RESUMO
Renal involvement is one of the most severe manifestations of systemic lupus erythematosus (SLE). Renal biopsy is the gold standard when it comes to knowing whether a patient has lupus nephritis, and the degree of renal disease present. However, the biopsy has various complications, bleeding being the most common. Therefore, the development of alternative, non-invasive diagnostic tests for kidney disease in patients with SLE is a priority. Micro RNAs (miRNAs) are differentially expressed in various tissues, and changes in their expression have been associated with several pathological processes. The aim of this study was to identify changes in the abundance of miRNAs in plasma samples from patients with lupus nephritis that could potentially allow the diagnosis of renal damage in SLE patients. This is an observational case-control cross-sectional study, in which we characterized the differential abundance profiles of miRNAs among patients with different degrees of lupus compared with SLE patients without renal involvement and healthy control individuals. We found 89 miRNAs with changes in their abundance between lupus nephritis patients and healthy controls, and 17 miRNAs that showed significant variations between SLE patients with or without renal involvement. Validation for qPCR of a group of miRNAs on additional samples from lupus patients with or without nephritis, and from healthy individuals, showed that five miRNAs presented an average detection sensitivity of 97%, a specificity of 70.3%, a positive predictive value of 82.5%, a negative predictive value of 96% and a diagnosis efficiency of 87.9%. These results strongly suggest that miR-221-5p, miR-380-3p, miR-556-5p, miR-758-3p and miR-3074-3p are potential diagnostic biomarkers of lupus nephritis in patients with SLE. The observed differential pattern of miRNA abundance may have functional implications in the pathophysiology of SLE renal damage.
Assuntos
Biomarcadores/sangue , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Lúpus Eritematoso Sistêmico/genética , Nefrite Lúpica/genética , MicroRNAs/sangue , Adulto , Feminino , Perfilação da Expressão Gênica/métodos , Humanos , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Análise de Componente Principal , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto JovemRESUMO
Objetivo: Conocer la afluencia, permanencia y grado de satisfacción de los pacientes adultos que acuden a las clínicas de la Facultad de Odontología de la Universidad de El Salvador (FOUES), en el periodo 2010-2014. METODOLOGÍA: El estudio es observacional descriptivo de corte transversal, realizado en la Facultad de Odontología de la Universidad de El Salvador (FOUES) con 368 pacientes adultos con expediente clínico. Los métodos de recolección de datos fueron: a) una guía de observación que registró información personal de cada paciente; b) cuestionario, aplicado en dos opciones: presencial a pacientes que aceptaron asistir a la Facultad y que aún permanecían recibiendo atención y vía telefónica a los sujetos que al ser contactados no podían asistir. El instrumento permitió conocer las experiencias del paciente, causas de abandono o permanencia, niveles de satisfacción y resolución del motivo de consulta. RESULTADOS: El promedio de la afluencia de pacientes adultos registrados en el área de archivo de la FOUES del 2010 al 2014 fue de 1,836 por año. Permanencia 61.7%. En cuanto a los niveles de satisfacción en la atención brindada por el personal administrativo, docente y estudiante el 51.2% se mostró satisfecho. Con el tratamiento que recibió para resolver el motivo de consulta 36.7% muy satisfecho. CONCLUSIÓN: La afluencia de pacientes en la FOUES fue de 1,836 por año, 60.9% del sexo femenino, la permanencia al plan de tratamiento fue 61.7%, y 51.2% se mostró satisfecho con la atención que recibió de administrativos, docentes y estudiante.
Objective: To know the influx, stay, and level of satisfaction of adult patients coming to clinics of the School of Dentistry of El Salvador (FOUES) during the period 2010-2014. Methodology This is an observational, descriptive, cross-sectional study carried out at the School of Dentistry of the University of El Salvador with 368 adult patients with medical record. The methods for data gathering were: a) an observation guide to record personal information of each patient; b) questionnaire applied in two ways: face-to-face to patients who accepted to come to the School and who still were receiving attention, and by phone to subjects who expressed not being able to attend. The instrument allowed to know the experiences of the patient, causes for abandonment or stay, levels of satisfaction and resolution of the consultation. Results: The average of the influx of adult patients recorded at the FOUES archive area from 2010 to 2014 was 1,836 per year. Stay 61.7%. As to the levels of satisfaction for attention given by the administrative, teaching, and student personnel, 51.2% was satisfied. With respect to the treatment received to resolve the cause for consultation, 36.7% was satisfied. Conclusion: The influx of patients in the FOUES was 1,836 per year, 60.9% females, the stay for the treatment plan was 61.7%, and 51.2% was satisfied with the attention received by administrative, teaching, and student personnel.