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Diversos estudios han reportado que el cuidado informal de adultos mayores, personas con alguna enfermedad o discapacidad, e incluso el cuidado de menores de edad, tiene un impacto en la salud física y mental de las personas cuidadoras (PC). El objetivo del presente estudio fue identificar los riesgos a la salud mental de las PC, teniendo como referencia el concepto de “carga de cuidado” que alude a las demandas físicas, emocionales, sociales y/o económicas de las actividades de cuidado, y la tensión que estas producen. Los participantes respondieron a un tamizaje entre abril y diciembre de 2020, vía una plataforma electrónica, mismo que tuvo por objeto identificar y atender problemas de salud mental que pudieran presentarse o agravarse por la pandemia y las medidas de confinamiento adoptadas para mitigarla. Más de 51,000 personas reportaron ser PC de menores, adultos mayores y/o enfermos crónicos, lo que permitió identificar variaciones en la carga de cuidado considerando el impacto de distintos perfiles de cuidadores (según el tipo y número de personas dependientes). Las condiciones de salud mental evaluadas fueron estrés agudo, ansiedad generalizada, ansiedad por la salud y depresión. Los resultados confirman que las PC que cuidan más de un tipo de persona dependiente tienen mayores probabilidades de riesgo a desarrollar alguna de las condiciones de salud mental. Así mismo, quienes cuidaban alguna persona con enfermedad crónica fueron los más vulnerables, mientras que tener un menor de edad al cuidado actuó en alguna medida como un factor protector.

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.

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.

El presente artículo tiene como objetivo realizar un acercamiento al tratamiento de algunos de los temas enmarcados en la intersección entre la antropología social o cultural y el estudio de la cognición. Para introducir el tema, las autoras nos dan una explicación de los antecedentes del campo de conocimiento que es la antropología, además de la importancia de la cultura dentro de esta disciplina. En particular, se hace referencia a la antropología cognitiva, un campo que comenzó a desarrollarse en Estados Unidos a mediados del siglo xx y que cobró fuerza y siguió nuevos derroteros en los años ochenta y noventa en Francia. Se realiza, por lo tanto, un recorrido por algunos conceptos que delimitaron las diferentes líneas de investigación en este campo de estudio. Uno de los factores más importantes dentro de la antropología cognitiva es el lenguaje que refleja la cultura de nativos en una región.

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.

Background: The presence of interstitial lung disease (ILD) is a common extra-articular manifestation in patients diagnosed with Rheumatoid Arthritis (RA), dyspnea being its cardinal symptom. Several of the drugs commonly used to treat this condition, such as TNF inhibitors (anti-TNF) and Disease Modifying Antirheumatic Drugs (DMARDs), have been implicated in the development or exacerbation of ILD. In regard to Tofacitinib, results of post hoc analysis of its pivotal and extension studies report a numerically lower ILD incidence rate in the group that received this drug compared with placebo. Objectives: To describe the evolution of dyspnea, spirometric parameters, DLCO and high resolution computed tomography (HRCT) findings in patients with RA diagnosis with associated PID who received Tofacitinib for a period of 12 months. Methods: Patients with a diagnosis of RA who fulfilled criteria ACR 1987/ACR-EULAR 2010, with interstitial lung disease previously diagnosed from clinical findings, spirometry and/or HRCT were included. Tofacitinib was used in dose of 10 mg/day orally. Design: Descriptive, retrospective, multicentric study. The following variables were analyzed: change at 12 months from baseline in the degree of dyspnea (according to the modified scale of dyspnea MMRC), forced vital capacity (FVC), DLCO and findings in HRCT. Continuous variables were reported as mean and standard deviation or median and interquartile range as appropriate. The categorical variables were reported as percentages. Results: Fifteen patients were included. 60% (n: 9) were women. The mean age was 64.4 years (± 10.92). The median time of evolution of RA was 9 years (IQR: 4-40). The median time of evolution of interstitial lung disease was 4 years (IQR: 1-24).13% (n: 2) of the patients were receiving methotrexate (MTX) at the time of evaluation, 60% (n: 9) of the patients had previously received it. 80% (n: 12) had previously received DMARD different from MTX. 33% of the patients (n: 5) had received previous biological treatment. All patients received tofacitinib at a dose of 10mg/day. 47% of patients (n = 7) received tofacitinib monotherapy and 53% (n = 8) received it combined with DMARDsc. 27% (n: 4) of the patients had grade 3-4 dyspnea at baseline.Improvement in the dyspnea scale was observed in 8 patients, while in the rest, it remained stable. The forced vital capacity (FVC) at baseline was 80% in 2 patients. At 12 months, 4 patients achieved a FVC> 80%.The average of DLCO at baseline was 45.6 (± 18.84), with an improvement of 30% at 12 months in 4 patients. No progression of the disease was observed in the HRCT at 12 months in any of the patients evaluated. Conclusion: The present preliminary study was performed with patients of daily practice, not being available in all cases, the corresponding respiratory functional examinations. However, despite these limitations, none of the patients showed worsening of dyspnea, with improvement in some patients. Regarding respiratory functional examinations and DLCO, not only they remained stable after treatment in the majority of patients evaluated, but 4 patients presented improvement with respect to baseline parameters. It is necessary to perform more studies, with systematized controls of the pulmonary function and images, to corroborate this hypothesis. Disclosure of Interests: Marisel Bejarano: None declared, Maria Natalia Tamborenea: None declared, Mario Alberto Goni: None declared, Lina Saldarriaga: None declared, Cecilia Pisoni: None declared, Rodrigo Garcia Salinas: None declared, Mariana Salcedo: None declared, Claudia Helling Employee of: I am an employee of Pfizer, Adrian Salas Consultant for: Pfizer, Employee of: I am an employee of Pfizer

The Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire is the first needs-based instrument specifically designed to measure quality of life (QoL) of patients with rheumatoid arthritis (RA). The aims of our study were to develop an Argentinean version of the RAQoL and to determine its reproducibility, validity, and sensitivity to change in patients with RA. Translation process was performed according to internationally accepted methodology. Internal consistency and test-retest reliability were calculated. Criterion and construct validity were assessed by comparing the RAQoL with parameters of disease activity, the Health Assessment Questionnaire (HAQ), and the Medical Outcomes Study 36-item health survey (SF-36) questionnaire. Sensitivity to change was measured at 6-12 months using standardized response mean (SRM). The minimal important change was defined as a change of 1 or 1.96 times the standard error of measurement. A total of 97 patients with RA were included. Cronbach's α was 0.93, and test-retest reliability was 0.95. The RAQoL showed moderate to strong correlation with parameters of disease activity, the HAQ, and the SF-36. Functional status was the main determinant of patients' level of QoL. The SRM of the RAQoL was 0.24. Agreement between 20 % improvement in RAQoL and ACR20 response was moderate. Minimal important change was 2.2 (1 SEM) or 4.3 (1.96 SEM). The Argentinean version of the RAQoL is the first Spanish translation of this questionnaire. Our findings show it to be valid, reliable, and sensitive to changes in RA clinical status.

Fuente TESIUNAM