Registro Iberoamericano de Espondiloartritis (RESPONDIA): Chile / RESPONDIA. Iberoamerican Spondyloarthritis Registry: Chile

Objetivos: Describir las principales características demográficas y clínicas de los pacientes chilenos con espondiloartritis ingresados en el Registro Iberoamericano de Espondiloartritis (RESPONDIA). Pacientes y métodos: Estudio descriptivo y transversal de un grupo de pacientes chilenos con espondiloartritis ingresados en RESPONDIA según criterios preestablecidos, entre enero de 2006 y diciembre de 2007. Participaron 5 centros universitarios chilenos, 4 de Santiago y uno de Valparaíso. Resultados: Se incluyó a 109 pacientes, 66 varones (58,4%), con una edad media desviación estándar de 42 22 años y una duración promedio de enfermedad en el momento del diagnóstico de 7,1 años (1-29 años). Los diagnósticos fueron de espondilitis anquilosante (58,7%), artritis psoriásica (25,6%), espondiloartritis indiferenciada (7,3%), artritis asociada a enfermedad inflamatoria intestinal (5,5%), espondiloartritis de inicio juvenil (1,8%) y artritis reactiva (0,9%). Respecto a su presentación clínica, el 42,5% tuvo afectación mixta (axial y periférica); el 36,3%, afectación axial exclusivo, y el 9,7%, afectación periférica exclusiva. El dolor lumbar inflamatorio fue el síntoma más frecuente (74,3%) seguido de artritis de las extremidades inferiores (59,3%). La manifestación extraarticular más frecuente fue la uveítis (18,6%). El 40% de los pacientes tenía algún grado de incapacidad laboral. Conclusiones: El perfil clínico más frecuente en este grupo de pacientes chilenos con espondiloartritis fue la combinación de manifestaciones axiales y periféricas. El diagnóstico más frecuente fue el de espondilitis anquilosante, seguido por el de artritis psoriásica (AU)

Objectives:To describe the main demographic and clinical characteristics of Chilean patients with Spondyloarthritis included in the Ibero American Spondyloarhtritis Registry (RESPONDIA). Patients and methods: Descriptive and cross-sectional study of Chilean patients with Spondyloarthritis registered in the RESPONDIA database. Five Chilean university hospitals participated in the inclusion of patients (4 from Santiago and 1 from Valparaiso), between January 2006 and December 2007, according to the defined protocol. Results: 109 patients were included in the registry, 66 males (58.4%) with an average age of 42 22 years, and average disease duration of 7.1 years (range 1-29 years). Diagnoses of the patients were Ankilosing Spondylitis (58.7%), Psoriatic Arthritis (25.6%), Undifferentiated Spondyloarthritis (7.3%), Inflammatory Bowel Disease Arthritis (5.5%), Juvenile Onset Spondyloarthritis (1.8%) and Reactive Arthritis (0.9%). Regarding clinical forms, 42.5% had mixed disease, 36.3% had axial disease, and 9.7% had peripheral disease. Inflammatory low back pain was the most frequent symptom reported (74.3%) followed by arthritis of the lower extremities (59.3%). The most common extra-articular disease manifestation was uveitis (18.6%). Some kinds of work disability were reported in 40% of the patients. Conclusions: The most frequent clinical profile in this group of Chilean patients with Spondiloarthritis was the combination of axial and peripheral diseases. The most common diagnosis was ankilosing spondylitis and psoriatic arthritis (AU)

Outcome of chilean patients with lupus nephritis and response to intravenous cyclophosphamide.

Several recent open studies suggest that the response rates of lupus nephritis to intravenous (IV) cyclophosphamide are lower than those observed in clinical trials. One explanation could be ethnic differences; for example, black patients more frequently have treatment-resistant lupus nephritis. Another could be the inclusion of patients who are noncompliant with therapy. From our register of 268 systemic lupus erythematosus (SLE) patients examined between 1973 and 1996, 61 patients were treated for proliferative lupus nephritis (17 had World Health Organization [WHO] type III and 43 had WHO type IV) and were followed through to 2001. Exclusion criteria included a serum creatinine level >3 mg/dL. In this retrospective study, we assessed renal outcome and survival with an endpoint of end-stage renal disease (ESRD) or death (Kaplan-Meier). In the univariate analysis, worse prognostic factors for survival were serum creatinine >1.3 mg/dL (p < 0.001), age <30 years (p < 0.001), class 2 renal function stage (p < 0.03), and renal biopsy activity index >7 (p < 0.02). In the subgroup of 26 patients treated with IV cyclophosphamide, survival at 5 and 10 years was 82% and 73%, respectively. The dosage of IV cyclophosphamide was slightly lower than usual and used for a shorter period (median = 23 months) than what is usually recommended because of the high frequency of complications. Renal outcome of the IV cyclophosphamide-treated patients was poorer than that reported in the National Institutes of Health series (ESRD: 15% versus 3%). This low survival rate could reflect the short course and lower doses of IV cyclophosphamide used or ethnic differences. These data emphasize the need for continuous research for better-tolerated drug schemes for treatment of our lupus nephritis patients.

Intoxicación por fosfina de aluminio / Aluminium phosphine intoxication

Se revisa la literatura existente sobre intoxicaciones por fosfuros de hidrógeno, a consecuencia de un caso clínico tratado en la UCI de adultos del hospital Gustavo Fricke, en Diciembre de 1993. Se analiza el manejo, tratamiento y pronóstico de éstas, a partir de las cuales se proponen algunas medidas preventivas