¿Cuál es la calidad de vida de los adultos con vitiligo en México? / What is the quality of life of adults with vitiligo in Mexico?

Resumen Introducción: El vitiligo es incurable, lentamente progresivo, su prevalencia varía de 0.4 a 2.0 %. La calidad de vida relacionada con la salud (CVRS) se refiere al bienestar autopercibido asociado a la presencia de una enfermedad y su tratamiento. Métodos: Estudio transversal en un centro dermatológico. Se incluyeron adultos con vitiligo no segmentario (VNS), en tanto que se excluyeron pacientes con otros trastornos pigmentarios y otros tipos de vitiligo. Se aplicó el cuestionario VitiQoL (0 = sin afectación, 90 = máxima afectación), el Vitiligo Extent Score (VES) y el Vitiligo Area Scoring Index (VASI). Resultados: Participaron 492 pacientes, 63 % mujeres. Se obtuvieron 32.6 puntos de promedio en el VitiQoL (IC 95 % = 30.6-34.5). La autopercepción de gravedad y la CVRS se correlacionaron (r = 0.568, p < 0.001). La edad, el sexo femenino, la menor educación y la mayor gravedad autopercibida se asociaron a peor CVRS. La proporción de personas que reportaron una adicción fue similar en los grupos con peor y mejor CVRS (28 % versus 32 %, p = 0.23). Conclusión: La peor CVRS se explica por la autopercepción de gravedad, preocupación por la progresión de la enfermedad, aspecto de la piel y acciones necesarias para evitar la exposición al sol durante la recreación.

Abstract Introduction: Vitiligo is an incurable, slowly progressive skin condition, the prevalence of which ranges from 0.4 to 2.0%. Health-related quality of life (HRQoL) refers to self-perceived well-being associated with the presence of a disease and its treatment. Methods: Cross-sectional study at a dermatological center. Adults with non-segmental vitiligo (NSV) were included, while patients with other pigmentary disorders and other types of vitiligo were excluded. The VitiQoL questionnaire (0 = no skin involvement, 90 = maximum skin involvement), the Vitiligo Extent Score (VES) and the Vitiligo Area Scoring Index (VASI) were applied. Results: 492 patients did participate; 63% were women. An average score of 32.6 was obtained on VitiQoL (95% CI = 30.6-34.5). Self-perception of severity and HRQoL were correlated (r = 0.568, p < 0.001). Age, the female gender, lower education and higher self-perceived severity were associated with poorer HRQoL. The proportion of subjects who reported an addiction was similar in the worst and best HRQoL groups (28% vs. 32%, p = 0.23). Conclusion: Poorer HRQoL is explained by severity self-perception, concern about disease progression, appearance of the skin and necessary actions to avoid sun exposure during recreation.

What is the quality of life of adults with vitiligo in Mexico?

INTRODUCTION: Vitiligo is an incurable, slowly progressive skin condition, the prevalence of which ranges from 0.4 to 2.0%. Health-related quality of life (HRQoL) refers to self-perceived well-being associated with the presence of a disease and its treatment. METHODS: Cross-sectional study at a dermatological center. Adults with non-segmental vitiligo (NSV) were included, while patients with other pigmentary disorders and other types of vitiligo were excluded. The VitiQoL questionnaire (0 = no skin involvement, 90 = maximum skin involvement), the Vitiligo Extent Score (VES) and the Vitiligo Area Scoring Index (VASI) were applied. RESULTS: 492 patients did participate; 63% were women. An average score of 32.6 was obtained on VitiQoL (95% CI = 30.6-34.5). Self-perception of severity and HRQoL were correlated (r = 0.568, p < 0.001). Age, the female gender, lower education and higher self-perceived severity were associated with poorer HRQoL. The proportion of subjects who reported an addiction was similar in the worst and best HRQoL groups (28% vs. 32%, p = 0.23). CONCLUSION: Poorer HRQoL is explained by severity self-perception, concern about disease progression, appearance of the skin and necessary actions to avoid sun exposure during recreation.

INTRODUCCIÓN: El vitiligo es incurable, lentamente progresivo, su prevalencia varía de 0.4 a 2.0 %. La calidad de vida relacionada con la salud (CVRS) se refiere al bienestar autopercibido asociado a la presencia de una enfermedad y su tratamiento. MÉTODOS: Estudio transversal en un centro dermatológico. Se incluyeron adultos con vitiligo no segmentario (VNS), en tanto que se excluyeron pacientes con otros trastornos pigmentarios y otros tipos de vitiligo. Se aplicó el cuestionario VitiQoL (0 = sin afectación, 90 = máxima afectación), el Vitiligo Extent Score (VES) y el Vitiligo Area Scoring Index (VASI). RESULTADOS: Participaron 492 pacientes, 63 % mujeres. Se obtuvieron 32.6 puntos de promedio en el VitiQoL (IC 95 % = 30.6-34.5). La autopercepción de gravedad y la CVRS se correlacionaron (r = 0.568, p < 0.001). La edad, el sexo femenino, la menor educación y la mayor gravedad autopercibida se asociaron a peor CVRS. La proporción de personas que reportaron una adicción fue similar en los grupos con peor y mejor CVRS (28 % versus 32 %, p = 0.23). CONCLUSIÓN: La peor CVRS se explica por la autopercepción de gravedad, preocupación por la progresión de la enfermedad, aspecto de la piel y acciones necesarias para evitar la exposición al sol durante la recreación.

Pulmonary Infections with Nontuberculous Mycobacteria, Catalonia, Spain, 1994-2014.

In Spain, systematic reporting of pulmonary infections with nontuberculous mycobacteria is not mandatory. Therefore, to determine trends, we retrospectively identified cases for January 1994-December 2014 in Catalonia. Over the 21 years, prevalence increased and was associated with being male. Mycobacterium avium complex and M. abscessus prevalence increased; M. kansasii prevalence decreased.

Declining mortality from adult pneumococcal infections linked to children's vaccination.

OBJECTIVE: To determine changes in mortality among adults with invasive pneumococcal disease (IPD) after introducing pneumococcal conjugate vaccines (PCVs) in children. METHODS: An active surveillance of adults with culture-proven IPD in Barcelona. Serotype-specific mortality and rates of disease and death were analysed in three periods: baseline (1994-2001), PCV7 (2002-2009) and PCV13 (2010-2013). RESULTS: Overall, IPD caused by PCV7 serotypes was associated with increased case fatality rate (24 percent). In patients 18-64 years (baseline vs. PCV7 vs. PCV13 periods), case fatality rate from IPD decreased (22 vs.14 vs. 12 percent), and it was associated with a decline in PCV7 serotypes (3.56 vs. 2.80 vs. 1.49 cases/10(5) person-years) and in PCV7 serotypes-specific death (0.74 vs. 0.53 vs. 0.09 deaths/10(5) person-years). In patients ≥65 years, case fatality rate did not change (24 vs. 22 vs. 24 percent); however, there was a decline in PCV7 serotypes-specific death (4.94 vs. 3.58 vs. 2.45 deaths/10(5) person-years), and an increase in non-PCV serotypes-specific death (2.55 vs. 3.70 vs. 4.09 deaths/10(5) person-years). CONCLUSIONS: The use of PCVs for children was associated with a reduction of mortality from IPD in adults 18-64 years, through the indirect effect of herd protection. In older adults, age-related factors could play a role in IPD mortality.

Absence of ribosomal RNA of Mycobacterium tuberculosis complex in sarcoidosis.

OBJECTIVE: To determine whether Mycobacterium tuberculosis ribosomal RNA (rRNA) is present in fresh tissue specimens from patients with sarcoidosis. DESIGN: A prospective study. SETTING: A university-based hospital. Patients Thirty-five patients diagnosed as having sarcoidosis at the University Hospital of Bellvitge, Barcelona, Spain, were included in the study. Fresh tissue samples with granulomatous inflammation were prospectively collected between 1997 and 2001 from all patients. For each sample tested, approximately 1 negative control was included. MAIN OUTCOME MEASURES: Mycobacterium tuberculosis rRNA was detected using an isothermal enzymatic amplification system of target rRNA of M tuberculosis complex via DNA intermediates. Smears for acid-fast staining and mycobacteriological cultures were also obtained. RESULTS: A total of 78 biopsy specimens (57 skin, 10 lymph node, 3 lacrimal gland, 2 spleen, 2 lung, 2 muscle, 1 bone, and 1 nerve) collected from 74 patients (35 patients with sarcoidosis and 39 control patients) were included in the study. Stains for acid-fast bacilli and mycobacterial cultures were negative for organisms in all cases. Mycobacterium tuberculosis rRNA was not detected in the specimens from any patients with sarcoidosis or in those from control patients whose cultures were negative for organisms. Ribosomal RNA was detected in 6 tissue specimens from patients with cultures that were positive for M tuberculosis and that were processed in parallel to the samples included in the study. CONCLUSIONS: Although previous studies have reported that mycobacterial antigens may play a role in granuloma formation in some patients with sarcoidosis, our results suggest that M tuberculosis cannot be considered to be the etiologic agent of the disease.