Características de la hospitalización reumatológica en un hospital de nivel terciario / Features of patients with rheumatic diseases admitted to a tertiary care hospital

Background: The diagnostic profile of patients with rheumatic diseases admitted to a general hospital is variable. Aim: To report the epidemiological profile of patients with rheumatic diseases admitted to a tertiary care hospital. Material and methods: All admissions to a Medicine ward of a general hospital and seen by the Rheumatology team were prospectively registered during one year in 1999. Patients were classified as primarily admitted for a rheumatic disease or admitted for other cause that required a consultation with the Rheumatology team. Results: One hundred forty five admissions due to rheumatic diseases were registered. Of these, 82 were due to primary rheumatic diseases. Systemic lupus erythematosus, rheumatoid arthritis and vasculitis were the main diagnoses and the mean hospital stay was 18.5 days. Sixty three patients required a consultation with the Rheumatology team specially due to osteoarthritis and crystal induced diseases. Conclusions: Admissions due to rheumatic diseases are prolonged, correspond to 0.46 per cent of all admissions and the main responsible disease is systemic lupus erythematosus

Infección por nocardia asteroides en un paciente con lupus eritematoso sistémico / Nocardia asteroides infection in a patient with systemic lupus erythematosus

Nocardia asteroides infection are unusually observed in sistemic Lupus erithematous (SLE) patients. They are generally associated to steroidal and immunosuppressive therapy. We report a 24 years old female with SLE diagnosed in 1994 who developed a severe preeclampsia in her first pregnancy requiring emergency caesarean section. Post partum acute renal failure and type IV lupus nephropathy were treated with hemodialysis, metilprednisolone, cyclophosphamide and prednisone. Three months later, while she was receving the fourth cyclophosphamide dose, she presented with a pleuro pneumonia and occipital abscess, both caused by Nocardia asteroides. She was treated with cotrimoxazole + cefixime and pleural decortication was required. Five months later, she developed Meningitis caused by Nocardia asteroides and hydrocephalus. She was treated with ceftriaxone, vancomycin, cotrimoxazole and ventricular shunting procedure. Two months later, a retroperitoneal abscess was diagosed and surgically drained but the patient died, due to a methicillin-resistant Staphylococcus aureus septicemia

Educación en pacientes con artritis reumatoidea: evaluación de una encuesta de intereses / Education of patients with rheumatoid arthritis: assessment of a survey of interests

Background: The congruence of interests between health care providers and clients is essential if subjects with chronic diseases will be educated. Aim: To assess, in patients with rheumatoid arthritis, those fields in which they would like to receive education. Patients and methods: Eighty eight patients with rheumatoid arthritis were surveyed about the topics in whicb they would like to be educated. The inquiry included medical aspects, handicap overcoming, social issues and labor aspects. Results: Eighty two percent of Patients were interested in medical aspects, 77 percent in social issues and 71 percent in handicap overcoming. Eighty three percent of Patients with greater handicaps preferred handicap overcoming, 75 percent social aspects and 74 percent medical aspects. Younger patients had a greater interest in labor aspects, those with a recently diagnosed disease were interested in legal rights and those with a prolonged disease wanted information about self help groups. Conclusions: The greater educational interests of patients with rheumatoid arthritis were on medical aspects. However, those impaired by the disease were interested in handicap overcoming. Age and duration of the disease also influenced the educational interests of patients. Thus, education in these patients must be individualized

Prevalencia de artritis reumatoide en mineros portadores de silicosis: estudio caso-control / Prevalence of rheumatoid arthritis in silice exposed mining workers: a case-control study

It has been stated that rheumatoid arthritis would be more frequent in silice exposed men as compared to general male population. Published studies are scarce, controversial and there are no copper mining studies. The aim was to investigate if rheumatoid arthritis prevalence is greater in male silicotic patients (admited between 1970-1975) than in non silice exposed men who entered to the mining company in the same period. The study group were silicotic men of the cohort and control group were non silice exposed men, age and enter date matched. Rheumatoid arthritis prevalence was stablished un both groups between mining company admission and december 1987. One patient developed rheumatoid arthritis in the study group and none in the control group. This finding suggests that rheumatoid arthritis prevalence in silicotic men is not significantly greater than in non silice exposed men in our medium

Prostaglandina F2 alfa comparada con placebo en reflujo gastroensofágico: evaluación clínica y manométrica / Prostaglandin F2 alpha compared with placebo in gastroesophageal reflux: clinical and manometric assesment

Los factores que controlan la competencia de la unión gastroesofágica, han sido estudiados cuidadosamente en la última década. Aunque no se ha identificado la presencia anatómica de un enfínter gastroesofágico inferior en el hombre, existe una zona manométricamente definida de alta presión en el esófago distal. La magnitud de la presión de este esfínter, tiene una buena correlación con la incidencia de reflujo gastroesofágico patológico. Las acciones de prostaglandina F2 alfa sobre la contracción de la musculatura lisa son bien conocidas. Más importantes, sin embargo son las pocas publicaciones que enfocan la acción de prostaglandina F2 alfa sobre la contracción del esfínter esofágico inferior. Hemos desarrollado este trabajo, para investigar los efectos de esta sustancia sobre síntomas y los cambios en la manometría esofágica, en dos grupos de pacientes, que ingresan a un estudio aleatorio y dobre ciego con prostaglandina F2 alfa o placebo. La ingestión oral de prostaglandina F2 alfa, no muestra ningún cambio en la presión del esfínter esofágico inferior en comparación con el placebo. Los hallazgos clínicos, sin embargo sugieren que esta sustancia podría ser un agente útil en el alivio sintomático de esta patología. El mecanismo responsable de esta acción es desconocido. Sugerimos que puediera estar involucrada una acción citoprotectora, pero se requiere mayor investigación para dilucidarlo