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1.
Eur Arch Paediatr Dent ; 25(1): 17-25, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37999852

ABSTRACT

OBJECTIVE: To establish the influence of overweight/obesity, medicated hypothyroidism, and medicated non-syndromic hypogrowth on maxillary and mandibular growth. MATERIALS AND METHODS: The relation between 10 craniofacial anthropometric measurements and hypothyroidism (n = 216), overweight/obesity (n = 108), and non-syndromic hypogrowth (n = 250) were evaluated in patients aged 1-19 years and a control group of healthy patients (n = 587). A subgroup analysis was performed at the peak growth in all groups. RESULTS: Patients with overweight/obesity and hypothyroidism showed increased craniofacial growth, while hypogrowth patients showed differences in zygomatic width and nasal base growth. Females with hypothyroidism and non-syndromic hypogrowth showed decreased head circumference at peak growth. Several anthropometric measurements were increased in patients with overweight/obesity, including head circumference. When all age groups were analyzed, overweight/obese and hypothyroidism patients showed increased zygomatic width while decreased hypogrowth. Overall, most craniofacial anthropometric measurements in overweight/obese patients were increased. Finally, the peak growth in males with hypothyroidism and subjects with non-syndromic hypogrowth was delayed compared to the control group (p < 0.05). CONCLUSIONS: Children and adolescents with overweight/obesity and endocrine disorders showed alterations in craniofacial growth. Clinicians must be aware that the growth peak in these patients may be delayed when planning maxillary and mandibular orthopedic treatment.


Subject(s)
Hypothyroidism , Overweight , Male , Child , Female , Humans , Adolescent , Cross-Sectional Studies , Colombia , Obesity/complications , Hypothyroidism/complications , Body Mass Index
2.
3 Biotech ; 13(11): 364, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37840880

ABSTRACT

Kinetic assays with a nitrifying consortium with whole nitrifying cells amended with 5 mg 2-CP-C/L and 100, 200, 300, or 500 mg NH4+-N/L were carried out in batch and nitrifying sequencing batch reactor (SBR) cultures. No nitrification activity was observed in batch assays with 100 mg NH4+-N/L and 5 mg 2-CP-C/L. Nevertheless, increasing the ammonium concentration from 200 to 500 mg NH4+-N/L allowed simultaneous ammonium and nitrite oxidation even in the presence of 5 mg 2-CP-C/L plus the halogenated compound consumption. Under these conditions, the ammonium monooxygenase enzyme participated in 2-CP consumption. Complete nitrification and simultaneous elimination of 5 mg 2-CP-C/L were achieved in the SBR amended with 200-500 mg NH4+-N/L. The inhibitory effect of 2-CP on the nitrite oxidation process completely disappeared under these conditions. Assays with nitrifying cell-free extracts, ammonium (100 mg NH4+-N/L), and 2-CP (5 mg 2-CP-C/L) were also conducted. In the absence of 2-CP, the nitrifying cell-free extracts maintained up to 60% of the nitrifying activity compared to whole-cells. Contrary to whole-cell assays, cell-free extracts were capable of simultaneously oxidizing ammonium and consuming 2-CP. However, the inhibitory effect of 2-CP on nitrification was still present as lower specific rates of ammonium consumption and nitrate production were obtained. Thus, these assays indicate that the presence of 2-CP affects both, the ammonium transport mechanism and the activity of nitrifying enzymes. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03764-z.

4.
IEEE Int Conf Rehabil Robot ; 2022: 1-6, 2022 07.
Article in English | MEDLINE | ID: mdl-36176111

ABSTRACT

Musculoskeletal injuries can severely inhibit performance of activities of daily living. In order to regain function, rehabilitation is often required. Assistive rehabilitation devices can be used to increase arm mobility by guiding therapeutic exercises or assisting with motion. Electromyography (EMG) may be able to provide an intuitive interface between the patient and the device if appropriate classification models allow smart systems to relate these signals to the desired device motion. Unfortunately, the accuracy of pattern recognition models classifying motion in constrained laboratory environments significantly drops when used for detecting dynamic unconstrained movements. The objectives of this study were to quantity how various motion factors affect arm muscle activations during dynamic motion, and to use these motion factors and EMG signals for detecting interaction forces between the person and the environment during motion. The results quantity how EMG features change significantly with variations in arm positions, interaction forces, and motion velocities. The results also show that pattern recognition models were able to detect intended characteristics of motion based solely on EMG signals. Prediction of force was improved from 73.77% correct to 79.17% accuracy during elbow flexion-extension by properly selecting the features, and providing measurable arm position and velocity information as additional inputs to a linear discriminant analysis model.


Subject(s)
Elbow Joint , Self-Help Devices , Activities of Daily Living , Elbow Joint/physiology , Electromyography/methods , Humans , Motion , Movement/physiology
6.
Clin Transl Oncol ; 22(10): 1710-1729, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32052383

ABSTRACT

Due to improvements in the number of cancer survivors and survival time, there is a growing interest in healthy behaviors, such as physical activity (PA), and their potential impact on cancer- and non-cancer-related morbidity in individuals with cancer. Commissioned by the Spanish Society of Medical Oncology (SEOM), in this review, we sought to distill the most recent evidence on this topic, focusing on the mechanisms that underpin the effects of PA on cancer, the role of PA in cancer prevention and in the prognosis of cancer and practical recommendations for clinicians regarding PA counseling. Despite the available information, the introduction of exercise programs into the global management of cancer patients remains a challenge with several areas of uncertainty. Among others, the most effective behavioral interventions to achieve long-term changes in a patient's lifestyle and the optimal intensity and duration of PA should be defined with more precision in future studies.


Subject(s)
Exercise , Neoplasms/prevention & control , Cancer Survivors , Counseling , Female , Humans , Male , Medical Oncology , Neoplasms/mortality , Neoplasms/therapy , Prognosis , Societies, Medical
7.
Article in English, Spanish | MEDLINE | ID: mdl-31902736

ABSTRACT

AIMS OF THE STUDY: To compare efficacy and safety of a home-made platelet-rich plasma (PRP) solution versus hyaluronic acid in patients with hip osteoarthritis not responding to conservative treatment and to correlate cellular composition of PRP to clinical outcomes. MATERIAL AND METHODS: This is a phase III clinical trial, double-blinded, controlled and randomised into two treatment groups (PRP and hyaluronic acid). Patients received one hip ultrasound-guided injection. Follow up was 12 months. Pain was assessed using VAS score, HHS and WOMAC were used as functional scores, analgesia, adverse events, cellular components (PRP group) in peripheral blood and in PRP were recorded. Clinical response was assessed using OARSI criteria. RESULTS: Seventy-four patients were included. Both groups improved in VAS, WOMAC and HHS score and reduced the amount of analgesia (p<.05). Significant differences were seen at 1 year post-treatment in HHS score (PRP 70.9 [3.7-58], hyaluronic acid 60.2[43-74.2] p<.05). No adverse events were observed in none of the groups. Platelet concentration was different between responders and non-responders (at 1 month, non-responders 449[438-578] x103 platelets/µl versus responders 565 [481-666] x103 platelets/µl, p<.044). There was a correlation between leukocytes concentration and clinical scores (VAS at six months, r=0.748, p<.013, WOMAC at 6 months r=0.748, p <.013). Patients with early stage hip OA showed higher response rate to PRP compared with late stage (11.51 OR, 95%CI 2.34-50.65, p<.03). CONCLUSIONS: Platelet-rich plasma injection improved hip function, reduced pain and the use of analgesia. It is important to bear in mind the cellular composition in order to achieve a better clinical response.


Subject(s)
Hyaluronic Acid/therapeutic use , Intercellular Signaling Peptides and Proteins/therapeutic use , Osteoarthritis, Hip/therapy , Platelet-Rich Plasma , Viscosupplements/therapeutic use , Adult , Aged , Double-Blind Method , Female , Follow-Up Studies , Humans , Injections, Intra-Articular , Male , Middle Aged , Treatment Outcome , Ultrasonography, Interventional
8.
IEEE Int Conf Rehabil Robot ; 2019: 1103-1108, 2019 06.
Article in English | MEDLINE | ID: mdl-31374777

ABSTRACT

According to the World Health Organization, stroke is the third leading cause of disability. A common consequence of stroke is hemiparesis, which leads to the impairment of one side of the body and affects the performance of activities of daily living. It has been proven that targeting the motor impairments as early as possible while using wearable mechatronic devices as a robot assisted therapy, and letting the patient be in control of the robotic system, can improve the rehabilitation outcomes. However, despite the increased progress on control methods for wearable mechatronic devices, a need for a more natural interface that allows for better control remains. In this work, a user-independent gesture classification method based on a sensor fusion technique using surface electromyography (EMG) and an inertial measurement unit (IMU) is presented. The Myo Armband was used to extract EMG and IMU data from healthy subjects. Participants were asked to perform 10 types of gestures in 4 different arm positions while using the Myo on their dominant limb. Data obtained from 14 participants were used to classify the gestures using a Multilayer Perceptron Network. Finally, the classification algorithm was tested on 5 novel users, obtaining an average accuracy of 78.94%. These results demonstrate that by using the proposed approach, it is possible to achieve a more natural human machine interface that allows better control of wearable mechatronic devices during robot assisted therapies.


Subject(s)
Gestures , Hand/physiology , Activities of Daily Living , Adolescent , Adult , Algorithms , Electromyography , Female , Fingers/physiology , Humans , Male , Neural Networks, Computer , Pattern Recognition, Automated , Wearable Electronic Devices , Wrist/physiology , Young Adult
9.
Heliyon ; 5(1): e01152, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30723830

ABSTRACT

Exposure to arsenic (As) is considered one of the primary health risks humans face worldwide. This study was conducted to determine As absorption by broad beans and lettuce crops grown in soil with As contents and irrigated with water contaminated with this toxic element, in Pastos Chicos, Jujuy (Argentina). Total dry biomass (TDB) and total As were determined in soils, roots, leaves, pods and seeds. These data were used to determine several parameters, such as translocation (TF) and bioconcentration (BCF) factors, target hazard quotient (THQ), and carcinogenic risk (CR). Broad bean plants had the lowest biomass production when exposed to As in irrigation water and soil. Lettuce plants presented TDB reductions of 33.3 and 42.8% when grown in soil polluted with As, and in control soil under irrigation with contaminated water, respectively. The presence of this toxicant in broad bean seeds and lettuce leaves (edible parts) exceeded the limits established by Código Alimentario Argentino, i.e. 0.10 and 0.30 mg/kg, respectively. THQ values for lettuce leaves were higher than 1, the same as those for broad bean seeds when grown in soil with As contents and irrigated with arsenic-contaminated water, thus suggesting that consumers would run significant risks when consuming these vegetables. Furthermore, this type of exposure to As implied a CR that exceeded the acceptable 1 × 10-4 risk level. Hence, we may conclude that consuming lettuce and broad beans grown at the evaluated site brings about considerable health risks for local residents.

10.
Rev Gastroenterol Mex (Engl Ed) ; 84(2): 165-173, 2019.
Article in English, Spanish | MEDLINE | ID: mdl-29954618

ABSTRACT

INTRODUCTION AND AIMS: Fecal incontinence is a disabling condition with devastating consequences for the patients. Medical and surgical options are not very satisfactory, reason by which regenerative medicine has been considered in this field. In the present research, we analyzed functional and histologic effects after implanting pluripotent stem cells (PSCs) in a murine model with sphincterotomy. MATERIALS AND METHODS: Female Wistar rats were subjected to sphincterotomy and divided into three groups. Group 1 (control group) was treated with 300µL of balanced saline solution and group 2 (late treatment) and group 3 (early treatment) received 50,000 PSCs resuspended in 300µL of balanced saline solution. All animals were evaluated through high-resolution anorectal manometry 24hours before and after sphincterotomy and every month for three months. Finally, the rats were euthanized and histopathologic sections from the anal canal were obtained. RESULTS: All groups showed a decrease in resting anal pressure and squeeze anal pressure 24hours after sphincterotomy. At the third month, higher anal pressures in the groups treated with PSCs were detected. Regarding the histologic effects, the microscopic architecture was restored and there was a significant decrease in the inflammatory response in the groups treated with PSCs. CONCLUSION: PSCs implantation improves anal tone, as well as histologic structure, presenting better regenerative results when implanted as early treatment.


Subject(s)
Anal Canal/surgery , Fecal Incontinence/therapy , Pluripotent Stem Cells/transplantation , Postoperative Complications/therapy , Sphincterotomy/adverse effects , Anal Canal/physiopathology , Animals , Fecal Incontinence/etiology , Fecal Incontinence/physiopathology , Female , Manometry , Rats , Rats, Wistar , Regeneration , Treatment Outcome
11.
J Environ Manage ; 218: 23-30, 2018 Jul 15.
Article in English | MEDLINE | ID: mdl-29665483

ABSTRACT

The accumulation of arsenic (As) in vegetables poses a risk of contamination to humans via the food chain. Two chard (var. cicla and var. d'ampuis) crops were grown for 60 days in greenhouses on Aridisol soil, and irrigated with water from Pastos Chicos, Jujuy (Argentina). The soil and water used in the trial presented 49 and 1.44 mg/L As concentration levels, respectively. Total dry biomass (TDB) and total As were determined in soils, roots and leaves. The latter was quantified by atomic absorption spectrometry with hydride generation, and bioconcentration and translocation factors were determined. TDB in var. cicla showed statistically significant differences when the plant was cultivated in control soil and watered with the toxicant (2.04 g), as compared with the treatment without exposure (2.8 g). TDB in var. d'ampuis presented statistically significant differences with respect to that of the control when the plants were grown in soils with As and watered with the toxicant (3.3 g). This variety increased its biomass in the presence of As. In the two Swiss chard varieties evaluated, the largest As accumulation in root and leaves was found when they were cultivated in contaminated soil and watered with distilled water. The presence of the toxicant in the leaves exceeded the limits established by Código Alimentario Argentino, i.e. 0.30 mg/kg. Total target hazard quotient (THQ) values for As were higher than 1, suggesting that consumers would run significant risks when consuming these chard varieties. Furthermore, it was determined that the carcinogenic risk (CR) posed by this type of exposure to As exceeded the acceptable risk level of 1 × 10-6. Based on this evidence, we may conclude that consuming chard cultivated on the evaluated site brings about considerable risks to local residents' health.


Subject(s)
Arsenic , Beta vulgaris , Soil Pollutants , Argentina , Food Contamination , Humans , Soil , Water
12.
J Endocrinol Invest ; 41(7): 755-764, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29204916

ABSTRACT

BACKGROUND: In a previous work, we found linkage and association of type 1 diabetes (T1D) to a 12 known gene region at chromosome 2p25 in Colombian families. Here, we present further work on this candidate region. MATERIALS AND METHODS: Seventeen SNPs located on the 12 candidate genes, in 100 familial trios set, were tested by ARMS-tetraprimer-PCR or PCR-RFLP. Five extra SNPs in the vicinity of rs10186193 were typed. A replica phase included 97 novel familial trios, in whom diabetes-related auto-antibodies (AABs) were tested in sera of the patients. In addition to transmission disequilibrium tests, haplotype analyses were carried out using the unphased software. RESULTS: SNP rs10186193 (at RNASEH1 gene) showed association with T1D (P = 0.005). The additional five SNPs revealed that rs7607888 (P = 2.03 × 10-7), rs55981318 (P = 0.018), and rs1136545 (P = 1.93 × 10-9) were also associated with T1D. Haplotype analysis showed association for rs55981318-rs10186193 (P = 0.0005), rs7563960-rs7607888 (P = 0.0007), rs7607888-rs1136545 (P = 9.21 × 10-10), and rs1136545-rs11538545 (P = 6.67 × 10-8). In contrast, the new set of 97 familial trios tested for SNPs rs55981318, rs10186193, and rs7607888 did not support the previous finding; however, by combining the sample (197 trios), evidence of association of T1D with rs55981318 and rs7607888 was conclusive. In addition, a two-loci haplotype analysis of the combined sample showed significant association of RNASEH1 with T1D (P = 3.1 × 10-5). CONCLUSION: In conclusion, our analyses suggest that RNASEH1 gene variants associate with susceptibility/protection to T1D in Colombia.


Subject(s)
Diabetes Mellitus, Type 1/genetics , Polymorphism, Single Nucleotide , Ribonuclease H/genetics , Adult , Child , Colombia/epidemiology , Diabetes Mellitus, Type 1/epidemiology , Family , Female , Gene Frequency , Genetic Association Studies , Genetic Predisposition to Disease , Haplotypes , Humans , Linkage Disequilibrium , Male , Polymorphism, Restriction Fragment Length
15.
J Sports Med Phys Fitness ; 55(10): 1184-92, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25828195

ABSTRACT

AIM: Handball is one of the most challenging sports for the knee joint. Persistent strength and jumping capacity alterations may be observed among athletes who have suffered anterior cruciate ligament (ACL) injury. The aim of this study was to examine unilateral and bilateral jumping ability differences between previously ACL-reconstructed rehabilitated elite handball athletes and sex, age and uninjured sport activity level-pairs of control players. METHODS: It was a Cross-sectional study with one factor: previous ACL injury. We recruited 22 male (6 ACL-reconstructed and 16 uninjured control players) and 21 female (6 ACL-reconstructed and 15 uninjured control players) elite handball players who were evaluated 6.2±3.4 years after surgical ACL reconstruction. A battery of jump tests, including both bilateral and unilateral maneuvers, was performed. Two-tailed unpaired (intergroup comparison) and paired (intragroup comparison) t-tests were performed for mean comparisons. The P-value cut-off for significance was set at <0.05. RESULTS: The previously ACL-reconstructed female athletes showed a lower bilateral drop jump contact time (0.429±179.9 vs. 0.349±151 s, P<0.05) and less distance reached (3.820±0.54 vs. 4.428±0.44 m, P<0.05) in the unilateral triple hop for distance (UTHD) on their reconstructed leg compared with the dominant legs of the uninjured control athletes. No significant differences were observed for any other recorded variable. Among the male athletes, no significant differences between groups were found for the studied jumping variables. CONCLUSION: Previously ACL-reconstructed elite female handball athletes demonstrated both lower vertical bilateral drop jump (VBDJ) contact times and lower UTHD scores for the injured leg several years after injury. These deficits could contribute to an increase in ACL re-injury risk.


Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Athletic Injuries/surgery , Leg/physiology , Plyometric Exercise , Adult , Age Factors , Anterior Cruciate Ligament Injuries/physiopathology , Athletic Injuries/physiopathology , Cross-Sectional Studies , Female , Humans , Male , Sex Factors
16.
Water Sci Technol ; 71(2): 277-82, 2015.
Article in English | MEDLINE | ID: mdl-25633952

ABSTRACT

The metabolic and kinetic behavior of a nitrifying sludge exposed to 2-chlorophenol (2-CP) was evaluated in batch cultures. Two kinds of nitrifying culture were used; one acclimated to 4-methylphenol (4-mp), and the other unacclimated to 4-mp. The unacclimated culture was affected adversely by the 2-CP's presence, since neither nitrification nor 2-CP oxidation was observed. Nonetheless, the acclimated culture showed metabolic capacity to nitrify and mineralize 2-CP. Ammonium removal was 100%, with a nitrifying yield of 0.92 ± 0.04 mg NO(3)(-)-N/mg NH(4)(+)-N consumed. The consumption efficiency for 2-CP was 100% and the halogenated compound was mineralized to CO2. Denaturing gradient gel electrophoresis (DGGE) patterns showed the shift in microbial community structure, indicating that microbial diversity was due to the acclimation process. This is the first evidence where nitrifying culture acclimated to 4-mp completely removed ammonium and 2-CP.


Subject(s)
Bacteria/metabolism , Chlorophenols/metabolism , Ammonium Compounds/metabolism , Bacteria/genetics , Bacteria/growth & development , Bacteria/isolation & purification , Biodegradation, Environmental , Kinetics , Nitrification , Oxidation-Reduction , Sewage/chemistry , Sewage/microbiology
17.
J Mater Chem B ; 2(45): 8017-8025, 2014 Dec 07.
Article in English | MEDLINE | ID: mdl-25364507

ABSTRACT

Iron(III)-doped silica nanoshells are shown to possess an in vitro cell-receptor mediated targeting functionality for endocytosis. Compared to plain silica nanoparticles, iron enriched ones are shown to be target-specific, a property that makes them potentially better vehicles for applications, such as drug delivery and tumor imaging, by making them more selective and thereby reducing the nanoparticle dose. Iron(III) in the nanoshells can interact with endogenous transferrin, a serum protein found in mammalian cell culture media, which subsequently promotes transport of the nanoshells into cells by the transferrin receptor-mediated endocytosis pathway. The enhanced uptake of the iron(III)-doped nanoshells relative to undoped silica nanoshells by a transferrin receptor-mediated pathway was established using fluorescence and confocal microscopy in an epithelial breast cancer cell line. This process was also confirmed using fluorescence activated cell sorting (FACS) measurements that show competitive blocking of nanoparticle uptake by added holo-transferrin.

18.
Theriogenology ; 82(7): 1028-35, 2014 Oct 15.
Article in English | MEDLINE | ID: mdl-25139756

ABSTRACT

The present study was carried out to determine whether the presence of photostimulated sedated male goats could stimulate the LH preovulatory surge and ovulation in seasonal anestrous goats. Sexually experienced male goats were treated with artificial long days (16 hours light per day) from 1 November to 15 January to stimulate their sexual activity in March and April, corresponding to the natural sexual rest. A female group of goats (n=20) was exposed to non-sedated males who displayed an intense sexual behavior and provided strong odor (non-sedated group). Another female group of goats (n=20) was exposed to the photo-stimulated male goats, but these males were sedated with Xylazine 2% to prevent the expression of sexual behavior (sedated group). The sedated males also provided a strong odor. Females of both groups had full physical and visual contact with non-sedated or sedated males. In both groups, the males remained with females during 4 days. The LH preovulatory surge of 10 female goats per group was measured by determination of LH plasma concentrations in samples taken every 3 hours. In addition, in all goats, (n=20 by group), ovulation was determined by measuring plasma concentrations of progesterone. The proportion of female goats showing a preovulatory LH surge was higher in goats exposed to non-sedated (10/10) than in those exposed to sedated bucks (0/10; P<0.0001). Similarly, most of does in contact with non-sedated males ovulated (19/20), but none of those in contact with sedated males did so (0/20; P<0.0001). We conclude that the expression of an intense sexual behavior by male goats is necessary to induce LH preovulatory surge and ovulation in seasonally anovulatory goats.


Subject(s)
Goats/physiology , Luteinizing Hormone/physiology , Ovulation/physiology , Sexual Behavior, Animal/physiology , Animals , Female , Male , Odorants , Seasons
19.
Rev Sci Tech ; 32(1): 89-103, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23837368

ABSTRACT

Neurobrucellosis and osteomyelitis are common pathologies of humans and cetaceans infected with Brucella ceti or B. pinnipedialis. Currently, 53 species of marine mammal are known to show seropositivity for brucellae, and B. ceti or B. pinnipedialis have been isolated or identified in polymerase chain reaction assays in 18 of these species. Brucellae have also been isolated from fish and identified in lungworm parasites of pinnipeds and cetaceans. Despite these circumstances, there are no local or global requirements for monitoring brucellosis in marine mammals handled for multiple purposes such as capture, therapy, rehabilitation, investigation, slaughter or consumption. Since brucellosis is a zoonosis and may be a source of infection to other animals, international standards for Brucella in potentially infected marine mammals are necessary.


Subject(s)
Brucella/isolation & purification , Brucellosis/veterinary , Caniformia/microbiology , Cetacea/microbiology , Animals , Brucellosis/epidemiology , Brucellosis/microbiology , Fish Diseases/epidemiology , Fish Diseases/microbiology , Fishes , Fresh Water/microbiology , Global Health , Humans , Oceans and Seas , Species Specificity , Water Microbiology , Zoonoses
20.
Lupus ; 22(9): 899-907, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23857989

ABSTRACT

OBJECTIVES: The objective of this paper is to assess the predictors of time-to-lupus renal disease in Latin American patients. METHODS: Systemic lupus erythematosus (SLE) patients (n = 1480) from Grupo Latino Americano De Estudio de Lupus (GLADEL's) longitudinal inception cohort were studied. Endpoint was ACR renal criterion development after SLE diagnosis (prevalent cases excluded). Renal disease predictors were examined by univariable and multivariable Cox proportional hazards regression analyses. Antimalarials were considered time dependent in alternative analyses. RESULTS: Of the entire cohort, 265 patients (17.9%) developed renal disease after entering the cohort. Of them, 88 (33.2%) developed persistent proteinuria, 44 (16.6%) cellular casts and 133 (50.2%) both; 233 patients (87.9%) were women; mean (± SD) age at diagnosis was 28.0 (11.9) years; 12.2% were African-Latin Americans, 42.5% Mestizos, and 45.3% Caucasians (p = 0.0016). Mestizo ethnicity (HR 1.61, 95% CI 1.19-2.17), hypertension (HR 3.99, 95% CI 3.02-5.26) and SLEDAI at diagnosis (HR 1.04, 95% CI 1.01-1.06) were associated with a shorter time-to-renal disease occurrence; antimalarial use (HR 0.57, 95% CI 0.43-0.77), older age at onset (HR 0.90, 95% CI 0.85-0.95, for every five years) and photosensitivity (HR 0.74, 95% CI 0.56-0.98) were associated with a longer time. Alternative model results were consistent with the antimalarial protective effect (HR 0.70, 95% CI 0.50-0.99). CONCLUSIONS: Our data strongly support the fact that Mestizo patients are at increased risk of developing renal disease early while antimalarials seem to delay the appearance of this SLE manifestation. These data have important implications for the treatment of these patients regardless of their geographic location.


Subject(s)
Antimalarials/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Lupus Nephritis/prevention & control , Adolescent , Adult , Age of Onset , Antimalarials/administration & dosage , Cohort Studies , Female , Follow-Up Studies , Humans , Hypertension/epidemiology , Latin America/epidemiology , Longitudinal Studies , Lupus Erythematosus, Systemic/ethnology , Lupus Erythematosus, Systemic/physiopathology , Lupus Nephritis/ethnology , Male , Multivariate Analysis , Photosensitivity Disorders/epidemiology , Proportional Hazards Models , Regression Analysis , Risk Factors , Severity of Illness Index , Time Factors , Young Adult
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