Adaptación transcultural y validación de la metodología del Programa Orientado a la Comunidad para el Control de Enfermedades Reumáticas (COPCORD) en población indígena Wayuu. Venezuela / Transcultural Adaptation and Validation of the Methodology of the Community Oriented Programme for Control of Rheumatic Disease (COPCORD) in the Indigenous Wayuu Population. Venezuela

Objetivo: Adaptar transculturalmente y validar la metodología COPCORD en población indígena Wayuu del estado Zulia, Venezuela. Metodología: Se realizó un estudio de corte transversal en indígenas Wayuu de los municipios Mara y Guajira del estado Zulia, Venezuela, se adaptó transculturalmente la versión venezolana del cuestionario COPCORD y se tradujo del español venezolano al wayuunaiki (idioma Wayuu). Cien indígenas Wayuu aceptaron participar y se les administró el instrumento, casa por casa, por personal de salud bilingüe capacitado. Los individuos COPCORD positivos fueron evaluados por reumatólogos. Se realizó análisis descriptivo de variables, se midieron alfa de Cronbach, correlación de Spearman, análisis de prueba de cribado (sensibilidad, especificidad, VPP y RVs+). Resultados: El 66% fueron mujeres, edad promedio 41,4años, el 20% monolingües, el 21% analfabetos, el 69% unidos/casados, el 57% con trabajo informal. El 62% reportaron dolor, el 56% con criterios de enfermedades reumáticas; las más frecuentes fueron: osteoartritis (32,3%), lumbalgia mecánica (13,9%) y síndrome doloroso regional reumático (12,3%). Cinco dimensiones del instrumento presentaron alfa de Cronbach >0,7. La sensibilidad fue del 100% y la especificidad del 11,1%, VPP 14,3%, RVs+ 1,13%. Conclusión: El COPCORD es válido y útil como herramienta de cribado para la detección de malestares musculoesqueléticos y enfermedades reumáticas en la población indígena Wayuu.(AU)

Objective: To adapt cross-culturally and validate the COPCORD methodology in the indigenous Wayuu population of Zulia state, Venezuela. Methodology: A cross-sectional study was conducted on Wayuu indigenous people from the Mara and Guajira municipalities of the state of Zulia, Venezuela. The Venezuelan version of the COPCORD questionnaire was transculturally adapted and translated from Venezuelan Spanish to Wayuunaiki (Wayuu language). One hundred indigenous Wayuu, agreed to participate, they were administered the instrument, house by house, by health personnel, who were bilingual and previously trained. Positive COPCORD individuals were evaluated by rheumatologists. A descriptive analysis of variables was performed, Cronbach's alpha was measured, Spearman's correlation, screening test analysis (sensitivity, specificity, VPP and SVR+). Results: 66% were women, average age 41.4years, 20% monolingual, 21% illiterate, 69% in a couple/married, 57% with informal work. Sixty-two percent reported pain, 56% with criteria of rheumatic diseases, the most frequent were: osteoarthritis (32.3%), mechanical lower back pain (13.9%), and regional rheumatic pain syndrome (12.3%). Five dimensions of the instrument presented Cronbach's alpha >0.7. The sensitivity was 100% and specificity 11.1%, VPP 14.3%, SVR+ 1.13%. Conclusion: The COPCORD is valid and useful as a screening tool for the detection of musculoskeletal complaints and rheumatic diseases in the indigenous Wayuu population.(AU)

Transcultural Adaptation and Validation of the Methodology of the Community Oriented Programme for Control of Rheumatic Disease (COPCORD) in the Indigenous Wayuu Population. Venezuela. / Adaptación transcultural y validación de la metodología del Programa Orientado a la Comunidad para el Control de Enfermedades Reumáticas (COPCORD) en población indígena Wayuu. Venezuela.

OBJECTIVE: To adapt cross-culturally and validate the COPCORD methodology in the indigenous Wayuu population of Zulia state, Venezuela. METHODOLOGY: A cross-sectional study was conducted on Wayuu indigenous people from the Mara and Guajira municipalities of the state of Zulia, Venezuela. The Venezuelan version of the COPCORD questionnaire was transculturally adapted and translated from Venezuelan Spanish to Wayuunaiki (Wayuu language). One hundred indigenous Wayuu, agreed to participate, they were administered the instrument, house by house, by health personnel, who were bilingual and previously trained. Positive COPCORD individuals were evaluated by rheumatologists. A descriptive analysis of variables was performed, Cronbach's alpha was measured, Spearman's correlation, screening test analysis (sensitivity, specificity, VPP and SVR+). RESULTS: 66% were women, average age 41.4years, 20% monolingual, 21% illiterate, 69% in a couple/married, 57% with informal work. Sixty-two percent reported pain, 56% with criteria of rheumatic diseases, the most frequent were: osteoarthritis (32.3%), mechanical lower back pain (13.9%), and regional rheumatic pain syndrome (12.3%). Five dimensions of the instrument presented Cronbach's alpha >0.7. The sensitivity was 100% and specificity 11.1%, VPP 14.3%, SVR+ 1.13%. CONCLUSION: The COPCORD is valid and useful as a screening tool for the detection of musculoskeletal complaints and rheumatic diseases in the indigenous Wayuu population.

Evaluación de los valores séricos de prolactina en lupus eritematoso sistémico / Assessment of serum prolactin levels in patients with systemic lupus erythematosus

El propósito del presente estudio fue determinar la relación entre los valores de prolactina sérica y las características clínicas de pacientes con lupus eritematoso sistémico (LES) asistentes a la consulta de Reumatología del Servicio Autónomo Hospital Universitario de Maracaibo, en Maracaibo, Venezuela. Se realizó un estudio descriptivo, correlacional y transversal en pacientes femeninas, mayores de 18 años, con diagnóstico de LES, quienes asistieron al Hospital Universitario de Maracaibo, durante los meses de noviembre 2012 a junio del 2013; se les realizó una historia clínica integral, basada en anamnesis y examen físico, con énfasis en la búsqueda de manifestaciones clínicas de actividad lúpica y se tomaron muestras sanguíneas para la determinación de las concentraciones séricas de prolactina, en el momento de la evaluación de la paciente. Se utilizaron como rangos normales, valores entre 2,1 y 25 ng/mL. La población consistió en un total de 50 pacientes y se clasificó en dos grupos: el primer grupo conformado por 28 mujeres con crisis lúpica y el segundo por 22 sin crisis al momento del estudio. La concentración promedio de prolactina sérica fue de 39,0 ± 59,5 ng/dL para el primer grupo y de 14,2 ± 7,2 ng/dL para el segundo grupo, con diferencias estadísticamente significativas (p=0,044). Las pacientes con crisis lúpica presentaron valores de prolactina más elevados que las pacientes en remisión, no obstante que solo la séptima parte de ellas tenían cifras de prolactina fuera del rango normal. Todas las pacientes asintomáticas presentaron niveles normales de prolactina, por el contrario, todas las pacientes con hiperprolactinemia estaban en crisis lúpica.

To determine the relationship between hyperprolactinemia levels and clinical features of patients with systemic lupus erythematosus (SLE), a descriptive, correlational and cross-sectional study, was performed in female patients over 18 years old, who attended the Rheumatology Clinic at the Hospital Universitario, in Maracaibo, Venezuela, from November 2012 to June 2013. They underwent a comprehensive medical history evaluation, based on interviews and physical examination, with emphasis on the search for clinical manifestations of lupus activity. Blood samples were taken in order to determine prolactin levels at the moment of the patient evaluation. Values from 2.1 to 47.6 ng/mL were considered as normal. The population was classified into two groups: a group formed by 28 women with lupus crisis and another group formed by 22 patients without crisis. The average prolactin serum level was 39.0 ± 59.5 ng/dL for the first group and 14.2 ± 7.2 ng/dL for the second group, indicating statistical significance (p = 0.044). Patients with lupus crisis had prolactin values higher than those of asymptomatic patients, although only oneseventh of them had absolute hyperprolactinemia. All asymptomatic patients had normal levels of prolactin. All patients with hyperprolactinemia were in lupus crisis.

Assessment of serum prolactin levels in patients with systemic lupus erythematosus. / Evaluación de los valores séricos de prolactina en lupus eritematoso sistémico.

To determine the relationship between hyperprolactinemia levels and clinical features of patients with systemic lupus erythematosus (SLE), a descriptive, correlational and cross-sectional study, was performed in female patients over 18 years old, who attended the Rheumatology Clinic at the Hospital Universitario, in Maracaibo, Venezuela, from November 2012 to June 2013. They underwent a comprehensive medical history evaluation, based on interviews and physical examination, with emphasis on the search for clinical manifestations of lupus activity. Blood samples were taken in order to determine prolactin levels at the moment of the patient evaluation. Values from 2.1 to 47.6 ng/mL were considered as normal. The population was classified into two groups: a group formed by 28 women with lupus crisis and another group formed by 22 patients without crisis. The average prolactin serum level was 39.0 ± 59.5 ng/dL for the first group and 14.2 ± 7.2 ng/dL for the second group, indicating statistical significance (p = 0.044). Patients with lupus crisis had prolactin values higher than those of asymptomatic patients, although only one-seventh of them had absolute hyperprolactinemia. All asymptomatic patients had normal levels of prolactin. All patients with hyperprolactinemia were in lupus crisis.

A possible defective estimation of antineutrophil cytoplasmic antibodies in systemic lupus erythematosus due ot the coexistence of periodontitis: preliminary observations

The objectives of this study is to determine if periodontitis-related ANCA hinder the accurate estimation of this kind of autoantibodies in systemic lupus erythematosus (SLE), due to the frequent coexistence of SLE and periodontitis, and the high incidence of antineutrophil cytoplasmic antibodies (ANCA) in this periodontal condition. Thirty SLE, thirty periodontitis lacking systemic involvement patients, and twenty healthy controls were utilized in this study. The periodontal condition and the presence of ANCA in sera of all individuals was carefully evaluated. For ANCA determination an EIA essay was utilized, directed to a neutrophil granular extract and six neutrophil granule proteins. Sixty percent of SLE patients had periodontitis, and sixty-five percent were ANCA positive. Eighty three percent of all ANCA cases were coexisting with periodontitis. A significant association (p > 0.005) between periodontitis and ANCA was found (Chi Square Test). Fifty percent of the patients with periodontitis lacking systemic involvement were ANCA positive. The results obtained in this study suggest that the figures of ANCA previously reported for SLE, might be overestimated due to the inadvertent presence of periodontitis

Anticuerpos anticitoplasmáticos de neutrófilos (ANCA): un estudio sobre su presencia en patologías no asociadas con arteritis / Antineutrophil cytoplasmatic antibodies (ANCA): study on its presence in pathologies not associated with artheritis

En la presente investigación, se ha estudiado la presencia de anticuerpos anticitoplasmáticos de neutrófilos (ANCA) en 101 pacientes con diferentes patologías: Artritis reumatoide, lupus eritematoso sistémico, neutropenia idiopática, síndrome de Down, glomerulonefritis aguda postes-treptocóccica, síndrome nefrótico con cambios mínimos, periodontitis del adulto, calcinosis tumoral, lipodistrofia y monoartritis. Inmunofluorescencia indirecta e inmunoensayo enzimático indirecto(ELISA) fueron las técnicas utilizadas para la detección de estos autoanticuerpos. Nuestros resultados muestran el patrón de distribución de ANCA en estas enfermedades y por primera vez se describe la presencia de estos autoanticuerpos en enfermedades como síndrome de Down, glomerulonefritis aguda postestreptococcica y periodontitis del adulto. El alto grado de positividad para ésta última enfermedad, plantea la posibilidad de que un número de casos positivos para ANCA reportados para ciertas enfermedades sistémicas, correspondan verdaderamente a otra enfermedad concurrente no detectada