ABSTRACT
An in situ generated pyridinium trifluoromethoxide salt (PyOCF3) is a highly effective deoxyfluorination reagent for the synthesis of acid fluorides. PyOCF3 is formed at room temperature from the reaction of 2,4-dinitro(trifluoromethoxy)benzene with 4-dimethylaminopyridine. PyOCF3 undergoes slow release of fluorophosgene and fluoride, which serve as the electrophile and nucleophile, respectively, for deoxyfluorination. A wide substrate scope and high functional group tolerance are demonstrated. Furthermore, the acid fluorides can be purified by filtration and telescoped to various known reactions.
ABSTRACT
The objective was to describe the clinical characteristics and the frequency of the ANA/DFS70 autoantibodies in patients affected by undifferentiated connective tissue disease (UCTD) in a tertiary hospital in Colombia. This descriptive cross-sectional study enrolled patients who fulfilled the classification criteria for UCTD. ANAHEp- 2 test and the modified assay for ANA/DFS70 autoantibodies were performed through the indirect immunofluorescence technique. Erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and the antibodies to anti-extractable nuclear antigens, DNA, phospholipids (IgG, IgM, IgA), and cyclic citrullinated peptide were also evaluated. Fifty-three patients were studied; 42/53 (79%) tested positive for ANA and 5/42 (11.9%) for ANA/DFS70 antibodies with a dense fine speckled fluorescent pattern (AC-2) in ANA HEp-2 test that was confirmed by a modified HEp-2-DFS70 assay. Patients had arthralgia (87%, n=47), non-erosive arthritis (66%, n=34), xerostomia (64%, n=34), xerophthalmia (42%, n=22), and Raynaud's phenomenon (17%, n=9). Arthralgia, xerophthalmia, xeroderma, and absence of disease evolution to a specific disease over five years were more frequent in patients with a positive result for the anti-DFS70 antibodies. The ANA/DFS70 autoantibodies were more frequent in patients with UCTD compared to other rheumatic diseases for which they were initially evaluated. More studies are required to support the predictive role of this antibody to the absence of progression to a well-defined connective tissue disease.
Subject(s)
Undifferentiated Connective Tissue Diseases , Xerophthalmia , Adaptor Proteins, Signal Transducing , Antibodies, Antinuclear , Arthralgia , Autoantibodies , Colombia/epidemiology , Cross-Sectional Studies , Humans , Transcription FactorsABSTRACT
INTRODUCTION: Fibromyalgia is a chronic disease characterised by the presence of musculoskeletal pain, usually associated with other symptoms, including depression, fatigue, and sleep disorders. There is no objective information on the beliefs and perceptions of the diagnosis and treatment of fibromyalgia among rehabilitation and physical medicine specialists. The aim of this study was to describe these beliefs and perceptions among a group of physical medicine and rehabilitation specialists in Colombia. METHODS: We performed a cross-sectional study. A focus group was held with the participation of 2 rheumatologists, one physical medicine and rehabilitation specialist and an expert in qualitative research. The group designed a survey to assess the beliefs and perceptions of physical medicine and rehabilitation specialists of the diagnosis and treatment of fibromyalgia. The self-administered, anonymous questionnaire was completed during meetings of the Colombian Association of Physical Medicine and Rehabilitation. RESULTS: The questionnaire was completed by 99 physical medicine and rehabilitation specialists. Of these, 17.1% (n=17) believed there was insufficient evidence to consider fibromyalgia a disease, 86.8% (n=86) used the ACR 1990 criteria to diagnose patients with fibromyalgia, and 33.3% (n=33) used the criteria of the 2010 classification. The most commonly used drugs for the management of fibromyalgia were antidepressants, prescribed by 84.8% of the surveyed physicians, followed by analgesics (75.7%) and anticonvulsants (66.6%). Concerning multidisciplinary management, 50.6% referred these patients to a rheumatologist and 40.7% to a psychiatrist. In all, 77.2% of rehabilitation specialists believed that patients with fibromyalgia should be managed by their specialty. CONCLUSION: This study provides information on perceptions of the diagnosis and treatment of fibromyalgia among a group of Colombian rehabilitation specialists and found frequent use of the ACR 1990 classification. Among these physicians, the use of drugs, especially antidepressants and analgesics, was high. Most believed that patients with fibromyalgia should be treated by rehabilitation specialists.
Subject(s)
Attitude of Health Personnel , Fibromyalgia , Physiatrists/psychology , Rheumatologists/psychology , Analgesics/therapeutic use , Anticonvulsants/therapeutic use , Antidepressive Agents/therapeutic use , Colombia , Cross-Sectional Studies , Culture , Fibromyalgia/diagnosis , Fibromyalgia/drug therapy , Fibromyalgia/psychology , Focus Groups , Humans , Practice Patterns, Physicians' , Qualitative Research , Research Personnel/psychologyABSTRACT
INTRODUCTION: Registries are essential to keep track of systemic lupus erythematosus (SLE) epidemiology and to provide better care to patients. The Colombian Ministry of Health has adopted a registry (SISPRO) to gather comprehensive information coming from the Colombian health system, which provides close to universal coverage (around 95%). The information collected from SISPRO is available for scientific analysis. OBJECTIVES: We used data collected by SISPRO to estimate prevalence and specific characteristics of patients with SLE registered from January 2012 to December 2016. METHODS: This is a descriptive epidemiological study using the International Statistical Classification of Diseases and Related Health Problems as search terms related to SLE, based on SISPRO data. Criteria for diagnosis are not explicitly addressed in each individual case. RESULTS: National records report 41,804 patients with a diagnosis of SLE for an estimated prevalence of 91.9/100,000 subjects (based on a total population of 47,663,162), being more frequent in women (89% cases). When adjusted, female and male prevalences were 204.3 and 20.2 per 100,000 (ratio 10.1) with a 7.9:1 female:male ratio, and were highest in the 45-49-year age group. CONCLUSIONS: This is the first study that describes demographic characteristics of SLE in Colombia, with useful information for decision makers. It also suggests a similar prevalence to other countries.
Subject(s)
Lupus Erythematosus, Systemic/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Child, Preschool , Colombia/epidemiology , Female , Humans , Infant , Lupus Erythematosus, Systemic/diagnosis , Male , Middle Aged , Prevalence , Registries , Sex Distribution , Young AdultABSTRACT
Se realizó un estudio con 50 pacientes que presentaban Infarto Agudo del Miocardio (IMA) y contraindicación para emplear estreptoquinasa recombinante, se les administró nitropental y ácido acetilsalicíco (ASA).A 25 de ellos se les aplicó tratamiento con oxigenación hiperbárica (OHB), y se mantuvo el resto de la medicación para este tipo de afección y de las enfermedades concomitantes.Se utilizó la cámara hiperbárica PDK-2U administrándose Oxigeno Hiperbárico (ATA)por un período de 60 minutos cada 12 horas durante el primer día, luego una sesión diaria hasta completar 10 días de tratamiento. Se mantuvo el paciente con monitoreo cardíaco contínuo (MCC), se le realizó electrocardiograma al concluir cada sesión, ecocardiograma simple antes del egreso hospitalario y a los 90 días; con esta periodicidad se efectuó la ergometría de esfuerzo, inicialmente submáxima, se incorporó al Plan de rehabilitación cardiaca integral, finalmente se realizó la ergometría de esfuerzo máximo
Subject(s)
Humans , Adult , Myocardial Infarction/therapy , Myocardial Infarction/rehabilitation , Hyperbaric OxygenationABSTRACT
Se realizó un estudio con 50 pacientes que presentaban Infarto Agudo del Miocardio (IMA) y contraindicación para emplear estreptoquinasa recombinante, se les administró nitropental y ácido acetilsalicíco (ASA).A 25 de ellos se les aplicó tratamiento con oxigenación hiperbárica (OHB), y se mantuvo el resto de la medicación para este tipo de afección y de las enfermedades concomitantes.Se utilizó la cámara hiperbárica PDK-2U administrándose Oxigeno Hiperbárico (ATA)por un período de 60 minutos cada 12 horas durante el primer día, luego una sesión diaria hasta completar 10 días de tratamiento. Se mantuvo el paciente con monitoreo cardíaco contínuo (MCC), se le realizó electrocardiograma al concluir cada sesión, ecocardiograma simple antes del egreso hospitalario y a los 90 días; con esta periodicidad se efectuó la ergometría de esfuerzo, inicialmente submáxima, se incorporó al Plan de rehabilitación cardiaca integral, finalmente se realizó la ergometría de esfuerzo máximo
Subject(s)
Humans , Adult , Myocardial Infarction , Hyperbaric OxygenationABSTRACT
Among a total of 220 liver transplants, reduced-size liver was used in 21 cases due to discrepancies in size between recipient and donors in 19 patients. In the case of two adult patients suffering from fulminant hepatic failure and in a critical condition, only one donor organ became available, so that the graft was divided to give the two recipients an equal opportunity. The two patients with fulminant hepatic failure were admitted to the ICU requiring mechanical respiration almost at the same time. Hepatitis serologies were HBcAb+, HBsAb+, and VCA+ in one and negative in the second. They had different blood groups (A.Rh+, O.Rh-), and the only donor available was located in Milan, Italy. The graft perfused with UW. was divided into two (right side, segments IV, V, VI, VII, and VIII, and left side, segments I, II and III). The recipients were transplanted 50 and 48 hours after admission. The cold ischemia time was 7.10 and 16.50 hours. The first patient, who received the right lobe, was extubated at 48 hours and discharged on the 40th postransplant day. The second patient remained unconscious with progressive deterioration; an EEG on the 4th day revealed absence of higher cortical function.
Subject(s)
Hepatic Encephalopathy/surgery , Liver Transplantation/methods , Adult , Humans , Male , Middle Aged , Treatment OutcomeSubject(s)
Liver Transplantation/methods , Adult , Child , Humans , Liver/anatomy & histology , Liver/surgerySubject(s)
Liver Transplantation , Oxygen/blood , Hemodynamics , Humans , Reperfusion , Time FactorsABSTRACT
Fifteen orthotopic liver transplants were performed from 23 April 1986 to June 1987 in 14 patients (age range 3-56 years). In 12 transplants, extracorporeal bypass was used. The installation was effected by suprahepatic and infrahepatic cava-caval and portaportal anastomoses. Arterial anastomosis was realized after reperfusing the graft through the vena porta. In 13 transplants the donor celiac trunk was anastomosed to the receptor's right hepatic artery. In one ten year-old girl, the donor celiac trunk was anastomosed to the left hepatic artery. In one patient who underwent retransplantation for rejection, the donor organ had two separate hepatic arteries and the right and left hepatic arteries were respectively anastomosed to the right and primitive hepatic arteries of the receptor. All patients were followed up periodically by Doppler echography and trimethyl-Br IDA 99 mTc scan, which, consistently confirmed the permeability of the anastomosis and dependent vessels, and the good perfusion and function of the grafts, which were free of infarcted areas. Three patients died at 30 and 31 days and postmortem studies demonstrated vascular permeability. Angiography was performed in one patient, evidencing a good vascular caliber in the hepatic arteriography.
