Caribbean Latinx with moderate-severe asthma bear greater asthma morbidity than other Latinx.

BACKGROUND: Hispanic/Latinx (HL) ethnicity encompasses racially and culturally diverse subgroups. Studies suggest that Puerto Ricans (PR) may bear greater asthma-related morbidity than Mexicans, but these were conducted in children or had limited clinical characterization. OBJECTIVES: This study sought to determine whether disparities in asthma morbidity exist among HL adult subgroups. METHODS: Adults with moderate-severe asthma were recruited from US clinics, including from Puerto Rico, for the Person Empowered Asthma Relief (PREPARE) trial. Considering the shared heritage between PR and other Caribbean HL (Cubans and Dominicans [C&D]), the investigators compared baseline self-reported clinical characteristics between Caribbean HL (CHL) (PR and C&D: n = 457) and other HLs (OHL) (Mexicans, Spaniards, Central/South Americans; n = 141), and between CHL subgroups (C&D [n = 56] and PR [n = 401]). This study compared asthma morbidity measures (self-reported exacerbations requiring systemic corticosteroids, emergency department/urgent care (ED/UC) visits, hospitalizations, health care utilization) through negative binomial regression. RESULTS: CHL compared to OHL were similar in age, body mass index, poverty status, blood eosinophils, and fractional exhaled nitric oxide but were prescribed more asthma controller therapies. Relative to OHL, CHL had significantly increased odds of asthma exacerbations (odds ratio [OR]: 1.84; 95% CI: 1.4-2.4), ED/UC visits (OR: 1.88; 95% CI: 1.4-2.5), hospitalization (OR: 1.98; 95% CI: 1.06-3.7), and health care utilization (OR: 1.91; 95% CI: 1.44-2.53). Of the CHL subgroups, PR had significantly increased odds of asthma exacerbations, ED/UC visits, hospitalizations, and health care utilization compared to OHL, whereas C&D only had increased odds of exacerbations compared to OHL. PR compared to C&D had greater odds of ED/UC and health care utilization. CONCLUSIONS: CHL adults, compared with OHL, adults reported nearly twice the asthma morbidity; these differences are primarily driven by PR. Novel interventions are needed to reduce morbidity in this highly impacted population.

Dermatomiositis juvenil: experiencia clínica y epidemiológica / Juvenile dermatomyositis: clinical and epidemiologic experience

Se estudiaron en forma retrospectiva 27 casos con diagnóstico de Dermatomiositis Juvenil (DMJ) de un total de 1.307 pacientes con enfermedades del tejido conectivo; 19 de los cuales cumplieron con los criterios diagnósticos de Bohan y Peters. El sexo femenino fue el más frecuentemente afectado; el 52,63% de los casos presentaron los primeros síntomas entre los 5 y 9 años; lesiones en piel, debilidad en miembros inferiores y fiebre fueron los motivos de consulta más frecuentes. La Aldolasa y la LDH fueron las enzimas musculares que se elevaron en el mayor número de casos. La electromiografía fue más sensible que la biopsia muscular en el diagnóstico de la enfermedad. Considerando las características epidemiológicas y clínicas encontradas en nuestro estudio, sugerimos que éstas sirvan como pautas para el diagnóstico certero de la DMJ en Venezuela