49 results on '"Eduardo Kerzberg"'
Search Results
2. Use of platelet inhibitors for digital ulcers related to systemic sclerosis: EUSTAR study on derivation and validation of the DU-VASC model
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Alexandru Garaiman 1, Klaus Steigmiller 2, Catherine Gebhard 3, Carina Mihai 1, Rucsandra Dobrota 1, Cosimo Bruni 4, Marco Matucci-Cerinic 5, Joerg Henes 6, Jeska de Vries-Bouwstra 7, Vanessa Smith 8, Andrea Doria 9, Yannick Allanore 10, Lorenzo Dagna 11, Branimir Anić 12, Carlomaurizio Montecucco 13, Otylia Kowal-Bielecka 14, Mickael Martin 15, Yoshiya Tanaka 16, Anna-Maria Hoffmann-Vold 17, Ulrike Held 2, Oliver Distler 1, Mike Oliver Becker 1, EUSTAR Silvia Bellando Randone, Gemma Lepri, Ulrich Walker, Florenzo Iannone, Suzana Jordan, Radim Becvar, Ewa Gindzienska-Sieskiewicz, Katarzyna Karaszewska, Maurizio Cutolo, Giovanna Cuomo, Elise Siegert, Simona Rednic, Jérome Avouac, Carole Desbas, Roberto Caporali, Lorenzo Cavagna, Patricia E Carreira, Srdan Novak, László Czirják, Michele Iudici, Eugene J Kucharz, Elisabetta Zanatta, Bernard Coleiro, Gianluca Moroncini, Dominique Farge Bancel, Paolo Airò, Roger Hesselstr, Mislav Radic, Alexandra Balbir-Gurman, Nicolas Hunzelmann, Raffaele Pellerito, Alessandro Giollo, Jadranka Morovic-Vergles, Christopher Denton, Nemanja Damjanov, Ann-Christian Pecher, Vera Ortiz Santamaria, Stefan Heitmann, Dorota Krasowska, Paul Hasler, Ivan Foeldvari, Maria João Salvador, Bojana Stamenkovic, Carlo Francesco Selmi, Lidia P Ananieva, Ariane Herrick, Ulf Müller-Ladner, Raffaele De Palma, Merete Engelhart, Gabriela Szücs, Carlos de la Puente, Øyvind Midtvedt, Torhild Garen, Håvard Fretheim, Eric Hachulla, Valeria Riccieri, Ruxandra Maria Ionescu, Ana Maria Gheorghiu, Cord Sunderkötter, Jörg Distler, Francesca Ingegnoli, Luc Mouthon, Francesco Paolo Cantatore, Susanne Ullman, Maria Rosa Pozzi, Kilian Eyerich, Piotr Wiland, Marie Vanthuyne, Juan Jose Alegre-Sancho, Kristine Herrmann, Ellen De Langhe, Marko Baresic, Miroslav Mayer, Sule Yavuz, Brigitte Granel, Carolina de Souza Müller, Svetlana Agachi, Simon Stebbings, D'Alessandro Mathieu, Alessandra Vacca, Kamal Solanki, Douglas Veale, Esthela Loyo, Carmen Tineo, Mengtao Li, Edoardo Rosato, Fahrettin Oksel, Figen Yargucu, Cristina-Mihaela Tanaseanu, Rosario Foti, Codrina Ancuta, Britta Maurer, Jacob van Laar, Marzena Olesinska, Cristiane Kayser, Nihal Fathi, Paloma García de la Peña Lefebvre, Jorge Juan Gonzalez Martin, Jean Sibilia, Ira Litinsky, Francesco Del Galdo, Lesley Ann Saketkoo, Eduardo Kerzberg, Washington Bianch, Breno Valdetaro Bianchi, Ivan Castellví, Massimiliano Limonta, Doron Rimar, Maura Couto, François Spertini, Antonella Marcoccia, Sarah Kahl, Ivien M Hsu, Thierry Martin, Sergey Moiseev, Pavel Novikov, Lorinda S Chung, Tim Schmeiser, Dominik Majewski, Zbigniew Zdrojewski, Julia Martínez-Barrio, Vera Bernardino, Gabriela Riemekasten, Yair Levy, Elena Rezus, Omer Nuri Pamuk, Piercarlo Sarzi Puttini, Hadi Poormoghim, Ina Kötter, Francis Gaches, Laura Belloli, Petros Sfikakis, Daniel Furst, Ana-Maria Ramazan, H U Scherer, Tom W J Huizinga, Marie-Elise Truchetet, Alain Lescoat, Giacomo De Luca, Corrado Campochiaro, J M van Laar, Lidia Rudnicka, Susana Oliveira, Fabiola Atzeni, Masataka Kuwana, Arsene Mekinian, Cédric L, Mathieu Puyade, Pascal Roblot, Satoshi Kubo, Yasuyuki Todoroki, 1, Alexandru Garaiman, 2, Klaus Steigmiller, 3, Catherine Gebhard, 1, Carina Mihai, 1, Rucsandra Dobrota, 4, Cosimo Bruni, 5, Marco Matucci-Cerinic, 6, Joerg Hene, 7, Jeska de Vries-Bouwstra, 8, Vanessa Smith, 9, Andrea Doria, Allanore 10, Yannick, Dagna 11, Lorenzo, Anić 12, Branimir, Montecucco 13, Carlomaurizio, Kowal-Bielecka 14, Otylia, Martin 15, Mickael, Tanaka 16, Yoshiya, Hoffmann-Vold 17, Anna-Maria, 2, Ulrike Held, 1, Oliver Distler, 1, Mike Oliver Becker, Silvia Bellando Randone, Eustar, Lepri, Gemma, Walker, Ulrich, Iannone, Florenzo, Jordan, Suzana, Becvar, Radim, Gindzienska-Sieskiewicz, Ewa, Karaszewska, Katarzyna, Cutolo, Maurizio, Cuomo, Giovanna, Siegert, Elise, Rednic, Simona, Avouac, Jérome, Desbas, Carole, Caporali, Roberto, Cavagna, Lorenzo, E Carreira, Patricia, Novak, Srdan, Czirják, László, Iudici, Michele, J Kucharz, Eugene, Zanatta, Elisabetta, Coleiro, Bernard, Moroncini, Gianluca, Farge Bancel, Dominique, Airò, Paolo, Hesselstr, Roger, Radic, Mislav, Balbir-Gurman, Alexandra, Hunzelmann, Nicola, Pellerito, Raffaele, Giollo, Alessandro, Morovic-Vergles, Jadranka, Denton, Christopher, Damjanov, Nemanja, Pecher, Ann-Christian, Ortiz Santamaria, Vera, Heitmann, Stefan, Krasowska, Dorota, Hasler, Paul, Foeldvari, Ivan, João Salvador, Maria, Stamenkovic, Bojana, Francesco Selmi, Carlo, P Ananieva, Lidia, Herrick, Ariane, Müller-Ladner, Ulf, DE PALMA, Raffaele, Engelhart, Merete, Szücs, Gabriela, de la Puente, Carlo, Midtvedt, Øyvind, Garen, Torhild, Fretheim, Håvard, Hachulla, Eric, Riccieri, Valeria, Maria Ionescu, Ruxandra, Maria Gheorghiu, Ana, Sunderkötter, Cord, Distler, Jörg, Ingegnoli, Francesca, Mouthon, Luc, Paolo Cantatore, Francesco, Ullman, Susanne, Rosa Pozzi, Maria, Eyerich, Kilian, Wiland, Piotr, Vanthuyne, Marie, Jose Alegre-Sancho, Juan, Herrmann, Kristine, De Langhe, Ellen, Baresic, Marko, Mayer, Miroslav, Yavuz, Sule, Granel, Brigitte, de Souza Müller, Carolina, Agachi, Svetlana, Stebbings, Simon, Mathieu, D'Alessandro, Vacca, Alessandra, Solanki, Kamal, Veale, Dougla, Loyo, Esthela, Tineo, Carmen, Li, Mengtao, Rosato, Edoardo, Oksel, Fahrettin, Yargucu, Figen, Tanaseanu, Cristina-Mihaela, Foti, Rosario, Ancuta, Codrina, Maurer, Britta, van Laar, Jacob, Olesinska, Marzena, Kayser, Cristiane, Fathi, Nihal, García de la Peña Lefebvre, Paloma, Juan Gonzalez Martin, Jorge, Sibilia, Jean, Litinsky, Ira, Del Galdo, Francesco, Ann Saketkoo, Lesley, Kerzberg, Eduardo, Bianch, Washington, Valdetaro Bianchi, Breno, Castellví, Ivan, Limonta, Massimiliano, Rimar, Doron, Couto, Maura, Spertini, Françoi, Marcoccia, Antonella, Kahl, Sarah, M Hsu, Ivien, Martin, Thierry, Moiseev, Sergey, Novikov, Pavel, S Chung, Lorinda, Schmeiser, Tim, Majewski, Dominik, Zdrojewski, Zbigniew, Martínez-Barrio, Julia, Bernardino, Vera, Riemekasten, Gabriela, Levy, Yair, Rezus, Elena, Nuri Pamuk, Omer, Sarzi Puttini, Piercarlo, Poormoghim, Hadi, Kötter, Ina, Gaches, Franci, Belloli, Laura, Sfikakis, Petro, Furst, Daniel, Ramazan, Ana-Maria, U Scherer, H, J Huizinga, Tom W, Truchetet, Marie-Elise, Lescoat, Alain, De Luca, Giacomo, Campochiaro, Corrado, M van Laar, J, Rudnicka, Lidia, Oliveira, Susana, Atzeni, Fabiola, Kuwana, Masataka, Mekinian, Arsene, L, Cédric, Puyade, Mathieu, Roblot, Pascal, Kubo, Satoshi, Todoroki, Yasuyuki, and University of Zurich
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prognostic prediction model ,Rheumatology ,10051 Rheumatology Clinic and Institute of Physical Medicine ,digital ulcers ,platelets inhibitors ,610 Medicine & health ,Pharmacology (medical) ,SSc ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) - Abstract
Objective To develop and validate the prognostic prediction model DU-VASC to assist the clinicians in decision-making regarding the use of platelet inhibitors (PIs) for the management of digital ulcers in patients with systemic sclerosis. Secondly, to assess the incremental value of PIs as predictor. Methods We analysed patient data from the European Scleroderma Trials and Research group registry (one time point assessed). Three sets of derivation/validation cohorts were obtained from the original cohort. Using logistic regression, we developed a model for prediction of digital ulcers (DUs). C-Statistics and calibration plots were calculated to evaluate the prediction performance. Variable importance plots and the decrease in C-statistics were used to address the importance of the predictors. Results Of 3710 patients in the original cohort, 487 had DUs and 90 were exposed to PIs. For the DU-VASC model, which includes 27 predictors, we observed good calibration and discrimination in all cohorts (C-statistic = 81.1% [95% CI: 78.9%, 83.4%] for the derivation and 82.3% [95% CI: 779.3%, 85.3%] for the independent temporal validation cohort). Exposure to PIs was associated with absence of DUs and was the most important therapeutic predictor. Further important factors associated with absence of DUs were lower modified Rodnan skin score, anti-Scl-70 negativity and normal CRP. Conversely, the exposure to phosphodiesterase-5 inhibitor, prostacyclin analogues or endothelin receptor antagonists seemed to be associated with the occurrence of DUs. Nonetheless, previous DUs remains the most impactful predictor of DUs. Conclusion The DU-VASC model, with good calibration and discrimination ability, revealed that PI treatment was the most important therapy-related predictor associated with reduced DU occurrence.
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- 2022
3. Drugs Recommended in Adult Rheumatic Diseases, But Considered for Off-Label Use in Argentina
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Fernando Villalobos, Carla Matellan, Gabriel Sequeira, and Eduardo Kerzberg
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Drug ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Abatacept ,Argentina ,General Medicine ,Off-Label Use ,Guideline ,medicine.disease ,Off-label use ,United States ,Rheumatology ,Arthritis, Rheumatoid ,Rheumatic Diseases ,Rheumatoid arthritis ,Internal medicine ,medicine ,Humans ,Rituximab ,Medical prescription ,business ,media_common ,medicine.drug - Abstract
Background Off-label (OL) drug use is the prescription of a drug for indications other than those authorised in its technical datasheet. The objective of this study was to identify drugs recommended in rheumatology but considered for off-label use in Argentina. Methods A list of medications for certain selected rheumatic conditions was compiled. A drug was considered recommended if it was endorsed by a) at least one Argentine or Pan-American treatment guideline or consensus, or b) two international treatment guidelines, or c) one international treatment guideline and one selected textbook. Approval of these drugs for any condition in Argentina until December 31st, 2018 was explored, and medicines were divided into those with on-label indications and those considered for OL use. Results One hundred and thirty-six medications were analysed in 13 clinical conditions. Sixty-seven OL recommendations (49%) were found, and several drugs had more than one. All the conditions included the recommendation of at least 1 OL drug except osteoporosis and rheumatoid arthritis. The frequency of OL recommendations for the following conditions was 100%: calcium pyrophosphate dihydrate crystal deposition disease, polymyalgia rheumatica, Sjogren syndrome, and systemic sclerosis. The drugs with the highest number of OL recommendations were methotrexate (in 7 conditions), and glucocorticoids and mycophenolate (in 4). There were 2 OL recommendations for rituximab and 1 for abatacept. Conclusions Almost all the rheumatic disorders analysed involved the recommendation of at least 1 OL medication, and in 4 conditions all the recommendations were OL. Most OL drugs recommended in rheumatology are neither biological nor small-molecule therapies.
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- 2022
4. Systemic lupus erythematosus diagnosed during hospitalization: Greater baseline disease activity, short-term damage, and death
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Sabrina Porta, Romina Hassan, Valeria Aquino, Natalia Estrella, Marina Laura Micelli, Gabriel Sequeira, and Eduardo Kerzberg
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General Medicine - Published
- 2022
5. Phenotype of limited cutaneous systemic sclerosis patients with positive anti-topoisomerase I antibodies: data from the EUSTAR cohort
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Elisabetta Zanatta 1, Dörte Huscher 2, Augusta Ortolan 1, Jérôme Avouac 3, Paolo Airò 4, Alexandra Balbir-Gurman 5, Elise Siegert 6, Marco Matucci Cerinic 7, Franco Cozzi 8, Gabriela Riemekasten 9, Anna-Maria Hoffmann-Vold 10, Oliver Distler 11, Armando Gabrielli 12, Stefan Heitmann 13, Nicolas Hunzelmann 14, Carlomaurizio Montecucco 15, Jadranka Morovic-Vergles 16, Camillo Ribi 17, Andrea Doria 1, Yannick Allanore 3, EUSTAR collaborators, Giovanna Cuomo, Gianluca Moroncini, Jiri Stork, Fiorenzo Iannone, Ulrich Walker, Eugenia Bertoldo, Dorota Krasowska, Maria João Salvador, Mohammed Tikly, Eric Hachulla, Valeria Riccieri, Ami Sha, Ana Maria Gheorghiu, Cord Sunderkötter, Francesca Ingegnoli, Luc Mouthon, Vanessa Smith, Francesco Paolo Cantatore, Kilian Eyerich, Piotr Wiland, Marie Vanthuyne, Branimir Anic, Maria Üprus, Brigitte Granel, Alessandra Vacca, Cristina-Mihaela Tanaseanu, Paloma García de la Peña Lefebvre, Jean Sibilia, Ira Litinsky, Lesley Ann Saketkoo, Eduardo Kerzberg, Massimiliano Limonta, Doron Rimar, Petros Sfikakis, Maurizio Cutolo, Patricia E Carreira, Rosario Foti, Srdan Novak, Michele Iudici, Mislav Radic, Raffaele Pellerito, Carlo Francesco Selmi, Lidia P Ananieva, Gabriela Szücs, Carlos de la Puente, Ruxandra Maria Ionescu, Jörg Distler, Maria Rosa Pozzi, Juan Jose Alegre-Sancho, Kristine Herrmann, Ellen De Langhe, Sule Yavuz, Carolina de Souza Müller, Svetlana Agachi, Douglas Veale, Esthela Loyo, Mengtao Li, Edoardo Rosato, Britta Maurer, Ivan Castellví, François Spertini, Kamal Solanki, Nicoletta Del Papa, Gerard Espinosa, László Czirják, Bernard Coleiro, Dominique Farge Bancel, Christopher Denton, Nemanja Damjanov, Jörg Henes, Vera Ortiz Santamaria, Michaela Kohm, Bojana Stamenkovic, 1, Elisabetta Zanatta, 2, Dörte Huscher, 1, Augusta Ortolan, 3, Jérôme Avouac, 4, Paolo Airò, 5, Alexandra Balbir-Gurman, 6, Elise Siegert, 7, Marco Matucci Cerinic, 8, Franco Cozzi, 9, Gabriela Riemekasten, Hoffmann-Vold 10, Anna-Maria, Distler 11, Oliver, Gabrielli 12, Armando, Heitmann 13, Stefan, Hunzelmann 14, Nicola, Montecucco 15, Carlomaurizio, Morovic-Vergles 16, Jadranka, Ribi 17, Camillo, 1, Andrea Doria, 3, Yannick Allanore, Collaborators, Eustar, Cuomo, Giovanna, Moroncini, Gianluca, Stork, Jiri, Iannone, Fiorenzo, Walker, Ulrich, Bertoldo, Eugenia, Krasowska, Dorota, João Salvador, Maria, Tikly, Mohammed, Hachulla, Eric, Riccieri, Valeria, Sha, Ami, Maria Gheorghiu, Ana, Sunderkötter, Cord, Ingegnoli, Francesca, Mouthon, Luc, Smith, Vanessa, Paolo Cantatore, Francesco, Eyerich, Kilian, Wiland, Piotr, Vanthuyne, Marie, Anic, Branimir, Üprus, Maria, Granel, Brigitte, Vacca, Alessandra, Tanaseanu, Cristina-Mihaela, García de la Peña Lefebvre, Paloma, Sibilia, Jean, Litinsky, Ira, Ann Saketkoo, Lesley, Kerzberg, Eduardo, Limonta, Massimiliano, Rimar, Doron, Sfikakis, Petro, Cutolo, Maurizio, E Carreira, Patricia, Foti, Rosario, Novak, Srdan, Iudici, Michele, Radic, Mislav, Pellerito, Raffaele, Francesco Selmi, Carlo, P Ananieva, Lidia, Szücs, Gabriela, de la Puente, Carlo, Maria Ionescu, Ruxandra, Distler, Jörg, Rosa Pozzi, Maria, Jose Alegre-Sancho, Juan, Herrmann, Kristine, De Langhe, Ellen, Yavuz, Sule, de Souza Müller, Carolina, Agachi, Svetlana, Veale, Dougla, Loyo, Esthela, Li, Mengtao, Rosato, Edoardo, Maurer, Britta, Castellví, Ivan, Spertini, Françoi, Solanki, Kamal, Del Papa, Nicoletta, Espinosa, Gerard, Czirják, László, Coleiro, Bernard, Farge Bancel, Dominique, Denton, Christopher, Damjanov, Nemanja, Henes, Jörg, Ortiz Santamaria, Vera, Kohm, Michaela, and Stamenkovic, Bojana
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interstitial lung disease ,Scleroderma, Systemic ,Hypertension, Pulmonary ,disease subset ,anti-topoisomerase I ,Scleroderma ,Systemic sclerosis ,cutaneous form ,outcome ,Phenotype ,Rheumatology ,Scleroderma, Limited ,Antibodies, Antinuclear ,Scleroderma, Diffuse ,Humans ,Pharmacology (medical) ,Lung Diseases, Interstitial - Abstract
Objectives To characterize patients with positive anti-topoisomerase I (ATA) in lcSSc. Methods SSc patients enrolled in the EUSTAR cohort with a disease duration of ≤3 years at database entry were considered. We assessed the risk of major organ involvement in the following groups: ATA-lcSSc vs ACA-lcSSc and vs ANA without specificity (ANA)-lcSSc, and ATA-lcSSc vs ATA-dcSSc. Cox regression models with time-dependent covariates were performed with the following outcomes: new-onset interstitial lung disease (ILD), ILD progression [forced vital capacity (FVC) decline ≥10% and ≥5% vs values at ILD diagnosis), primary myocardial involvement (PMI), pulmonary hypertension (PH), any organ involvement and all-cause mortality. Results We included 1252 patients [194 ATA-lcSSc (15.5%)], with 7.7 years (s.d. 3.5) of follow-up. ILD risk was higher in ATA-lcSSc vs ACA- and ANA-lcSSc and similar to ATA-dcSSc, although with less frequent restrictive lung disease. The risk of FVC decline ≥10% (35% of ATA-lcSSc) was lower in ATA-lcSSc than in ATA-dcSSc, whereas FVC decline ≥5% occurs similarly between ATA-lcSSc (58% of patients) and other SSc subsets, including ATA-dcSSc. The risk of PMI was similar in ATA-lcSSc and ANA-lcSSc but lower than in ACA-lcSSc; no difference in PH and mortality risk was observed among lcSSc subsets. The risk of any organ involvement, PMI and PH was lower and the mortality tended to be lower in ATA-lcSSc vs ATA-dcSSc. Conclusion ATA-lcSSc patients have a high risk of ILD, albeit with a lower risk of progression compared with ATA-dcSSc, supporting careful screening for ILD in this subgroup.
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- 2022
6. Participación laboral en espondiloartritis axial radiográfica y no radiográfica
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Carla Airoldi, María Victoria Martire, Paula Girard Bosch, Mariana Benegas, Vanesa Duarte, Vanesa Cosentino, Fernando Sommerfleck, Josefina Marin, Juan Manuel Bande, Julieta Gamba, Rodrigo Águila Maldonado, Edson Velozo, Marina Oliver, Romina Nieto, Paula González, Diego Vila, Eduardo Kerzberg, Micaela Cosatti, Janina Tapia, Pamela Giorgis, Lyseth Macias Oviedo, Santiago Scarafia, and Emilce Schneeberger
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Introducción: las limitaciones laborales son un punto importante a considerar en el tratamiento de la espondiloartritis axial (EspAax) dado que esta enfermedad afecta a las personas en la etapa más productiva de la vida.Objetivos: describir la situación laboral en pacientes con EspAax de Argentina, incluyendo la espondilitis anquilosante (EA) y la espondiloartritis axial no radiográfica (EspAax-nr), y evaluar los factores asociados a la pérdida de productividad laboral (PPL) en esta cohorte nacional y los factores asociados a estar empleado.
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- 2021
7. Digital pitting scars are associated with a severe disease course and death in systemic sclerosis: a study from the EUSTAR cohort
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Michael, Hughes, Calvin, Heal, Jörg, Henes, Alexandra, Balbir-Gurman, Jörg H W, Distler, Paolo, Airò, Ulf, Müller-Ladner, Nicolas, Hunzelmann, Eduardo, Kerzberg, Lidia, Rudnicka, Marie-Elise, Truchetet, Simon, Stebbings, Yoshiya, Tanaka, Anna Maria, Hoffman-Vold, Armando, Gabrielli, Oliver, Distler, Marco, Matucci-Cerinic, and Ulrich, Walker
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Adult ,Male ,medicine.medical_specialty ,Telangiectases ,Disease ,Logistic regression ,Cicatrix ,Rheumatology ,Calcinosis ,death ,Internal medicine ,digital pitting scars ,Skin Ulcer ,Humans ,Medicine ,scleroderma ,Pharmacology (medical) ,vasculopathy ,Aged ,Gangrene ,Scleroderma, Systemic ,business.industry ,Interstitial lung disease ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,digital ischaemia ,Cohort ,Disease Progression ,Female ,business ,SSc - Abstract
Objective Digital pitting scars (DPS) are frequent, but little studied in SSc to date. Methods An analysis of SSc patients enrolled in the EUSTAR database. Primary objectives were to (i) examine DPS prevalence; (ii) examine whether DPS are associated with digital ulcers (DUs) and active digital ischaemia (DUs or gangrene); and (iii) describe other associations with DPS including internal organ complications. Secondary objectives were whether DPS are associated with (i) functional impairment; (ii) structural microvascular disease; and (iii) mortality. Descriptive statistics and parametric/non-parametric tests were used. Binary logistic regression was used to examine the association between DPS and DUs, active digital ischaemia and mortality. Results A total of 9671 patients were included with reported DPS at any time point (n = 4924) or ‘never’ DPS (n = 4747). The majority (86.9%) were female and mean age was 55.7 years. DPS were associated with longer disease and Raynaud’s duration (both P ≤ 0.001). DPS were associated with interstitial lung disease, pulmonary hypertension, conduction blocks, telangiectases, calcinosis (all P ≤ 0.001) and joint synovitis (P = 0.021). Patients were more likely to have more severe capillaroscopic abnormality and greater hand functional impairment. Multivariable logistic regression analyses showed that DPS were associated (odds ratio) with DUs: 22.03 (19.51–24.87), active digital ischaemia: 6.30 (5.34–7.42) and death: 1.86 (1.48–2.36). Conclusion DPS are associated with a severe disease course including death. The impact of DPS on hand function and ischaemia is significant. The presence of DPS should alert the clinician to a poor prognosis and need to optimize the therapeutic strategy.
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- 2021
8. Evaluación de las necesidades educacionales de los pacientes con artritis reumatoide mediante el cuestionario SpENAT
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Eduardo Kerzberg, Javier Rosa, José Angel Caracciolo, Laura Raiti, Andrea D’Orazio, Diana Klajn, Valeria Astudillo, Claudia Hartvig, Dora Pereira, Marta Mamani, José Velazco Zamora, Silvia Papasidero, Federico Giordano, Oscar Rillo, Mónica Sacnum, Rodolfo Perez Alamino, Hernán Maldonado Ficco, Mariana Benegas, María José Latorre Medina, A. C. Costi, Cinthya Retamozo, María de los Ángeles Correa, Olga Romano, Adriana Perez Dávila, María Julia Santa Cruz, Gustavo Citera, Damaris Alvarez, Vanesa Cruzat, Julia Sosa, Gisela Pendón, Mercedes García, Nicolás Lloves, Karin Kirmayr, Silvana Pérez, María Zalazar, Rosana Quintana, Gabriela Chávez Sánchez, María del Carmen Massé García, Fernando Melo, Graciela Gómez, Yamila Chichotky, B A Pons-Estel, Analía Bohr, and Paula Kohan
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education.field_of_study ,Domain (biology) ,business.industry ,Population ,Low activity ,Pain management ,Rheumatology ,High activity ,Medicine ,Disease characteristics ,Support system ,Statistical analysis ,business ,education ,Humanities - Abstract
espanolIntroduccion El Educational Needs Assessment Tool-version espanola (SpENAT) es un cuestionario autorreportado que evalua las necesidades educacionales (NEd) con el fin de dar informacion adaptada y centrada en el paciente con artritis reumatoide (AR). Comprende 39 preguntas agrupadas en 7 dominios: Manejo del dolor, Movimiento, Sentimientos, Proceso de artritis, Tratamientos, Medidas de autoayuda y Sistemas de apoyo. Objetivos Evaluar las NEd en pacientes con AR mediante el SpENAT y determinar cuales son las principales fuentes de informacion a las que consultan. Material y metodos Estudio multicentrico, observacional, analitico, de corte transversal. Se incluyeron pacientes consecutivos ≥ 18 anos con diagnostico de AR (ACR 87 y/o ACR-EULAR 2010). Se consignaron datos demograficos, nivel educativo, caracteristicas de la enfermedad y medidas clinimetricas. Todos los pacientes completaron el SpENAT y fueron interrogados acerca de las fuentes a las que acuden para obtener informacion de su enfermedad. Analisis estadistico Se describieron las caracteristicas poblacionales. Se determinaron las NEd como porcentajes del puntaje maximo posible de cada dominio. Se compararon las necesidades por dominio segun sexo, anos de educacion, tiempo de evolucion, uso de biologico y capacidad funcional mediante test de Anova y las comparaciones de a pares con prueba t de Student y correccion de Bonferroni. Se determino correlacion entre los dominios con test de Spearman. Se comparo la edad segun la fuente de informacion con la prueba t de Student. Resultados Se incluyeron 496 pacientes de 20 centros de todo el pais. Se observaron mayores NEd en los dominios Movimiento, Sentimientos y Proceso de artritis. Los pacientes de mayor nivel educacional (> 7 anos) refirieron mayores NEd en los dominios Proceso de artritis y Medidas de autoayuda. Un mayor deterioro funcional (HAQ ≥ 0,87) se asocio con unas mayores NEd en todos los dominios. Los pacientes con alta actividad mostraron mayores NEd que los pacientes en remision en los dominios Manejo del dolor, Movimiento, Sentimientos, Tratamientos y Sistemas de apoyo, y que los pacientes con baja actividad en los dominios Medidas de autoayuda y Sistemas de apoyo. Todos los dominios del SpENAT mostraron correlaciones positivas entre si (p Conclusion Los pacientes con AR manifestaron un gran interes por conocer mas sobre su enfermedad. Un elevado deterioro funcional se asocia con mayores NEd. Los pacientes con alta actividad de la enfermedad presentan mayores NEd en casi todos los dominios. El medico reumatologo es la principal fuente de informacion del paciente con AR. EnglishBackground The SpENAT, a Spanish version of the Educational Needs Assessment Tool, is a self-completed questionnaire that assesses educational needs (ENs) with the purpose of providing tailored and patient-centered information. It consists of 39 questions grouped into the 7 following domains: Pain management, Movement, Feelings, Arthritic process, Treatments, Self-help measures and Support system. Objectives The objective of the study was to describe the ENs of rheumatoid arthritis (RA) patients using the SpENAT and to determine the main sources of information consulted by these patients. Material and methods Multicenter, observational, cross-sectional study. We included consecutive patients ≥ 18 years with diagnosis of RA (ACR 87/ACR-EULAR 2010). Sociodemographic data, disease characteristics and clinimetric properties were recorded. All patients completed the SpENAT and were asked about the sources employed to obtain information about their disease. Statistical analysis Population characteristics were described. ENs were determined as percentages of the highest possible score for each domain. Needs for each domain according to sex, years of education, disease duration, use of biologicals and functional capacity were analyzed by means of ANOVA, and bivariate comparisons were made with Student's t-test and the Bonferroni correction. Correlation between domains was determined with the Spearman correlation coefficient. We compared patients’ age by source of information with Student's t-test. Results We included 496 patients from 20 centers across the country. More ENs were observed in the domains of Movement, Feelings and the Arthritic process. Patients with higher educational level (> 7 years) reported more ENs in the Arthritic process and Self-help measure domains. A higher functional impairment (HAQ-A ≥ 0.87) was associated with more ENs in every domain. Patients with high activity showed more ENs than those in remission in the domains of Pain management, Movement, Feelings, Treatments and Support system, as well as those with low activity in Self-help measures and Support system domains. All SpENAT domains showed positive correlations among each other (P Conclusion RA patients were very interested about knowing more about their disease. High functional impairment was associated with more ENs. Patients with high disease activity had higher EN levels in almost every domain. The rheumatologist was the main source of information for the patient with RA.
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- 2020
9. Evaluation of the educational needs in Argentine patients with rheumatoid arthritis using the SpENAT questionnaire
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Nicolás Lloves, A. C. Costi, Federico Giordano, Rodolfo Perez Alamino, Javier Rosa, José Angel Caracciolo, Laura Raiti, Andrea D’Orazio, Valeria Astudillo, Adriana Perez Dávila, Analía Bohr, Mercedes García, Marta Mamani, Vanesa Cruzat, Fernando Melo, Rosana Quintana, Diana Klajn, Oscar Rillo, María Medina, Damaris Alvarez, José Velazco Zamora, Silvia Papasidero, Gabriela Chávez Sánchez, Julia Sosa, Yamila Chichotky, Hernán Maldonado Ficco, Karin Kirmayr, Cinthya Retamozo, María Zalazar, Graciela Gómez, Dora Pereira, Claudia Hartvig, Bernardo A. Pons-Estel, Olga Romano, Silvana Pérez, María Julia Santa Cruz, Gustavo Citera, Eduardo Kerzberg, Gisela Pendón, Paula Kohan, Mónica Sacnum, María Romelia Bogarín Correa, Mariana Benegas, and María del Carmen Massé García
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Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,media_common.quotation_subject ,Population ,Argentina ,Disease ,Arthritis, Rheumatoid ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Humans ,Medicine ,030212 general & internal medicine ,education ,media_common ,030203 arthritis & rheumatology ,education.field_of_study ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Bonferroni correction ,Feeling ,Rheumatoid arthritis ,Needs assessment ,symbols ,Physical therapy ,Female ,Observational study ,Self Report ,Analysis of variance ,business ,Needs Assessment - Abstract
The SpENAT, a Spanish version of the Educational Needs Assessment Tool, is a self-completed questionnaire that assesses educational needs (ENs) with the purpose of providing tailored and patient-centered information. It consists of 39 questions grouped into the 7 following domains: Pain management, Movement, Feelings, Arthritic process, Treatments, Self-help measures and Support system.The objective of the study was to describe the ENs of rheumatoid arthritis (RA) patients using the SpENAT and to determine the main sources of information consulted by these patients.Multicenter, observational, cross-sectional study. We included consecutive patients≥18 years with diagnosis of RA (ACR 87/ACR-EULAR 2010). Sociodemographic data, disease characteristics and clinimetric properties were recorded. All patients completed the SpENAT and were asked about the sources employed to obtain information about their disease.Population characteristics were described. ENs were determined as percentages of the highest possible score for each domain. Needs for each domain according to sex, years of education, disease duration, use of biologicals and functional capacity were analyzed by means of ANOVA, and bivariate comparisons were made with Student's t-test and the Bonferroni correction. Correlation between domains was determined with the Spearman correlation coefficient. We compared patients' age by source of information with Student's t-test.We included 496 patients from 20 centers across the country. More ENs were observed in the domains of Movement, Feelings and the Arthritic process. Patients with higher educational level (7 years) reported more ENs in the Arthritic process and Self-help measure domains. A higher functional impairment (HAQ-A≥0.87) was associated with more ENs in every domain. Patients with high activity showed more ENs than those in remission in the domains of Pain management, Movement, Feelings, Treatments and Support system, as well as those with low activity in Self-help measures and Support system domains. All SpENAT domains showed positive correlations among each other (P.0001), the most important being Pain management/Movement and Treatments/Arthritic process (r≥0.7). The source of information most frequently consulted was the rheumatologist (93.95%); those who made use of Internet were on average younger (P=.0004).RA patients were very interested about knowing more about their disease. High functional impairment was associated with more ENs. Patients with high disease activity had higher EN levels in almost every domain. The rheumatologist was the main source of information for the patient with RA.
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- 2020
10. A useful tool to assess quality of LIFE in rheumatoid arthritis patients that does not require a license: QOL-RA II
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A. L. Barbaglia, María de los Ángeles Correa, María Janina Tapia, Eliana Blanco, Eduardo Kerzberg, Emilce Edith Schneeberger, Federico Luján Benavidez, Hernán Maldonado Ficco, Claudia Hartvig, Mariana Salcedo, Marcela Bazzarelli, Gustavo Citera, Dafne Capelusnik, Luciana Gonzales Lucero, Romina Lim, Silvana Pérez, C. A. Isnardi, and María Hu
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030203 arthritis & rheumatology ,medicine.medical_specialty ,business.industry ,Construct validity ,Arthritis ,General Medicine ,medicine.disease ,Rheumatology ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Cronbach's alpha ,Internal medicine ,Rheumatoid arthritis ,Cohort ,medicine ,030212 general & internal medicine ,business ,Depression (differential diagnoses) - Abstract
To validate the Quality of Life-Rheumatoid Arthritis Scale II (QOL-RA II) in an Argentinean cohort of patients with rheumatoid arthritis (RA). Patients ≥ 18 years old, with a diagnosis of RA according to ACR-EULAR 2010 criteria, were included in a cross-sectional study. Sociodemographic data, comorbidities, RA characteristics, disease activity, and current treatment were registered. Questionnaires were administered, including EQ-5D-3 L, QOL-RA II, HAQ-A, and PHQ-9. The QOL-RA II was re-administered in 20 patients to evaluate reproducibility. Four hundred and thirty patients were included. Median QOL-RA was 6.6 (IQR 5.3–8). Mean time to complete it was 1.7 ± 0.57 min and to calculate it was 12 ± 1.7 s. It showed very good reliability (Cronbach’s alpha 0.97), reproducibility (ICC, 0.96), and good correlation between the different items and the total questionnaire, without evidence of redundancy. Besides, QOL-RA II presented good correlation with EQ-5D-3L (Rho, 0.6) and moderate with DAS28 (Rho, 0.38), and CDAI (Rho, 0.46). Worse quality of life was observed in patients not doing physical activity, unemployed, and current smokers. Patients with higher disease activity had a significant poorer quality of life. Adjusting by age, sex and disease duration, unemployment, higher disease activity, disability, and the presence of depression were independently associated to worse quality of life. QOL-RA II demonstrated good construct validity, reproducibility, and reliability. It was easy to complete and calculate and does not require a license for its use, thus making it the optimal tool for assessing the quality of life in Spanish-speaking patients with RA.
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- 2020
11. Assessment of the Sources of Information by Patients With Rheumatic Diseases
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Maria Pia Izaguirre Germain, Paola Andrea Ávila, Nauan Fara, Julia Pretini, Maria Elena Gaona, Pia Pissani, Maira Arias Saavedra, Valeria Aquino, Mariana Espindola Echazu, Manuela Laffont, Magdalena Acevedo, Lucrecia Garcia Faura, Romina Hassan, Karen Roberts, Jorge Alejandro Brigante, Damaris Alvarez, Marina Laura Micelli, Vanesa Laura Cosentino, Sandra Montoya, Gabriel Sequeira, and Eduardo Kerzberg
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Adult ,Arthritis, Rheumatoid ,Rheumatology ,Rheumatic Diseases ,Humans ,Lupus Erythematosus, Systemic ,Reproducibility of Results - Abstract
The aim of this study was to ascertain the frequency of use, search intent (SI), level of accessibility, and degree of reliability of sources of information (SOIs) in rheumatology.A survey among adult outpatients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and spondyloarthritis was conducted. They were asked if they had procured information from 12 selected SOIs during the past year. Search intent was defined as the source they would like to consult. Accessibility and reliability were assessed through 0-to-10 scales (minimum and maximum, respectively).Four hundred two patients were surveyed. They had consulted a median of 3 SOIs (interquartile range, 2-6) but described a higher SI: median of 5 SOIs (interquartile range 3-8); p = 0.001.The most consulted SOIs were the physician (83%), other patients (45%), and Facebook (36%). The main differences between SI and the searches actually performed were observed in community lectures by health care professionals (49%), scientific societies (48%), and associations of patients (27%); p0.001. These 3 sources showed low level of accessibility. Facebook, press, radio, and YouTube were the least reliable sources.Patients consulted a median of 3 SOIs but reported a significantly higher SI. Although patients demand more information, the request is leveled at SOIs with difficult accessibility but high reliability.
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- 2021
12. Lung Ultrasound as a Screening Method for Interstitial Lung Disease in Patients With Systemic Sclerosis
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Lucia I Lubertino, Maria Fernanda Quaglia, Maria Del Carmen Binda, Eduardo Kerzberg, Maria Angeles Barth, Romina Isabel Hassan, and Sandra Fabiana Montoya
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Male ,Thorax ,medicine.medical_specialty ,Radiography ,Argentina ,Sensitivity and Specificity ,Scleroderma ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Screening method ,Humans ,Mass Screening ,Medicine ,In patient ,030212 general & internal medicine ,Lung ,Ultrasonography ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,business.industry ,Disease progression ,Interstitial lung disease ,Reproducibility of Results ,Middle Aged ,respiratory system ,medicine.disease ,Respiratory Function Tests ,respiratory tract diseases ,Lung ultrasound ,body regions ,Disease Progression ,Female ,Radiography, Thoracic ,Radiology ,Lung Diseases, Interstitial ,Tomography, X-Ray Computed ,business - Abstract
Patients with systemic sclerosis (SSc) undergo chest radiographs and high-resolution computed tomography (HRCT) of the thorax both for interstitial lung disease (ILD) detection and for disease progression monitoring.The aim of this study was to assess whether lung ultrasound (LUS) is a useful screening tool for ILD in patients with SSc in comparison with HRCT.This was a longitudinal cohort study carried out from December 2015 to April 2016. An LUS was performed to examine B-lines in 67 consecutive patients who met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for SSc and had a previous HRCT. B-lines were quantified and classified according to the score modified from Picano. Severity and extent of lung involvement on the HRCT were determined by means of the Warrick score.Twenty-nine patients had both abnormal HRCT (Warrick score7) and abnormal LUS, 2 had a mild score (6-15 B-lines), and 27 had either moderate or severe scores (≥16 B-lines). Of the 38 patients with negative HRCT, 25 presented some degree of lung involvement on the LUS. Thus, LUS has a sensitivity of 100% and a specificity of 34%. Receiver operating characteristic curve analysis showed the analytic relation between the number of B-lines and the presence of ILD on the HRCT (area under the curve, 0.80; 95% confidence interval, 0.69-0.90).Lung ultrasound may be a method to detect abnormal lung findings in a noninvasive manner in patients with SSc. Because of its high sensitivity, a low score almost rules out the need for an HRCT.
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- 2019
13. A new tool to assess the quality of life of patients with rheumatoid arthritis that does not require a license: the QOL-RA II (Quality Of Life-Rheumatoid Arthritis Scale-II) questionnaire
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Carolina Ayelen Isnardi, Dafne Capelusnik, Emilce Edith Schneeberger, María de los Ángeles Correa, Romina Lim, María Hu, María Janina Tapia, Eduardo Kerzberg, Eliana Blanco, Federico Luján Benavídez, Luciana González Lucero, Ana Lucía Barbaglia, Marcela Bazzarelli, Hernán Maldonado Ficco, Silvana Pérez, Claudia Hartvig, Mariana Salcedo, and Gustavo Citera
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humanities - Abstract
We have recently validated the Quality of Life-Rheumatoid Arthritis Scale (QOL-RA). We have found some limitations, that is why, with the author’s permission, we have changed two questions and developed a new Spanish version, QOL-RA II. Objective: to validate the QOL-RA II in an Argentinean cohort of patients with Rheumatoid Arthritis (RA). Material and methods: cross-sectional study. Patients ≥18 years old, with a diagnosis of RA according to ACR-EULAR 2010 criteria were included. Sociodemographic data, comorbidities, RA characteristics, disease activity current treatment were registered. Questionnaires were administered: EQ-5D-3L, QOL-RA, HAQ-A and PHQ-9. The QOL-RA II was re-administered in 20 patients to evaluate reproducibility. Statistical analysis: Student´s T, ANOVA and Chi2 tests. Spearman correlation. Cronbach´s alpha. Reproducibility using ICC. Multinomial logistic regression with completed factorial model. Multiple linear regression.
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- 2019
14. Spanish Validation of the GEPARD Questionnaire for the Detection of Psoriatic Arthritis in Argentinian Patients with Psoriasis
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Maria Janina Tapia Moreira, Enrique R. Soriano, S. Scarafia, Fernando Sommerfleck, Mariana Benegas, María Paula Girard Bosch, Vanesa Cosentino, Hernán Maldonado Ficco, Erika Catay, Natalia Estrella, Eduardo Kerzberg, María Victoria Martire, and Josefina Marin
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Adult ,Male ,medicine.medical_specialty ,Argentina ,Early detection ,Dermatology ,Osteoarthritis ,Sensitivity and Specificity ,Likelihood ratios in diagnostic testing ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Surveys and Questionnaires ,Psoriasis ,medicine ,Humans ,Translations ,In patient ,Language ,business.industry ,Arthritis, Psoriatic ,Gold standard ,Area under the curve ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Area Under Curve ,030220 oncology & carcinogenesis ,Female ,business - Abstract
Background/Objective: Psoriatic arthritis (PsA) is preceded by psoriasis in approximately 80% of cases. Dermatologists are pivotal for early detection. It is important to have simple tools that allow the detection of PsA in patients with skin psoriasis. The aim of our study was to evaluate the performance of an adapted version of the GEPARD Questionnaire in Spanish in Argentinian patients with psoriasis. Methods: This is a cross-sectional study. A new Spanish (Argentinian) (GEPARDa) translated version of the original questionnaire (German) was developed and then tested as a diagnostic tool in patients with psoriasis, PsA, osteoarthritis associated to psoriasis, and osteoarthritis, all evaluated by rheumatologists who used the CASPAR criteria. Results: Eighty-three patients were included (55 [66.3%] women with a mean age of 50.7 years [SD 6.3]). Forty-four patients had PsA (29 [34.9%] patients had previous diagnosis of PsA, and 15 [18%] were newly diagnosed after referral by their dermatologists), and 39 patients were without PsA (18 [21.6%] patients had psoriasis without articular involvement, 6 [7.22%] had psoriasis associated with osteoarthritis, and 15 [18%] had osteoarthritis). An area under the curve of 0.9554 (SD 0.01; 95% CI 0.91–0.99) was calculated considering the CASPAR criteria as the gold standard. With a cutoff of ≥6 the questionnaire showed a sensitivity of 88.64%, a specificity of 89.74%, a positive likelihood ratio of 8.6, and a negative likelihood ratio of 0.12. Conclusions: The GEPARDa version has proven to be a diagnostic tool with excellent performance so that it can be considered a valid tool for the detection of PsA in Argentinian patients.
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- 2019
15. Adipokines, Cardiovascular Risk, and Therapeutic Management in Obesity and Psoriatic Arthritis
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Sabrina Porta, Matilde Otero-Losada, Rodolfo A. Kölliker Frers, Vanesa Cosentino, Eduardo Kerzberg, and Francisco Capani
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lcsh:Immunologic diseases. Allergy ,cardiovascular risk ,obesity ,Immunology ,Adipokine ,Adipose tissue ,Inflammation ,Review ,Disease ,Bioinformatics ,metabolic syndrome ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Adipokines ,Animals ,Humans ,Immunology and Allergy ,Medicine ,Disease management (health) ,pathophysiology ,psoriatic arthritis ,030203 arthritis & rheumatology ,treatment ,business.industry ,Arthritis, Psoriatic ,medicine.disease ,Adipose Tissue ,Heart Disease Risk Factors ,Mild Chronic Inflammation ,Metabolic syndrome ,medicine.symptom ,lcsh:RC581-607 ,business - Abstract
Psoriatic arthritis is a chronic inflammatory disease with skin and joint pathology as the dominant characteristics. Scientific evidence supports its systemic nature and relevant relationship with obesity, metabolic syndrome, and associated conditions. Metabolic syndrome and obesity share common signaling pathways with joint inflammation, reinforcing the idea that adipose tissue is a major contributor to disease development and severity. The adipose tissue is not a mere energy store but also an endocrine organ participating in the immune response. In the search for the best therapeutic strategy for a patient, we should appraise the adipose tissue as an endocrine and immune organ responsible for mild chronic inflammation. Today, our challenge is not only to achieve disease remission but to control the associated comorbidities as well. In light of the high prevalence of obesity in psoriatic arthritis patients and the importance of the adipose tissue in the development of chronic inflammation, we aimed to identify the most relevant articles in this regard published in English until June 2020 using the PubMed database. Search terms included psoriatic arthritis, in combination with metabolic syndrome, obesity, adipokines, cardiovascular disease, and treatment. This review summarizes the current evidence regarding the role of adipose tissue as an adipokine-secreting endocrine organ, discussing its influence on disease development and severity, and ultimately in meeting successful disease management.
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- 2021
16. Immune-Mediated Inflammation: Human T CD4 Helper Lymphocyte Diversity and Plasticity in Health and Disease
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Vanesa Cosentino, Sabrina Porta, Lucas Udovin, Francisco Capani, Eduardo Kerzberg, Rodolfo Alberto Kolliker Frers, Maria Ines Herrera, and Matilde Otero-Losada
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media_common.quotation_subject ,Lymphocyte ,InformationSystems_INFORMATIONSTORAGEANDRETRIEVAL ,Inflammation ,Disease ,Biology ,Immune system ,medicine.anatomical_structure ,Immunology ,medicine ,medicine.symptom ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,Diversity (politics) ,media_common - Published
- 2020
17. A useful tool to assess quality of LIFE in rheumatoid arthritis patients that does not require a license: QOL-RA II
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Carolina Ayelen, Isnardi, Emilce Edith, Schneeberger, Dafne, Capelusnik, María, de Los Ángeles Correa, Romina, Lim, María, Hu, María Janina, Tapia, Eduardo, Kerzberg, Eliana, Blanco, Federico Luján, Benavidez, Luciana, Gonzales Lucero, Ana Lucía, Barbaglia, Marcela, Bazzarelli, Hernán Maldonado, Ficco, Silvana, Pérez, Claudia, Hartvig, Mariana, Salcedo, and Gustavo, Citera
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Arthritis, Rheumatoid ,Cross-Sectional Studies ,Adolescent ,Surveys and Questionnaires ,Quality of Life ,Humans ,Reproducibility of Results - Abstract
To validate the Quality of Life-Rheumatoid Arthritis Scale II (QOL-RA II) in an Argentinean cohort of patients with rheumatoid arthritis (RA). Patients ≥ 18 years old, with a diagnosis of RA according to ACR-EULAR 2010 criteria, were included in a cross-sectional study. Sociodemographic data, comorbidities, RA characteristics, disease activity, and current treatment were registered. Questionnaires were administered, including EQ-5D-3 L, QOL-RA II, HAQ-A, and PHQ-9. The QOL-RA II was re-administered in 20 patients to evaluate reproducibility. Four hundred and thirty patients were included. Median QOL-RA was 6.6 (IQR 5.3-8). Mean time to complete it was 1.7 ± 0.57 min and to calculate it was 12 ± 1.7 s. It showed very good reliability (Cronbach's alpha 0.97), reproducibility (ICC, 0.96), and good correlation between the different items and the total questionnaire, without evidence of redundancy. Besides, QOL-RA II presented good correlation with EQ-5D-3L (Rho, 0.6) and moderate with DAS28 (Rho, 0.38), and CDAI (Rho, 0.46). Worse quality of life was observed in patients not doing physical activity, unemployed, and current smokers. Patients with higher disease activity had a significant poorer quality of life. Adjusting by age, sex and disease duration, unemployment, higher disease activity, disability, and the presence of depression were independently associated to worse quality of life. QOL-RA II demonstrated good construct validity, reproducibility, and reliability. It was easy to complete and calculate and does not require a license for its use, thus making it the optimal tool for assessing the quality of life in Spanish-speaking patients with RA. Key Points • The evaluation of quality of life is very important in patients with Rheumatoid Arthritis. • Most of the questionnaires used to assess the quality of life require a license to use. • QOL-RA II is a valid and simple questionnaire to evaluate the quality of life of patients with RA and does not require a license for its use.
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- 2020
18. Significant weight loss in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database
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Michael Hughes, Calvin Heal, Elise Siegert, Eric Hachulla, Paolo Airó, Antonella Riccardi, Oliver Distler, Marco Matucci-Cerinic, Andrea Doria, Lorenzo Baretta, Alexandra Balbir-Gurman, Patricia E Carreira, Vanessa Smith, Carlos Alberto, Jörg Distler von Mühlen, Ulf Müller-Ladner, Lidia P Ananieva, László Czirják, Jörg Henes, Jeska de Vries-Bouwstra, Mengtao Li, Fabian Mendoza, Nemanja Damjanov, Ivan Castellví, Alessandro Giollo, Stefan Heitmann, Edoardo Rosato, Lorenzo Dagna, Christopher P Denton, Marie Vanthuyne, Fabio Cacciapaglia, Valeria Riccieri, Nicolas Hunzelmann, Ami Shah, Carlomaurizio Montecucco, Raffaele Pellerito, Ruxandra Maria Ionescu, Simona Rednic, Ulrich Walker, Maria Rosa Pozzi, Anna-Maria Hoffmann-Vold, Marie-Elise Truchetet, Susanne Ullman, Carolina de Souza Müller, Juan Jose Alegre-Sancho, Eduardo Kerzberg, Francesco Del Galdo, Gabriela Riemekasten, Branimir Anic, Marko Baresic, Miroslav Mayer, Fahrettin Oksel, Figen Yargucu, Ellen De Langhe, Ina Kötter, Mohammed Tikly, Radim Becvar, Douglas Veale, Dorota Krasowska, Andrea Lo Monaco, Lidia Rudnicka, Ana Maria Gheorghiu, Piercarlo Sarzi Puttini, Mislav Radic, Armando Gabrielli, Maria João Salvador, Carlos de la Puente, Gabriela Szücs, Sule Yavuz, Rosario Foti, Otylia Kowal Bielecka, Codrina Ancuta, Peter Villiger, Sabine Adler, Patrick Jego, Michaela Kohm, Eugene J Kucharz, Dominique Farge Bancel, Tim Schmeiser, Alberto Cauli, Alessandra Vacca, Kamal Solanki, Piotr Wiland, Paloma García de la Peña Lefebvre, Jorge Juan Gonzalez Martin, Sergio Jimenez, Lesley Ann Saketkoo, Roger Hesselstrand, Francesca Ingegnoli, Jean Sibilia, Merete Engelhart, Esthela Loyo, Carmen Tineo, Francesco Paolo Cantatore, Brigitte Krummel-Lorenz, Petros Sfikakis, Cristiane Kayser, Vera Ortiz Santamaria, Bojana Stamenkovic, Giovanna Cuomo, Francesco Puppo, Thierry Zenone, Nihal Fathi, Ira Litinsky, Carlo Chizzolini, Monika Swacha, Washington Bianchi, Breno Valdetaro Bianchi, Maria Üprus, Kati Otsa, Masataka Kuwana, Panayiotis Vlachoyiannopoulos, Sarah Kahl, Bernard Coleiro, François Spertini, Walid Ahmed Abdel Atty Mohamed, Sergey Moiseev, Pavel Novikov, Dominik Majewski, Simon Stebbings, Svetlana Agachi, Massimiliano Limonta, Carlo Francesco Selmi, Elena Rezus, Kristine Herrmann, Brigitte Granel, Goda Seskute, Matthias Seidel, Paul Hasler, Maurizio Cutolo Vera Bernardino, Carmen Pizzorni, Jadranka Morovic-Vergles, Daniel Furst, Ana-Maria Ramazan, Gianluigi Bajocchi, Lisa Stamp, Doron Rimar, Antonella Marcoccia, Srdan Novak, Luc Mouthon, Jiri Stork, Lorinda S Chung, Hadi Poormoghim, Francis Gaches, Laura Belloli, Cristina-Mihaela Tanaseanu, Fabiola Atzeni, Kilian Eyerich, Ivien M Hsu, Jacob van Laar, Mary Ellen Csuka, Omer Nuri Pamuk, Maura Couto, Arsene Mekinian, Murat Inanc, Ivan Foeldvari, Julia Martínez-Barrio, Yair Levy, Juliana Markus, Susana Oliveira, Hughes, Michael, Heal, Calvin, Siegert, Elise, Hachulla, Eric, Airó, Paolo, Riccardi, Antonella, Distler, Oliver, Matucci-Cerinic, Marco, Doria, Andrea, Baretta, Lorenzo, Balbir-Gurman, Alexandra, E Carreira, Patricia, Smith, Vanessa, Alberto, Carlo, Distler von Mühlen, Jörg, Müller-Ladner, Ulf, P Ananieva, Lidia, Czirják, László, Henes, Jörg, de Vries-Bouwstra, Jeska, Li, Mengtao, Mendoza, Fabian, Damjanov, Nemanja, Castellví, Ivan, Giollo, Alessandro, Heitmann, Stefan, Rosato, Edoardo, Dagna, Lorenzo, P Denton, Christopher, Vanthuyne, Marie, Cacciapaglia, Fabio, Riccieri, Valeria, Hunzelmann, Nicola, Shah, Ami, Montecucco, Carlomaurizio, Pellerito, Raffaele, Maria Ionescu, Ruxandra, Rednic, Simona, Walker, Ulrich, Rosa Pozzi, Maria, Hoffmann-Vold, Anna-Maria, Truchetet, Marie-Elise, Ullman, Susanne, de Souza Müller, Carolina, Jose Alegre-Sancho, Juan, Kerzberg, Eduardo, Del Galdo, Francesco, Riemekasten, Gabriela, Anic, Branimir, Baresic, Marko, Mayer, Miroslav, Oksel, Fahrettin, Yargucu, Figen, De Langhe, Ellen, Kötter, Ina, Tikly, Mohammed, Becvar, Radim, Veale, Dougla, Krasowska, Dorota, Lo Monaco, Andrea, Rudnicka, Lidia, Maria Gheorghiu, Ana, Sarzi Puttini, Piercarlo, Radic, Mislav, Gabrielli, Armando, João Salvador, Maria, de la Puente, Carlo, Szücs, Gabriela, Yavuz, Sule, Foti, Rosario, Kowal Bielecka, Otylia, Ancuta, Codrina, Villiger, Peter, Adler, Sabine, Jego, Patrick, Kohm, Michaela, J Kucharz, Eugene, Farge Bancel, Dominique, Schmeiser, Tim, Cauli, Alberto, Vacca, Alessandra, Solanki, Kamal, Wiland, Piotr, García de la Peña Lefebvre, Paloma, Juan Gonzalez Martin, Jorge, Jimenez, Sergio, Ann Saketkoo, Lesley, Hesselstrand, Roger, Ingegnoli, Francesca, Sibilia, Jean, Engelhart, Merete, Loyo, Esthela, Tineo, Carmen, Paolo Cantatore, Francesco, Krummel-Lorenz, Brigitte, Sfikakis, Petro, Kayser, Cristiane, Ortiz Santamaria, Vera, Stamenkovic, Bojana, Cuomo, Giovanna, Puppo, Francesco, Zenone, Thierry, Fathi, Nihal, Litinsky, Ira, Chizzolini, Carlo, Swacha, Monika, Bianchi, Washington, Valdetaro Bianchi, Breno, Üprus, Maria, Otsa, Kati, Kuwana, Masataka, Vlachoyiannopoulos, Panayioti, Kahl, Sarah, Coleiro, Bernard, Spertini, Françoi, Ahmed Abdel Atty Mohamed, Walid, Moiseev, Sergey, Novikov, Pavel, Majewski, Dominik, Stebbings, Simon, Agachi, Svetlana, Limonta, Massimiliano, Francesco Selmi, Carlo, Rezus, Elena, Herrmann, Kristine, Granel, Brigitte, Seskute, Goda, Seidel, Matthia, Hasler, Paul, Cutolo Vera Bernardino, Maurizio, Pizzorni, Carmen, Morovic-Vergles, Jadranka, Furst, Daniel, Ramazan, Ana-Maria, Bajocchi, Gianluigi, Stamp, Lisa, Rimar, Doron, Marcoccia, Antonella, Novak, Srdan, Mouthon, Luc, Stork, Jiri, S Chung, Lorinda, Poormoghim, Hadi, Gaches, Franci, Belloli, Laura, Tanaseanu, Cristina-Mihaela, Atzeni, Fabiola, Eyerich, Kilian, M Hsu, Ivien, van Laar, Jacob, Ellen Csuka, Mary, Nuri Pamuk, Omer, Couto, Maura, Mekinian, Arsene, Inanc, Murat, Foeldvari, Ivan, Martínez-Barrio, Julia, Levy, Yair, Markus, Juliana, and Oliveira, Susana
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,weight loss, systemic sclerosis, nutrition ,Immunology ,Disease ,computer.software_genre ,General Biochemistry, Genetics and Molecular Biology ,Scleroderma ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Risk Factors ,Weight loss ,Internal medicine ,Weight Loss ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,610 Medicine & health ,Aged ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,Database ,business.industry ,Middle Aged ,medicine.disease ,030104 developmental biology ,Mood ,Databases as Topic ,Female ,Outcomes research ,medicine.symptom ,business ,computer ,Rheumatism - Abstract
Gastrointestinal (GI) involvement is almost universal in patients with systemic sclerosis (SSc) and is associated with significant disease-related morbidity and mortality.1 The entire GI tract can be involved and other disease features (eg, low mood, terminal organ failure and functional hand impairment) can result in significant nutritional impairment. Severe GI involvement has been reported to occur in ~10% of patients with SSc and often occurs early in the course of the disease.2 However, identification of patients at high risk of clinically significant weight loss is extremely challenging, including from the high prevalence of GI symptoms in patients with SSc. Therefore, there is a need to understand high-risk patients including potentially modifiable risk factors, with a view to early intervention strategies. Against this background, the aim of this study was to examine potential clinical risk factors of significant weight loss in patients with SSc. We performed an analysis of patients with SSc enrolled in the multinational, longitudinal European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) database. In our study, we defined significant weight loss as 4.5 kg and/or least 5% of their body weight at 5 months onwards.3 Patients with a recorded second visit after 3 months and before 12 months were included in the analysis. We adopted a pragmatic approach (relevant to clinical practice) in …
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- 2020
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19. Description of the resources for rheumatology training and speciality certification and recertification requirements in Argentina
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Magdalena Acevedo, Leila Abbas, Natalia Estrella, Nauan Fara, Gabriel Sequeira, Marina Laura Micelli, and Eduardo Kerzberg
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Certification ,Universities ,media_common.quotation_subject ,Immunology ,Argentina ,03 medical and health sciences ,0302 clinical medicine ,Continuing medical education ,Rheumatology ,Immunology and Allergy ,Medicine ,Humans ,030212 general & internal medicine ,Duration (project management) ,media_common ,030203 arthritis & rheumatology ,Medical education ,business.industry ,Significant part ,Medical school ,Internship and Residency ,Education, Medical, Graduate ,Service (economics) ,Public university ,Health Resources ,business - Abstract
The objective of the study was to analyse resources for rheumatology training, and speciality certification and recertification requirements in Argentina. Information was gathered regarding vacancies, entry requirements, duration and validity of the specialist degree in every residency and postgraduate course in adult rheumatology. The following aspects were analysed: monitoring authority, certification and recertification requirements, and mandatory recertification. Six out of 36 universities offer rheumatology postgraduate courses. Out of 65 vacancies, 36 (55%) are implemented by a National Public University in the Autonomous City of Buenos Aires (CABA), and 46 (70%) are in CABA. There are 32 vacancies for rheumatology residencies in 7 out of 24 districts, 16 of them (50%) in CABA. There are 2- to 3-year postgraduate courses; entry requirements range from 1-year experience in internal medicine to either complete residency or specialist degree in internal medicine. Training formats vary from full-time university residency to either university-based courses with part-time dedication in a rheumatology service without residency or non-university courses with part-time dedication. Not every specialist degree is automatically homologated in every jurisdiction. Provincial governments and colleges of physicians are the certification and recertification authorities; medical school was included in one district. Recertification is mandatory in only 8 districts; 40-50% of the process is achieved by merely practising as a rheumatologist. Most of the training resources are concentrated in CABA. Although there are various options, not all of them are automatically homologated. Recertification is not mandatory nationwide, and a significant part of the process involves practising as a rheumatologist.
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- 2019
20. AB0689 INCIDENCE AND SEVERITY OF COVID-19 IN PATIENTS WITH SPONDYLOARTHRITIS IN ARGENTINA: EXPERIENCE IN A COUNTRY WITH STRICT ISOLATION
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S. Scarafia, R. Águila Maldonado, S. Nasi, J. Alcivar Navarrete, L. Abbas, M. Machado Escobar, R. Nieto, R. Garcia Salinas, M. S. Gálvez Elkin, G. P. Pendon, D. Vila, R. Luis, M. J. Gamba, Eduardo Kerzberg, Mariana Benegas, V. Cosentino, Emilio Buschiazzo, C. Airoldi, F. Sommerfleck, E. Saturansky, P. Girard Bosch, V. Duarte, M. A. Medina, M. L. Acosta Felquer, V. Martire, D. Zelaya, M. Cosatti, and N. Callahuara
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Immunology ,Population ,medicine.disease ,General Biochemistry, Genetics and Molecular Biology ,Psoriatic arthritis ,Rheumatology ,Internal medicine ,Adalimumab ,medicine ,Immunology and Allergy ,Cumulative incidence ,education ,BASFI ,business ,BASDAI ,Depression (differential diagnoses) ,medicine.drug - Abstract
Background:There are limited data worldwide on the behavior of SARSCOV2 in patients with Spondyloarthritis (SpA).Objectives:To describe the incidence and severity of COVID-19 disease in patients with SpA in Argentina.Methods:Patients with axial spondyloarthritis (AxSpA) radiological (EA) and non-radiological (AxSpA-nr) and peripheral spondyloarthritis (according to ASAS criteria) and psoriatic arthritis (PsA) (according to CASPAR criteria) were included. Sociodemographic data, comorbidities, disease activity and treatments were collected at baseline. The patients were followed up by phone or in person monthly. Data were collected from 1/4/2020 to 9/20/2020. Descriptive statistics were performed with mean and standard deviation (SD) and median and quartile 25-75 according to distribution, and the cumulative incidence (AI) of the disease was calculated.Results:320 patients were included, of which 55% were male, with a mean age of 50 SD 13, 21.6% had a diagnosis of AS, 6.9% SpAax-nr, 6.9% SpAp, and 64.7% PsA, BASDAI 3.65 (3), BASFI 3 (1.5-9), PASI 0.3 (0-7), BSA 0.2 (0-6). Fourteen patients with a diagnosis of COVID-19 (4.4%) were reported, of which 10 diagnoses were by positive PCR and 4 by positive symptoms and close contact. 93% (13) of the cases were patients from the Province of Buenos and CABA and 1 patient from Santiago del Estero. The total IA for the country was 0.04. Of the 14 patients with COVID-19, 7 (50%) were men, 4 had a diagnosis of AS, 1 of SpAax-nr, 9 (64.3%) PsA. 100% live in urban areas, 2 (14%) have hypertension, 1 (7%) DBT, 1 (7%) COPD, 2 (14%) depression or anxiety, 11(97%) had received influenza vaccine 2020, 13 (93%), Antineumoccic 23, 14 (100%) Antineumoccic 13. Regarding the treatments: 4 (28.6%) were in treatment with anti TNF (3 with Adalimumab, 1 with certolizumab pegol), 4 (28.6%) with Anti IL17 (3 with Secukinumab, 1 with Ixekizumab), 8 (57%) with methotrexate and 2 (14%) with Leflunomide. Place of follow-up of the disease: 10 (71.4%) at home, 3 (21.4%) in the common room and 1 (7) in the intensive care unit. Treatments received for COVID-19: 1 (7%) antiretroviral, 1 (7%) antibiotic and 1 (7%) steroids. None of the patients died from COVID-19.Conclusion:An incidence of 4.4% of COVID-19 was found in this population with SpA and most of the patiend had mild symptoms and no deaths were reported.Disclosure of Interests:Victoria Martire: None declared, Carla Airoldi: None declared, María Soledad Gálvez Elkin: None declared, MAXIMILIANO MACHADO ESCOBAR: None declared, Noel Callahuara: None declared, Vanesa Duarte Employee of: Novartis, José Alcivar Navarrete: None declared, Emilio Buschiazzo: None declared, Etel Saturansky: None declared, María Julieta Gamba: None declared, Paula Girard Bosch: None declared, David Zelaya: None declared, Rodrigo Garcia Salinas: None declared, María Alejandra Medina: None declared, Micaela Cosatti Employee of: Jannsen, SANTIAGO SCARAFIA: None declared, Maria Laura Acosta Felquer: None declared, Vanesa Cosentino: None declared, Fernando Sommerfleck: None declared, Ramiro Luis: None declared, Gisela Paola Pendon: None declared, Rodrigo Águila Maldonado: None declared, Silvina Nasi: None declared, Romina Nieto: None declared, Leila Abbas: None declared, Diego Vila: None declared, Eduardo Kerzberg: None declared, Mariana Benegas: None declared
- Published
- 2021
21. FRI0318 REAL-LIFE EVALUATION OF HEALTH STATUS USING ASAS HEALTH INDEX ON PATIENTS WITH AXIAL AND PERIPHERAL SPONDYLOARTHRITIS IN ARGENTINA
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J. Tapia, L. L. Macias Oviedo, M. J. Gamba, V. Martire, Emilce Edith Schneeberger, M. Mendez Garcia, R. Nieto, L. Garcia, D. Vila, E. Velozo, S. Scarafia, V. Duarte, V. Cosentino, J. M. Bande, P. Giorgis, M. Cosatti, C. Airoldi, P. Girard Bosch, F. Sommerfleck, Mariana Benegas, Eduardo Kerzberg, M. Oliver, P. Gonzalez, and Josefina Marin
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medicine.medical_specialty ,business.industry ,Immunology ,medicine.disease ,Logistic regression ,General Biochemistry, Genetics and Molecular Biology ,Health index ,Peripheral spondyloarthritis ,Life evaluation ,Rheumatology ,Interquartile range ,Internal medicine ,Diabetes mellitus ,medicine ,Immunology and Allergy ,In patient ,business ,Depression (differential diagnoses) - Abstract
Background:The questionnaire “Assessment of Spondyloarthritis international Society Health Index” (ASAS HI) was developed to measure functionality and health status in patients with spondyloarthritis (SpA)1.Objectives:To describe the state of health measured by ASAS HI in Argentinian patients with SpA and to evaluate factors associated with poor health.Methods:Analytical, cross sectional, multicenter study. Patients with SpA according to ASAS criteria were consecutively included from 15 Argentinian centers. Statistical analysis: frequencies and percentages (%), mean and standard deviation (SD) or median and interquartile range (IQR). Bivariate analysis and logistic regression were performed to evaluate the factors associated with poor health status (ASAS HI > or equal to 12). Correlation with other parameters was evaluated by Spearman correlation.Results:We included 274 patients with a mean age 49 (SD 14) years, median disease duration 60 month (IQR 24-135), 155 (56.6%) of patients are male, 47% (n:129) axial SpA and 52.9 (n:145) peripheral SpA. One hundred and nine patients (43.4%) presented good health status, 117 (42.7%) had moderate state of health and 38 (13.9%) had poor health. In the bivariate analyses patients with ASAS health index greater than or equal to 12 (poor status), were older [54 (11) vs 48 (14), p: 0.01], had higher disease duration [11(IQR 57-192) vs 60 (IQR 24-120), p: 0.02], more hypertension [20 (52.6%) vs 67 (28.4%), p:0.004], more diabetes mellitus [10 (26.3%) vs 22(9.3%), p: 0.006], depression [6 (15.8%) vs 10 (4.2%), p:0.013], anxiety [8 (21%) vs (22 (9.3%),p:0.046], less years of education [9.8 (SD 3.5) vs 13 (SD 10), p:0.001], higher ASQol [12.6 (SD 4.6) vs 5.7 (SD4), p < 0.001], BASFI [7(SD2) vs 4(SD6), p: 0.001], DAS28 [4.71 (SD3.2) vs 2.8 (SD1),p: Conclusion:Poor health status is associated with disease activity, poor quality of life and functional activity. ASAS HI has a good correlation with other parameters to evaluate SpA, reinforcing the construct validity of this new tool.References:[1]Kiltz U,et al.Ann Rheum Dis2018;0:1–7.Disclosure of Interests:None declared
- Published
- 2020
22. 271 Frequency of neonatal lupus in reference centers in the management of pregnancy and autoimmune diseases
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Florencia Mollerach, Maximiliano Machado Escobar, Marina Scolnik, Belen Maria Virasoro, Maria Jose Lopez Perez, Mercedes Croce, Rosa Serrano Morales, Diana Dubinsky, Adrián Estevez, Paula Alba, Fabiola Natalia Camargo Serrudo, Cruz Lascano, María Constanza Danielsen, María de la Paz Leon, Cintia Otaduy, Laura Onetti, Cecilia Alvarez, Verónica Bellomio, Daniela Flores Rengifo, Mayra Etcheverry, V. Savio, María Hu, Marina Werner, Fernanda Guzzanti, Eduardo Kerzberg, C. Gobbi, C. Maldini, Emma E. Civit, Cecilia Pisoni, Ana M. Bertoli, Alejandra M. Babini, and Verónica Saurit
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Pediatrics ,medicine.medical_specialty ,Pregnancy ,business.industry ,Mortality rate ,Autoantibody ,Dilated cardiomyopathy ,Endocardial fibroelastosis ,Disease ,medicine.disease ,Serology ,Cohort ,medicine ,business - Abstract
Background Neonatal lupus (NL) is a disease in children of mothers who have specific anti-Ro/La IgG autoantibodies by passive transplacental transfer. LN is characterized by skin and cardiac involvement, as well as cytopenias, hepatic or neurological manifestations. NL can be diagnosed intra-uterus or in neonatal period, being self-limiting in several months or be irreversible. Congenital heart block (CHB) in a structurally normal heart, is perhaps the most serious manifestation with an estimated mortality rate of around 19%. Objetives: to estimate the frequency of NL in children of mothers with anti-Ro/La in reference centers in the management of pregnancy and autoimmune diseases in Argentina, and to describe maternal and children features. Methods A descriptive multicenter study was conducted in reference centers in the management of autoimmune diseases and pregnancy in Argentina. Inclusion criteria were the presence of positive maternal serology anti-Ro/La and at least one pregnancy. Demographic and maternal-fetal clinical data were obtained from the clinical histories and each center completed a data collection form created for this study. We defined a NL case (born or not) who presented, pre and/or postpartum, characteristic skin lesions, cytopenias, cardiac involvement (CHB, endocardial fibroelastosis and dilated cardiomyopathy), hepatic or neurological manifestations. Ethnicity was classified using GLADEL groups. NL frequency was calculated dividing the number NL cases by the number of mothers with positive anti-Ro/La serology. Results 18 reference centers in the management of autoimmune diseases and pregnancy participated in this study in 7 different geographic areas of Argentina (6 of Buenos Aires, 6 of Cordoba, 1 of Jujuy, 1 of Mendoza, 1 of Santa Fe, 1 of Santiago del Estero and 2 of Tucuman). 193 mothers with positive anti-Ro/La serology were included with 364 pregnancies. 19 cases NL cases were reported (10 diagnosed during pregnancy and 9 in post-partum. The frequency of NL was estimated at 9.8% [95% CI 6.3–14.9] (CHB=6.2% [IC95% 3.5–10.7]). Table 1 describes the maternal and fetal characteristics of NL cases. The most frequent manifestations were skin (n=7) and cardiac involvement (n=12). In 1 case, there was a history of NL in a previous pregnancy. Of the patients with CHB, 5 required a pacemaker. Conclusions In conclusion, the frequency of NL in our multicentric cohort is greater than other international cohorts. Differences could be related to genetic/environmental factors as well as methodological limitations and selection bias. Funding Source(s): None
- Published
- 2019
23. Use of systemic glucocorticoids in patients with psoriatic arthritis by Argentinian and other Latin-American rheumatologists
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Carolina Aimo, Eduardo Kerzberg, Vanesa Cosentino, and Gabriel Sequeira
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inorganic chemicals ,Costa Rica ,medicine.medical_specialty ,Panama ,Immunology ,Peripheral arthritis ,Argentina ,Colombia ,Dactylitis ,Psoriatic arthritis ,Rheumatology ,Prednisone ,Internal medicine ,Surveys and Questionnaires ,medicine ,Immunology and Allergy ,Humans ,heterocyclic compounds ,In patient ,Practice Patterns, Physicians' ,Glucocorticoids ,Mexico ,Biological Products ,Duration of Therapy ,business.industry ,Low dose ,Arthritis, Psoriatic ,Enthesitis ,medicine.disease ,Venezuela ,Latin America ,Antirheumatic Agents ,cardiovascular system ,Drug Therapy, Combination ,Ecuador ,medicine.symptom ,Rheumatologists ,business ,Brazil ,medicine.drug - Abstract
To analyse the administration of systemic glucocorticoids (SGC) to patients with Psoriatic arthritis (PsA). Online, anonymous, multiple-choice, closed-ended survey on SGC use in PsA, dose, duration of therapy, and the reason for administration. One hundred and twenty rheumatologists from Argentina (ARG) and 75 from other countries in Latin-America (LAT) completed the survey. Only 6% of the respondents indicated that they did not prescribe SGC, and 65% claimed that they administered them to less than 10% of their patients. Among those physicians who used SGC, 71% prescribed between 5 and 10 mg/day of prednisone, and only 5% over 10 mg/day. Seventy-three percent of the respondents administered SGC for less than 3 months, and 93% associated them with DMARDs, Biological Therapy (BT), or DMARDs plus BT. Clinical indications for SGC were (more than one option was possible): peripheral arthritis (79%), dactylitis (23%), enthesitis (20%), cutaneous involvement (11%), and axial involvement (8%). Thirty-four percent of ARG physicians versus 21% of LAT used SGC in over 10% of their patients (p 0.07) while 76.5% of ARG versus 59% of LAT administered doses higher than 5 mg/day of prednisone (p 0.01). SGC were indicated by most of the rheumatologists surveyed, but only to a reduced number of patients with PsA, at low doses, for short periods of time, associated with DMARDs/BT, and with the aim of treating peripheral joint manifestations. Argentinian physicians tended to prescribe SGC to more patients and at slightly higher doses.
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- 2019
24. The non-silent epidemic: low back pain as a primary cause of hospitalisation
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Elida Marconi, Carlos Guevel, Eduardo Kerzberg, María de las Mercedes Fernández, Gabriel Sequeira, and Manuela Laffont
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Immunology ,Argentina ,Medical care ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Risk Factors ,Health care ,Female patient ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Young adult ,Aged ,Aged, 80 and over ,030203 arthritis & rheumatology ,business.industry ,Health condition ,Length of Stay ,Middle Aged ,Low back pain ,Patient Discharge ,Hospitalization ,Emergency medicine ,Ambulatory ,Physical therapy ,Female ,National average ,medicine.symptom ,business ,Low Back Pain - Abstract
Low back pain (LBP) is the most common cause of pain in adults and the second health condition that prompts patients to seek ambulatory medical care visits. To analyse the impact of LBP on hospitalisations in healthcare facilities within the official subsector in Argentina between 2006 and 2010. Discharges in which the original diagnosis had been either adult LBP or lumbosciatica were assessed. The data comprised age, gender, province of residence, average length of stay (LOS) in the hospital, intra-hospital death, and the Provincial Human Development Index (PHDI). 17,859 discharges had an original diagnosis of LBP and 10,948 of lumbosciatica, which jointly accounted for 18.7 % of all the discharges documented for Diseases of Osteomuscular System and Connective Tissue (DOMS). Hospital discharges of female patients represented 53.7 %. The average age upon admission was 47.7 years in men versus 47.9 in women. The average LOS was slightly higher in men (4.2 vs. 3.8 days, p 0.01). In provinces with a PHDI below the national average, a surgical procedure was performed in 3.1 % of the discharges versus 4.1 % in the provinces with a PHDI above the national average (p < 0.001). LBP was the most frequent cause of hospitalisation due to DOMS. It occurred with a slightly higher frequency in women and prompted short hospitalisations. A surgical procedure was carried out during hospitalisation in very few cases, but the percentage of surgeries during hospitalisation was higher in provinces with a PHDI above the national average.
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- 2016
25. OP0266-HPR WORK PRODUCTIVITY IN PATIENTS WITH AXIAL AND PERIPHERAL SPONDYLOARTHRITIS
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R. Águila Maldonado, S. Scarafia, J. Tapia, Mariana Benegas, V. Cosentino, Paz Gonzalez, Eduardo Kerzberg, L. L. Macias Oviedo, M. Oliver, E. Velozo, C. Airoldi, P. Giorgis, D. Vila, V. Martire, J. M. Bande, J. Gamba, Emilce Edith Schneeberger, P. Girard Bosch, M. Cosatti, Josefina Marin, R. Nieto, V. Duarte, and F. Sommerfleck
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Ankylosing spondylitis ,medicine.medical_specialty ,Visual analogue scale ,business.industry ,Immunology ,Enthesitis ,medicine.disease ,General Biochemistry, Genetics and Molecular Biology ,Rheumatology ,Quality of life ,Internal medicine ,Presenteeism ,medicine ,Immunology and Allergy ,Functional ability ,medicine.symptom ,business ,BASFI ,BASDAI - Abstract
Background:Work disability is an important outcome in the treatment of Spondyloarthritis (SpA) since this disease affects people in the most productive stage of life.Objectives:The aim of this study is to investigate the working status and the factors associated with work productivity loss (WPL) in patients with axial (axSpA) and peripheral SpA (pSpA).Methods:Patients with SpA according to ASAS criteria were included consecutively in this multicentric cross-sectional study. Evaluation of activity through a visual analogue scale (0-100), enthesitis (LEI), functional capacity (HAQ and BASFI), disease activity (DAS28 and BASDAI), health status (ASAS Health Index) and quality of life (ASQoL) were calculated. The Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded. The Work Productivity and Activity Impairment Spondyloarthritis (WPAI SpA) questionnaire was used to assess work productivity.Spearman’s correlation coefficient (ρ) was used to assess the correlation with the percentage of WPL.Results:274 patients with SpA were recruited, 129 (47.1%) with axSpA and 145 (52.9%) with pSpA. 56.6% were women and 33.2% stopped working due to the underlying disease.Among axSpA patients, 70% were radiographic and 30% non radiographic, mean age 45.5 (SD14) yrs, median disease duration 72 (IQR 36-144) months and diagnosis delay 20 (IQR 11-70) months. 45.7% were employed, median hours worked in the last week was 40 (IQR 25-45), median scores for absenteeism was 0% (IQR 0-2), presenteeism 30% (IQR 5-40), WPL 30% (IQR 10-52.5) and activity impairment 30% (IQR 10-50). A positive correlation was found between WPL and the following variables: HAQ (ρ:0.40, pAmong pSpA patients, mean age was 52.3 (SD13) yrs, median disease duration 60 (IQR 14-120) months and diagnosis delay 12 (IQR 3-24) months. 46.9% were employed, median hrs worked in the last week was 30 (IQR 14-40), absenteeism 0% (IQR 0-7), presenteeism 30% (IQR 2.5-58), WPL 30% (IQR 5-52) and activity impairment 20% (IQR 0-40). A positive correlation was found between WPL and: HAQ (ρ:0.49, pConclusion:Our study showed that WPL in this national cohort was 30% in both groups of patients and is associated with disease activity, enthesitis, health status, quality of life and functional ability.Disclosure of Interests:None declared
- Published
- 2020
26. FRI0180 SURVEY ON HELP-SEEKING AND DISEASE TRAJECTORY IN SYSTEMIC LUPUS ERYTHEMATOSUS
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Eduardo Kerzberg, L. Garcia Faura, P. Avila, Damaris Alvarez, Nauan Fara, M. Micelli, A. Cañizares Calderón, M. F. Eguez del Pozo, and Gabriel Sequeira
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medicine.medical_specialty ,Rheumatology ,business.industry ,Disease trajectory ,Immunology ,Immunology and Allergy ,Medicine ,business ,Intensive care medicine ,General Biochemistry, Genetics and Molecular Biology ,Help-seeking - Abstract
Background:Few studies in Latin America have analysed the time lag since patients experience the first joint symptoms until they consult a physician, and a diagnosis is made, and most of them have dealt with patients sustaining Rheumatoid Arthritis (RA)1-2.Objectives:To study both patient and disease factors that have some bearing on the time lag until a physician is first consulted and a diagnosis is made.Methods:Multiple-choice survey to patients of 18 years of age or older who metSystemic Lupus Erythematosus (SLE) Classification Criteria (2012). The following aspects were measured:time lag from symptom onset to first medical consultation (Time 1), time lag since first medical consultation until a diagnosis is made (Time 2), and time lag until the first consultation with a rheumatologist.Patients were interviewed at the time or within 6 months of diagnosis, and asked about the physician they first consulted and the one who made the diagnosis. They were also requested to describe one disease onset out of 4 trajectories: acute, acute with temporary remissions, chronic with partial improvements, or sustained chronic. Patients were required to recount their response to the first symptoms, the limitations brought about by the disease (employing the Steinbrocker scale), and whether help-seeking was first aimed at consulting a physician or they decided to wait. A group of patients with Rheumatoid Arthritis (RA) answered the same survey. Every patient signed an informed consent form, and the study was approved by the Hospital Bioethics Committee.Results:Twenty-eight patients with SLE and 29 patients with RA filled in the survey. SLE patients were younger as expected (32 years vs 49 years; p Table 1.SLERAPn2829Education (median)SecondarySecondary0.07Had a job11 (39%)15 (52%)0.5Had health insurance8 (29%)15 (52%)0.1Had computer/mobile phone with an Internet connection25(89%)18(62)%0.04Steinbrocker (median with range 25-75%)3(2-3)3(3-4)0.06Immediately sought medical help15 (54%)16 (56%)0.9Did not know what to do when the first symptoms appeared7 (25%)13(45%)0.2Diagnosis made by a rheumatologist20 (71%)23 (80%)0.7Time 1 in patients with SLE was significantly lower with a median of 7 days, range(25-75%)1-30 days vs 30 days in RA, range 14-180 (p 0.01), and the former also showed a trend to lower median Time 2: 81 days, range 25-209 vs 185 days in RA, range 60-275 (p 0.1). Besides, they showed a significantly shorter time lag until the first visit to a rheumatologist with a median of 120 days, range 35-225 vs 330 days, range 120-450 in patients with RA (p 0.005).Conclusion:SLE patients consult a physician and visit a rheumatologist sooner than RA patients do, and they also show a trend to obtain a faster diagnosis. Education, health insurance, employment, the disease impact on their daily life and initial response to the symptoms do not appear to account for their swiftness in seeking medical help.References:[1]Mussano E, Missakian S, Onetti CM (2007) Estudio demográficosocial de pacientes con artritis reumatoidea en la provincia de Córdoba (Argentina). Rev Argent Reumatol 4:13–22.[2]Rodríguez-Polanco E, Al Snih S, Kuo YF et al (2011) Lag time between onset of symptoms and diagnosis in Venezuelan patients with rheumatoid arthritis. Rheumatol Int 31:657–665. doi:10.1007/s00296-009-1358-9.Disclosure of Interests:None declared
- Published
- 2020
27. Prevalence of cardiovascular disease and major risk factors in patients with rheumatoid arthritis: a multinational cross-sectional study
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Allan Gibofsky, Anand N. Malaviya, Janos Gal, Laura Horne, Roman Zahora, Jeff Greenberg, George W. Reed, Meilien Ho, Leda Laurindo, Alina Onofrei, Eduardo Kerzberg, Tatiana Popkova, Jeffrey R. Curtis, Daniel E. Furst, Oscar Rillo, Joel M. Kremer, Bernado A. Pons-Estel, Sebastião Cezar Radominski, Dimitrios A. Pappas, Fredrik Nyberg, and Kathy Lampl
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Male ,medicine.medical_specialty ,Cross-sectional study ,Argentina ,India ,Hyperlipidemias ,Disease ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Risk Factors ,Internal medicine ,Epidemiology ,Hyperlipidemia ,medicine ,Prevalence ,Humans ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Europe, Eastern ,Prospective Studies ,Registries ,Mexico ,030203 arthritis & rheumatology ,business.industry ,General Medicine ,medicine.disease ,United States ,Cross-Sectional Studies ,Cardiovascular Diseases ,Rheumatoid arthritis ,Hypertension ,Female ,business ,Body mass index ,Brazil - Abstract
To compare the prevalence of cardiovascular disease (CVD) and major CVD risk factors among rheumatoid arthritis (RA) patients enrolled in a large US and multinational registry. We compared CVD and CVD risk factor prevalence from 11 countries enrolled in the CORRONA US and CORRONA International registries; patients from the 10 ex-US participating countries were grouped by region (Eastern Europe, Latin America, and India). Unadjusted summary data were presented for demographics and disease characteristics; comparisons for prevalence of CVD risk factors and CVD were age/gender standardized to the age/gender distribution of the US enrolled patients. Overall, 25,987 patients were included in this analysis. Compared to patients from the ex-US regions, US participants had longer disease duration and lower disease activity, yet were more likely to receive a biologic agent. Additionally, CORRONA US participants had the highest body mass index (BMI). Enrolled patients in India had the lowest BMI, were more rarely smokers, and had a low prevalence of hyperlipidemia, hypertension, and prior CVD compared to the US and other ex-US regions. Participants from Eastern Europe had a higher prevalence of hypertension and hyperlipidemia and highest prevalence of all manifestations of CVD. Differences in the prevalence of both CVD and major CVD risk factors were observed across the four regions investigated. Observed differences may be influenced by variations in both non-modifiable/modifiable characteristics of patient populations, and may contribute to heterogeneity on the observed safety of investigational and approved therapies in studies involving RA patients from different origins.
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- 2017
28. THU0619 Prevalence of pneumococcal vaccination in rheumatologic patients with community acquired pneumonia. biobadasar registry
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Sergio Paira, I Gandino, A Brigante, E. Mussano, A Benitez, I. Exeni, L Roa Perez, Eduardo Kerzberg, J.C. Barreira, Ana M. Bertoli, B Virasoro, Karin Kirmayr, L. Carlevaris, L. F Somma, C. Sanchez Andia, B Kisluk, G. Gόmez, E Bedoya, Cristina G. Battagliotti, Oscar Rillo, Rosana Quintana, D Pereira, A.M. Cappuccio, María Victoria Collado, G Casado, C. Costi, M. de la Sota, O Cerda, E. Cavillon, F Melo, S Soaures de Souza, Soledad Retamozo, E. Velozo, Aníbal Quinteros, A Bohr, S Agüero, Larroude, Amelia Granel, B Barrios, Dlv María Celina, P Astesana, A. Smichowski, and I Petkovic
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Pediatrics ,medicine.medical_specialty ,Univariate analysis ,business.industry ,medicine.disease ,Vaccination ,Pneumococcal vaccine ,Community-acquired pneumonia ,Cohort ,medicine ,Cumulative incidence ,Adverse effect ,business ,Kidney disease - Abstract
Background Biobadasar is a registry that monitors adverse events in patients who use biological treatments in rheumatologic diseases conducted by the Argentine Society of Rheumatology. As in others international registries the community acquired pneumonia (CAP) has been detected as one of the most frequent infectological adverse events. Although all immunosuppressed patients should be vaccinated against streptococcus pneumoniae, there is a proportion of patients who are not. Objectives Evaluate the prevalence of pneumococcal vaccination in patients with CAP within the Biobadasar database. Assess factors associated with Severe CAP in these patients. Methods A cross-sectional, multicentric study was made in BIOBADASAR database from 2010 to2016. In patients who reported CAP data of demographics, comorbidities and state of pneumococcal immunization was collected. Microbiological data, treatment and outcome of the event were considered. The severity of CAP was assessed according to the opinion of the attending physician, hospitalization, risk of life and/or death. Values are expressed as mean ± standard deviation, median (ranges) and frequencies (percentages), as appropriate. We performed bivariate and multivariate logistic regression analysis to identify variables associated with the event. Results Of the 4029 patients enrolled in the registry, the cumulative incidence of CAP was 4.2% (n 170), 72.4% (n 123) were women. The mean age was 57 (SD +/- 14.5). Biological treatment was found in 81.8% (n 139). Patient s that have received the pneumococcal vaccine were 40.6% (n=69). Severe CAP was detected in 7.1%. Streptococco Pneumoniae was the main pathogen isolated in 13% of the cases. Overall mortality was 4.1%. In the univariate analysis for severe CAP we found statistical significance for Smoking OR 3.88, CI95 1.063–14.22, p= 0.029 and chronic kidney disease (CKD) OR 31, CI95 2.6–376, p= 0.007. When performing a multiple logistic regression model, only renal failure OR 7.39 CI95 0.003–0.38 p= 0.007 was a predictor of severe CAP. Not significative association with immunosuppressive treatment (p: 0.09), age (p: 0.464), or vaccination (p: 0.937) Conclusions The annual incidence of CAP in Argentina varies between 0.5 -1.1% while in our cohort it was four times higher. The prevalence of pneumococcal vaccination was less than 50%, showing that, although the literature and guidelines establish the need for vaccination, this is not so in the real world. In the multivariate analysis, only CKD was related to severe CAP. Although in the univariate analysis the CKD and the smoking habit represented factors associated with severity. We must emphasize the medical education in following the international vaccination guidelines. Disclosure of Interest None declared
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- 2017
29. FRI0229 Survey on transportation and storage of biological therapies by patients
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M Arias Saavedra, Eduardo Kerzberg, Damaris Alvarez, Gabriel Sequeira, JJ Astudillo Andrade, and Carolina Aimo
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medicine.medical_specialty ,Biological therapies ,Package insert ,business.industry ,General surgery ,Pharmacy ,Treatment failure ,Pharmacological action ,Informed consent ,medicine ,Patient assistance ,medicine.symptom ,business ,Wasting - Abstract
Background in order to ensure the pharmacological action of thermolabile drugs, it is mandatory to keep the cold chain unbroken from manufacturing to administration since lack of observance of these rules may compromise their efficacy. (1,2) Objectives to ascertain key aspects of transportation and storage of Biological Therapy (BT) on the part of the patients. Methods survey among outpatients who either were treated in the centre or attended the centre for the administration of a BT. Inclusion criteria encompassed patients of over 18 years of age, who were receiving a BT (at least one dose over the last 12 months) whose patient information leaflet indicated, “... must be refrigerated at 2°C to 8°C (36°F to 46°F). Do not freeze.” The survey comprised 31 questions about transportation and storage of the BT from the moment of collection from the pharmacy to its administration. This study was approved by the Bioethics Committee. Every patient signed an informed consent form. Results Eighty-three patients were interviewed (76% female and 24% males), their average age was 53 years old, 60% had Rheumatoid Arthritis, 24% Psoriatic Arthritis, and 16% sustained other conditions. Sixty-four percent were undergoing BT for the first time. Forty-eight percent were enrolled in a patient assistance programme. Had patients been fully informed of the importance of proper transportation and storage of the drug?No, 20% acknowledged that the first time they dealt with a BT, they had not been made aware of the relevance of its correct preservation. Are patients administered the BT immediately after collecting it from the pharmacy?No, 77% collected the drug at least 7 days before administration and though they received the BT in a cooler with ice packs (except in 5 cases) 71% was uninformed of how long it could be kept in this condition. Is the BT duly stored in the patient9s refrigerator?No, 28% misplaced the drug (65% in the freezer), and 90% did not know the temperature range at which it should be kept in the fridge. Only 1 patient used a thermometer to control the appliance temperature. Is there another crucial point as to BT storage at home?Yes, 53% of the 83 patients had experienced frequent power cuts in summer; out of these, 59% on a weekly basis. Forty percent of the 83 patients had power cuts of over 12 hours, 28% of over 24 hours, and 22% of over 48 hours. Out of the 83 patients, 37% took the BT to another house to avoid wasting it, and 4 had to dispose of it due to a protracted power cut. Five patients were away from home for over 48 hours during which the BT was in the fridge and they had not assigned another person to take care of the drug during their absence. Is the BT removed from the fridge only for its immediate administration?No, 46% of the respondents travelled to a centre, half of them for over an hour, carrying the BT. Conclusions before administering a BT, it is imperative to brief patients on suitable transportation and storage methods. Thus, treatment failure should prompt a thorough assessment of transportation and storage conditions. References Allegra JR, Brennan J, Lanier V, Lavery R, Markenzie B. Storage temperatures of out-of-hospital medications. Acad Emerg Med. 1999;6:1098–103. Marco JL, Cuellar MJ, Perez-Castellό I, Castellό A, Muelas J, Pelegri J. La cadena del frio de los medicamentos termolabiles en el domicilio del paciente. Pharm Care Esp. 2008;10:40–3. Disclosure of Interest None declared
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- 2017
30. Breastfeeding initiation, duration, and reasons for weaning in patients with systemic lupus erythematosus
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Julia Pretini, Gabriel Sequeira, Eduardo Kerzberg, Magdalena Acevedo, and Marina Laura Micelli
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Adult ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Cross-sectional study ,Immunology ,Breastfeeding ,Kaplan-Meier Estimate ,Weaning ,Risk Assessment ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Rheumatology ,immune system diseases ,Adrenal Cortex Hormones ,Risk Factors ,030225 pediatrics ,Immunology and Allergy ,Medicine ,Humans ,Lupus Erythematosus, Systemic ,Young adult ,skin and connective tissue diseases ,Retrospective Studies ,030203 arthritis & rheumatology ,Pregnancy ,business.industry ,Retrospective cohort study ,Hydroxychloroquine ,medicine.disease ,Breast Feeding ,Cross-Sectional Studies ,Antirheumatic Agents ,Female ,business ,Breast feeding ,medicine.drug - Abstract
To assess breastfeeding in patients with systemic lupus erythematosus (SLE), a cross-sectional study of patients with SLE compared to a non-SLE sample was performed. Patients who had pregnancies subsequent to their diagnosis of SLE and who were followed up in the hospital were interviewed. The group of non-SLE mothers consisted of patients who had no known rheumatic disease at the time of their pregnancy, and who were approached at the hospital paediatrics service waiting room. Thirty-six pregnancies in 31 patients with SLE and the same number of non-SLE mothers were studied. The number of SLE patients who did not initiate breastfeeding was higher than that of non-SLE mothers (19.4 vs 5.6%, respectively; p 0.07). The average duration of breastfeeding in SLE patients was 6 months (SD 6 months) versus 12 months (SD 8 months) in non-SLE mothers (log rank p: 0.003). Fifty-three percent of the non-SLE mothers indicated no particular reason for weaning, and considered that they had nursed their children a suitable amount of time. Conversely, SLE patients often set weaning in motion on the grounds that they had been placed on medication (41%). However, when the treatment was analysed, in 6 out of 12 cases, it consisted of low doses of either corticosteroids or hydroxychloroquine. Patients with SLE showed reduced rates of initiating breastfeeding. They also showed reduced duration of breastfeeding, and the reason for cessation was frequently cited to be therapies which were actually of low risk. Breastfeeding duration could be optimised by improving the level of information provided to patients.
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- 2016
31. Una encuesta sobre la evaluación y el tratamiento actual de la gota en Buenos Aires, Argentina
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Gabriel Sequeira, Eduardo Kerzberg, Nauan Fara, and Janitzia Vázquez Mellado
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Rheumatology ,business.industry ,Medicine ,business ,Humanities - Abstract
Resumen Objetivo Evaluar la gestion actual de la gota en los medicos generales y especialistas en Buenos Aires. Material y metodos Preguntas de seleccion multiple, encuesta anonima, realizada a 33 reumatologos (REU), 52 especialistas en medicina interna (EMI) y 86 medicos generales (Otros). Resultados Los REU atienden a pacientes con gota muy frecuentemente o habitualmente en un 51,5% de los casos vs. un 11,5% de EMI y un 8,1% de Otros. Al momento del diagnostico, los cristales de acido urico fueron identificados por un 51,5% de REU vs. un 28,8% de EMI y Otros 26,7%; los tofos fueron identificados por un 60,6% de REU % vs. un 30,8% de EMI y un 30,2% Otros. Los REU y los EMI usan colchicina para la gota aguda en el 75,8 y el 80,8%, respectivamente, frente al 7,7% de Otros. La medida de altura/peso y la circunferencia de la cintura del paciente fue realizada con menos frecuencia por REU que por EMI (el 66,7 vs. el 92,3% y el 45,5 vs. el 75%, respectivamente). Conclusiones Los REU suelen examinar a los pacientes con gota, pero en una etapa cronica. La identificacion de los cristales en el liquido sinovial es baja. El uso de colchicina sigue siendo alto. Los REU deben mejorar la evaluacion del sindrome metabolico.
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- 2012
32. A Survey on the Current Evaluation and Treatment of Gout in Buenos Aires, Argentina
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Eduardo Kerzberg, Janitzia Vázquez Mellado, Nauan Fara, and Gabriel Sequeira
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medicine.medical_specialty ,Chronic stage ,Acute gout ,Waist ,Practice patterns ,business.industry ,General Medicine ,medicine.disease ,Surgery ,Internal medicine specialists ,Gout ,Uric acid crystals ,Current management ,Internal medicine ,medicine ,business - Abstract
Objective To evaluate the current management of gout in general practitioners and specialists in Buenos Aires city. Material and methods Multiple choice, anonymous, survey, performed on 33 rheumatologists (REU), 52 Internal Medicine specialists (EMI) and 86 general practitioners (Otros). Results Gout is a very common or usual disease for 51.5% of REU vs 11.5% EMI and 8.1% Otros. At diagnosis, uric acid crystals are identified by 51.5% REU vs 28.8% EMI and 26.7% Otros and tophi observed by 60.6% REU vs 30.8% EMI and 30.2% Otros. REU and EMI should indicate colchicine for acute gout in 75.8% and 80.8% respectively vs 7.7% of Otros. REU measure patient's height/weight and waist circumference less frequently than EMI (66.7% vs 92.3% and 45.5% vs 75% respectively). Conclusions REU usually examine patients with gout but in a chronic stage. The identification of crystals in synovial fluid is low. The use of colchicine is still high. REU should improve the evaluation of the metabolic syndrome.
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- 2012
33. A gender gap in primary and secondary heart dysfunctions in systemic sclerosis: a EUSTAR prospective study
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Antonio C. Zea Mendoza, Jean Sibilia, Kamal Solanki, Cristina Mihaela Tanaseanu, Fredrick M. Wigley, Guido Valesini, M. Govoni, Lisa K. Stamp, Christopher P. Denton, Yolanda Braun-Moscovici, Ruxandra Ionescu, Øyvind Midtvedt, Ileana Nicoara, Aleksandra Stanković, Rüdiger Hein, Alina Dumitrascu, Susanne Ullman, Alan Tyndall, Sergio A. Jimenez, Irena Butrimiene, Alan Doube, Eugene J. Kucharz, Mohammed Tikly, Pier Luigi Meroni, Simon Stebbings, Renata Sokolik, Alexandra Balbir Gurman, Roger Hesselstrand, Kirsten Damgaard, Francesco Paolo Cantatore, Razvan Ionitescu, Silvana Zeni, Marco Matucci-Cerinic, Maria Rosa Pozzi, Jacques-Eric Gottenberg, Srdan Novak, Ana Maria Gherghe, David Launay, Liliana Groppa, Carlomaurizio Montecucco, Roxana Sfrent Cornateanu, Stefan Heitmann, Paloma García de la Peña Lefebvre, Daniela Opris, Peter T. Chapman, Line V. Iversen, Bernard Coleiro, Ulf Müller-Ladner, John Highton, Mara Oleszowsky, Gabriella Szücs, Magdalena Kopec-Medrek, Carlos De La Puente Buijdos, Paola Caramaschi, Magdalena Szmyrka-Kaczmarek, Rucsandra Dobrota, Gabriele Valentini, Fabiana Montoya, Blaz Rozman, Alberto Sulli, Hélène Chifflot, Raffaella Scorza, Patricia Carreira, Paulius Venalis, Lisa Maria Bambara, Torhild Garen, Isabela Tiglea, Agneta Scheja, Duska Martinovic, Jörg H W Distler, Jörg Henes, Giovanni Lapadula, Luc Mouthon, Diana Karpec, Douglas J. Veale, Valeria Riccieri, Nicolas Hunzelmann, Muriel Elhai, Serena Guiducci, Codrina Ancuta, Simonetta Pisarri, Thierry Zenone, Esthela Loyo, Branimir Anić, Claudia Günther, R. Becvar, Eugen Russu, Serena Vettori, Carlo Chizzolini, Vanessa Smith, Mengtao Li, Stanislaw Sierakowsky, Carmel Mallia, Małgorzata Widuchowska, Carolina de Souza Müller, László Czirják, Algirdas Venalis, Adrian Hij, Marta Valero Exposito, Simona Rednic, Miroslav Mayer, Laura Groseanu, Walter Alberto Sifuentes Giraldo, Murray Baron, Dominique Farge, Anna Kotulska, Marko Baresic, Svetlana Agachi, Martin Aringer, Merete Engelhart, John L. O'Donnell, Jérôme Avouac, Filip De Keyser, Ulrich A. Walker, Roberto Caporali, Harald Burkhardt, P. G. Vlachoyiannopoulos, Maurizio Cutolo, Frank A. Wollheim, Edoardo Rosato, Suzanne Kafaja, Valderílio Feijó Azevedo, Kilian Eyerich, Paolo Airò, Emmanuel Chatelus, L. Ananieva, Ira Litinsky, Andrea Lo Monaco, Vanesa Cosentino, Rita Rugiene, Eric Hachulla, P. Saar, Bojana Stamenkovic, Brigitte Krummel-Lorenz, Yannick Allanore, Elisabeth Knott, Oliver Distler, Matthias Seidel, Silvia Rodriguez Rubio, Franco Cozzi, Mihai Bojinca, Nemanja Damjanov, Maria João Salvador, Joanna Busquets, Otylia Kowal Bielecka, André Kahan, Jacek Szechiński, Daniel E. Furst, C. Mihai, Rodica Chirieac, Ewa Morgiel, Georg Schett, Armando Gabrielli, Giovanna Cuomo, Piotr Wiland, Maya N. Starovoytova, Sebastião Cezar Radominski, Gitte Strauss, Lealea Chiaburu, Florenzo Iannone, Carol M. Black, Andrea Himsel, Eduardo Kerzberg, Cecília Varjú, Vera Ortiz Santamaria, Gabriela Riemekasten, Dorota Krasowska, Marilena Gorga, Monica Popescu, Marie O'Rourke, Henrik Nielsen, Raffaele Pellerito, Ada Corrado, Elhai, M, Avouac, J, Walker, Ua, Matucci Cerinic, M, Riemekasten, G, Airò, P, Hachulla, E, Valentini, Gabriele, Carreira, Pe, Cozzi, F, Balbir Gurman, A, Braun Moscovici, Y, Damjanov, N, Ananieva, Lp, Scorza, R, Jimenez, S, Busquets, J, Li, M, Müller Ladner, U, Kahan, A, Distler, O, Allanore, Y, EUSTAR co, Author, EUSTAR co, Authors, Matucci-Cerinic, M, Airo, P, Valentini, G, Gurman, Ab, Braun-Moscovici, Y, Mt, Li, Muller-Ladner, U, Allanore, Y EUSTAR co-authors: Serena Guiducci, Alan, Tyndall, Giovanni, Lapadula, Florenzo, Iannone, Radim, Becvar, Stanislaw, Sierakowsky, Otylia Kowal Bielecka, Maurizio, Cutolo, Alberto, Sulli, Cuomo, Giovanna, Vettori, Serena, Simona, Rednic, Ileana, Nicoara, Vlachoyiannopoulos, P, Montecucco, C, Roberto, Caporali, Srdan, Novak, László, Czirják, Cecilia, Varju, Carlo, Chizzolini, Eugene, J Kucharz, Anna, Kotulska, Magdalena, Kopec-Medrek, Malgorzata, Widuchowska, Blaz, Rozman, Carmel, Mallia, Bernard, Coleiro, Armando, Gabrielli, Dominique, Farge, Adrian, Hij, Roger, Hesselstrand, Agneta, Scheja, Frank, Wollheim, Duska, Martinovic, Govoni, M, Andrea Lo Monaco, Nicolas, Hunzelmann, Raffaele, Pellerito, Lisa Maria Bambara, Paola, Caramaschi, Carol, Black, Christopher, Denton, Jörg, Hene, Vera Ortiz Santamaria, Stefan, Heitmann, Dorota, Krasowska, Matthias, Seidel, Mara, Oleszowsky, Harald, Burkhardt, Andrea, Himsel, Maria, J Salvador, Bojana, Stamenkovic, Aleksandra, Stankovic, Mohammed, Tikly, Maya, N Starovoytova, Merete, Engelhart, Gitte, Strau, Henrik, Nielsen, Kirsten, Damgaard, Gabriella, Szüc, Antonio Zea Mendoza, Carlos de la Puente Buijdos, Walter, A Sifuentes Giraldo, Øyvind, Midtvedt, Torhild, Garen, David, Launay, Guido, Valesini, Valeria, Riccieri, Ruxandra Maria Ionescu, Daniela, Opri, Laura, Groseanu, Fredrick, M Wigley, Carmen, M Mihai, Roxana Sfrent Cornateanu, Razvan, Ionitescu, Ana Maria Gherghe, Marilena, Gorga, Rucsandra, Dobrota, Mihai, Bojinca, Georg, Schett, Jörg Hw Distler, Pierluigi, Meroni, Silvana, Zeni, Luc, Mouthon, Filip De Keyser, Vanessa, Smith, Francesco, P Cantatore, Ada, Corrado, Susanne, Ullman, Line, Iversen, Maria, R Pozzi, Kilian, Eyerich, Rüdiger, Hein, Elisabeth, Knott, Jacek, Szechinski, Piotr, Wiland, Magdalena, Szmyrka-Kaczmarek, Renata, Sokolik, Ewa, Morgiel, Brigitte, Krummel-Lorenz, Petra, Saar, Martin, Aringer, Claudia, Günther, Branimir, Anic, Marko, Baresic, Miroslav, Mayer, Sebastião, C Radominski, Carolina de Souza Müller, Valderílio, F Azevedo, Svetlana, Agachi, Liliana, Groppa, Lealea, Chiaburu, Eugen, Russu, Thierry, Zenone, Simon, Stebbing, John, Highton, Lisa, Stamp, Peter, Chapman, Murray, Baron, John, O'Donnell, Kamal, Solanki, Alan, Doube, Douglas, Veale, Marie, O'Rourke, Esthela, Loyo, Edoardo, Rosato, Simonetta, Pisarri, Cristina-Mihaela, Tanaseanu, Monica, Popescu, Alina, Dumitrascu, Isabela, Tiglea, Rodica, Chirieac, Codrina, Ancuta, Daniel, E Furst, Suzanne, Kafaja, Paloma García de la Peña Lefebvre, Silvia Rodriguez Rubio, Marta Valero Exposito, Jean, Sibilia, Emmanuel, Chatelu, Jacques Eric Gottenberg, Hélène, Chifflot, Ira, Litinsky, Algirdas, Venali, Irena, Butrimiene, Paulius, Venali, Rita, Rugiene, Diana, Karpec, Eduardo, Kerzberg, Fabiana, Montoya, Vanesa, Cosentino, and Chizzolini, Carlo
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0301 basic medicine ,Male ,heart dysfunction ,Databases, Factual ,Epidemiology ,autoimmune diseases ,epidemiology ,systemic sclerosis ,Kaplan-Meier Estimate ,0302 clinical medicine ,Cardiovascular Disease ,Immunology and Allergy ,Prospective Studies ,Age of Onset ,skin and connective tissue diseases ,Prospective cohort study ,ddc:616 ,Orvostudományok ,Middle Aged ,Prognosis ,Connective tissue disease ,3. Good health ,Europe ,Cardiovascular Diseases ,Cohort ,Disease Progression ,Female ,Autoimmune Diseases ,Systemic Sclerosis ,Human ,Adult ,medicine.medical_specialty ,Prognosi ,Immunology ,Socio-culturale ,Klinikai orvostudományok ,Autoimmune Disease ,General Biochemistry, Genetics and Molecular Biology ,Follow-Up Studie ,03 medical and health sciences ,Sex Factors ,Rheumatology ,Internal medicine ,medicine ,Humans ,Sex Distribution ,Systemic Sclerosi ,Aged ,030203 arthritis & rheumatology ,Lupus erythematosus ,Scleroderma, Systemic ,business.industry ,medicine.disease ,Pulmonary hypertension ,Prospective Studie ,030104 developmental biology ,Heart failure ,Age of onset ,business ,Follow-Up Studies - Abstract
OBJECTIVES: In agreement with other autoimmune diseases, systemic sclerosis (SSc) is associated with a strong sex bias. However, unlike lupus, the effects of sex on disease phenotype and prognosis are poorly known. Therefore, we aimed to determine sex effects on outcomes. METHOD: We performed a prospective observational study using the latest 2013 data extract from the EULAR scleroderma trials and research (EUSTAR) cohort. We looked at (i) sex influence on disease characteristics at baseline and (ii) then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and survival. RESULTS: 9182 patients with SSc were available (1321 men) for the baseline analyses. In multivariate analysis, male sex was independently associated with a higher risk of diffuse cutaneous subtype (OR: 1.68, (1.45 to 1.94); p
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- 2014
34. Intercentre variance in patient reported outcomes is lower than objective rheumatoid arthritis activity measures: a cross-sectional study
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Rieki Alten, Eduardo Kerzberg, Horace J. Spencer, Alexandros A. Drosos, Codrina Ancuta, Lykke Midtbøll Ørnbjerg, Nevsun Inanc, Rodica Chirieac, Antonio Naranjo, T. Sokka, Pál Géher, Elena Nikiphorou, Nasim A. Khan, and Rüediger Müller
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Male ,medicine.medical_specialty ,Cross-sectional study ,Severity of Illness Index ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,medicine ,Humans ,Pharmacology (medical) ,In patient ,030212 general & internal medicine ,Patient Reported Outcome Measures ,030203 arthritis & rheumatology ,Core set ,Analysis of covariance ,Analysis of Variance ,business.industry ,Reproducibility of Results ,Variance (accounting) ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Treatment Outcome ,Rheumatoid arthritis ,Antirheumatic Agents ,Physical therapy ,Standard protocol ,Female ,Analysis of variance ,business - Abstract
Objective To assess intercentre variability in the ACR core set measures, DAS28 based on three variables (DAS28v3) and Routine Assessment of Patient Index Data 3 in a multinational study. Methods Seven thousand and twenty-three patients were recruited (84 centres; 30 countries) using a standard protocol in the Quantitative Standard Monitoring of Patients with RA study. Analysis of variance (ANOVA) and mixed-effect analysis of covariance models were used to model the relationship between study centre and different patient-reported and physician-reported RA activity measures. These models were built to adjust for the remaining ACR core set measure (for each ACR core set measure or each composite index), socio-demographics and medical characteristics. ANOVA and analysis of covariance models yielded similar results, and ANOVA tables were used to present variance attributable to recruiting centre. Results The proportion of variances attributable to recruiting centre was lower for patient reported outcomes (PROs: pain, HAQ, patient global) compared with objective measures (joint counts, ESR, physician global) in all models. In the full model, variance in PROs attributable to recruiting centre ranged from 1.53% for patient global to 3.71% for HAQ compared with objective measures that ranged from 5.92% for physician global to 9.25% for ESR; and was lower for Routine Assessment of Patient Index Data 3 (2.6%) compared with DAS28v3 (11.75%). Conclusion Intercentre variability in PROs is lower than objective measures of RA activity demonstrating that PROs may be more comparable across centres, and the need for standardization of objective measures.
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- 2016
35. A comparison between nailfold capillaroscopy patterns in adulthood in juvenile and adult-onset systemic sclerosis: A EUSTAR exploratory study
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F. Lauffer, Kati Otsa, Oliver Distler, S. Zeni, Marco Matucci Cerinic, Maria Rosa Pozzi, Margarita Pileckyte, John Highton, Paola Caramaschi, Jacek Szechiński, Maria João Salvador, Diana Karpec, Maurizio Cutolo, Codrina Ancuta, Patrizia Boracchi, Simonetta Pisarri, Fabiana Montoya, Vanessa Smith, Mengtao Li, Carolina de Souza Müller, Patricia Carreira, C. Mihai, Henrik Nielsen, Luc Mouthon, L. Denisov, Marc Frerix, Pier Luigi Meroni, Øyvind Midtvedt, Francesco Paolo Cantatore, Ada Corrado, Sebastião Cezar Radominski, Serena Guiducci, Francesco Puppo, Simon Stebbings, Armando Gabrielli, Giovanna Cuomo, Irena Butrimiene, Piotr Wiland, Ira Litinsky, Maria Uprus, Merete Engelhart, Roger Hesselstrand, Ulrich A Walker, Rodica Chirieac, Ulf Müller-Ladner, David Launay, Kirsten Damgaard, Kamal Solanki, Cristina Mihaela Tanaseanu, Torhild Garen, Isabela Tiglea, Aleksandra Stanković, L. Ananieva, Francesca Ingegnoli, Magdalena Szmyrka-Kaczmarek, Jörg Henes, Alan Tyndall, Roberta Gualtierotti, Rüdiger Hein, Ewa Morgiel, Edoardo Rosato, Ivan Foeldvari, Valderílio Feijó Azevedo, Gitte Strauss, Valeria Riccieri, Anna Kotulska, Marta Valero Exposito, R. Becvar, José António Pereira da Silva, Blaz Rozman, Vera Ortiz-Santamaria, Paloma García de la Peña Lefebvre, Szilvia Szamosi, Małgorzata Widuchowska, Gabriella Szücs, Martin Aringer, Paulius Venalis, Roberto Caporali, Kilian Eyerich, Florenzo Iannone, Alina Dumitrascu, Eugene J. Kucharz, Laura Groseanu, Alessandra Vacca, Monica Popescu, Cristiane Kayser, Yannick Allanore, Brigitte Krummel-Lorenz, P. Saar, Mihai Bojinca, Magdalena Kopec-Medrek, Eduardo Kerzberg, Cecília Varjú, Nemanja Damjanov, Luis Eduardo Coelho Andrade, Rita Rugiene, Paolo Airò, Filip De Keyser, Nicola Ughi, Bojana Stamenkovic, Claudia Günther, Ruxandra Ionescu, László Czirják, Matthias Seidel, Silvia Rodriguez Rubio, Paola Gottschalk, Dirk M. Wuttge, Alan Doube, Vanesa Cosentino, Thierry Zenone, Dominique Farge-Bancel, Esthela Loyo, Algirdas Venalis, Renata Sokolik, Alberto Sulli, Rosario Foti, Stefan Heitmann, Eric Hachulla, Juan José Alegre-Sancho, Carlomaurizio Montecucco, Daniela Opris, Ingegnoli, F, Boracchi, P, Gualtierotti, R, Smith, V, Cutolo, M, Foeldvari, I, Airò, P, Alegre-Sancho, Jj, Allanore, Y, Ananieva, Lp, Ancuta, C, Andrade, Le, Aringer, M, Becvar, R, Bojinca, M, Butrimiene, I, Cantatore, Fp, Caporali, R, Caramaschi, P, Carreira, Pe, Chirieac, R, Corrado, A, Cosentino, V, Cuomo, G, Czirjak, L, Da Silva, Ja, la Peña Lefebvre, Pg, De Keyser, F, de Souza Müller, C, Damgaard, K, Damjanov, N, Denisov, Ln, Distler, O, Doube, A, Dumitrascu, A, Engelhart, M, Exposito, Mv, Eyerich, K, Farge-Bancel, D, Azevedo, Vf, Foti, R, Frerix, M, Gabrielli, A, Garen, T, Gottschalk, P, Groseanu, L, Guiducci, S, Günther, C, Hachulla, Hein, R, Heitmann, S, Henes, J, Hesselstrand, R, Highton, J, Iannone, F, Ionescu, Rm, Kayser, C, Karpec, D, Kerzberg, E, Kotulska, A, Kopec-Medrek, M, Kucharz, E, Krummel-Lorenz, B, Lauffer, F, Launay, D, Li, M, Litinsky, I, Loyo, E, Cerinic, Mm, Meroni, P, Midtvedt, Ø, Mihai, Cm, Montecucco, C, Montoya, F, Morgiel, E, Mouthon, L, Müller-Ladner, U, Nielsen, H, Opris, D, Ortiz-Santamaria, V, Otsa, K, Pileckyte, M, Pisarri, S, Popescu, M, Pozzi, Mr, Puppo, F, Radominski, Sc, Riccieri, V, Rosato, E, Rozman, B, Rubio, Sr, Rugiene, R, Saar, P, Salvador, Mj, Seidel, M, Sokolik, R, Solanki, K, Stamenkovic, B, Stankovic, A, Stebbings, S, Strauss, G, Sulli, A, Szamosi, S, Szechinski, J, Szmyrka-Kaczmarek, M, Szücs, G, Tanaseanu, Cm, Tiglea, I, Tyndall, A, Ughi, N, Uprus, M, Vacca, A, Varju, C, Venalis, A, Venalis, P, Walker, Ua, Widuchowska, M, Wiland, P, Wuttge, Dm, Zeni, S, and Zenone, T.
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Klinikai orvostudományok ,Biochemistry ,Juvenile systemic sclerosi ,Scleroderma ,Microscopic Angioscopy ,Systemic sclerosi ,Scleroderma, Localized ,Young Adult ,Medicine ,Juvenile ,Humans ,Young adult ,Age of Onset ,skin and connective tissue diseases ,Child ,Nailfold Capillaroscopy ,Videocapillaroscopy ,Aged ,Retrospective Studies ,EUSTAR ,Scleroderma, Systemic ,integumentary system ,Capillaroscopy ,business.industry ,Similar distribution ,Microcirculation ,Autoantibody ,Retrospective cohort study ,Orvostudományok ,Cell Biology ,Middle Aged ,medicine.disease ,Dermatology ,Capillaries ,Nailfold capillaroscopy ,Female ,Age of onset ,Cardiology and Cardiovascular Medicine ,business ,Juvenile systemic sclerosis ,Systemic sclerosis - Abstract
Objective: Qualitative capillaroscopy patterns in juvenile- and adult-onset systemic sclerosis (SSc) were studied in adulthood using data from the EULAR Scleroderma Trials and Research (EUSTAR) database. Methods: Data collected between June 2004 and April 2013 were examined with focus on capillaroscopy. In this retrospective exploratory study, series of patients with juvenile-onset SSc were matched with series of adult-onset SSc having the same gender and autoantibody profile. Results: 30 of 123 patients with juvenile-onset and 2108 of 7133 with adult-onset SSc had data on capillaroscopy. Juvenile-onset SSc showed scleroderma pattern more frequently than adult-onset SSc (93.3% and 88%). The OR was 2.44 and 95% Cl 0.57-10.41. An active scleroderma pattern was present in 58% of juvenile- and 61% of adult-onset SSc. The OR was 0.91 and 95% Cl 0.28-2.93. The late scleroderma pattern was present in 61% of juvenile- and 55.5% of adult-onset SSc. The OR was 1.06 and 95% Cl 0.34-3.56. Conclusion: This is the first exploratory study on the comparison of capillaroscopy between juvenile- and adult-onset SSc in adulthood. Juvenile-onset SSc had an increase prevalence of sderoderma pattern, but a similar distribution of the three patterns was suggested. Further studies are needed to define this issue. (C) 2015 Elsevier Inc. All rights reserved.
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- 2015
36. FRI0340 Breastfeeding in Systemic Lupus Erithematosus
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M. Acevedo, Eduardo Kerzberg, J. Pretini, G. Sequeira, and M. Micelli
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Pediatrics ,medicine.medical_specialty ,business.industry ,Immunology ,Breastfeeding ,Hydroxychloroquine ,General Biochemistry, Genetics and Molecular Biology ,Birth rate ,Log-rank test ,Rheumatology ,Informed consent ,Epidemiology ,medicine ,Immunology and Allergy ,Weaning ,business ,Complication ,medicine.drug - Abstract
Background Breastfeeding is the optimal source of nourishment for newborns and infants during their first year of life.Both short and long benefits accrue to mothers who breastfeed (1,2). The clinical condition of patients with systemic lupus erythematosus (SLE) may have an impact on breastfeeding onset and duration. Objectives Assess breastfeeding in patients with SLE. Methods Retrospective case-control study. Patients who had got pregnant after being diagnosed with SLE (4 or more SLICC ACR/EULAR criteria) and whose pregnancies had been followed up in the hospital were interviewed. The control group consisted of patients approached in the waiting-room of the paediatrics service. The data collected included epidemiological information, main features of their pregnancies and newborns, breastfeeding duration, and reasons for weaning. This study was approved by the Bioethics Committee of the Ramos Mejia Hospital, and both patients and controls signed the informed consent form. Results Thirty-six pregnancies in 31 patients with SLE and the same number of controls were studied. The following features were similar in both groups: current age, age at the time of delivery, level of education, average number of children, number of patients that breastfed for the first time, and preterm birth rates. Patients with SLE had planned their pregnancies ahead less frequently than controls (16.7% vs 44.4%, p 0.02), they had experienced a greater number of complications during the pregnancies (33.6% vs 5.6%; p 0.007), and their newborns showed a higher trend to minor complications (25% vs 11.1%; p 0.2). Twenty-five percent of the patients with SLE presented some kind of complication during puerperium, mainly related to disease activity, versus none in the controls (p 0.001). Also, a higher number of patients with SLE did not even initiate breastfeeding (19.4% vs 5.6% in the controls; p 0.07). Breastfeeding average duration in patients with SLE was 6 months (SD 6 months) versus 12 months (SD 8 months) in the controls (Log Rank p: 0.003). Fifty-two percent of the controls mentioned that there had been no reason for weaning and considered that they had nursed their children a suitable amount of time. Conversely, patients with SLE frequently set weaning in motion on the grounds that they had been placed on medication (42%). However, when the medication was analysed, in 6 of 11 cases (55%), it consisted of low doses of corticoids or Hydroxychloroquine. Conclusions In this retrospective case-control study it was observed that patients with SLE show a lower trend to initiate breastfeeding, and they sustain it for less time than controls (6 months vs 12 months respectively). Although the most common reason for weaning is the administration of medication, breastfeeding duration could be optimised by improving the level of information provided to patients. References American Academy of Pediatrics. Section on breastfeeding: policy statement: breastfeeding and the use of human milk. Pediatrics 2012; 129: e827–41. World Health Organization. Breastfeeding health topic. Available at http://www.who.int/topics/breastfeeding/es[accessed on 15 January 2016]. Acknowledgement Prof. Ana Insausti. Disclosure of Interest None declared
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- 2016
37. A survey on the current evaluation and treatment of gout in Buenos Aires, Argentina
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Nauan, Fara, Janitzia, Vázquez Mellado, Gabriel, Sequeira, and Eduardo, Kerzberg
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Gout ,Rheumatology ,Allopurinol ,Health Care Surveys ,General Practice ,Practice Guidelines as Topic ,Argentina ,Internal Medicine ,Humans ,Guideline Adherence ,Practice Patterns, Physicians' ,Colchicine ,Gout Suppressants - Abstract
To evaluate the current management of gout in general practitioners and specialists in Buenos Aires city.multiple choice, anonimous, survey, performed to 33 rheumatologists (REU), 52 Internal Medicine specialists (EMI) and 86 general practitioners (Otros).Gout is a very common or usual disease for 51.5% of REU vs 11.5% EMI and 8.1% Otros. At diagnosis, uric acid crystals are identified by 51.5% REU vs 28.8% EMI and 26.7% Otros and tophi observed by 60.6% REU vs 30.8% EMI and 30.2% Otros. REU and EMI should indicate colchicine for acute gout in 75.8% and 80.8% respectively vs 7.7% of Otros. REU measure patient's height/weight and waist circumference less frequently than EMI (66.7% vs 92.3% and 45.5% vs 75% respectively).REU usually examine patients with gout but in a chronic stage. The identification of crystals in synovial fluid is low. The use ofcolchicine is still high. REU should improve the evaluation of the metabolic syndrome.
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- 2012
38. Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial
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Eastell, R, Lang, T, Boonen, S, Cummings, S, Delmas, Pd, Cauley, Ja, Horowitz, Z, Kerzberg, E, Bianchi, G, Kendler, D, Leung, P, Man, Z, Mesenbrink, P, Eriksen, Ef, Black, Dm, Eduardo, Kerzberg, Zulema, Man, Carlos, Mautalen, Maria, Ridruejo, Guillermo, Tate, Jorge, Velasco, Michael, Hooper, Mark, Kotowicz, Peter, Nash, Richard, Prince, Anthony, Roberts, Philip, Sambrook, Harald, Dobnig, Gerd, Finkenstedt, Guenter, Hoefle, Klaus, Klaushofer, Martin, Pecherstorfer, Peter, Peichl, Jean, Body, Steven, Boonen, JEAN PIERRE DEVOGELAER, Piet, Geusens, Jean, Kaufman, João, Brenol, Jussara, Kochen, Rubem, Lederman, Sebastiao, Radominski, Vera, Szejnfeld, Cristiano, Zerbini, Jonathan, Adachi, Jacques, Brown, Denis, Choquette, David, Hanley, Robert, Josse, David, Kendler, Richard, Kremer, Frederic, Morin, Wojciech, Olszynski, Alexandra, Papaioannou, Chiu, Kinyuen, Baoying, Chen, Shouqing, Lin, Nohemi, Casas, Monique, Chalem, Juan, Jaller, Jose, Molina, Hannu, Aro, Jorma, Heikkinen, Heikki, Kröger, Lasse, Mäkinen, Juha, Saltevo, Jorma, Salmi, Matti, Välimäki, CLAUDE LAURENT BENHAMOU, Pierre, Delmas, Patrice, Fardellone, Georges, Werhya, Bruno, Allolio, Dieter, Felsenberg, Joachim, Happ, Manfred, Hartard, Johannes, Hensen, Peter, Kaps, Joern, Kekow, Ruediger, Moericke, Bernd, Ortloff, Peter, Schneider, Siegfried, Wassenberg, PING CHUNG LEUNG, Adam, Balogh, Bela, Gomor, Tibor, Hidvégi, Laszlo, Koranyi, Péter, Lakatos, Gyula, Poór, Zsolt, Tulassay, RIVKA DRESNER POLLAK, Varda, Eshed, JOSEPH FOLDES, A., SOPHIA ISH SHALOM, Iris, Vered, Mordechai, Weiss, Silvano, Adami, Antonella, Barone, Gerolamo, Bianchi, Giannini, Sandro, GIOVANNI CARLO ISAIA, Luisetto, Giovanni, Salvatore, Minisola, Nicola, Molea, Ranuccio, Nuti, Sergio, Ortolani, Mario, Passeri, Alessandro, Rubinacci, Bruno, Seriolo, Luigi, Sinigaglia, WOONG HWAN CHOI, MOO II KANG, GHI SU KIM, HYE SOON KIM, YONG KI KIM, SUNG KIL LIM, HO YOUNG SON, HYUN KOO YOON, Carlos, Abud, Pedro, Garcia, Salomon, Jasqui, Luis, Ochoa, Javier, Orozco, Javier, Santos, Ian, Reid, Sigbjørn, Elle, Johan, Halse, Arne, Høiseth, Hans, Olav, HØIVIK INGUN RØED, Arne, Skag, Jacob, Stakkestad, Unni, Syversen, Janusz, Badurski, Edward, Czerwinski, Roman, Lorenc, EWA MARCINOWSKA SUCHOWIERSKA, Andrzej, Sawicki, Jerzy, Supronik, Eduard, Ailamazyan, Lidiya, Benevolenskaya, Alexander, Dreval, Leonid, Dvoretsky, Raisa, Dyomina, Vadim, Mazurov, Galina, Melnichenko, Ashot, Mkrtoumyan, ALEXANDER ORLOV MOROZOV, Olga, Ostroumova, Eduard, Pikhlak, Tatiana, Shemerovskaya, Nadezhda, Shostak, Irina, Skripnikova, Vera, Smetnik, Evgenia, Tsyrlina, Galina, Usova, Alsu, Zalevskaya, Irina, Zazerskaya, Eugeny, Zotkin, Osten, Ljunggren, Johan, Lofgren, Mats, Palmér, Maria, Saaf, Martin, Stenström, Paul, Hasler, Olivier, Lamy, Kurt, Lippuner, Claude, Merlin, René, Rizzoli, Robert, Theiler, Alan, Tyndall, Daniel, Uebelhart, JUNG FU CHEN, PO QUANG CHEN, LIN SHOW CHIN, JAWL SHAN HWANG, TZAY SHING YANG, Mayuree, Jirapinyo, Rojanasthien, Sattaya, Sutin, Sriussadaporn, Soontrapa, Supasin, Nimit, Taechakraichana, Kittisak, Wilawan, Hugh, Donnachie, Richard, Eastell, William, Fraser, Alistair, Mclellan, David, Reid, John, Abruzzo, Ronald, Ackerman, Robert, Adler, John, Aloia, Charles, Birbara, Barbara, Bode, Henry, Bone, Donald, Brandon, Jane, Cauley, Felicia, Cosman, Daniel, Dionne, Robert, Downs, James, Dreyfus, RONALD EMKEY, VICTOR E. L. I. N. O. F. F., Joseph, Fanciullo, Darrell, Fiske, Palmieri, Genaro, Gollapudi, M., Richard, Gordon, James, Hennessey, Paul, Howard, Karen, Johnson, Conrad, Johnston, Risa, Kagan, Shelly, Kafka, Jeffrey, Kaine, Terry, Klein, William, Koltun, Meryl, Leboff, Bruce, Levine, MICHAEL LEWIECKI, E., CORA ELIZABETH LEWIS, Angelo, Licata, Michael, Lillestol, Barry, Lubin, Raymond, Malamet, Antoinette, Mangione, Velimir, Matkovic, Daksha, Mehta, Paul, Miller, Sam, Miller, Murphy, FREDERIK T., Susan, Nattrass, David, Podlecki, Christopher, Recknor, Clifford, Rosen, Daniel, Rowe, Robert, Rude, Thomas, Schnitzer, Yvonne, Sherrer, Stuart, Silverman, Kenna, Stephenson, Barbara, Troupin, Joseph, Tucci, Reina, Villareal, Nelson, Watts, Richard, Weinstein, Robert, Weinstein, Michael, Weitz, and Richard, White
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musculoskeletal diseases ,medicine.medical_specialty ,Compressive Strength ,Bone density ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,Lumbar vertebrae ,Zoledronic Acid ,Article ,Drug Administration Schedule ,Bone densitometry ,Absorptiometry, Photon ,Clinical trials ,Bone Density ,Humans ,Medicine ,Quantitative computed tomography ,Osteoporosis, Postmenopausal ,Aged ,Aged, 80 and over ,Bone mineral ,Lumbar Vertebrae ,Bone Density Conservation Agents ,Diphosphonates ,medicine.diagnostic_test ,Femur Neck ,business.industry ,musculoskeletal, neural, and ocular physiology ,Imidazoles ,Bone QCT ,Bisphosphonates ,musculoskeletal system ,medicine.disease ,body regions ,Zoledronic acid ,medicine.anatomical_structure ,Female ,Hip Joint ,sense organs ,Radiology ,Tomography, X-Ray Computed ,business ,Densitometry ,Follow-Up Studies ,medicine.drug - Abstract
Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p0.01) and QCT (5.7%, p0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p0.0001), total hip (10.8%, p0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p0.0001).Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.
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- 2010
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39. FRI0052 Variations in Disease Activity and Therapeutic Management of Rheumatoid Arthritis in Different International Regions: A Comparison of Data from the Corrona International and Corrona US Registries
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A. Whitworth, J. Gal, A. Malaviya, Eduardo Kerzberg, R. Zahora, Jeff Greenberg, Kathy Lampl, Fredrik Nyberg, Meilien Ho, Ieda Maria Magalhães Laurindo, Laura Horne, O. Rillo, B.A. Pons-Estel, Allan Gibofsky, K.C. Saunders, George W. Reed, Tatiana Popkova, Joel M. Kremer, Sebastião Cezar Radominski, A.U. Onofrei, and Dimitrios A. Pappas
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Pathology ,medicine.medical_specialty ,Horizon Pharma ,Standard of care ,business.operation ,business.industry ,Abbott Laboratories ,Disease duration ,Immunology ,Medical school ,medicine.disease ,General Biochemistry, Genetics and Molecular Biology ,Disease activity ,Rheumatology ,Rheumatoid arthritis ,Family medicine ,medicine ,Immunology and Allergy ,business ,Regional differences - Abstract
Background The CORRONA International (C.Intl) rheumatoid arthritis (RA) registry is a multinational RA registry uniformly collecting baseline and longitudinal data. We explored variations in RA disease activity and drug utilization across regions participating in C.Intl, and CORRONA US (C.USA) RA registries. Methods The C.Intl registry is a multi-center, observational registry. Adult RA patients (pts) have been enrolled from 83 rheumatology practices in 10 countries in 3 regions: Latin America (LA) (Mexico, Brazil, Argentina), Eastern Europe (EEu) (Poland, Czech Republic, Hungary, Romania, Russia, Ukraine), Asia (India). The C.USA registry enrolls pts from 111 rheumatology practices across the US. Both registries collect data in a similar manner from rheumatologists and RA pts. We present baseline descriptive data across the regions participating in C.Intl, including variations in RA drug utilization, disease activity and functionality. We explored differences stratified by new (≤3 years duration) versus established (3+ years) disease. We compared C.Intl data by region with data from the most recent visit of pts enrolled in C.USA. Results 5696 pts enrolled in C.Intl and 20,291 RA pts followed in C.USA were analyzed. Mean (Standard Deviation (SD)) age was highest in the US and lowest in Asia [LA 54.2 years (12.9), EEu 57.1 (12.2), Asia 47.6 (11.9), US 60.3 (12.6)]. The majority of patients were women (LA: 86.7%, EEu: 83.4%, Asia: 85.5%, US: 76.6%). Mean (SD) disease duration was indicative of overall established dx [LA 9.9 years (8.7), EEu 9.1 (8.6), Asia 6.3 (5.8), US 12 (10.1)]. The majority of pts were seropositive (LA 83.5%, EEu 76.4%, Asia 65.4%, US 76%). Disease activity was higher, functionality worse, but biologic drug utilization and narcotic pain medication use were lower, in C.Intl regions compared to C.USA (Table 1). Conclusions There are regional differences in disease activity, functionality, and management of RA, which may be influenced by variations in demographic and genetic backgrounds of pt populations, prescribing patterns of local physicians and differences in standard of care. Acknowledgements This study is sponsored by CORRONA. Initial funding for the CORRONA International was provided by AstraZeneca. In the last two years, AbbVie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Lilly, Novartis, Pfizer, Savient, Vertex, and UCB have supported CORRONA through contracted subscriptions. Disclosure of Interest D. Pappas Employee of: CORRONA, Inc., Paid instructor for: Novartis, K. Lampl Shareholder of: AstraZeneca, Employee of: AstraZeneca, J. Kremer Shareholder of: CORRONA, Inc., Employee of: CORRONA, Inc., S. Radominski Grant/research support: Pfizer,BMS,AstraZeneca, Amgen, Sanofi, Novartis, Celltrion, Roche;, Consultant for: Pfizer,BMS,AstraZeneca, Employee of: Universidade Federal do Parana- Curitiba- Brzazil;, Speakers bureau: Pfizer,BMS,AstraZeneca,Janssen,Sanofi, GSK, J. Gal: None declared, F. Nyberg Shareholder of: AstraZeneca, Employee of: AstraZeneca, A. Malaviya Consultant for: Part-time Consultant Rheumatologist at ISIC Hospital, Advisory Board Member Janssen Pharma, Roche Pharma, Pfizer Pharma, Sanofi Pharma, A. Whitworth Employee of: CORRONA, Inc., O. Rillo: None declared, A. Gibofsky Shareholder of: Amgen, BMS, GlaxoSmithKline, Johnson & Johnson, Pfizer, Roche, Consultant for: Amgen, AstraZeneca, Celgene, Horizon, Iroko, Pfizer, Roche, Antares, UCB, Speakers bureau: Amgen, Pfizer, Roche, UCB; Stockholder, T. Popkova Speakers bureau: GlaxoSmithKline, MSD, AstraZeneca, M. Ho Employee of: AstraZeneca, I. Laurindo Consultant for: Abbott,AstraZeneca, Bristol, Janssen, Pfizer, Speakers bureau: Abbott, AstraZeneca, Bristol, Janssen, Pfizer, Roche, G. Reed Employee of: CORRONA, Inc., E. Kerzberg: None declared, L. Horne Shareholder of: AstraZeneca, Employee of: AstraZeneca, R. Zahora: None declared, K. Saunders Employee of: CORRONA, Inc., B. Pons-Estel Grant/research support: GLADAR, ABBOTT Laboratories, A. Onofrei Employee of: UMASS Medical School, J. Greenberg Shareholder of: CORRONA, Inc., Consultant for: AstraZeneca, Pfizer, Employee of: CORRONA, Inc. DOI 10.1136/annrheumdis-2014-eular.1692
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- 2014
40. SAT0134 Prevalence of Cardiovascular Risk Factors and Cardiovascular Disease in Rheumatoid Arthritis Patients across International Regions: A Comparison of the Corrona International and Corrona US Registries
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Oscar Rillo, Kathy Lampl, Sebastião Cezar Radominski, A. Malaviya, Fredrik Nyberg, Eduardo Kerzberg, Meilien Ho, T.V. Popkova, Laura Horne, Jeff Greenberg, Joel M. Kremer, A. Whitworth, K.C. Saunders, R. Zahora, A.U. Onofrei, B.A. Pons-Estel, Allan Gibofsky, Ieda Maria Magalhães Laurindo, J. Gal, George W. Reed, and Dimitrios A. Pappas
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medicine.medical_specialty ,Horizon Pharma ,business.operation ,Abbott Laboratories ,business.industry ,Immunology ,Cardiovascular risk factors ,Disease ,medicine.disease ,Comorbidity ,General Biochemistry, Genetics and Molecular Biology ,Rheumatology ,Family medicine ,Rheumatoid arthritis ,medicine ,Immunology and Allergy ,Disease characteristics ,In patient ,business - Abstract
Background Cardiovascular disease (CVD) is a major comorbidity in patients (pts) with rheumatoid arthritis (RA). We explored variations in the prevalence of cardiovascular (CV) risk factors and CVD among RA pts in different international regions using data from CORRONA International (C.Intl) and CORRONA US (C.USA) RA registries. Methods The C.Intl registry is a multi-center, observational registry. Adult RA pts have been enrolled from 83 rheumatology practices in 10 countries in 3 regions - Latin America (Mexico, Brazil, Argentina), Eastern Europe (Poland, Czech Republic, Hungary, Romania, Russia, Ukraine), Asia (India). The C.USA registry enrolls pts from 111 rheumatology practices across the United States. Both registries collect data in a similar manner from rheumatologists and RA pts at regular clinical encounters. We compared cross-sectional baseline descriptive C.Intl data for demographic and disease characteristics with cross-sectional data from the most recent visit of C.USA-enrolled pts. Prevalence for CV risk factors and CVD are presented crude for C.USA and age/gender-standardized to the C.USA age/gender distribution (age categories Results We analyzed 5696 pts enrolled in C.Intl and 20291 pts actively followed in C.USA. While there are cross-sectional differences across all regions, the greatest differences are between the US and C.Intl regions overall. There is a higher percentage of male pts in C.USA, disease duration is longer, and pts tend to have lower disease activity, yet are more likely to receive a biologic (Table 1). After adjusting for age and gender differences by standardization, enrolled pts in India have the lowest BMI, are more rarely smokers and have a low prevalence of hyperlipidemia and CVD compared to other C.Intl regions and C.USA (Table 1). C.USA participants have the highest BMI. Participants from Eastern Europe suffer more frequently from hypertension and hyperlipidemia and have the highest prevalence of all manifestations of CVD (Table 1). Conclusions Data from the C.Intl and C.USA registries reveal variations in disease characteristics, as well as prevalence of CV risk factors and CVD, across different regions. Observed variations may be influenced by differences in the composition and treatment of pts populations, and this should be considered in analyses and evaluation of pts from different geographic origins. Acknowledgements This study is sponsored by CORRONA. Initial funding for the CORRONA International was provided by AstraZeneca. In the last two years, AbbVie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Lilly, Novartis, Pfizer, Savient, Vertex, and UCB have supported CORRONA through contracted subscriptions. Disclosure of Interest D. Pappas Employee of: CORRONA, Inc., Paid instructor for: Novartis, K. Lampl Shareholder of: AstraZeneca, Employee of: AstraZeneca, J. Kremer Shareholder of: CORRONA, Inc., Employee of: CORRONA, Inc., S. Radominski Consultant for: Pfizer, BMS, AstraZeneca, Employee of: Universidade Federal do Parana- Curitiba- Brazil;, Speakers bureau: Pfizer,BMS,AstraZeneca,Janssen,Sanofi, GSK, J. Gal: None declared, F. Nyberg Shareholder of: AstraZeneca, Employee of: AstraZeneca, A. Malaviya Consultant for: Part-time Consultant Rheumatologist at ISIC Hospital, Advisory Board Member Janssen Pharma, Roche Pharma, Pfizer Pharma, Sanofi Pharma, A. Whitworth Employee of: CORRONA, Inc., O. Rillo: None declared, A. Gibofsky Shareholder of: Amgen, BMS, GlaxoSmithKline, Johnson&Johnson, Pfizer, Roche, Consultant for: Amgen, AstraZeneca, Celgene, Horizon, Iroko, Pfizer, Roche, Antares, UCB, Speakers bureau: Amgen, Pfizer, Roche, UCB, T. Popkova Speakers bureau: GlaxoSmithKline, MSD, AstraZeneca, M. Ho Employee of: AstraZeneca, I. Laurindo Consultant for: Abbott, AstraZeneca, Bristol,Janssen,Pfizer, Speakers bureau: Abbott, AstraZeneca, Bristol,Janssen,Pfizer, Roche, G. Reed Employee of: CORRONA, Inc., E. Kerzberg: None declared, L. Horne Shareholder of: AstraZeneca, Employee of: AstraZeneca, R. Zahora: None declared, K. Saunders Employee of: CORRONA, Inc., B. Pons-Estel Grant/research support: GLADAR, Abbott Laboratories, A. Onofrei Employee of: UMASS Medical School, J. Greenberg Shareholder of: CORRONA, Inc., Consultant for: AstraZeneca, Pfizer, Employee of: CORRONA, Inc. DOI 10.1136/annrheumdis-2014-eular.1695
- Published
- 2014
41. Serum kinetics, bioavailability and bone scanning of 99mTc-labelled sodium olpadronate in patients with different rates of bone turnover
- Author
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E. Montuori, D. Messina, M. Ortiz, Eja Roldán, E. B. Degrossi, J. C. Barreira, O. J. Degrossi, Eduardo Kerzberg, H. García del Río, and A. Pérez Lloret
- Subjects
medicine.medical_specialty ,Bone disease ,Osteoporosis ,Administration, Oral ,Biological Availability ,Bone and Bones ,Bone remodeling ,Excretion ,Arthritis, Rheumatoid ,Pharmacokinetics ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Radionuclide Imaging ,Pharmacology ,Diphosphonates ,Chemistry ,Area under the curve ,General Medicine ,Blood Proteins ,Organotechnetium Compounds ,medicine.disease ,Osteitis Deformans ,Blood proteins ,Bioavailability ,Endocrinology ,Injections, Intravenous - Abstract
The activity of olpadronate labelled with technetium-99m(99mTc) was monitored in plasma and urine samples after single oral (925 MBq 99mTc/10 mg, coadministered with 50 mg cold drug) and intravenous (925 MBq 99mTc/5 mg) administrations to two groups of patients with different rates of bone turnover. The first group comprised high bone turnover (HBTO) patients suffering from Paget's bone disease; the second group comprised patients with normal to low bone turnover (NBTO) having the diagnosis of rheumatoid arthritis and secondary osteoporosis. Kinetic variables were correlated with anthropomorphometric variables, biological markers of bone metabolism and plasma proteins. Data were also obtained after repeatedly dosing the HBTO patients. Additionally, Paget's bone and healthy bone (PB/HB) uptake before and after low-dose oral treatment were assessed by means of scintigraphy. Results showed that most of the kinetic variables did not differ between the two groups of patients, except for a greater V ss and smaller blood area under the curve AUC in the patients with HBTO. After a repeated-dose administration period, the blood AUC activity and Whole Body Retention (WBR) of the HBTO patients tended to be similar to those of the NBTO patients. In both groups, after oral dosing, the C max was 20 times lower than the C 0.5 after i.v. injection, and the oral bioavailability ranged from 3% to 4%. Finally, the plasma t 1/2β ranged from 9 to 14 h. Correlation coefficients were obtained from multiple regression analysis; kinetic variables showed very low correlations with anthropomorphometric measurements. In contrast the V ss and WBR were significantly correlated with serum alkaline phosphatase levels and the V ss also with urine hydroxyproline levels. Plasma protein concentration was also correlated with excretion parameters such as CLP and plasma t 1/2β after an oral dose. Scintigraphic studies in the HBTO group allowed bone selectivity to be seen through skeletal drug uptake. The 15 Pagetic lesions analysed in the HBTO group showed a decrease in PB/HB ratio from 3.8 in the basal study to 2.7 after olpadronate administration for 30 days at the rate of 50 mg/day. In conclusion, the kinetic profile of 99mTc-labelled olpadronate, mainly AUC and WBR, showed a dependence upon bone metabolism and seemed unrelated to body size variables. HBTO patients showed a lower blood AUC but a higher V ss. Both variables may have been reflecting the fact that the drug binds selectively with calcified tissues and, in turn, with the target compartment. Scintigraphy confirmed the labelled-compound bone selectivity as a desirable feature for a bone-scanning agent.
- Published
- 1995
42. Hand bone densitometry in rheumatoid arthritis
- Author
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Gabriel Sequeira, A Cavallo, V Marcos, Eduardo Kerzberg, and E Roldán
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Pathology ,medicine.medical_specialty ,Histology ,Physiology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Rheumatoid arthritis ,medicine ,medicine.disease ,business ,Densitometry - Published
- 2001
43. [Giant duodenal diverticula with heterotopic gastric mucosa. Its demonstration with technetium 99]
- Author
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Eduardo Kerzberg, Orfus S, Saleme J, Slater H, De Paula A, and Huberman E
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Male ,Diverticulum ,Malabsorption Syndromes ,Gastric Mucosa ,Intestinal Perforation ,Humans ,Technetium ,Duodenal Diseases ,Gastrointestinal Hemorrhage ,Radionuclide Imaging ,Diverticulitis ,Intestinal Obstruction - Abstract
The duodenal diverticulum, except for occasional findings, are diagnosed by their complications, these are found in 10% of the cases and they are: 1) diverticulitis 2) haemorrhage 3) mechanic disturbances 4) perforation 5) obstruction 6) malabsorption syndrome. The case that motivated our communication appeared as a massive haemorrhage, that was medically treated considering the high mortality, rate of the surgical procedures. As the duodenal diverticuli can be cause of acute or chronic digestive haemorrhage, and this is frequently due to the erosion produced, by the heterotopic gastric mucosae, we consider that its demonstration with technetium 99 can be a valuable diagnostic method, as has already been demonstrated in other pathologies that present heterotopic mucosae, and as has been demonstrated in our case.
- Published
- 1981
44. [Oxidative cellular damage in the digestive system]
- Author
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Ej, Roldán, Eduardo Kerzberg, and Ed, Huberman
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Ethanol ,Free Radicals ,Liver ,Gastric Mucosa ,Luminescent Measurements ,Animals ,Intestinal Mucosa ,Digestive System ,Oxidation-Reduction ,Pancreas ,Rats - Published
- 1987
45. [Colonic angiodysplasia: report of a case and considerations]
- Author
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Eduardo Kerzberg, Rapoport B, Roldán M, Sánchez D, Arzeno J, and Huberman E
- Subjects
Colonic Diseases ,Colon ,Angiography ,Humans ,Female ,Aortic Valve Stenosis ,Colonoscopy ,Gastrointestinal Hemorrhage - Abstract
An important etiology of gastrointestinal disease hemorrhage is the angiodisplasic in the last decades the recognition of this pathology has advanced due to the endoscopic and arteriographic techniques. Higher frequency is observed in patients older than 60 years old attributing its etiology to degenerative changes being associated between 20 and 25% with aortic stenosis. Expectant or surgical therapeutics depend on the importance of the hemorrhage and the general state of the patient, the patient that motivated this review presented previous low gastrointestinal hemorrhages. The use of selective arteriography on the last internation allowed us to make the diagnosis of colonic angio displasia.
46. [Cognitive dysfunction in systemic lupus erythematosus in relation to disease activity and damage]
- Author
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Dorman G, Micelli M, Cosentino V, Ottone L, Nuñez MR, Mangone C, Rc, Rey, Eduardo Kerzberg, and Genovese O
47. [Gastrointestinal involvement in progressive systemic sclerosis]
- Author
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Mg, Alvarez, Re, Rubaldo, Eduardo Kerzberg, De Paula A, and Ed, Huberman
- Subjects
Radiography ,Esophagus ,Scleroderma, Systemic ,Manometry ,Intestine, Small ,Mouth Mucosa ,Humans ,Digestive System - Abstract
25 patients with clinical, radiological and manometrical features of PSS in the gastrointestinal tract were reviewed, looking mainly for the esophageal involvement. All of the data obtained in our serie agreed with those of most of the authors. Outlining: The lack of relationship between the evolution of the skin involvement and GI tract involvement. The high incidence of esophageal involvement, especially functional alterations even in the absence of clinical and/or radiological symptomatology. The usefulness of manometric method in the diagnosis of motor involvement of esophages, especially for the evaluation of lower esophageal esphincter. Although the esophageal and intestinal involvement are more frequent and well known, any area of the GI tract may be damaged during the course of this disease. Since up to now, an ethiological therapy to stop the course of the disease is not known, it's important to search for earlier alterations in order to start with a pathophysiological and symptomatic treatment to avoid complications.
48. [Kinetics of chemoluminiscence of rat intestine during ischemia and reperfusion]
- Author
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Ej, Roldán, Eduardo Kerzberg, and Boveris A
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Intestines ,Oxygen ,Analysis of Variance ,Time Factors ,Free Radicals ,Thioctic Acid ,Ischemia ,Reperfusion Injury ,Luminescent Measurements ,Animals ,Rats, Inbred Strains ,Ligation ,Rats - Abstract
Oxygen free radicals are involved in ischemic and reperfusion tissular injuries. Chemiluminescence of organs reflects the steady state level of peroxy radicals, usually generated by oxygen radicals. In this study, chemiluminescence of intestine has been determined in rats subjected to 2, 5 or 10 min of occlusive ischemia by ligation. During the ischemic period, chemoluminescence tends to decrease. After delegation, a constant response, a chemiluminescence overshoot, can be obtained only in the group of rats subjected to 2 min of ligation. This methodology does not provide constant results with longer periods of ligation. In other groups of rats subjected to 2 min of ligation and then delegated, the kinetics of the organ emission in function of time show a mean overshoot of about 44% after 3 min of reperfusion. This early excess of chemiluminescence is maintained for the first 10 to 20 min after delegation, but not for longer periods. The administration of a free radical scavenger, thioctic acid 100 mg/kg i.p., prevents or reduces the amount of the overshoot previously described during the 20 min postdelegation follow-up period. These data suggest that excessive oxygen radical generation occurs in vivo during the early minutes of reperfusion and may be the consequence of very fast enzymatic changes during the short-term previous hypoxic period. Further studies are needed to demonstrate the subsequent functional alteration and the pathological implication of this phenomenon.
49. [Lung cancer. Analysis of 240 cases]
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Ml, Torino, Pa, Valicenti, Temín Párraga R, Grabivker G, Franchi M, Eduardo Kerzberg, and Ed, Huberman
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Adult ,Male ,Lung Neoplasms ,Humans ,Female ,Middle Aged ,Aged ,Retrospective Studies
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