Joint ultrasound baseline abnormalities predict a specific long-term clinical outcome in systemic lupus erythematosus patients.

Objective To describe long-term clinical and serological outcome in all systemic lupus erythematosus (SLE) domains in SLE patients with hand arthralgia (HA) and joint ultrasound (JUS) inflammatory abnormalities, and to compare them with asymptomatic SLE patients with normal JUS. Methods SLE patients with HA who presented JUS inflammatory abnormalities ('cases') and SLE patients without HA who did not exhibit JUS abnormalities at baseline ('controls') were included. All SLE clinical and serological domain involvement data were collected. End follow-up clinical activity and damage scores (systemic lupus erythematosus disease activity index (SLEDAI), Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR)) were recorded. JUS inflammatory abnormalities were defined based on the Proceedings of the Seventh International Consensus Conference on Outcome Measures in Rheumatology Clinical Trials (OMERACT-7) definitions. Statistical analyses were carried out to compare 'cases' and 'controls'. Results A total of 35 patients were recruited. The 'cases', n = 18/35, had a higher incidence of musculoskeletal involvement (arthralgia and/or arthritis) through the follow-up period (38.9% vs 0%, p = 0.008) and received more hydroxychloroquine (61.1% vs 25.0%, p = 0.034) and methotrexate (27.8% vs 0%, p = 0.046) compared to 'controls', n = 17/35. Other comparisons did not reveal any statistical differences. Conclusions We found SLE patients with arthralgia who presented JUS inflammatory abnormalities received more hydroxychloroquine and methotrexate, mainly due to persistent musculoskeletal involvement over time. JUS appears to be a useful technique for predicting worse musculoskeletal outcome in SLE patients.

Positron range estimations with PeneloPET.

Technical advances towards high resolution PET imaging try to overcome the inherent physical limitations to spatial resolution. Positrons travel in tissue until they annihilate into the two gamma photons detected. This range is the main detector-independent contribution to PET imaging blurring. To a large extent, it can be remedied during image reconstruction if accurate estimates of positron range are available. However, the existing estimates differ, and the comparison with the scarce experimental data available is not conclusive. In this work we present positron annihilation distributions obtained from Monte Carlo simulations with the PeneloPET simulation toolkit, for several common PET isotopes ((18)F, (11)C, (13)N, (15)O, (68)Ga and (82)Rb) in different biological media (cortical bone, soft bone, skin, muscle striated, brain, water, adipose tissue and lung). We compare PeneloPET simulations against experimental data and other simulation results available in the literature. To this end the different positron range representations employed in the literature are related to each other by means of a new parameterization for positron range profiles. Our results are generally consistent with experiments and with most simulations previously reported with differences of less than 20% in the mean and maximum range values. From these results, we conclude that better experimental measurements are needed, especially to disentangle the effect of positronium formation in positron range. Finally, with the aid of PeneloPET, we confirm that scaling approaches can be used to obtain universal, material and isotope independent, positron range profiles, which would considerably simplify range correction.

Prevalencia del trastorno por estrés agudo y trastorno por estrés postraumático en soldados colombianos heridos en combate / Prevalence of acute stress disorder and post-traumatic stress disorder in Colombian soldiers wounded in combat / Prevalencia da reação ao stress agudo e do transtorno por stress postraumático nos soldados feridos no combate hospitalizado no Hospital Militar Central de Bogotá

El objetivo de este trabajo fue determinar la prevalencia de la reacción a estrés agudo y del trastorno por estrés postraumático en los soldados heridos en combate que ingresan al Hospital Militar. Para ello se realizó un estudio descriptivo de corte transversal en el que se aplicó el Clinical Administered Postraumática Stress Disorder Scale (CAPS) a una muestra de pacientes hospitalizados por heridas en combate en el Hospital Militar Central de Bogotá. Se midió la prevalencia y la frecuencia, haciendo un análisis bivariado de los datos obtenidos. Se obtuvo una prevalencia del 16,66% para trastorno por estrés postraumático y ningún caso de trastorno por estrés agudo, lo que proporciona una clara evidencia de que las lesiones provocadas durante un combate percibido como traumático, son un factor de riesgo mayor para el desarrollo de trastorno por estrés postraumático...

The objective of this work was to determine the prevalence of acute stress disorder and post-traumatic stress disorder in soldiers wounded in combat admitted to the Military Hospital. For this purpose we proceeded to realize a cross cut, descriptive study in which we applied the CAPS (clinical administered post traumatic stress disorder scale), to a sample of patients admitted due to combat wounds to the Hospital Militar Central de Bogota. We measured prevalence and frequency and did a bivariate analysis of the collected data. We obtained a prevalence of 16,66 % for posttraumatic stress disorder and there were no cases of acute stress disorder, providing clear evidence that the injuries provoked during combat perceived as traumatic, are a factor of significant risk for the development of post-traumatic stress disorder...

O objetivo deste trabalho foi determinar a prevalência da reação ao stress agudo e do transtorno do stress do pós-traumático nos soldados feridos no combate que ingressam no hospital militar. Foi realizado um estudo descritivo de corte transversal onde se aplicou o Clinical Administered Post Traumática Stress Disorder Scale (CAPS) a uma amostra de pacientes hospitalizados por feridas no combate no hospital militar central de Bogotá. Medimos a prevalência e a freqüência, fazendo um análise bivariado dos dados coletados. Uma prevalência de 16.66% para os transtornos por stress pós-traumático foi obtida e nenhum caso do transtorno por reação ao stress agudo, o que fornece uma evidência clara de que os ferimentos causados durante um combate percebido como traumático são o fator do risco maior para o desenvolvimento de transtornos por stress pós-traumático...

Trastorno por estrés postraumático en psiquiatría militar / Postraumatic stress disorder in military psychiatry / Transtorno por estrés pos-traumatico na psiquitria militar

En Psiquiatría Militar, dadas las situaciones de conflicto interno o externo al que frecuentemente se deben enfrentan los miembros de las Fuerzas Armadas, el trastorno por estrés postraumático es de gran relevancia, lo que exige estudiarlo y analizarlo con profundidad. Es claro que las experiencias emocionalmente fuertes transforman al ser humano y que mientras hay individuos que luego de sufrir experiencias de ese tipo logran superarlas sin que se evidencien grandes secuelas, otros, por el contrario, parecen quedarse para siempre en el acontecimiento. Se plantea la hipótesis de que aunque el trastorno por estrés postraumático a existido siempre, es la forma de describirlo y de interpretar su sintomatología la que ha ido cambiando, o tal vez, evolucionando. Para demostrar el planteamiento y para detectar aspectos que orienten un mejor manejo, teniendo en cuenta que los cuadros clínicos no se presentan de igual manera y que la crueldad de las guerras es cada vez mayor, se hace un análisis del abordaje hecho al trastorno por estrés postraumático en algunos de los más importantes conflictos armados a nivel mundial...

Post traumatic stress disorder is of great relevance In Military Psychiatry, given the situations of internal or external conflict which the members of the Armed Forces frequently must face, which demands to study it and to analyze it with depth. It is clear that emotionally strong experiences transform the human being and that, while there are individuals that after undergoing experiences of that type manage to surpass them without great sequels, others, seem to remain forever in the event. One considers the hypothesis that although post traumatic stress disorder has always existed, is the form to describe it and to perhaps interpret its symptomatology that has been changing, or perhaps, evolving. In order to demonstrate this exhibit and to detect aspects that direct to a better management, we make an analysis of the approach taken to the post traumatic stress disorder in some of the most important armed conflicts at world-wide level, taking into account that the clinical pictures are not presented in similar fashion and that the cruelty of the wars is even greater with time...

Na psiquiatria militar, dado as situações do conflito interno ou externo a que freqüentemente se devem enfrentar os membros das forças armadas, o transtorno por stress pós-traumático é de grande relevância, que exige estudar-lo e o analisar-lo com profundidade. E claro que as experiências emocionalmente fortes transformam ao ser humano e que há indivíduos que após ser submetidos a experiências desse tipo conseguem superar-lhas sem seqüelas; outros, pelo contrario, parecem ficar sempre dentro do evento. Considera-se a hipótese que embora o transtorno por stress pós-traumático, a existido sempre, a mudado ou evoluído o jeito de descrever e interpretar sua sintomatologia. Para demonstrar a exposição e detectar os aspectos que orientam uma manipulação melhor, considerando que os quadros clínicos não aparecem da maneira igual e que a crueldade das guerras é cada vez maior, se fazem uma análise de abordagem feito o transtorno por stress do pós-traumático em alguns dos conflitos armados mais importantes do mundo...