje promedio en la cursada de Medicina puede ayudar a identificar a los alumnos en riesgo de fallar.(AU)

Objectives: To evaluate the trajectory of students enrolled in the specialty training in rheumatology. Methods: Retrospective analysis (2009-2016). Promotion, repetition, and dropout rates were determined. Analysis was performed to define variables associated with academic success. Results: Out of 119 students, the actual promotion rate was 66.4%, 11.8% failed an exam (at least) and completed the course after the stipulated time, and the dropout rate was 7.6%. Among residents, the promotion rate was 82.5% vs. 48.2% among the rest (P<.001), the lagging students’ repetition rate was 3.2% vs. 21.4% among the rest (P=.005), and the dropout rate was 3.2% vs. 12.5% among the rest (P=.06). A higher average score in medical school increased the chances of success in the postgraduate programme (OR: 3.41; 95%CI: 2.0-6.4; P<.001). Conclusions: The residency was associated with higher rates of academic success in postgraduate studies. The average score in medical school can help identify students at risk of failure.(AU)

Speciality training in rheumatology: Promotion, repetition and dropout rates in the city of Buenos Aires.

OBJECTIVES: To evaluate the trajectory of students enrolled in the specialty training in rheumatology. METHODS: Retrospective analysis (2009-2016). Promotion, repetition, and dropout rates were determined. Analysis was performed to define variables associated with academic success. RESULTS: Out of 119 students, the actual promotion rate was 66.4%, 11.8% failed an exam (at least) and completed the course after the stipulated time, and the dropout rate was 7.6%. Among residents, the promotion rate was 82.5% vs. 48.2% among the rest (p < 0.001), the lagging students' repetition rate was 3.2% vs. 21.4% among the rest (p 0.005), and the dropout rate was 3.2% vs. 12.5% among the rest (p = 0.06). A higher average score in medical school increased the chances of success in the postgraduate programme (OR 3.41 CI 95% 2.0-6.4; p < 0.001). CONCLUSIONS: The residency was associated with higher rates of academic success in postgraduate studies. The average score in medical school can help identify students at risk of failure.

Valores de referencia para el 1-minute sit-to-stand test en pacientes pediátricos con artritis idiopática juvenil / Reference values for the 1-minute sit-to-stand test in pediatric patients with juvenile idiopathic arthritis

Resumen Introducción: los niños con artritis idiopática juvenil (AIJ) experimentan períodos de dolor e inmovilidad que afectan sus capacidades condicionales. Objetivos: describir los valores de referencia para el 1-minute Sit-to-Stand Test (1-STS; test de 1 minuto de sentarse y pararse) en niños con AIJ como evaluación de la capacidad aeróbico-funcional y de la fuerza muscular de los miembros inferiores (MMII). Materiales y métodos: se realizó un estudio observacional que incluyó a 15 niños con AIJ de entre 5 y 16 años. Se evaluó su rendimiento en el 1-STS. Resultados: se encontró una correlación positiva significativa entre el 1-STS y el test de la marcha de 6 minutos (r=0,56; p=0,03), como con el índice de capacidad funcional (CAPFUN) (r=0,54; p=0,03). No se observaron correlaciones significativas entre el Childhood Health Assessment Questionnaire (CHAQ) y el 1-STS (r=-0,21; p=0,44), tampoco con el Juvenile Arthritis Disease Activity Score (JADAS-10) (p=0,83). Conclusiones: el 1-STS parece prometedor para medir la capacidad aeróbico-funcional y la fuerza muscular de los miembros inferiores en niños con AIJ oligoarticular.

Abstract Introduction: children with juvenile idiopathic arthritis (JIA) experience periods of pain and immobility that affect their physical capacities. Objectives: to describe reference values for the 1-minute sit to stand test (1-STS) in children with JIA as an assessment of aerobic-functional capacity and lower limb muscle strength. Materials and methods: an observational study was conducted, including 15 children with JIA aged between 5 and 16 years. Their performance in the 1-STS was assessed. Results: a significant positive correlation was found between the 1-STS and the 6-Minute Walk Test (r=0,56; p=0,03), as well as with the Functional Capacity Index (CAPFUN) (r=0,54; p=0,03). No significant correlations were observed between the Childhood Health Assessment Questionnaire (CHAQ) and the 1-STS (r=-0,21; p=0,44), nor with the Juvenile Arthritis Disease Activity Score (JADAS-10) (p=0,83). Conclusions: the 1-STS appears promising for assessing aerobic-functional capacity and lower limb muscle strength in children with oligoarticular JIA.

Características del empleo y la remuneración económica en el ejercicio de la Reumatología en diferentes distritos de Argentina / Characteristics of employment and economic remuneration in the practice of Rheumatology in different districts of Argentina

Resumen Introducción: la Reumatología es una especialidad clínica con elevada demanda y gran desigualdad en su ejercicio en Latinoamérica y el país. Objetivos: describir el estado del ejercicio de la Reumatología en nuestro país. Materiales y métodos: estudio observacional de corte transversal que recabó información a través de una encuesta online difundida por e-mail y de un código QR en el 54º Congreso Argentino de Reumatología. Resultados: se recibieron 127 respuestas; 86 (67,7%) fueron del sexo femenino, con una mediana de edad de 45 años. Ciento trece (113; 89%) encuestados eran especialistas en Reumatología, con 20 años (RIC 14-28) de ejercicio de la medicina y 13 años (RIC 6,5-20) de la especialidad. El 55,5% ejercía tanto en el ámbito público como privado, el 38,6% solo en el privado y el 7,6% únicamente en el público. Del total, el 84,3% trabajaba en dos o más lugares y el 21,2% en cuatro o más. Sesenta de los encuestados (60; 59,8%) recibía una remuneración mensual de entre 100.000 a 249.000 pesos (U$S: 501,68-1249,18) y 27 (23,1%) de menos de 100.000 pesos (U$S 501,68). Conclusiones: nuestro estudio muestra un alto porcentaje de profesionales que se desempeña en múltiples lugares de trabajo. Una quinta parte de ellos tenía remuneración baja.

Abstract Introduction: Rheumatology is a clinical specialty with high demand and great inequality in its practice throughout Latin America and our country. Objectives: to describe the state of the practice of Rheumatology in our country. Materials and methods: cross-sectional observational study that collected information through an online survey distributed by e-mail and through a QR code in the 54th Argentine Congress of Rheumatology. Results: 127 responses were received. Eighty-six (67.7%) were women, with a median age of 45 years. One hundred thirteen (89%) were specialists in Rheumatology, with 20 years (IQR 14-28) in the practice of medicine and 13 years (IQR 6.5-20) in the specialty. The 55.5% worked in both the public and private spheres, 38.6% only in the private sphere and 7.6% only in the public sphere. Of the total, 84.3% worked in 2 or more locations, with 21.2% working in 4 or more. In 60 (59.8%), the monthly remuneration was between 100,000 to 249,000 pesos (U$S: 501.68-1249.18) and in 27 (23.1%) it was less than 100,000 pesos (US$ 501.68). Conclusions: Our study shows that a high percentage of professionals who work in multiple places. One-fifth of respondents had low pay.

Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review.

INTRODUCTION: In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA. MATERIAL AND METHODS: Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews. RESULTS: We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis. DISCUSSION: Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis. CONCLUSION: Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.

Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: Systematic literature review / Tendencias emergentes en los programas de atención dirigidos por enfermeras para el manejo de pacientes con artritis reumatoide establecida: Revisión sistemática de la literatura

Introduction: In patients with rheumatoid arthritis (RA), nurses are considered as essential, not only to ensure pharmacological safety, but also in the promotion in self-care and decision-making, favouring the empowerment of patients. This systematic review aimed to summarize the available literature on the health education by the nurse in patients with RA. Material and methods: Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. The search ended in August 2021. Nineteen studies were retained for inclusion and evaluated with the Scottish Intercollegiate Guidelines Network for Systematic Reviews. Results: We found statistically significant improvement in self-care (five studies), disease activity (three studies), quality of life (two studies), satisfaction (five studies) and adherence (one study) with the nursing-led management of patients with established rheumatoid arthritis. Discussion: Although there is solid evidence of improvement in satisfaction and self-care, there seems to be a trend also to improve other outcomes, such as DAS28, from the EULAR recommendations, the expansion of the therapeutic arsenal for rheumatoid arthritis and shared decision-making. In addition, recently and due to the implementation of new technologies, the role of the nurse has been evaluated through virtual consultations. The results of recent studies have shown that this an effective and well-accepted novel approach for the management of patients with stable rheumatoid arthritis. Conclusion: Our study suggests that nurse-led health education, in addition of improvement in satisfaction and self-care, improve activity disease scores in RA patients.(AU)

Introducción: En los pacientes con artritis reumatoide, las enfermeras se consideran esenciales, no solo para garantizar la seguridad farmacológica, sino también en la prestación de promoción en el autocuidado y la toma de decisiones, favoreciendo el empoderamiento de los pacientes. Esta revisión sistemática tuvo como objetivo resumir la literatura disponible sobre la educación sanitaria por parte de la enfermera en pacientes con artritis reumatoide. Material y métodos: Siguiendo los procedimientos de la Colaboración Cochrane, la declaración PRISMA y la lista de comprobación PRISMA, se recuperaron los estudios cuantitativos relevantes publicados en las bases de datos CINAHL, Scopus, PubMed y Medic y, a continuación, se revisaron sistemáticamente. La búsqueda finalizó en agosto de 2021. Diecinueve estudios fueron retenidos para su inclusión y evaluados con la Scottish Intercollegiate Guidelines Network for Systematic Reviews. ResultadosSe encontró una mejoría estadísticamente significativa en el autocuidado (cinco estudios), la actividad de la enfermedad (tres estudios), la calidad de vida (dos estudios), la satisfacción (cinco estudios) y la adherencia (un estudio) con el manejo dirigido por enfermería de pacientes con artritis reumatoide establecida. Discusión: Aunque siempre ha habido evidencias de mejora en la satisfacción y el autocuidado, parece haber una tendencia a mejorar también otros resultados, como el de Disease Activity Score in 28 Joints (DAS28), a partir de las recomendaciones de la European League Against Rheumatism (EULAR), la ampliación del arsenal terapéutico para la artritis reumatoide y la toma de decisiones compartida. Además, recientemente y debido a la implantación de las nuevas tecnologías, se ha evaluado el papel de la enfermera a través de las consultas virtuales. Los resultados de estudios recientes han demostrado que se trata de un nuevo enfoque...(AU)

Un paciente con... Tos / A patient with... Cough

El 3,3-10% de la población presenta tos crónica, siendo un motivo frecuente de consulta en Atención Primaria (AP). Se plantea el caso de una mujer de 61 años con tos de 3 meses de evolución. La sospecha diagnóstica es de fibrosis pulmonar en el contexto de una posible artritis reumatoide versus neumonía intersticial descamativa secundaria a aripiprazol. El caso clínico sirve de reflexión sobre la importancia de una buena anamnesis en AP, así como un correcto uso de las pruebas complementarias para valorar causas menos frecuentes de un síntoma común. Debe desarrollarse una capacidad inductiva y valorar el contexto del síntoma guía para confeccionar un diagnóstico sindrómico lo más acertado posible, lo cual es muy valioso en este nivel asistencial. (AU)

Chronic cough is a common reason for consultation in primary care (prevalence approximately 3.3% to 10.0%). We report a case of a 61-year-old woman with a three-month history of cough. The most accurate diagnosis is pulmonary fibrosis in the context of rheumatoid arthritis versus desquamative interstitial pneumonia secondary to aripiprazole. This case study serves as a reflection on the importance of a good history in primary care. Moreover, it is relevant to correctly use complementary tests. It is especially important to make a good syndromic diagnosis and evaluate the context of the patient in front of us. (AU)

Utilidad de la consulta electrónica entre los centros de atención primaria y el Servicio de Reumatología de un hospital terciario / Usefulness of an electronic consultation system between primary care health centres and the rheumatology department of a tertiary hospital

Introducción y objetivo: Las enfermedades reumáticas representan casi el 30% de las consultas atendidas en los centros de atención primaria españoles. El objetivo principal fue analizar la demanda de consultas reumatológicas desde atención primaria y su resolución mediante el sistema de consulta electrónica. Pacientes y métodos: Estudio descriptivo retrospectivo de las consultas electrónicas procedentes de los centros de atención primaria del área sanitaria al Servicio de Reumatología de un hospital terciario, entre los meses de julio de 2020 y mayo de 2021. Resultados: Se recogieron las últimas 500 consultas consecutivas. La media de edad de los pacientes fue 59 años; el 74% eran mujeres. Los principales motivos de consulta fueron la osteoporosis y el tratamiento de pacientes en seguimiento por el servicio por artritis reumatoide y espondiloartritis. El tiempo medio de respuesta fue de dos días; el 57% necesitaron ser citados en consulta externa. Discusión: La consulta electrónica permitió resolver, en una media de dos días, las consultas del 42,6% de los pacientes.(AU)

Background and objective: Rheumatic diseases account for almost 30% of consultations attended in Spanish primary care centres. The main objective was to analyse the demand for rheumatology consultations from Primary Care and their resolution using the electronic consultation system. Patients and methods: Retrospective descriptive study of electronic consultations from primary care centres in the health area to the Rheumatology service of a tertiary hospital, between July 2020 and May 2021. Results: The last 500 consecutive consultations were collected. Mean age of patients was 59.5 years; 74.2% were women. Main reasons for consultation were osteoporosis and treatment of patients with rheumatoid arthritis and spondyloarthritis under follow-up by the department. Mean response time was 2 days. Fifty-seven per cent of patients required outpatient appointments. Discussion: Over 40% of queries were resolved thanks to the electronic consultation system in an average of 2 days, otherwise patients would have been referred to specialized care.(AU)

Sesgos de género en la reumatología española: Percepciones y realidad / Gender biases in Spanish rheumatology: Perception and facts

Objetivo: Identificar percepciones en cuanto a sesgos de género en la reumatología española y cuantificar la implicación de ambos sexos en todos los ámbitos de la especialidad. Métodos: Se envió una encuesta a todos los miembros de la SER, sobre participación y percepción de sesgos y de la propia capacitación y se revisaron los datos reales de participación en órganos directivos, congresos, comités y de los servicios de reumatología españoles en los últimos cinco años. Resultados: La encuesta fue respondida por 95 personas, 4,8% de los miembros de la SER (14 hombres y 81 mujeres). No se detectaron diferencias por sexo en edad, nivel académico, puesto, centro de trabajo, reparto de tareas laborales y del ámbito familiar; tampoco en las invitaciones a puestos de poder en los cinco últimos años, ni en la percepción de capacidad para ocupar los distintos puestos de poder. Los hombres encuestados consideran con mayor frecuencia que actividades como la participación en un comité científico o dar una ponencia no dan poder. Un tercio de los participantes de ambos sexos considera que la SER debería revisar sus procesos con perspectiva de género y menos de un tercio cree que debe hacerse por cuotas. Tras revisar los datos de 2015 a 2020, los ratios hombre a mujer en las principales actividades de liderazgo en reumatología en España son: 1) juntas directivas de la SER 3:2 sin presidenta ni tesorera; 2) comités científicos de los congresos 2:1; 3) ponentes y moderadores: simposios satélites, 4:1; 4) editores jefes de revistas científicas 9:1; 5) puestos académicos global 1,7:1, catedráticos 9:1, profesores titulares 100% hombres y 6) jefes de servicio: 75% son hombres a pesar de representar 40% de reumatólogos en España. Conclusión: A pesar de un creciente número de mujeres en la reumatología española, estas no están suficientemente representadas en puestos de liderazgo, existiendo un sesgo de género no percibido.(AU)

Objective: To identify perceptions of gender bias in Spanish rheumatology and to quantify the involvement of both sexes in all areas of the specialty. Methods: A survey was sent to all members of the SER on participation and perception of biases and of their own competencies, and actual data on participation in governing bodies, congresses, committees, and Spanish rheumatology departments in the last 5 years were reviewed. Results: The survey was answered by 95 rheumatologist, 4.8% of SER members (14 men and 81 women), both groups being similar in terms of age, academic level, and position and work centre. No differences were detected in the distribution of work and non-work tasks between sexes, nor in invitations to positions of power in the last five years, nor in the perception of capacity to occupy the different positions of power, which was high for both sexes. Male respondents more frequently consider that activities such as participating in a scientific committee or giving a conference are not empowering. A third of both sexes consider that the SER should review its processes with a gender perspective but less than a third believe that this should be done by quotas. The reality of the last 5 years is that 1) there is a male to female ratio of 3:2 on SER boards of directors and in this period there has been no female president or treasurer; 2) in the scientific committees of the congresses men predominate (2:1) although slightly less in the local organizing committee; 3) there are more male speakers and moderators than women (very striking in satellite symposia, 4: 1); 4) 9 out of 10 editors-in-chief are men; 5) in academic positions there are 3 men for every 2 women, 9 to 1 in professorships or emeritus positions; although more women supervise residents; and 6) there are more women (60%) than men (40%) in Spanish rheumatology departments, although 75% of department chiefs are men. Conclusion: Although not perceived by either the men or the women...(AU)

Takayasu's arteritis as an incidental finding in a patient with celiac disease: the importance of positron emission computed tomography.

BACKGROUND: Takayasu arteritis is a large-vessel vasculitis which affects large-caliber elastic arteries, primarily the aorta and its main branches. It mainly affects women between 20-30 years, so it is rare in children. CASE REPORT: We describe the case of a 15-year-old female who was followed up since she was 9 years old due to celiac disease. At the age of 13, anaemia of chronic disorders associated to elevated C-reactive protein and erythrocyte sedimentation were detected. The patient remained asymptomatic. After excluding other diseases, we requested a positron emission computed tomography (PET-CT); lesions compatible with large-vessel vasculitis were detected. Cardiology evaluation showed an aneurysm in the right coronary artery. Angio-CT suggested Takayasu type III arteritis. CONCLUSIONS: The delay in the diagnosis of Takayasu arteritis in pediatric patients is quite common. In this case, we have found phase II lesions, with no previous phase I symptoms. However, PET-CT allowed the diagnosis of vasculitis, key to the diagnosis of the patient.

INTRODUCCIÓN: La arteritis de Takayasu es una vasculitis de grandes vasos que afecta a las arterias elásticas de gran calibre, fundamentalmente la aorta y sus ramas principales. Ocurre frecuentemente en mujeres entre los 20-30 años, por lo que es muy infrecuente en la edad pediátrica. CASO CLÍNICO: Se presenta el caso de una paciente de 15 años en seguimiento desde los 9 años por enfermedad celiaca. A los 13 años se detectó anemia de trastornos crónicos, elevación de proteína C reactiva y velocidad de sedimentación globular. La paciente permaneció en todo momento asintomática. Tras descartar otros procesos, se solicitó tomografía computarizada por emisión de positrones (PET-TC), donde se detectaron lesiones compatibles con vasculitis de grandes vasos. La valoración por Cardiología evidenció un aneurisma en coronaria derecha. Se realizó angio-TC, que sugirió arteritis de Takayasu tipo III. CONCLUSIONES: Es frecuente un retraso en el diagnóstico de la arteritis de Takayasu en los pacientes pediátricos. En este caso se encontraron lesiones de la fase II sin la presencia de síntomas correspondientes a la fase I. El PET-TC permitió el diagnóstico de vasculitis, clave para el diagnóstico de la paciente.

Publication outcomes of abstracts presented at the Argentine Congress of Rheumatology / Tasa de publicación de los resúmenes presentados al Congreso Argentino de Reumatología

Objective: To analyse the outcome of scientific abstracts submitted to the Argentine Congress of Rheumatology (ACOR) in 2000, 2005, 2010, and 2015. Methods: Every abstract submitted to the ACOR was analysed. The number of these manuscripts published was determined through Google Scholar and PubMed searches. The impact of the scientific journals was established through the SCImago Journal (SJR) indicator. Results: Considering the 727 abstracts evaluated, 10.2% of the articles were found in journals indexed by Google Scholar, and 6.6% in PubMed: 4.7% were published in 2000, 9.4% in 2005, 14.6% in 2010, and 11.9% in 2015 (Log Rank test 0.008), with a statistically significant increase between 2010 and 2015 compared to 2000 (HR 3.3; 95% CI 1.5–7; p 0.002 and HR 2.9; CI 1.4–6.3; p 0.005 respectively). The median SJR of the journals was 0.46 and 67.6% had SJR available. Conclusions: The publication rate was low, and only a few articles were published in the most prestigious journals within the speciality.(AU)

Objetivo: Analizar la tasa de publicación de los resúmenes presentados al Congreso Argentino de Reumatología (ACOR) en 2000, 2005, 2010 y 2015. Métodos: Todos los resúmenes enviados al ACOR fueron evaluados. Se determinó la tasa de publicación mediante una búsqueda en Google Scholar y PubMed. Se examinó la relevancia de las revistas científicas a través del indicador SCImago Journal (SJR). Resultados: Se evaluaron 727 resúmenes. Se encontró un 10,2% de artículos publicados en revistas indexadas por Google Scholar y un 6,6% en PubMed. El 4,7% fueron publicados en 2000, el 9,4% en 2005, el 14,6% en 2010 y el 11,9% en 2015 (Log Rank test: 0,008), con un aumento estadísticamente significativo entre 2010 y 2015 frente al 2000 (HR: 3,3; IC95%: 1,5-7; p=0,002 y HR: 2,9; IC95%: 1,4-6,3; p=0,005, respectivamente). La mediana del SJR de dichas revistas fue de 0,46, y el 67,6% tenían SJR disponible. Conclusiones: La tasa de publicación es baja, y solo unos pocos trabajos fueron publicados en las revistas más prestigiosas de la especialidad.(AU)

Publication outcomes of abstracts presented at the Argentine Congress of Rheumatology.

OBJECTIVE: To analyse the outcome of scientific abstracts submitted to the Argentine Congress of Rheumatology (ACOR) in 2000, 2005, 2010, and 2015. METHODS: Every abstract submitted to the ACOR was analysed. The number of these manuscripts published was determined through Google Scholar and PubMed searches. The impact of the scientific journals was established through the SCImago Journal (SJR) indicator. RESULTS: Considering the 727 abstracts evaluated, 10.2% of the articles were found in journals indexed by Google Scholar, and 6.6% in PubMed: 4.7% were published in 2000, 9.4% in 2005, 14.6% in 2010, and 11.9% in 2015 (Log Rank test 0.008), with a statistically significant increase between 2010 and 2015 compared to 2000 (HR 3.3; 95% CI 1.5-7; p 0.002 and HR 2.9; CI 1.4-6.3; p 0.005 respectively). The median SJR of the journals was 0.46 and 67.6% had SJR available. CONCLUSIONS: The publication rate was low, and only a few articles were published in the most prestigious journals within the speciality.

Evento científico "REUMA Santiago 2023"

Fotorreportaje realizado durante los días 16 y 17 de junio de 2023en el curso del evento científico REUMA Santiago 2023, organizado por el capítulo de reumatología de la ciudad de Santiago de Cuba.

Photo report made on June 16 and 17, 2023 during the REUMA Santiago 2023 scientific event, organized by the rheumatology chapter of the city of Santiago de Cuba.

Usefulness of an electronic consultation system between primary care health centres and the rheumatology department of a tertiary hospital.

BACKGROUND AND OBJECTIVE: Rheumatic diseases account for almost 30% of consultations attended in Spanish primary care centres. The main objective was to analyse the demand for rheumatology consultations from Primary Care and their resolution using the electronic consultation system. PATIENTS AND METHODS: Retrospective descriptive study of electronic consultations from primary care centres in the health area to the Rheumatology service of a tertiary hospital, between July 2020 and May 2021. RESULTS: The last 500 consecutive consultations were collected. Mean age of patients was 59.5 years; 74.2% were women. Main reasons for consultation were osteoporosis and treatment of patients with rheumatoid arthritis and spondyloarthritis under follow-up by the department. Mean response time was 2 days. Fifty-seven per cent of patients required outpatient appointments. DISCUSSION: Over 40% of queries were resolved thanks to the electronic consultation system in an average of 2 days, otherwise patients would have been referred to specialized care.